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Stirrat T, Martin R, Waller J, Dev A, Umair M. The clinical year dilemma: Examining the stressors and alternatives of pre-radiology training. Curr Probl Diagn Radiol 2024:S0363-0188(24)00088-4. [PMID: 38735792 DOI: 10.1067/j.cpradiol.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 05/02/2024] [Indexed: 05/14/2024]
Abstract
Since its reinstatement in 1997, the effectiveness of the clinical year prior to radiology residency has been a contentious topic concerning its role in cultivating skilled radiologists. This review evaluates the limitations of the one-year internship and explores alternative approaches. Utilizing databases such as PubMed, Google Scholar, and Scopus, this study identified pertinent articles that aligned with the inclusion criteria for post-graduate year 1 (PGY-1) training before radiology residency. Through a qualitative analysis of the literature, the review identifies prevalent themes concerning the drawbacks of the preliminary clinical year and potential alternative strategies. Many current trainees express skepticism about the value of the clinical year, noting a disconnect between its generalist nature and the specialized demands of subsequent radiology training. Interns felt uncertain about radiology exam indications and found radiology departments to be unapproachable, reflecting the need for alternative educational strategies to improve the preparedness and confidence of radiology interns as they transition from academic environments to clinical practice. The preparatory clinical year prior to entering radiology residency presents a mix of utility, along with alternative approaches to structuring this year. These alternatives include incorporating it into the undergraduate medical curriculum, restructuring or designing radiology-focused clinical years, and reevaluating the overall effectiveness of the clinical year in training.
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Affiliation(s)
| | | | | | - Arvind Dev
- Albert Einstein College of Medicine, USA
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2
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Alvarez-Quinto R, Grinstead S, Kinard G, Martin R, Mollov D. Complete genome sequence of vaccinium-associated virus C, a new member of the family Totiviridae from Vaccinium floribundum. Arch Virol 2024; 169:86. [PMID: 38558201 DOI: 10.1007/s00705-024-06008-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 02/15/2024] [Indexed: 04/04/2024]
Abstract
Blueberries (Vaccinium sp.) are a major crop grown in the Pacific Northwest region. Currently, there are at least 17 known viruses that infect blueberry plants, and some of them cause a wide range of symptoms and economic losses. A new virus, vaccinium-associated virus C (VaVC) (family Totiviridae, genus Totivirus) was identified in an imported blueberry accession from the USDA-ARS National Clonal Germplasm Repository in Corvallis, Oregon. The complete genomic sequence of VaVC was determined, but the biological significance of VaVC is unknown and requires further study. Additional Vaccinium sp. accessions should be screened to investigate the incidence of this new virus.
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Affiliation(s)
- Robert Alvarez-Quinto
- Department of Botany and Plant Pathology, Oregon State University, Corvallis, OR, 97333, USA
- Department of Plant Pathology, University of Minnesota, St. Paul, MN, 55108, USA
| | - Samuel Grinstead
- USDA-ARS, National Germplasm Resources Laboratory, Beltsville, MD, 20705, USA
| | - Gary Kinard
- USDA-ARS, National Germplasm Resources Laboratory, Beltsville, MD, 20705, USA
| | - Robert Martin
- Department of Botany and Plant Pathology, Oregon State University, Corvallis, OR, 97333, USA
| | - Dimitre Mollov
- USDA-ARS, Horticultural Crops Disease and Pest Management Research Unit, Corvallis, OR, 97330, USA.
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3
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Duryea EL, Martin R, McIntire D, Spong CY, Nelson DB. Perinatal Outcomes among Women Identified by a Community Health Needs Assessment. Am J Perinatol 2024; 41:67-71. [PMID: 34784613 DOI: 10.1055/s-0041-1740014] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aim of the study is to compare perinatal outcomes for women with greater social needs, as identified by the Community Health Needs Assessment, to those of women living in other areas of the county. STUDY DESIGN This was a retrospective cohort study of pregnant women delivering at a large inner-city county hospital. Perinatal outcomes were analyzed for women living within a target area with substantial health disparities and social needs, and compared with those women living outside the target area. Statistical analysis included student's t-test, Chi square, and logistic regression. RESULTS Between January 2015 and July 2020, 66,936 women delivered at Parkland hospital. Of these, 7,585 (11%) resided within the target area. These women were younger (26.8 ± 6.5 vs. 27.9 ± 6.4 years, p < 0.001), more likely to be black (37 vs. 13%, p < 0.001), and had a higher body mass index or BMI (33.3 ± 7.0 vs. 32.6 ± 6.4 kg/m2, p < 0.001). All women were likely to access prenatal care, with 7,320 (96.5%) in the target area and 57,677 (97.2%) outside the area attending at least one visit. Adverse perinatal outcomes were increased for women living within the target area, which persisted after adjustment for age, race, and BMI. This included an increased risk of preeclampsia (adjusted risk ratio [aRR] 1.1, 95% confidence interval or CI [1.03, 1.2]) and abruption (aRR 1.3, 95% CI [1.1, 1.7]), as well as preterm birth before both 34 weeks (aRR 1.3, 95% CI [1.2, 1.5]) and 28 weeks (aRR 1.3, 95% CI [1.02,1.7]). It follows that neonatal ICU admission (aRR 2.1, 95% CI [1.3, 3.4]) and neonatal death (aRR 1.2, 95% CI [1.1, 1.3]) were increased within the target area. Interestingly, rate of postpartum visit attendance was higher in the target area (57 vs. 48%), p < 0.001. CONCLUSION Even among vulnerable populations, women in areas with worse health disparities and social needs are at greater risk of adverse perinatal outcomes. Efforts to achieve health equity will need to address social disparities. KEY POINTS · At a county hospital, 97% of women accessed prenatal care.. · Greater social needs were associated with adverse perinatal outcomes.. · Differences persisted with adjustment for age, race, and BMI..
