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Lin F, Li Y, Wang J, Jardines S, King R, Chrenek MA, Wiggs JL, Boatright JH, Geisert EE. POU6F2, a risk factor for glaucoma, myopia and dyslexia, labels specific populations of retinal ganglion cells. Sci Rep 2024; 14:10096. [PMID: 38698014 PMCID: PMC11066091 DOI: 10.1038/s41598-024-60444-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/23/2024] [Indexed: 05/05/2024] Open
Abstract
Pou6f2 is a genetic connection between central corneal thickness (CCT) in the mouse and a risk factor for developing primary open-angle glaucoma. POU6F2 is also a risk factor for several conditions in humans, including glaucoma, myopia, and dyslexia. Recent findings demonstrate that POU6F2-positive retinal ganglion cells (RGCs) comprise a number of RGC subtypes in the mouse, some of which also co-stain for Cdh6 and Hoxd10. These POU6F2-positive RGCs appear to be novel of ON-OFF directionally selective ganglion cells (ooDSGCs) that do not co-stain with CART or SATB2 (typical ooDSGCs markers). These POU6F2-positive cells are sensitive to damage caused by elevated intraocular pressure. In the DBA/2J mouse glaucoma model, heavily-labeled POU6F2 RGCs decrease by 73% at 8 months of age compared to only 22% loss of total RGCs (labeled with RBPMS). Additionally, Pou6f2-/- mice suffer a significant loss of acuity and spatial contrast sensitivity along with an 11.4% loss of total RGCs. In the rhesus macaque retina, POU6F2 labels the large parasol ganglion cells that form the magnocellular (M) pathway. The association of POU6F2 with the M-pathway may reveal in part its role in human glaucoma, myopia, and dyslexia.
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Affiliation(s)
- Fangyu Lin
- Department of Ophthalmology, Emory University, 1365B Clifton Road NE, Atlanta, GA, 30322, USA
| | - Ying Li
- Department of Ophthalmology, Emory University, 1365B Clifton Road NE, Atlanta, GA, 30322, USA
| | - Jiaxing Wang
- Department of Ophthalmology, Emory University, 1365B Clifton Road NE, Atlanta, GA, 30322, USA
| | - Sandra Jardines
- Department of Ophthalmology, Emory University, 1365B Clifton Road NE, Atlanta, GA, 30322, USA
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
| | - Rebecca King
- Department of Ophthalmology, Emory University, 1365B Clifton Road NE, Atlanta, GA, 30322, USA
| | - Micah A Chrenek
- Department of Ophthalmology, Emory University, 1365B Clifton Road NE, Atlanta, GA, 30322, USA
| | - Janey L Wiggs
- Massachusetts Eye and Ear, Harvard Medical School Boston, Boston, MA, USA
| | - Jeffrey H Boatright
- Department of Ophthalmology, Emory University, 1365B Clifton Road NE, Atlanta, GA, 30322, USA
- Atlanta Veterans Administration Center for Visual and Neurocognitive Rehabilitation, Decatur, GA, USA
| | - Eldon E Geisert
- Department of Ophthalmology, Emory University, 1365B Clifton Road NE, Atlanta, GA, 30322, USA.
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Baxter EM, Bowers N, King R, Brocklehurst S, Edwards SA. Factors contributing to high performance of sows in free farrowing systems. Porcine Health Manag 2024; 10:16. [PMID: 38698485 PMCID: PMC11064381 DOI: 10.1186/s40813-024-00366-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/19/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Pressure to abolish farrowing crates is increasing, and producers are faced with decisions about which alternative system to adopt. For sow welfare, well designed free farrowing systems without close confinement are considered optimal but producers have concerns about increased piglet mortality, particularly crushing by the sow. Reporting accurate performance figures from commercial farms newly operating such systems could inform the transition process. This study investigated performance on three commercial farms operating four different zero-confinement systems, three of which were newly installed. A total of 3212 litters from 2920 sows were followed from farrowing to weaning over a three-year period with key performance indicators (KPIs) recorded. Mixed Models (LMMs, GLMMs) determined the influence of different factors (e.g. farrowing system, sow parity, management aspects) and litter characteristics on performance, including levels and causes of piglet mortality. RESULTS Piglet mortality was significantly influenced by farm/system. Live-born mortality ranged from 10.3 to 20.6% with stillbirths ranging from 2.5 to 5.9%. A larger litter size and higher parity resulted in higher levels of mortality regardless of system. In all systems, crushing was the main cause of piglet mortality (59%), but 31% of sows did not crush any piglets, whilst 26% crushed only one piglet and the remaining sows (43%) crushed two or more piglets. System significantly influenced crushing as a percentage of all deaths, with the system with the smallest spatial footprint (m2) compared to the other systems, recording the highest levels of crushing. Time from the start of the study influenced mortality, with significant reductions in crushing mortality (by ~ 4%) over the course of the three-year study. There was a highly significant effect of length of time (days) between moving sows into the farrowing accommodation and sows farrowing on piglet mortality (P < 0.001). The less time between sows moving in and farrowing, the higher the levels of piglet mortality, with ~ 3% increase in total mortality every five days. System effects were highly significant after adjusting for parity, litter size, and days pre-farrowing. CONCLUSION These results from commercial farms demonstrate that even sows that have not been specifically selected for free farrowing are able, in many cases, to perform well in these zero-confinement systems, but that a period of adaptation is to be expected for overall farm performance. There are performance differences between the farms/systems which can be attributed to individual farm/system characteristics (e.g. pen design and management, staff expertise, pig genotypes, etc.). Higher parity sows and those producing very large litters provide a greater challenge to piglet mortality in these free farrowing systems (just as they do in crate systems). Management significantly influences performance, and ensuring sows have plenty of time to acclimatise between moving in to farrowing accommodation and giving birth is a critical aspect of improving piglet survival.
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Affiliation(s)
- Emma M Baxter
- Animal and Veterinary Sciences Research Group, Scotland's Rural College (SRUC), West Mains Road, Edinburgh, EH9 3JG, UK.
| | - Nicola Bowers
- Farmvet Integrated Livestock Services, Unit 3 Zenith Park Network Centre, Whaley Road, Barnsley, S75 1HT, UK
- School of Natural and Environmental Sciences, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - Rebecca King
- ADAS Leeds, 4205 Park Approach, Leeds, LS15 8GB, UK
- School of Natural and Environmental Sciences, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | | | - Sandra A Edwards
- School of Natural and Environmental Sciences, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
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Parajuli A, Mitchell J, King N, Arjyal A, Latham S, King R, Baral S. Drivers of antimicrobial resistance within the communities of Nepal from One Health perspective: a scoping review. Front Public Health 2024; 12:1384779. [PMID: 38706550 PMCID: PMC11066241 DOI: 10.3389/fpubh.2024.1384779] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 04/01/2024] [Indexed: 05/07/2024] Open
Abstract
Background A major driver of antimicrobial resistance (AMR) is the inappropriate use of antimicrobials. At the community level, people are often engaged in behaviors that drive AMR within human, animal, and environmental (One Health) impacts. This scoping review consolidates research to determine (a) the community's knowledge, attitudes, and practices around AMR; (b) existing community-based interventions; and (c) barriers and enablers to addressing AMR in Nepal. Methods This scoping review follows the Joanna Briggs Institute scoping review methodology. Literature indexed in PubMed, Scopus, CINAHL, Global Index Medicus, HINARI-SUMMON, Embase (Ovid), Global Health (Ovid), CAB Abstracts (Ovid), Web of Science, and Google Scholar between January 2000 and January 2023 were reviewed for inclusion. Articles were included in the review if they considered the issues of AMR at the community level in Nepal; this excluded clinical and laboratory-based studies. A total of 47 studies met these criteria, were extracted, and analyzed to consolidate the key themes. Results A total of 31 (66%) articles exclusively included human health; five (11%) concentrated only on animal health; no studies solely focused on environmental aspects of AMR; and the remaining studies jointly presented human, animal, and environmental aspects. Findings revealed inadequate knowledge accompanied by inappropriate practice in both the human and animal health sectors. Four community interventions improved knowledge and practices on the appropriate use of antimicrobials among community people. However, various social and economic factors were found as barriers to the appropriate use of antimicrobials in the community. Conclusion Community engagement and One Health approaches could be key tools to improve awareness of AMR and promote behavioral change related to AM use in communities, as current studies have revealed inadequate knowledge alongside inappropriate practices shared in both human and animal health sectors. Systematic review registration DOI: 10.17605/OSF.IO/FV326.
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Affiliation(s)
| | - Jessica Mitchell
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, United Kingdom
| | - Natalie King
- Academic Unit of Health Economics, University of Leeds, Leeds, United Kingdom
| | | | - Sophia Latham
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Rebecca King
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, United Kingdom
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White S, Tella D, Ostad B, Barquin D, Smith C, King R, Greene KL, Downs T, Kern NG. Grant funding among underrepresented minority and women urologists at academic institutions. Can J Urol 2024; 31:11777-11783. [PMID: 38401257] [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] [Subscribe] [Scholar Register] [Indexed: 02/26/2024]
Abstract
INTRODUCTION Grant funding to Urology has decreased over the last decade. Documented lack of gender and race diversity at the faculty level raises concerns for funding disparities. This study sought to characterize disparities based upon race and gender in National Institutes of Health (NIH) funding data to Urologic faculty. METHODS AND MATERIALS Data from 145 ACGME accredited Urology residency programs incorporating faculty gender and underrepresented in medicine (URiM) status was utilized. The NIH Research Portfolio Online Report Tool was queried between 1985 and 2023 for grants related to current Urology faculty. URiM status, gender, years of practice, academic rank, and Doximity residency program rank were factors in multivariable analysis. RESULTS A total of 2,131 faculty were included. Three hundred one Urologists received 793 urologic grants for a total of $993,919,052 in funding. By race, grants were awarded to: White 72.9%, Asian 21.8%, Hispanic 3.0%, Black 2.1%. Men received 708 grants (89.3%) worth $917,083,475 total. Women received 85 grants (10.7%) worth $76,835,577 total. Likelihood of being awarded a grant was significantly associated with non-URiM status (p < 0.001) and men (p < 0.0001). On multivariable analysis, Doximity rank (p < 0.001) and academic rank (p < 0.001) were significant predictors of receiving a grant; male gender, URiM status, and years of practice were not. Academic rank was also a significant predictor of number of grants received (p = 0.04) and total funding (p = 0.04); years of practice, Doximity rank, URiM status, and gender were not. CONCLUSIONS NIH grants were more likely awarded to higher ranked faculty from higher Doximity ranked institutions with no differences based on URiM status or gender.
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Affiliation(s)
- Simon White
- Department of Urology, University of Virginia, Charlottesville, Virginia, USA
| | - David Tella
- Department of Urology, University of Virginia, Charlottesville, Virginia, USA
| | - Bahrom Ostad
- Department of Urology, University of Virginia, Charlottesville, Virginia, USA
| | - David Barquin
- Department of Urology, Duke University, Durham, North Carolina, USA
| | - Caleigh Smith
- Department of Urology, University of Virginia, Charlottesville, Virginia, USA
| | - Rebecca King
- School of Medicine, Virginia Tech Carilion, Roanoke, Virginia, USA
| | - Kirsten L Greene
- Department of Urology, University of Virginia, Charlottesville, Virginia, USA
| | - Tracy Downs
- Department of Urology, University of Virginia, Charlottesville, Virginia, USA
| | - Nora G Kern
- Department of Urology, University of Virginia, Charlottesville, Virginia, USA
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Parajuli A, Garbovan L, Bhattarai B, Arjyal A, Baral S, Cooke P, Latham S, Barrington DJ, Mitchell J, King R. Exploring community insights on antimicrobial resistance in Nepal: a formative qualitative study. BMC Health Serv Res 2024; 24:57. [PMID: 38212733 PMCID: PMC10782613 DOI: 10.1186/s12913-023-10470-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 12/12/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) is the process by which microbes evolve mechanisms to survive the medicines designed to destroy them i.e. antimicrobials (AMs). Despite being a natural process, AMR is being hastened by the abuse of AMs. In context of Nepal, there is limited information on drivers of AMR and barriers in addressing it from a community perspective. This study explores the local language and terminology used around AMs in the community, commonly used AMs and reasons for their usage, how these AMs are sourced, and the perceived barriers to addressing AMR via One Health approach. METHODS A phenomenological study design was utilized with applied qualitative research theoretically framed as pragmatism. Twelve in-depth interviews and informal discussions with a One Health focus, were purposively conducted with wide range of stakeholders and community resident of Kapilvastu municipality of Nepal during April 2022. The acquired data was analyzed manually via a thematic framework approach. The study obtained ethical approval from ethical review board of Nepal Health Research Council and University of Leeds. RESULTS Nepali and Awadhi languages does not have specific words for AMs or AMR, which is understandable by the community people. Rather, community use full explanatory sentences. People use AMs but have incomplete knowledge about them and they have their own local words for these medicines. The knowledge and usage of AMs across human and animal health is impacted by socio-structural factors, limited Government regulation, inadequate supply of AMs in local government health facilities and the presence of various unregulated health providers that co-exist within the health system. Novel ideas such as the use of visual and smart technology, for instance mobile phones and social media exposure, can enable access to information about AMs and AMR. CONCLUSION This study shows that terminology that is understandable by the community referring to AMs and AMR in Nepali and Awadhi languages does not exist, but full explanatory sentences and colloquial names are used. Despite regular utilisation, communities have incomplete knowledge regarding AMs. Since, knowledge alone cannot improve behaviour, behavioural interventions are required to address AMR via community engagement to co-produce their own solutions. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
| | - Lidis Garbovan
- Centre for World Cinema and Digital Cultures, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, UK
| | | | | | | | - Paul Cooke
- Centre for World Cinema and Digital Cultures, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, UK
| | - Sophia Latham
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Chester High Road, Neston, Liverpool, CH64 7TE, UK
| | - Dani J Barrington
- School of Population and Global Health, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western, 6009, Australia
| | - Jessica Mitchell
- Nuffield Centre for International Health and Development, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, UK
| | - Rebecca King
- Nuffield Centre for International Health and Development, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, UK
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Mitchell J, Hawkings H, Latham S, Fieroze F, Arjyal A, Barrington DJ, Baral S, Saify MB, Cooke P, Hamade P, Huque R, Parajuli A, Siddiki AZ, King R. Addressing antimicrobial resistance through community engagement: a framework for developing contextually relevant and impactful behaviour change interventions. JAC Antimicrob Resist 2023; 5:dlad124. [PMID: 38021035 PMCID: PMC10673675 DOI: 10.1093/jacamr/dlad124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Background Community engagement (CE) interventions often explore and promote behaviour change around a specific challenge. Suggestions for behaviour change should be co-produced in partnership with the community. To facilitate this, it is essential that the intervention includes key content that unpacks the challenge of interest via multiple sources of knowledge. However, where community lived experience and academic evidence appear misaligned, tensions can appear within the co-production dynamic of CE. This is specifically so within the context of antimicrobial resistance (AMR) where ideal behaviours are often superseded by what is practical or possible in a particular community context. Methods Here we describe a framework for the equitable development of contextually appropriate, clearly evidenced behavioural objectives for CE interventions. This framework explores different sources of knowledge on AMR, including the potentially competing views of different stakeholders. Findings The framework allows key content on AMR to be selected based upon academic evidence, contextual appropriateness and fit to the chosen CE approach. A case study of the framework in action exemplifies how the framework is applicable to a range of contexts, CE approaches and One Health topics beyond just AMR. Conclusions Within CE interventions, academic evidence is crucial to develop well-informed key content. However, this formative work should also involve community members, ensuring that their contextual knowledge is valued. The type of CE approach also needs careful consideration because methodological constraints may limit the breadth and depth of information that can be delivered within an intervention, and thus the scope of key content.
