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Ayala SG, Thomas N, Rohde M, Gupta A, Sanchez M, Tompkins M, Parikh SN, Ellis HB, Green DW, Yen YM, Fabricant PD, Wilson P, Shea KG. Osseous and Cartilaginous Trochlear Development in the Pediatric Knee: A Cadaveric Computed Tomography Study. Orthop J Sports Med 2024; 12:23259671241249132. [PMID: 38751851 PMCID: PMC11095196 DOI: 10.1177/23259671241249132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 11/13/2023] [Indexed: 05/18/2024] Open
Abstract
Background The anatomy of the trochlea plays a significant role in patellar stability. The developmental anatomy of the trochlea and its relationship to patellar stability remains poorly understood. Purpose To describe the developmental changes of the osseous and cartilaginous trochlear morphology in skeletally immature specimens. Study Design Descriptive laboratory study. Methods A total of 65 skeletally immature cadaveric knees between the ages of 2 months and 11 years were evaluated using computed tomography scans. The measurements in the axial plane of both cartilage and bone include medial, central, and lateral trochlear height; sulcus height; medial and later trochlear facet length; trochlear sulcus angle; patellar sulcus angle; condylar height asymmetry; and trochlear facet asymmetry. Additional measurements included trochlear depth and lateral trochlear inclination angle. In the sagittal plane, measurements included curvilinear trochlear length, direct trochlear length, condylar height, and patellar sulcus angle. Results Analysis of trochlear morphology using condylar height, condylar height asymmetry, and trochlear depth all increased with increasing age. The osseous and cartilaginous sulcus angles became deeper with age until age 8 and then plateaued. This corresponded with an increase in trochlear depth that also plateaued around age 8. Osseous condylar asymmetry increased with age but flipped from a larger medial condyle to a larger lateral condyle around age 8. The continued growth of the trochlea with age was further demonstrated in all measures in the sagittal view. Conclusion This cadaveric analysis demonstrated that there is an increase in condylar height as age increased by all measurements analyzed. These changes in condylar height continued to be seen through age 11, suggesting a still-developing trochlea past this age. By age 8, a plateau in sulcus angle, and sulcus depth suggests more proportionate growth after this point. Similar changes in trochlear and patellar shape with age suggests that the 2 structures may affect each other during development. Clinical Relevance This information can help design, develop, and determine timing of procedures that may alter the anatomy and stabilize the trochlear and patellofemoral joint.
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Affiliation(s)
- Salvador G. Ayala
- University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | - Nicholas Thomas
- Florida State University College of Medicine, Pensacola, Florida, USA
| | - Matthew Rohde
- Stanford School of Medicine, Stanford, California, USA
| | - Anshal Gupta
- Stanford School of Medicine, Stanford, California, USA
| | - Mark Sanchez
- Stanford School of Medicine, Stanford, California, USA
| | - Marc Tompkins
- University of Minnesota, Minneapolis, Minnesota, USA
| | - Shital N. Parikh
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Henry B. Ellis
- Texas Scottish Rite Hospital for Children, Dallas, Texas, USA
| | | | - Yi-Meng Yen
- Boston Children’s Hospital, Boston, Massachusetts, USA
| | | | - Phil Wilson
- Texas Scottish Rite Hospital for Children, Dallas, Texas, USA
| | - Kevin G. Shea
- Stanford School of Medicine, Stanford, California, USA
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2
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Bawaskar P, Thomas N, Ismail K, Guo Y, Chhikara S, Athwal PSS, Ranum A, Jadhav A, Mendez AH, Nadkarni I, Frerichs D, Velangi P, Ergando T, Akram H, Kanda A, Shenoy C. Nonischemic or Dual Cardiomyopathy in Patients With Coronary Artery Disease. Circulation 2024; 149:807-821. [PMID: 37929565 PMCID: PMC10951941 DOI: 10.1161/circulationaha.123.067032] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/02/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Randomized trials in obstructive coronary artery disease (CAD) have largely shown no prognostic benefit from coronary revascularization. Although there are several potential reasons for the lack of benefit, an underexplored possible reason is the presence of coincidental nonischemic cardiomyopathy (NICM). We investigated the prevalence and prognostic significance of NICM in patients with CAD (CAD-NICM). METHODS We conducted a registry study of consecutive patients with obstructive CAD on coronary angiography who underwent contrast-enhanced cardiovascular magnetic resonance imaging for the assessment of ventricular function and scar at 4 hospitals from 2004 to 2020. We identified the presence and cause of cardiomyopathy using cardiovascular magnetic resonance imaging and coronary angiography data, blinded to clinical outcomes. The primary outcome was a composite of all-cause death or heart failure hospitalization, and secondary outcomes were all-cause death, heart failure hospitalization, and cardiovascular death. RESULTS Among 3023 patients (median age, 66 years; 76% men), 18.2% had no cardiomyopathy, 64.8% had ischemic cardiomyopathy (CAD+ICM), 9.3% had CAD+NICM, and 7.7% had dual cardiomyopathy (CAD+dualCM), defined as both ICM and NICM. Thus, 16.9% had CAD+NICM or dualCM. During a median follow-up of 4.8 years (interquartile range, 2.9, 7.6), 1116 patients experienced the primary outcome. In Cox multivariable analysis, CAD+NICM or dualCM was independently associated with a higher risk of the primary outcome compared with CAD+ICM (adjusted hazard ratio, 1.23 [95% CI, 1.06-1.43]; P=0.007) after adjustment for potential confounders. The risks of the secondary outcomes of all-cause death and heart failure hospitalization were also higher with CAD+NICM or dualCM (hazard ratio, 1.21 [95% CI, 1.02-1.43]; P=0.032; and hazard ratio, 1.37 [95% CI, 1.11-1.69]; P=0.003, respectively), whereas the risk of cardiovascular death did not differ from that of CAD+ICM (hazard ratio, 1.15 [95% CI, 0.89-1.48]; P=0.28). CONCLUSIONS In patients with CAD referred for clinical cardiovascular magnetic resonance imaging, NICM or dualCM was identified in 1 of every 6 patients and was associated with worse long-term outcomes compared with ICM. In patients with obstructive CAD, coincidental NICM or dualCM may contribute to the lack of prognostic benefit from coronary revascularization.
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Affiliation(s)
- Parag Bawaskar
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Nicholas Thomas
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Khaled Ismail
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Yugene Guo
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Sanya Chhikara
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Pal Satyajit Singh Athwal
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Alison Ranum
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Achal Jadhav
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Abel Hooker Mendez
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Ishan Nadkarni
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Dominic Frerichs
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Pratik Velangi
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Tesfatsiyon Ergando
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Hassan Akram
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Adinan Kanda
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Chetan Shenoy
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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Png ME, Harris V, Grabey J, Hart ND, Jani BD, Butler D, Carson-Stevens A, Coates M, Cureton L, Dobson M, Dorward J, Evans P, Francis N, Gbinigie OA, Hayward G, Holmes J, Hood K, Khoo S, Ahmed H, Lown M, Mckenna M, Mort S, Nguyen-Van-Tam J, Rahman N, Richards DB, Thomas N, van Hecke O, Hobbs FR, Little P, Yu LM, Butler CC, Petrou S. Cost-utility analysis of molnupiravir plus usual care versus usual care alone as early treatment for community-based adults with COVID-19 and increased risk of adverse outcomes in the UK PANORAMIC trial. Br J Gen Pract 2024:BJGP.2023.0444. [PMID: 38228357 DOI: 10.3399/bjgp.2023.0444] [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: 08/25/2023] [Accepted: 11/20/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND The cost-effectiveness of molnupiravir, an oral antiviral for early treatment of SARS-CoV-2, has not been established in vaccinated populations. AIM To evaluate the cost-effectiveness of molnupiravir relative to usual care alone among mainly vaccinated community-based people at higher risk of severe outcomes from COVID-19 over six months. DESIGN AND SETTING Economic evaluation of the PANORAMIC trial in the UK. METHOD A cost-utility analysis that adopted a UK National Health Service and personal social services perspective and a six-month time horizon was performed using PANORAMIC trial data. Cost-effectiveness was expressed in terms of incremental cost per quality-adjusted life year (QALY) gained. Sensitivity and subgroup analyses assessed the impacts of uncertainty and heterogeneity. Threshold analysis explored the price for molnupiravir consistent with likely reimbursement. RESULTS In the base case analysis, molnupiravir had higher mean costs of £449 (95% confidence interval [CI] 445 to 453) and higher mean QALYs of 0.0055 (95% CI 0.004 to 0.007) than usual care (mean incremental cost per QALY of £81190). Sensitivity and subgroup analyses showed similar results, except those aged ≥75 years with a 55% probability of being cost-effective at a £30000 per QALY threshold. Molnupiravir would have to be priced around £147 per course to be cost-effective at a £15000 per QALY threshold. CONCLUSION Molnupiravir at the current cost of £513 per course is unlikely to be cost-effective relative to usual care over a six-month time horizon among mainly vaccinated COVID-19 patients at increased risk of adverse outcomes, except those aged ≥75 years.
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Affiliation(s)
- May Ee Png
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - Victoria Harris
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - Jenna Grabey
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - Nigel David Hart
- Queen's University Belfast, Centre for Medical Education, Belfast, United Kingdom
| | - Bhautesh Dinesh Jani
- University of Glasgow College of Medical Veterinary and Life Sciences, Institute of Health and wellbeing, Glasgow, United Kingdom
| | - Daniel Butler
- Queen's University Belfast, Centre for Medical Education, Belfast, United Kingdom
| | - Andrew Carson-Stevens
- Cardiff University, Division of Population Medicine, School of Medicine, Cardiff, United Kingdom
| | - Maria Coates
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - Lucy Cureton
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - Melissa Dobson
- University of Oxford, Oxford Respiratory Trials Unit, Oxford, United Kingdom
| | - Jienchi Dorward
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
- University of KwaZulu-Natal, Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
| | - Philip Evans
- University of Exeter, Faculty of Health and Life Sciences, Exeter, United Kingdom
- University of Leeds, National Institute of Health and Care Research (NIHR) Clinical Research Network (CRN), Leeds, United Kingdom
| | - Nick Francis
- University of Southampton, Primary Care Research Centre, Southampton, United Kingdom
| | | | - Gail Hayward
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - Jane Holmes
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - Kerenza Hood
- Cardiff University, Centre for Trials Research, Cardiff, United Kingdom
| | - Saye Khoo
- University of Liverpool, Department of Pharmacology, Liverpool, United Kingdom
| | - Haroon Ahmed
- Cardiff University, Division of Population Medicine, School of Medicine, Cardiff, United Kingdom
| | - Mark Lown
- University of Southampton, Primary Care Research Centre, Southampton, United Kingdom
| | - Micheal Mckenna
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - Sam Mort
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | | | - Najib Rahman
- University of Oxford, Oxford Respiratory Trials Unit, Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
- University of Oxford, Chinese Academy of Medicine Oxford Institute, Oxford, United Kingdom
| | - Duncan B Richards
- University of Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford, United Kingdom
| | - Nicholas Thomas
- Windrush Medical Practice, Witney, United Kingdom
- National Institute for Health and Care Research Applied Research Collaboration Oxford and Thames Valley, Oxford, United Kingdom
- Royal College of General Practitioners, London, United Kingdom
| | - Oliver van Hecke
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - Fd Richard Hobbs
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - Paul Little
- University of Southampton, Primary Care Research Centre, Southampton, United Kingdom
| | - Ly-Mee Yu
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - Christopher C Butler
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - Stavros Petrou
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
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4
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Biddle GJ, Thomas N, Edwardson CL, Clemes SA, Daley AJ. Burnout, psychological wellbeing, and musculoskeletal complaints in UK GPs: an observational study. BJGP Open 2023; 7:BJGPO.2023.0007. [PMID: 37474254 DOI: 10.3399/bjgpo.2023.0007] [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: 01/13/2023] [Revised: 04/14/2023] [Accepted: 06/29/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Healthcare systems are under unprecedented pressure. GPs are crucial to the health of the population, yet their own health and wellbeing is often overlooked. AIM To investigate feelings of burnout, psychological wellbeing, and musculoskeletal complaints in GPs across the UK and to examine whether these health outcomes vary according to the time GPs spent sitting, their participation in physical activity each day, and the time spent working per day or week. DESIGN & SETTING Observational study involving GPs located across the UK. METHOD An online survey was emailed to working members of the Royal College of General Practitioners and shared on social media between October and December 2020. The survey included questions on burnout, psychological wellbeing, musculoskeletal complaints, sitting time, physical activity, and time spent working. Mean differences were examined for burnout, psychological wellbeing, and musculoskeletal complaints. RESULTS Data from 406 GPs showed a high level of burnout (35.5%) and musculoskeletal complaints (neck, shoulder and back: 81.8%; arms: 28.3%; and legs: 49.8%). Psychological wellbeing was low in 22.9% of GPs. Burnout was lower in GPs who met current physical activity guidelines, while psychological wellbeing was higher in those with >2 breaks in sitting per hour. Musculoskeletal complaints were higher in those spending >50% of sitting time in prolonged bouts (≥30 minutes). CONCLUSION A high proportion of GPs reported experiencing burnout and musculoskeletal complaints, but these health concerns were less evident in GPs who spent less time in prolonged sitting, took more breaks in sitting, and who were more physically active.
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Affiliation(s)
- Gregory Jh Biddle
- The Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Science, Loughborough University, Loughborough, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Nicholas Thomas
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Charlotte L Edwardson
- Research, Royal College of General Practitioners, London, UK
- Sedentary Behaviour and Health, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- Sedentary Behaviour and Health, NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Stacy A Clemes
- School of Sport, Exercise and Health Science, Loughborough University, Loughborough, UK
| | - Amanda J Daley
- The Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Science, Loughborough University, Loughborough, UK
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5
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Rhodes CA, Thomas N, O'Hara KL, Hita L, Blake A, Wolchik SA, Fisher B, Freeman M, Chen D, Berkel C. Enhancing the Focus: How Does Parental Incarceration Fit into the Overall Picture of Adverse Childhood Experiences (ACEs) and Positive Childhood Experiences (PCEs)? Res Child Adolesc Psychopathol 2023; 51:1933-1944. [PMID: 37875642 PMCID: PMC11008286 DOI: 10.1007/s10802-023-01142-0] [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] [Accepted: 10/11/2023] [Indexed: 10/26/2023]
Abstract
Despite the five million children in the U.S. with an incarcerated parent, there is limited research on risk and protective factors for this population. We analyzed data from the National Survey for Children's Health (2018) to: (1) examine associations among parental incarceration and other adverse childhood experiences (ACEs), (2) characterize the association between parental incarceration and youth mental health outcomes, (3) examine differences in positive childhood experiences (PCEs; collective socialization, community engagement, neighborhood amenities, and family problem solving) by parental incarceration status, (4) examine whether PCEs were protective against mental health problems and if there was an interaction with parental incarceration status, and (5) examine the interaction between PCEs, parental incarceration, and ACEs on mental health problems. Results revealed that children with incarcerated parents had higher odds of experiencing other ACEs, higher odds of having mental health problems, and experienced fewer PCEs compared to children without incarcerated parents. Further, although PCEs were associated with a lower odds of mental health problems for both children with and without incarcerated parents, they did not mitigate the negative impact of parental incarceration on mental health outcomes. While PCEs attenuated the association between ACEs and mental health, parental incarceration status did not significantly moderate the interaction. These results highlight vulnerabilities and potential protective factors for children with incarcerated parents and have important implications for the development of multilevel intervention strategies that seek to promote resilience and reduce risk for this population.