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Affiliation(s)
- Elaine L Duryea
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Obstetrics, Parkland Health and Hospital System, Dallas, Texas
| | - Robert Martin
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Obstetrics, Parkland Health and Hospital System, Dallas, Texas
| | - Donald McIntire
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Catherine Y Spong
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Obstetrics, Parkland Health and Hospital System, Dallas, Texas
| | - David B Nelson
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Obstetrics, Parkland Health and Hospital System, Dallas, Texas
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Martin R, Lau HA, Morrison R, Bhargava P, Deiling K. The Rising Tide of Point-of-Care Ultrasound (POCUS) in Medical Education: An Essential Skillset for Undergraduate and Graduate Medical Education. Curr Probl Diagn Radiol 2023; 52:482-484. [PMID: 37479620 DOI: 10.1067/j.cpradiol.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/28/2023] [Indexed: 07/23/2023]
Abstract
As point-of-care ultrasound (POCUS) becomes an integral component of healthcare, both undergraduate and graduate medical POCUS education is urgently necessary in curricula. Despite the apparent need of POCUS curricula, there remains a lingering question: Are there evidence-based benefits to POCUS training in undergraduate and/or graduate medical education settings? Qualitative review of research was conducted to identify common themes for benefits of POCUS and the requirements and/or characteristics for effective POCUS educational curricula. Results for undergraduate medical education were separated into preclinical and clinical education. In preclinical POCUS education, POCUS education improves anatomy education and physical examination skills for sonographic assessment of abdominal, reproductive, cardiovascular, and renal structures. Further enhancement can be achieved via simulation devices that are generalized ultrasound simulation mannequins, one defined body region such as the abdomen, or local regions of interest such as the femoral triangle. In clinical undergraduate POCUS education, benefits involved greater performance on knowledge tests and general ultrasound competency in emergency medicine, surgical, family medicine, and physical medicine and rehabilitation clerkships. These studies also found improved comprehension of specific POCUS examinations such as those for ultrasound-guided injections, FAST, eFAST, and RUSH. Further integration of POCUS education into graduate medical education was found to successfully improve ultrasound knowledge and competency in both academic and military internal medicine residencies. One limitation of this study is that this article is a review resulting in no specific intervention being introduced. The resultant hypothesis of this systematic review cannot be tested; rather evidence-based recommendations are restricted to the currently available literature within the searched databases. From this review, it was found that the inclusion of a properly integrated POCUS curriculum can result in greater confidence in ultrasound use, increased knowledge of anatomy and basic sciences for various organ systems, improved ultrasound knowledge and performance in clinical clerkships, and offers improved confidence and knowledge in ultrasound during residency.
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Affiliation(s)
- Robert Martin
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ.
| | - Ho An Lau
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA
| | - Ryan Morrison
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ
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Garda S, Weber-Genzel L, Martin R, Leser U. BELB: a biomedical entity linking benchmark. Bioinformatics 2023; 39:btad698. [PMID: 37975879 PMCID: PMC10681865 DOI: 10.1093/bioinformatics/btad698] [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: 08/23/2023] [Revised: 10/30/2023] [Accepted: 11/16/2023] [Indexed: 11/19/2023] Open
Abstract
MOTIVATION Biomedical entity linking (BEL) is the task of grounding entity mentions to a knowledge base (KB). It plays a vital role in information extraction pipelines for the life sciences literature. We review recent work in the field and find that, as the task is absent from existing benchmarks for biomedical text mining, different studies adopt different experimental setups making comparisons based on published numbers problematic. Furthermore, neural systems are tested primarily on instances linked to the broad coverage KB UMLS, leaving their performance to more specialized ones, e.g. genes or variants, understudied. RESULTS We therefore developed BELB, a biomedical entity linking benchmark, providing access in a unified format to 11 corpora linked to 7 KBs and spanning six entity types: gene, disease, chemical, species, cell line, and variant. BELB greatly reduces preprocessing overhead in testing BEL systems on multiple corpora offering a standardized testbed for reproducible experiments. Using BELB, we perform an extensive evaluation of six rule-based entity-specific systems and three recent neural approaches leveraging pre-trained language models. Our results reveal a mixed picture showing that neural approaches fail to perform consistently across entity types, highlighting the need of further studies towards entity-agnostic models. AVAILABILITY AND IMPLEMENTATION The source code of BELB is available at: https://github.com/sg-wbi/belb. The code to reproduce our experiments can be found at: https://github.com/sg-wbi/belb-exp.