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Affiliation(s)
- Jessica Mitchell
- Nuffield Centre for International Health and Development, Leeds Institute for Health Sciences, Faculty of Medicine and Health, University of Leeds, Woodhouse, Leeds LS2 9JT, UK
| | - Helen Hawkings
- Malaria Consortium, The Green House 244-254 Cambridge Heath Rd, London EC2 9DA, UK
| | - Sophia Latham
- Department of Livestock and One Health, Institute of Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston CH64 7TE, UK
| | - Fariza Fieroze
- ARK Foundation, Suite C3 & C4, House 06, Road 109, Gulshan-2, Dhaka 1212, Bangladesh
| | | | - Dani Jennifer Barrington
- School of Population and Global Health, The University of Western Australia, 35 Stirling Highway, Crawley 6009, Western Australia
| | | | - Md Badruddin Saify
- ARK Foundation, Suite C3 & C4, House 06, Road 109, Gulshan-2, Dhaka 1212, Bangladesh
| | - Paul Cooke
- Faculty of Arts and Humanities, Centre for World Cinemas and Digital Cultures, University of Leeds, Woodhouse, Leeds LS2 9JT, UK
| | - Prudence Hamade
- Malaria Consortium, The Green House 244-254 Cambridge Heath Rd, London EC2 9DA, UK
| | - Rumana Huque
- ARK Foundation, Suite C3 & C4, House 06, Road 109, Gulshan-2, Dhaka 1212, Bangladesh
| | | | - Amam Zonaed Siddiki
- Faculty of Veterinary Medicine, Chattogram Veterinary and Animal Sciences University, Chattogram 4225, Bangladesh
| | - Rebecca King
- Nuffield Centre for International Health and Development, Leeds Institute for Health Sciences, Faculty of Medicine and Health, University of Leeds, Woodhouse, Leeds LS2 9JT, UK
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Grabowska W, King R, Roll S, Habermann IV, Hörder S, Hahn K, Willich SN, Schröder S, Brinkhaus B, Dietzel J. Reliability of a novel point of care device for monitoring diabetic peripheral neuropathy. Sci Rep 2023; 13:19043. [PMID: 37923763 PMCID: PMC10624654 DOI: 10.1038/s41598-023-45841-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/24/2023] [Indexed: 11/06/2023] Open
Abstract
We aimed to assess DPNCheck's reliability for repeated sural nerve conduction (NC) parameters. This post hoc analysis used data from the randomized controlled ACUDPN trial assessing NC of the N. Suralis every eight weeks over a 6-month period in 62 patients receiving acupuncture against diabetic peripheral neuropathy (DPN) symptoms. The reliability of DPNCheck for nerve conduction velocity and amplitude was assessed using intraclass correlation coefficients (ICC) and was calculated using data from single time points and repeated measures design. The results of the NC measurements were correlated with the Total Neuropathy Score clinical (TNSc). Overall, for both nerve velocity and amplitude, the reliability at each measurement time point can be described as moderate to good and the reliability using repeated measures design can be described as moderate. Nerve velocity and amplitude showed weak correlation with TNSc. DPNCheck's reliability results question its suitability for monitoring DPN's progression. Given the limitation of our analysis, a long-term, pre-specified, fully crossed study should be carried out among patients with DPN to fully determine the suitability of the device for DPN progression monitoring. This was the first analysis assessing the reliability of the DPNCheck for DPN progression monitoring using data from multiple collection time points.
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Affiliation(s)
- W Grabowska
- Institute of Social Medicine, Epidemiology and Health Economics, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Luisenstr. 57, 10117, Berlin, Germany
| | - R King
- Institute of Social Medicine, Epidemiology and Health Economics, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Luisenstr. 57, 10117, Berlin, Germany
| | - S Roll
- Institute of Social Medicine, Epidemiology and Health Economics, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Luisenstr. 57, 10117, Berlin, Germany
| | - I V Habermann
- Institute of Social Medicine, Epidemiology and Health Economics, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Luisenstr. 57, 10117, Berlin, Germany
| | - S Hörder
- Institute of Social Medicine, Epidemiology and Health Economics, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Luisenstr. 57, 10117, Berlin, Germany
| | - K Hahn
- Department of Neurology with Experimental Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - S N Willich
- Institute of Social Medicine, Epidemiology and Health Economics, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Luisenstr. 57, 10117, Berlin, Germany
| | - S Schröder
- Hanse Merkur Center for Traditional Chinese Medicine at the University Medical Center Hamburg-Eppendorf, Martinistrasse 64, 20251, Hamburg, Germany
| | - B Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Luisenstr. 57, 10117, Berlin, Germany
| | - J Dietzel
- Institute of Social Medicine, Epidemiology and Health Economics, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Luisenstr. 57, 10117, Berlin, Germany.
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Aruparayil N, Gnanaraj J, Mishra A, Bains L, Corrigan N, Brown J, Ensor T, King R, Shinkins B, Jayne D. Gasless laparoscopy in rural India-registry outcomes and evaluation of the learning curve. Surg Endosc 2023; 37:8227-8235. [PMID: 37653156 PMCID: PMC10615921 DOI: 10.1007/s00464-023-10392-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/13/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND A program of gasless laparoscopy (GL) has been implemented in rural North-East India. To facilitate safe adoption, participating rural surgeons underwent rigorous training prior to independent clinical practice. An online registry was established to capture clinical data on safety and efficacy and to evaluate initial learning curves for gasless laparoscopy. METHODS Surgeons who had completed the GL training program participated in the online RedCap Registry. Patients included in the registry provided informed consent for the use of their data. Data on operative times, conversion rates, perioperative complications, length of stay, and hospital costs were collected. Fixed reference cumulative sum (CUSUM) model was used to evaluate the learning curve based on operative times and conversion rates published in the literature. RESULTS Four surgeons from three rural hospitals in North-East India participated in the registry. The data were collected over 12 months, from September 2019 to August 2020. One hundred and twenty-three participants underwent GL procedures, including 109 females (88.6%) and 14 males. GL procedures included cholecystectomy, appendicectomy, tubal ligation, ovarian cystectomy, diagnostic laparoscopy, and adhesiolysis. The mean operative time was 75.3 (42.05) minutes for all the surgeries. Conversion from GL to open surgery occurred in 11.4% of participants, with 8.9% converted to conventional laparoscopy. The main reasons for conversion were the inability to secure an operative view, lack of operating space, and adhesions. The mean length of stay was 3 (2.1) days. The complication rate was 5.7%, with one postoperative death. The CUSUM analysis for GL cholecystectomy showed a longer learning curve for operative time and few conversions. The learning curve for GL tubal ligation was relatively shorter. CONCLUSION Gasless laparoscopy can be safely implemented in the rural settings of Northeast India with appropriate training programs. Careful case selection is essential during the early stages of the surgical learning curve.
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Affiliation(s)
- N Aruparayil
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK.
- St. James's University Hospital, Level 7, Clinical Sciences Building, Leeds, LS9 7TF, UK.
| | | | - A Mishra
- Maulana Azad Medical College, Delhi, India
| | - L Bains
- Maulana Azad Medical College, Delhi, India
| | - N Corrigan
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - J Brown
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - T Ensor
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK
| | - R King
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK
| | - B Shinkins
- Academic Unit of Health Economics, University of Leeds, Leeds, UK
- Division of Health Sciences, University of Warwick, Coventry, UK
| | - D Jayne
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
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Zelenetz AD, Gordon LI, Abramson JS, Advani RH, Andreadis B, Bartlett NL, Budde LE, Caimi PF, Chang JE, Christian B, DeVos S, Dholaria B, Fayad LE, Habermann TM, Hamid MS, Hernandez-Ilizaliturri F, Hu B, Kaminski MS, Karimi Y, Kelsey CR, King R, Krivacic S, LaCasce AS, Lim M, Messmer M, Narkhede M, Rabinovitch R, Ramakrishnan P, Reid E, Roberts KB, Saeed H, Smith SD, Svoboda J, Swinnen LJ, Tuscano J, Vose JM, Dwyer MA, Sundar H. NCCN Guidelines® Insights: B-Cell Lymphomas, Version 6.2023. J Natl Compr Canc Netw 2023; 21:1118-1131. [PMID: 37935098 DOI: 10.6004/jnccn.2023.0057] [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: 11/09/2023]
Abstract
Novel targeted therapies (small molecule inhibitors, antibody-drug conjugates, and CD19-directed therapies) have changed the treatment landscape of relapsed/refractory B-cell lymphomas. Bruton's tyrosine kinase (BTK) inhibitors continue to evolve in the management of mantle cell lymphoma (MCL), in both the relapsed/refractory and the frontline setting. Anti-CD19 CAR T-cell therapies are now effective and approved treatment options for relapsed/refractory follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), and MCL. Bispecific T-cell engagers represent a novel immunotherapeutic approach for relapsed FL and DLBCL after multiple lines of therapies, including prior CAR T-cell therapy. These NCCN Guideline Insights highlight the significant updates to the NCCN Guidelines for B-Cell Lymphomas for the treatment of FL, DLBCL, and MCL.
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Affiliation(s)
| | - Leo I Gordon
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | | | - Nancy L Bartlett
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | - Paolo F Caimi
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | | | - Beth Christian
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | - Sven DeVos
- UCLA Jonsson Comprehensive Cancer Center
| | | | - Luis E Fayad
- The University of Texas MD Anderson Cancer Center
| | | | - Muhammad Saad Hamid
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | | | - Boyu Hu
- Huntsman Cancer Institute at the University of Utah
| | | | | | | | | | | | | | - Megan Lim
- Memorial Sloan Kettering Cancer Center
| | | | | | | | | | | | | | | | | | - Jakub Svoboda
- Abramson Cancer Center at the University of Pennsylvania
| | - Lode J Swinnen
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
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Mitchell J, Arjyal A, Baral S, Barrington D, Cooke P, Fieroze F, Huque R, Hamade P, Hawkings H, Jones N, Latham S, Parajuli A, Saify MB, King R. Co-designing community-based interventions to tackle antimicrobial resistance (AMR): what to include and why. BMC Res Notes 2023; 16:290. [PMID: 37875996 PMCID: PMC10598890 DOI: 10.1186/s13104-023-06449-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/31/2023] [Indexed: 10/26/2023] Open
Abstract
Antimicrobial resistance (AMR) is a social and biological problem. Although resistance to antimicrobials is a natural phenomenon, many human behaviors are increasing the pressure on microbes to develop resistance which is resulting in many commonly used treatments becoming ineffective. These behaviors include unregulated use of antimicrobial medicines, pesticides and agricultural chemicals, the disposal of heavy metals and other pollutants into the environment, and human-induced climatic change. Addressing AMR thus calls for changes in the behaviors which drive resistance. Community engagement for antimicrobial resistance (CE4AMR) is an international and interdisciplinary network focused on tackling behavioural drivers of AMR at community level. Since 2019 this network has worked within Low-Middle Income Countries (LMICs), predominantly within Southeast Asia, to tackle behavioral drivers of AMR can be mitigated through bottom-up solutions championed by local people. This commentary presents seven Key Concepts identified from across the CE4AMR portfolio as integral to tackling AMR. We suggest it be used to guide future interventions aimed at addressing AMR via social, participatory, and behavior-change approaches.
