1
|
Bahler CD, Tachibana I, Tann M, Collins K, Swensson JK, Green MA, Mathias CJ, Tong Y, Yong C, Boris RS, Brocken E, Hutchins GD, Sims JB, Hill DV, Smith N, Ferari C, Love H, Koch MO. Comparing Magnetic Resonance Imaging and Prostate-Specific Membrane Antigen-Positron Emission Tomography for Prediction of Extraprostatic Extension of Prostate Cancer and Surgical Guidance: A Prospective Nonrandomized Clinical Trial. J Urol 2024:101097JU0000000000004032. [PMID: 38785259 DOI: 10.1097/ju.0000000000004032] [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: 11/21/2023] [Accepted: 04/30/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE Survivors of surgically managed prostate cancer may experience urinary incontinence and erectile dysfunction. Our aim was to determine if 68Ga-prostate-specific membrane antigen-11 positron emission tomography CT (PSMA-PET) in addition to multiparametric (mp) MRI scans improved surgical decision-making for nonnerve-sparing or nerve-sparing approach. MATERIALS AND METHODS We prospectively enrolled 50 patients at risk for extraprostatic extension (EPE) who were scheduled for prostatectomy. After mpMRI and PSMA-PET images were read for EPE prediction, surgeons prospectively answered questionnaires based on mpMRI and PSMA-PET scans on the decision for nerve-sparing or nonnerve-sparing approach. Final whole-mount pathology was the reference standard. Sensitivity, specificity, positive predictive value, negative predictive value, and receiver operating characteristic curves were calculated and McNemar's test was used to compare imaging modalities. RESULTS The median age and PSA were 61.5 years and 7.0 ng/dL. The sensitivity for EPE along the posterior neurovascular bundle was higher for PSMA-PET than mpMRI (86% vs 57%, P = .03). For MRI, the specificity, positive predictive value, negative predictive value, and area under the curve for the receiver operating characteristic curves were 77%, 40%, 87%, and 0.67, and for PSMA-PET were 73%, 46%, 95%, and 0.80. PSMA-PET and mpMRI reads differed on 27 nerve bundles, with PSMA-PET being correct in 20 cases and MRI being correct in 7 cases. Surgeons predicted correct nerve-sparing approach 74% of the time with PSMA-PET scan in addition to mpMRI compared to 65% with mpMRI alone (P = .01). CONCLUSIONS PSMA-PET scan was more sensitive than mpMRI for EPE along the neurovascular bundles and improved surgical decisions for nerve-sparing approach. Further study of PSMA-PET for surgical guidance is warranted in the unfavorable intermediate-risk or worse populations. CLINICALTRIALS.GOV IDENTIFIER NCT04936334.
Collapse
Affiliation(s)
- Clinton D Bahler
- Department of Urology, Indiana University, Indianapolis, Indiana
| | - Isamu Tachibana
- Department of Urology, Indiana University, Indianapolis, Indiana
| | - Mark Tann
- Department of Radiology, Indiana University, Indianapolis, Indiana
| | - Katrina Collins
- Department of Pathology, Indiana University, Indianapolis, Indiana
| | | | - Mark A Green
- Department of Radiology, Indiana University, Indianapolis, Indiana
| | - Carla J Mathias
- Department of Radiology, Indiana University, Indianapolis, Indiana
| | - Yan Tong
- Department of Statistics, Indiana University, Indianapolis, Indiana
| | - Courtney Yong
- Department of Urology, Indiana University, Indianapolis, Indiana
| | - Ronald S Boris
- Department of Urology, Indiana University, Indianapolis, Indiana
| | - Eric Brocken
- Department of Pathology, Indiana University, Indianapolis, Indiana
| | - Gary D Hutchins
- Department of Radiology, Indiana University, Indianapolis, Indiana
| | - Justin B Sims
- Department of Radiology, Indiana University, Indianapolis, Indiana
| | - Danielle V Hill
- Department of Radiology, Indiana University, Indianapolis, Indiana
| | - Nathaniel Smith
- Department of Radiology, Indiana University, Indianapolis, Indiana
| | | | - Harrison Love
- Department of Urology, Indiana University, Indianapolis, Indiana
| | - Michael O Koch
- Department of Urology, Indiana University, Indianapolis, Indiana
| |
Collapse
|
2
|
Stone RA, Brown A, Douglas F, Green MA, Hunter E, Lonnie M, Johnstone AM, Hardman CA. The impact of the cost of living crisis and food insecurity on food purchasing behaviours and food preparation practices in people living with obesity. Appetite 2024; 196:107255. [PMID: 38367913 DOI: 10.1016/j.appet.2024.107255] [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: 11/01/2023] [Revised: 01/12/2024] [Accepted: 02/06/2024] [Indexed: 02/19/2024]
Abstract
Lower income households are at greater risk of food insecurity and poor diet quality than higher income households. In high-income countries, food insecurity is associated with high levels of obesity, and in the UK specifically, the cost of living crisis (i.e., where the cost of everyday essentials has increased quicker than wages) is likely to have exacerbated existing dietary inequalities. There is currently a lack of understanding of the impact of the current UK cost of living crisis on food purchasing and food preparation practices of people living with obesity (PLWO) and food insecurity, however this knowledge is critical in order to develop effective prevention and treatment approaches to reducing dietary inequalities. Using an online survey (N = 583) of adults residing in England or Scotland with a body mass index (BMI) of ≥30 kg/m2, participants self-reported on food insecurity, diet quality, perceived impact of the cost of living crisis, and their responses to this in terms of food purchasing behaviours and food preparation practices. Regression analyses found that participants adversely impacted by the cost of living crisis reported experiencing food insecurity. Additionally, food insecurity was associated with use of specific purchasing behaviours (i.e., use of budgeting, use of supermarket offers) and food preparation practices (i.e., use of energy-saving appliances, use of resourcefulness). Exploratory analyses indicated that participants adversely impacted by the cost of living crisis and who used budgeting had low diet quality, whereas use of meal planning was associated with high diet quality. These findings highlight the fragility of food budgets and the coping strategies used by PLWO and food insecurity during the cost of living crisis. Policy measures and interventions are urgently needed that address the underlying economic factors contributing to food insecurity, to improve access to and affordability of healthier foods for all.
Collapse
Affiliation(s)
- Rebecca A Stone
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, L69 7ZA, UK.
| | - Adrian Brown
- Department of Medicine, Centre for Obesity Research, University College London, London, WC1E 6JF, UK.
| | - Flora Douglas
- School of Nursing, Midwifery & Paramedic Practice, Robert Gordon University, Aberdeen, AB10 7QE, UK.
| | - Mark A Green
- Department of Geography & Planning, University of Liverpool, Liverpool, L69 7ZT, UK.
| | - Emma Hunter
- School of Nursing, Midwifery & Paramedic Practice, Robert Gordon University, Aberdeen, AB10 7QE, UK.
| | - Marta Lonnie
- The Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
| | - Alexandra M Johnstone
- The Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
| | - Charlotte A Hardman
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, L69 7ZA, UK.
| |
Collapse
|
3
|
Thomas DM, Knight R, Gilbert JA, Cornelis MC, Gantz MG, Burdekin K, Cummiskey K, Sumner SCJ, Pathmasiri W, Sazonov E, Gabriel KP, Dooley EE, Green MA, Pfluger A, Kleinberg S. Transforming Big Data into AI-ready data for nutrition and obesity research. Obesity (Silver Spring) 2024; 32:857-870. [PMID: 38426232 DOI: 10.1002/oby.23989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 12/15/2023] [Accepted: 12/26/2023] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Big Data are increasingly used in obesity and nutrition research to gain new insights and derive personalized guidance; however, this data in raw form are often not usable. Substantial preprocessing, which requires machine learning (ML), human judgment, and specialized software, is required to transform Big Data into artificial intelligence (AI)- and ML-ready data. These preprocessing steps are the most complex part of the entire modeling pipeline. Understanding the complexity of these steps by the end user is critical for reducing misunderstanding, faulty interpretation, and erroneous downstream conclusions. METHODS We reviewed three popular obesity/nutrition Big Data sources: microbiome, metabolomics, and accelerometry. The preprocessing pipelines, specialized software, challenges, and how decisions impact final AI- and ML-ready products were detailed. RESULTS Opportunities for advances to improve quality control, speed of preprocessing, and intelligent end user consumption were presented. CONCLUSIONS Big Data have the exciting potential for identifying new modifiable factors that impact obesity research. However, to ensure accurate interpretation of conclusions arising from Big Data, the choices involved in preparing AI- and ML-ready data need to be transparent to investigators and clinicians relying on the conclusions.
Collapse
Affiliation(s)
- Diana M Thomas
- Department of Mathematical Sciences, United States Military Academy, West Point, New York, USA
| | - Rob Knight
- Bioinformatics and Systems Biology Program, University of California San Diego, La Jolla, California, USA
| | - Jack A Gilbert
- Department of Pediatrics and Scripps Institution of Oceanography, University of California San Diego, La Jolla, California, USA
| | - Marilyn C Cornelis
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Marie G Gantz
- Biostatics and Epidemiology Division, Research Triangle Institute International, Research Triangle Park, North Carolina, USA
| | - Kate Burdekin
- Biostatics and Epidemiology Division, Research Triangle Institute International, Research Triangle Park, North Carolina, USA
| | - Kevin Cummiskey
- Department of Mathematical Sciences, United States Military Academy, West Point, New York, USA
| | - Susan C J Sumner
- Department of Nutrition, Nutrition Research Institute, University of North Carolina Chapel Hill, Kannapolis, North Carolina, USA
| | - Wimal Pathmasiri
- Department of Nutrition, Nutrition Research Institute, University of North Carolina Chapel Hill, Kannapolis, North Carolina, USA
| | - Edward Sazonov
- Electrical and Computer Engineering Department, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Kelley Pettee Gabriel
- Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Erin E Dooley
- Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mark A Green
- Department of Geography & Planning, University of Liverpool, Liverpool, UK
| | - Andrew Pfluger
- Department of Geography and Environmental Engineering, United States Military Academy, West Point, New York, USA
| | - Samantha Kleinberg
- Computer Science Department, Stevens Institute of Technology, Hoboken, New Jersey, USA
| |
Collapse
|
4
|
Harris JA, Ji YD, Green MA, Moe J. Preference Signaling in Residency Applications: Does It Make Sense for Oral and Maxillofacial Surgery? J Oral Maxillofac Surg 2024; 82:512-515. [PMID: 38697689 DOI: 10.1016/j.joms.2023.12.013] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 05/05/2024]
Affiliation(s)
- Jack A Harris
- Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Miami and Jackson Memorial Hospital, Miami, FL.
| | - Yisi D Ji
- Resident, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA
| | - Mark A Green
- Instructor, Department of Plastic & Oral Surgery, Boston Children's Hospital, Boston, MA
| | - Justine Moe
- Clinical Associate Professor, Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI
| |
Collapse
|
5
|
Alvarez GA, Hebert KJ, Britt MC, Resnick CM, Padwa BL, Green MA. An Enhanced Recovery After Surgery (ERAS) Protocol for Orthognathic Surgery Reduces Rates of Postoperative Nausea. J Craniofac Surg 2024:00001665-990000000-01454. [PMID: 38656374 DOI: 10.1097/scs.0000000000010121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/16/2024] [Indexed: 04/26/2024] Open
Abstract
For many surgical procedures, enhanced recovery after surgery (ERAS) protocols have improved patient outcomes, particularly postoperative nausea and vomiting. The purpose of this study was to evaluate postoperative nausea following orthognathic surgery after the implementation of an ERAS protocol. This retrospective cohort study included patients between 12 and 35 years old who underwent orthognathic surgery at Boston Children's Hospital from April 2018 to December 2022. Patients with syndromes or a hospital stay greater than 48 hours were excluded from the study. The primary predictor was enrollment in our institutional ERAS protocol. The main outcome variable was postoperative nausea. Intraoperative and postoperative covariates were compared between groups using unpaired t tests and chi squared analysis. Univariate and multivariate regression models with 95% confidence intervals were performed to identify predictors for nausea. A P value<0.05 was considered significant. There were 128 patients (68 non-ERAS, 60 ERAS) included in this study (51.6% female, mean age 19.02±3.25 years). The ERAS group received less intraoperative fluid (937.0±462.3 versus 1583.6±847.6 mL, P≤0.001) and experienced less postoperative nausea (38.3% versus 63.2%, P=0.005). Enhanced recovery after surgery status (P=0.005) was a predictor for less postoperative nausea, whereas bilateral sagittal split osteotomy (P=0.045) and length of stay (P=0.007) were positive predictors for postoperative nausea in multivariate logistic regression analysis. Implementing an ERAS protocol for orthognathic surgery reduces postoperative nausea. Level of Evidence: Level III-therapeutic.
Collapse
Affiliation(s)
| | | | - Michael C Britt
- Department of Plastic and Oral Surgery, Boston Children's Hospital
| | - Cory M Resnick
- Harvard Medical School and Harvard School of Dental Medicine, Boston, MA
| | - Bonnie L Padwa
- Department of Plastic and Oral Surgery, Boston Children's Hospital
- Harvard Medical School and Harvard School of Dental Medicine, Boston, MA
| | - Mark A Green
- Department of Plastic and Oral Surgery, Boston Children's Hospital
- Harvard Medical School and Harvard School of Dental Medicine, Boston, MA
| |
Collapse
|
6
|
Green MA, Flanagan S, Britt MC. Cortical Block Grafting Successfully Augments Alveolar Cleft Sites for Dental Implant Placement. J Oral Maxillofac Surg 2024:S0278-2391(24)00216-7. [PMID: 38643967 DOI: 10.1016/j.joms.2024.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Supplemental bone grafting is regularly required before dental implant placement in patients with cleft lip and palate (CLP). PURPOSE The study purpose was to measure and compare implant osseointegration and changes in graft dimensions following lateral incisor onlay cortical bone grafting in CLP and non-CLP patients. STUDY DESIGN, SETTING, SAMPLE Retrospective cohort study composed of patients who presented to Boston Children's Hospital and underwent autogenous onlay cortical block bone grafting at lateral incisor sites from 2015 through 2023. Patients were excluded if the cone beam computed tomography (CBCT) quality was insufficient for accurate measurements. PREDICTOR VARIABLE The predictor variable was CLP status coded as CLP or non-CLP. MAIN OUTCOME VARIABLE The primary outcome variable was successful implant osseointegration confirmed by a torque of 35 N/cm or more after 3 months of implant healing. Secondary outcomes were change in bone width between preoperative and postoperative CBCT scans at lateral incisor sites and the need for additional bone augmentation prior to or during implant placement. COVARIATES Covariates were age, sex, cleft location, and time from bone graft to postoperative CBCT and implant placement. ANALYSES Data analyses were performed using t-tests, Fisher's exact tests, Mann-Whitney U tests, and Pearson's correlation. P < .05 was considered statistically significant. RESULTS A total of 22 subjects (16 with CLP) were evaluated. The mean age at the time of graft was 19.3 ± 2.4 years with 52.6% males. Implants were osseointegrated at 20 of 22 lateral incisor sites (1 CLP failure, 1 non-CLP failure). There was significant change in bone width after grafting for patients with CLP (P < .001). Patients with CLP experienced a 3.32 (± 1.80) mm and 2.99 (± 1.61) mm increase in bone width at 2 different levels. Patients with CLP achieved greater boney changes near the alveolar crest than noncleft patients (P = .008) but the change was not significantly different more apically (P = .86). One subject with CLP required additional grafting during implant placement. CONCLUSION AND RELEVANCE Cortical block onlay bone grafting is a predictable technique to augment lateral incisor sites in patients with CLP for placement of a dental implant.
Collapse
Affiliation(s)
- Mark A Green
- Instructor, Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, MA; Oral and Maxillofacial Surgeon, Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA.
| | - Sarah Flanagan
- Clinical Research Assistant, Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA
| | - Michael C Britt
- Clinical Research Assistant, Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA
| |
Collapse
|
7
|
Hebert KJ, Alvarez G, Flanagan S, Resnick CM, Padwa BL, Green MA. Does Anesthesiologist Experience Influence Early Postoperative Outcomes Following Orthognathic Surgery? J Oral Maxillofac Surg 2024; 82:270-278. [PMID: 38043584 DOI: 10.1016/j.joms.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/03/2023] [Accepted: 11/13/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Anesthesia provider experience impacts nausea and vomiting in other surgical specialties but its influence within orthognathic surgery remains unclear. PURPOSE The study purpose was to evaluate whether anesthesiologist experience with orthognathic surgery impacts postoperative outcomes, including nausea, emesis, narcotic use, and perioperative adverse events, for patients undergoing orthognathic surgery. STUDY DESIGN, SETTING, SAMPLE This is a retrospective cohort study of subjects aged 12 to 35 years old who underwent orthognathic surgery, including Le Fort 1 osteotomy ± bilateral sagittal split osteotomy, at Boston Children's Hospital from August 2018 to January 2022. Subjects were excluded if they had incomplete medical records, a syndromic diagnosis, or a hospital stay of greater than 2 days. PREDICTOR VARIABLE The predictor variable was attending anesthesia provider experience with orthognathic surgery. Providers were classified as experienced or inexperienced, with experienced providers defined as having anesthetized ≥10 orthognathic operations during the study period. MAIN OUTCOME VARIABLES The primary outcome variable was postoperative nausea. Secondary outcome variables were emesis, narcotic use in the hospital, and perioperative adverse events within 30 days of their operation. COVARIATES Study covariates included age, sex, race, comorbidities (body mass index, history of psychiatric illness, cleft lip and/or palate, chronic pain, postoperative nausea/vomiting, gastrointestinal conditions), enhanced recovery after surgery protocol enrollment, and intraoperative factors (operation performed, anesthesia/procedure times, estimated blood loss, intravenous fluid and narcotic administration, and anesthesiologist's years in practice). ANALYSES χ2 and unpaired t-tests were used to compare primary predictor and covariates against outcome variables. A P-value <.05 was considered significant. RESULTS There were 118 subjects included in the study after 4 were excluded (51.7% female, mean age 19.1 ± 3.30 years). There were 71 operations performed by 5 experienced anesthesiologists (mean cases/provider 15.4 ± 5.95) and 47 cases by 22 different inexperienced providers (mean cases/provider 1.91 ± 1.16). The nausea rate was 52.1% for experienced providers and 53.2% for inexperienced providers (P = .909). There were no statistically significant associations between anesthesiologist experience and any outcome variable (P > .341). CONCLUSIONS AND RELEVANCE Anesthesia providers' experience with orthognathic surgery did not significantly influence postoperative nausea, emesis, narcotic use, or perioperative adverse events.