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Affiliation(s)
| | - N Thomas
- Arizona State University, Tempe, USA
| | | | - L Hita
- Arizona State University, Tempe, USA
| | - A Blake
- Arizona State University, Tempe, USA
| | | | - B Fisher
- Arizona State University, Tempe, USA
| | - M Freeman
- Arizona State University, Tempe, USA
| | - D Chen
- Arizona State University, Tempe, USA
| | - C Berkel
- Arizona State University, Tempe, USA
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6
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Luque R, Osborn HP, Leleu A, Pallé E, Bonfanti A, Barragán O, Wilson TG, Broeg C, Cameron AC, Lendl M, Maxted PFL, Alibert Y, Gandolfi D, Delisle JB, Hooton MJ, Egger JA, Nowak G, Lafarga M, Rapetti D, Twicken JD, Morales JC, Carleo I, Orell-Miquel J, Adibekyan V, Alonso R, Alqasim A, Amado PJ, Anderson DR, Anglada-Escudé G, Bandy T, Bárczy T, Barrado Navascues D, Barros SCC, Baumjohann W, Bayliss D, Bean JL, Beck M, Beck T, Benz W, Billot N, Bonfils X, Borsato L, Boyle AW, Brandeker A, Bryant EM, Cabrera J, Carrazco-Gaxiola S, Charbonneau D, Charnoz S, Ciardi DR, Cochran WD, Collins KA, Crossfield IJM, Csizmadia S, Cubillos PE, Dai F, Davies MB, Deeg HJ, Deleuil M, Deline A, Delrez L, Demangeon ODS, Demory BO, Ehrenreich D, Erikson A, Esparza-Borges E, Falk B, Fortier A, Fossati L, Fridlund M, Fukui A, Garcia-Mejia J, Gill S, Gillon M, Goffo E, Gómez Maqueo Chew Y, Güdel M, Guenther EW, Günther MN, Hatzes AP, Helling C, Hesse KM, Howell SB, Hoyer S, Ikuta K, Isaak KG, Jenkins JM, Kagetani T, Kiss LL, Kodama T, Korth J, Lam KWF, Laskar J, Latham DW, Lecavelier des Etangs A, Leon JPD, Livingston JH, Magrin D, Matson RA, Matthews EC, Mordasini C, Mori M, Moyano M, Munari M, Murgas F, Narita N, Nascimbeni V, Olofsson G, Osborne HLM, Ottensamer R, Pagano I, Parviainen H, Peter G, Piotto G, Pollacco D, Queloz D, Quinn SN, Quirrenbach A, Ragazzoni R, Rando N, Ratti F, Rauer H, Redfield S, Ribas I, Ricker GR, Rudat A, Sabin L, Salmon S, Santos NC, Scandariato G, Schanche N, Schlieder JE, Seager S, Ségransan D, Shporer A, Simon AE, Smith AMS, Sousa SG, Stalport M, Szabó GM, Thomas N, Tuson A, Udry S, Vanderburg AM, Van Eylen V, Van Grootel V, Venturini J, Walter I, Walton NA, Watanabe N, Winn JN, Zingales T. A resonant sextuplet of sub-Neptunes transiting the bright star HD 110067. Nature 2023; 623:932-937. [PMID: 38030780 DOI: 10.1038/s41586-023-06692-3] [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: 05/02/2023] [Accepted: 09/28/2023] [Indexed: 12/01/2023]
Abstract
Planets with radii between that of the Earth and Neptune (hereafter referred to as 'sub-Neptunes') are found in close-in orbits around more than half of all Sun-like stars1,2. However, their composition, formation and evolution remain poorly understood3. The study of multiplanetary systems offers an opportunity to investigate the outcomes of planet formation and evolution while controlling for initial conditions and environment. Those in resonance (with their orbital periods related by a ratio of small integers) are particularly valuable because they imply a system architecture practically unchanged since its birth. Here we present the observations of six transiting planets around the bright nearby star HD 110067. We find that the planets follow a chain of resonant orbits. A dynamical study of the innermost planet triplet allowed the prediction and later confirmation of the orbits of the rest of the planets in the system. The six planets are found to be sub-Neptunes with radii ranging from 1.94R⊕ to 2.85R⊕. Three of the planets have measured masses, yielding low bulk densities that suggest the presence of large hydrogen-dominated atmospheres.
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Affiliation(s)
- R Luque
- Department of Astronomy and Astrophysics, University of Chicago, Chicago, IL, USA.
| | - H P Osborn
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
- Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
- Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - A Leleu
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - E Pallé
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Departamento de Astrofisica, Universidad de La Laguna, La Laguna, Tenerife, Spain
| | - A Bonfanti
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - O Barragán
- Sub-department of Astrophysics, Department of Physics, University of Oxford, Oxford, UK
| | - T G Wilson
- Centre for Exoplanet Science, SUPA School of Physics and Astronomy, University of St Andrews, St Andrews, UK
- Department of Physics, University of Warwick, Coventry, UK
- Centre for Exoplanets and Habitability, University of Warwick, Coventry, UK
| | - C Broeg
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
- Center for Space and Habitability, University of Bern, Bern, Switzerland
| | - A Collier Cameron
- Centre for Exoplanet Science, SUPA School of Physics and Astronomy, University of St Andrews, St Andrews, UK
| | - M Lendl
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - P F L Maxted
- Astrophysics Group, Lennard Jones Building, Keele University, Keele, UK
| | - Y Alibert
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
- Center for Space and Habitability, University of Bern, Bern, Switzerland
| | - D Gandolfi
- Dipartimento di Fisica, Universita degli Studi di Torino, Torino, Italy
| | - J-B Delisle
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - M J Hooton
- Cavendish Laboratory, University of Cambridge, Cambridge, UK
| | - J A Egger
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
| | - G Nowak
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Departamento de Astrofisica, Universidad de La Laguna, La Laguna, Tenerife, Spain
- Institute of Astronomy, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Toruń, Poland
| | - M Lafarga
- Department of Physics, University of Warwick, Coventry, UK
- Centre for Exoplanets and Habitability, University of Warwick, Coventry, UK
| | - D Rapetti
- NASA Ames Research Center, Moffett Field, CA, USA
- Research Institute for Advanced Computer Science, Universities Space Research Association, Washington, DC, USA
| | - J D Twicken
- NASA Ames Research Center, Moffett Field, CA, USA
- SETI Institute, Mountain View, CA, USA
| | - J C Morales
- Institut de Ciencies de l'Espai (ICE-CSIC), Bellaterra, Spain
- Institut d'Estudis Espacials de Catalunya (IEEC), Barcelona, Spain
| | - I Carleo
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- INAF - Osservatorio Astrofisico di Torino, Pino Torinese, Italy
| | - J Orell-Miquel
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Departamento de Astrofisica, Universidad de La Laguna, La Laguna, Tenerife, Spain
| | - V Adibekyan
- Instituto de Astrofísica e Ciências do Espaço, Universidade do Porto, Porto, Portugal
- Departamento de Física e Astronomia, Faculdade de Ciências, Universidade do Porto, Porto, Portugal
| | - R Alonso
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Departamento de Astrofisica, Universidad de La Laguna, La Laguna, Tenerife, Spain
| | - A Alqasim
- Mullard Space Science Laboratory, University College London, Dorking, UK
| | - P J Amado
- Instituto de Astrofísica de Andalucía (IAA-CSIC), Granada, Spain
| | - D R Anderson
- Department of Physics, University of Warwick, Coventry, UK
- Centre for Exoplanets and Habitability, University of Warwick, Coventry, UK
| | - G Anglada-Escudé
- Institut de Ciencies de l'Espai (ICE-CSIC), Bellaterra, Spain
- Institut d'Estudis Espacials de Catalunya (IEEC), Barcelona, Spain
| | - T Bandy
- European Space Research and Technology Centre (ESTEC), European Space Agency (ESA), Noordwijk, The Netherlands
| | | | | | - S C C Barros
- Instituto de Astrofisica e Ciencias do Espaco, Universidade do Porto, Porto, Portugal
- Departamento de Fisica e Astronomia, Faculdade de Ciencias, Universidade do Porto, Porto, Portugal
| | - W Baumjohann
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - D Bayliss
- Department of Physics, University of Warwick, Coventry, UK
| | - J L Bean
- Department of Astronomy and Astrophysics, University of Chicago, Chicago, IL, USA
| | - M Beck
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - T Beck
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
| | - W Benz
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
- Center for Space and Habitability, University of Bern, Bern, Switzerland
| | - N Billot
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - X Bonfils
- Université Grenoble Alpes, CNRS, IPAG, Grenoble, France
| | - L Borsato
- INAF - Osservatorio Astronomico di Padova, Padova, Italy
| | - A W Boyle
- Department of Astronomy, California Institute of Technology, Pasadena, CA, USA
| | - A Brandeker
- Department of Astronomy, Stockholm University, AlbaNova University Center, Stockholm, Sweden
| | - E M Bryant
- Department of Physics, University of Warwick, Coventry, UK
- Mullard Space Science Laboratory, University College London, Dorking, UK
| | - J Cabrera
- Institute of Planetary Research, German Aerospace Center (DLR), Berlin, Germany
| | - S Carrazco-Gaxiola
- Instituto de Astronomía, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
- Department of Physics and Astronomy, Georgia State University, Atlanta, GA, USA
- RECONS Institute, Chambersburg, PA, USA
| | - D Charbonneau
- Center for Astrophysics | Harvard & Smithsonian, Cambridge, MA, USA
| | - S Charnoz
- Université de Paris Cité, Institut de Physique du Globe de Paris, CNRS, Paris, France
| | - D R Ciardi
- Department of Astronomy, California Institute of Technology, Pasadena, CA, USA
| | - W D Cochran
- McDonald Observatory, The University of Texas, Austin, TX, USA
- Center for Planetary Systems Habitability, The University of Texas, Austin, TX, USA
| | - K A Collins
- Center for Astrophysics | Harvard & Smithsonian, Cambridge, MA, USA
| | - I J M Crossfield
- Department of Physics and Astronomy, University of Kansas, Lawrence, KS, USA
| | - Sz Csizmadia
- Institute of Planetary Research, German Aerospace Center (DLR), Berlin, Germany
| | - P E Cubillos
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
- INAF - Osservatorio Astrofisico di Torino, Pino Torinese, Italy
| | - F Dai
- Department of Astronomy, California Institute of Technology, Pasadena, CA, USA
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA, USA
| | - M B Davies
- Centre for Mathematical Sciences, Lund University, Lund, Sweden
| | - H J Deeg
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Departamento de Astrofisica, Universidad de La Laguna, La Laguna, Tenerife, Spain
| | - M Deleuil
- Aix Marseille Univ., CNRS, CNES, LAM, Marseille, France
| | - A Deline
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - L Delrez
- Astrobiology Research Unit, Université de Liège, Liège, Belgium
- Space sciences, Technologies and Astrophysics Research (STAR) Institute, Université de Liège, Liège, Belgium
| | - O D S Demangeon
- Instituto de Astrofisica e Ciencias do Espaco, Universidade do Porto, Porto, Portugal
- Departamento de Fisica e Astronomia, Faculdade de Ciencias, Universidade do Porto, Porto, Portugal
| | - B-O Demory
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
- Center for Space and Habitability, University of Bern, Bern, Switzerland
| | - D Ehrenreich
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
- Centre Vie dans l'Univers, Faculté des sciences, Université de Genève, Genève 4, Switzerland
| | - A Erikson
- Institute of Planetary Research, German Aerospace Center (DLR), Berlin, Germany
| | - E Esparza-Borges
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Departamento de Astrofisica, Universidad de La Laguna, La Laguna, Tenerife, Spain
| | - B Falk
- Space Telescope Science Institute, Baltimore, MD, USA
| | - A Fortier
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
- Center for Space and Habitability, University of Bern, Bern, Switzerland
| | - L Fossati
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - M Fridlund
- Leiden Observatory, University of Leiden, Leiden, The Netherlands
- Onsala Space Observatory, Department of Space, Earth and Environment, Chalmers University of Technology, Onsala, Sweden
| | - A Fukui
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Komaba Institute for Science, The University of Tokyo, Tokyo, Japan
| | - J Garcia-Mejia
- Center for Astrophysics | Harvard & Smithsonian, Cambridge, MA, USA
| | - S Gill
- Department of Physics, University of Warwick, Coventry, UK
| | - M Gillon
- Astrobiology Research Unit, Université de Liège, Liège, Belgium
| | - E Goffo
- Dipartimento di Fisica, Universita degli Studi di Torino, Torino, Italy
- Thüringer Landessternwarte Tautenburg, Tautenburg, Germany
| | - Y Gómez Maqueo Chew
- Instituto de Astronomía, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - M Güdel
- Department of Astrophysics, University of Vienna, Vienna, Austria
| | - E W Guenther
- Thüringer Landessternwarte Tautenburg, Tautenburg, Germany
| | - M N Günther
- European Space Research and Technology Centre (ESTEC), European Space Agency (ESA), Noordwijk, The Netherlands
| | - A P Hatzes
- Thüringer Landessternwarte Tautenburg, Tautenburg, Germany
| | - Ch Helling
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - K M Hesse
- Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
- Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - S B Howell
- NASA Ames Research Center, Moffett Field, CA, USA
| | - S Hoyer
- Aix Marseille Univ., CNRS, CNES, LAM, Marseille, France
| | - K Ikuta
- Department of Multi-Disciplinary Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - K G Isaak
- European Space Research and Technology Centre (ESTEC), European Space Agency (ESA), Noordwijk, The Netherlands
| | - J M Jenkins
- NASA Ames Research Center, Moffett Field, CA, USA
| | - T Kagetani
- Department of Multi-Disciplinary Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - L L Kiss
- Konkoly Observatory, HUN-REN Research Centre for Astronomy and Earth Sciences, Budapest, Hungary
- Institute of Physics, ELTE Eötvös Loránd University, Budapest, Hungary
| | - T Kodama
- Komaba Institute for Science, The University of Tokyo, Tokyo, Japan
| | - J Korth
- Lund Observatory, Division of Astrophysics, Department of Physics, Lund University, Lund, Sweden
| | - K W F Lam
- Institute of Planetary Research, German Aerospace Center (DLR), Berlin, Germany
| | - J Laskar
- IMCCE, UMR8028 CNRS, Observatoire de Paris, PSL Univ., Sorbonne Univ., Paris, France
| | - D W Latham
- Center for Astrophysics | Harvard & Smithsonian, Cambridge, MA, USA
| | - A Lecavelier des Etangs
- Institut d'Astrophysique de Paris, UMR7095 CNRS, Université Pierre & Marie Curie, Paris, France
| | - J P D Leon
- Department of Multi-Disciplinary Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - J H Livingston
- Astrobiology Center, Tokyo, Japan
- National Astronomical Observatory of Japan, Tokyo, Japan
- Department of Astronomical Science, The Graduate University for Advanced Studies, SOKENDAI, Tokyo, Japan
| | - D Magrin
- INAF - Osservatorio Astronomico di Padova, Padova, Italy
| | - R A Matson
- United States Naval Observatory, Washington, DC, USA
| | - E C Matthews
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - C Mordasini
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
- Center for Space and Habitability, University of Bern, Bern, Switzerland
| | - M Mori
- Department of Multi-Disciplinary Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - M Moyano
- Instituto de Astronomía, Universidad Católica del Norte, Antofagasta, Chile
| | - M Munari
- INAF - Osservatorio Astrofisico di Catania, Catania, Italy
| | - F Murgas
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Departamento de Astrofisica, Universidad de La Laguna, La Laguna, Tenerife, Spain
| | - N Narita
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Komaba Institute for Science, The University of Tokyo, Tokyo, Japan
- Astrobiology Center, Tokyo, Japan
| | - V Nascimbeni
- INAF - Osservatorio Astronomico di Padova, Padova, Italy
| | - G Olofsson
- Department of Astronomy, Stockholm University, AlbaNova University Center, Stockholm, Sweden
| | - H L M Osborne
- Mullard Space Science Laboratory, University College London, Dorking, UK
| | - R Ottensamer
- Department of Astrophysics, University of Vienna, Vienna, Austria
| | - I Pagano
- INAF - Osservatorio Astrofisico di Catania, Catania, Italy
| | - H Parviainen
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Departamento de Astrofisica, Universidad de La Laguna, La Laguna, Tenerife, Spain
| | - G Peter
- Institute of Optical Sensor Systems, German Aerospace Center (DLR), Berlin, Germany
| | - G Piotto
- INAF - Osservatorio Astronomico di Padova, Padova, Italy
- Dipartimento di Fisica e Astronomia "Galileo Galilei", Universita degli Studi di Padova, Padova, Italy
| | - D Pollacco
- Department of Physics, University of Warwick, Coventry, UK
| | - D Queloz
- Cavendish Laboratory, University of Cambridge, Cambridge, UK
- Department of Physics, ETH Zurich, Zurich, Switzerland
| | - S N Quinn
- Center for Astrophysics | Harvard & Smithsonian, Cambridge, MA, USA
| | - A Quirrenbach
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, Heidelberg, Germany
| | - R Ragazzoni
- INAF - Osservatorio Astronomico di Padova, Padova, Italy
- Dipartimento di Fisica e Astronomia "Galileo Galilei", Universita degli Studi di Padova, Padova, Italy
| | - N Rando
- European Space Research and Technology Centre (ESTEC), European Space Agency (ESA), Noordwijk, The Netherlands
| | - F Ratti
- European Space Research and Technology Centre (ESTEC), European Space Agency (ESA), Noordwijk, The Netherlands
| | - H Rauer
- Institute of Planetary Research, German Aerospace Center (DLR), Berlin, Germany
- Zentrum für Astronomie und Astrophysik, Technische Universität Berlin, Berlin, Germany
- Institut für Geologische Wissenschaften, Freie Universität Berlin, Berlin, Germany
| | - S Redfield
- Astronomy Department, Wesleyan University, Middletown, CT, USA
- Van Vleck Observatory, Wesleyan University, Middletown, CT, USA
| | - I Ribas
- Institut de Ciencies de l'Espai (ICE-CSIC), Bellaterra, Spain
- Institut d'Estudis Espacials de Catalunya (IEEC), Barcelona, Spain
| | - G R Ricker
- Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
- Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - A Rudat
- Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
- Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - L Sabin
- Instituto de Astronomía, Universidad Nacional Autónoma de México, Ensenada, Mexico
| | - S Salmon
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - N C Santos
- Instituto de Astrofisica e Ciencias do Espaco, Universidade do Porto, Porto, Portugal
- Departamento de Fisica e Astronomia, Faculdade de Ciencias, Universidade do Porto, Porto, Portugal
| | - G Scandariato
- INAF - Osservatorio Astrofisico di Catania, Catania, Italy
| | - N Schanche
- Center for Space and Habitability, University of Bern, Bern, Switzerland
- Department of Astronomy, University of Maryland, College Park, MD, USA
| | - J E Schlieder
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - S Seager
- Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
- Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - D Ségransan
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - A Shporer
- Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
- Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - A E Simon
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
| | - A M S Smith
- Institute of Planetary Research, German Aerospace Center (DLR), Berlin, Germany
| | - S G Sousa
- Instituto de Astrofisica e Ciencias do Espaco, Universidade do Porto, Porto, Portugal
| | - M Stalport
- Space sciences, Technologies and Astrophysics Research (STAR) Institute, Université de Liège, Liège, Belgium
| | - Gy M Szabó
- Gothard Astrophysical Observatory, ELTE Eötvös Loránd University, Szombathely, Hungary
- HUN-REN-ELTE Exoplanet Research Group, Szombathely, Hungary
| | - N Thomas
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
| | - A Tuson
- Cavendish Laboratory, University of Cambridge, Cambridge, UK
| | - S Udry
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - A M Vanderburg
- Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
- Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - V Van Eylen
- Mullard Space Science Laboratory, University College London, Dorking, UK
| | - V Van Grootel
- Space sciences, Technologies and Astrophysics Research (STAR) Institute, Université de Liège, Liège, Belgium
| | - J Venturini
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - I Walter
- Institute of Optical Sensor Systems, German Aerospace Center (DLR), Berlin, Germany
| | - N A Walton
- Institute of Astronomy, University of Cambridge, Cambridge, UK
| | - N Watanabe
- Department of Multi-Disciplinary Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - J N Winn
- Department of Astrophysical Sciences, Princeton University, Princeton, NJ, USA
| | - T Zingales
- Dipartimento di Fisica e Astronomia "Galileo Galilei", Universita degli Studi di Padova, Padova, Italy
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Tonner E, Crawshaw S, Dolman M, Chambers E, Williamson J, Thomas N, Hobbs R, Little P, Butler C, Evans P. Innovative methods of recruitment through the NIHR Clinical Research Network (CRN) into large-scale pandemic trials in primary care: the PANORAMIC trial experience. Br J Gen Pract 2023; 73:bjgp23X733665. [PMID: 37479296 DOI: 10.3399/bjgp23x733665] [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: 07/23/2023] Open
Abstract
BACKGROUND In the summer of 2021, after 18 months of the COVID-19 pandemic, there were still no clear evidence-based interventions for COVID-19 infection in the community. Recruiting large numbers at pace was a challenge to urgently generate the evidence needed to inform care within the pandemic. AIM To develop efficient, user-friendly recruitment methods to offer large numbers of acutely unwell, infectious people with COVID-19 UK the opportunity to participate in a priority trial and test the clinical and cost-effectiveness of molnupiravir. METHOD PANORAMIC was an adaptive platform clinical trial with participants randomised to either a novel antiviral or usual care. Participants needed to start antiviral medication within 5 days of symptom onset. Innovative methods of identifying positive individuals within general practice were developed, as well as online research procedures for delivery and follow-up, including through www.panoramictrial.org. RESULTS Novel methods of recruitment were developed in collaboration between the study team and the NIHR Clinical Research Network (CRN), and continually adapted during the study. These included virtual recruitment through the study website combined with GP recruitment via hub and spoke models: this was supported by data, stakeholder, and workforce infrastructure across devolved administration. PANORAMIC was the fastest recruiting study ever delivered by primary care in the NIHR CRN. There were 26 411 participants recruited. Final molnupiravir results will also be presented. CONCLUSION Large-scale, at-pace recruitment supported by the English CRN and equivalent networks across the UK, is achievable in a pandemic situation, producing potentially game-changing results of national and international importance.