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Affiliation(s)
- Jessica Mitchell
- Nuffield Centre for International Health and Development, Faculty of Medicine, University of Leeds, Woodhouse, Leeds, LS2 9JT, UK.
| | | | | | - Dani Barrington
- University of Western Australia, School of Population and Global Health, 35 Stirling Highway, Crawley, WA, 6009, Australia
| | - Paul Cooke
- Centre for World Cinema and Digital Cultures, Faculty of Arts and Humanities, University of Leeds, Woodhouse, Leeds, LS2 9JT, UK
| | | | | | - Prudence Hamade
- Malaria Consortium, The Green House 244-254 Cambridge Heath Rd, London, EC2 9DA, UK
| | - Helen Hawkings
- Malaria Consortium, The Green House 244-254 Cambridge Heath Rd, London, EC2 9DA, UK
| | - Nichola Jones
- Nuffield Centre for International Health and Development, Faculty of Medicine, University of Leeds, Woodhouse, Leeds, LS2 9JT, UK
| | - Sophia Latham
- Department of Livestock and One Health, Institute of Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, CH64 7TE, UK
| | | | | | - Rebecca King
- Nuffield Centre for International Health and Development, Faculty of Medicine, University of Leeds, Woodhouse, Leeds, LS2 9JT, UK
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Vauzour D, Scholey A, White DJ, Cohen NJ, Cassidy A, Gillings R, Irvine MA, Kay CD, Kim M, King R, Legido-Quigley C, Potter JF, Schwarb H, Minihane AM. A combined DHA-rich fish oil and cocoa flavanols intervention does not improve cognition or brain structure in older adults with memory complaints: results from the CANN randomized, controlled parallel-design study. Am J Clin Nutr 2023; 118:369-381. [PMID: 37315924 PMCID: PMC10447509 DOI: 10.1016/j.ajcnut.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 05/31/2023] [Accepted: 06/09/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND There is evidence that both omega-3 long-chain polyunsaturated fatty acids (PUFAs) (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) and cocoa flavanols can improve cognitive performance in both healthy individuals and in those with memory complaints. However, their combined effect is unknown. OBJECTIVES To investigate the combined effect of EPA/DHA and cocoa flavanols (OM3FLAV) on cognitive performance and brain structures in older adults with memory complaints. METHODS A randomized placebo-controlled trial of DHA-rich fish oil (providing 1.1 g/d DHA and 0.4 g/d EPA) and a flavanol-rich dark chocolate (providing 500 mg/d flavan-3-ols) was conducted in 259 older adults with either subjective cognitive impairment or mild cognitive impairment. Participants underwent assessment at baseline, 3 mo, and 12 mo. The primary outcome was the number of false-positives on a picture recognition task from the Cognitive Drug Research computerized assessment battery. Secondary outcomes included other cognition and mood outcomes, plasma lipids, brain-derived neurotrophic factor (BDNF), and glucose levels. A subset of 110 participants underwent structural neuroimaging at baseline and at 12 mo. RESULTS 197 participants completed the study. The combined intervention had no significant effect on any cognitive outcomes, with the exception of reaction time variability (P = 0.007), alertness (P < 0.001), and executive function (P < 0.001), with a decline in function observed in the OM3FLAV group (118.6 [SD 25.3] at baseline versus 113.3 [SD 25.4] at 12 mo for executive function) relative to the control, and an associated decrease in cortical volume (P = 0.039). Compared with the control group, OM3FLAV increased plasma HDL, total cholesterol ratio (P < 0.001), and glucose (P = 0.008) and reduced TG concentrations (P < 0.001) by 3 mo, which were sustained to 12 mo, with no effect on BDNF. Changes in plasma EPA and DHA and urinary flavonoid metabolite concentrations confirmed compliance to the intervention. CONCLUSIONS These results suggest that cosupplementation with ω-3 PUFAs and cocoa flavanols for 12 mo does not improve cognitive outcomes in those with cognitive impairment. This trial was registered at clinicaltrials.gov as NCT02525198.
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Affiliation(s)
- David Vauzour
- Norwich Medical School, University of East Anglia (UEA), Norwich, United Kingdom.
| | - Andrew Scholey
- Centre for Human Psychopharmacology, Swinburne University, Australia.
| | - David J White
- Centre for Human Psychopharmacology, Swinburne University, Australia
| | - Neal J Cohen
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Aedín Cassidy
- Norwich Medical School, University of East Anglia (UEA), Norwich, United Kingdom; Institute for Global Food Security, Queen's University Belfast, Belfast, Northern Ireland
| | - Rachel Gillings
- Norwich Medical School, University of East Anglia (UEA), Norwich, United Kingdom
| | - Michael A Irvine
- Norwich Medical School, University of East Anglia (UEA), Norwich, United Kingdom
| | - Colin D Kay
- Plants for Human Health Institute, Food Bioprocessing and Nutrition Sciences Department, North Carolina State University, North Carolina Research Campus, Kannapolis, NC, United States
| | - Min Kim
- Translational and Clinical Chemistry, Kings College London, London, Norwich, United Kingdom
| | - Rebecca King
- Centre for Human Psychopharmacology, Swinburne University, Australia
| | | | - John F Potter
- Norwich Medical School, University of East Anglia (UEA), Norwich, United Kingdom
| | - Hilary Schwarb
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Anne-Marie Minihane
- Norwich Medical School, University of East Anglia (UEA), Norwich, United Kingdom; Norwich Institute of Healthy Ageing (NIHA), UEA, Norwich, Norwich, United Kingdom
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12
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Tella D, Ostad B, Barquin D, Smith C, King R, Ballantyne C, Greene KL, Downs TM, Kern NG. Academic Productivity Among Underrepresented Minority and Women Urologists at Academic Institutions. Urology 2023; 178:9-16. [PMID: 37149061 DOI: 10.1016/j.urology.2023.03.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 02/17/2023] [Accepted: 03/01/2023] [Indexed: 05/08/2023]
Abstract
OBJECTIVE To characterize academic productivity for underrepresented minorities (URMs) vs non-URMs and by gender in Urology. METHODS A database was created from 145 Urology residency programs. URM status was determined by origin of name, photo, biography, Twitter, LinkedIn, and Doximity. A PubMed query was performed for publication output. URM status, gender, post-graduate year/years of practice, and Doximity residency rank were factors in multivariable analysis. RESULTS For residents, the median total publications was 2 [1,5] for URMs and 2 [1,5] for non-URMs (P=.54). The median first/last author publications was 1 [0,2] for URMs and 1 [0,2] for non-URMs (P=.79). The median total publications was 2 [0,4] for women and 2 [1,6] for men (P=.003). The median first/last author publications was 1 [0,2] for women and 1 [0,2] for men (P=.14). For faculty, the median total publications was 12 [3,32] for URMs and 19 [6,45] for non-URMs (P=.0002). The median first/last author publications was 4.5 [1,12] for URMs and 7 [2,20] for non-URM faculty (P=.0002). The median total publications was 11 [5,25] for women and 20 [6,49] for men (P<.0001). The median first/last author publications was 4 [1,11] for women and 8 [2,22] for men (P<.0001). On multivariable analysis, there was no difference in total publications and first/last author publications for URMs vs non-URMs. There remained a difference between genders for residents and faculty with total publications but not first/last author publications (P=.002/P=.10 residents, P=.004/P=.07 faculty). CONCLUSION Academic productivity was not different in URMs and non-URMs for both residents and faculty. Men residents and faculty had more total publications compared to women.
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Affiliation(s)
- David Tella
- Department of Urology, University of Virginia, Charlottesville, VA
| | - Bahrom Ostad
- Department of Urology, University of Virginia, Charlottesville, VA
| | | | - Caleigh Smith
- Department of Urology, University of Virginia, Charlottesville, VA
| | - Rebecca King
- School of Medicine, Virginia Tech Carilion, Blacksburg, VA
| | | | - Kirsten L Greene
- Department of Urology, University of Virginia, Charlottesville, VA
| | - Tracy M Downs
- Department of Urology, University of Virginia, Charlottesville, VA
| | - Nora G Kern
- Department of Urology, University of Virginia, Charlottesville, VA.
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Mitchell J, Cooke P, Arjyal A, Baral S, Jones N, Garbovan L, King R. Exploring the potential for children to act on antimicrobial resistance in Nepal: Valuable insights from secondary analysis of qualitative data. PLoS One 2023; 18:e0285882. [PMID: 37267313 PMCID: PMC10237405 DOI: 10.1371/journal.pone.0285882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/03/2023] [Indexed: 06/04/2023] Open
Abstract
This study explores the perceived roles of children in antimicrobial resistance (AMR) in two sites across Nepal. AMR is a global challenge and underpinned by many complex behavioural drivers including how antimicrobial medicines are sourced and used. Because of this social dynamic, several research groups are using community engagement (CE) approaches to understand AMR at community level. However, most data negate the importance of children in behaviours linked to, and potentially driving AMR. In this study, authors apply secondary analysis methods to 10 transcripts representing the views of 23 adults engaged in an AMR-focused film-making project. By focusing on participants' reference to children, we reveal that antimicrobial usage and adherence to health providers' messages can be influenced by the age of the patient. Secondly that children are involved in some of the behaviours which are known to drive antimicrobial resistance such as purchasing over-the-counter antibiotic drugs. Finally, community members discuss that, with careful creation of resources, AMR could be meaningfully presented in educational settings with a view to children acting as agents of change around AMR-driving behaviours. Findings suggest that age-inclusive community engagement projects could be effective in tackling AMR at community level in Nepal and other low resource settings.
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Affiliation(s)
- Jessica Mitchell
- Nuffield Centre for International Health and Development, Faculty of Medicine, University of Leeds, Leeds, United Kingdom
| | - Paul Cooke
- Centre for World Cinema and Digital Cultures, Faculty of Arts, Humanities and Cultures, University of Leeds, Leeds, United Kingdom
| | | | | | - Nichola Jones
- Nuffield Centre for International Health and Development, Faculty of Medicine, University of Leeds, Leeds, United Kingdom
| | - Lidis Garbovan
- Centre for World Cinema and Digital Cultures, Faculty of Arts, Humanities and Cultures, University of Leeds, Leeds, United Kingdom
| | - Rebecca King
- Nuffield Centre for International Health and Development, Faculty of Medicine, University of Leeds, Leeds, United Kingdom
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14
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Pipingas A, Reddan JM, Gauci S, Young LM, Kennedy G, Rowsell R, King R, Spiteri S, Minihane AM, Scholey A. Post-Prandial Cognitive and Blood Pressure Effects of a DHA-Rich Omega-3 Powder in Middle-Aged Males: A Pilot Study. Nutrients 2023; 15:2198. [PMID: 37432363 DOI: 10.3390/nu15092198] [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: 04/15/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 07/12/2023] Open
Abstract
The use of omega-3 polyunsaturated fatty acid (ω-3 PUFA) supplements is increasingly common among middle-aged and older adults. Users of ω-3 PUFA supplements often report using such supplements to support cognitive health, despite mixed findings reported within the ω-3 PUFA literature. To date, very few studies have explored cognitive effects in distinctly middle-aged (40 to 60 years) adults, and none have examined the acute effects (in the hours following a single dose) on cognitive performance. The current study evaluated whether a single dose of ω-3 PUFA (4020 mg docosahexaenoic acid and 720 mg eicosapentaenoic acid) influences cognitive performance and cardiovascular function in middle-aged males. Cognitive performance and cardiovascular function were assessed before and 3.5-4 h after consumption of a high dose of ω-3 PUFA (DHA + EPA) or placebo, incorporated into a standardized meal (i.e., single serve of Greek yogurt). In this study of middle-aged males, no significant differential treatment effects were observed for cognitive performance. However, a significant reduction in aortic systolic blood pressure (pre-dose to post-dose) was apparent following consumption of the ω-3 PUFA (DHA + EPA) treatment (mean difference = -4.11 mmHg, p = 0.004) but not placebo (mean difference = -1.39 mmHg, p = 0.122). Future replication in a sample comprising females, as well as patients with hypertension, is merited.
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Affiliation(s)
- Andrew Pipingas
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Jeffery Michael Reddan
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Sarah Gauci
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC 3220, Australia
| | - Lauren M Young
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Greg Kennedy
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Renee Rowsell
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Rebecca King
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Sam Spiteri
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | | | - Andrew Scholey
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC 3168, Australia
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Abstract
The South African (SA) medical internship training programme model was recently revised to extend training into the primary care platform. In this article, we reflect on the experiences of training under the new model from an intern perspective. We use these reflections to make recommendations to the Health Professions Council of SA on how to further improve the training model by implementing systems that guide and empower the intern doctor practising at a primary level of care.
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Affiliation(s)
- B Ramoolla
- Madwaleni District Hospital, Eastern Cape, South Africa.
| | - G Van der Haar
- Madwaleni District Hospital, Eastern Cape, South Africa.
| | - A Luke
- Bheki Mlangeni Distor any of the authorsrict Hospital, Gauteng, South Africa.
| | - R King
- Klerksdorp Tshepong Hospital Complex, North West Province, South Africa.
| | - N Jacob
- School of Public Health, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - B Luke
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Health, North West Province.