Collapse
Affiliation(s)
- Kelsey J Hebert
- DMD Candidate, Harvard School of Dental Medicine, Boston, MA
| | - Gerardo Alvarez
- DMD Candidate, Harvard School of Dental Medicine, Boston, MA
| | - Sarah Flanagan
- Clinical Research Assistant, Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA
| | - Cory M Resnick
- Associate Professor, Department of Plastic and Oral Surgery, Harvard School of Dental Medicine, Boston Children's Hospital, Boston, MA
| | - Bonnie L Padwa
- Professor, Department of Plastic and Oral Surgery, Harvard School of Dental Medicine, Boston Children's Hospital, Boston, MA
| | - Mark A Green
- Instructor, Department of Plastic and Oral Surgery, Harvard School of Dental Medicine, Boston Children's Hospital, Boston, MA.
| |
Collapse
|
8
|
Green MA, Zoida JC, Padwa BL. Does Differential Maxillary Expansion Prior to Alveolar Cleft Bone Grafting Affect Nasal Width? Cleft Palate Craniofac J 2024; 61:409-415. [PMID: 36189870 DOI: 10.1177/10556656221130829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE Determine the effects of differential maxillary expansion on nasal width in patients with unilateral cleft lip and alveolus with or without cleft of the secondary palate (UCLA ± P). DESIGN Retrospective radiographic study. SETTING Institutional. PARTICIPANTS Forty patients with UCLA ± P who had alveolar bone grafting (ABG) between 2015 and 2020 and available preexpansion and postexpansion cone beam computed tomography (CBCT) scans. Twenty patients with UCLA ± P who underwent ABG without expansion were included as controls. MAIN OUTCOME MEASURE Percent change in width at the nasal pyriform, inferior turbinates, and alar base on cleft and noncleft sides. RESULTS The study included 40 patients (24 males, mean age 9.6 years) and 20 controls (10 males, mean age 10.1 years). After maxillary expansion, there was an increase in width on the cleft and noncleft sides compared to nonexpanded controls at nasal pyriform (10.9% cleft side, P ≤ 0.001 and 4.3% noncleft side, P ≤ .001), inferior turbinate (8.7%, P ≤ .001 and 4.5%, P = .01), and alar base (6.7%, P = <.001 and 0.8% P = .54). The increase in width was greater on the cleft side than the noncleft side at the nasal pyriform (7.1%, P ≤ .001), inferior turbinate (4.3%, P ≤ .001), and alar base (7.0%, P ≤ 0.001) in the expansion group. There was good to excellent intra-rater and inter-rater agreement for measurements. CONCLUSION Patients with UCLA ± P who undergo differential maxillary expansion before ABG exhibit greater nasal widening on the cleft side.
Collapse
Affiliation(s)
- Mark A Green
- Harvard School of Dental Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Joseph C Zoida
- New York University College of Dental Medicine, New York, NY, USA
| | - Bonnie L Padwa
- Harvard School of Dental Medicine, Boston Children's Hospital, Boston, MA, USA
| |
Collapse
|
9
|
Watson J, Green MA, Giebel C, Akpan A. Identifying longitudinal healthcare pathways and subsequent mortality for people living with dementia in England: an observational group-based trajectory analysis. BMC Geriatr 2024; 24:150. [PMID: 38350866 PMCID: PMC10865521 DOI: 10.1186/s12877-024-04744-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 01/24/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The number of people living with dementia (PLWD) continues to increase, particularly those with severe symptomatology. Severe symptoms and greater ill-health result in more acute care need. Early healthcare interventions can prove beneficial. Healthcare use has not been analysed as a holistic set of interlinked events. This study explores different healthcare pathways among PLWD, social or spatial inequalities in healthcare pathways and subsequent mortality risk. METHODS Group-based trajectory models (GBTM) were applied to electronic healthcare records. We generated clusters of PLWD with similar five-year, post-diagnosis trajectories in rates of primary and secondary healthcare use. Potential social and spatial variations in healthcare use clusters were examined. Cox Proportional Hazards used to explore variation in subsequent mortality risk between healthcare use clusters. RESULTS Four healthcare use clusters were identified in both early- (n = 3732) and late-onset (n = 6224) dementia populations. Healthcare use variations were noted; consistent or diminishing healthcare use was associated with lower subsequent mortality risk. Increasing healthcare use was associated with increased mortality risk. Descriptive analyses indicated social and spatial variation in healthcare use cluster membership. CONCLUSION Healthcare pathways can help indicate changing need and variation in need, with differential patterns in initial healthcare use post-diagnosis, producing similar subsequent mortality risk. Care in dementia needs to be more accessible and appropriate, with care catered to specific and changing needs. Better continuity of care and greater awareness of dementia in primary can enhance prospects for PLWD. Research needs to further illuminate holistic care need for PLWD, including health and social care use, inequalities in care, health and outcomes.
Collapse
Affiliation(s)
- James Watson
- Department of Primary Care and Mental Health, The University of Liverpool, 1st Floor, Waterhouse Building B, Liverpool, L69 3GF, UK.
| | - Mark A Green
- School of Environmental Sciences, The University of Liverpool, Liverpool, UK
| | - Clarissa Giebel
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- Applied Research Collaboration North West Coast, Liverpool, UK
| | - Asangaedem Akpan
- Department of Medicine for Older People and Stroke, Liverpool University Hospitals NHS FT, Liverpool, UK
- Healthy Ageing Group, University of Cumbria, Carlisle, UK
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- Clinical Research Network, North West Coast, Liverpool, UK
| |
Collapse
|
10
|
Smith NJ, Green MA, Bahler CD, Tann M, Territo W, Smith AM, Hutchins GD. Comparison of tracer kinetic models for 68Ga-PSMA-11 PET in intermediate-risk primary prostate cancer patients. EJNMMI Res 2024; 14:6. [PMID: 38198060 PMCID: PMC10781928 DOI: 10.1186/s13550-023-01066-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/21/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND 68Ga-PSMA-11 positron emission tomography enables the detection of primary, recurrent, and metastatic prostate cancer. Regional radiopharmaceutical uptake is generally evaluated in static images and quantified as standard uptake values (SUVs) for clinical decision-making. However, analysis of dynamic images characterizing both tracer uptake and pharmacokinetics may offer added insights into the underlying tissue pathophysiology. This study was undertaken to evaluate the suitability of various kinetic models for 68Ga-PSMA-11 PET analysis. Twenty-three lesions in 18 patients were included in a retrospective kinetic evaluation of 55-min dynamic 68Ga-PSMA-11 pre-prostatectomy PET scans from patients with biopsy-demonstrated intermediate- to high-risk prostate cancer. Three kinetic models-a reversible one-tissue compartment model, an irreversible two-tissue compartment model, and a reversible two-tissue compartment model, were evaluated for their goodness of fit to lesion and normal reference prostate time-activity curves. Kinetic parameters obtained through graphical analysis and tracer kinetic modeling techniques were compared for reference prostate tissue and lesion regions of interest. RESULTS Supported by goodness of fit and information loss criteria, the irreversible two-tissue compartment model optimally fit the time-activity curves. Lesions exhibited significant differences in kinetic rate constants (K1, k2, k3, Ki) and semiquantitative measures (SUV and %ID/kg) when compared with reference prostatic tissue. The two-tissue irreversible tracer kinetic model was consistently appropriate across prostatic zones. CONCLUSIONS An irreversible tracer kinetic model is appropriate for dynamic analysis of 68Ga-PSMA-11 PET images. Kinetic parameters estimated by Patlak graphical analysis or full compartmental analysis can distinguish tumor from normal prostate tissue.
Collapse
Affiliation(s)
- Nathaniel J Smith
- Indiana University School of Medicine, 950 West Walnut Street, Indianapolis, IN, 46202, USA.
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA.
| | - Mark A Green
- Indiana University School of Medicine, 950 West Walnut Street, Indianapolis, IN, 46202, USA
| | - Clinton D Bahler
- Indiana University School of Medicine, 950 West Walnut Street, Indianapolis, IN, 46202, USA
| | - Mark Tann
- Indiana University School of Medicine, 950 West Walnut Street, Indianapolis, IN, 46202, USA
| | - Wendy Territo
- Indiana University School of Medicine, 950 West Walnut Street, Indianapolis, IN, 46202, USA
| | - Anne M Smith
- Siemens Medical Solutions USA, Inc., Knoxville, TN, USA
| | - Gary D Hutchins
- Indiana University School of Medicine, 950 West Walnut Street, Indianapolis, IN, 46202, USA
| |
Collapse
|
11
|
Burnside G, Cheyne CP, Leeming G, Humann M, Darby A, Green MA, Crozier A, Maskell S, O’Halloran K, Musi E, Carmi E, Khan N, Fisher D, Corcoran R, Dunning J, Edmunds WJ, Tharmaratnam K, Hughes DM, Malki-Epshtein L, Cook M, Roberts BM, Gallagher E, Howell K, Chand M, Kemp R, Boulter M, Fowler T, Semple MG, Coffey E, Ashton M, García-Fiñana M, Buchan IE. COVID-19 risk mitigation in reopening mass cultural events: population-based observational study for the UK Events Research Programme in Liverpool City Region. J R Soc Med 2024; 117:11-23. [PMID: 37351911 PMCID: PMC10858718 DOI: 10.1177/01410768231182389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 04/25/2023] [Indexed: 06/24/2023] Open
Abstract
OBJECTIVES To understand severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission risks, perceived risks and the feasibility of risk mitigations from experimental mass cultural events before coronavirus disease 2019 (COVID-19) restrictions were lifted. DESIGN Prospective, population-wide observational study. SETTING Four events (two nightclubs, an outdoor music festival and a business conference) open to Liverpool City Region UK residents, requiring a negative lateral flow test (LFT) within the 36 h before the event, but not requiring social distancing or face-coverings. PARTICIPANTS A total of 12,256 individuals attending one or more events between 28 April and 2 May 2021. MAIN OUTCOME MEASURES SARS-CoV-2 infections detected using audience self-swabbed (5-7 days post-event) polymerase chain reaction (PCR) tests, with viral genomic analysis of cases, plus linked National Health Service COVID-19 testing data. Audience experiences were gathered via questionnaires, focus groups and social media. Indoor CO2 concentrations were monitored. RESULTS A total of 12 PCR-positive cases (likely 4 index, 8 primary or secondary), 10 from the nightclubs. Two further cases had positive LFTs but no PCR. A total of 11,896 (97.1%) participants with scanned tickets were matched to a negative pre-event LFT: 4972 (40.6%) returned a PCR within a week. CO2 concentrations showed areas for improving ventilation at the nightclubs. Population infection rates were low, yet with a concurrent outbreak of >50 linked cases around a local swimming pool without equivalent risk mitigations. Audience anxiety was low and enjoyment high. CONCLUSIONS We observed minor SARS-CoV-2 transmission and low perceived risks around events when prevalence was low and risk mitigations prominent. Partnership between audiences, event organisers and public health services, supported by information systems with real-time linked data, can improve health security for mass cultural events.
Collapse
Affiliation(s)
- Girvan Burnside
- Deparment of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK
| | - Christopher P Cheyne
- Deparment of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK
| | - Gary Leeming
- Deparment of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK
| | - Michael Humann
- Department of Psychology, University of Liverpool, Liverpool L69 7ZA, UK
| | - Alistair Darby
- Department of Infection Biology and Microbiomes, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 3BX, UK
| | - Mark A Green
- Department of Geography and Planning, University of Liverpool L69 3BX, Liverpool, UK
| | - Alexander Crozier
- Division of Biosciences, University College London, London WC1E 6BT, UK
| | - Simon Maskell
- Department of Electrical Engineering and Electronics, University of Liverpool, Liverpool L69 3BX, UK
| | - Kay O’Halloran
- Department of Communication and Media, University of Liverpool, Liverpool L69 7ZG, UK
| | - Elena Musi
- Department of Communication and Media, University of Liverpool, Liverpool L69 7ZG, UK
| | - Elinor Carmi
- Department of Sociology and Criminology, City University, London EC1V 0HB, UK
| | - Naila Khan
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool L69 3BX, UK
| | - Debra Fisher
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool L69 3BX, UK
| | - Rhiannon Corcoran
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool L69 3BX, UK
| | - Jake Dunning
- Pandemic Sciences Institute, University of Oxford, Oxford OX3 7DQ, UK
| | - W John Edmunds
- Centre for Mathematical Modelling of Infectious Diseases and Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Kukatharmini Tharmaratnam
- Deparment of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK
| | - David M Hughes
- Deparment of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK
| | - Liora Malki-Epshtein
- Department of Civil, Environmental and Geomatic Engineering, University College London, London WC1E 6BT, UK
| | - Malcolm Cook
- Building Energy Research Group, School of Architecture, Building and Civil Engineering, Loughborough University, Loughborough LE11 3TU, UK
| | - Ben M Roberts
- Building Energy Research Group, School of Architecture, Building and Civil Engineering, Loughborough University, Loughborough LE11 3TU, UK
| | - Eileen Gallagher
- Clinical and Public Health Group, UK Health Security Agency, London SW1P 3JR, UK
| | - Kate Howell
- Clinical and Public Health Group, UK Health Security Agency, London SW1P 3JR, UK
| | - Meera Chand
- Clinical and Public Health Group, UK Health Security Agency, London SW1P 3JR, UK
| | - Robin Kemp
- William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - Matthew Boulter
- Clinical and Public Health Group, UK Health Security Agency, London SW1P 3JR, UK
| | - Tom Fowler
- Clinical and Public Health Group, UK Health Security Agency, London SW1P 3JR, UK
- William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - Malcolm G Semple
- Department of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 3BX, UK
| | - Emer Coffey
- Liverpool City Council, Liverpool L3 1AH, UK
| | - Matt Ashton
- Liverpool City Council, Liverpool L3 1AH, UK
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool L69 3GB, UK
| | - The COVID-19 Genomics UK (COG-UK) Consortium
- Deparment of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK
- Department of Psychology, University of Liverpool, Liverpool L69 7ZA, UK
- Department of Infection Biology and Microbiomes, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 3BX, UK
- Department of Geography and Planning, University of Liverpool L69 3BX, Liverpool, UK
- Division of Biosciences, University College London, London WC1E 6BT, UK
- Department of Electrical Engineering and Electronics, University of Liverpool, Liverpool L69 3BX, UK
- Department of Communication and Media, University of Liverpool, Liverpool L69 7ZG, UK
- Department of Sociology and Criminology, City University, London EC1V 0HB, UK
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool L69 3BX, UK
- Pandemic Sciences Institute, University of Oxford, Oxford OX3 7DQ, UK
- Centre for Mathematical Modelling of Infectious Diseases and Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
- Department of Civil, Environmental and Geomatic Engineering, University College London, London WC1E 6BT, UK
- Building Energy Research Group, School of Architecture, Building and Civil Engineering, Loughborough University, Loughborough LE11 3TU, UK
- Clinical and Public Health Group, UK Health Security Agency, London SW1P 3JR, UK
- William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
- Liverpool City Council, Liverpool L3 1AH, UK
- Department of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 3BX, UK
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool L69 3GB, UK
- *Shared senior authorship
| | - Marta García-Fiñana
- Deparment of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK
| | - Iain E Buchan
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool L69 3GB, UK
| |
Collapse
|
12
|
Smith NJ, Green MA, Bahler CD, Tann M, Territo W, Smith AM, Hutchins GD. Comparison of Tracer Kinetic Models for 68Ga-PSMA-11 PET in Intermediate Risk Primary Prostate Cancer Patients. Res Sq 2023:rs.3.rs-3420161. [PMID: 37961116 PMCID: PMC10635384 DOI: 10.21203/rs.3.rs-3420161/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] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
BACKGROUND 68Ga-PSMA-11 positron emission tomography enables the detection of primary, recurrent, and metastatic prostate cancer. Regional radiopharmaceutical uptake is generally evaluated in static images and quantified as standard uptake values (SUV) for clinical decision-making. However, analysis of dynamic images characterizing both tracer uptake and pharmacokinetics may offer added insights into the underlying tissue pathophysiology. This study was undertaken to evaluate the suitability of various kinetic models for 68Ga-PSMA-11 PET analysis. Twenty-three lesions in 18 patients were included in a retrospective kinetic evaluation of 55-minute dynamic 68Ga-PSMA-11 pre-prostatectomy PET scans from patients with biopsy-demonstrated intermediate to high-risk prostate cancer. A reversible one-tissue compartment model, irreversible two-tissue compartment model, and a reversible two-tissue compartment model were evaluated for their goodness-of-fit to lesion and normal reference prostate time-activity curves. Kinetic parameters obtained through graphical analysis and tracer kinetic modeling techniques were compared for reference prostate tissue and lesion regions of interest. RESULTS Supported by goodness-of-fit and information loss criteria, the irreversible two-tissue compartment model was selected as optimally fitting the time-activity curves. Lesions exhibited significant differences in kinetic rate constants (K1, k2, k3, Ki) and semiquantitative measures (SUV) when compared with reference prostatic tissue. The two-tissue irreversible tracer kinetic model was consistently appropriate across prostatic zones. CONCLUSIONS An irreversible tracer kinetic model is appropriate for dynamic analysis of 68Ga-PSMA-11 PET images. Kinetic parameters estimated by Patlak graphical analysis or full compartmental analysis can distinguish tumor from normal prostate tissue.