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Affiliation(s)
- Samuele Garda
- Computer Science Department, Humboldt-Universität zu Berlin, Berlin 10099, Germany
| | - Leon Weber-Genzel
- Center for Information and Language Processing, Ludwig-Maximilians-Universität München, München 80539, Germany
| | - Robert Martin
- Computer Science Department, Humboldt-Universität zu Berlin, Berlin 10099, Germany
| | - Ulf Leser
- Computer Science Department, Humboldt-Universität zu Berlin, Berlin 10099, Germany
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Martin R, Guthmann R. Does taking BP medicine at night (vs morning) result in fewer cardiovascular events? J Fam Pract 2023; 72:E11-E13. [PMID: 37976342 DOI: 10.12788/jfp.0697] [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] [Indexed: 11/19/2023]
Abstract
PROBABLY NOT. In patients who have hypertension, the timing of administration of antihypertensive medications does not appear to impact cardiovascular outcomes (strength of recommendation: B; contradictory randomized controlled trials).
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Affiliation(s)
- Robert Martin
- Advocate Illinois Masonic, Family Medicine Residency, Chicago
| | - Rick Guthmann
- Advocate Illinois Masonic, Family Medicine Residency, Chicago
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7
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Wilke AJ, Martin R, Bates NA, Jastifer JR, Martin KD. Technique Variation in the Surgical Treatment of Lateral Ankle Instability. Foot Ankle Spec 2023:19386400231202029. [PMID: 37823588 DOI: 10.1177/19386400231202029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
INTRODUCTION Lateral ankle sprains are the most common type of injury to the ankle and can lead to ankle instability. There are many described techniques for the surgical treatment of lateral ankle instability. The purpose of this study is to quantify the variation in surgeon technique for lateral ankle instability treatment. METHODS Surveys were sent to 62 orthopaedic foot and ankle surgeons regarding surgical technique for the treatment of lateral ankle instability. Clinical agreement was defined as greater than 80% agreement to assess the cohesiveness of surgical methods as described by Marx et al. Results. Response rate was 49/62 (79%). There was clinical agreement for not using bone tunnels and not using metal anchors. All other factors lacked clinical agreement. A greater average number of throws and knots (4.2 for each, range 1-6 throws, range 2-12 knots) were used by surgeons that do not believe knots cause pain compared to an average of 3.9 (range, 1-6) throws and 4.0 (range, 2-15) knots by surgeons who do believe knots cause pain. The association that surgeon who believed knots do cause pain and thus used fewer knots and throws was not statistically significant (P > .05). The preferred material by surgeons in our study are as follows: nonabsorbable braided suture (26/49, 53%), suture tape (15/49, 31%), and fiber tape (4/49, 8%). Among surgeons who use absorbable suture (34/49, 69%), there was no significant difference (P > .05) between surgeons who believe knots cause pain (23/34, 68%) and those who do not (11/34, 32%). DISCUSSION AND CONCLUSION Among this small sample of orthopaedic foot and ankle surgeons, there is wide variation in surgical technique for lateral ankle instability treatment and little agreement on the clinical standard of care. This disagreement highlights the need for comparative outcome studies in the treatment of ankle instability. LEVEL OF EVIDENCE Level III: Retrospective cohort study.
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Affiliation(s)
| | | | | | | | - Kevin D Martin
- The Ohio State University Wexner Medical Center, Columbus, Ohio
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8
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Petrovic B, Martin R, Romero AM, Askounis P, Buchanan L, Rossi F, Bernat R, Alves JG. EURADOS ISO/IEC 17025 guidance for IMS: suggestions on how to interpret and implement the requirements including examples from accredited laboratories. Radiat Prot Dosimetry 2023; 199:1707-1709. [PMID: 37819287 DOI: 10.1093/rpd/ncac186] [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: 07/22/2022] [Revised: 07/22/2022] [Accepted: 08/22/2022] [Indexed: 10/13/2023]
Abstract
Individual monitoring of external radiation is an activity usually regulated by national regulatory bodies in most countries. Regulations generally contain technical requirements to be met by the individual monitoring services (IMS), in order to ensure that the measurements are correct and therefore the dosimetry results are reliable. In some countries, the requirements include or even consist of the accreditation of the service according to the standard ISO/IEC 17025: 'General requirements for the competence of testing and calibration laboratories.' It is a fact that accreditation is a growing trend among European IMS as a way to guarantee confidence in their technical competence. The acceptance of the dosimetry results between countries and their indentation in the respective National Dose Registries is facilitated if laboratories conform to the ISO/IEC 17025 standard. In the framework of the activities of EURADOS (European Radiation Dosimetry Group) working group 2 'Harmonization of Individual Monitoring in Europe' and attending to the concern of many European IMS in the process of accreditation, a guide has been prepared. The purpose was to assist and encourage IMS to apply for accreditation and to share the authors' own experience with the process. The guide intends to be a practical reference for IMS on how to interpret and implement the ISO/IEC 17025 requirements to the specific activity of a personal dosimetry service for external radiation, emphasizing those aspects of special interest. It includes examples from dosimetry laboratories already accredited. The major novelties from a new edition of ISO/IEC 17025: 2017 are also identified in the guide. Finally, the guide aims to assist the auditing process, giving examples of auditor's questions and how to show evidence of compliance. The main findings are presented.