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Pujalte GGA, Narducci DM, Smith MS, King R, Logan K, Callender SS, Liebman CA, Kane SF, Israel MP, Wolf SF, Nuti R, Khodaee M. Athletes With Attention-Deficit/Hyperactivity Disorder: Position Statement of the American Medical Society for Sports Medicine. Clin J Sport Med 2023; 33:195-208. [PMID: 37185161 DOI: 10.1097/jsm.0000000000001152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 05/17/2023]
Abstract
ABSTRACT Athletes of all ages may be affected by medical and mental health issues. Sports medicine physicians should be familiar with common conditions that may affect the well-being of athletes, such as attention-deficit/hyperactivity disorder (ADHD). ADHD behaviors have the potential to affect a person's ability to concentrate. It is likely that social and cognitive therapies combined with pharmacotherapy will be the most effective way to treat ADHD in athletes. Medications used for ADHD, especially stimulant types, are known to improve alertness, reaction time, anaerobic performance, and endurance, which would potentially improve athletic performance. Furthermore, stimulant medications may enable student athletes with ADHD to focus on academic studies for longer periods of time, beyond usual levels of fatigue, important for those who may be exhausted after practices and games. The purported performance enhancement effects and potential adverse effects of stimulant medications have prompted many sports governing bodies to ban prescription stimulants or establish strict rules for their use. Athletes taking physician-prescribed stimulants to treat ADHD need to provide the appropriate documentation for approval before competition or risk punitive measures. Physicians should strive to provide a high quality of care to athletes with ADHD through early diagnosis, appropriate and careful multidisciplinary treatment, and complete and timely documentation to facilitate continued sports participation.
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Affiliation(s)
- George G A Pujalte
- Department of Family Medicine and Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida
| | - Dusty Marie Narducci
- Department of Family Medicine, University of South Florida College of Medicine, Tampa, Florida
| | - Michael Seth Smith
- Sports Medicine Institute, Department of Orthopaedics, Florida Health, Gainesville, Florida
| | - Rebecca King
- Primary Care National Landing, Virginia Hospital Center, Arlington, Virginia
| | - Kelsey Logan
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Shelley Street Callender
- Departments of Pediatrics and Family Medicine, Mercer University School of Medicine, Macon, Georgia
| | - Catherine A Liebman
- Department Family Medicine and Community Health, Penn Health, Philadelphia, Pennsylvania
| | - Shawn F Kane
- Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Michael P Israel
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Sigrid F Wolf
- Division of Orthopaedic Surgery and Sports Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Morteza Khodaee
- AF Williams Family Medicine Clinic, UCHealth, Denver, Colorado
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Putnis N, Riches N, Nyamayaro A, Boucher D, King R, Walker IF, Burger A, Southworth P, Mwanjali V, Walley J. Evaluation of a Depression Intervention in People With HIV and/or TB in Eswatini Primary Care Facilities: Implications for Southern Africa. Glob Health Sci Pract 2023; 11:GHSP-D-22-00016. [PMID: 37116919 PMCID: PMC10141428 DOI: 10.9745/ghsp-d-22-00016] [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] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/14/2023] [Indexed: 03/31/2023]
Abstract
INTRODUCTION Depression associated with chronic illnesses is common in Southern Africa, yet there are major treatment gaps. This study assesses the feasibility and acceptability of the Healthy Activity Program intervention for depression among people with HIV and/or TB. The intervention involves training nonspecialist nurses in depression, including identification, counseling based on behavioral activation theory, and structured referral. METHODS This is a mixed methods evaluation of a pilot counseling service integrated within routine HIV and TB care from 2018 to 2019. Participants included people living with HIV and/or patients with TB in rural Eswatini. RESULTS A total of 324 people living with HIV and/or TB were screened for depression, with 19% (62/324) screening positive. The median number of sessions attended was 3 (interquartile range: 1-5), with 16/60 (26%) attending the minimum 5 sessions. Qualitative results indicated acceptability, but there were concerns about feasibility. CONCLUSIONS The Healthy Activity Program is a promising option to manage the treatment gap for depression in people with HIV and/or TB. However, task-shifting to nonspecialist health care professionals without increasing staff capacity is a barrier to implementation. Realistic and pragmatic assessments of capacity and workforce are essential.
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Affiliation(s)
- Nina Putnis
- Nuffield Institute of International Health and Development, University of Leeds, Leeds, United Kingdom
| | - Nick Riches
- Nuffield Institute of International Health and Development, University of Leeds, Leeds, United Kingdom
| | - Archibald Nyamayaro
- Nuffield Institute of International Health and Development, University of Leeds, Leeds, United Kingdom
- Good Shepherd Hospital, Siteki, Eswatini
| | | | - Rebecca King
- Nuffield Institute of International Health and Development, University of Leeds, Leeds, United Kingdom
| | - Ian F. Walker
- Nuffield Institute of International Health and Development, University of Leeds, Leeds, United Kingdom
| | | | - Paul Southworth
- Nuffield Institute of International Health and Development, University of Leeds, Leeds, United Kingdom
| | | | - John Walley
- Nuffield Institute of International Health and Development, University of Leeds, Leeds, United Kingdom
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Ahmed I, King R, Akter S, Akter R, Aggarwal VR. Determinants of antibiotic self-medication: A systematic review and meta-analysis. Res Social Adm Pharm 2023; 19:1007-1017. [PMID: 37019706 DOI: 10.1016/j.sapharm.2023.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Decreasing the prevalence of antibiotic self-medication among the public requires proper understanding of the risk factors involved. However, the determinants of antibiotic self-medication are not well defined. OBJECTIVES To identify patient and health system-related determinants of antibiotic self-medication among the public. METHODS A systematic review of quantitative observational studies and qualitative studies was undertaken. PubMed, Embase, and Web of Science were searched to identify studies on determinants of antibiotic self-medication. The data were analyzed using meta-analysis, descriptive analysis, and thematic analysis. RESULTS Sixty-eight studies were included in the review. From meta-analyses, male sex (pooled odds ratio [POR]: 1.52, 95% confidence interval [CI]: 1.19-1.75), lack of satisfaction with healthcare services/physicians (POR: 3.53, 95% CI: 2.26-4.75) were associated with antibiotic self-medication. In subgroup analysis, lower age was directly associated with self-medication in high-income countries (POR: 1.61, 95% CI: 1.10-2.36). In low- and middle-income countries, people with greater knowledge of antibiotics were less likely to self-medicate (POR: 0.2, 95% CI: 0.08-0.47). Patient-related determinants identified from descriptive and qualitative studies included previous experience with antibiotics and similar symptoms, perceived low severity of disease, intention to save time and get better quickly, cultural beliefs about curative power of antibiotics, advice from family/friends, and having home stock of antibiotics. Health system-related determinants included high cost of consulting physicians and low cost of self-medication, lack of access to physician/medical care, lack of trust/confidence in physicians, greater trust in pharmacists, long distance of physicians/healthcare facilities, long waiting time at healthcare facilities, easy access to antibiotics from pharmacies, and convenience associated with self-medication. CONCLUSIONS Patient and health system-related determinants are associated with antibiotic self-medication. Interventions to decrease antibiotic self-medication should incorporate community programs along with appropriate policies and healthcare reforms targeting these determinants with specific attention to population at high risk of self-medication.
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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian 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Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 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20
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Mitchell J, Cooke P, Ahorlu C, Arjyal A, Baral S, Carter L, Dasgupta R, Fieroze F, Fonseca-Braga M, Huque R, Lewycka S, Kalpana P, Saxena D, Tomley F, Tsekleves E, Vu Thi Quynh G, King R. Community engagement: The key to tackling Antimicrobial Resistance (AMR) across a One Health context? Glob Public Health 2022; 17:2647-2664. [PMID: 34882505 DOI: 10.1080/17441692.2021.2003839] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 10/27/2021] [Indexed: 12/15/2022]
Abstract
Antimicrobial resistance (AMR) is a One Health problem underpinned by complex drivers and behaviours. This is particularly so in low - and middle-income countries (LMICs), where social and systemic factors fuel (mis)use and drive AMR. Behavioural change around antimicrobial use could safeguard both existing and future treatments. However, changing behaviour necessitates engaging with people to understand their experiences. This publication describes a knowledge-exchange cluster of six LMIC-based projects who co-designed and answered a series of research questions around the usage of Community Engagement (CE) within AMR. Findings suggest that CE can facilitate AMR behaviour change, specifically in LMICs, because it is a contextualised approach which supports communities to develop locally meaningful solutions. However, current CE interventions focus on human aspects, and demand-side drivers, of AMR. Our cluster suggests that broader attention should be paid to AMR as a One Health issue. The popularity of mixed methods approaches within existing CE for AMR interventions suggests there is interdisciplinary interest in the uptake of CE. Unfortunately, the specificity and context-dependency of CE can make it difficult to evaluate and scale. Nevertheless, we suggest that in synthesising learnings from CE, we can develop a collective understanding of its scope to tackle AMR across contexts. .
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Affiliation(s)
- Jessica Mitchell
- Nuffield Centre for International Health and Development, University of Leeds, Woodhouse, UK
| | - Paul Cooke
- Centre for World Cinema and Digital Cultures, University of Leeds, Woodhouse, UK
| | - Collins Ahorlu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | | | | | - Laura Carter
- School of Geography, University of Leeds, Woodhouse, UK
| | - Rajib Dasgupta
- One Health Poultry Hub, UK
- Centre of Social Medicine & Community Health, Jawaharlal Nehru University, New Delhi, India
| | | | | | | | - Sonia Lewycka
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Oxford University Clinical Research Unit, National Hospital for Tropical Diseases, Ha Noi, Vietnam
| | - Pachillu Kalpana
- Indian Institute of Public Health Gandhinagar, Gandhinagar, India
| | - Deepak Saxena
- Indian Institute of Public Health Gandhinagar, Gandhinagar, India
| | - Fiona Tomley
- One Health Poultry Hub, UK
- Royal Veterinary College, Hatfield, UK
| | | | - Gioa Vu Thi Quynh
- Oxford University Clinical Research Unit, National Hospital for Tropical Diseases, Ha Noi, Vietnam
| | - Rebecca King
- Nuffield Centre for International Health and Development, University of Leeds, Woodhouse, UK
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21
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Agarwal M, Kabat C, III WJ, Kirby N, Stathakis S, Cummins S, King R, Maani E. Reduction in Total On-Table Time for Palliative Radiation Patients Using Pre-Treatment Field Validation. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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22
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Lamberson M, Radoncic V, King R, Dubuque A, Hobson S, Clouser R, Callas P, McNamara M. 299EMF Community Outreach for Patient Engagement: A Randomized Controlled Trial Using Implementation Framework. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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23
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Willeke K, Janson P, Zink K, Stupp C, Tischer C, Kittel-Schneider S, Berghöfer A, Ewert T, King R, Heuschmann PU, Zapf A, Wildner M, Keil T. Comparing the Occurrence of Mental and Physical Disorders in
Self-employed Individuals with that of Employees: a Systematic
Review. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753714] [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: 12/12/2022]
Affiliation(s)
- K Willeke
- Bavarian Health and Food Safety Authority, State Institute of Health,
Erlangen, Deutschland
- University of Würzburg, Institute of Clinical Epidemiology and
Biometry, Würzburg, Deutschland
| | - P Janson
- Bavarian Health and Food Safety Authority, State Institute of Health,
Erlangen, Deutschland
- University of Würzburg, Institute of Clinical Epidemiology and
Biometry, Würzburg, Deutschland
| | - K Zink
- Bavarian Health and Food Safety Authority, State Institute of Health,
Erlangen, Deutschland
| | - C Stupp
- Bavarian Health and Food Safety Authority, State Institute of Health,
Erlangen, Deutschland
- University of Würzburg, Institute of Clinical Epidemiology and
Biometry, Würzburg, Deutschland
| | - C Tischer
- Department of Health Security, Finnish Institue of Health and Welfare,
Kuopio, Finnland
| | - S Kittel-Schneider
- University Hospital Würzburg, Department of Psychiatry,
Psychotherapy and Psychosomatic Medicine, Würzburg,
Deutschland
| | - A Berghöfer
- Charité – Universitätsmedizin Berlin, Institute
of Social Medicine, Epidemiology and Health Economics, Berlin,
Deutschland
| | - T Ewert
- Bavarian Health and Food Safety Authority, State Institute of Health,
Erlangen, Deutschland
| | - R King
- Charité – Universitätsmedizin Berlin, Institute
of Social Medicine, Epidemiology and Health Economics, Berlin,
Deutschland
| | - PU Heuschmann
- University of Würzburg, Institute of Clinical Epidemiology and
Biometry, Würzburg, Deutschland
- University Hospital Würzburg, Clinical Trial Center Wuerzburg,
Würzburg, Deutschland
| | - A Zapf
- Bavarian State Ministry of the Environment and Consumer Protection,
Munich, Deutschland
- University of Munich, Pettenkofer School of Public Health, Munich,
Deutschland
| | - M Wildner
- Bavarian Health and Food Safety Authority, State Institute of Health,
Erlangen, Deutschland
- University of Munich, Pettenkofer School of Public Health, Munich,
Deutschland
| | - T Keil
- Bavarian Health and Food Safety Authority, State Institute of Health,
Erlangen, Deutschland
- University of Würzburg, Institute of Clinical Epidemiology and
Biometry, Würzburg, Deutschland
- Charité – Universitätsmedizin Berlin, Institute
of Social Medicine, Epidemiology and Health Economics, Berlin,
Deutschland
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24
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Barouqa M, Greipp P, King R, McPhail ED. Plasmablastic lymphoma with MYC::IGH fusion and BCL2 rearrangement. eJHaem 2022; 3:1080-1081. [PMID: 36051039 PMCID: PMC9422022 DOI: 10.1002/jha2.513] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/02/2022] [Accepted: 06/02/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Mohammad Barouqa
- Mayo Clinic Department of Laboratory Medicine and Pathology Rochester Minnesota USA
| | - Patricia Greipp
- Mayo Clinic Department of Laboratory Medicine and Pathology Rochester Minnesota USA
| | - Rebecca King
- Mayo Clinic Department of Laboratory Medicine and Pathology Rochester Minnesota USA
| | - Ellen D. McPhail
- Mayo Clinic Department of Laboratory Medicine and Pathology Rochester Minnesota USA
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25
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Mitchell J, O'Neill AJ, King R. Creating a framework to align antimicrobial resistance (AMR) research with the global guidance: a viewpoint. J Antimicrob Chemother 2022; 77:2315-2320. [PMID: 35748621 DOI: 10.1093/jac/dkac205] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We describe here an initial analysis of national and international guidance documents on antimicrobial resistance (AMR) to propose a framework to align AMR research activities with global guidance. The framework provides a summary roadmap for core activities in AMR research and highlights the need for interdisciplinary and One Health collaboration. This analysis also revealed limitations in the current guidance, including a lack of explicit mention of some research activities highly relevant to AMR and a dearth of concrete objectives; consequently, an over-reliance on global guidance could be funnelling research efforts down a generic trajectory without regard to contextual factors. We suggest this framework be used by academics and policymakers to align AMR research and guidance. However, we recommend that deeper exploration be undertaken to fully contextualize the development of meaningful questions based on current knowledge, methodologies and gap analyses.