Collapse
Affiliation(s)
| | | | | | - Mark Tann
- Indiana University School of Medicine
| | | | - Anne M Smith
- Siemens Medical Solutions USA Inc: Siemens Healthcare USA
| | | |
Collapse
|
13
|
Zhang X, Tulloch JSP, Knott S, Allison R, Parvulescu P, Buchan IE, Garcia-Finana M, Piroddi R, Green MA, Baird S, Barr B. Evaluating the impact of using mobile vaccination units to increase COVID-19 vaccination uptake in Cheshire and Merseyside, UK: a synthetic control analysis. BMJ Open 2023; 13:e071852. [PMID: 37802621 PMCID: PMC10565187 DOI: 10.1136/bmjopen-2023-071852] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 09/20/2023] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVE To evaluate the impact of mobile vaccination units on COVID-19 vaccine uptake of the first dose, the percentage of vaccinated people among the total eligible population. We further investigate whether such an effect differed by deprivation, ethnicity and age. DESIGN Synthetic control analysis. SETTING The population registered with general practices (GPs) in nine local authority areas in Cheshire and Merseyside in Northwest England, UK. INTERVENTION Mobile vaccination units that visited 37 sites on 54 occasions between 12 April 2021 and 28 June 2021. We defined intervention neighbourhoods as having their population weighted centroid located within 1 km of mobile vaccination sites (338 006 individuals). A weighted combination of neighbourhoods that had not received the intervention (1 495 582 individuals) was used to construct a synthetic control group. OUTCOME The weekly number of first-dose vaccines received among people aged 18 years and over as a proportion of the population. RESULTS The introduction of a mobile vaccination unit into a neighbourhood increased the number of first vaccinations conducted in the neighbourhood by 25% (95% CI 21% to 28%) within 3 weeks after the first visit to a neighbourhood, compared with the synthetic control group. Interaction analyses showed smaller or no effect among older age groups, Asian and black ethnic groups, and the most socioeconomically deprived populations. CONCLUSIONS Mobile vaccination units are effective interventions for increasing vaccination uptake, at least in the short term. While mobile units can be geographically targeted to reduce inequalities, we found evidence that they may increase inequalities in vaccine uptake within targeted areas, as the intervention was less effective among groups that tended to have lower vaccination uptake. Mobile vaccination units should be used in combination with activities to maximise outreach with black and Asian communities and socioeconomically disadvantaged groups.
Collapse
Affiliation(s)
- Xingna Zhang
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | | | - Shane Knott
- Public Health, Liverpool City Council, Liverpool, UK
| | | | | | - Iain E Buchan
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | | | - Roberta Piroddi
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Mark A Green
- Geography & Planning, University of Liverpool, Liverpool, UK
| | | | - Ben Barr
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| |
Collapse
|
14
|
Malecki SL, Jung HY, Loffler A, Green MA, Gupta S, MacFadden D, Daneman N, Upshur R, Fralick M, Lapointe-Shaw L, Tang T, Weinerman A, Kwan JL, Liu JJ, Razak F, Verma AA. Identifying clusters of coexisting conditions and outcomes among adults admitted to hospital with community-acquired pneumonia: a multicentre cohort study. CMAJ Open 2023; 11:E799-E808. [PMID: 37669812 PMCID: PMC10482492 DOI: 10.9778/cmajo.20220193] [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: 09/07/2023] Open
Abstract
BACKGROUND Little is known about patterns of coexisting conditions and their influence on clinical care or outcomes in adults admitted to hospital for community-acquired pneumonia (CAP). We sought to evaluate how coexisting conditions cluster in this population to advance understanding of how multimorbidity affects CAP. METHODS We studied 11 085 adults admitted to hospital with CAP at 7 hospitals in Ontario, Canada. Using cluster analysis, we identified patient subgroups based on clustering of comorbidities in the Charlson Comorbidity Index. We derived and replicated cluster analyses in independent cohorts (derivation sample 2010-2015, replication sample 2015-2017), then combined these into a total cohort for final cluster analyses. We described differences in medications, imaging and outcomes. RESULTS Patients clustered into 7 subgroups. The low comorbidity subgroup (n = 3052, 27.5%) had no comorbidities. The DM-HF-Pulm subgroup had prevalent diabetes, heart failure and chronic lung disease (n = 1710, 15.4%). One disease category defined each remaining subgroup, as follows: pulmonary (n = 1621, 14.6%), diabetes (n = 1281, 11.6%), heart failure (n = 1370, 12.4%), dementia (n = 1038, 9.4%) and cancer (n = 1013, 9.1%). Corticosteroid use ranged from 11.5% to 64.9% in the dementia and pulmonary subgroups, respectively. Piperacillin-tazobactam use ranged from 9.1% to 28.0% in the pulmonary and cancer subgroups, respectively. The use of thoracic computed tomography ranged from 5.7% to 36.3% in the dementia and cancer subgroups, respectively. Adjusting for patient factors, the risk of in-hospital death was greater in the cancer (adjusted odds ratio [OR] 3.12, 95% confidence interval [CI] 2.44-3.99), dementia (adjusted OR 1.57, 95% CI 1.05-2.35), heart failure (adjusted OR 1.66, 95% CI 1.35-2.03) and DM-HF-Pulm subgroups (adjusted OR 1.35, 95% CI 1.12-1.61), and lower in the diabetes subgroup (adjusted OR 0.67, 95% CI 0.50-0.89), compared with the low comorbidity group. INTERPRETATION Patients admitted to hospital with CAP cluster into clinically recognizable subgroups based on coexisting conditions. Clinical care and outcomes vary among these subgroups with little evidence to guide decision-making, highlighting opportunities for research to personalize care.
Collapse
Affiliation(s)
- Sarah L Malecki
- Department of Internal Medicine (Malecki), University of Toronto; Li Ka Shing Knowledge Institute (Jung, Loffler, Gupta, Razak, Verma), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Department of Geography & Planning (Green), University of Liverpool, Liverpool, UK; Division of Respirology (Gupta), Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (MacFadden); University of Ottawa (MacFadden), Ottawa, Ont.; Sunnybrook Health Sciences Centre (Daneman, Weinerman); Division of Clinical Public Health (Upshur), Dalla Lana School of Public Health, University of Toronto; Sinai Health System (Fralick, Kwan); Department of Medicine (Fralick, Lapointe-Shaw, Tang, Weinerman, Kwan, Liu, Razak, Verma), University of Toronto; University Health Network (Lapointe-Shaw, Liu); Trillium Health Partners (Tang); Institute of Health Policy, Management and Evaluation (Razak, Verma), University of Toronto, Toronto, Ont
| | - Hae Young Jung
- Department of Internal Medicine (Malecki), University of Toronto; Li Ka Shing Knowledge Institute (Jung, Loffler, Gupta, Razak, Verma), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Department of Geography & Planning (Green), University of Liverpool, Liverpool, UK; Division of Respirology (Gupta), Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (MacFadden); University of Ottawa (MacFadden), Ottawa, Ont.; Sunnybrook Health Sciences Centre (Daneman, Weinerman); Division of Clinical Public Health (Upshur), Dalla Lana School of Public Health, University of Toronto; Sinai Health System (Fralick, Kwan); Department of Medicine (Fralick, Lapointe-Shaw, Tang, Weinerman, Kwan, Liu, Razak, Verma), University of Toronto; University Health Network (Lapointe-Shaw, Liu); Trillium Health Partners (Tang); Institute of Health Policy, Management and Evaluation (Razak, Verma), University of Toronto, Toronto, Ont
| | - Anne Loffler
- Department of Internal Medicine (Malecki), University of Toronto; Li Ka Shing Knowledge Institute (Jung, Loffler, Gupta, Razak, Verma), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Department of Geography & Planning (Green), University of Liverpool, Liverpool, UK; Division of Respirology (Gupta), Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (MacFadden); University of Ottawa (MacFadden), Ottawa, Ont.; Sunnybrook Health Sciences Centre (Daneman, Weinerman); Division of Clinical Public Health (Upshur), Dalla Lana School of Public Health, University of Toronto; Sinai Health System (Fralick, Kwan); Department of Medicine (Fralick, Lapointe-Shaw, Tang, Weinerman, Kwan, Liu, Razak, Verma), University of Toronto; University Health Network (Lapointe-Shaw, Liu); Trillium Health Partners (Tang); Institute of Health Policy, Management and Evaluation (Razak, Verma), University of Toronto, Toronto, Ont
| | - Mark A Green
- Department of Internal Medicine (Malecki), University of Toronto; Li Ka Shing Knowledge Institute (Jung, Loffler, Gupta, Razak, Verma), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Department of Geography & Planning (Green), University of Liverpool, Liverpool, UK; Division of Respirology (Gupta), Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (MacFadden); University of Ottawa (MacFadden), Ottawa, Ont.; Sunnybrook Health Sciences Centre (Daneman, Weinerman); Division of Clinical Public Health (Upshur), Dalla Lana School of Public Health, University of Toronto; Sinai Health System (Fralick, Kwan); Department of Medicine (Fralick, Lapointe-Shaw, Tang, Weinerman, Kwan, Liu, Razak, Verma), University of Toronto; University Health Network (Lapointe-Shaw, Liu); Trillium Health Partners (Tang); Institute of Health Policy, Management and Evaluation (Razak, Verma), University of Toronto, Toronto, Ont
| | - Samir Gupta
- Department of Internal Medicine (Malecki), University of Toronto; Li Ka Shing Knowledge Institute (Jung, Loffler, Gupta, Razak, Verma), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Department of Geography & Planning (Green), University of Liverpool, Liverpool, UK; Division of Respirology (Gupta), Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (MacFadden); University of Ottawa (MacFadden), Ottawa, Ont.; Sunnybrook Health Sciences Centre (Daneman, Weinerman); Division of Clinical Public Health (Upshur), Dalla Lana School of Public Health, University of Toronto; Sinai Health System (Fralick, Kwan); Department of Medicine (Fralick, Lapointe-Shaw, Tang, Weinerman, Kwan, Liu, Razak, Verma), University of Toronto; University Health Network (Lapointe-Shaw, Liu); Trillium Health Partners (Tang); Institute of Health Policy, Management and Evaluation (Razak, Verma), University of Toronto, Toronto, Ont
| | - Derek MacFadden
- Department of Internal Medicine (Malecki), University of Toronto; Li Ka Shing Knowledge Institute (Jung, Loffler, Gupta, Razak, Verma), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Department of Geography & Planning (Green), University of Liverpool, Liverpool, UK; Division of Respirology (Gupta), Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (MacFadden); University of Ottawa (MacFadden), Ottawa, Ont.; Sunnybrook Health Sciences Centre (Daneman, Weinerman); Division of Clinical Public Health (Upshur), Dalla Lana School of Public Health, University of Toronto; Sinai Health System (Fralick, Kwan); Department of Medicine (Fralick, Lapointe-Shaw, Tang, Weinerman, Kwan, Liu, Razak, Verma), University of Toronto; University Health Network (Lapointe-Shaw, Liu); Trillium Health Partners (Tang); Institute of Health Policy, Management and Evaluation (Razak, Verma), University of Toronto, Toronto, Ont
| | - Nick Daneman
- Department of Internal Medicine (Malecki), University of Toronto; Li Ka Shing Knowledge Institute (Jung, Loffler, Gupta, Razak, Verma), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Department of Geography & Planning (Green), University of Liverpool, Liverpool, UK; Division of Respirology (Gupta), Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (MacFadden); University of Ottawa (MacFadden), Ottawa, Ont.; Sunnybrook Health Sciences Centre (Daneman, Weinerman); Division of Clinical Public Health (Upshur), Dalla Lana School of Public Health, University of Toronto; Sinai Health System (Fralick, Kwan); Department of Medicine (Fralick, Lapointe-Shaw, Tang, Weinerman, Kwan, Liu, Razak, Verma), University of Toronto; University Health Network (Lapointe-Shaw, Liu); Trillium Health Partners (Tang); Institute of Health Policy, Management and Evaluation (Razak, Verma), University of Toronto, Toronto, Ont
| | - Ross Upshur
- Department of Internal Medicine (Malecki), University of Toronto; Li Ka Shing Knowledge Institute (Jung, Loffler, Gupta, Razak, Verma), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Department of Geography & Planning (Green), University of Liverpool, Liverpool, UK; Division of Respirology (Gupta), Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (MacFadden); University of Ottawa (MacFadden), Ottawa, Ont.; Sunnybrook Health Sciences Centre (Daneman, Weinerman); Division of Clinical Public Health (Upshur), Dalla Lana School of Public Health, University of Toronto; Sinai Health System (Fralick, Kwan); Department of Medicine (Fralick, Lapointe-Shaw, Tang, Weinerman, Kwan, Liu, Razak, Verma), University of Toronto; University Health Network (Lapointe-Shaw, Liu); Trillium Health Partners (Tang); Institute of Health Policy, Management and Evaluation (Razak, Verma), University of Toronto, Toronto, Ont
| | - Michael Fralick
- Department of Internal Medicine (Malecki), University of Toronto; Li Ka Shing Knowledge Institute (Jung, Loffler, Gupta, Razak, Verma), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Department of Geography & Planning (Green), University of Liverpool, Liverpool, UK; Division of Respirology (Gupta), Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (MacFadden); University of Ottawa (MacFadden), Ottawa, Ont.; Sunnybrook Health Sciences Centre (Daneman, Weinerman); Division of Clinical Public Health (Upshur), Dalla Lana School of Public Health, University of Toronto; Sinai Health System (Fralick, Kwan); Department of Medicine (Fralick, Lapointe-Shaw, Tang, Weinerman, Kwan, Liu, Razak, Verma), University of Toronto; University Health Network (Lapointe-Shaw, Liu); Trillium Health Partners (Tang); Institute of Health Policy, Management and Evaluation (Razak, Verma), University of Toronto, Toronto, Ont
| | - Lauren Lapointe-Shaw
- Department of Internal Medicine (Malecki), University of Toronto; Li Ka Shing Knowledge Institute (Jung, Loffler, Gupta, Razak, Verma), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Department of Geography & Planning (Green), University of Liverpool, Liverpool, UK; Division of Respirology (Gupta), Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (MacFadden); University of Ottawa (MacFadden), Ottawa, Ont.; Sunnybrook Health Sciences Centre (Daneman, Weinerman); Division of Clinical Public Health (Upshur), Dalla Lana School of Public Health, University of Toronto; Sinai Health System (Fralick, Kwan); Department of Medicine (Fralick, Lapointe-Shaw, Tang, Weinerman, Kwan, Liu, Razak, Verma), University of Toronto; University Health Network (Lapointe-Shaw, Liu); Trillium Health Partners (Tang); Institute of Health Policy, Management and Evaluation (Razak, Verma), University of Toronto, Toronto, Ont
| | - Terence Tang
- Department of Internal Medicine (Malecki), University of Toronto; Li Ka Shing Knowledge Institute (Jung, Loffler, Gupta, Razak, Verma), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Department of Geography & Planning (Green), University of Liverpool, Liverpool, UK; Division of Respirology (Gupta), Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (MacFadden); University of Ottawa (MacFadden), Ottawa, Ont.; Sunnybrook Health Sciences Centre (Daneman, Weinerman); Division of Clinical Public Health (Upshur), Dalla Lana School of Public Health, University of Toronto; Sinai Health System (Fralick, Kwan); Department of Medicine (Fralick, Lapointe-Shaw, Tang, Weinerman, Kwan, Liu, Razak, Verma), University of Toronto; University Health Network (Lapointe-Shaw, Liu); Trillium Health Partners (Tang); Institute of Health Policy, Management and Evaluation (Razak, Verma), University of Toronto, Toronto, Ont
| | - Adina Weinerman
- Department of Internal Medicine (Malecki), University of Toronto; Li Ka Shing Knowledge Institute (Jung, Loffler, Gupta, Razak, Verma), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Department of Geography & Planning (Green), University of Liverpool, Liverpool, UK; Division of Respirology (Gupta), Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (MacFadden); University of Ottawa (MacFadden), Ottawa, Ont.; Sunnybrook Health Sciences Centre (Daneman, Weinerman); Division of Clinical Public Health (Upshur), Dalla Lana School of Public Health, University of Toronto; Sinai Health System (Fralick, Kwan); Department of Medicine (Fralick, Lapointe-Shaw, Tang, Weinerman, Kwan, Liu, Razak, Verma), University of Toronto; University Health Network (Lapointe-Shaw, Liu); Trillium Health Partners (Tang); Institute of Health Policy, Management and Evaluation (Razak, Verma), University of Toronto, Toronto, Ont
| | - Janice L Kwan
- Department of Internal Medicine (Malecki), University of Toronto; Li Ka Shing Knowledge Institute (Jung, Loffler, Gupta, Razak, Verma), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Department of Geography & Planning (Green), University of Liverpool, Liverpool, UK; Division of Respirology (Gupta), Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (MacFadden); University of Ottawa (MacFadden), Ottawa, Ont.; Sunnybrook Health Sciences Centre (Daneman, Weinerman); Division of Clinical Public Health (Upshur), Dalla Lana School of Public Health, University of Toronto; Sinai Health System (Fralick, Kwan); Department of Medicine (Fralick, Lapointe-Shaw, Tang, Weinerman, Kwan, Liu, Razak, Verma), University of Toronto; University Health Network (Lapointe-Shaw, Liu); Trillium Health Partners (Tang); Institute of Health Policy, Management and Evaluation (Razak, Verma), University of Toronto, Toronto, Ont
| | - Jessica J Liu
- Department of Internal Medicine (Malecki), University of Toronto; Li Ka Shing Knowledge Institute (Jung, Loffler, Gupta, Razak, Verma), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Department of Geography & Planning (Green), University of Liverpool, Liverpool, UK; Division of Respirology (Gupta), Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (MacFadden); University of Ottawa (MacFadden), Ottawa, Ont.; Sunnybrook Health Sciences Centre (Daneman, Weinerman); Division of Clinical Public Health (Upshur), Dalla Lana School of Public Health, University of Toronto; Sinai Health System (Fralick, Kwan); Department of Medicine (Fralick, Lapointe-Shaw, Tang, Weinerman, Kwan, Liu, Razak, Verma), University of Toronto; University Health Network (Lapointe-Shaw, Liu); Trillium Health Partners (Tang); Institute of Health Policy, Management and Evaluation (Razak, Verma), University of Toronto, Toronto, Ont
| | - Fahad Razak
- Department of Internal Medicine (Malecki), University of Toronto; Li Ka Shing Knowledge Institute (Jung, Loffler, Gupta, Razak, Verma), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Department of Geography & Planning (Green), University of Liverpool, Liverpool, UK; Division of Respirology (Gupta), Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (MacFadden); University of Ottawa (MacFadden), Ottawa, Ont.; Sunnybrook Health Sciences Centre (Daneman, Weinerman); Division of Clinical Public Health (Upshur), Dalla Lana School of Public Health, University of Toronto; Sinai Health System (Fralick, Kwan); Department of Medicine (Fralick, Lapointe-Shaw, Tang, Weinerman, Kwan, Liu, Razak, Verma), University of Toronto; University Health Network (Lapointe-Shaw, Liu); Trillium Health Partners (Tang); Institute of Health Policy, Management and Evaluation (Razak, Verma), University of Toronto, Toronto, Ont
| | - Amol A Verma
- Department of Internal Medicine (Malecki), University of Toronto; Li Ka Shing Knowledge Institute (Jung, Loffler, Gupta, Razak, Verma), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Department of Geography & Planning (Green), University of Liverpool, Liverpool, UK; Division of Respirology (Gupta), Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (MacFadden); University of Ottawa (MacFadden), Ottawa, Ont.; Sunnybrook Health Sciences Centre (Daneman, Weinerman); Division of Clinical Public Health (Upshur), Dalla Lana School of Public Health, University of Toronto; Sinai Health System (Fralick, Kwan); Department of Medicine (Fralick, Lapointe-Shaw, Tang, Weinerman, Kwan, Liu, Razak, Verma), University of Toronto; University Health Network (Lapointe-Shaw, Liu); Trillium Health Partners (Tang); Institute of Health Policy, Management and Evaluation (Razak, Verma), University of Toronto, Toronto, Ont.