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Affiliation(s)
- B Petrovic
- Public Health Institute of Republic of Srpska (PHIRS), Banja Luka, Bosnia and Herzegovina
| | - R Martin
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid, Spain
| | - A M Romero
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid, Spain
| | - P Askounis
- Greek Atomic Energy Commission (EEAE), Athens, Greece
| | - L Buchanan
- Atomic Weapon Establishment (AWE), Berkshire, UK
| | - F Rossi
- AOU Careggi, Florence, Italy
| | - R Bernat
- Ruđer Bošković Institute (RBI), Zagreb, Croatia
| | - J G Alves
- University of Lisboa, Instituto Superior Técnico, Lisbon, Portugal
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Perles LA, Niedzielski J, Sawakuchi G, Martin R, Schueler E, Taniguchi CM, Ludmir EB, Vivar OI, Das P, Koong AC, Farber LA, Koay EJ, Beddar S. Assessment of the Spatial Bio-Distribution of NBTXR3 for Locally Advanced or Borderline-Resectable Pancreatic Ductal Adenocarcinoma (LAPC or BRPC) Patients Undergoing Radiation Therapy. Int J Radiat Oncol Biol Phys 2023; 117:e332-e333. [PMID: 37785172 DOI: 10.1016/j.ijrobp.2023.06.2385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) NBTXR3 is a novel radioenhancer composed of functionalized hafnium oxide nanoparticles that are injected directly into the tumor. An ongoing phase I trial is assessing the application of NBTXR3 in the treatment of locally-advanced or borderline-resectable pancreatic ductal adenocarcinoma, with the primary goal of determining the recommended NBTXR3 dose for a subsequent phase II trial. Using patients from the ongoing phase I trial, we evaluated the spatial bio-distribution of NBTXR3 in the pancreas as function of time and assessed if there is migration of the compound during radiation therapy. MATERIALS/METHODS Adult patients with LAPC or BRPC were enrolled. Analysis of 8 patients who underwent CT simulation at least 24 hours after receiving the NBTXR3 intratumoral injection in the pancreatic lesion under general anesthesia guided by an endoscopic ultrasound was conducted. Patients were simulated with and without iodinated intravenous contrast under breath hold, with 3mm CT slice thickness and 50-60cm FoV. A contrast-enhanced CT series was chosen for RT planning purposes. All patients were planned for a 15-fraction IMRT course using 6-MV beam energy, with 45Gy and 37.5Gy dose levels (using a simultaneous integrated boost technique) to gross primary tumor and microscopic disease/regional nodes, respectively. Daily image guidance included either cone-beam CT (CBCT, n = 1) or CT-on-Rails (CTOR, n = 7) and were fused to the planning CT images using Velocity, ver. 3.0.1. The NBTXR3 volume was determined by thresholding the images to 165 HU and 300 HU for CTOR and CBCT images, respectively. Bones, stents, and artifacts were manually removed from the NBTXR3 volume. The volumes for the NBTXR3 and the NBTXR3 overlapping with the GTV for each patient were individually fit to a linear model in R, ver. 4.1.3. RESULTS One patient from the CTOR cohort was excluded from analysis due to the small volume of NBTXR3 (0.02 cm3) compared to the rest of the cohort (0.716 - 6.917 cm3). The total volume of NBTXR3 in the CBCT images could not be analyzed due the substantial image artifacts, only the volume overlapping the GTV was calculated. There were no statistically significant changes (p > 0.1 Adj-R2 = 0.99) in the raw volume of NBTXR3 for the duration of the treatment in all CTOR patients. For the NBTXR3 volume overlapping with the GTV, five cases did not present with a volume change during the treatment (p > 0.1 Adj-R2 = 0.99), while one CTOR case had a reduction in volume of about 1.5%/day (p = 0.7), and the CBCT case had a reduction of 3%/day (p < 0.001). CONCLUSION The raw volume of NBTXR3 injected in the pancreas did not significantly change over the duration of the three weeks of treatment. We also did not observe significant changes in the NBTXR3 volume overlapping the GTV in most cases. The stability of NBTXR3 was demonstrated during RT.