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Affiliation(s)
- Jessica Mitchell
- Nuffield Centre for International Health and Development, Worsley Building, Faculty of Medicine and Health, University of Leeds, Leeds LS2 9JT, UK.,AMR@Leeds, University of Leeds, Leeds LS2 9JT, UK
| | - Alex J O'Neill
- AMR@Leeds, University of Leeds, Leeds LS2 9JT, UK.,School of Molecular & Cellular Biology, Garstang Building, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Rebecca King
- Nuffield Centre for International Health and Development, Worsley Building, Faculty of Medicine and Health, University of Leeds, Leeds LS2 9JT, UK.,AMR@Leeds, University of Leeds, Leeds LS2 9JT, UK
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26
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Ong B, Rocimo A, King R, Yasay E. P-135 Capecitabine maintenance chemotherapy in the treatment of metastatic colorectal cancer: A meta-analysis. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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27
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Jones N, Mitchell J, Cooke P, Baral S, Arjyal A, Shrestha A, King R. Gender and Antimicrobial Resistance: What Can We Learn From Applying a Gendered Lens to Data Analysis Using a Participatory Arts Case Study? Front Glob Womens Health 2022; 3:745862. [PMID: 35720810 PMCID: PMC9199426 DOI: 10.3389/fgwh.2022.745862] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 04/22/2022] [Indexed: 11/13/2022] Open
Abstract
Antimicrobial resistance (AMR), the natural process by which bacteria become resistant to the medicines used to kill them, is becoming one of the greatest threats to health globally. AMR is accelerating at alarming rates due to behaviors across human, animal, and environmental health sectors as well as governance and policy shortfalls across each sector. Antimicrobial resistant infections occur through the same channels as other infectious diseases and are most common in countries/areas where there is limited access to improved sanitation facilities, reliable healthcare and health education. At the community level, much remains to be understood about the drivers of antimicrobial resistance and how to generate community-led, acceptable solutions. Gender can influence every part of an individual's health experiences; access to knowledge, healthcare facilities, financial resources and paid employment are all heavily gendered and influence behaviors relating to the procurement of antimicrobial and antibiotic agents. This analysis uses data gathered during a participatory video study designed to work with two communities in Nepal to understand drivers of antibiotic mis and over use from the perspective of the communities themselves. Findings reveal that gender impacts upon many aspects of AMR-driving behaviors within this community and stimulate essential discussion as to the importance of gender in future AMR research. This paper places a spotlight on gender in the wider AMR conversation, an area that is currently neglected, and improve our collective knowledge on the drivers of AMR from a gendered perspective.
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Affiliation(s)
- Nichola Jones
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, United Kingdom
| | - Jessica Mitchell
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, United Kingdom
| | - Paul Cooke
- Faculty of Arts, Humanities and Cultures, University of Leeds, Leeds, United Kingdom
| | | | | | | | - Rebecca King
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, United Kingdom
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28
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King R, Giedrimiene D. The impact of comorbidities on preventive care of patients with myocardial infarction: is there still a gender gap? Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
The management of comorbidities is a significant component of preventive care to address the development of cardiovascular disease. Consistent care provided by a primary care physician (PCP) may be important in bridging any gender disparity in patients with comorbidities for the prevention of acute myocardial infarction (AMI).
Purpose
To identify gaps in established care by a PCP between genders and to evaluate the impact of comorbidities in patients who have experienced AMI.
Methods
Data collected for 250 total patients for this retrospective study included gender, PCP documentation, and comorbidities (hypertension, hyperlipidemia, diabetes, chronic kidney disease (CKD), arrhythmia) among patients admitted for an AMI. Data on previous MI, coronary artery bypass graft (CABG), and stent were also collected. 27 patients were excluded due to incomplete documentation.
Results
Out of 223 included patients, 138 (61.9%) were males and 85 (38.1%) were females with 172 (77.1%) having care by a PCP. PCP services have been utilized by 100 (72.5%) males and 72 (84.7%) females, mean age = 64.39 years.
Multiple comorbidities were identified in 191 (85.7%) out of 223 patients, including 156 (81.7%) who have used PCP services and number of comorbidities varied from 1 to 5. Of these patients, 74 (43.0%) had 1-2 comorbidities: males 51 vs 23 females, and 82 patients: 41 males vs 41 females had 3-5 comorbidities that impacted their treatment and preventive care.
Among the most common comorbidities were hypertension - n=165 (74.0%) and hyperlipidemia - n=157 (70.4%). Other comorbidities included diabetes - n=82 (36.8%), CKD - n=42 (18.8%), and previous arrhythmia - n=35 (15.7%). Overall, the utilization of PCP services was between 83-93% in these patients with documented comorbidities.
Gender-based comparison between patients who have utilized PCP services showed that more males were diagnosed with hypertension than females: 78 vs 59, p=0.033; more males with hyperlipidemia: 75 vs 55, p=0.051; no significant difference was noticed in case of diabetes: 36 males vs 38 females (p=0.457), in case of CKD: 22 males vs 17 females (p=0.138), previous MI - 21 males vs 22 females (p=0.381), or previous arrhythmia - 19 males vs 13 females (p=0.805).
The findings regarding previous procedures among those who used PCP services showed that CABG was done for 16 males vs 8 females (p=1.0), coronary stent placement – 25 males vs 21 females (p= 0.196), and significantly more males have received antiplatelet therapy - 61 vs 36 females (p=0.031).
Conclusion
Identification of comorbidities was significantly associated with PCP care utilization in both genders, however more males have been diagnosed with hypertension and other comorbidities. The findings show that timely identification of comorbidities is highly dependent on PCP services and is related to preventive treatment in both genders of patients who experienced AMI.
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Affiliation(s)
- R King
- Frank H. Netter MD School of Medicine, North Haven, United States of America
| | - D Giedrimiene
- University of Saint Joseph, West Hartford, United States of America
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King R, Gunnarsdottir MJ, Narfason Þ, Hjaltadóttir S, Sigurðsson Á, Herschan J, Gardarsson SM, McKeown RM, Pond K. Adapting sanitary inspections for the monitoring of small drinking water supplies in Iceland. J Water Health 2022; 20:755-769. [PMID: 35635770 DOI: 10.2166/wh.2022.144] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Sanitary inspections (SIs) are checklists of questions used to identify actual and potential sources and pathways of drinking water contamination. Though the importance of SI adaptation to local contexts is widely acknowledged, there is currently limited guidance on how this should be undertaken in practice. During this research, World Health Organization (WHO) draft template SI forms for spring and borehole supplies were adapted for use in Iceland based on a series of desk reviews and field tests, an approach which may guide other future SI adaptation processes. SI results were collected from 25 spring supplies and nine borehole supplies in three regions of Iceland using adapted SI forms. These results were combined with 10-year historical water quality data from the same supplies to explore potential relationships between both data sets. Binary logistic regression test results indicated a statistically significant association (P = 0.025; odds ratio (OR) 1.864, 95% CI 1.080-3.220) between SI Question 3 (Does ponding from surface water occur around the spring/borehole?) receiving a 'High' risk level assignment and at least one historical incidence of water quality noncompliance for the parameters heterotrophic plate count 22 °C, total coliforms, Escherichia coli, and turbidity at the same supply. The significant modifications applied to the starting template during the testing and development of the Icelandic SI form emphasises the importance of a robust adaptation process to ensure SI forms are appropriate for the local context. Results from the analysis of SI and water quality test results demonstrated the potential for these data sets to identify the primary risks at a supply. This information may then be used to direct remedial actions, especially when the amount of relevant data increases over time.
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Affiliation(s)
- R King
- Centre for Environmental Health and Engineering (CEHE), Department of Civil and Environmental Engineering, University of Surrey, Guildford, Surrey GU2 5XH, UK E-mail:
| | - M J Gunnarsdottir
- Faculty of Civil and Environmental Engineering, University of Iceland, Reykjavik, Iceland
| | - Þ Narfason
- Environment and Public Health Authority of West Iceland, Akranes, Iceland
| | - S Hjaltadóttir
- Environment and Public Health Authority of Northwest Iceland, Saudarkrokur, Iceland
| | - Á Sigurðsson
- Environmental and Public Health Authority of South Iceland, Selfoss, Iceland
| | - J Herschan
- Centre for Environmental Health and Engineering (CEHE), Department of Civil and Environmental Engineering, University of Surrey, Guildford, Surrey GU2 5XH, UK E-mail:
| | - S M Gardarsson
- Faculty of Civil and Environmental Engineering, University of Iceland, Reykjavik, Iceland
| | - R M McKeown
- World Health Organization, Geneva CH-1211, Switzerland
| | - K Pond
- Centre for Environmental Health and Engineering (CEHE), Department of Civil and Environmental Engineering, University of Surrey, Guildford, Surrey GU2 5XH, UK E-mail:
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Abstract
Prevention is better than cure. Coroners are not often thought to have a role in prevention, even though they have a duty to produce prevention of future death reports. Such reports are supposed to stimulate changes to prevent further deaths from recognised problems, but we speculated that they do not achieve their purpose. The reports are categorised, published online and are publicly available. This study set out to analyse prevention of future death reports to understand how far they prompt change, in two healthcare-related categories. Reports dated in 2020 were reviewed and data were collated detailing the contents of each one and whether there was a response. Results showed that the prevention of future death reports are inconsistent with regard to the details they included and there is no evidence that concerns raised by Coroners stimulate significant, widespread change in the healthcare system.
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Affiliation(s)
| | - Emyr Wyn Benbow
- Department of Histopathology, Manchester Royal Infirmary, Manchester, UK
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Aruparayil N, Bolton W, Mishra A, Bains L, Gnanaraj J, King R, Ensor T, King N, Jayne D, Shinkins B. Clinical effectiveness of gasless laparoscopic surgery for abdominal conditions: systematic review and meta-analysis. Surg Endosc 2021; 35:6427-6437. [PMID: 34398284 PMCID: PMC8599349 DOI: 10.1007/s00464-021-08677-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 03/08/2021] [Accepted: 08/07/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND In high-income countries, laparoscopic surgery is the preferred approach for many abdominal conditions. Conventional laparoscopy is a complex intervention that is challenging to adopt and implement in low resource settings. This systematic review and meta-analysis evaluate the clinical effectiveness of gasless laparoscopy compared to conventional laparoscopy with CO2 pneumoperitoneum and open surgery for general surgery and gynaecological procedures. METHODS A search of the MEDLINE, EMBASE, Global Health, AJOL databases and Cochrane Library was performed from inception to January 2021. All randomised (RCTs) and comparative cohort (non-RCTs) studies comparing gasless laparoscopy with open surgery or conventional laparoscopy were included. The primary outcomes were mortality, conversion rates and intraoperative complications. SECONDARY OUTCOMES operative times and length of stay. The inverse variance random-effects model was used to synthesise data. RESULTS 63 studies were included: 41 RCTs and 22 non-RCTs (3,620 patients). No procedure-related deaths were reported in the studies. For gasless vs conventional laparoscopy there was no difference in intraoperative complications for general RR 1.04 [CI 0.45-2.40] or gynaecological surgery RR 0.66 [0.14-3.13]. In the gasless laparoscopy group, the conversion rates for gynaecological surgery were high RR 11.72 [CI 2.26-60.87] when compared to conventional laparoscopy. For gasless vs open surgery, the operative times were longer for gasless surgery in general surgery RCT group MD (mean difference) 10 [CI 0.64, 19.36], but significantly shorter in the gynaecology RCT group MD - 18.74 [CI - 29.23, - 8.26]. For gasless laparoscopy vs open surgery non-RCT, the length of stay was shorter for gasless laparoscopy in general surgery MD - 3.94 [CI - 5.93, - 1.95] and gynaecology MD - 1.75 [CI - 2.64, - 0.86]. Overall GRADE assessment for RCTs and Non-RCTs was very low. CONCLUSION Gasless laparoscopy has advantages for selective general and gynaecological procedures and may have a vital role to play in low resource settings.