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Affiliation(s)
| | | | | | | | | | | | - Richard Hobbs
- PANORAMIC trial team, Oxford Primary Care, University of Oxford
| | - Paul Little
- PANORAMIC trial team, Primary Care Research Centre, University of Southampton
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Baig Mirza A, Pedro Lavrador J, Gebreyohanes A, Vastani A, China M, Kalaitzoglou D, Bartram J, Eid H, Bleil C, Bell D, Thomas N, Malik I, Grahovac G. Prognostic Factors for Surgically Managed Spontaneous Spinal Epidural Hematoma: A Single-Center Case Series of 18 Patients. Oper Neurosurg (Hagerstown) 2023; 24:391-403. [PMID: 36701561 DOI: 10.1227/ons.0000000000000562] [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: 06/29/2022] [Accepted: 09/30/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Spontaneous spinal epidural hematoma (SSEH) is a rare pathology, which carries a significant morbidity. OBJECTIVE To review our institutional experience of surgically managed patients with SSEH, seeking to better understand clinical prognostic factors related to postoperative outcomes and thereby improve counseling of patients before treatment. METHODS All patients who underwent surgical management of SSEH between September 2011 and 2021. Baseline and postoperative clinical and radiological characteristics are presented, including the American Spinal Injury Association grade (ASIA). Statistical analyses were performed using Stata 13.1. RESULTS Eighteen patients were identified in total (11 male patients and 7 female patients) with a median age of 59.5 (range 3-83) years. The most common spinal region affected was cervicothoracic (33.3%). Limb weakness (94.4%) and urinary dysfunction (83.3%) represented the most common presenting symptoms. Preoperatively, the presence of spinal cord edema on imaging was associated with worse preoperative Medical Research Council (MRC) grade ( P = .033), female sex was associated with preserved saddle sensation ( P = .04), and patients receiving antiplatelet medication were associated with a higher risk of preoperative axial back pain ( P = .005). Higher postoperative MRC grade was associated with higher preoperative ASIA ( P = .012) and MRC grade ( P = .005), and preservation of saddle sensation ( P = .018). Postoperative improvements in axial back pain were associated with higher preoperative ASIA grade ( P = .035) and anticoagulation treatment ( P = .029). CONCLUSION Neurosurgical intervention for SSEH yields positive outcomes and benefits patients. Patients with higher preoperative ASIA, MRC grade, and those presenting with preserved saddle sensation may experience further improved clinical outcomes after intervention.
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Affiliation(s)
- Asfand Baig Mirza
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Jose Pedro Lavrador
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Axumawi Gebreyohanes
- Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Amisha Vastani
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Musa China
- Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London, UK.,University College London (UCL) Medical School, London, UK
| | - Dimitrios Kalaitzoglou
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - James Bartram
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Hazem Eid
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Christina Bleil
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - David Bell
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Nicholas Thomas
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Irfan Malik
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Gordan Grahovac
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
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Pryor J, Agarwal N, Randhawa S, Thomas N, Steele M, Gray A, Smith J. Treating 2 Birds with 1 Stone: Lobectomy for Diagnosis of Lung Cancer and Lung Volume Reduction Surgery Post-Transplant. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Ghimire P, Pang G, Philip J, Hazem S, Rajwani K, Lavrador JP, Grahovac G, Bleil C, Thomas N, Gullan R, Vergani F, Bhangoo R, Ashkan K. Therapeutic Strategies and Challenges in the Management of Craniospinal Tumors in Pregnancy: A Ten-Year Retrospective Tertiary-Center Study, Systematic Review, and Proposal of Treatment Algorithms. World Neurosurg 2023; 171:e213-e229. [PMID: 36481447 DOI: 10.1016/j.wneu.2022.11.139] [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: 10/13/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study aims to review therapeutic strategies in the management of craniospinal tumors in pregnant patients and the factors that may influence the management along with their influence on maternal and fetal outcomes. METHODS A retrospective single-center cohort study was performed at a tertiary neurosurgical referral center. Pregnant patients referred to the neuro-oncology multidisciplinary meeting (MDM) with craniospinal tumor were included. Ten-year patient data were collected from hospital records and neuro-oncology MDM outcomes. A systematic review was performed of the available literature as per PRISMA guidelines. RESULTS Twenty-five patients were identified, with a mean age of 31 years. Of these patients, 88% (n = 22) had cranial lesions and 12% (n = 3) had spinal lesions. Most of the patients had World Health Organization grade I/II tumors. Of the patients, 44% underwent surgery when pregnant, whereas in 40%, this was deferred until after the due date. Of patients, 16% did not require surgical intervention and were followed up with serial imaging in the MDM. The left lateral/park bench position was the preferred position for the spinal and posterior fossa lesions. Systematic review and retrospective data led to proposal of treatment algorithms addressing the therapeutic strategy for management of craniospinal tumors during pregnancy. Factors that may influence maternal and fetal outcomes during management of these tumors were identified, including aggressiveness of the tumor and stage of pregnancy. CONCLUSIONS Craniospinal tumors presenting in pregnancy are challenging. The surgical management needs to be tailored individually and as part of a multidisciplinary team approach. Factors influencing maternal and fetal outcomes are to be considered during management and patient counseling.
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Affiliation(s)
- Prajwal Ghimire
- King's College Hospital NHS Foundation Trust, London, United Kingdom.
| | - Graeme Pang
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Jerry Philip
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Sally Hazem
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Kapil Rajwani
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | | | - Gordan Grahovac
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Cristina Bleil
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Nicholas Thomas
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Richard Gullan
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Francesco Vergani
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Ranjeev Bhangoo
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Keyoumars Ashkan
- King's College Hospital NHS Foundation Trust, London, United Kingdom; Kings College London, London, United Kingdom
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Dorjulus B, Prieto C, Elger RS, Oredein I, Chandran V, Yusuf B, Wilson R, Thomas N, Marshall J. An evaluation of factors associated with safe infant sleep practices among perinatal home visiting participants in Florida, United States. J Child Health Care 2023; 27:78-90. [PMID: 34517738 DOI: 10.1177/13674935211044871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sleep-related deaths are a leading cause of infant mortality in Florida. The American Academy of Pediatrics recommends placing infants to sleep on their back, alone, and without soft bedding. Compliance with these guidelines varies among parents. This evaluation examined the rates of safe infant sleep practices and associated factors among 1985 participants enrolled in Florida Maternal, Infant, and Early Childhood Home Visiting (FL MIECHV) programs during 2017-2019. Participant- and program-level variables were examined in relation to three sleep practices: infant position, bedding, and bed-sharing at 2-3 months to determine which factors were associated with high rates of safe sleep outcomes. Analyses included univariate descriptive statistics, bivariate statistics, and multivariable logistic regression. Most caregivers (70%) reported always placing their babies to sleep on their back, alone, and without soft bedding. Factors such as primary language, race, education, housing situation, and year the Safe Baby™ curriculum implemented were significantly associated with safe infant sleep practices. Bearing this in mind, FL MIECHV can tailor safe sleep education, messaging, and strategies to support participants at highest risk. Recent adoption of the Safe Baby™ curriculum, and associated staff training, was an important factor influencing parents' infant sleep practices.
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Affiliation(s)
- Barbara Dorjulus
- College of Public Health, 7831University of South Florida, Tampa, FL, USA
| | - Concha Prieto
- College of Public Health, 7831University of South Florida, Tampa, FL, USA
| | - Rafaella S Elger
- College of Public Health, 7831University of South Florida, Tampa, FL, USA
| | | | - Vidya Chandran
- College of Public Health, 7831University of South Florida, Tampa, FL, USA
| | - Bola Yusuf
- College of Public Health, 7831University of South Florida, Tampa, FL, USA
| | - Roneé Wilson
- College of Public Health, 7831University of South Florida, Tampa, FL, USA
| | - Nicholas Thomas
- College of Public Health, 7831University of South Florida, Tampa, FL, USA
| | - Jennifer Marshall
- College of Public Health, 7831University of South Florida, Tampa, FL, USA
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Sauvage E, Gehanno J, Thomas N, Rollin L. Prévalence du SARS-CoV-2, étude sérologique en France chez des salariés non confinés et confinés. ARCH MAL PROF ENVIRO 2023. [PMCID: PMC9892330 DOI: 10.1016/j.admp.2023.101798] [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: 02/05/2023]
Abstract
Objectifs: Evaluer rétrospectivement le taux de salariés, confinés (en télétravail) et non confinés, infectés par le SARS-CoV-2 après le 1er confinement (Avril à Mai 2020). Méthode: Un dépistage sérologique des anticorps anti-SARS-CoV-2, IgG et IgM, et un questionnaire sur leurs symptômes a été proposé aux 2090 salariés d’une même entreprise. Résultats: La sérologie était positive pour 5,6% des 786 salariés inclus entre fin avril et juillet 2020 : 4,05% chez les non confinés, et 6,72%, chez les confinés (p=NS). Parmi les positifs, 86,4% avaient présenté des symptômes, sans différence significative entre confinés et non confinés. Enfin, 1.7% des asymptomatiques étaient positifs. Les symptômes n’étaient pas significativement différents entre les 2 groupes sauf pour l’anosmie-agueusie significativement plus fréquente dans le groupe des confinés. Les symptômes significativement associés à une sérologie positive étaient l’anosmie-agueusie, la fièvre-sensation de fièvre-frissons, les courbatures, la fatigue malaise, un syndrome grippal et des symptômes respiratoires. Ce faible taux de contamination peut être le résultat des mesures de prévention renforcées mises en place pour les salariés dès fin janvier 2020 par le Médecin du Travail pour limiter le risque de contamination au sein des locaux. Conclusion: La prévalence du SARS-CoV-2 dans l’entreprise de fin avril à juillet 2020 était inférieure de moitié au taux rapporté dans la population d’Ile de France à la même période sans différence entre les salariés ayant poursuivi leur activité en présentiel par rapport aux confinés.