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Affiliation(s)
- L A Perles
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Niedzielski
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - G Sawakuchi
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - R Martin
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E Schueler
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C M Taniguchi
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E B Ludmir
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - P Das
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A C Koong
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L A Farber
- The Farber Center for Radiation Oncology, New York, NY
| | - E J Koay
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Beddar
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
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Chang E, Wong FCL, Erwin WD, Das P, Holliday E, Koong AC, Ludmir EB, Smith GL, Taniguchi CM, Beddar S, Martin R, Niedzielski J, Perles LA, Park PC, Kaseb A, Lee S, Tzeng CW, Vauthey JN, Koay EJ. Phase 1 Trial of SPECT-Guided Liver-Directed Ablative Radiotherapy for Patients with Low Functional Liver Volume. Int J Radiat Oncol Biol Phys 2023; 117:S106. [PMID: 37784280 DOI: 10.1016/j.ijrobp.2023.06.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Traditional liver dose constraints specify that a critical volume of 700 cc of non-tumor liver should be spared from receiving a hepatotoxic dose. We evaluated the safety of liver-directed ablative radiotherapy for patients with hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (iCCA), or liver metastases (LM) with Child-Pugh (CP) A5 liver function at baseline and with low functional liver volume as estimated by Tc-99m sulfur colloid single photon emission computed tomography (SPECT). We hypothesized that functional liver image guidance with SPECT would allow safe delivery of ablative radiotherapy in patients with limited liver volume. MATERIALS/METHODS A phase 1 trial with a 3+3 design was conducted to evaluate the safety of comprehensive ablative radiotherapy to the liver disease using escalating functional non-target liver radiation dose constraints. Eligibility criteria included (1) a diagnosis of HCC, iCCA, or LM, (2) prior treatment with irinotecan or oxaliplatin chemotherapy or liver resection, and (3) a minimum functional liver volume of 400 cc as estimated by SPECT using a threshold of 40% maximum intensity. Patients with CP >A5 liver function, prior liver-directed radiotherapy, or prior Yttrium-90 therapy were excluded. The prescription dose was 67.5-75 Gy in 15 fractions or 75-100 Gy in 25 fractions. The volumetric dose constraint for functional non-target liver receiving <24 Gy for 15 fractions or <27 Gy for 25 fractions was determined by the dose level of trial enrollment: level 0 was ≥400 cc and level +1 was ≥300 cc. A level -1 was included if needed. We used standard 15 and 25 fraction dose constraints for other organs at risk. The following dose limiting toxicities (DLTs) were assessed within 6-8 weeks of completing radiotherapy: Grade 3 hypoalbuminemia, increase in INR, increase in bilirubin, or ascites, or Grade 4 hepatic failure or any radiation-related toxicity. RESULTS Twelve patients enrolled between February 2016 and June 2022. The median (range) GTV was 36 (2-651) cc. The median CT anatomical non-tumor liver volume was 1584 (764-2699) cc, and the median SPECT functional liver volume was 1117 (570-1928) cc, with a Pearson correlation coefficient of 0.98 (p<0.001). The median non-target SPECT functional liver volume below the volumetric dose constraint was 684 (429-1244) cc. None of the 3 patients treated in dose level 0, and none of the 9 patients treated in dose level +1 experienced any DLTs. The 1-year in-treatment-field control rate was 55%, and 1-year overall survival was 71%. CONCLUSION Ablative radiotherapy can be safely delivered using functional SPECT image guidance, which enables sparing lower volumes of functional liver than traditionally accepted in patients with CP A5 liver function. Further evaluation with a phase 2 study is warranted.
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Affiliation(s)
- E Chang
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - F C L Wong
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - W D Erwin
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P Das
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E Holliday
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A C Koong
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E B Ludmir
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - G L Smith
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C M Taniguchi
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Beddar
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - R Martin
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Niedzielski
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L A Perles
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P C Park
- University of California, Davis, Davis, CA
| | - A Kaseb
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Lee
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C W Tzeng
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J N Vauthey
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E J Koay
- The University of Texas MD Anderson Cancer Center, Houston, TX
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11
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Martin R. Symptoms of dry eye related to the relative humidity of living places. Cont Lens Anterior Eye 2023; 46:101865. [PMID: 37208284 DOI: 10.1016/j.clae.2023.101865] [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: 09/01/2022] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 05/21/2023]
Abstract
PURPOSE To investigate the impact of relative humidity (RH) and climate variables of the place of residence on symptoms of dry eye disease (DED) in primary eye care practice. METHODS A cross-sectional analysis of the Ocular Surface Disease Index (OSDI) dry eye classification of 1.033 patients [classified as non-DED (OSDI ≤22) and DED (OSDI >22)] was conducted in a multicentre study in Spain. Participants were classified according to the 5-year RH value (data from the Spanish Climate Agency -www.aemet.es) into two groups: those who lived in low RH (<70%) places and those who lived in high RH (≥70%) places. Additionally, differences in daily climate records (EU Copernicus Climate Change Service) were assessed. RESULTS The prevalence of DED symptoms was 15.5% (95% CI 13.2%-17.6%). Participants who lived in places with <70% RH showed a higher prevalence of DED (17.7%; 95% CI 14.5%-21.1%; P < 0.01 adjusted for age and sex) than those who lived in places with ≥70% RH (13.6%; 95% CI 11.1%-16.7%) and a closer, but not statistically significant, risk for DED (OR = 1.34, 95% CI 0.96 to 1.89; P = 0.09) than previously described DED risk factors [age older than 50 years (OR = 1.51, 95% CI 1.06 to 2.16; P = 0.02) and female sex (OR = 1.99, 95% CI 1.36 to 2.90; P < 0.01)]. Some climate data showed statistically significant differences (P < 0.05) between participants with DED and non-DED (mean wind gusts; atmospheric pressure; mean and minimum relative humidity); these variables did not significantly increase DED risk (OR close to 1.0 and P > 0.05). CONCLUSION This study is the first to describe the impact of climate data on dryness symptomatology in Spain, confirming that participants who live in locations with RH <70% have a higher prevalence (corrected for age and sex) of DED. These findings support the use of climate databases in DED research.