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Affiliation(s)
- N Aruparayil
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK. .,NIHR Global Health Research Group, Surgical Technologies, Clinical Sciences Building, Level 7, Room 7.19, Leeds, LS9 7TF, UK.
| | - W Bolton
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK.,NIHR Global Health Research Group, Surgical Technologies, Clinical Sciences Building, Level 7, Room 7.19, Leeds, LS9 7TF, UK
| | - A Mishra
- Maulana Azad Medical College, Delhi, India
| | - L Bains
- Maulana Azad Medical College, Delhi, India
| | | | - R King
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.,NIHR Global Health Research Group, Surgical Technologies, Clinical Sciences Building, Level 7, Room 7.19, Leeds, LS9 7TF, UK
| | - T Ensor
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.,NIHR Global Health Research Group, Surgical Technologies, Clinical Sciences Building, Level 7, Room 7.19, Leeds, LS9 7TF, UK
| | - N King
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - D Jayne
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK.,NIHR Global Health Research Group, Surgical Technologies, Clinical Sciences Building, Level 7, Room 7.19, Leeds, LS9 7TF, UK
| | - B Shinkins
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.,NIHR Global Health Research Group, Surgical Technologies, Clinical Sciences Building, Level 7, Room 7.19, Leeds, LS9 7TF, UK
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32
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Heredia Melero G, King R, Nagle J. 64 Robotic sacral colpopexy with autologous fascia lata and rectopexy. Am J Obstet Gynecol 2021. [DOI: 10.1016/j.ajog.2021.04.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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33
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Desai SH, Mwangi R, Maurer M, King R, Cerhan J, Feldman A, Habermann T, Farooq U, Thompson C, Wang Y, Ansell SM, Witzig TE, Nowakowski GN. DO CELL‐OF‐ORIGIN, DOUBLE EXPRESSER, AND DOUBLE HIT STATUS AFFECT OUTCOMES IN RELAPSED/REFRACTORY DIFFUSE LARGE B CELL LYMPHOMA (R/R DLBCL)? A PROSPECTIVE OBSERVATIONAL STUDY. Hematol Oncol 2021. [DOI: 10.1002/hon.66_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: 11/06/2022]
Affiliation(s)
- S. H. Desai
- Mayo Clinic Division of Hematology, Department of Medicine Rochester Minnesota USA
| | - R. Mwangi
- Mayo Clinic Department of Quantitative Health Sciences Rochester Minnesota USA
| | - M. Maurer
- Mayo Clinic Department of Quantitative Health Sciences Rochester Minnesota USA
| | - R. King
- Mayo Clinic Department of Laboratory Medicine and Pathology Rochester Minnesota USA
| | - J. Cerhan
- Mayo Clinic Department of Quantitative Health Sciences Rochester Minnesota USA
| | - A. Feldman
- Mayo Clinic Division of Hematology, Department of Medicine Rochester Minnesota USA
| | - T. Habermann
- Mayo Clinic Division of Hematology, Department of Medicine Rochester Minnesota USA
| | - U. Farooq
- University of Iowa Hospitals and Clinics Department of Hematology, Oncology and Bone Marrow Transplant, Iowa City Iowa USA
| | - C. Thompson
- Mayo Clinic Division of Hematology, Department of Medicine Rochester Minnesota USA
| | - Y. Wang
- Mayo Clinic Division of Hematology, Department of Medicine Rochester Minnesota USA
| | - S. M. Ansell
- Mayo Clinic Division of Hematology, Department of Medicine Rochester Minnesota USA
| | - T. E. Witzig
- Mayo Clinic Division of Hematology, Department of Medicine Rochester Minnesota USA
| | - G. N. Nowakowski
- Mayo Clinic Division of Hematology, Department of Medicine Rochester Minnesota USA
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34
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Desai S, Laplant B, Macon W, Young J, King R, Wang Y, Inwards D, Micallef I, Johnston PB, Porrata LF, Ansell SM, Habermann TM, Witzig TE, Nowakowski GS. INTERIM PET/CT PREDICTS OUTCOMES OF DIFFUSE LARGE B‐CELL LYMPHOMA (DLBCL) TREATED WITH FRONTLINE LENALIDOMIDE/RCHOP (R2CHOP): LONG‐TERM ANALYSIS OF MC078E. Hematol Oncol 2021. [DOI: 10.1002/hon.83_2880] [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: 11/08/2022]
Affiliation(s)
- S. Desai
- Mayo Clinic Division of Hematology Department of Medicine Rochester Minnesota USA
| | - B. Laplant
- Mayo Clinic Department of Quantitative Health Sciences Rochester Minnesota USA
| | - W. Macon
- Mayo Clinic Department of Laboratory Medicine and Pathology Rochester Minnesota USA
| | - J. Young
- Mayo Clinic Division of Nuclear Medicine Department of Radiology Rochester Minnesota USA
| | - R. King
- Mayo Clinic Department of Laboratory Medicine and Pathology Rochester Minnesota USA
| | - Y. Wang
- Mayo Clinic Division of Hematology Department of Medicine Rochester Minnesota USA
| | - D. Inwards
- Mayo Clinic Division of Hematology Department of Medicine Rochester Minnesota USA
| | - I. Micallef
- Mayo Clinic Division of Hematology Department of Medicine Rochester Minnesota USA
| | - P. B. Johnston
- Mayo Clinic Division of Hematology Department of Medicine Rochester Minnesota USA
| | - L. F. Porrata
- Mayo Clinic Division of Hematology Department of Medicine Rochester Minnesota USA
| | - S. M. Ansell
- Mayo Clinic Division of Hematology Department of Medicine Rochester Minnesota USA
| | - T. M. Habermann
- Mayo Clinic Division of Hematology Department of Medicine Rochester Minnesota USA
| | - T. E. Witzig
- Mayo Clinic Division of Hematology Department of Medicine Rochester Minnesota USA
| | - G. S. Nowakowski
- Mayo Clinic Division of Hematology Department of Medicine Rochester Minnesota USA
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Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
The management of patients with multiple comorbidities represents a significant burden on healthcare each year. Despite requiring regular medical care to treat chronic conditions, a large number of these patients may not receive proper care. Significant disparities have been identified in patients with multiple comorbidities and those who experience acute coronary syndrome or acute myocardial infarction (AMI). Only limited data exists to identify the impact of comorbidities and utilization of primary care physician (PCP) services on the development of adverse outcomes, such as AMI.
Purpose
The primary objective was to analyze how PCP services utilization can be associated with comorbidities in patients who experienced an AMI.
Methods
This study was based on retrospective data analysis which included 250 patients admitted to the Hartford Hospital Emergency Department (ED) for an AMI. Out of these, 27 patients were excluded due to missing documentation. Collected data included age, gender, medications and recorded comorbidities, such as hypertension, hyperlipidemia, diabetes mellitus (DM), chronic kidney disease (CKD) and previous arrhythmia. Each patient was assessed regarding utilization of PCP services. Statistical analysis was performed in order to identify differences between patients with documented PCP services and those without by using the Chi-square test.
Results
The records allowed for identification of documented PCP services for 172 out of 223 (77.1%) patients. The most common comorbidities were hypertension and hyperlipidemia: in 165 (74.0%) and 157 (70.4%) cases respectively. The most frequent comorbidity was hypertension: 137 out of 172 (79.7%) in pts with PCP vs 28 out of 51 (54.9%) without PCP, and significantly more often in patients with PCP, p< 0.001. Hyperlipidemia was the second most frequent comorbidity: in 130 out of 172 (75.6%) vs 27 out of 51 (52.9%) accordingly, and also significantly more often (p< 0.002) in patients with PCP services. The number of comorbidities ranged from 0-5, including 32 (14.3%) patients without comorbidities: 16 (9.3%) with a PCP and 16 (31.4%) without PCP services. The majority of patients - 108 (48.5% of 223), had 2-3 documented comorbidities: 89 (51.8%) had two and 19 (34.6%) had three. The remaining 40 (17.9%) patients had 4-5 comorbidities: 37 (21.5%) of them with a PCP and 3 (10.3%) without, with a significant difference (p < 0.001) found for patients with a higher number of comorbidities who utilized PCP services.
Conclusions
Our study shows that the majority of patients who presented with an AMI had one or more comorbidities. Furthermore, patients who did not utilize PCP services had fewer identified comorbidities. This suggests that there may be a significant number of patients who experienced AMI with undiagnosed comorbidities due to not having access to PCP services.
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Affiliation(s)
- R King
- Frank H. Netter MD School of Medicine, North Haven, United States of America
| | - D Giedrimiene
- University of Saint Joseph, West Hartford, United States of America
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36
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Sheu T, Park S, Rao A, Gans D, King R, Whitehead T, Swischuk J. Abstract No. 577 Basket thrombectomy using distal protection wires for arterial thromboembolism: a case series. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Hunnisett LM, Kelly PF, Bleay S, Plasser F, King R, McMurchie B, Goddard P. Mechanistic insight into the fluorescence activity of forensic fingerprinting reagents. J Chem Phys 2021; 154:124313. [PMID: 33810701 DOI: 10.1063/5.0040555] [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: 11/15/2022] Open
Abstract
Fingerprint detection is still the primary investigative technique for deciphering criminal inquiries and identifying individuals. The main forensic fingerprinting reagents (FFRs) currently in use can require multiple treatment steps to produce fingerprints of sufficient quality. Therefore, the development of new, more effective FFRs that require minimal chemical treatment is of great interest in forensic chemistry. In this work, prudently crafted density functional theory and time-dependent density functional theory calculations are utilized to derive mechanistic insight into the optical activity of the non-fluorescent product of ninhydrin, diketohydrindylidenediketohydrindamine (DYDA), and fluorescent product of DFO (1,8-diazafluoren-9-one). We investigate various protonation sites to gain an understanding of isomeric preference in the solid-state material. A relaxed scan of a single torsion angle rotation in the S1 minimized geometry of the O-protonated DYDA isomer suggests a conical intersection upon ∼10° rotation. We show that the absence of a rigid hydrogen-bonded network in the crystal structure of DYDA supports the hypothesis of torsion rotation, which leads de-excitation to occur readily. Conversely, for the fluorescent DFO product, our calculations support an avoided crossing suggestive of a non-radiative mechanism when the torsion angle is rotated by about ∼100°. This mechanistic insight concurs with experimental observations of fluorescence activity in DFO and may aid the photophysical understanding of poorly visualized fingerprints due to weak fluorescence. We show that identifying suggestive avoided crossings via the method described here can be used to initialize thoughts toward the computational design of FFRs.
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Affiliation(s)
- L M Hunnisett
- Department of Chemistry, Loughborough University, Epinal Way, Loughborough LE11 3TU, United Kingdom
| | - P F Kelly
- Department of Chemistry, Loughborough University, Epinal Way, Loughborough LE11 3TU, United Kingdom
| | - S Bleay
- School of Applied Sciences, London South Bank University, 103 Borough Road, London SE1 0AA, United Kingdom
| | - F Plasser
- Department of Chemistry, Loughborough University, Epinal Way, Loughborough LE11 3TU, United Kingdom
| | - R King
- Foster and Freeman Ltd., Vale Park, Evesham, Wrexham WR11 1TD, United Kingdom
| | - B McMurchie
- Foster and Freeman Ltd., Vale Park, Evesham, Wrexham WR11 1TD, United Kingdom
| | - P Goddard
- Department of Chemistry, Loughborough University, Epinal Way, Loughborough LE11 3TU, United Kingdom
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38
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Virk A, Bella Jalloh M, Koedoyoma S, Smalle IO, Bolton W, Scott JA, Brown J, Jayne D, Ensor T, King R. What factors shape surgical access in West Africa? A qualitative study exploring patient and provider experiences of managing injuries in Sierra Leone. BMJ Open 2021; 11:e042402. [PMID: 33649054 PMCID: PMC8098971 DOI: 10.1136/bmjopen-2020-042402] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Surgical access is central to universalising health coverage, yet 5 billion people lack timely access to safe surgical services. Surgical need is particularly acute in post conflict settings like Sierra Leone. There is limited understanding of the barriers and opportunities at the service delivery and community levels. Focusing on fractures and wound care which constitute an enormous disease burden in Sierra Leone as a proxy for general surgical need, we examine provider and patient perceived factors impeding or facilitating surgical care in the post-Ebola context of a weakened health system. METHODS Across Western Area Urban (Freetown), Bo and Tonkolili districts, 60 participants were involved in 38 semistructured interviews and 22 participants in 5 focus group discussions. Respondents included surgical providers, district-level policy-makers, traditional healers and patients. Data were thematically analysed, combining deductive and inductive techniques to generate codes. RESULTS Interacting demand-side and supply-side issues affected user access to surgical services. On the demand side, high cost of care at medical facilities combined with the affordability and convenient mode of payment to the traditional health practitioners hindered access to the medical facilities. On the supply side, capacity shortages and staff motivation were challenges at facilities. Problems were compounded by patients' delaying care mainly spurred by sociocultural beliefs in traditional practice and economic factors, thereby impeding early intervention for patients with surgical need. In the absence of formal support services, the onus of first aid and frontline trauma care is borne by lay citizens. CONCLUSION Within a resource-constrained context, supply-side strengthening need accompanying by demand-side measures involving community and traditional actors. On the supply side, non-specialists could be effectively utilised in surgical delivery. Existing human resource capacity can be enhanced through better incentives for non-physicians. Traditional provider networks can be deployed for community outreach. Developing a lay responder system for first-aid and front-line support could be a useful mechanism for prompt clinical intervention.