| |
Collapse
|
15
|
Green MA, McKee M, Hamilton OK, Shaw RJ, Macleod J, Boyd A, Katikireddi SV. Associations between self-reported healthcare disruption due to covid-19 and avoidable hospital admission: evidence from seven linked longitudinal studies for England. BMJ 2023; 382:e075133. [PMID: 37468148 PMCID: PMC10354595 DOI: 10.1136/bmj-2023-075133] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVES To examine whether there is an association between people who experienced disrupted access to healthcare during the covid-19 pandemic and risk of an avoidable hospital admission. DESIGN Observational analysis using evidence from seven linked longitudinal cohort studies for England. SETTING Studies linked to electronic health records from NHS Digital from 1 March 2020 to 25 August 2022. Data were accessed using the UK Longitudinal Linkage Collaboration trusted research environment. PARTICIPANTS Individual level records for 29 276 people. MAIN OUTCOME MEASURES Avoidable hospital admissions defined as emergency hospital admissions for ambulatory care sensitive and emergency urgent care sensitive conditions. RESULTS 9742 participants (weighted percentage 35%, adjusted for sample structure of longitudinal cohorts) self-reported some form of disrupted access to healthcare during the covid-19 pandemic. People with disrupted access were at increased risk of any (odds ratio 1.80, 95% confidence interval 1.39 to 2.34), acute (2.01, 1.39 to 2.92), and chronic (1.80, 1.31 to 2.48) ambulatory care sensitive hospital admissions. For people who experienced disrupted access to appointments (eg, visiting their doctor or an outpatient department) and procedures (eg, surgery, cancer treatment), positive associations were found with measures of avoidable hospital admissions. CONCLUSIONS Evidence from linked individual level data shows that people whose access to healthcare was disrupted were more likely to have a potentially preventable hospital admission. The findings highlight the need to increase healthcare investment to tackle the short and long term implications of the pandemic, and to protect treatments and procedures during future pandemics.
Collapse
Affiliation(s)
- Mark A Green
- Geographic Data Science Lab, Department of Geography & Planning, University of Liverpool, Liverpool, UK
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Olivia Kl Hamilton
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Richard J Shaw
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - John Macleod
- Population Health Sciences, University of Bristol, Bristol, UK
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Andy Boyd
- Population Health Sciences, University of Bristol, Bristol, UK
| | | |
Collapse
|
16
|
Jolugbo P, Willott T, Lin WH, Maisey T, O'Callaghan D, Green MA, Jayne DG, Khot MI. Fluorescent imaging using novel conjugated polymeric nanoparticles-affimer probes in complex in vitro models of colorectal cancer. Nanoscale 2023. [PMID: 37466243 DOI: 10.1039/d3nr02160b] [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] [Indexed: 07/20/2023]
Abstract
We developed a carcinoembryonic antigen (CEA) conjugated polymer nanoparticle (CPN510-CEA-Af) probe to target CEA-expressing CRC cells in vitro. Its efficacy was evaluated in 2D and 3D cultures of LS174T, LoVo, and HT29 CRC cell lines. CPN510-CEA-Af produced greater fluorescent signal intensity than unconjugated particles in both 2D cells and 3D spheriods, indicating its potential as a probe for image-guided colorectal cancer surgery.
Collapse
Affiliation(s)
- Precious Jolugbo
- Leeds Institute of Medical Research at St James', School of Medicine, St James University Hospital, University of Leeds, Leeds, LS9 7TF, UK.
| | - Thomas Willott
- Leeds Institute of Medical Research at St James', School of Medicine, St James University Hospital, University of Leeds, Leeds, LS9 7TF, UK.
| | - Wei-Hsiang Lin
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, M13 9PL, UK
| | - Thomas Maisey
- Leeds Institute of Medical Research at St James', School of Medicine, St James University Hospital, University of Leeds, Leeds, LS9 7TF, UK.
| | | | - Mark A Green
- Stream Bio Ltd, Alderley Park, Nether Alderley, Cheshire, SK10 4TG, UK
- Department of Physics, Faculty of Natural, Mathematical & Engineering Sciences, King's College London, Strand, London, WC2R 2LS, UK
| | - David G Jayne
- Leeds Institute of Medical Research at St James', School of Medicine, St James University Hospital, University of Leeds, Leeds, LS9 7TF, UK.
| | - M Ibrahim Khot
- Leeds Institute of Medical Research at St James', School of Medicine, St James University Hospital, University of Leeds, Leeds, LS9 7TF, UK.
| |
Collapse
|
17
|
Smith NJ, Deaton TK, Territo W, Graner B, Gauger A, Snyder SE, Schulte ML, Green MA, Hutchins GD, Veronesi MC. Hybrid 18F-Fluoroethyltyrosine PET and MRI with Perfusion to Distinguish Disease Progression from Treatment-Related Change in Malignant Brain Tumors: The Quest to Beat the Toughest Cases. J Nucl Med 2023; 64:1087-1092. [PMID: 37116915 PMCID: PMC10315704 DOI: 10.2967/jnumed.122.265149] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/16/2023] [Indexed: 04/30/2023] Open
Abstract
Conventional MRI has important limitations when assessing for progression of disease (POD) versus treatment-related changes (TRC) in patients with malignant brain tumors. We describe the observed impact and pitfalls of implementing 18F-fluoroethyltyrosine (18F-FET) perfusion PET/MRI into routine clinical practice. Methods: Through expanded-access investigational new drug use of 18F-FET, hybrid 18F-FET perfusion PET/MRI was performed during clinical management of 80 patients with World Health Organization central nervous system grade 3 or 4 gliomas or brain metastases of 6 tissue origins for which the prior brain MRI results were ambiguous. The diagnostic performance with 18F-FET PET/MRI was dually evaluated within routine clinical service and for retrospective parametric evaluation. Various 18F-FET perfusion PET/MRI parameters were assessed, and patients were monitored for at least 6 mo to confirm the diagnosis using pathology, imaging, and clinical progress. Results: Hybrid 18F-FET perfusion PET/MRI had high overall accuracy (86%), sensitivity (86%), and specificity (87%) for difficult diagnostic cases for which conventional MRI accuracy was poor (66%). 18F-FET tumor-to-brain ratio static metrics were highly reliable for distinguishing POD from TRC (area under the curve, 0.90). Dynamic tumor-to-brain intercept was more accurate (85%) than SUV slope (73%) or time to peak (73%). Concordant PET/MRI findings were 89% accurate. When PET and MRI conflicted, 18F-FET PET was correct in 12 of 15 cases (80%), whereas MRI was correct in 3 of 15 cases (20%). Clinical management changed after 88% (36/41) of POD diagnoses, whereas management was maintained after 87% (34/39) of TRC diagnoses. Conclusion: Hybrid 18F-FET PET/MRI positively impacted the routine clinical care of challenging malignant brain tumor cases at a U.S. institution. The results add to a growing body of literature that 18F-FET PET complements MRI, even rescuing MRI when it fails.
Collapse
Affiliation(s)
- Nathaniel J Smith
- School of Medicine, Indiana University, Indianapolis, Indiana
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana; and
| | | | - Wendy Territo
- School of Medicine, Indiana University, Indianapolis, Indiana
| | - Brian Graner
- School of Medicine, Indiana University, Indianapolis, Indiana
| | - Andrew Gauger
- School of Medicine, Indiana University, Indianapolis, Indiana
| | - Scott E Snyder
- School of Medicine, Indiana University, Indianapolis, Indiana
| | | | - Mark A Green
- School of Medicine, Indiana University, Indianapolis, Indiana
| | - Gary D Hutchins
- School of Medicine, Indiana University, Indianapolis, Indiana
| | | |
Collapse
|
18
|
Watson J, Green MA, Giebel C, Darlington-Pollock F, Akpan A. Social and spatial inequalities in healthcare use among people living with dementia in England (2002-2016). Aging Ment Health 2023; 27:1476-1487. [PMID: 35959941 PMCID: PMC9612936 DOI: 10.1080/13607863.2022.2107176] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/18/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Healthcare services for people living with dementia (PLWD) are stretched, and government promises of increased funding remain undelivered. With the UK dementia population to surpass 1 million by 2024, and dementia care costs predicted to almost treble by 2040, it is essential we understand differences in healthcare use among PLWD. This study aimed to explore social and spatial variations in healthcare use among people diagnosed with dementia (2002-2016). METHODS Data were derived from Electronic Health Records of Clinical Practice Research Datalink GP patients in England (n = 142,302). To standardise healthcare contacts, rates of healthcare contacts per year were calculated for three primary (GP observations and medications) and three secondary healthcare types [Accident & Emergency (A&E) attendances and, emergency and elective hospital admissions]. Fully-adjusted generalised linear regression models were used to identify healthcare use variation by social and spatial groups. Twelve models were generated, one for each healthcare type in early- and late-onset populations separately. RESULTS This study highlights numerous social and spatial variations in healthcare use among PLWD. Among PLWD, several groups tended to have healthcare service use more closely associated with negative outcomes, including a greater likelihood of A&E attendances and emergency and elective hospital admissions. These groups include: men, people from White ethnicity groups and people from more deprived and rural areas. CONCLUSIONS Systemic and social measures are needed to reduce variations in healthcare use inequalities in PWLD. These include greater healthcare continuity, health checks and medicines reviews, culturally appropriate services, better and more accessible treatment and improved infrastructure.
Collapse
Affiliation(s)
- James Watson
- School of Environmental Sciences, The University of Liverpool, Liverpool, United Kingdom
| | - Mark A. Green
- School of Environmental Sciences, The University of Liverpool, Liverpool, United Kingdom
| | - Clarissa Giebel
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom
- NIHR ARC NWC, Liverpool, United Kingdom
| | | | - Asangaedem Akpan
- Department of Medicine for Older People and Stroke, Liverpool University Hospitals NHS FT, Liverpool, United Kingdom
- Healthy Ageing Group, University of Cumbria, Cumbria, United Kingdom
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
- NIHR CRN NWC, Liverpool, United Kingdom
| |
Collapse
|
19
|
Green MA, Ritchie C, Flanagan S, Nuzzi L, Padwa BL. Prognosis of Maxillary Central Incisors in Patients with Bilateral Cleft Lip/Palate. Cleft Palate Craniofac J 2023:10556656231175337. [PMID: 37160755 DOI: 10.1177/10556656231175337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
Evaluate periodontal bone support of maxillary central incisors (MCI) in patients with bilateral complete cleft lip and palate (BCCLP). Determine if syndromic diagnosis, age at time of alveolar bone graft (ABG), presence of maxillary lateral incisor (MLI), history of dentofacial orthopedics, maxillary expansion, and pre-maxillary osteotomy are associated with the periodontal bone support of MCI. Retrospective radiographic study. Tertiary care children's hospital. One hundred seventy-nine patients with BCCLP (22 syndromic) who had post-operative ABG cone beam computed tomography (CBCT) scans taken between 2002-2018. Crown to root (C/R) ratio of MCI measured on CBCT scans. The C/R ratio in 65% of MCI indicated periodontally compromised teeth. Presence of a MLI improved bone support on adjacent MCI when compared to those missing a MLI (51.4% vs 28.4%, P = .010). There was no significant difference in C/R ratios for syndromic diagnosis, age at ABG, history of dentofacial orthopedics, maxillary expansion, and pre-maxillary osteotomy. The majority of MCI in patients with BCCLP are periodontally compromised but bone support is improved when cleft adjacent lateral incisors are present.
Collapse
Affiliation(s)
- Mark A Green
- Department of Plastic and Oral Surgery, Harvard School of Dental Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Collin Ritchie
- Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sarah Flanagan
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Laura Nuzzi
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Bonnie L Padwa
- Department of Plastic and Oral Surgery, Harvard School of Dental Medicine, Boston Children's Hospital, Boston, MA, USA
| |
Collapse
|
20
|
Clegg ME, Methven L, Lanham-New SA, Green MA, Duggal NA, Hetherington MM. The Food4Years Ageing Network: Improving foods and diets as a strategy for supporting quality of life, independence and healthspan in older adults. NUTR BULL 2023; 48:124-133. [PMID: 36718711 PMCID: PMC10946951 DOI: 10.1111/nbu.12599] [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: 04/29/2022] [Revised: 11/20/2022] [Accepted: 11/28/2022] [Indexed: 02/01/2023]
Abstract
By 2050, it is predicted that one in four people in the United Kingdom will be aged 65 years and over. Increases in lifespan are not always translated into years spent in good health. Incidence rates for chronic diseases are increasing, with treatments allowing people to live longer with their disease. There is good evidence to support changes to lifestyle to maintain or improve body composition, cognitive health, musculoskeletal health, immune function and vascular health in older adults. Much research has been done in this area, which has produced significant support for foods and nutrients that contribute to improved healthspan. Yet two major barriers remain: firstly, older adult consumers are not meeting current UK recommendations for macro- and micronutrients that could benefit health and quality of life and secondly, the UK-specific recommendations may not be sufficient to support the ageing population, particularly for nutrients with key physiological roles. More work is needed to improve intakes of specific foods, diets and nutrients by older adults, through a variety of mechanisms including (i) development of specific food products; (ii) improved clarity of information and (iii) appropriate marketing, and policy changes to enable incentives. The Food4Years Ageing Network aims to build a wide-reaching and multidisciplinary community that is committed to the development, integration and communication of healthy, affordable foods and specific diets for all older adults across the UK food landscape. The Network will identify evidence-based strategies for improving food intake and nutrition in older adults, paving the way to "living well while living longer."