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Affiliation(s)
- R Martin
- Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA), Paseo de Belén, 17 - Campus Miguel Delibes, Valladolid 47011, España; Universidad de Valladolid, Departamento de Física Teórica, Atómica y Óptica, Paseo de Belén, 7 - Campus Miguel Delibes, Valladolid 47011, España; Optometry Research Group, IOBA Eye Institute, School of Optometry, University of Valladolid, Valladolid, Spain.
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Ryan DA, Martin R, Appel L, Ayed NB, Kogan L, Kirk A. Initial progress of the magnetic diagnostics of the MAST-U tokamak. Rev Sci Instrum 2023; 94:073501. [PMID: 37404097 DOI: 10.1063/5.0156334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/15/2023] [Indexed: 07/06/2023]
Abstract
MAST Upgrade has just begun its third physics campaign in April of 2023. The set of magnetic probes used to diagnose the magnetic field and currents on MAST Upgrade are described, and their calibration procedures are outlined including calculation of uncertainties. The median uncertainty in the calibration factors of the flux loops and pickup coils are calculated as 1.7% and 6.3%. The arrays of installed instability diagnostics are described, and the detection and diagnosis of a specimen MHD mode are demonstrated. Plans for the improvement of the magnetics arrays are outlined.
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Affiliation(s)
| | | | - L Appel
- UKAEA, Abingdon, United Kingdom
| | | | - L Kogan
- UKAEA, Abingdon, United Kingdom
| | - A Kirk
- UKAEA, Abingdon, United Kingdom
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Lafferty A, Duryea E, Martin R, Moseley L, Lopez M, McIntire DD, Spong CY, Nelson DB. A Prospective Study of Social Needs Associated with Mental Health Among Postpartum Patients Living in Underserved Communities. Am J Perinatol 2023. [PMID: 37339676 DOI: 10.1055/a-2113-2739] [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: 06/22/2023]
Abstract
OBJECTIVE Given the rising rates of maternal morbidity and mortality in the United States and the contribution of mental illness, especially among individuals living in under-resourced communities, the objective was to evaluate the prevalence of unmet health-related social needs and their impact on perinatal mental health outcomes. STUDY DESIGN This was a prospective observational study of postpartum patients residing within regions with increased rates of poor perinatal outcomes and sociodemographic disparities. Patients were enrolled in a multidisciplinary public health initiative "Extending Maternal Care After Pregnancy (eMCAP)" between October 1, 2020, and October 31, 2021. Unmet health-related social needs were assessed at delivery. Symptoms of postpartum depression and anxiety were evaluated at one month postpartum utilizing the Edinburg Postnatal Depression Scale (EPDS) and Generalized Anxiety Disorder-7 (GAD-7) screening tools respectively. Mean EPDS and GAD7 scores and odds of screening positive (scoring ≥10) were compared among individuals with and without unmet health-related social needs with p< 0.05 considered significant. RESULTS Of participants enrolled in eMCAP, 603 completed at least one EPDS or GAD7 at one month. Most had at least one social need, most commonly dependence on social programs for food (n=413/603 (68%)). Individuals lacking transportation to medical (OR 4.0, 95% CI: 1.2 - 13.32) and non-medical appointments (OR 4.17 95% CI: 1.08 - 16.03) had significantly higher odds of screening positive on EPDS while participants lacking transportation to medical appointments (OR 2.73 95% CI: 0.97 - 7.70) had significantly higher odds of screening positive on GAD7. CONCLUSION Among postpartum individuals in underserved communities, social needs correlate with higher depression and anxiety screening scores. This highlights the need to address social needs to improve maternal mental health.