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Affiliation(s)
- Amrit Virk
- Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Mohamed Bella Jalloh
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Songor Koedoyoma
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Isaac O Smalle
- Department of Surgery, College of Medicine, University of Sierra Leone, Freetown, Sierra Leone
- Department of Global Health, King's College, London, UK
| | | | - J A Scott
- School of Medicine, University of Leeds, Leeds, UK
| | - Julia Brown
- School of Medicine, University of Leeds, Leeds, UK
| | - David Jayne
- School of Medicine, University of Leeds, Leeds, UK
| | - Tim Ensor
- School of Medicine, University of Leeds, Leeds, UK
| | - Rebecca King
- School of Medicine, University of Leeds, Leeds, UK
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39
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Hicks JP, Latham SM, Huque R, Das M, Newell J, Abdullah SM, Al Azdi Z, Jahan I, Rassi C, Hamade P, Shafique M, Islam MS, King R. Antibiotic practices among household members and their domestic animals within rural communities in Cumilla district, Bangladesh: a cross-sectional survey. BMC Public Health 2021; 21:406. [PMID: 33632193 PMCID: PMC7908663 DOI: 10.1186/s12889-021-10457-w] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/12/2021] [Indexed: 12/19/2022] Open
Abstract
Background Antibiotic resistance is a global threat to human health, and inappropriate use of antibiotics in humans and animals is widely considered to be a key driver of antibiotic resistant infections. Antibiotic use in humans and animals is growing rapidly in low- and, particularly, middle-income countries. However, there is little detailed understanding about practices related to the use of antibiotics in humans and animals within community settings in such countries. Here we aimed to understand the antibiotic practices of rural households across Cumilla district, Bangladesh, in relation to household members and their domestic animals. Methods In 2018 we conducted a cross-sectional survey using representative cluster sampling methods. We collected self-reported information from 682 female and 620 male household heads, with women also asked about their children’s antibiotic practices. Results Only 48% (95% CI: 40, 56%) of women and men had heard of antibiotics, and among those women and men who were aware of antibiotics and the children of those women 70% (95% CI: 64, 76%) reported having previously taken antibiotics, while among these individuals who reported previously taking antibiotics 21% (95% CI: 18, 25%) said they had done so most recently within the last month. Risky/inappropriate antibiotic practices in humans and animals were often reported. For example, among women and men who were aware of antibiotics and the children of those women 52% (95% CI: 40, 63%) reported previously taking antibiotics for a “cough/cold”, despite antibiotics being typically inappropriate for use against viral upper respiratory tract infections. Among poultry-owning respondents who were aware of antibiotics 11% (95% CI: 8, 15%) reported previously giving healthy poultry antibiotics, mainly for growth/prophylaxis, while among cattle-owning respondents who were aware of antibiotics and reported previously giving their cattle feed 20% (95% CI: 9, 37%) said the feed had contained antibiotics at least sometimes. Conclusions Our results highlight the need for context-adapted interventions at both the community level and the health systems level to reduce inappropriate antibiotic use among humans and domestic animals in rural Bangladesh. Successfully reducing inappropriate use of antibiotics among humans and animals is a required and critical step in tackling antimicrobial resistance. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10457-w.
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Affiliation(s)
- Joseph Paul Hicks
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, LS2 9JT, UK.
| | - Sophia M Latham
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, Cheshire, CH64 7TE, UK
| | - Rumana Huque
- ARK Foundation, Suite C-3 & C-4, House # 06, Road # 109, Gulshan-2, Dhaka, 1212, Bangladesh.,Department of Economics, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Mahua Das
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, LS2 9JT, UK
| | - Jane Newell
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE, UK
| | - S M Abdullah
- ARK Foundation, Suite C-3 & C-4, House # 06, Road # 109, Gulshan-2, Dhaka, 1212, Bangladesh.,Department of Economics, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Zunayed Al Azdi
- ARK Foundation, Suite C-3 & C-4, House # 06, Road # 109, Gulshan-2, Dhaka, 1212, Bangladesh
| | - Ishrat Jahan
- ARK Foundation, Suite C-3 & C-4, House # 06, Road # 109, Gulshan-2, Dhaka, 1212, Bangladesh
| | - Christian Rassi
- Malaria Consortium, The Green House, 244-254 Cambridge Heath Road, London, E2 9DA, UK
| | - Prudence Hamade
- Malaria Consortium, The Green House, 244-254 Cambridge Heath Road, London, E2 9DA, UK
| | - Muhammad Shafique
- Malaria Consortium, The Green House, 244-254 Cambridge Heath Road, London, E2 9DA, UK
| | - Mohammad Saiful Islam
- Faculty of Surgery and Professor of Paediatric Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Rebecca King
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, LS2 9JT, UK
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Rivington M, King R, Duckett D, Iannetta P, Benton TG, Burgess PJ, Hawes C, Wellesley L, Polhill JG, Aitkenhead M, Lozada-Ellison LM, Begg G, Williams AG, Newton A, Lorenzo-Arribas A, Neilson R, Watts C, Harris J, Loades K, Stewart D, Wardell-Johnson D, Gandossi G, Udugbezi E, Hannam JA, Keay C. UK food and nutrition security during and after the COVID-19 pandemic. NUTR BULL 2021; 46:88-97. [PMID: 33821148 PMCID: PMC8014680 DOI: 10.1111/nbu.12485] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/12/2021] [Accepted: 01/19/2021] [Indexed: 11/30/2022]
Abstract
The COVID‐19 pandemic is a major shock to society in terms of health and economy that is affecting both UK and global food and nutrition security. It is adding to the ‘perfect storm’ of threats to society from climate change, biodiversity loss and ecosystem degradation, at a time of considerable change, rising nationalism and breakdown in international collaboration. In the UK, the situation is further complicated due to Brexit. The UK COVID‐19Food andNutritionSecurity project, lasting one year, is funded by the Economic and Social Research Council and is assessing the ongoing impact of COVID‐19 on the four pillars of food and nutrition security: access, availability, utilisation and stability. It examines the food system, how it is responding, and potential knock on effects on the UK’s food and nutrition security, both in terms of the cascading risks from the pandemic and other threats. The study provides an opportunity to place the initial lessons being learnt from the on‐going responses to the pandemic in respect of food and nutrition security in the context of other long‐term challenges such as climate change and biodiversity loss.
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Affiliation(s)
- M Rivington
- The James Hutton Institute Aberdeen Aberdeen UK
| | | | - D Duckett
- The James Hutton Institute Aberdeen Aberdeen UK
| | - P Iannetta
- The James Hutton Institute Aberdeen Aberdeen UK
| | | | | | - C Hawes
- The James Hutton Institute Aberdeen Aberdeen UK
| | | | - J G Polhill
- The James Hutton Institute Aberdeen Aberdeen UK
| | | | | | - G Begg
- The James Hutton Institute Aberdeen Aberdeen UK
| | | | - A Newton
- The James Hutton Institute Aberdeen Aberdeen UK
| | | | - R Neilson
- The James Hutton Institute Aberdeen Aberdeen UK
| | | | | | - K Loades
- The James Hutton Institute Aberdeen Aberdeen UK
| | - D Stewart
- The James Hutton Institute Aberdeen Aberdeen UK
| | | | - G Gandossi
- The James Hutton Institute Aberdeen Aberdeen UK
| | - E Udugbezi
- The James Hutton Institute Aberdeen Aberdeen UK
| | | | - C Keay
- The James Hutton Institute Aberdeen Aberdeen UK
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Boazak EM, King R, Wang J, Chu CM, Toporek AM, Sherwood JM, Overby DR, Geisert EE, Ethier CR. Smarce1 and Tensin 4 Are Putative Modulators of Corneoscleral Stiffness. Front Bioeng Biotechnol 2021; 9:596154. [PMID: 33634081 PMCID: PMC7902041 DOI: 10.3389/fbioe.2021.596154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 01/14/2021] [Indexed: 11/13/2022] Open
Abstract
The biomechanical properties of the cornea and sclera are important in the onset and progression of multiple ocular pathologies and vary substantially between individuals, yet the source of this variation remains unknown. Here we identify genes putatively regulating corneoscleral biomechanical tissue properties by conducting high-fidelity ocular compliance measurements across the BXD recombinant inbred mouse set and performing quantitative trait analysis. We find seven cis-eQTLs and non-synonymous SNPs associating with ocular compliance, and show by RT-qPCR and immunolabeling that only two of the candidate genes, Smarce1 and Tns4, showed significant expression in corneal and scleral tissues. Both have mechanistic potential to influence the development and/or regulation of tissue material properties. This work motivates further study of Smarce1 and Tns4 for their role(s) in ocular pathology involving the corneoscleral envelope as well as the development of novel mouse models of ocular pathophysiology, such as myopia and glaucoma.
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Affiliation(s)
- Elizabeth M Boazak
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States
| | - Rebecca King
- Department of Ophthalmology, Emory University, Atlanta, GA, United States
| | - Jiaxing Wang
- Department of Ophthalmology, Emory University, Atlanta, GA, United States
| | - Cassandra M Chu
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States
| | - Aaron M Toporek
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States
| | - Joseph M Sherwood
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Darryl R Overby
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Eldon E Geisert
- Department of Ophthalmology, Emory University, Atlanta, GA, United States
| | - C Ross Ethier
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States.,George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
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42
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Pozdnyakova O, Orazi A, Kelemen K, King R, Reichard KK, Craig FE, Quintanilla-Martinez L, Rimsza L, George TI, Horny HP, Wang SA. Myeloid/Lymphoid Neoplasms Associated With Eosinophilia and Rearrangements of PDGFRA, PDGFRB, or FGFR1 or With PCM1-JAK2. Am J Clin Pathol 2021; 155:160-178. [PMID: 33367495 DOI: 10.1093/ajcp/aqaa208] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To summarize cases submitted to the 2019 Society for Hematopathology/European Association for Haematopathology Workshop under the category of myeloid/lymphoid neoplasms with eosinophilia and PDGFRA, PDGFRB, or FGFR1 or with PCM1-JAK2 rearrangements, focusing on recent updates and relevant practice findings. METHODS The cases were summarized according to their respective gene rearrangement to illustrate the spectrum of clinical, laboratory, and histopathology manifestations and to explore the appropriate molecular genetic tests. RESULTS Disease presentations were heterogeneous, including myeloproliferative neoplasms (MPNs), myelodysplastic syndromes (MDSs), MDS/MPN, acute myeloid leukemia, acute B- or T-lymphoblastic lymphoma/acute lymphoblastic lymphoma (ALL/LBL), or mixed-lineage neoplasms. Frequent extramedullary involvement occurred. Eosinophilia was common but not invariably present. With the advancement of RNA sequencing, cryptic rearrangements were recognized in genes other than PDGFRA. Additional somatic mutations were more frequent in the FGFR1-rearranged cases. Cases with B-ALL presentations differed from Philadelphia-like B-ALL by the presence of an underlying MPN. Cases with FLT3 and ABL1 rearrangements could be potential candidates for future inclusion in this category. CONCLUSIONS Accurate diagnosis and classification of this category of myeloid/lymphoid neoplasms has important therapeutic implications. With the large number of submitted cases, we expand our understanding of these rare neoplasms and improve our ability to diagnose these genetically defined disorders.