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Affiliation(s)
- E. Sauvage
- CMPC-Thalie Santé, service interentreprise de médecine du travail, CMPC-Thalie Santé 62 bis av André Morizet, 92100 Boulogne-Billancourt, France
| | - J.F. Gehanno
- Institute of Occupational Health, Rouen University Hospital, France,Inserm, U1142, LIMICS, laboratoire d’informatique médicale et d’ingénierie des connaissances en e-Santé, Sorbonne université, Paris, France,Université de Rouen - Normandie, Rouen, France
| | - N. Thomas
- Observatoire régional de la Santé et du Social, Amiens, France
| | - L. Rollin
- Institute of Occupational Health, Rouen University Hospital, France,Inserm, U1142, LIMICS, laboratoire d’informatique médicale et d’ingénierie des connaissances en e-Santé, Sorbonne université, Paris, France,Université de Rouen - Normandie, Rouen, France,Nom et adresse de l’auteur de correspondance: Service de Médecine du Travail et de pathologie professionnelle CHU de Rouen, 1 rue de Germont, 76031 Rouen cedex, France
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Hardt K, Vandebosch A, Sadoff J, Le Gars M, Truyers C, Lowson D, Van Dromme I, Vingerhoets J, Kamphuis T, Scheper G, Ruiz-Guiñazú J, Faust SN, Spinner CD, Schuitemaker H, Van Hoof J, Douoguih M, Struyf F, Albertson TE, Sandrock C, Lee JS, Looney MR, Tapson VF, Wiysonge CS, Velarde LHA, Backenroth D, Bhushanan J, Brandenburg B, Cárdenas V, Chen B, Chen F, Chetty P, Chu PL, Cooper K, Custers J, Delanghe H, Duca A, Henrick T, Juraszek J, Nalpas C, Peeters M, Pinheiro J, Roels S, Ryser MF, Salas J, Santoro Matias S, Scheys I, Shetty P, Shukarev G, Stoddard J, Talloen W, Tran N, Vaissiere N, van Son-Palmen E, Xu J, Goecker EA, Greninger AL, Jerome KR, Roychoudhury P, Takuva SG, Accini Mendoza JL, Achtyes E, Ahsan H, Alhatemi A, Allen N, Arribas JR, Bahrami G, Bailon L, Bajwa A, Baker J, Baron M, Benet S, Berdaï D, Berger P, Bertoch T, Bethune C, Bevilacqua S, Biagioni Santos MS, Binnian I, Bisnauthsing K, Boivin JM, Bollen H, Bonnet S, Borobia AM, Botelho-Nevers E, Bright P, Britten V, Brown C, Buadi A, Buntinx E, Burgess L, Bush L, Capeding MR, Carr QO, Carrasco Mas A, Catala H, Cathie K, Caudill TS, Cereto Castro F, Chau K, Chavoustie S, Chowdhury M, Chronos N, Cicconi P, Cifuentes L, Cobo SM, Collins H, Colton H, Cuaño CRG, D'Onofrio V, Dargan P, Darton T, Deane P, Del Pozo JL, Derdelinckx I, Desai A, Dever M, Díaz-Pollán B, DiBuono M, Doust M, Duncan C, Echave-Sustaeta JM, Eder F, Ellis K, Elzi S, Emmett S, Engelbrecht J, Evans M, Farah T, Felton T, Ferreira JP, Floutier C, Flume P, Ford S, Fragoso V, Freedman A, Frentiu E, Galloway C, Galtier F, Garcia Diaz J, García García I, Garcia A, Gardener Z, Gauteul P, Geller S, Gibson A, Gillet C, Girerd N, Girodet PO, Gler MT, Glover R, Go HDD, Gokani K, Gonthier D, Green C, Greenberg R, Griffin C, Grobbelaar C, Guancia A, Hakkarainen G, Harris J, Hassman M, Heimer D, Hellstrom-Louw E, Herades Y, Holroyd C, Hussen N, Isidro MGD, Jackson Y, Jain M, João Filho EC, Johnson D, Jones B, Joseph N, Jumeras A, Junquera P, Kellett-Wright J, Kennedy P, Kilgore PE, Kim K, Kimmel M, Konis G, Kutner M, Lacombe K, Launay O, Lazarus R, Lederman S, Lefebvre G, Lennon Collins K, Leroux-Roels I, Lim KWO, Lins M, Liu E, Llewelyn M, Mahomed A, Maia BP, Marín-Candon A, Martínez-Gómez X, Martinot JB, Mazzella A, McCaughan F, McCormack L, McGettigan J, Mehra P, Mejeur R, Miller V, Mills A, Molto Marhuenda J, Moodley P, Mora-Rillo M, Mothe B, Mullan D, Munro A, Myers P, Nell J, Newman Lobato Souza T, O'Halloran JA, Ochoa Mazarro MD, Oliver A, Onate Gutierrez JM, Ortega J, Oshita M, Otero Romero S, Overcash JS, Owens D, Packham A, Paiva de Sousa L, Palfreeman A, Pallares CJ, Patel R, Patel S, Pelkey L, Peluso D, Penciu F, Pinto SJ, Pounds K, Pouzar J, Pragalos A, Presti R, Price D, Qureshi E, Ramalho Madruga JV, Ramesh M, Rankin B, Razat B, Riegel Santos B, Riesenberg R, Riffer E, Roche S, Rose K, Rosellini P, Rossignol P, Safirstein B, Salazar H, Sanchez Vallejo G, Santhosh S, Seco-Meseguer E, Seep M, Sherry E, Short P, Soentjens P, Solis J, Soriano Viladomiu A, Sorli C, Spangenthal S, Spence N, Stephenson E, Strout C, Surowitz R, Taladua KM, Tellalian D, Thalamas C, Thiriphoo N, Thomas J, Thomas N, Trout G, Urroz M, Veekmans B, Veekmans L, Villalobos REM, Webster B, White A, Williams G, Williams H, Wilson B, Winston A, Wiselka M, Zervos M. Efficacy, safety, and immunogenicity of a booster regimen of Ad26.COV2.S vaccine against COVID-19 (ENSEMBLE2): results of a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Infect Dis 2022; 22:1703-1715. [PMID: 36113538 PMCID: PMC9639796 DOI: 10.1016/s1473-3099(22)00506-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Despite the availability of effective vaccines against COVID-19, booster vaccinations are needed to maintain vaccine-induced protection against variant strains and breakthrough infections. This study aimed to investigate the efficacy, safety, and immunogenicity of the Ad26.COV2.S vaccine (Janssen) as primary vaccination plus a booster dose. METHODS ENSEMBLE2 is a randomised, double-blind, placebo-controlled, phase 3 trial including crossover vaccination after emergency authorisation of COVID-19 vaccines. Adults aged at least 18 years without previous COVID-19 vaccination at public and private medical practices and hospitals in Belgium, Brazil, Colombia, France, Germany, the Philippines, South Africa, Spain, the UK, and the USA were randomly assigned 1:1 via a computer algorithm to receive intramuscularly administered Ad26.COV2.S as a primary dose plus a booster dose at 2 months or two placebo injections 2 months apart. The primary endpoint was vaccine efficacy against the first occurrence of molecularly confirmed moderate to severe-critical COVID-19 with onset at least 14 days after booster vaccination, which was assessed in participants who received two doses of vaccine or placebo, were negative for SARS-CoV-2 by PCR at baseline and on serology at baseline and day 71, had no major protocol deviations, and were at risk of COVID-19 (ie, had no PCR-positive result or discontinued the study before day 71). Safety was assessed in all participants; reactogenicity, in terms of solicited local and systemic adverse events, was assessed as a secondary endpoint in a safety subset (approximately 6000 randomly selected participants). The trial is registered with ClinicalTrials.gov, NCT04614948, and is ongoing. FINDINGS Enrolment began on Nov 16, 2020, and the primary analysis data cutoff was June 25, 2021. From 34 571 participants screened, the double-blind phase enrolled 31 300 participants, 14 492 of whom received two doses (7484 in the Ad26.COV2.S group and 7008 in the placebo group) and 11 639 of whom were eligible for inclusion in the assessment of the primary endpoint (6024 in the Ad26.COV2.S group and 5615 in the placebo group). The median (IQR) follow-up post-booster vaccination was 36·0 (15·0-62·0) days. Vaccine efficacy was 75·2% (adjusted 95% CI 54·6-87·3) against moderate to severe-critical COVID-19 (14 cases in the Ad26.COV2.S group and 52 cases in the placebo group). Most cases were due to the variants alpha (B.1.1.7) and mu (B.1.621); endpoints for the primary analysis accrued from Nov 16, 2020, to June 25, 2021, before the global dominance of delta (B.1.617.2) or omicron (B.1.1.529). The booster vaccine exhibited an acceptable safety profile. The overall frequencies of solicited local and systemic adverse events (evaluated in the safety subset, n=6067) were higher among vaccine recipients than placebo recipients after the primary and booster doses. The frequency of solicited adverse events in the Ad26.COV2.S group were similar following the primary and booster vaccinations (local adverse events, 1676 [55·6%] of 3015 vs 896 [57·5%] of 1559, respectively; systemic adverse events, 1764 [58·5%] of 3015 vs 821 [52·7%] of 1559, respectively). Solicited adverse events were transient and mostly grade 1-2 in severity. INTERPRETATION A homologous Ad26.COV2.S booster administered 2 months after primary single-dose vaccination in adults had an acceptable safety profile and was efficacious against moderate to severe-critical COVID-19. Studies assessing efficacy against newer variants and with longer follow-up are needed. FUNDING Janssen Research & Development.
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Affiliation(s)
- Karin Hardt
- Janssen Research & Development, Beerse, Belgium
| | | | | | | | | | - David Lowson
- Janssen Research & Development, High Wycombe, UK
| | | | | | | | - Gert Scheper
- Janssen Vaccines & Prevention, Leiden, Netherlands
| | | | - Saul N Faust
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, Southampton, UK; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | | | | | | | | | - Frank Struyf
- Janssen Research & Development, Beerse, Belgium.
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Liller KD, Thomas N, Ramirez J, Amoros E, Diblanda A, Salinas A, Agrawal K, Trejos R. The Florida Violent Death Reporting System 2019 Data Findings Including a Qualitative Focus on Suicide Deaths of Young Black Males. Am J Lifestyle Med 2022. [DOI: 10.1177/15598276221136523] [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] Open
Abstract
The Florida Violent Death Reporting System (FLVDRS) includes violent death data abstracted from death certificates (DC), medical examiner (ME) reports, and law enforcement (LE) records. Abstractors also produce narratives from the ME and LE information. This manuscript focuses on the findings from the 2019 FLVDRS. Quantitative data were reviewed using SPSS and STATA and MAXQDA was used for the qualitative analysis. Results showed that most deaths were suicides (69.0%). Males comprised most of all the violent deaths (77.4%). Qualitative analysis focused on available narratives of Black males regardless of ethnicity, ages 10–24 years, who died of suicide (n = 19). The most prominent codes from the qualitative analysis included scene location, suicide method, engagement with LE, known history of psychiatric conditions, known history of self-injurious behavior, and recent life events. Subcodes related to the parent codes are also provided for further explanation of the findings. Future research will allow confirmation of findings and development of targeted intervention programs.
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Affiliation(s)
- Karen D. Liller
- University of South Florida College of Public Health, Tampa, FL, USA (KDL, NT, JR, EA, AD, AS, KA, RT)
| | - Nicholas Thomas
- University of South Florida College of Public Health, Tampa, FL, USA (KDL, NT, JR, EA, AD, AS, KA, RT)
| | - Jennifer Ramirez
- University of South Florida College of Public Health, Tampa, FL, USA (KDL, NT, JR, EA, AD, AS, KA, RT)
| | - Elizabeth Amoros
- University of South Florida College of Public Health, Tampa, FL, USA (KDL, NT, JR, EA, AD, AS, KA, RT)
| | - Alexis Diblanda
- University of South Florida College of Public Health, Tampa, FL, USA (KDL, NT, JR, EA, AD, AS, KA, RT)
| | - Abraham Salinas
- University of South Florida College of Public Health, Tampa, FL, USA (KDL, NT, JR, EA, AD, AS, KA, RT)
| | - Kelli Agrawal
- University of South Florida College of Public Health, Tampa, FL, USA (KDL, NT, JR, EA, AD, AS, KA, RT)
| | - Rolando Trejos
- University of South Florida College of Public Health, Tampa, FL, USA (KDL, NT, JR, EA, AD, AS, KA, RT)
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Thomas N, Stankard A, Cosgrave N, Conlon B, Monahan P, Halpin T, Britton D, Byrne P, McShane S, Sohail I, Grogan AM, Reilly A, Thapa A, Alsubaie N, Rane P, O'Connor J, Gray S, Kaja A, Gehani K, Kovalyshyn V, O'Brien H. 92 CONTINUING TO ‘BE HIP’: ORTHOGERIATRIC SERVICE IMPROVEMENTS IN 2021. Age Ageing 2022. [PMCID: PMC9620584 DOI: 10.1093/ageing/afac218.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Scotland first demonstrated that adherence to nationally agreed hip fracture standards improve patient survival, reduces the duration of admission, and reduces the need for high dependency care. Our study aims to assess adherence to the Irish Hip Fracture Standards (IHFS) in our hospital for 2021 amidst the COVID-19 pandemic, translating to improved clinical outcomes for our patients. Methods The IHF database was retrospectively analysed, comparing quarters 1-4 in 2021 with our 2020 results. Results IHFS1, patient time to the ward < 4hours, was maintained at 67% in 2021 versus 71% overall in 2020. There was improvement in IHFS2, time to surgery within 48 hours, up to 73% in 2021 versus 66% in 2020. IHFS3 was 4% in 2021 versus 3% overall in 2020. Further improvements were noted for IHFS4, with 95% of patients reviewed by a Geriatrician in 2021 versus 87% in 2020. IHFS5 also improved with 97% of patients receiving a bone health assessment in 2021 versus 87% in 2020. Moreover, IHFS6, improved with 97% of patients undergoing a specialised falls assessment in 2021 versus 87% in 2020. Conclusion The improvement in 2021 figures is reflective of the return of redeployed services during the COVID-19 pandemic inclusive of the Orthogeriatric Service, the Fracture Liaison Service Advanced Nurse Practitioner, the Trauma Co-ordinator, and the specialist Orthopaedic ward complete with its Orthopaedic nurses and Multi-Disciplinary Team, and improved Emergency Department pathways. These continued improvements in the IHFS further emphasise that success is dependent on a team that is joined at the hip
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Affiliation(s)
- N Thomas
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - A Stankard
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - N Cosgrave
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - B Conlon
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - P Monahan
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - T Halpin
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - D Britton
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - P Byrne
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - S McShane
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - I Sohail
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - AM Grogan
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - A Reilly
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - A Thapa
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - N Alsubaie
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - P Rane
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - J O'Connor
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - S Gray
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - A Kaja
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - K Gehani
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - V Kovalyshyn
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - H O'Brien
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
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Stankard A, Thomas N, Cosgrave N, Conlon B, Monaghan P, Halpin T, English D, Byrne P, McShane S, Sohail I, Grogan AM, Reilly A, Thapa A, Alsubaie N, Rane P, O'Connor J, Gray S, Kaja A, Gehani K, Kovalyshyn V, O'Brien H. 258 RISING TO THE CHALLENGE: ORTHOGERIATRIC SERVICE IMPROVEMENT AND COVID-19. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Nationally agreed hip fracture standards have contributed to the improvement of outcomes in hip fracture patients. In 2020, our hospital was awarded “The Golden Hip” for achieving highest compliance with Irish Hip Fracture Standards (IHFS) nationally for 2019.
Methods
Data from the Irish Hip Fracture Database (IHFD)was retrospectively analysed to assess our performance in 2020 versus 2019 in hip fracture patients over sixty. Multiple quality improvement interventions were put in place throughout 2019 to ensure improvement in IHFS1-6 compliance: Creation of the Hip Fracture Pathway Subgroup, IHFS 1 Breaches Audit, Orthogeriatric input at Orthopaedic inductions, weekly Multi-disciplinary Team meetings, a Nutritional Hip Fracture Pathway and addition of the Fracture Liaison Service Advanced Nurse Practitioner.
Results
There were 239 hip fracture patients in 2020 vs 249 in 2019. IHFS1 compliance improved with the percentage of patients admitted to the Orthopaedic ward within 4 hours increasing to 71% in 2020 from 56% in 2019. There was improvement in IHFS2-time to surgery <48 hours- 66% in 2020 vs 60% in 2019. IHFS3-pressure ulcer rate-was at the national average, 3% in 2020 vs 2% in 2019. IHFS4 (reviewed by a Geriatrician), IHFS5 (received a bone health assessment) and IHFS6 (received a specialised falls assessment) were lower overall; 87% in 2020 vs 98% in 2019. For all quarters (Q),43% of patients met all IHFS in our hospital in 2020 vs 32% in 2019, resulting in €90,000 in Best Practice Tariff funding.
Conclusion
Lower results for IHFS 4,5 and 6 reflect the arrival of the COVID-19 pandemic which led to redeployment of the Orthogeriatric Service and redeployment of the MDT from end of Q1 to Q3. When services in 2020 were preserved,1 in 2 hip fracture patients met all IHFS, vs 1 in 3 patients in 2019. Despite the pandemic, we continued to achieve the highest level of IHFS compliance nationally, being awarded a second consecutive “Golden Hip” for 2020.
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Affiliation(s)
- A Stankard
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - N Thomas
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - N Cosgrave
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - B Conlon
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - P Monaghan
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - T Halpin
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - D English
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - P Byrne
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - S McShane
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - I Sohail
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - AM Grogan
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - A Reilly
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - A Thapa
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - N Alsubaie
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - P Rane
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - J O'Connor
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - S Gray
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - A Kaja
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - K Gehani
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - V Kovalyshyn
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - H O'Brien
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
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Frantzias J, Ghimire P, Lavrador JP, Pereira N, Bhangoo R, Thomas N. Combined extradural and intradural approach to a trigeminal nerve hemangiopericytoma with cranial nerve monitoring: a technical note of a rare case. J Surg Case Rep 2022; 2022:rjac445. [PMID: 36299911 PMCID: PMC9592151 DOI: 10.1093/jscr/rjac445] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 09/04/2022] [Indexed: 01/24/2023] Open
Abstract
Hemangiopericytoma (HPC) of the trigeminal nerve is extremely rare. We present a case of a large cystic HPC of the mandibular division of the trigeminal nerve, only the third case described in the literature, with both intradural and extradural components. We describe the surgical approach, assisted by neurophysiological techniques of mapping and monitoring including blink reflex and triggered electromyography. Additionally, we report a method of monitoring of the sensory branches of the trigeminal nerve, poorly described in the literature, through peripheral and direct nerve stimulation and recording of transcranial somatosensory evoked potentials.