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Affiliation(s)
| | - Elaine Duryea
- Obstetrics & Gynecology, UT Southwestern Medical School, Dallas, United States
| | - Robert Martin
- Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, United States
| | - Lisa Moseley
- Obstetrics & Gynecology, UT Southwestern Medical School, Dallas, United States
| | - Melissa Lopez
- Obstetrics & Gynecology, UT Southwestern Medical School, Dallas, United States
| | | | | | - David Bryan Nelson
- Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, United States
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Brilli L, Martin R, Argenti G, Bassignana M, Bindi M, Bonet R, Choler P, Cremonese E, Della Vedova M, Dibari C, Filippa G, Galvagno M, Leolini L, Moriondo M, Piccot A, Stendardi L, Targetti S, Bellocchi G. Uncertainties in the adaptation of alpine pastures to climate change based on remote sensing products and modelling. J Environ Manage 2023; 336:117575. [PMID: 36893538 DOI: 10.1016/j.jenvman.2023.117575] [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] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/02/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Over the last century, the management of pastoral systems has undergone major changes to meet the livelihood needs of alpine communities. Faced with the changes induced by recent global warming, the ecological status of many pastoral systems has seriously deteriorated in the western alpine region. We assessed changes in pasture dynamics by integrating information from remote-sensing products and two process-based models, i.e. the grassland-specific, biogeochemical growth model PaSim and the generic crop-growth model DayCent. Meteorological observations and satellite-derived Normalised Difference Vegetation Index (NDVI) trajectories of three pasture macro-types (high, medium and low productivity classes) in two study areas - Parc National des Écrins (PNE) in France and Parco Nazionale Gran Paradiso (PNGP) in Italy - were used as a basis for the model calibration work. The performance of the models was satisfactory in reproducing pasture production dynamics (R2 = 0.52 to 0.83). Projected changes in alpine pastures due to climate-change impacts and adaptation strategies indicate that: i) the length of the growing season is expected to increase between 15 and 40 days, resulting in changes in the timing and amount of biomass production, ii) summer water stress could limit pasture productivity; iii) earlier onset of grazing could enhance pasture productivity; iv) higher livestock densities could increase the rate of biomass regrowth, but major uncertainties in modelling processes need to be considered; and v) the carbon sequestration potential of pastures could decrease under limited water availability and warming.
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Affiliation(s)
- L Brilli
- National Research Council - Institute of BioEconomy (IBE-CNR), 50145, Sesto Fiorentino, Italy; University of Florence, DAGRI, 50144, Florence, Italy.
| | - R Martin
- Université Clermont Auvergne, INRAE, VetAgro Sup, UREP, 63000, Clermont-Ferrand, France
| | - G Argenti
- University of Florence, DAGRI, 50144, Florence, Italy
| | | | - M Bindi
- University of Florence, DAGRI, 50144, Florence, Italy
| | - R Bonet
- Parc National des Ecrins, Domaine de Charance, 05000, Gap, France
| | - P Choler
- Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, LECA, 38000, Grenoble, France
| | - E Cremonese
- Climate Change Unit, Environmental Protection Agency of Aosta Valley, Saint-Christophe, Italy
| | - M Della Vedova
- Parc National des Ecrins, Domaine de Charance, 05000, Gap, France
| | - C Dibari
- University of Florence, DAGRI, 50144, Florence, Italy
| | - G Filippa
- Climate Change Unit, Environmental Protection Agency of Aosta Valley, Saint-Christophe, Italy
| | - M Galvagno
- Climate Change Unit, Environmental Protection Agency of Aosta Valley, Saint-Christophe, Italy
| | - L Leolini
- University of Florence, DAGRI, 50144, Florence, Italy
| | - M Moriondo
- National Research Council - Institute of BioEconomy (IBE-CNR), 50145, Sesto Fiorentino, Italy; University of Florence, DAGRI, 50144, Florence, Italy
| | - A Piccot
- Institut Agricole Régional, 11100, Aosta, Italy
| | - L Stendardi
- University of Florence, DAGRI, 50144, Florence, Italy
| | - S Targetti
- University of Bologna, Department of Agricultural and Food Sciences, Viale Fanin, 50, 40127, Bologna, Italy
| | - G Bellocchi
- Université Clermont Auvergne, INRAE, VetAgro Sup, UREP, 63000, Clermont-Ferrand, France
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15
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Botvinick-Greenhouse J, Martin R, Yang Y. Learning dynamics on invariant measures using PDE-constrained optimization. Chaos 2023; 33:063152. [PMID: 37368043 DOI: 10.1063/5.0149673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/02/2023] [Indexed: 06/28/2023]
Abstract
We extend the methodology in Yang et al. [SIAM J. Appl. Dyn. Syst. 22, 269-310 (2023)] to learn autonomous continuous-time dynamical systems from invariant measures. The highlight of our approach is to reformulate the inverse problem of learning ODEs or SDEs from data as a PDE-constrained optimization problem. This shift in perspective allows us to learn from slowly sampled inference trajectories and perform uncertainty quantification for the forecasted dynamics. Our approach also yields a forward model with better stability than direct trajectory simulation in certain situations. We present numerical results for the Van der Pol oscillator and the Lorenz-63 system, together with real-world applications to Hall-effect thruster dynamics and temperature prediction, to demonstrate the effectiveness of the proposed approach.