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Affiliation(s)
- Olga Pozdnyakova
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Attilio Orazi
- Department of Pathology, Texas Tech University Health Sciences Center, P. L. Foster School of Medicine, El Paso
| | | | - Rebecca King
- Division of Hematopathology, Mayo Clinic, Rochester, MN
| | | | - Fiona E Craig
- Division of Hematopathology, Mayo Clinic, Rochester, MN
| | - Leticia Quintanilla-Martinez
- Institute of Pathology and Neuropathology, Eberhard Karls University of Tübingen and Comprehensive Cancer Center, Tübingen University Hospital, Tübingen, Germany
| | - Lisa Rimsza
- Division of Hematopathology, Mayo Clinic, Rochester, MN
| | - Tracy I George
- Department of Pathology, University of Utah School of Medicine, Salt Lake City
| | | | - Sa A Wang
- MD Anderson Cancer Center, Houston, TX
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43
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van Bavel B, Ford LB, King R, Lwasa S, Namanya D, Twesigomwe S, Elsey H, Harper SL. Integrating climate in Ugandan health and subsistence food systems: where diverse knowledges meet. BMC Public Health 2020; 20:1864. [PMID: 33276748 PMCID: PMC7718713 DOI: 10.1186/s12889-020-09914-9] [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: 07/01/2020] [Accepted: 11/18/2020] [Indexed: 12/03/2022] Open
Abstract
Background The effects of food insecurity linked to climate change will be exacerbated in subsistence communities that are dependent upon food systems for their livelihoods and sustenance. Place-and community-based forms of surveillance are important for growing an equitable evidence base that integrates climate, food, and health information as well as informs our understanding of how climate change impacts health through local and Indigenous subsistence food systems. Methods We present a case-study from southwestern Uganda with Batwa and Bakiga subsistence communities in Kanungu District. We conducted 22 key informant interviews to map what forms of monitoring and knowledge exist about health and subsistence food systems as they relate to seasonal variability. A participatory mapping exercise accompanied key informant interviews to identify who holds knowledge about health and subsistence food systems. Social network theory and analysis methods were used to explore how information flows between knowledge holders as well as the power and agency that is involved in knowledge production and exchange processes. Results This research maps existing networks of trusted relationships that are already used for integrating diverse knowledges, information, and administrative action. Narratives reveal inventories of ongoing and repeated cycles of observations, interpretations, evaluations, and adjustments that make up existing health and subsistence food monitoring and response. These networks of local health and subsistence food systems were not supported by distinct systems of climate and meteorological information. Our findings demonstrate how integrating surveillance systems is not just about what types of information we monitor, but also who and how knowledges are connected through existing networks of monitoring and response. Conclusion Applying conventional approaches to surveillance, without deliberate consideration of the broader contextual and relational processes, can lead to the re-marginalization of peoples and the reproduction of inequalities in power between groups of people. We anticipate that our findings can be used to inform the initiation of a place-based integrated climate-food-health surveillance system in Kanungu District as well as other contexts with a rich diversity of knowledges and existing forms of monitoring and response. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-09914-9.
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Affiliation(s)
- Bianca van Bavel
- Priestley International Centre for Climate, University of Leeds, Priestley Building, Leeds, West Yorkshire, LS2 9JT, UK.
| | - Lea Berrang Ford
- Priestley International Centre for Climate, University of Leeds, Priestley Building, Leeds, West Yorkshire, LS2 9JT, UK.,Nuffield Centre for International Health & Development, University of Leeds, Leeds, West Yorkshire, UK.,Indigenous Health Adaptation to Climate Change Research Team, Kampala, Uganda.,Universidad Peruana Cayetano Heredia, Lima, Peru.,University of Leeds, Leeds, UK.,University of Alberta, Edmonton, Canada
| | - Rebecca King
- Nuffield Centre for International Health & Development, University of Leeds, Leeds, West Yorkshire, UK
| | - Shuaib Lwasa
- Indigenous Health Adaptation to Climate Change Research Team, Kampala, Uganda.,Universidad Peruana Cayetano Heredia, Lima, Peru.,University of Leeds, Leeds, UK.,University of Alberta, Edmonton, Canada.,Department of Geography, Geo-Informatics & Climate Sciences, Makerere University, Kampala, Uganda.,The Global Center on Adaptation, Rotterdam, The Netherlands
| | - Didacus Namanya
- Indigenous Health Adaptation to Climate Change Research Team, Kampala, Uganda.,Universidad Peruana Cayetano Heredia, Lima, Peru.,University of Leeds, Leeds, UK.,University of Alberta, Edmonton, Canada.,Ministry of Health, Kampala, Uganda
| | | | - Helen Elsey
- Department of Health Sciences, University of York, York, North Yorkshire, UK
| | - Sherilee L Harper
- Indigenous Health Adaptation to Climate Change Research Team, Kampala, Uganda.,Universidad Peruana Cayetano Heredia, Lima, Peru.,University of Leeds, Leeds, UK.,University of Alberta, Edmonton, Canada.,School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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44
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Butler M, King R, Giffen M, Spencer H. Trigeminal neuralgia – when first line drug management fails – 5-year experience. Br J Oral Maxillofac Surg 2020. [DOI: 10.1016/j.bjoms.2020.10.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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45
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Castillo JJ, Abeykoon JP, Gustine JN, Zanwar S, Mein K, Flynn CA, Demos MG, Guerrera ML, Kofides A, Liu X, Munshi M, Tsakmaklis N, King R, Yang G, Hunter ZR, Advani RH, Palomba ML, Ansell SM, Gertz MA, Kapoor P, Treon SP. Partial response or better at six months is prognostic of superior progression-free survival in Waldenström macroglobulinaemia patients treated with ibrutinib. Br J Haematol 2020; 192:542-550. [PMID: 33207010 DOI: 10.1111/bjh.17225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 09/23/2020] [Indexed: 02/06/2023]
Abstract
Ibrutinib is associated with durable responses in patients with Waldenström macroglobulinaemia (WM). We hypothesized that response depth is predictive of progression-free survival (PFS) in WM patients treated with ibrutinib. Using landmark analyses, we evaluated response depth in two cohorts of WM patients treated with ibrutinib monotherapy. The learning cohort was composed of 93 participants from two clinical trials, and the validation cohort of 190 consecutive patients treated off clinical trial. Rates of partial response (PR) or better at six months in learning and validation cohorts were 64% and 71% respectively (P = 0·29). In the learning cohort, three-year PFS rates for patients who attained PR or better at six months versus not were 81% and 57% respectively (P = 0·009). In the validation cohort, three-year PFS rates for patients who attained PR or better at six months versus not were 83% and 54% respectively (P = 0·008). In multivariate analyses, attaining PR or better at six months was associated with superior PFS in the learning [hazard ratio (HR) 0·38; P = 0·01] and validation cohorts (HR 0·18; P = 0·004). Attaining PR at six months on ibrutinib emerges as an intermediate outcome of interest and should be validated as surrogate for PFS in clinical trials evaluating Bruton tyrosine kinase inhibitors in WM.
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Affiliation(s)
- Jorge J Castillo
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Jithma P Abeykoon
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Joshua N Gustine
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Boston University Medical School, Boston, MA, USA
| | - Saurabh Zanwar
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Kirsten Mein
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Catherine A Flynn
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Maria G Demos
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Maria L Guerrera
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Amanda Kofides
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Xia Liu
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Manit Munshi
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Nickolas Tsakmaklis
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Rebecca King
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Guang Yang
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Zachary R Hunter
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Ranjana H Advani
- Stanford Cancer Institute, Stanford University, Stanford, CA, USA
| | - Maria Lia Palomba
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Stephen M Ansell
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Morie A Gertz
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Prashant Kapoor
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Steven P Treon
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
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Trotti LM, Ong JC, Plante DT, Friederich Murray C, King R, Bliwise DL. Disease symptomatology and response to treatment in people with idiopathic hypersomnia: initial data from the Hypersomnia Foundation registry. Sleep Med 2020; 75:343-349. [PMID: 32950878 PMCID: PMC7669698 DOI: 10.1016/j.sleep.2020.08.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/27/2020] [Accepted: 08/31/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE/BACKGROUND Knowledge of idiopathic hypersomnia symptomatology derives from clinical case series. Web-based registries provide complementary information by allowing larger sample sizes, with greater geographic and social diversity. PATIENTS/METHODS Data were obtained from the Hypersomnia Foundation's online registry. Common clinical features of idiopathic hypersomnia and other central disorders of hypersomnolence were queried, for the last thirty days and when symptoms were most severe. Symptoms were compared between idiopathic hypersomnia participants with and without long sleep durations and between participants with idiopathic hypersomnia and those with either form of narcolepsy. Frequency of medication use and residual symptoms on medication were evaluated. RESULTS Five-hundred sixty-three registry respondents were included, with idiopathic hypersomnia (n = 468), narcolepsy type 2 (n = 44), and narcolepsy type 1 (n = 51). "Brain fog," poor memory, and sleep drunkenness were all present in most idiopathic hypersomnia respondents, with brain fog and sleep drunkenness more commonly endorsed by those with long sleep durations. Eighty-two percent of participants with idiopathic hypersomnia were currently treated with medication, most commonly traditional psychostimulants such as amphetamine salts. Among treated patients, symptoms improved while on medication, but substantial residual hypersomnia symptoms remained. Participants with narcolepsy type 1 were more likely than those with idiopathic hypersomnia to endorse intentional and unintentional daytime naps and automatic behaviors. CONCLUSIONS Symptoms of idiopathic hypersomnia extend well beyond excessive daytime sleepiness, and these symptoms frequently persist despite treatment. These findings highlight the importance of online registries in identifying gaps in the use and effectiveness of current treatments.
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Affiliation(s)
- Lynn Marie Trotti
- Department of Neurology and Emory Sleep Center, Emory University School of Medicine, USA.
| | - Jason C Ong
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University Feinberg School of Medicine, USA
| | - David T Plante
- Department of Psychiatry, University of Wisconsin-Madison, USA
| | | | - Rebecca King
- Current Board Member, Hypersomnia Foundation, USA
| | - Donald L Bliwise
- Department of Neurology and Emory Sleep Center, Emory University School of Medicine, USA
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Wymore C, King R, Stange N, Wetjen K, Hoogerwerf P, Wood K, Shilyansky J, Mulford L, Jennissen C. 290 Rural Youth’s Exposure to Firearm-Related Injury and Death and Their Attitudes Regarding Firearms. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.304] [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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Hall H, Kep J, Brown J, Pyakalyia J, King R, Mahmood A, Sitaing M. Midwifery leadership, advocacy and action to improve maternal health in PNG. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.860] [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: 11/12/2022] Open
Abstract
Abstract
Background
The SDG target for maternal mortality is less than 70 per 100,000 live births; in Papua New Guinea, it is estimated to be 145. PNG will require significant resources and strong leadership to meet the 2030 target. The PNG Midwifery Leadership Buddy Program (Buddy Program), funded and coordinated by Rotary, offers an innovative model to improve maternal health, which may be transferable to other low-middle-income countries.
Objectives
The Buddy Program aims to build midwifery leadership resulting in improved outcomes in PNG. As partners, midwives from PNG and Australia undertake leadership training in Port Moresby and enter a reciprocal peer support relationship. Over 12 months, they support each other in their professional roles and progress a quality improvement project.
Results
Three cohorts of midwives (18 from each country), have participated in the leadership training and the first group has completed 12 months of peer support. Participants have reported increased confidence for leadership, action and advocacy. There has been some communication challenges and variation in expectations, predominately due to cultural differences. The Buddy Program has resulted in a number of tangible projects including the introduction of family planning education at a local school and University, introduction of respectful care in pregnancy charter and increased surveillance and treatment of pregnant women with anaemia. Interestingly, a number of participants have continued to support each other beyond the initial 12-month commitment.
Conclusions
Supportive partnerships that grow midwifery leadership hold significant potential to increase the quality of maternity care and reduce preventable maternal deaths in low-middle-income countries.
Key messages
Midwifery leadership plays a vital role in addressing the SDG targets for maternal health. The Buddy Program offers an innovative model to progress the agenda for universal access to quality maternity care.
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Affiliation(s)
- H Hall
- Nursing& Midwifery, Monash University, Frankston, Australia
- Australian College of Midwives, Canberra, Australia
- ARCCIM, UTS, Sydney, Australia
| | - J Kep
- PNG Midwifery Society, Port Moresby, Papua New Guinea
| | - J Brown
- Morialta, Rotary, Adelaide, Australia
| | - J Pyakalyia
- PNG Midwifery Society, Port Moresby, Papua New Guinea
| | - R King
- Australian College of Midwives, Canberra, Australia
| | - A Mahmood
- Morialta, Rotary, Adelaide, Australia
| | - M Sitaing
- PNG Midwifery Society, Port Moresby, Papua New Guinea
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Reynolds E, Covert K, Bennett M, Driver S, King R, Reynolds M. A-35 On-Field Dizziness and Timing of Referral to Vestibular Therapy Following Adolescent Sports-Related Concussion: Initial Findings. Arch Clin Neuropsychol 2020. [DOI: 10.1093/arclin/acaa036.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
To examine if adolescent patients who experienced on-field dizziness immediately following sports-related concussion (SRC) and were referred to vestibular therapy (VT) in 7–9 days returned to play faster when compared to referrals made > 10 days.
Method
Registry data for an outpatient clinic specializing in adolescent SRC was analyzed. Of the 85 adolescent patients included, 67 (79%) experienced dizziness immediately following injury; 36 (54%) of which were referred to VT. Mean age at time of injury was 15.3 years; 61.1% were male (n = 22); most were injured while participating in football (38.9%), soccer (16.7%), or wrestling (13.9%). Days to initial VT evaluation from time of injury and days from VT to clearance from concussion protocol were analyzed using a Poisson regression model; age and sex were controlled.
Results
Patients referred to VT 7–9 days post-injury returned to play 16 ± 13.4 days earlier (20.7 ± 18.6 days; p < .0001) than patients who received VT 10–20 days post SRC (36.7 days±32). While non-significant, individuals referred to VT > 21 days post-injury returned to play 6 days later than those referred < 10 days (26.3 ± 32.9; p = .14).
Conclusions
Appropriate and timely referrals to VT following the presence of on-field dizziness after SRC may play an integral role in recovery, although more research in this area is needed. Initial findings suggest that when determining optimal time frame for referral to VT, 7–9 days post-injury may be most beneficial for adolescents following SRC.
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50
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King R, Bucks N. Right Arm Numbness In An Adolescent. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000679700.27873.21] [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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