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Affiliation(s)
| | - Prajwal Ghimire
- Correspondence address. Department of Neurosurgery and Department of Biomedical Engineering and Imaging Sciences, King’s College Hospital, London, UK. E-mail: ,
| | - Jose P Lavrador
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, UK
| | | | - Ranjeev Bhangoo
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, UK
| | - Nicholas Thomas
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, UK
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Pak HL, Lambru G, Okasha M, Maratos E, Thomas N, Shapey J, Barazi S. Fully Endoscopic Microvascular Decompression for Trigeminal Neuralgia: Technical Note Describing a Single-Center Experience. World Neurosurg 2022; 166:159-167. [PMID: 35817347 DOI: 10.1016/j.wneu.2022.07.014] [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: 06/19/2022] [Accepted: 07/04/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Microscopic microvascular decompression (MVD) of the trigeminal nerve is the gold standard surgical treatment for medically refractory classical trigeminal neuralgia. Endoscopy has significantly advanced surgery and provides enhanced visualization of the cerebellopontine angle and its critical neurovascular structures. We present our initial experience of fully endoscopic microvascular decompression (e-MVD). METHODS This retrospective case series investigated e-MVD performed from September 2016 to February 2020 at a single institution. Clinical data including presenting symptoms, medications, operative findings, postoperative complications, and outcomes were recorded. The 5-point Barrow Neurological Institute (BNI) pain intensity score was used to quantify patients' pain relief. RESULTS During the study period, 25 patients with trigeminal neuralgia (10 males, 15 females; mean [SD] age = 63 [10.4] years) underwent e-MVD. All patients had a preoperative BNI score of V. The left side was affected in 15 patients. Complications occurred in 2 patients: both experienced hearing loss, and one experienced transient facial weakness 7 days after surgery. The facial weakness had resolved by the last follow-up. All patients were completely pain-free (BNI score I) immediately postoperatively. On latest follow-up, 22 patients have remained pain-free, and 3 patients have recurrent pain that is being controlled with medication (BNI score III). CONCLUSIONS Our study demonstrated that e-MVD is a safe, possibly effective method of performing MVD with the added benefit of improved visualization of the operative field for the operating surgeon and the surgical team. Larger prospective studies are required to evaluate whether performing e-MVD confers any additional benefits in long-term clinical outcome of patients with trigeminal neuralgia.
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Affiliation(s)
- Ho Lim Pak
- Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom.
| | - Giorgio Lambru
- Headache Centre, Pain Management and Neuromodulation Centre, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Mohamed Okasha
- Department of Neurosurgery, King's College Hospital, London, United Kingdom
| | - Eleni Maratos
- Department of Neurosurgery, King's College Hospital, London, United Kingdom
| | - Nicholas Thomas
- Department of Neurosurgery, King's College Hospital, London, United Kingdom
| | - Jonathan Shapey
- Department of Neurosurgery, King's College Hospital, London, United Kingdom
| | - Sinan Barazi
- Department of Neurosurgery, King's College Hospital, London, United Kingdom
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19
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Borsetto D, Sethi M, Clarkson K, Obholzer R, Thomas N, Maratos E, Barazi SA, Baig Mirza A, Okasha M, Danesi G, Pusateri A, Bivona R, Ferri GG, El Alouani J, Castellucci A, Rutherford S, Lloyd S, Anwar B, Polesel J, Buttimore J, Gamazo N, Mannion R, Tysome JR, Bance M, Axon P, Donnelly N. Evidence-based surveillance protocol for vestibular schwannomas: a long-term analysis of tumor growth using conditional probability. J Neurosurg 2022; 137:1026-1033. [PMID: 35180698 DOI: 10.3171/2022.1.jns211544] [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: 07/22/2021] [Accepted: 01/03/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The growth characteristics of vestibular schwannomas (VSs) under surveillance can be studied using a Bayesian method of growth risk stratification by time after surveillance onset, allowing dynamic evaluations of growth risks. There is no consensus on the optimum surveillance strategy in terms of frequency and duration, particularly for long-term growth risks. In this study, the long-term conditional probability of new VS growth was reported for patients after 5 years of demonstrated nongrowth. This allowed modeling of long-term VS growth risks, the creation of an evidence-based surveillance protocol, and the proposal of a cost-benefit analysis decision aid. METHODS The authors performed an international multicenter retrospective analysis of prospectively collected databases from five tertiary care referral skull base units. Patients diagnosed with sporadic unilateral VS between 1990 and 2010 who had a minimum of 10 years of surveillance MRI showing VS nongrowth in the first 5 years of follow-up were included in the analysis. Conditional probabilities of growth were calculated according to Bayes' theorem, and nonlinear regression analyses allowed modeling of growth. A cost-benefit analysis was also performed. RESULTS A total of 354 patients were included in the study. Across the surveillance period from 6 to 10 years postdiagnosis, a total of 12 tumors were seen to grow (3.4%). There was no significant difference in long-term growth risk for intracanalicular versus extracanalicular VSs (p = 0.41). At 6 years, the residual conditional probability of growth from this point onward was seen to be 2.28% (95% CI 0.70%-5.44%); at 7 years, 1.35% (95% CI 0.25%-4.10%); at 8 years, 0.80% (95% CI 0.07%-3.25%); at 9 years, 0.47% (95% CI 0.01%-2.71%); and at 10 years, 0.28% (95% CI 0.00%-2.37%). Modeling determined that the remaining lifetime risk of growth would be less than 1% at 7 years 7 months, less than 0.5% at 8 years 11 months, and less than 0.25% at 10 years 4 months. CONCLUSIONS This multicenter study evaluates the conditional probability of VS growth in patients with long-term VS surveillance (6-10 years). On the basis of these growth risks, the authors posited a surveillance protocol with imaging at 6 months (t = 0.5), annually for 3 years (t = 1.5, 2.5, 3.5), twice at 2-year intervals (t = 5.5, 7.5), and a final scan after 3 years (t = 10.5). This can be used to better inform patients of their risk of growth at particular points along their surveillance timeline, balancing the risk of missing late growth with the costs of repeated imaging. A cost-benefit analysis decision aid was also proposed to allow units to make their own decisions regarding the cessation of surveillance.
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Affiliation(s)
- Daniele Borsetto
- 1Department of Skull Base Surgery, Cambridge University Hospitals, Cambridge
| | - Mantegh Sethi
- 1Department of Skull Base Surgery, Cambridge University Hospitals, Cambridge
| | | | - Rupert Obholzer
- 3Department of Otolaryngology, Guy's and St. Thomas' NHS Foundation Trust, London
| | - Nicholas Thomas
- 4Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Eleni Maratos
- 4Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Sinan A Barazi
- 4Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Asfand Baig Mirza
- 4Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Mohamed Okasha
- 4Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Giovanni Danesi
- 5Division of ENT and Skull Base Microsurgery, Ospedali Riuniti, Bergamo
| | | | - Rachele Bivona
- 5Division of ENT and Skull Base Microsurgery, Ospedali Riuniti, Bergamo
| | - Gian Gaetano Ferri
- 6ENT & Audiology Unit, Department of Diagnostic, Experimental and Specialty Medicine (DIMES), S.Orsola-Malpighi University Hospital, Bologna
| | - Janan El Alouani
- 6ENT & Audiology Unit, Department of Diagnostic, Experimental and Specialty Medicine (DIMES), S.Orsola-Malpighi University Hospital, Bologna
| | - Andrea Castellucci
- 6ENT & Audiology Unit, Department of Diagnostic, Experimental and Specialty Medicine (DIMES), S.Orsola-Malpighi University Hospital, Bologna
- 7ENT Unit, Department of Surgery, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Scott Rutherford
- 8Department of Neurosurgery, Salford Royal Hospitals NHS Foundation Trust, Manchester
| | - Simon Lloyd
- 9Department of Otolaryngology, Manchester Royal Infirmary, Manchester, United Kingdom; and
| | - Bilal Anwar
- 9Department of Otolaryngology, Manchester Royal Infirmary, Manchester, United Kingdom; and
| | - Jerry Polesel
- 10Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Juliette Buttimore
- 1Department of Skull Base Surgery, Cambridge University Hospitals, Cambridge
| | - Nicola Gamazo
- 1Department of Skull Base Surgery, Cambridge University Hospitals, Cambridge
| | - Richard Mannion
- 1Department of Skull Base Surgery, Cambridge University Hospitals, Cambridge
| | - James R Tysome
- 1Department of Skull Base Surgery, Cambridge University Hospitals, Cambridge
| | - Manhoar Bance
- 1Department of Skull Base Surgery, Cambridge University Hospitals, Cambridge
| | - Patrick Axon
- 1Department of Skull Base Surgery, Cambridge University Hospitals, Cambridge
| | - Neil Donnelly
- 1Department of Skull Base Surgery, Cambridge University Hospitals, Cambridge
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Capelo HL, Kühn J, Pommerol A, Piazza D, Brändli M, Cerubini R, Jost B, Bodénan JD, Planchet T, Spadaccia S, Schräpler R, Blum J, Schönbächler M, Mayer L, Thomas N. TEMPus VoLA: The timed Epstein multi-pressure vessel at low accelerations. Rev Sci Instrum 2022; 93:104502. [PMID: 36319368 DOI: 10.1063/5.0087030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 08/07/2022] [Indexed: 06/16/2023]
Abstract
The field of planetary system formation relies extensively on our understanding of the aerodynamic interaction between gas and dust in protoplanetary disks. Of particular importance are the mechanisms triggering fluid instabilities and clumping of dust particles into aggregates, and their subsequent inclusion into planetesimals. We introduce the timed Epstein multi-pressure vessel at low accelerations, which is an experimental apparatus for the study of particle dynamics and rarefied gas under micro-gravity conditions. This facility contains three experiments dedicated to studying aerodynamic processes: (i) the development of pressure gradients due to collective particle-gas interaction, (ii) the drag coefficients of dust aggregates with variable particle-gas velocity, and (iii) the effect of dust on the profile of a shear flow and resultant onset of turbulence. The approach is innovative with respect to previous experiments because we access an untouched parameter space in terms of dust particle packing fraction, and Knudsen, Stokes, and Reynolds numbers. The mechanisms investigated are also relevant for our understanding of the emission of dust from active surfaces, such as cometary nuclei, and new experimental data will help interpreting previous datasets (Rosetta) and prepare future spacecraft observations (Comet Interceptor). We report on the performance of the experiments, which has been tested over the course of multiple flight campaigns. The project is now ready to benefit from additional flight campaigns, to cover a wide parameter space. The outcome will be a comprehensive framework to test models and numerical recipes for studying collective dust particle aerodynamics under space-like conditions.
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Affiliation(s)
- H L Capelo
- Space Research and Planetary Sciences Division, Physikalisches Institut, University of Bern, Sidlerstrasse 5, CH-3012 Bern, Switzerland
| | - J Kühn
- Space Research and Planetary Sciences Division, Physikalisches Institut, University of Bern, Sidlerstrasse 5, CH-3012 Bern, Switzerland
| | - A Pommerol
- Space Research and Planetary Sciences Division, Physikalisches Institut, University of Bern, Sidlerstrasse 5, CH-3012 Bern, Switzerland
| | - D Piazza
- Space Research and Planetary Sciences Division, Physikalisches Institut, University of Bern, Sidlerstrasse 5, CH-3012 Bern, Switzerland
| | - M Brändli
- Space Research and Planetary Sciences Division, Physikalisches Institut, University of Bern, Sidlerstrasse 5, CH-3012 Bern, Switzerland
| | - R Cerubini
- Space Research and Planetary Sciences Division, Physikalisches Institut, University of Bern, Sidlerstrasse 5, CH-3012 Bern, Switzerland
| | - B Jost
- Space Research and Planetary Sciences Division, Physikalisches Institut, University of Bern, Sidlerstrasse 5, CH-3012 Bern, Switzerland
| | - J-D Bodénan
- ETH Zurich, Institute of Geochemistry and Petrology, 8092 Zurich, Switzerland
| | - T Planchet
- Space Research and Planetary Sciences Division, Physikalisches Institut, University of Bern, Sidlerstrasse 5, CH-3012 Bern, Switzerland
| | - S Spadaccia
- Space Research and Planetary Sciences Division, Physikalisches Institut, University of Bern, Sidlerstrasse 5, CH-3012 Bern, Switzerland
| | - R Schräpler
- Institut fur Geophysik und extraterrestrische Physik, Technische Universitat Braunschweig, Mendelssohnstr. 3, D-38106 Braunschweig, Germany
| | - J Blum
- Institut fur Geophysik und extraterrestrische Physik, Technische Universitat Braunschweig, Mendelssohnstr. 3, D-38106 Braunschweig, Germany
| | - M Schönbächler
- ETH Zurich, Institute of Geochemistry and Petrology, 8092 Zurich, Switzerland
| | - L Mayer
- Center for Theoretical Astrophysics and Cosmology, Institute for Computational Science, University of Zurich, Winterthurerstrasse 190, CH-8057 Zurich, Switzerland
| | - N Thomas
- Space Research and Planetary Sciences Division, Physikalisches Institut, University of Bern, Sidlerstrasse 5, CH-3012 Bern, Switzerland
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21
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Smith LC, Mariegaard L, Vernal DL, Christensen AG, Albert N, Thomas N, Hjorthøj C, Glenthøj LB, Nordentoft M. The CHALLENGE trial: the effects of a virtual reality-assisted exposure therapy for persistent auditory hallucinations versus supportive counselling in people with psychosis: study protocol for a randomised clinical trial. Trials 2022; 23:773. [PMID: 36100943 PMCID: PMC9468536 DOI: 10.1186/s13063-022-06683-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/24/2022] [Indexed: 11/22/2022] Open
Abstract
Background Many patients suffering from schizophrenia spectrum disorders continue having distressing auditory hallucinations in spite of treatment with antipsychotic medication. The aim of this trial is to examine the effect of a targeted virtual reality therapy for persistent auditory hallucinations in individuals with psychosis. The trial explores whether this type of therapy can decrease the severity, frequency and distress of auditory hallucinations and, additionally, whether it can reduce clinical symptoms and enhance daily functioning in individuals with psychosis. Methods The study is a randomised, assessor-blinded parallel-group superiority clinical trial, allocating a total of 266 patients to either the experimental intervention or supportive counselling. The participants will be randomised to either (1) seven sessions of virtual reality therapy or (2) seven sessions of supportive counselling to be delivered within the first 12 weeks after inclusion in the study. All participants will be assessed at baseline and 12 and 24 weeks post-baseline. Independent assessors blinded to the treatment allocation will evaluate the outcome. The primary outcome is the level of auditory hallucinations measured with the Psychotic Symptoms Rating Scales (PSYRATS-AH) total score at the cessation of treatment at 12 weeks. Secondary outcomes are frequency of auditory hallucinations, the distress caused by auditory hallucinations, perceived voice power, patient acceptance of voices, patients’ ability to respond to voices in an assertive way and social and daily function. Discussion Promising evidence of the efficacy of this immersive virtual reality-based therapy for auditory hallucinations exist, but evidence needs to be established in a large, methodological rigorous trial. If the therapy proves to be beneficial in reducing the severity of refractory auditory hallucinations, a large group of patients with schizophrenia and related disorders could be the target group of this short-term psychotherapeutic intervention.
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Affiliation(s)
- L C Smith
- Research Unit (CORE), Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Capital Region of Denmark, Denmark.
| | - L Mariegaard
- Research Unit (CORE), Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Capital Region of Denmark, Denmark
| | - D L Vernal
- Psychiatry, Aalborg University Hospital, Aalborg, North Denmark Region, Denmark
| | - A G Christensen
- Mental Health Center Esbjerg, Esbjerg, Region of South Denmark, Denmark
| | - N Albert
- Research Unit (CORE), Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Capital Region of Denmark, Denmark
| | - N Thomas
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - C Hjorthøj
- Research Unit (CORE), Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Capital Region of Denmark, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - L B Glenthøj
- Research Unit (CORE), Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Capital Region of Denmark, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - M Nordentoft
- Research Unit (CORE), Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Capital Region of Denmark, Denmark
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22
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Jordan T, Chen J, Li N, Burette S, Culton D, Geng S, Googe P, Thomas N, Diaz L, Liu Z. 050 Eotaxin-1 and matrix metalloproteinase-9 are critical in anti-BP180 IgE-induced experimental bullous pemphigoid. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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23
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Agazzi H, Hayford H, Thomas N, Dickinson S, Ortiz C, Salinas-Miranda A. Pandemic parenting: A pilot study of in-person versus internet-DOCS K-5 for caregivers of school-age children with disruptive behaviors. Clin Child Psychol Psychiatry 2022; 27:569-585. [PMID: 35485248 DOI: 10.1177/13591045221096313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Behavioral parent training (BPT) programs are needed to address disruptive behavior disorders among school-aged children. Given the prolonged COVID-19 pandemic and associated mental health consequences, adapting BPTs to telehealth modalities is necessary to ensure continued services to children and families. This pilot study evaluated the use of a telehealth vs in-person modality to deliver the Developing Our Children's Skills K-5 (DOCS K-5) BPT. Participants were caregivers of children enrolled in elementary school exhibiting disruptive behaviors who participated in either in-person DOCS K-5 (n = 21) or internet-DOCS K-5 (i-DOCS K-5; n = 34). Pre- and post-intervention outcome measures were collected for child disruptive behavior, parenting stress, and caregiver symptoms of depression while consumer satisfaction was assessed at post-test only. Multiple linear and Poisson regression models were performed to assess the effect of session modality on the outcomes. Child disruptive behavior, parenting stress and depression, and consumer satisfaction scores were not significantly different across groups, even after adjusting for baseline characteristics. The results of this study provide preliminary evidence that the i-DOCS K-5 modality is as effective as the in-person program. Study findings may be beneficial to practitioners treating school-age children and utilizing telehealth interventions during the COVID-19 pandemic and onward.