Collapse
Affiliation(s)
- Miriam E Clegg
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - Lisa Methven
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - Susan A Lanham-New
- Nutritional Sciences Department, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Surrey, UK
| | - Mark A Green
- Department of Geography and Planning, University of Liverpool, Liverpool, UK
| | - Niharika A Duggal
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | | |
Collapse
|
21
|
Flanagan SG, Green MA. Is Preoperative Urine Human Chorionic Gonadotropin (hCG) Testing Necessary for Pediatric Patients Before Oral and Maxillofacial Surgery Procedures With Sedation? J Oral Maxillofac Surg 2023; 81:150-155. [PMID: 36462536 DOI: 10.1016/j.joms.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 11/07/2022] [Accepted: 11/07/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE Human chorionic gonadotropin (hCG) testing is performed prior to surgical procedures to ensure patient and fetal safety. The purpose of this study was to evaluate the utility of routine pregnancy testing prior to elective outpatient oral and maxillofacial surgery procedures being performed with intravenous sedation (IVS). METHODS A retrospective cohort study was implemented assessing hCG testing in postmenarche females who underwent elective outpatient oral surgery procedures scheduled with IVS at a tertiary care institution. Medical records were used to identify eligible subjects aged 12 to 45 years. The primary predictor variable was age, and the primary outcome variable was urine hCG test result. Age was divided into groups to reflect early adolescence (12 to 14 years), mid-adolescence (15 to 17 years), late adolescence/early adulthood (18 to 24 years) and adulthood (25+ years). Secondary outcome variables included inability to void for hCG testing, change in anesthetic, case cancellation or rescheduling and were measured over a 2 year period. Descriptive statistics were performed. Relative risk (RR) and Cochran-Armitage test for trend were calculated to determine the statistical significance of age on inability to void. RESULTS The sample consisted of 5,006 females, with a median age (IQR, range) of 18.0 (3.6, 12.0 to 43.6) years. There was one positive urine hCG result providing a preoperative pregnancy rate of 0.02%. Fourteen of 1,195 subjects (1.2%) over a 2 year period were unable to provide a urine hCG sample. There was a statistically significant trend in inability to void as age groups got older (P = .001). Patients aged 12 to 17 years had an increased risk of being unable to void compared to patients 18 years and older (RR: 14.30, 95% CI: 1.88 to 108.99, P = .01). The total cost of testing over the 11 year observation period was $9,019.59. CONCLUSIONS The risk of surgical cancellations and delayed care due to patients' inability to void preoperatively plus a lack of any positive preoperative urine hCG findings in patients under 18 years of age in this study, call into question the necessity of routine preoperative hCG screening in pediatric patients presenting for IVS for elective outpatient oral and maxillofacial procedures.
Collapse
Affiliation(s)
- Sarah G Flanagan
- Clinical Research Assistant, Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA
| | - Mark A Green
- Instructor, Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, MA; Oral and Maxillofacial Surgeon, Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA.
| |
Collapse
|
22
|
Green MA, Semple MG. Occupational inequalities in the prevalence of COVID-19: A longitudinal observational study of England, August 2020 to January 2021. PLoS One 2023; 18:e0283119. [PMID: 37018176 PMCID: PMC10075431 DOI: 10.1371/journal.pone.0283119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 03/02/2023] [Indexed: 04/06/2023] Open
Abstract
The COVID-19 pandemic has reinforced, amplified and created new health inequalities. Examining how COVID-19 prevalence varies by measures of work and occupation may help to understand these inequalities. The aim of the study is to evaluate how occupational inequalities in the prevalence of COVID-19 varies across England and their possible explanatory factors. We used data for 363,651 individuals (2,178,835 observations) aged 18 years and over between 1st May 2020 and 31st January 2021 from the Office for National Statistics Covid Infection Survey, a representative longitudinal survey of individuals in England. We focus on two measures of work; employment status for all adults, and work sector of individuals currently working. Multi-level binomial regression models were used to estimate the likelihood of testing positive of COVID-19, adjusting for known explanatory covariates. 0.9% of participants tested positive for COVID-19 over the study period. COVID-19 prevalence was higher among adults who were students or furloughed (i.e., temporarily not working). Among adults currently working, COVID-19 prevalence was highest in adults employed in the hospitality sector, with higher prevalence for individuals employed in transport, social care, retail, health care and educational sectors. Inequalities by work were not consistent over time. We find an unequal distribution of infections relating to COVID-19 by work and employment status. While our findings demonstrate the need for greater workplace interventions to protect employees tailored to their specific work sector needs, focusing on employment alone ignores the importance of SARS-CoV-2 transmission outside of employed work (i.e., furloughed and student populations).
Collapse
Affiliation(s)
- Mark A Green
- Department of Geography & Planning, University of Liverpool, Liverpool, United Kingdom
| | - Malcolm G Semple
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| |
Collapse
|
23
|
Bahler CD, Green MA, Tann MA, Swensson JK, Collins K, Alexoff D, Kung H, Brocken E, Mathias CJ, Cheng L, Hutchins GD, Koch MO. Assessing extra-prostatic extension for surgical guidance in prostate cancer: Comparing two PSMA-PET tracers with the standard-of-care. Urol Oncol 2023; 41:48.e1-48.e9. [PMID: 36333187 DOI: 10.1016/j.urolonc.2022.10.003] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/20/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Incontinence and impotence occur following radical prostatectomy due to injury to nerves and sphincter muscle. Preserving nerves and muscle adjacent to prostate cancer risks positive surgical margins. Advanced imaging with MRI has improved cancer localization but limitations exist. OBJECTIVE To measure the accuracy for assessing extra-prostatic extension at nerve bundles for 2 PSMA-PET tracers and to compare the PET accuracy to standard-of-care predictors including MRI and biopsy results. MATERIALS AND METHODS We studied men with PSMA-targeted PET imaging, performed prior to prostatectomy in men largely with intermediate to high-risk prostate cancer, and retrospectively evaluated for assessment of extra-prostatic extension with whole-mount analysis as reference standard. Two different PSMA-PET tracers were included: 68Ga-PSMA-11 and 68Ga-P16-093. Blinded reviews of the PET and MRI scans were performed to assess extra-prostatic extension (EPE). Sensitivity and specificity for extra-prostatic extension were compared using McNemar's Chi2. RESULTS Pre-operative PSMA-PET imaging was available for 71 patients with either 68Ga-P16-093 (n = 25) or 68Ga-PSMA-11 (n = 46). There were 24 (34%) with pT3a (EPE) and 16 (23%) with pT3b (SVI). EPE Sensitivity (87% vs. 92%), Specificity (77% vs. 76%), and ROC area (0.82 vs. 0.84) were similar between P16-093 and PSMA-11, respectively (P = 0.87). MRI (available in only 45) found high specificity (83%) but low sensitivity (60%) for EPE when using a published grading system. MRI sensitivity was significantly lower than the PSMA-PET (60% vs. 90%, P = 0.02), but similar to PET when using a >5 mm capsular contact (76% vs. 90%, P = 0.38). A treatment change to "nerve sparing" was recommended in 21 of 71 (30%) patients based on PSMA-PET imaging. CONCLUSIONS Presurgical PSMA-PET appeared useful as a tool for surgical planning, changing treatment plans in men with ≥4+3 or multi-core 3+4 prostate cancer resulting in preservation of nerve-bundles.
Collapse
Affiliation(s)
| | - Mark A Green
- Indiana University, Department of Radiology and Imaging Sciences, Indianapolis, IN
| | - Mark A Tann
- Indiana University, Department of Radiology and Imaging Sciences, Indianapolis, IN
| | | | - Katrina Collins
- Indiana University, Department of Pathology, Indianapolis, IN
| | | | - Hank Kung
- University of Pennsylvania, Department of Radiology, Philadelphia, PA
| | - Eric Brocken
- Indiana University, Department of Pathology, Indianapolis, IN
| | - Carla J Mathias
- Indiana University, Department of Radiology and Imaging Sciences, Indianapolis, IN
| | - Liang Cheng
- Indiana University, Department of Pathology, Indianapolis, IN
| | - Gary D Hutchins
- Indiana University, Department of Radiology and Imaging Sciences, Indianapolis, IN
| | - Michael O Koch
- Indiana University, Department of Urology, Indianapolis, IN
| |
Collapse
|
24
|
Green MA, Hungerford DJ, Hughes DM, Garcia-Fiñana M, Turtle L, Cheyne C, Ashton M, Leeming G, Semple MG, Singleton A, Buchan I. Changing patterns of SARS-CoV-2 infection through Delta and Omicron waves by vaccination status, previous infection and neighbourhood deprivation: a cohort analysis of 2.7 M people. BMC Infect Dis 2022; 22:889. [PMID: 36435775 PMCID: PMC9701390 DOI: 10.1186/s12879-022-07878-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 11/14/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Our study examines if SARS-CoV-2 infections varied by vaccination status, if an individual had previously tested positive and by neighbourhood socioeconomic deprivation across the Delta and Omicron epidemic waves of SARS-CoV-2. METHODS Population cohort study using electronic health records for 2.7 M residents in Cheshire and Merseyside, England (3rd June 2021 to 1st March 2022). Our outcome variable was registered positive test for SARS-CoV-2. Explanatory variables were vaccination status, previous registered positive test and neighbourhood socioeconomic deprivation. Cox regression models were used to analyse associations. RESULTS Originally higher SARS-CoV-2 rates in the most socioeconomically deprived neighbourhoods changed to being higher in the least deprived neighbourhoods from the 1st September 2021, and were inconsistent during the Omicron wave. Individuals who were fully vaccinated (two doses) were associated with fewer registered positive tests (e.g., individuals engaged in testing between 1st September and 27th November 2021-Hazards Ratio (HR) = 0.48, 95% Confidence Intervals (CIs) = 0.47-0.50. Individuals with a previous registered positive test were also less likely to have a registered positive test (e.g., individuals engaged in testing between 1st September and 27th November 2021-HR = 0.16, 95% CIs = 0.15-0.18. However, the Omicron period saw smaller effect sizes for both vaccination status and previous registered positive test. CONCLUSIONS Changing patterns of SARS-CoV-2 infections during the Delta and Omicron waves reveals a dynamic pandemic that continues to affect diverse communities in sometimes unexpected ways.
Collapse
Affiliation(s)
- Mark A Green
- Department of Geography and Planning, University of Liverpool, Liverpool, UK.
| | - Daniel J Hungerford
- Centre for Global Vaccine Research, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, L69 7BE, UK
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, L69 7BE, UK
| | - David M Hughes
- Department of Health Data Science, University of Liverpool, Liverpool, UK
| | | | - Lance Turtle
- Centre for Global Vaccine Research, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, L69 7BE, UK
| | - Christopher Cheyne
- Department of Health Data Science, University of Liverpool, Liverpool, UK
| | | | - Gary Leeming
- Civic Data Cooperative, University of Liverpool, Liverpool, UK
| | - Malcolm G Semple
- Centre for Global Vaccine Research, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Alex Singleton
- Department of Geography and Planning, University of Liverpool, Liverpool, UK
| | - Iain Buchan
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, L69 7BE, UK
- Civic Data Cooperative, University of Liverpool, Liverpool, UK
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| |
Collapse
|
25
|
Bourke S, Donà F, Teijeiro Gonzalez Y, Qazi Chaudhry B, Panamarova M, Mackay E, Zammit PS, Dailey LA, Eggert US, Suhling K, Green MA. Biocompatible Magnetic Conjugated Polymer Nanoparticles for Optical and Lifetime Imaging Applications in the First Biological Window. ACS Appl Polym Mater 2022; 4:8193-8202. [PMID: 36405304 PMCID: PMC9667460 DOI: 10.1021/acsapm.2c01153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
Conjugated polymers are organic semiconductors that can be used for fluorescence microscopy of living specimens. Here, we report the encapsulation of the bright-red-emitting conjugated polymer, poly[{9,9-dihexyl-2,7-bis(1-cyanovinylene)fluorenylene}-alt-co-{2,5-bis(N,N'-diphenylamino)-1,4-phenylene}] (CN-FO-DPD), and superparamagnetic iron oxide nanoparticles (SPIONs) within poly(styrene-co-maleic anhydride) (PSMA) micelles. The resulting particles exhibited an emission peak at 657 nm, a fluorescence quantum yield of 21%, an average diameter of 65 nm, and a ζ potential of -30 mV. They are taken up by cells, and we describe their use in fluorescence microscopy of living Hela cells and zebrafish embryos and their associated cytotoxicity in HEK, HeLa, and HCE cells.
Collapse
Affiliation(s)
- Struan Bourke
- Department
of Physics, King′s College London, London WC2R 2LS, U.K.
| | - Federico Donà
- Randall
Centre for Cell and Molecular Biophysics, Faculty of Life Sciences
and Medicine, King’s College London, London SE1 1UL, U.K.
| | | | | | - Maryna Panamarova
- Randall
Centre for Cell and Molecular Biophysics, Faculty of Life Sciences
and Medicine, King’s College London, London SE1 1UL, U.K.
| | - Eirinn Mackay
- Department
of Cell and Developmental Biology, University
College London, Gower Street, London WC1E
6BT, U.K.
| | - Peter S. Zammit
- Randall
Centre for Cell and Molecular Biophysics, Faculty of Life Sciences
and Medicine, King’s College London, London SE1 1UL, U.K.
| | - Lea Ann Dailey
- Department
of Pharmaceutical Technology and Biopharmaceutics, University of Vienna, Universitätsring 1, 1010 Vienna, Austria
| | - Ulrike S. Eggert
- Randall
Centre for Cell and Molecular Biophysics, Faculty of Life Sciences
and Medicine, King’s College London, London SE1 1UL, U.K.
| | - Klaus Suhling
- Department
of Physics, King′s College London, London WC2R 2LS, U.K.
| | - Mark A. Green
- Department
of Physics, King′s College London, London WC2R 2LS, U.K.
| |
Collapse
|
26
|
Wanjohi MN, Pradeilles R, Asiki G, Holdsworth M, Kimani-Murage EW, Muthuri SK, Irache A, Laar A, Zotor F, Tandoh A, Klomegah S, Graham F, Osei-Kwasi HA, Green MA, Coleman N, Mensah K, Akparibo R, Aryeteey R, Rousham EK, Bricas N, Bohr M, Griffiths P. Community perceptions on the factors in the social food environment that influence dietary behaviour in cities of Kenya and Ghana: a Photovoice study. Public Health Nutr 2022; 26:1-13. [PMID: 36305344 PMCID: PMC9989710 DOI: 10.1017/s1368980022002270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/08/2022] [Accepted: 10/04/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To explore communities' perspectives on the factors in the social food environment that influence dietary behaviours in African cities. DESIGN A qualitative study using participatory photography (Photovoice). Participants took and discussed photographs representing factors in the social food environment that influence their dietary behaviours. Follow-up in-depth interviews allowed participants to tell the 'stories' of their photographs. Thematic analysis was conducted, using data-driven and theory-driven (based on the socio-ecological model) approaches. SETTING Three low-income areas of Nairobi (n 48) in Kenya and Accra (n 62) and Ho (n 32) in Ghana. PARTICIPANTS Adolescents and adults, male and female aged ≥13 years. RESULTS The 'people' who were most commonly reported as influencers of dietary behaviours within the social food environment included family members, friends, health workers and food vendors. They mainly influenced food purchase, preparation and consumption, through (1) considerations for family members' food preferences, (2) considerations for family members' health and nutrition needs, (3) social support by family and friends, (4) provision of nutritional advice and modelling food behaviour by parents and health professionals, (5) food vendors' services and social qualities. CONCLUSIONS The family presents an opportunity for promoting healthy dietary behaviours among family members. Peer groups could be harnessed to promote healthy dietary behaviours among adolescents and youth. Empowering food vendors to provide healthier and safer food options could enhance healthier food sourcing, purchasing and consumption in African low-income urban communities.
Collapse
Affiliation(s)
- Milkah N Wanjohi
- Maternal and Child Wellbeing Unit, African Population and Health Research Center, P.O Box 01787-00100, Nairobi, Kenya
| | - Rebecca Pradeilles
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, Loughborough, UK
| | - Gershim Asiki
- Health and Systems for Health Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri-food systems), (Université Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institute Agro, IRD), Montpellier, France
| | - Elizabeth W Kimani-Murage
- Maternal and Child Wellbeing Unit, African Population and Health Research Center, P.O Box 01787-00100, Nairobi, Kenya
| | - Stella K Muthuri
- Population Dynamics and Reproductive Health Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Ana Irache
- Warwick Center for Applied Health Research and Delivery, Warwick Medical School, University of Warwick, Coventry, UK
| | - Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Francis Zotor
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Akua Tandoh
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Senam Klomegah
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Fiona Graham
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | | | - Mark A Green
- Department of Geography & Planning, University of Liverpool, Liverpool, UK
| | - Nathaniel Coleman
- Department of Obstetrics and Gynaecology, University of Ghana Medical School, Korle Bu, Accra, Ghana
| | - Kobby Mensah
- Department of Marketing and Entrepreneurship, University of Ghana Business School, Legon, Accra, Ghana
| | - Robert Akparibo
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Richmond Aryeteey
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Emily K Rousham
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, Loughborough, UK
| | - Nicolas Bricas
- French Agricultural Research Centre for International Development (CIRAD), Montpellier Cedex 5, France
| | - Marco Bohr
- School of Art and Design, Nottingham Trent University, Nottingham, UK
| | - Paula Griffiths
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, Loughborough, UK
| |
Collapse
|
27
|
Hunter RF, Rodgers SE, Hilton J, Clarke M, Garcia L, Ward Thompson C, Geary R, Green MA, O'Neill C, Longo A, Lovell R, Nurse A, Wheeler BW, Clement S, Porroche-Escudero A, Mitchell R, Barr B, Barry J, Bell S, Bryan D, Buchan I, Butters O, Clemens T, Clewley N, Corcoran R, Elliott L, Ellis G, Guell C, Jurek-Loughrey A, Kee F, Maguire A, Maskell S, Murtagh B, Smith G, Taylor T, Jepson R. GroundsWell: Community-engaged and data-informed systems transformation of Urban Green and Blue Space for population health - a new initiative. Wellcome Open Res 2022; 7:237. [PMID: 36865374 PMCID: PMC9971655 DOI: 10.12688/wellcomeopenres.18175.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 11/20/2022] Open
Abstract
Natural environments, such as parks, woodlands and lakes, have positive impacts on health and wellbeing. Urban Green and Blue Spaces (UGBS), and the activities that take place in them, can significantly influence the health outcomes of all communities, and reduce health inequalities. Improving access and quality of UGBS needs understanding of the range of systems (e.g. planning, transport, environment, community) in which UGBS are located. UGBS offers an ideal exemplar for testing systems innovations as it reflects place-based and whole society processes , with potential to reduce non-communicable disease (NCD) risk and associated social inequalities in health. UGBS can impact multiple behavioural and environmental aetiological pathways. However, the systems which desire, design, develop, and deliver UGBS are fragmented and siloed, with ineffective mechanisms for data generation, knowledge exchange and mobilisation. Further, UGBS need to be co-designed with and by those whose health could benefit most from them, so they are appropriate, accessible, valued and used well. This paper describes a major new prevention research programme and partnership, GroundsWell, which aims to transform UGBS-related systems by improving how we plan, design, evaluate and manage UGBS so that it benefits all communities, especially those who are in poorest health. We use a broad definition of health to include physical, mental, social wellbeing and quality of life. Our objectives are to transform systems so that UGBS are planned, developed, implemented, maintained and evaluated with our communities and data systems to enhance health and reduce inequalities. GroundsWell will use interdisciplinary, problem-solving approaches to accelerate and optimise community collaborations among citizens, users, implementers, policymakers and researchers to impact research, policy, practice and active citizenship. GroundsWell will be shaped and developed in three pioneer cities (Belfast, Edinburgh, Liverpool) and their regional contexts, with embedded translational mechanisms to ensure that outputs and impact have UK-wide and international application.