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Affiliation(s)
- Heather Agazzi
- Departments of Pediatrics & Psychiatry, 33697University of South Florida, USA
| | - Holland Hayford
- Department of Pediatrics, 33697University of South Florida, USA
| | - Nicholas Thomas
- Harrell Center for the Study of Family Violence, College of Public Health, 27117University of South Florida, USA
| | - Sarah Dickinson
- Department of Pediatrics, 33697University of South Florida, USA
| | - Cristina Ortiz
- Department of Pediatrics, 33697University of South Florida, USA
| | - Abraham Salinas-Miranda
- Harrell Center for the Study of Family Violence & USF Center of Excellence in Maternal and Child Health Education, Science and Practice, 27117University of South Florida, USA
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24
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Atz E, Walsh B, O'Brien C, Collier M, Berman A, Billingsley L, Blake JB, Broll J, Chornay D, Crain W, Cragwell T, Dobson N, Kujawski J, Kuntz K, Naldoza V, Nutter R, Porter FS, Sibeck D, Simms K, Thomas N, Turner D, Weatherwax A, Yousuff A, Zosuls A. The cusp plasma imaging detector (CuPID) cubesat observatory: Instrumentation. Rev Sci Instrum 2022; 93:064504. [PMID: 35778053 DOI: 10.1063/5.0085534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/17/2022] [Indexed: 06/15/2023]
Abstract
The Cusp Plasma Imaging Detector (CuPID) CubeSat observatory is a 6U CubeSat designed to observe solar wind charge exchange in magnetospheric cusps to test competing theories of magnetic reconnection at the Earth's magnetopause. The CuPID is equipped with three instruments, namely, a wide field-of-view (4.6° × 4.6°) soft x-ray telescope, a micro-dosimeter suite, and an engineering magnetometer optimized for the science operation. The instrument suite has been tested and calibrated in relevant environments, demonstrating successful design. The testing and calibration of these instruments produced metrics and coefficients that will be used to create the CuPID mission's data product.
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Affiliation(s)
- Emil Atz
- Center for Space Physics, College of Engineering, Boston University, Boston, Massachusetts 02215, USA
| | - Brian Walsh
- Center for Space Physics, College of Engineering, Boston University, Boston, Massachusetts 02215, USA
| | - Connor O'Brien
- Center for Space Physics, College of Engineering, Boston University, Boston, Massachusetts 02215, USA
| | - Michael Collier
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - Ariel Berman
- The Aerospace Corporation, Los Angeles, California 90245, USA
| | - Lisa Billingsley
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - J Bernard Blake
- The Aerospace Corporation, Los Angeles, California 90245, USA
| | - Jeffery Broll
- Center for Space Physics, College of Engineering, Boston University, Boston, Massachusetts 02215, USA
| | - Dennis Chornay
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - William Crain
- The Aerospace Corporation, Los Angeles, California 90245, USA
| | - Thompson Cragwell
- Center for Space Physics, College of Engineering, Boston University, Boston, Massachusetts 02215, USA
| | - Norman Dobson
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | | | - Kip Kuntz
- The Henry A. Rowland Department of Physics and Astronomy, Johns Hopkins University, Baltimore, Maryland 21210, USA
| | - Van Naldoza
- Center for Space Physics, College of Engineering, Boston University, Boston, Massachusetts 02215, USA
| | - Rousseau Nutter
- Center for Space Physics, College of Engineering, Boston University, Boston, Massachusetts 02215, USA
| | - F Scott Porter
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - David Sibeck
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - Kenneth Simms
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - Nicholas Thomas
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - Drew Turner
- Space Exploration Sector, Johns Hopkins Applied Physics Laboratory, Laurel, Maryland 20723, USA
| | | | - Ajmal Yousuff
- Drexel University, Philadelphia, Pennsylvania 19104, USA
| | - Aleks Zosuls
- Center for Space Physics, College of Engineering, Boston University, Boston, Massachusetts 02215, USA
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25
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Davey C, Luqmani B, Thomas N, McAdam E. Transforming wastewater ammonia to carbon free energy: Integrating fuel cell technology with ammonia stripping for direct power production. Sep Purif Technol 2022. [DOI: 10.1016/j.seppur.2022.120755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Boukas A, Aizpurua M, Maratos E, Kalyal N, Giamouriadis A, Barkas K, King A, Bodi I, Thomas N. A novel case of paravertebral glomangiomyomatosis. Br J Neurosurg 2022:1-6. [PMID: 35379054 DOI: 10.1080/02688697.2022.2054945] [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: 11/15/2021] [Revised: 02/25/2022] [Accepted: 03/13/2022] [Indexed: 11/02/2022]
Abstract
Glomangiomyomatosis is an extremely rare variant of glomus tumours. We describe the first known case of paravertebral glomangiomyomatosis in the literature to cause spinal cord compression. A 45-year old female patient presented with sudden onset of left leg pain and progressive weakness in left-sided hip flexion. An MRI spine revealed a large, lobulated, heterogeneous mass cantered on the left L2/3 foramen, mimicking a dumbbell nerve sheath tumour. The mass was invading the psoas muscle and displayed evidence of recent haemorrhage. The patient underwent debulking of the lesion via a left retroperitoneal approach. Surgery was uneventful, with clinical improvement and resolution of leg pain post-operatively. Histopathology of the tumour revealed delineated glomus-like cells and foci of spindled shaped cells resembling myoid differentiation. Immuno-histochemical features of the tumour confirmed the diagnosis of glomangiomyomatosis. The patient continued under close follow up, representing 18 months later with clinical and radiological progression of the disease with similar symptoms of leg pain but no weakness. Follow up MRI revealed progression of the intraspinal and paraspinal components of the tumour with thecal compression. A posterior approach was utilized in order to decompress the intraspinal component, which again was uneventful, and improved the patient's symptoms. This is the first known case of paravertebral glomangiomyomatosis in the literature and this rare entity should be considered in the differential diagnosis of nerve sheath tumours due to risk of progression and recurrence.
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Affiliation(s)
| | - Miren Aizpurua
- Department of Neuropathology, King's College Hospital, London, UK
| | - Eleni Maratos
- Department of Neurosurgery, King's College Hospital, London, UK
| | - Nida Kalyal
- Department of Neurosurgery, King's College Hospital, London, UK
| | | | | | - Andrew King
- Department of Neuropathology, King's College Hospital, London, UK
| | - Istvan Bodi
- Department of Neuropathology, King's College Hospital, London, UK
| | - Nicholas Thomas
- Department of Neurosurgery, King's College Hospital, London, UK
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27
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Mayne I, Thomas N, McGovern A. Rapid, patient-led titration of basal insulin can be used to achieve tight glycaemic control in gestational diabetes mellitus with insulin resistance. BMJ Case Rep 2022; 15:e248533. [PMID: 35272992 PMCID: PMC8915315 DOI: 10.1136/bcr-2021-248533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2022] [Indexed: 11/04/2022] Open
Abstract
A woman with gestational diabetes mellitus (GDM) and significant insulin resistance in her third pregnancy was diagnosed with a fasting blood glucose reading of 5.7 mmol/L (103 mg/dL) at 28+1 weeks gestation and referred to our diabetes team. Using a rapid, patient-led approach to basal insulin titration this patient achieved therapeutic doses and glucose targets in the limited time available during pregnancy, without causing significant hypoglycaemia. This method of insulin titration empowers women with GDM to take control of their own management and could reduce complications in GDM pregnancies at negligible additional cost. The only additional cost being that of the higher insulin doses used.
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Affiliation(s)
- Isabelle Mayne
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Nicholas Thomas
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
- Department of Diabetes and Endocrinology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Andrew McGovern
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
- Department of Diabetes and Endocrinology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
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28
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Sampathkumar G, Valiyaparambil PP, Kumar H, Bhavani N, Nair V, Menon U, Menon A, Abraham N, Chapla A, Thomas N. Low genetic confirmation rate in South Indian subjects with a clinical diagnosis of maturity-onset diabetes of the young (MODY) who underwent targeted next-generation sequencing for 13 genes. J Endocrinol Invest 2022; 45:607-615. [PMID: 34741762 DOI: 10.1007/s40618-021-01698-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 10/29/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE To screen for maturity-onset diabetes of the young (MODY) variants in subjects with an early age of onset and positive family history of diabetes mellitus. METHODS 60 subjects with onset of diabetes between 3 and 30 years of age and parental history (onset < 35 years) of diabetes were recruited after excluding autoimmune, pancreatic and syndromic forms of diabetes. Detailed pedigree chart and clinical data were recorded. MODY genetic testing (MODY 1-13) was performed and variant classification was done adhering to the ACMG guidelines. RESULTS Baseline characteristics of subjects were as follows: mean age of onset of diabetes 19.9 ± 7 years, mean duration of diabetes 6.3 ± 6.8 years, BMI 23.3 ± 3 kg/m2 and C-peptide 1.56 ± 1.06 nmol/l. Four out of sixty (6.6%) were positive for variants classifiable as pathogenic/likely pathogenic: one patient with HNF4Ac.691C > T, (p.Arg231Trp), two with HNF 1A c.746C > A(p.Ser249Ter) and c.1340C > T(p.Pro447Leu), and one with ABCC8 c.4544C > T (p.Thr1515Met). MODY 1 and MODY 3 variants were documented in the paediatric age group (< 18 years). CONCLUSION A genetic diagnosis of MODY could be confirmed in only 6.6% (4/60) of patients clinically classifiable as MODY. This is less than that reported in clinically diagnosed MODY subjects of European descent. Newly published population data and more stringent criteria for assessment of pathogenicity and younger age of onset of type 2 diabetes in Indians could have contributed to the lower genetic confirmation rate. Apart from variants in the classical genes (HNF1A, HNF4A), a likely pathogenic variant in a non-classical gene (ABCC8) was noted in this study.
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Affiliation(s)
- G Sampathkumar
- Department of Endocrinology, Amrita Institute of Medical Sciences, Amrita University, Ponnekara P.O, Cochin, 682041, Kerala, India
| | - P P Valiyaparambil
- Department of Endocrinology, Amrita Institute of Medical Sciences, Amrita University, Ponnekara P.O, Cochin, 682041, Kerala, India.
| | - H Kumar
- Department of Endocrinology, Amrita Institute of Medical Sciences, Amrita University, Ponnekara P.O, Cochin, 682041, Kerala, India
| | - N Bhavani
- Department of Endocrinology, Amrita Institute of Medical Sciences, Amrita University, Ponnekara P.O, Cochin, 682041, Kerala, India
| | - V Nair
- Department of Endocrinology, Amrita Institute of Medical Sciences, Amrita University, Ponnekara P.O, Cochin, 682041, Kerala, India
| | - U Menon
- Department of Endocrinology, Amrita Institute of Medical Sciences, Amrita University, Ponnekara P.O, Cochin, 682041, Kerala, India
| | - A Menon
- Department of Endocrinology, Amrita Institute of Medical Sciences, Amrita University, Ponnekara P.O, Cochin, 682041, Kerala, India
| | - N Abraham
- Department of Endocrinology, Amrita Institute of Medical Sciences, Amrita University, Ponnekara P.O, Cochin, 682041, Kerala, India
| | - A Chapla
- Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India
| | - N Thomas
- Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India
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Occean JR, Thomas N, Lim AC, Lovett SM, Michael-Asalu A, Salinas-Miranda AA. Prevalence and Factors Associated With Intimate Partner Violence Among Women in Haiti: Understanding Household, Individual, Partner, and Relationship Characteristics. J Interpers Violence 2021; 36:11356-11384. [PMID: 31928293 DOI: 10.1177/0886260519898443] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Intimate partner violence (IPV) is a significant public health issue with detrimental consequences for women's reproductive, mental, and physical health. In Haiti, IPV is a major obstacle to women's development. Yet, the determinants of IPV victimization are still not well understood. In this study, we utilized the 2016-2017 Haiti Demographic and Health Survey to determine the prevalence of IPV victimization and its subtypes (emotional, physical, and sexual abuse) among married or cohabiting women (N = 3,805) of reproductive age (15-49) by their current husband/partner. Logistic regression was conducted to explore the association between IPV and household, individual, husband/partner, and relationship characteristics. The prevalence of IPV victimization was 32.5% with the majority reporting emotional (24.7%) followed by physical (16.8%) and sexual (10.5%) violence. Increased odds of IPV victimization were found among women with children in the household (adjusted odds ratio [AOR] = 1.45, 95% confidence interval [CI] = [1.03, 2.02]), with attitudinal acceptance of wife-beating (AOR = 1.45, 95% CI = [1.05, 2.02]), and those who witnessed their father beating their mother (AOR = 1.49, 95% CI = [1.18, 2.67]). Higher odds of reporting IPV victimization were also found among women whose partner drank alcohol (AOR = 2.89, 95% CI = [2.29, 3.65]), who were in a polygynous relationship (AOR = 1.76, 95% CI = [1.23, 2.40]), and displayed one or more controlling behaviors (AOR = 1.92, 95% CI = [1.42, 2.59]). Women who reported being afraid of their partner had greater odds of IPV victimization (AOR = 16.22, 95% CI = [8.38, 31.39]). Decreased odds of reporting IPV were associated with women living in rural areas (AOR = 0.73, 95% CI = [0.53, 1.00]) and those unmarried, but living with their partner (AOR = 0.62, 95% CI = [0.43, 0.90]). Our findings identify subgroups of women in Haiti that may be vulnerable to IPV victimization. Thus, we recommend a differentiated approach to IPV prevention strategies and interventions that consider women's family structure in the household as well as individual, partner, and relationship characteristics.
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Affiliation(s)
| | | | | | | | | | - Abraham A Salinas-Miranda
- University of South Florida, Tampa, USA
- Universidad Nacional Autónoma de Nicaragua, Managua, Nicaragua
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Agazzi H, Hayford H, Thomas N, Ortiz C, Salinas-Miranda A. A nonrandomized trial of a behavioral parent training intervention for parents with children with challenging behaviors: In-person versus internet-HOT DOCS. Clin Child Psychol Psychiatry 2021; 26:1076-1088. [PMID: 34156883 DOI: 10.1177/13591045211027559] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Behavioral parent training (BPT) programs are the first-line interventions for childhood disruptive behaviors. In light of the COVID-19 pandemic, adapting these programs to telehealth modalities is necessary to ensure continued services to children and families. This study evaluates the use of telehealth versus in-person modality to deliver the Helping Our Toddlers, Developing Our Children's Skills (HOT DOCS) BPT. The study design was quasi-experimental with two nonequivalent groups: in-person HOT DOCS (n = 152) and internet-HOT DOCS (n = 46). Participants were caregivers of children ages 2-5 exhibiting disruptive behaviors. Pre- and post-intervention outcome measures were collected for child disruptive behavior and parenting stress and post-test only for consumer satisfaction. Multiple linear and Poisson regression models were performed to assess the effect of class modality on the outcomes. Child disruptive behavior and parenting stress post-test scores for in-person and telehealth groups were not significantly different, even after adjusting for baseline characteristics. Consumer satisfaction scores were significantly more positive for the in-person group. The results of this study provide preliminary evidence for the i-HOT DOCS modality as being as effective as the in-person program. Study findings may be beneficial to practitioners utilizing telehealth interventions during the COVID-19 pandemic and onward.
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Affiliation(s)
- Heather Agazzi
- Departments of Pediatrics & Psychiatry, 33697University of South Florida, Tampa, FL, USA
| | - Holland Hayford
- Department of Pediatrics, University of South Florida, Tampa, FL, USA
| | - Nicholas Thomas
- Harrell Center for the Study of Family Violence, College of Public Health, 27117University of South Florida, Tampa, FL, USA
| | - Cristina Ortiz
- Department of Pediatrics, University of South Florida, Tampa, FL, USA
| | - Abraham Salinas-Miranda
- Harrell Center for the Study of Family Violence & USF Center of Excellence in Maternal and Child Health Education, Science and Practice, University of South Florida, Tampa, FL, USA
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Smith L, Thomas N, Arnold A, Bell R, Zayed H, Tyrrell M, Padayachee S. A Comparison of Computed Tomography Angiography and Colour Duplex Ultrasound Surveillance Post Infrarenal Endovascular Aortic Aneurysm Repair: Financial Implications and Impact of Different International Surveillance Guidelines. J Vasc Surg 2021. [DOI: 10.1016/j.jvs.2021.07.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sleiwah A, Mughal M, Thomas N, Roblin P, Townley W, Jeannon JP. Locally Advanced Scalp Tumors: Clinical and Survival Outcomes of a Tertiary Unit. Ann Plast Surg 2021; 87:271-277. [PMID: 34397516 DOI: 10.1097/sap.0000000000002673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Locally advanced nonmelanoma skin cancers of the head and neck are well described in the current literature. However, data about clinical and survival outcomes are lacking. We present survival data from a tertiary head and neck cancer unit in London. METHODS A retrospective analysis of data collected from a single institution was conducted. All patients with locally advanced cutaneous scalp carcinomas invading the skull between 2011 and 2019 were included. Data included patient demographics, tumor, comorbidities, interventions, flap survival, and metal work exposure. Survival outcomes were examined using Kaplan-Meier analysis. RESULTS Twenty-three patients were identified. The mean age was 72 years. Eighteen patients were male, and 5 were female. Five patients were immunosuppressed. Nineteen patients underwent outer cortex drill-down/full-thickness calvarial resection, followed by reconstruction with free tissue transfer. Six patients had titanium mesh reconstruction after segmental skull resections. Three patients underwent further surgery because of exposed metalwork. Disease-free survival at 3 years after surgery was 60%. CONCLUSIONS Locally advanced nonmelanoma skin cancers invading the bone are sporadic. There are little published data on clinical and survival outcomes in this group. Despite the nature of these skin lesions, a high degree of local control can be obtained by extensive surgical resection, outer table drill-down, and calvarial resection. We conclude that aggressive management of the bony invasion improves disease-free survival and improves local control.
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Affiliation(s)
- Aseel Sleiwah
- From the Plastic Surgery Department, Guy's & St Thomas Hospital
| | - Maleeha Mughal
- From the Plastic Surgery Department, Guy's & St Thomas Hospital
| | | | - Paul Roblin
- From the Plastic Surgery Department, Guy's & St Thomas Hospital
| | - William Townley
- From the Plastic Surgery Department, Guy's & St Thomas Hospital
| | - Jean-Pierre Jeannon
- Ear, Nose and Throat Department, Guy's & St Thomas Hospital, London, United Kingdom
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Paul J, Devarapalli V, Johnson JT, Cherian KE, Jebasingh FK, Asha HS, Kapoor N, Thomas N, Paul TV. Do proximal hip geometry, trabecular microarchitecture, and prevalent vertebral fractures differ in postmenopausal women with type 2 diabetes mellitus? A cross-sectional study from a teaching hospital in southern India. Osteoporos Int 2021; 32:1585-1593. [PMID: 33502560 DOI: 10.1007/s00198-021-05855-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 01/19/2021] [Indexed: 12/18/2022]
Abstract
UNLABELLED This study from southern India showed that the trabecular microarchitecture and proximal hip geometry were significantly impaired in postmenopausal women with diabetes as compared to age and BMI matched non-diabetic controls. This is despite there being no significant difference in bone mineral density at the femoral neck and hip not between both groups. One-third of the study subjects with type 2 diabetes had prevalent vertebral fractures. Bone mineral density assessment as a standalone tool may not adequately reflect bone health in subjects with diabetes. INTRODUCTION There is limited information with regard to bone health in Indian postmenopausal women with type 2 diabetes. We studied the bone mineral density (BMD), trabecular bone score (TBS), prevalent vertebral fractures (VF), proximal hip geometry, and bone mineral biochemistry in ambulatory postmenopausal women with and without type 2 diabetes mellitus (T2DM). METHODS This was a cross-sectional study conducted at a tertiary care center. BMD, TBS, prevalent vertebral fractures, and hip structural analysis (HSA) were assessed using a dual-energy X-ray absorptiometry (DXA) scanner. Bone mineral biochemical profiles were also studied. RESULTS A total of 202 ambulatory postmenopausal women known to have type 2 diabetes mellitus with mean (SD) age of 65.6 (5.2) years and 200 age and BMI matched non-diabetic controls with mean (SD) age of 64.9 (4.7) years were recruited from the local community. Although the prevalence of lumbar spine osteoporosis was significantly lower among cases (30.7%) as compared to controls (42.9%), the prevalence of degraded bone microarchitecture (TBS < 1.200) was significantly higher among cases (51%) than in controls (23.5%); P < 0.001. Prevalent vertebral fractures were not significantly different in cases and controls. The various geometric indices of the proximal hip were significantly impaired in subjects with diabetes as compared to controls. CONCLUSION This study may highlight the utility of the trabecular bone score and hip structural analysis in subjects with diabetes, where the bone mineral density tends to be paradoxically high, and may not adequately predict fracture risk.
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Affiliation(s)
- J Paul
- Department of Endocrinology, Christian Medical College, Vellore, India
| | - V Devarapalli
- Department of Endocrinology, Christian Medical College, Vellore, India
| | - J T Johnson
- Department of Endocrinology, Christian Medical College, Vellore, India
| | - K E Cherian
- Department of Endocrinology, Christian Medical College, Vellore, India
| | - F K Jebasingh
- Department of Endocrinology, Christian Medical College, Vellore, India
| | - H S Asha
- Department of Endocrinology, Christian Medical College, Vellore, India
| | - N Kapoor
- Department of Endocrinology, Christian Medical College, Vellore, India
| | - N Thomas
- Department of Endocrinology, Christian Medical College, Vellore, India
| | - T V Paul
- Department of Endocrinology, Christian Medical College, Vellore, India.
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Thomas N. A comprehensive investigation of the Galilean moon, Io, by tracing mass and energy flows. Exp Astron (Dordr) 2021; 54:791-807. [PMID: 36915621 PMCID: PMC9998583 DOI: 10.1007/s10686-021-09768-y] [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: 07/09/2020] [Accepted: 05/31/2021] [Indexed: 06/18/2023]
Abstract
Io is the most volcanically-active object in the solar system. The moon ejects a tonne per second of sulphur-rich gases that fill the vast magnetosphere of Jupiter and drives million-amp electrical currents that excite strong auroral emissions. We present the case for including a detailed study of Io within Voyage 2050 either as a standalone mission or as a contribution to a NASA New Frontiers mission, possibly within a Solar System theme centred around current evolutionary or dynamical processes. A comprehensive investigation will provide answers to many outstanding questions and will simultaneously provide information on processes that have formed the landscapes of several other objects in the past. A mission investigating Io will also study processes that have shaped the Earth, Moon, terrestrial planets, outer planet moons, and potentially extrasolar planets. The aim would be simple - tracing the mass and energy flows in the Io-Jupiter system.
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Affiliation(s)
- N. Thomas
- Physikalisches Institut, University of Bern, Sidlerstrasse 5, CH-3012 Bern, Switzerland
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Mayekar MK, Caswell D, Vokes N, Wu W, McCoach C, Blakely C, Temiz NA, Kerr DL, Rotow J, Haderk F, Cech L, Gini B, Nanjo S, Tan L, Yu J, Gomez C, Gui P, Yu E, Thomas N, Downward J, Harris R, Van Allen E, Swanton C, Bivona T. Abstract LB124: APOBEC3B fuels evolution of resistance during targeted cancer therapy. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-lb124] [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
Despite recent advances in cancer treatment, lung cancer remains the leading cause of cancer mortality worldwide. Lung adenocarcinoma is the most prevalent subtype of lung cancer. Genomic profiling of lung adenocarcinomas has led to the identification of several targetable oncogenic drivers. Therapies targeting the oncogenic-driver pathway using various tyrosine kinase inhibitors (TKIs), are effective initially but responses are often transient and tumors eventually regrow due to drug resistance. Furthermore, drug resistance can arise via the selection of pre-existing resistant clones or via the de novo acquisition of mutations that are not present before therapy. We set out to understand the mechanism for the de novo acquisition of drug resistance mutations in oncogene-driven lung cancers. To do so, we investigated the gene expression changes that occur upon inhibition of oncogenic pathways. We found that oncoprotein targeted therapy induces adaptations favorable for APOBEC genome mutagenesis. Treatment with small molecule inhibitors against EGFR and ALK promoted transcriptional upregulation of members of APOBEC family of cytidine deaminases and downregulation of the uracil glycosylase UNG, the key protein needed for removal of APOBEC-induced DNA lesions. These changes in mRNA levels resulted in functional effects that can impact nuclear DNA by increasing nuclear APOBEC activity and reducing nuclear uracil excision capacity. Determination of changes in APOBEC mRNA levels and nuclear APOBEC activity over time and depletion studies identified APOBEC3B as a driver of both baseline and targeted therapy-induced nuclear APOBEC activity in pre-clinical lung cancer models. We found that APOBEC3B mediates genetic evolution and emergence of resistance during targeted therapy. We identified NF-kB pathway induction and c-Jun downregulation as key mediators of these treatment-induced molecular changes. Furthermore, we find an upregulation of APOBEC3B in lung cancer patients with progressive disease and a high proportion of APOBEC-associated mutations in patient tumors treated with targeted therapy. Some putative resistance mutations in patient tumors were also in the APOBEC-preferred context. Our study identifies a novel targeted therapy-induced evolutionary process involving an APOBEC DNA deaminase that could serve as an attractive co-target to elicit more durable treatment responses.
Citation Format: Manasi K. Mayekar, Deborah Caswell, Natalie Vokes, Wei Wu, Caroline McCoach, Collin Blakely, Nuri Alpay Temiz, Daniel Lucas Kerr, Julia Rotow, Franziska Haderk, Lauren Cech, Beatrice Gini, Shigeki Nanjo, Lisa Tan, Johnny Yu, Carlos Gomez, Philippe Gui, Elizabeth Yu, Nicholas Thomas, Julian Downward, Reuben Harris, Eliezer Van Allen, Charles Swanton, Trever Bivona. APOBEC3B fuels evolution of resistance during targeted cancer therapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr LB124.
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Affiliation(s)
| | | | - Natalie Vokes
- 3The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Wei Wu
- 1University of California San Francisco, San Francisco, CA
| | | | - Collin Blakely
- 1University of California San Francisco, San Francisco, CA
| | | | | | | | | | - Lauren Cech
- 1University of California San Francisco, San Francisco, CA
| | - Beatrice Gini
- 1University of California San Francisco, San Francisco, CA
| | - Shigeki Nanjo
- 1University of California San Francisco, San Francisco, CA
| | - Lisa Tan
- 1University of California San Francisco, San Francisco, CA
| | - Johnny Yu
- 1University of California San Francisco, San Francisco, CA
| | - Carlos Gomez
- 1University of California San Francisco, San Francisco, CA
| | - Philippe Gui
- 1University of California San Francisco, San Francisco, CA
| | - Elizabeth Yu
- 1University of California San Francisco, San Francisco, CA
| | | | | | | | | | | | - Trever Bivona
- 1University of California San Francisco, San Francisco, CA
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Orem J, Martin M, Mbulaiteye SM, Mullighan CG, Mungall AJ, Mungall K, Namirembe C, Noy A, Petrello H, Ogwang MD, Martin J, Reynolds SJ, Swerdlow SH, Traverse‐Glehen A, Wilson WH, Marra MA, Staudt LM, Scott DW, Morin RD, Timothy G, Dryer M, Dreval K, Gerhard DS, Hilton LK, Abramson JS, Bartlett NL, Bethony J, Bowen J, Bryan A, Casper C, Thomas N, Gastier‐Foster JM, Grande BM, Griner NB, Gross TG, Harris NL, Irvin JD, Jaffe E, Leal F. KEY GENETIC AND MOLECULAR ABERRATIONS IDENTIFIED IN BOTH ADULT AND EBV‐POSITIVE BURKITT LYMPHOMA PATIENTS. Hematol Oncol 2021. [DOI: 10.1002/hon.68_2879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Smith L, Thomas N, Arnold A, Bell R, Zayed H, Tyrrell M, Padayachee S. Editor's Choice - A Comparison of Computed Tomography Angiography and Colour Duplex Ultrasound Surveillance Post Infrarenal Endovascular Aortic Aneurysm Repair: Financial Implications and Impact of Different International Surveillance Guidelines. Eur J Vasc Endovasc Surg 2021; 62:193-201. [PMID: 34140226 DOI: 10.1016/j.ejvs.2021.04.005] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 03/21/2021] [Accepted: 04/03/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Use of colour duplex ultrasound (CDUS) and computed tomography angiography (CTA) for infrarenal endovascular aortic aneurysm repair (EVAR) surveillance differs in internationally published guidelines. This study aimed firstly to compare CDUS detection of significant sac abnormalities with CTA. Secondly, a sensitivity analysis was conducted to compare financial estimates of the, predominantly CDUS based, local and Society of Vascular Surgery (SVS) protocols, the risk stratified European Society of Vascular Surgery (ESVS) protocol, and the CTA based National Institute of Health and Care Excellence (NICE) protocol. METHODS Agreement between CDUS and CTA was assessed for detection of significant sac abnormalities. Surveillance protocols were extrapolated from published guidelines and applied to infrarenal EVAR patients active on local surveillance at a large, single centre. Surveillance intensity was dependent on presence of endoleak and subsequent risk of treatment failure in accordance with surveillance recommendations. Estimates for each surveillance protocol were inclusive of a range of published incidences of endoleak, contrast associated acute kidney injury (AKI), and excess hospital bed days, and estimated for a hypothetical five year surveillance period. RESULTS The kappa coefficient between CDUS and CTA for detecting sac abnormalities was 0.68. Maximum five year surveillance cost estimates for the 289 active EVAR patients were £272 359 for SVS, £230 708 for ESVS, £643 802 for NICE, and £266 777 for local protocols, or £1 270, £1 076, £3 003, and £1 244 per patient. Differences in endoleak incidence accounted for a 1.1 to 1.4 fold increase in costs. AKI incidence accounted for a 3.3 to 6.2 fold increase in costs. CONCLUSION A combined CTA and CDUS EVAR surveillance protocol, with CTA reserved for early seal assessment and confirmatory purposes, provides an economical approach without compromising detection of sac abnormalities. AKI, as opposed to direct imaging costs, accounted for the largest differences in surveillance cost estimates.
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Affiliation(s)
- Luke Smith
- Ultrasonic Angiology, Guy's Hospital, London, United Kingdom.
| | - Nicholas Thomas
- Ultrasonic Angiology, Guy's Hospital, London, United Kingdom
| | - Andrew Arnold
- Ultrasonic Angiology, Guy's Hospital, London, United Kingdom
| | - Rachel Bell
- Department of Vascular Surgery, St Thomas' Hospital, London, United Kingdom
| | - Hany Zayed
- Department of Vascular Surgery, St Thomas' Hospital, London, United Kingdom
| | - Mark Tyrrell
- Department of Vascular Surgery, St Thomas' Hospital, London, United Kingdom
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Dreval K, Thomas N, Gerhard DS, Hilton LK, Wong J, Abramson JS, Bartlett NL, Bethony J, Bowen J, Bryan AC, Casper C, Dyer M, Gastier‐Foster JM, Grande BM, Greiner T, Griner NB, Gross TG, Harris NL, Irvin JD, Jaffe E, Leal F, Martin JP, Martin M, Mbulaiteye SM, Mullighan CG, Mungall AJ, Mungall K, Namirembe C, Noy A, Ogwang MD, Orem J, Petrello H, Reynolds SJ, Swerdlow SH, Traverse‐Glehen A, Wilson WH, Marra MA, Staudt LM, Scott DW, Morin RD. COPY NUMBER VARIATION ANALYSIS IDENTIFIES DISTINCT GENOMIC FEATURES IN ADULT BURKITT LYMPHOMA. Hematol Oncol 2021. [DOI: 10.1002/hon.67_2879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Radke A, Thomas N, Lee K, Butler J, Magnusson K, Hagen T. Mitochondrial Structure and Function is Impaired in the β‐amyloidosis 5xFAD Mouse at an Extreme Early Age Prior to Neurocognitive Decline. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.04709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
Introduction Pi and colleagues reviewed eight case-control studies comparing the oral health (decayed, missing and filled teeth [DMFT], Plaque Index [PI], Gingival Index [GI] and salivary pH) of children with autism (n = 475) to children without autism (n = 565).Method The search strategy involved the use of PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang and Chinese Scientific and Technological Journal (VIP) to find case-control studies which met pre-defined inclusion criteria and were published before September 2018. The quality of each study was evaluated using the Newcastle-Ottowa Scale and only high-quality studies were included. Means and standard deviations for outcomes measured by each included study were presented. Data were pooled using the random-effects model via Review Manager 5.3, and presented as mean differences and 95% confidence intervals. Consistency was measured using I2. Sensitivity analysis was performed by removing one study with a large sample to explore effects on heterogeneity.Results The authors found eight eligible case-control studies conducted in Asia (n = 7) or South America (n = 1). Six of the eight compared DMFT of children with autism to those without and three of the eight compared PI, GI and/or salivary pH. While a meta-analysis is presented for each of the oral health outcome areas, there are discrepancies in the reporting. The included studies in each of the meta-analysis do not correspond with the characteristics of the studies provided.Conclusions The authors suggest from their meta-analyses that children with autism experience a higher prevalence of dental disease than children without autism. However, as currently presented, the study lacks internal validity and findings are not reliable.