Collapse
Affiliation(s)
- Ruth F. Hunter
- Centre for Public Health, Queen's University Belfast, Belfast, UK,
| | - Sarah E. Rodgers
- Department of Public Health, Policy & Systems, University of Liverpool, Liverpool, UK,
| | - Jeremy Hilton
- School of Defence and Security, Cranfield University, Bedfordshire, UK
| | - Mike Clarke
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Leandro Garcia
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Rebecca Geary
- Department of Public Health, Policy & Systems, University of Liverpool, Liverpool, UK
| | - Mark A. Green
- Department of Geography & Planning, University of Liverpool, Liverpool, UK
| | - Ciaran O'Neill
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Alberto Longo
- School of Biological Sciences, Queen's University Belfast, Belfast, UK
| | - Rebecca Lovell
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK
| | - Alex Nurse
- Department of Geography & Planning, University of Liverpool, Liverpool, UK
| | - Benedict W. Wheeler
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK
| | - Sarah Clement
- Department of Geography and Planning, University of Western Australia, Perth, Australia
| | | | - Rich Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Ben Barr
- Department of Public Health, Policy & Systems, University of Liverpool, Liverpool, UK
| | - John Barry
- School of History, Anthropology, Philosophy and Politics, Queen's University Belfast, Belfast, UK
| | - Sarah Bell
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK
| | - Dominic Bryan
- School of History, Anthropology, Philosophy and Politics, Queen's University Belfast, Belfast, UK
| | - Iain Buchan
- Department of Public Health, Policy & Systems, University of Liverpool, Liverpool, UK
| | - Olly Butters
- Department of Public Health, Policy & Systems, University of Liverpool, Liverpool, UK
| | - Tom Clemens
- School of Geosciences, University of Edinburgh, Edinburgh, UK
| | - Natalie Clewley
- School of Defence and Security, Cranfield University, Bedfordshire, UK
| | - Rhiannon Corcoran
- Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Lewis Elliott
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK
| | - Geraint Ellis
- School of Natural and Built Environment, Queen's University Belfast, Belfast, UK
| | - Cornelia Guell
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK
| | - Anna Jurek-Loughrey
- School of Electronics, Electrical Engineering and Computer Science, Queen's University Belfast, Belfast, UK
| | - Frank Kee
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Aideen Maguire
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Simon Maskell
- Electrical Engineering and Electronics, University of Liverpool, Liverpool, UK
| | - Brendan Murtagh
- School of Natural and Built Environment, Queen's University Belfast, Belfast, UK
| | - Grahame Smith
- Nursing and Allied Health, Liverpool John Moores University, Liverpool, UK
| | - Timothy Taylor
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK
| | - Ruth Jepson
- Scottish Collaboration for Public Health Research and Policy (SCPHRP), University of Edinburgh, Edinburgh, UK,
| | | |
Collapse
|
28
|
Jackson LR, Masi MR, zarrinmayeh H, Das SK, Green MA, Snyder SE, Wang N, Pollok K, Hutchins GD, Butch ER, Veronesi MC. Abstract 1661: Development of a patient-derived glioblastoma model in the transgenic Rag2 Null rat: In vivo imaging, histology, and combination therapy assessment. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-1661] [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
Abstract
An important obstacle to translating promising drug treatments against glioblastoma (GBM) to the clinic is lack of resistant GBM animal models that more accurately parallel the clinical course of GBM drug resistance found in patients.
In this project, a recurrent patient derived intracranial GBM tumor model (GB10) was developed for the first time in the novel Rag2 Null transgenic rat to establish a reproducible preclinical brain tumor model. Histologic characterization confirmed markers of high nuclear proliferation (30% Ki67) and presence of neovascularity (3% Von Willebrand Factor VIII) in all tumors. Serial in vivo imaging was performed to determine a clinically relevant late stage of tumor across all rats before initiation of treatment, accounting for heterogeneity of tumor size and growth rate characteristics. Overall survival was measured following oral administration of control, Temozolomide (TMZ), or combination therapy with TMZ and Idasanutlin.
Eighteen Rag2 Null rats were intracranially implanted with GB10, a well characterized, recurrent cell line from the Mayo Clinic Brain Tumor Patient-Derived Xenograft National Resource. Bi-weekly high resolution, 2-dimensional T2 magnetic resonance imaging (2DT2 MRI) was performed on a Bruker 9.4 tesla scanner until tumor volume reached 30 µL. 14 days later, simultaneous positron emission tomography and magnetic resonance imaging (PET MRI) was performed on each rat with three dimensional T1 post-contrast (3DT1 CE), amino acid-based 18F-Flouroethyltyrosine (18F-FET), and amide proton transfer-chemical exchange saturation transfer (amide-CEST). Measured tumor parameters included volumetry (3DT1 CE), metabolic activity (18F-FET), and mobile phase intracellular protein content (amide-CEST), to confirm late-stage viable tumors of similar size (15.3 mm^2 +/-1.38 based on SEM, N=16) and metabolism (2:1 ratio of activity of tumor relative to contralateral control brain tissue). Two rats were removed: 1 died prematurely of infection and 1 had extra-axial tumor location.
Oral treatment groups were as follows: Control (N= 5), TMZ (N=6) or TMZ + Idasanutlin (N=5). Kaplan Meier survival curves for the TMZ treated group (80.2+/-4.1 days) and combined TMZ + Idasanutlin group (93.8+/-6.2 days) were both significantly increased (P<0.001) compared to control (67.4+/-4.5 days). Survival for the TMZ + Idasanutlin treated group was also significantly increased (P<0.001) relative to TMZ treated group indicating efficacy of combination therapy.
In conclusion, a robust, resistant, patient derived GBM animal model was developed using serial, high field, non-invasive, multimodality, molecular imaging along with histopathologic analysis. Feasibility of assessing treatment response was also demonstrated with both a standard of care and experimental combination therapy, in the late stage of GBM growth.
Citation Format: Luke R. Jackson, Megan R. Masi, Hamideh zarrinmayeh, Sudip K. Das, Mark A. Green, Scott E. Snyder, Nian Wang, Karen Pollok, Gary D. Hutchins, Elizabeth R. Butch, Michael C. Veronesi. Development of a patient-derived glioblastoma model in the transgenic Rag2 Null rat: In vivo imaging, histology, and combination therapy assessment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1661.
Collapse
Affiliation(s)
| | - Megan R. Masi
- 1Indiana University School of Medicine, Indianapolis, IN
| | | | - Sudip K. Das
- 1Indiana University School of Medicine, Indianapolis, IN
| | - Mark A. Green
- 1Indiana University School of Medicine, Indianapolis, IN
| | | | - Nian Wang
- 1Indiana University School of Medicine, Indianapolis, IN
| | - Karen Pollok
- 1Indiana University School of Medicine, Indianapolis, IN
| | | | | | | |
Collapse
|
29
|
Zhang X, Owen G, Green MA, Buchan I, Barr B. Evaluating the impacts of tiered restrictions introduced in England, during October and December 2020 on COVID-19 cases: a synthetic control study. BMJ Open 2022; 12:e054101. [PMID: 35414548 PMCID: PMC9006191 DOI: 10.1136/bmjopen-2021-054101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To analyse the impact on SARS-CoV-2 transmission of tier 3 restrictions introduced in October and December 2020 in England, compared with tier 2 restrictions. We further investigate whether these effects varied between small areas by deprivation. DESIGN Synthetic control analysis. SETTING We identified areas introducing tier 3 restrictions in October and December, constructed a synthetic control group of places under tier 2 restrictions and compared changes in weekly infections over a 4-week period. Using interaction analysis, we estimated whether this effect varied by deprivation and the prevalence of a new variant (B.1.1.7). INTERVENTIONS In both October and December, no indoor between-household mixing was permitted in either tier 2 or 3. In October, no between-household mixing was permitted in private gardens and pubs and restaurants remained open only if they served a 'substantial meal' in tier 3, while in tier 2 meeting with up to six people in private gardens were allowed and all pubs and restaurants remained open. In December, in tier 3, pubs and restaurants were closed, while in tier 2, only those serving food remained open. The differences in restrictions between tier 2 and 3 on meeting outside remained the same as in October. MAIN OUTCOME MEASURE Weekly reported cases adjusted for changing case detection rates for neighbourhoods in England. RESULTS Introducing tier 3 restrictions in October and December was associated with a 14% (95% CI 10% to 19%) and 20% (95% CI 13% to 29%) reduction in infections, respectively, compared with the rates expected with tier 2 restrictions only. The effects were similar across levels of deprivation and by the prevalence of the new variant. CONCLUSIONS Compared with tier 2 restrictions, additional restrictions in tier 3 areas in England had a moderate effect on transmission, which did not appear to increase socioeconomic inequalities in COVID-19 cases.
Collapse
Affiliation(s)
- Xingna Zhang
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Gwilym Owen
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Mark A Green
- Department of Geography and Planning, University of Liverpool, Liverpool, UK
| | - Iain Buchan
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Ben Barr
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| |
Collapse
|
30
|
Green MA, McKee M, Katikireddi SV. Remote general practitioner consultations during COVID-19. Lancet Digit Health 2022; 4:e7. [PMID: 34952678 PMCID: PMC8691847 DOI: 10.1016/s2589-7500(21)00279-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/18/2021] [Accepted: 12/03/2021] [Indexed: 01/19/2023]
Affiliation(s)
- Mark A Green
- Geographic Data Science Lab, Department of Geography and Planning, University of Liverpool, Liverpool L69 7ZT, UK; MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | |
Collapse
|
31
|
Green MA, Mathias CJ, Smith NJ, Cheng M, Hutchins GD. In Vivo Quantitative Whole-Body Perfusion Imaging Using Radiolabeled Copper(II) Bis(Thiosemicarbazone) Complexes and Positron Emission Tomography (PET). Methods Mol Biol 2022; 2393:751-771. [PMID: 34837210 DOI: 10.1007/978-1-0716-1803-5_40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Traditional quantitative perfusion imaging methods require complex data acquisition and analysis strategies; typically require ancillary arterial blood sampling for measurement of input functions; are limited to single organ or tissue regions in an imaging session; and because of their complexity, are not well suited for routine clinical implementation in a standardized fashion that can be readily repeated across diverse clinical sites. The whole-body perfusion method described in this chapter has the advantages of on-demand radiotracer production; simple tissue pharmacokinetics enabling standardized estimation of perfusion; short-lived radionuclides, facilitating repeat or combination imaging procedures; and scalability to support widespread clinical implementation. This method leverages the unique physiological characteristics of radiolabeled copper(II) bis(thiosemicarbazone) complexes and the detection sensitivity of positron emission tomography (PET) to produce quantitatively accurate whole-body perfusion images. This chapter describes the synthesis of ethylglyoxal bis(thosemicarbazonato)copper(II) labeled with copper-62 ([62Cu]Cu-ETS), its unique physiological characteristics, a simple tracer kinetic model for estimation of perfusion using image-derived input functions, and validation of the method against a reference standard perfusion tracer. A detailed description of the methods is provided to facilitate implementation of the perfusion imaging method in PET imaging facilities.
Collapse
Affiliation(s)
- Mark A Green
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Carla J Mathias
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Nathaniel J Smith
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Monica Cheng
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Gary D Hutchins
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.
| |
Collapse
|
32
|
Green MA, Mathias CJ. Synthesis and formulation of [64Cu]Cu-PTSM for PET perfusion imaging in small animal models. Appl Radiat Isot 2022; 182:110119. [DOI: 10.1016/j.apradiso.2022.110119] [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: 09/30/2021] [Revised: 01/12/2022] [Accepted: 01/18/2022] [Indexed: 11/30/2022]
|
33
|
Green MA, Hobbs M, Ding D, Widener M, Murray J, Reece L, Singleton A. The Association between Fast Food Outlets and Overweight in Adolescents Is Confounded by Neighbourhood Deprivation: A Longitudinal Analysis of the Millennium Cohort Study. Int J Environ Res Public Health 2021; 18:ijerph182413212. [PMID: 34948820 PMCID: PMC8703340 DOI: 10.3390/ijerph182413212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/02/2021] [Accepted: 12/09/2021] [Indexed: 11/28/2022]
Abstract
The aim of our study is to utilise longitudinal data to explore if the association between the retail fast food environment and overweight in adolescents is confounded by neighbourhood deprivation. Data from the Millennium Cohort Study for England were obtained for waves 5 (ages 11/12; 2011/12; n = 13,469) and 6 (ages 14/15; 2014/15; n = 11,884). Our outcome variable was overweight/obesity defined using age and sex-specific International Obesity Task Force cut points. Individuals were linked, based on their residential location, to data on the density of fast food outlets and neighbourhood deprivation. Structural Equation Models were used to model associations and test for observed confounding. A small positive association was initially detected between fast food outlets and overweight (e.g., at age 11/12, Odds Ratio (OR) = 1.0006, 95% Confidence Intervals (CI) = 1.0002–1.0009). Following adjusting for the confounding role of neighbourhood deprivation, this association was non-significant. Individuals who resided in the most deprived neighbourhoods had higher odds of overweight than individuals in the least deprived neighbourhoods (e.g., at age 11/12 OR = 1.95, 95% CIs = 1.64–2.32). Neighbourhood deprivation was also positively associated to the density of fast food outlets (at age 11/12 Incidence Rate Ratio = 3.03, 95% CIs = 2.80–3.28).
Collapse
Affiliation(s)
- Mark A. Green
- Geographic Data Science Lab, Department of Geography & Planning, University of Liverpool, Liverpool L69 7ZT, UK; (J.M.); (A.S.)
- Correspondence:
| | - Matthew Hobbs
- GeoHealth Laboratory, University of Canterbury, Christchurch 8140, New Zealand;
- School of Health Sciences, University of Canterbury, Christchurch 8140, New Zealand
| | - Ding Ding
- School of Public Health, University of Sydney, Sydney 2006, Australia; (D.D.); (L.R.)
| | - Michael Widener
- Department of Geography & Planning, University of Toronto, Toronto, ON M5S 3G3, Canada;
| | - John Murray
- Geographic Data Science Lab, Department of Geography & Planning, University of Liverpool, Liverpool L69 7ZT, UK; (J.M.); (A.S.)
| | - Lindsey Reece
- School of Public Health, University of Sydney, Sydney 2006, Australia; (D.D.); (L.R.)
| | - Alex Singleton
- Geographic Data Science Lab, Department of Geography & Planning, University of Liverpool, Liverpool L69 7ZT, UK; (J.M.); (A.S.)
| |
Collapse
|
34
|
Abstract
Approximately 5% of children experience difficulty with the complex coordination of sucking, swallowing and breathing required for feeding. Infants with craniofacial malformations may have anatomic and neurologic contributions to feeding problems. Examples include cleft lip and/or palate, micrognathia, maxillary hypoplasia, and pharyngeal dysfunction. Interventions may facilitate weight gain and avoid failure-to-thrive in these infants. An interdisciplinary approach to address feeding challenges in children with craniofacial differences is necessary. Positional changes, latching maneuvers, specialized feeder nipples, squeezable bottles, and cup feeding can be implemented early. Surgical intervention, including gastrostomy tube placement, tongue lip adhesion, mandibular distraction osteogenesis and tracheostomy, may be required in more severe cases.