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Affiliation(s)
- N Thomas
- Faculty of Health, University of Plymouth, UK.
| | - S Blake
- Child Health, University of Exeter Medical School, UK
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Ganeshan S, Hsiang E, Peng T, Thomas N, Garcia-Grossman I, Javaherian K, Lyon Z, Vidyarthi A. Enabling patient communication for hospitalised patients during and beyond the COVID-19 pandemic. BMJ Innov 2021; 7:316-320. [PMID: 34192018 PMCID: PMC7948155 DOI: 10.1136/bmjinnov-2020-000636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/16/2021] [Accepted: 02/24/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Smitha Ganeshan
- Department of Hospital Medicine, University of California San Francisco, San Francisco, California, USA
| | - Esther Hsiang
- Department of Hospital Medicine, University of California San Francisco, San Francisco, California, USA
| | - Theodore Peng
- Department of Hospital Medicine, University of California San Francisco, San Francisco, California, USA
| | - Nicholas Thomas
- Department of Hospital Medicine, University of California San Francisco, San Francisco, California, USA
| | - Ilana Garcia-Grossman
- Department of Hospital Medicine, University of California San Francisco, San Francisco, California, USA
| | - Kavon Javaherian
- Department of Hospital Medicine, University of California San Francisco, San Francisco, California, USA
| | - Zoe Lyon
- Department of Hospital Medicine, University of California San Francisco, San Francisco, California, USA
| | - Arpana Vidyarthi
- Department of Hospital Medicine, University of California San Francisco, San Francisco, California, USA
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Joshi M, J. Rahill G, Carrington C, Mabie A, Salinas-Miranda A, Thomas N, Morales A, Grippo L, Grey A. “They are not satisfied until they see our blood”: Syndemic HIV risks for trans women in urban Haiti. International Journal of Mental Health 2021. [DOI: 10.1080/00207411.2021.1891364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Manisha Joshi
- College of Behavioral and Community Sciences (CBCS), School of Social Work, University of South Florida, Tampa, Florida, USA
| | - Guitele J. Rahill
- College of Behavioral and Community Sciences (CBCS), School of Social Work, University of South Florida, Tampa, Florida, USA
| | - Cherelle Carrington
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Alexander Mabie
- College of Behavioral and Community Sciences (CBCS), School of Social Work, University of South Florida, Tampa, Florida, USA
| | | | - Nicholas Thomas
- College of Public Health (COPH), University of South Florida, Tampa, Florida, USA
| | - Amanda Morales
- College of Behavioral and Community Sciences (CBCS), School of Social Work, University of South Florida, Tampa, Florida, USA
| | - Lucy Grippo
- College of Behavioral and Community Sciences (CBCS), School of Social Work, University of South Florida, Tampa, Florida, USA
| | - Amanda Grey
- College of Behavioral and Community Sciences (CBCS), School of Social Work, University of South Florida, Tampa, Florida, USA
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Thomas N, Myall N, Sun F, Patil T, Mushtaq R, Yu C, Pollom E, Nagpal S, Camidge R, Rusthoven C, Braunstein S, Wakelee H, Mccoach C. P76.14 Time to First Progression in Patients with NSCLC with Brain Metastases Receiving 3rd Generation TKI alone vs TKI + Brain Radiation. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shabeer MP, Abiramalatha T, Gibikote S, Rebekah G, Thomas N. Bedside sonography performed by neonatology residents to confirm central vascular catheter position in neonates - A Prospective Diagnostic Evaluation study. J Neonatal Perinatal Med 2021; 14:101-107. [PMID: 32310193 DOI: 10.3233/npm-200409] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 12/21/2022]
Abstract
OBJECTIVE To evaluate the diagnostic accuracy and utility of bedside ultrasound (US) by neonatology residents to confirm position of umbilical venous catheter (UVC), umbilical arterial catheter (UAC), and peripherally inserted central catheter (PICC). METHODS In this prospective study, we included neonates who required UVC, UAC or PICC insertion. Two neonatology residents performed all bedside US examinations after a short period of training. Plain radiograph was taken as gold standard. Time taken for confirmation of catheter position by US and radiograph was recorded. RESULTS We recruited 71 neonates for UVC and UAC, and 40 neonates for PICC. Sensitivity and specificity of US in identifying a malpositioned catheter was good for UVC (94% and 66.7% respectively) and UAC (86.7% and 94.5%). Agreement between radiograph and US was good for UVC [0.718 (0.512, 0.861); p < 0.001] and UAC [0.857 (0.682, 0.953); p < 0.001]. Sensitivity (47.8%) of US in identifying a malpositioned PICC was low, though specificity (82.4%) was good. Agreement between radiograph and US in identifying PICC position was poor [0.25 (-0.084, 0.545); p 0.024]. This was due to incorrect interpretation of catheter position on radiograph in some infants, which was confirmed by the radiologist. The median time taken for US was significantly less than time taken for radiograph in confirming the position of UVC (50 vs. 155 minutes; p < 0.001)), UAC (45 vs. 128 minutes; p < 0.001), and PICC (60 vs. 136 minutes; p < 0.001). CONCLUSION US examination byneonatology residents has good diagnostic accuracy in confirming the position of UAC and UVC, and possibly PICC in neonates. The time taken to confirm catheter position by US is significantly less than radiograph.
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Affiliation(s)
- M P Shabeer
- Department of Neonatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - T Abiramalatha
- Department of Neonatology, Christian Medical College, Vellore, Tamil Nadu, India.,Department of Neonatology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, India
| | - S Gibikote
- Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - G Rebekah
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | - N Thomas
- Department of Neonatology, Christian Medical College, Vellore, Tamil Nadu, India
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Delara R, Islam M, Thomas N, Mi L, Lim E, Yi J. Shared Decision Making in Opioid Prescribing in Gynecologic Surgery: A Prospective Randomized Controlled Trial. J Minim Invasive Gynecol 2020. [DOI: 10.1016/j.jmig.2020.08.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Thomas N, Saraswathy G. PRO13 In-Silico Determination of Therapeutic Possibilities for Type-1 Gaucher Disease: A GENE Database Linked Analysis. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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de Lusignan S, Jones N, Dorward J, Byford R, Liyanage H, Briggs J, Ferreira F, Akinyemi O, Amirthalingam G, Bates C, Lopez Bernal J, Dabrera G, Eavis A, Elliot AJ, Feher M, Krajenbrink E, Hoang U, Howsam G, Leach J, Okusi C, Nicholson B, Nieri P, Sherlock J, Smith G, Thomas M, Thomas N, Tripathy M, Victor W, Williams J, Wood I, Zambon M, Parry J, O'Hanlon S, Joy M, Butler C, Marshall M, Hobbs FDR. The Oxford Royal College of General Practitioners Clinical Informatics Digital Hub: Protocol to Develop Extended COVID-19 Surveillance and Trial Platforms. JMIR Public Health Surveill 2020; 6:e19773. [PMID: 32484782 PMCID: PMC7333793 DOI: 10.2196/19773] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [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] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/29/2020] [Accepted: 06/01/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Routinely recorded primary care data have been used for many years by sentinel networks for surveillance. More recently, real world data have been used for a wider range of research projects to support rapid, inexpensive clinical trials. Because the partial national lockdown in the United Kingdom due to the coronavirus disease (COVID-19) pandemic has resulted in decreasing community disease incidence, much larger numbers of general practices are needed to deliver effective COVID-19 surveillance and contribute to in-pandemic clinical trials. OBJECTIVE The aim of this protocol is to describe the rapid design and development of the Oxford Royal College of General Practitioners Clinical Informatics Digital Hub (ORCHID) and its first two platforms. The Surveillance Platform will provide extended primary care surveillance, while the Trials Platform is a streamlined clinical trials platform that will be integrated into routine primary care practice. METHODS We will apply the FAIR (Findable, Accessible, Interoperable, and Reusable) metadata principles to a new, integrated digital health hub that will extract routinely collected general practice electronic health data for use in clinical trials and provide enhanced communicable disease surveillance. The hub will be findable through membership in Health Data Research UK and European metadata repositories. Accessibility through an online application system will provide access to study-ready data sets or developed custom data sets. Interoperability will be facilitated by fixed linkage to other key sources such as Hospital Episodes Statistics and the Office of National Statistics using pseudonymized data. All semantic descriptors (ie, ontologies) and code used for analysis will be made available to accelerate analyses. We will also make data available using common data models, starting with the US Food and Drug Administration Sentinel and Observational Medical Outcomes Partnership approaches, to facilitate international studies. The Surveillance Platform will provide access to data for health protection and promotion work as authorized through agreements between Oxford, the Royal College of General Practitioners, and Public Health England. All studies using the Trials Platform will go through appropriate ethical and other regulatory approval processes. RESULTS The hub will be a bottom-up, professionally led network that will provide benefits for member practices, our health service, and the population served. Data will only be used for SQUIRE (surveillance, quality improvement, research, and education) purposes. We have already received positive responses from practices, and the number of practices in the network has doubled to over 1150 since February 2020. COVID-19 surveillance has resulted in tripling of the number of virology sites to 293 (target 300), which has aided the collection of the largest ever weekly total of surveillance swabs in the United Kingdom as well as over 3000 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serology samples. Practices are recruiting to the PRINCIPLE (Platform Randomised trial of INterventions against COVID-19 In older PeopLE) trial, and these participants will be followed up through ORCHID. These initial outputs demonstrate the feasibility of ORCHID to provide an extended national digital health hub. CONCLUSIONS ORCHID will provide equitable and innovative use of big data through a professionally led national primary care network and the application of FAIR principles. The secure data hub will host routinely collected general practice data linked to other key health care repositories for clinical trials and support enhanced in situ surveillance without always requiring large volume data extracts. ORCHID will support rapid data extraction, analysis, and dissemination with the aim of improving future research and development in general practice to positively impact patient care. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19773.
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Affiliation(s)
- Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Royal College of General Practitioners, London, United Kingdom
| | - Nicholas Jones
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Jienchi Dorward
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Rachel Byford
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Harshana Liyanage
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - John Briggs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Filipa Ferreira
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Oluwafunmi Akinyemi
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | | | | | | | | | - Alex J Elliot
- Real-time Syndromic Surveillance Team, Field Service, Public Health England, Birmingham, United Kingdom
| | - Michael Feher
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Uy Hoang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Gary Howsam
- Royal College of General Practitioners, London, United Kingdom
| | - Jonathan Leach
- Royal College of General Practitioners, London, United Kingdom
| | - Cecilia Okusi
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Brian Nicholson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Philip Nieri
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Julian Sherlock
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Gillian Smith
- Real-time Syndromic Surveillance Team, Field Service, Public Health England, Birmingham, United Kingdom
| | - Mark Thomas
- Royal College of General Practitioners, London, United Kingdom
| | - Nicholas Thomas
- Royal College of General Practitioners, London, United Kingdom
| | - Manasa Tripathy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - William Victor
- Royal College of General Practitioners, London, United Kingdom
| | - John Williams
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Ian Wood
- Royal College of General Practitioners, London, United Kingdom
- EMIS Group, Leeds, United Kingdom
| | | | | | | | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Chris Butler
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Martin Marshall
- Royal College of General Practitioners, London, United Kingdom
| | - F D Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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Lim MH, Penn DL, Thomas N, Gleeson JFM. Is loneliness a feasible treatment target in psychosis? Soc Psychiatry Psychiatr Epidemiol 2020; 55:901-906. [PMID: 31127348 DOI: 10.1007/s00127-019-01731-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 05/13/2019] [Indexed: 01/10/2023]
Abstract
PURPOSE Loneliness is a challenge for individuals with psychosis; however, interventions rarely target loneliness in this group. METHOD We developed a pilot positive psychology group intervention designed to reduce loneliness in psychosis and examined its feasibility and acceptability. RESULTS Sixteen participants attended 5.38 (SD = 0.70) out of six sessions, with a dropout rate of 10%. Participants were significantly less lonely at post-treatment (p < 0.001, d = 1.51), and maintained their improvements from post-treatment to follow-up (p = 0.81, d = 0.07). CONCLUSIONS Loneliness may be a feasible and acceptable treatment target within psychosocial treatments.
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Affiliation(s)
- M H Lim
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia. .,Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Australia.
| | - D L Penn
- Department of Psychology and Neurosciences, University of North Carolina Chapel Hill, Chapel Hill, USA.,School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, Australia
| | - N Thomas
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
| | - J F M Gleeson
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, Australia
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Shivakumar G, Thomas N, Sollychin M, Takács A, Kolamunna S, Melgar P, Connally F, Neil C, Bousman C, Jayaram M, Pantelis C. Protocol for Clozapine Rechallenge in a Case of Clozapine-Induced Myocarditis. Can J Psychiatry 2020; 65:448-453. [PMID: 31818135 PMCID: PMC7298578 DOI: 10.1177/0706743719892709] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Protocol for clozapine rechallenge in patients with a history of clozapine-induced myocarditis. METHOD Clozapine-related cardiovascular adverse effects including myocarditis and cardiomyopathy have limited its widespread use in treatment-resistant schizophrenia. Here, we present a case of clozapine-induced myocarditis and successful cautious rechallenge. Ms. AA, a young female patient with severe psychosis developed myocarditis during her initial clozapine titration phase, which was thus discontinued. Subsequent response to other medications was poor, and she remained significantly disabled. We reviewed blood-based biomarkers identified during the emergence of her index episode of myocarditis and developed a successful clozapine rechallenge protocol, based on careful monitoring of changes in these indices and a very slow clozapine re-titration. RESULTS AND CONCLUSIONS This protocol may have utility in the management of patients with a history of clozapine-induced myocarditis.
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Affiliation(s)
- G Shivakumar
- Adult Mental Health Rehabilitation Unit, North Western Mental Health, Melbourne Health, Western Health, Sunshine Hospital, St Albans, Victoria, Australia
| | - N Thomas
- Adult Mental Health Rehabilitation Unit, North Western Mental Health, Melbourne Health, Western Health, Sunshine Hospital, St Albans, Victoria, Australia.,Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Western Centre for Health, Research & Education, St Albans, Victoria, Australia
| | - M Sollychin
- Adult Mental Health Rehabilitation Unit, North Western Mental Health, Melbourne Health, Western Health, Sunshine Hospital, St Albans, Victoria, Australia
| | - A Takács
- Adult Mental Health Rehabilitation Unit, North Western Mental Health, Melbourne Health, Western Health, Sunshine Hospital, St Albans, Victoria, Australia
| | - S Kolamunna
- Adult Mental Health Rehabilitation Unit, North Western Mental Health, Melbourne Health, Western Health, Sunshine Hospital, St Albans, Victoria, Australia
| | - P Melgar
- Adult Mental Health Rehabilitation Unit, North Western Mental Health, Melbourne Health, Western Health, Sunshine Hospital, St Albans, Victoria, Australia
| | - F Connally
- Adult Mental Health Rehabilitation Unit, North Western Mental Health, Melbourne Health, Western Health, Sunshine Hospital, St Albans, Victoria, Australia
| | - C Neil
- Western Health, Department of Cardiology, University of Melbourne, Victoria, Australia
| | - C Bousman
- Department of Medical Genetics, University of Calgary, Alberta, Canada.,Department of Psychiatry, University of Calgary, Alberta, Canada.,Department of Physiology and Pharmacology, University of Calgary, Alberta, Canada
| | - M Jayaram
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Western Centre for Health, Research & Education, St Albans, Victoria, Australia
| | - C Pantelis
- Adult Mental Health Rehabilitation Unit, North Western Mental Health, Melbourne Health, Western Health, Sunshine Hospital, St Albans, Victoria, Australia.,Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Western Centre for Health, Research & Education, St Albans, Victoria, Australia
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Petretta A, Thomas N, Saunders M, Hargens T, Luden N. The Effect Of Nap Duration On Sleep Inertia, Muscle Strength, And 3-km Cycling Time Trial Performance. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000679588.25417.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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