Collapse
Affiliation(s)
- Mark A Green
- Instructor of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, Oral and Maxillofacial Surgeon, Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Cory M Resnick
- Harvard School of Dental Medicine and Harvard Medical School, Oral and Maxillofacial Surgeon, Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA.
| |
Collapse
|
35
|
Pradeilles R, Irache A, Wanjohi MN, Holdsworth M, Laar A, Zotor F, Tandoh A, Klomegah S, Graham F, Muthuri SK, Kimani-Murage EW, Coleman N, Green MA, Osei-Kwasi HA, Bohr M, Rousham EK, Asiki G, Akparibo R, Mensah K, Aryeetey R, Bricas N, Griffiths P. Urban physical food environments drive dietary behaviours in Ghana and Kenya: A photovoice study. Health Place 2021; 71:102647. [PMID: 34375838 PMCID: PMC8520917 DOI: 10.1016/j.healthplace.2021.102647] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 06/20/2021] [Accepted: 08/02/2021] [Indexed: 11/26/2022]
Abstract
We identified factors in the physical food environment that influence dietary behaviours among low-income dwellers in three African cities (Nairobi, Accra, Ho). We used Photovoice with 142 males/females (≥13 years). In the neighbourhood environment, poor hygiene, environmental sanitation, food contamination and adulteration were key concerns. Economic access was perceived as a major barrier to accessing nutritionally safe and healthy foods. Home gardening supplemented household nutritional needs, particularly in Nairobi. Policies to enhance food safety in neighbourhood environments are required. Home gardening, food pricing policies and social protection schemes could reduce financial barriers to safe and healthy diets.
Collapse
Affiliation(s)
- Rebecca Pradeilles
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom.
| | - Ana Irache
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Michelle Holdsworth
- IRD (French National Research Institute for Sustainable Development), NUTRIPASS Unit, Université de Montpellier-IRD, Montpellier, France
| | - Amos Laar
- University of Ghana, Department of Population, Family & Reproductive Health, School of Public Health, Accra, Ghana
| | - Francis Zotor
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Akua Tandoh
- University of Ghana, Department of Population, Family & Reproductive Health, School of Public Health, Accra, Ghana
| | - Senam Klomegah
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Fiona Graham
- Population Health Sciences Institute, Newcastle University, United Kingdom
| | | | | | - Nathaniel Coleman
- University of Ghana, Department of Population, Family & Reproductive Health, School of Public Health, Accra, Ghana; Department of Obstetrics and Gynaecology, University of Ghana Medical School, College of Health Sciences, Accra, Ghana
| | - Mark A Green
- Department of Geography and Planning, University of Liverpool, UK
| | | | - Marco Bohr
- School of Art & Design, Nottingham Trent University, UK
| | - Emily K Rousham
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
| | - Gershim Asiki
- African Population and Health Research Center, Nairobi, Kenya
| | - Robert Akparibo
- Public Health Section, School of Health and Related Research, University of Sheffield, United Kingdom
| | - Kobby Mensah
- Department of Marketing and Entrepreneurship, University of Ghana Business School, Accra, Ghana
| | - Richmond Aryeetey
- University of Ghana, Department of Population, Family & Reproductive Health, School of Public Health, Accra, Ghana
| | - Nicolas Bricas
- UMR MOISA, CIRAD- Agricultural Research & International Cooperation Organization, Montpellier, France
| | - Paula Griffiths
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
| |
Collapse
|
36
|
Green MA, García-Fiñana M, Barr B, Burnside G, Cheyne CP, Hughes D, Ashton M, Sheard S, Buchan IE. Evaluating social and spatial inequalities of large scale rapid lateral flow SARS-CoV-2 antigen testing in COVID-19 management: An observational study of Liverpool, UK (November 2020 to January 2021). Lancet Reg Health Eur 2021; 6:100107. [PMID: 34002172 PMCID: PMC8114854 DOI: 10.1016/j.lanepe.2021.100107] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Large-scale asymptomatic testing of communities in Liverpool (UK) for SARS-CoV-2 was used as a public health tool for containing COVID-19. The aim of the study is to explore social and spatial inequalities in uptake and case-detection of rapid lateral flow SARS-CoV-2 antigen tests (LFTs) offered to people without symptoms of COVID-19. METHODS Linked pseudonymised records for asymptomatic residents in Liverpool who received a LFT for COVID-19 between 6th November 2020 to 31st January 2021 were accessed using the Combined Intelligence for Population Health Action resource. Bayesian Hierarchical Poisson Besag, York, and Mollié models were used to estimate ecological associations for uptake and positivity of testing. FINDINGS 214 525 residents (43%) received a LFT identifying 5192 individuals as positive cases of COVID-19 (1.3% of tests were positive). Uptake was highest in November when there was military assistance. High uptake was observed again in the week preceding Christmas and was sustained into a national lockdown. Overall uptake were lower among males (e.g. 40% uptake over the whole period), Black Asian and other Minority Ethnic groups (e.g. 27% uptake for 'Mixed' ethnicity) and in the most deprived areas (e.g. 32% uptake in most deprived areas). These population groups were also more likely to have received positive tests for COVID-19. Models demonstrated that uptake and repeat testing were lower in areas of higher deprivation, areas located further from test sites and areas containing populations less confident in the using Internet technologies. Positive tests were spatially clustered in deprived areas. INTERPRETATION Large-scale voluntary asymptomatic community testing saw social, ethnic, digital and spatial inequalities in uptake. COVID-19 testing and support to isolate need to be more accessible to the vulnerable communities most impacted by the pandemic, including non-digital means of access. FUNDING Department of Health and Social Care (UK) and Economic and Social Research Council.
Collapse
Affiliation(s)
- Mark A. Green
- Senior Lecturer in Health Geography, Department of Geography & Planning, University of Liverpool, Liverpool, UK
| | - Marta García-Fiñana
- Professor of Health Data Science, Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - Ben Barr
- Professor in Applied Public Health Research, Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Girvan Burnside
- Senior Lecturer in Biostatistics, Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - Christopher P. Cheyne
- Research Associate, Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - David Hughes
- Lecturer in Health Data Science, Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - Matthew Ashton
- Director of Public Health, Liverpool City Council, Liverpool, UK
| | - Sally Sheard
- Andrew Geddes and John Rankin Professor of Modern History, Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Iain E. Buchan
- Chair in Public Health and Clinical Informatics, Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| |
Collapse
|
37
|
Zhao M, Leggett E, Bourke S, Poursanidou S, Carter-Searjeant S, Po S, Palma do Carmo M, Dailey LA, Manning P, Ryan SG, Urbano L, Green MA, Rakovich A. Theranostic Near-Infrared-Active Conjugated Polymer Nanoparticles. ACS Nano 2021; 15:8790-8802. [PMID: 33978405 DOI: 10.1021/acsnano.1c01257] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Conjugated polymer nanoparticles (CPNs) based on a common solar cell material (PTB7) have been prepared, and their potential in theranostic applications based on bioimaging and photosensitizing capabilities has been evaluated. The main absorption and emission bands of the prepared CPNs both fell within the NIR-I (650-950 nm) transparency window, allowing facile and efficient implementation of our CPNs as bioimaging agents, as demonstrated in this work for A549 human lung cancer cell cultures. The prepared CPN samples were also shown to produce reactive oxygen species (ROS) upon photoexcitation in the near-infrared or ultraviolet spectral regions, both in aqueous solutions and in HaCaT keratinocyte cell cultures. Importantly, we show that the photosensitizing ability of our CPNs was largely determined by the nature of the stabilizing shell: coating the CPNs with a Pluronic F-127 copolymer led to an improvement of photoinitiated ROS production, while using poly[styrene-co-maleic anhydride] instead completely quenched said process. This work therefore demonstrates that the photosensitizing capability of CPNs can be modulated via an appropriate selection of stabilizing material and highlights the significance of this parameter for the on-demand design of theranostic probes based on CPNs.
Collapse
Affiliation(s)
- Miao Zhao
- Physics Department, King's College London, Strand Building, London, WC2R 2LS, U.K
| | - Edward Leggett
- Physics Department, King's College London, Strand Building, London, WC2R 2LS, U.K
| | - Struan Bourke
- Physics Department, King's College London, Strand Building, London, WC2R 2LS, U.K
| | - Souzana Poursanidou
- Department of Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire, College Lane, Hatfield, Hertfordshire AL10 9AB, U.K
| | | | - Steve Po
- Physics Department, King's College London, Strand Building, London, WC2R 2LS, U.K
| | | | - Lea Ann Dailey
- Department of Pharmaceutical Technology and Biopharmacy, University of Vienna, Vienna, 1090, Austria
| | - Philip Manning
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, Tyne and Wear NE2 4HH, U.K
| | - Sean G Ryan
- Department of Physics, Astronomy and Mathematics, University of Hertfordshire, College Lane, Hatfield, Hertfordshire AL10 9AB, U.K
- Centre for Advanced Biomedical Imaging, University College London, Gower Street, London, WC1E 6BT, U.K
| | - Laura Urbano
- Department of Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire, College Lane, Hatfield, Hertfordshire AL10 9AB, U.K
| | - Mark A Green
- Physics Department, King's College London, Strand Building, London, WC2R 2LS, U.K
| | - Aliaksandra Rakovich
- Physics Department, King's College London, Strand Building, London, WC2R 2LS, U.K
| |
Collapse
|
38
|
Green MA, Padwa BL. Does Timing of Secondary Alveolar Bone Grafting Affect the Need for Additional Bone Augmentation Prior to Implant Placement at Cleft Sites? J Oral Maxillofac Surg 2021; 79:1927-1931. [PMID: 34119476 DOI: 10.1016/j.joms.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study was to identify factors that influence the need for a supplemental bone graft prior to dental implant placement at previously grafted alveolar cleft sites. PATIENTS AND METHODS Retrospective case series of patients with cleft lip/palate who had both alveolar bone grafting (ABG) and placement of a dental implant(s) to replace a missing incisor(s) at the cleft site by the senior surgeon (BLP) at Boston Children's Hospital from 2005 through 2020. Primary outcome variable was need for a supplemental bone graft prior to dental implant placement. Predictor variables included gender, cleft type (unilateral vs. bilateral), implant site, number of implants placed, age at ABG and implant placement, time between ABG and implant, history of maxillary expansion and whether the patient had a Le Fort I osteotomy to correct maxillary hypoplasia before implant placement. Descriptive statistics were computed and comparative analyses were performed using Pearson X2, Fisher exact, and Mann-Whitney U tests. RESULTS There were 84 implants placed in 59 patients (64.2% female) with cleft lip and palate who had alveolar bone grafting of which 57.1% (n = 48) required a supplemental graft prior to placement. Median time (IQR) from alveolar bone grafting to implant placement was significantly longer in patients who required additional grafting (8.1 versus 5.4 years, P < .001). Patients who required supplemental bone were significantly younger at the time of alveolar bone grafting (10.1 versus 12.3 years, P < .001). Cleft sites in patients who had a Le Fort I osteotomy prior to implant placement required bony augmentation more often than cleft sites in patients who did not have a Le Fort I osteotomy (58.7% versus 33.3%, P = .03). CONCLUSIONS Patients with cleft lip and/or palate who undergo alveolar bone grafting should be counseled that they are likely to require a supplemental bone graft prior to implant placement.
Collapse
Affiliation(s)
- Mark A Green
- Instructor, Harvard School of Dental Medicine, Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA.
| | - Bonnie L Padwa
- Professor, Harvard School of Dental Medicine, Oral Surgeon in Chief, Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA
| |
Collapse
|
39
|
Park JG, Collins BA, Darago LE, Runčevski T, Ziebel ME, Aubrey ML, Jiang HZH, Velasquez E, Green MA, Goodpaster JD, Long JR. Magnetic ordering through itinerant ferromagnetism in a metal-organic framework. Nat Chem 2021; 13:594-598. [PMID: 33859391 DOI: 10.1038/s41557-021-00666-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 02/18/2021] [Indexed: 11/09/2022]
Abstract
Materials that combine magnetic order with other desirable physical attributes could find transformative applications in spintronics, quantum sensing, low-density magnets and gas separations. Among potential multifunctional magnetic materials, metal-organic frameworks, in particular, bear structures that offer intrinsic porosity, vast chemical and structural programmability, and the tunability of electronic properties. Nevertheless, magnetic order within metal-organic frameworks has generally been limited to low temperatures, owing largely to challenges in creating a strong magnetic exchange. Here we employ the phenomenon of itinerant ferromagnetism to realize magnetic ordering at TC = 225 K in a mixed-valence chromium(II/III) triazolate compound, which represents the highest ferromagnetic ordering temperature yet observed in a metal-organic framework. The itinerant ferromagnetism proceeds through a double-exchange mechanism, which results in a barrierless charge transport below the Curie temperature and a large negative magnetoresistance of 23% at 5 K. These observations suggest applications for double-exchange-based coordination solids in the emergent fields of magnetoelectrics and spintronics.
Collapse
Affiliation(s)
- Jesse G Park
- Department of Chemistry, University of California, Berkeley, CA, USA
| | - Brianna A Collins
- Department of Chemistry, University of Minnesota-Twin Cities, Minneapolis, MN, USA
| | - Lucy E Darago
- Department of Chemistry, University of California, Berkeley, CA, USA
| | - Tomče Runčevski
- Department of Chemistry, Southern Methodist University, TX, USA
| | - Michael E Ziebel
- Department of Chemistry, University of California, Berkeley, CA, USA
| | - Michael L Aubrey
- Department of Chemistry, University of California, Berkeley, CA, USA
| | - Henry Z H Jiang
- Department of Chemistry, University of California, Berkeley, CA, USA.,Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Ever Velasquez
- Department of Chemical and Biomolecular Engineering, University of California, Berkeley, CA, USA
| | - Mark A Green
- School of Physical Sciences, University of Kent, Canterbury, UK
| | - Jason D Goodpaster
- Department of Chemistry, University of Minnesota-Twin Cities, Minneapolis, MN, USA
| | - Jeffrey R Long
- Department of Chemistry, University of California, Berkeley, CA, USA. .,Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA. .,Department of Chemical and Biomolecular Engineering, University of California, Berkeley, CA, USA.
| |
Collapse
|
40
|
Darlington-Pollock F, Green MA, Simpson L. Why were there 231 707 more deaths than expected in England between 2010 and 2018? An ecological analysis of mortality records. J Public Health (Oxf) 2021; 44:310-318. [PMID: 33765120 PMCID: PMC8083632 DOI: 10.1093/pubmed/fdab023] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/03/2020] [Accepted: 01/19/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Policy responses to the Global Financial Crisis emphasized wide-ranging fiscal austerity measures, many of which have been found to negatively impact health outcomes. This paper investigates change in patterns of mortality at local authority level in England (2010-11 to 2017-18) and the relation with fiscal austerity measures. METHODS Data from official local authority administrative records are used to quantify the gap between observed deaths and what was anticipated in the 2010-based subnational population projections. Regression analyses are used to explore the relation between excess deaths, austerity and wider process of population change at local authority level. RESULTS We estimate 231 707 total excess deaths, the majority of which occurred since 2014-15 (89%) across the majority of local authorities (91%). Austerity is positively associated with excess deaths. For working age adults, there is a clear gradient to the impact of austerity, whereas for older adults, the impact is more uniform. CONCLUSIONS Fiscal austerity policies contributed to an excess of deaths for older people and widened social inequalities for younger populations. These results call for an end to all austerity measures and require further research into areas with the highest total excess deaths as a priority following the COVID-19 pandemic.
Collapse
Affiliation(s)
| | - Mark A Green
- Department of Geography and Planning, University of Liverpool, L69 7ZT Liverpool, UK
| | - Ludi Simpson
- Cathie Marsh Institute for Social Research, University of Manchester, M13 9BL, Manchester, UK
| |
Collapse
|
41
|
Bykov AY, Shukla A, van Schilfgaarde M, Green MA, Zayats AV. Ultrafast Carrier and Lattice Dynamics in Plasmonic Nanocrystalline Copper Sulfide Films. Laser Photon Rev 2021; 15:2000346. [PMID: 34484456 PMCID: PMC8408971 DOI: 10.1002/lpor.202000346] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/29/2020] [Indexed: 05/26/2023]
Abstract
Excited carrier dynamics in plasmonic nanostructures determines many important optical properties such as nonlinear optical response and photocatalytic activity. Here it is shown that mesoscopic plasmonic covellite nanocrystals with low free-carrier concentration exhibit a much faster carrier relaxation than in traditional plasmonic materials. A nonequilibrium hot-carrier population thermalizes within first 20 fs after photoexcitation. A decreased thermalization time in nanocrystals compared to a bulk covellite is consistent with the reduced Coulomb screening in ultrathin films. The subsequent relaxation of thermalized, equilibrium electron gas is faster than in traditional plasmonic metals due to the lower carrier concentration and agrees well with that in a bulk covellite showing no evidence of quantum confinement or hot-hole trapping at the surface states. The excitation of coherent optical phonon modes in a covellite is also demonstrated, revealing coherent lattice dynamics in plasmonic materials, which until now was mainly limited to dielectrics, semiconductors, and semimetals. These findings show advantages of this new mesoscopic plasmonic material for active control of optical processes.
Collapse
Affiliation(s)
- Anton Yu. Bykov
- Department of Physics and London Centre for NanotechnologyKing's College LondonLondonWS2R 2LSUK
| | - Amaresh Shukla
- Department of Physics and London Centre for NanotechnologyKing's College LondonLondonWS2R 2LSUK
| | - Mark van Schilfgaarde
- Department of Physics and London Centre for NanotechnologyKing's College LondonLondonWS2R 2LSUK
- Prof. M. van SchilfgaardeNational Renewable Energy LaboratoryGoldenColorado80401USA
| | - Mark A. Green
- Department of Physics and London Centre for NanotechnologyKing's College LondonLondonWS2R 2LSUK
| | - Anatoly V. Zayats
- Department of Physics and London Centre for NanotechnologyKing's College LondonLondonWS2R 2LSUK
| |
Collapse
|
42
|
Overcast WB, Davis KM, Ho CY, Hutchins GD, Green MA, Graner BD, Veronesi MC. Advanced imaging techniques for neuro-oncologic tumor diagnosis, with an emphasis on PET-MRI imaging of malignant brain tumors. Curr Oncol Rep 2021; 23:34. [PMID: 33599882 PMCID: PMC7892735 DOI: 10.1007/s11912-021-01020-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW This review will explore the latest in advanced imaging techniques, with a focus on the complementary nature of multiparametric, multimodality imaging using magnetic resonance imaging (MRI) and positron emission tomography (PET). RECENT FINDINGS Advanced MRI techniques including perfusion-weighted imaging (PWI), MR spectroscopy (MRS), diffusion-weighted imaging (DWI), and MR chemical exchange saturation transfer (CEST) offer significant advantages over conventional MR imaging when evaluating tumor extent, predicting grade, and assessing treatment response. PET performed in addition to advanced MRI provides complementary information regarding tumor metabolic properties, particularly when performed simultaneously. 18F-fluoroethyltyrosine (FET) PET improves the specificity of tumor diagnosis and evaluation of post-treatment changes. Incorporation of radiogenomics and machine learning methods further improve advanced imaging. The complementary nature of combining advanced imaging techniques across modalities for brain tumor imaging and incorporating technologies such as radiogenomics has the potential to reshape the landscape in neuro-oncology.
Collapse
Affiliation(s)
- Wynton B. Overcast
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N University Blvd. Room 0663, Indianapolis, IN 46202 USA
| | - Korbin M. Davis
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N University Blvd. Room 0663, Indianapolis, IN 46202 USA
| | - Chang Y. Ho
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Goodman Hall, 355 West 16th Street, Suite 4100, Indianapolis, IN 46202 USA
| | - Gary D. Hutchins
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Research 2 Building (R2), Room E124, 920 W. Walnut Street, Indianapolis, IN 46202-5181 USA
| | - Mark A. Green
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Research 2 Building (R2), Room E124, 920 W. Walnut Street, Indianapolis, IN 46202-5181 USA
| | - Brian D. Graner
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Goodman Hall, 355 West 16th Street, Suite 4100, Indianapolis, IN 46202 USA
| | - Michael C. Veronesi
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Research 2 Building (R2), Room E174, 920 W. Walnut Street, Indianapolis, IN 46202-5181 USA
| |
Collapse
|
43
|
Green MA, Watson AW, Brunstrom JM, Corfe BM, Johnstone AM, Williams EA, Stevenson E. Comparing supermarket loyalty card data with traditional diet survey data for understanding how protein is purchased and consumed in older adults for the UK, 2014-16. Nutr J 2020; 19:83. [PMID: 32791968 PMCID: PMC7427066 DOI: 10.1186/s12937-020-00602-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/06/2020] [Indexed: 11/10/2022] Open
Abstract
Background Our ability to understand population-level dietary intake patterns is dependent on having access to high quality data. Diet surveys are common diet assessment methods, but can be limited by bias associated with under-reporting. Food purchases tracked using supermarket loyalty card records may supplement traditional surveys, however they are rarely available to academics and policy makers. The aim of our study is to explore population level patterns of protein purchasing and consumption in ageing adults (40 years onwards). Methods We used diet survey data from the National Diet and Nutrition Survey (2014–16) on food consumption, and loyalty card records on food purchases from a major high street supermarket retailer (2016–17) covering the UK. We computed the percentage of total energy derived from protein, protein intake per kg of body mass, and percentage of protein acquired by food type. Results We found that protein consumption (as the percentage of total energy purchased) increased between ages 40–65 years, and declined thereafter. In comparison, protein purchased in supermarkets was roughly 2–2.5 percentage points lower at each year of age. The proportion of adults meeting recommended levels of protein was lowest in age groups 55–69 and 70+. The time of protein consumption was skewed towards evening meals, with low intakes during breakfast or between main meals. Meat, fish and poultry dominated as sources of protein purchased and consumed, although adults also acquired a large share of their protein from dairy and bread, with little from plant protein. Conclusions Our study provides novel insights into how protein is purchased and consumed by ageing adults in the UK. Supermarket loyalty card data can reveal patterns of protein purchasing that when combined with traditional sources of dietary intake may enhance our understanding of dietary behaviours.
Collapse
Affiliation(s)
- Mark A Green
- Geographic Data Science Lab, School of Environmental Sciences, University of Liverpool, Liverpool, UK.
| | - Anthony W Watson
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon-Tyne, UK
| | | | - Bernard M Corfe
- Department of Oncology & Metabolism, University of Sheffield, Sheffield, UK
| | | | | | - Emma Stevenson
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon-Tyne, UK
| |
Collapse
|
44
|
Bahler CD, Johnson MM, Davicioni E, Zhang J, Cheng L, Green MA, Koch MO. Predictors of Prostate-specific Membrane Antigen (PSMA/FOLH1) Expression in a Genomic Database. Urology 2020; 144:117-122. [PMID: 32619596 DOI: 10.1016/j.urology.2020.06.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To assess predictors of prostate-specific membrane antigen (PSMA) expression in a genomic database; positron emission tomography with PSMA-targeted radiopharmaceuticals is increasingly being utilized. METHODS The de-identified Decipher Biosciences database, which includes expression for more than 46,000 coding and noncoding genes per patient, was queried for expression of FOLH1 (PSMA). Prostate cancer patients who underwent radical prostatectomy and received the Decipher Test were included in the analysis. PSMA expression was compared to the Gleason Grade Group, Decipher risk category (a validated 22 biomarker genomic score), basal versus luminal molecular subtype, and androgen receptor activity. Multivariable regression analyses were performed. RESULTS The Decipher de-identified Decipher Biosciences database contained 16,807 men who underwent prostatectomy with the average age being 65-year old and most being Gleason Grade Group 2 (35%) or 3 (27%). Higher Grade Group was associated with higher PSMA expression except in Grade Group 5 [Grade group: 1 (0.66), 2 (0.84), 3 (0.99), 4 (1.07), 5 (0.99), P <.001]. Luminal subtype was found to have much higher PSMA expression when compared to basal (1.01 vs 0.68, P <.001). The androgen receptor activity signature demonstrated a dramatic difference between basal (0.19) and luminal (0.62) subtypes (P <.001). In the multivariable model, luminal patients, high androgen receptor activity scores, and high Grade Groups were significantly associated with higher FOLH1 percentile rank (P <.001). CONCLUSION High PSMA expression (FOLH1) was associated with high androgen receptor activity and luminal subtype. Genomic tests could aid in predicting, interpreting, and/or directing PSMA theranostics.
Collapse
Affiliation(s)
- Clinton D Bahler
- Department of Urology, Indiana University, Indianapolis, IN; Department of Radiology and Imaging Sciences, Indiana University, Indianapolis, IN.
| | | | | | | | - Liang Cheng
- Department of Urology, Indiana University, Indianapolis, IN; Department of Pathology, Indiana University, Indianapolis, IN
| | - Mark A Green
- Department of Radiology and Imaging Sciences, Indiana University, Indianapolis, IN
| | - Michael O Koch
- Department of Urology, Indiana University, Indianapolis, IN
| |
Collapse
|
45
|
Ding D, Del Pozo Cruz B, Green MA, Bauman AE. Is the COVID-19 lockdown nudging people to be more active: a big data analysis. Br J Sports Med 2020; 54:1183-1184. [PMID: 32605932 DOI: 10.1136/bjsports-2020-102575] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2020] [Indexed: 11/03/2022]
Affiliation(s)
- Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia .,Charles Perkins Centre, The Univesity of Sydney, Camperdown, New South Wales, Australia
| | - Borja Del Pozo Cruz
- Faculty of Health Sciences, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Mark A Green
- Department of Geography and Planning, School of Environmental Sciences, University of Liverpool, Liverpool, Merseyside, UK
| | - Adrian E Bauman
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.,Charles Perkins Centre, The Univesity of Sydney, Camperdown, New South Wales, Australia
| |
Collapse
|
46
|
Abelha TF, Dreiss CA, Green MA, Dailey LA. Conjugated polymers as nanoparticle probes for fluorescence and photoacoustic imaging. J Mater Chem B 2020; 8:592-606. [DOI: 10.1039/c9tb02582k] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In this review, the role of conjugated polymer nanoparticles (CPNs) in emerging bioimaging techniques is described.
Collapse
Affiliation(s)
- Thais Fedatto Abelha
- King's College London
- Institute of Pharmaceutical Science
- London
- UK
- School of Pharmacy
| | - Cécile A. Dreiss
- King's College London
- Institute of Pharmaceutical Science
- London
- UK
| | | | | |
Collapse
|
47
|
Bourke S, Teijeiro Gonzalez Y, Donà F, Panamarova M, Suhling K, Eggert U, Dailey LA, Zammit P, Green MA. Cellular imaging using emission-tuneable conjugated polymer nanoparticles. RSC Adv 2019; 9:37971-37976. [PMID: 35541819 PMCID: PMC9075778 DOI: 10.1039/c9ra07983a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 11/12/2019] [Indexed: 11/21/2022] Open
Abstract
New materials that exhibit tuneable optical properties, notable emission across the visible spectrum, are of immense interest to biologists as they present a broad palette of colours from a single imaging agent that can be utilised in biological detection. Such a flexible system, when combined with the advantages of using conjugated polymer nanoparticles in cell imaging results in a widely useful medical diagnostic system. Here, we describe tuneable emission observed through oxidation of a conjugated polymer followed by the formation of nanoparticles and their subsequent use in cell imaging.
Collapse
Affiliation(s)
- Struan Bourke
- Department of Physics, King's College London London WC2R 2LS UK
| | | | - Federico Donà
- Randall Division of Cell and Molecular Biophysics, Faculty of Life Sciences and Medicine, New Hunt's House, King's College London Guy's Campus London SE1 1UL UK
| | - Maryna Panamarova
- Randall Division of Cell and Molecular Biophysics, Faculty of Life Sciences and Medicine, New Hunt's House, King's College London Guy's Campus London SE1 1UL UK
| | - Klaus Suhling
- Department of Physics, King's College London London WC2R 2LS UK
| | - Ulrike Eggert
- Randall Division of Cell and Molecular Biophysics, Faculty of Life Sciences and Medicine, New Hunt's House, King's College London Guy's Campus London SE1 1UL UK
| | - Lea Ann Dailey
- Institute of Pharmacy, Martin-Luther University Halle-Wittenberg Wolfgang-Langenbeck-Strasse 4 06120 Halle (Saale) Germany
| | - Peter Zammit
- Randall Division of Cell and Molecular Biophysics, Faculty of Life Sciences and Medicine, New Hunt's House, King's College London Guy's Campus London SE1 1UL UK
| | - Mark A Green
- Department of Physics, King's College London London WC2R 2LS UK
| |
Collapse
|
48
|
Buckley CM, Austin S, Corfe BM, Green MA, Johnstone AM, Stevenson EJ, Williams EA, Brunstrom JM. Protein Valuation in Food Choice Is Positively Associated with Lean Mass in Older Adults. J Nutr 2019; 149:2056-2064. [PMID: 31198945 PMCID: PMC6825819 DOI: 10.1093/jn/nxz124] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 04/03/2019] [Accepted: 05/13/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Calorie for calorie, protein is more satiating than carbohydrate or fat. However, it remains unclear whether humans perceive calories derived from these macronutrients equally and whether lean mass is associated with a tendency to "value" protein when dietary decisions are made. OBJECTIVES This study aimed to determine the test-retest reliability of a novel method for quantifying macronutrient valuations in human volunteers and to determine whether "protein valuation" is associated with a higher fat-free mass index (FFMI) in older adults. METHODS A 2-alternative, forced-choice task in which 25 foods were compared in 300 trials was undertaken in 2 studies. In study 1, participants (age range 19-71 y, n = 92) attended 2 test sessions, spaced 1 wk apart. In study 2, older adults (age range 40-85 y; n = 91) completed the food-choice task and assessed the test foods for liking, expected satiety, and perceived healthiness. Body composition and habitual protein intake were assessed in both studies. Data were analyzed through the use of individual binomial logistic regressions and multilevel binomial logistic regressions. RESULTS In study 1, measures of macronutrient valuation showed excellent test-retest reliability; responses in the forced-choice task were highly correlated (week 1 compared with week 2; protein, r = 0.83, P < 0.001; carbohydrate, r = 0.90, P < 0.001; fat, r = 0.90, P < 0.001). Calorie for calorie, protein and carbohydrate were stronger predictors of choice than fat (P < 0.001). In study 2, protein was a stronger predictor than both carbohydrate (P = 0.039) and fat (P = 0.003), and a positive interaction was observed between protein valuation and FFMI (OR = 1.64; 95% CI: 1.38, 1.95; P < 0.001). This was the case after controlling for age, gender, liking for foods, and habitual protein consumption. CONCLUSIONS Together, these findings demonstrate that adult humans value calories derived from protein, carbohydrate, and fat differently, and that the tendency to value protein is associated with greater lean mass in older adults.
Collapse
Affiliation(s)
- Charlotte M Buckley
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom,Address correspondence to CMB (e-mail: )
| | - Sophie Austin
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Bernard M Corfe
- Department of Oncology and Metabolism, The Medical School, The University of Sheffield, Sheffield, United Kingdom
| | - Mark A Green
- Department of Geography and Planning, School of Environmental Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Alexandra M Johnstone
- Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - Emma J Stevenson
- Human Nutrition Research Centre, Institute of Cellular Medicine, Medical School, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Elizabeth A Williams
- Department of Oncology and Metabolism, The Medical School, The University of Sheffield, Sheffield, United Kingdom
| | - Jeffrey M Brunstrom
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom,National Institute for Health Research, Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
| |
Collapse
|
49
|
Wade A, Hobbs M, Green MA. Investigating the relationship between multimorbidity and dental attendance: a cross-sectional study of UK adults. Br Dent J 2019; 226:138-143. [PMID: 30679858 DOI: 10.1038/sj.bdj.2019.47] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2018] [Indexed: 11/09/2022]
Abstract
Introduction Regular dental attendance is related to better oral health. However, long-standing health conditions (LSHCs) may be related to dental attendance and this relationship may vary by socioeconomic status. Method Data were collected from wave two (2013–2015) of the Yorkshire Health Study (n= 7,654). Data included dental attendance, LSHC, age, gender, education-level, smoking, body mass index, and area-level deprivation. Logistic regression (attend or not) was used to analyse associations with LSHC and multimorbidity. Results Overall, 63.1% (n = 4,826) of individuals attended the dentist. Of these, 37.8% (n =2894) had no LSHC, 26.0% (n = 1987) had one LSHC and 36.4% (n = 2784) had two or more LSHC. The presence of a singular LSHC was not associated with dental attendance(OR = 0.91 [0.81, 1.04]), however, those with two or more LSHCs were more likely to attend the dentist (OR = 0.81 [95% CI 0.72, 0.92]). Interactions between individual-level education, as a marker of socioeconomic status, and LSHC revealed few associations with dental attendance. Conclusion Multimorbidity was associated with dental attendance such that those with multimorbidity were more likely to attend. These important findings highlight the increasing challenge of multimorbidity for global healthcare systems.
Collapse
Affiliation(s)
- A Wade
- Leeds General Infirmary, Leeds, LS1 3EX
| | - M Hobbs
- GeoHealth Laboratory, Geospatial Research Institute, Christchurch, New Zealand
| | - M A Green
- School of Environmental Sciences, University of Liverpool, Liverpool, United Kingdom
| |
Collapse
|
50
|
Hobbs M, Green MA, Wilkins E, Lamb KE, McKenna J, Griffiths C. Associations between food environment typologies and body mass index: Evidence from Yorkshire, England. Soc Sci Med 2019; 239:112528. [PMID: 31499332 DOI: 10.1016/j.socscimed.2019.112528] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/29/2019] [Accepted: 08/29/2019] [Indexed: 01/06/2023]
Abstract
International research linking food outlets and body mass index (BMI) is largely cross-sectional, yielding inconsistent findings. However, addressing the exposure of food outlets is increasingly considered as an important adult obesity prevention strategy. Our study investigates associations between baseline food environment types and change in BMI over time. Survey data were used from the Yorkshire Health Study (n=8,864; wave one: 2010-2012, wave two: 2013-2015) for adults aged 18-86. BMI was calculated using self-reported height (cm) and weight (kg). Restaurants, cafés, fast-food, speciality, convenience and large supermarkets were identified from the Ordnance Survey Point of Interest database within 1600m radial buffer of home postcodes. K-means cluster analysis developed food environment typologies based on food outlets and population density. Large supermarkets, restaurants, cafés, fast-food, speciality and convenience food outlets all clustered together to some extent. Three neighbourhood typologies were identified. However, multilevel models revealed that relative to cluster one all were unrelated to change in BMI (cluster 2, b= -0.146 [-0.274, 0.566]; cluster 3, b= 0.065 [-0.224, 0.356]). There was also little evidence of gender-based differences in these associations when examined in a three-way interaction. Policymakers may need to begin to consider multiple types of food outlet clusters, while further research is needed to confirm how these relate to changed BMI.
Collapse
Affiliation(s)
- M Hobbs
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom; GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, New Zealand.
| | - M A Green
- School of Environmental Sciences, University of Liverpool, Liverpool, United Kingdom
| | - E Wilkins
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom
| | - K E Lamb
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, 3052, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, 3052, Australia
| | - J McKenna
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom
| | - C Griffiths
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom
| |
Collapse
|