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Affiliation(s)
| | - Robert Martin
- DEVCOM Army Research Laboratory, Research Triangle Park, Durham, North Carolina 27709, USA
| | - Yunan Yang
- Institute for Theoretical Studies, ETH Zürich, Zürich 8092, Switzerland
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Guthmann R, Martin R, Dixon A. Fecal Immunochemical Testing Compared With Colonoscopy. Am Fam Physician 2023; 107:642-644. [PMID: 37327169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Affiliation(s)
- Richard Guthmann
- Advocate Illinois Masonic Family Medicine Residency, Chicago, Illinois
| | - Robert Martin
- Advocate Illinois Masonic Family Medicine Residency, Chicago, Illinois
| | - Ashtyn Dixon
- Advocate Illinois Masonic Family Medicine Residency, Chicago, Illinois
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Martin R. Growing Pains of Nonphysician Providers in Radiology. Curr Probl Diagn Radiol 2023; 52:149-152. [PMID: 36804418 DOI: 10.1067/j.cpradiol.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 12/04/2022] [Accepted: 01/18/2023] [Indexed: 01/26/2023]
Abstract
Nonphysician providers (NPPs) place in medicine continues to evolve regardless of controversy. NPPs presence in academic and private practices continues to grow in all fields. Despite their growth, there remains Contention and debate about the capability, safety, efficiency, and aptitude of NPP's abilities for proper image ordering, image interpretation, and performing radiology-related tasks. NNPs role in healthcare across the United States continues to grow in all facets of healthcare, including radiology and radiologist related procedures. The claims submitted by NPPs involving radiology have significantly increased. However, current research suggests that the current scope of practice maintains the levels of capability, safety, efficiency and aptitude of a physician. It is imperative to note that there remains no evidence comparing diagnostic accuracy/errors between NPPs and radiologists. Despite the increased radiology services rendered by NPPs, the output of NPPs is still fractional compared to radiologists but it is mostly fluoroscopy and radiography. As with medical student education, the education for NPPs has continued to grow to encompass more aspects of medicine, including radiology. Evidence-based programs for NPP radiology training offers potential to encourage proper radiology service rendering. 10,15 NPPs are skilled in their ability to provide care for specific common conditions and potential greater ability to follow protocol. All of these factors promote the opportunity to take tedious tasks and/or cases from overworked radiologists to pursue greater generation of profit and work-life balance.
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Affiliation(s)
- Robert Martin
- Rowan University School of Osteopathic Medicine, 30 Cherry Circle, Blackwood, NJ, 08012.
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Bhutta HE, Moharamzadeh K, Martin R, Martin N. Patient Satisfaction with Upper and Lower Complete Dentures: A Service Evaluation Report. Eur J Prosthodont Restor Dent 2023; 31:59-71. [PMID: 35852120 DOI: 10.1922/ejprd_2416bhutta13] [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] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 04/20/2022] [Indexed: 03/03/2023]
Abstract
PURPOSE The purpose of this questionnaire-based service evaluation was to assess patient satisfaction with complete dentures provided in a dental teaching hospital. METHODS Patients completed the self-administered questionnaire before, immediately after, and 2-months following provision of new complete dentures. The questionnaire consisted of the following sections: Patient characteristics, current denture history and satisfaction with the fit of upper/lower complete dentures, chewing ability, speech, and aesthetics. Descriptive analysis, chi-square test, student t-test, and 2-way-ANOVA were performed on satisfaction levels pre-and post-treatment to assess denture fit, chewing ability, speech, and appearance. Age and gender-wise satisfaction levels along with correlations and associations between patient satisfaction levels and various factors were assessed. RESULTS 147 participants, including 91 males (61.9%) and 56 females (38.1%) completed the study. A statistically significant improvement in satisfaction scores was seen post-treatment in all domains (p⟨0.05), with most respondents showing great satisfaction. Overall, satisfaction levels were: Upper complete denture fit (82%), appearance (87%), speech (67%), chewing ability and lower complete denture fit (39%). A strong positive correlation was observed between the number of previous dentures used and patient satisfaction with upper denture fit (R=1). CONCLUSION Denture replacement positively impacts the satisfaction of patients and improves complete denture acceptance.
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Affiliation(s)
- H E Bhutta
- School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - K Moharamzadeh
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - R Martin
- School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - N Martin
- School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
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Nelson DB, Martin R, Duryea EL, Lafferty AK, McIntire DD, Pruszynski J, Rochin E, Spong CY. Extending Maternal Care After Pregnancy: An Initiative to Address Health Care Disparities and Enhance Access to Care After Delivery. Jt Comm J Qual Patient Saf 2023; 49:274-279. [PMID: 36966113 DOI: 10.1016/j.jcjq.2023.02.003] [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] [Received: 11/11/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023]
Abstract
PROBLEM DEFINITION A substantial proportion of maternal morbidity and mortality occurs after birth. However, little is known about the optimal design of programs to improve outcomes and decrease disparities during this period. CONTEXT Parkland Health is a tax-supported health system in Dallas that delivers more than 11,000 patients annually. A community needs assessment identified substantial health disparities in this community. The proportion of women in this region with diabetes mellitus (DM) and chronic hypertension (CHTN) during pregnancy is higher than surrounding regions, but access to care in the area is difficult because of the limited availability of ambulatory care. INITIAL APPROACH The authors created extending Maternal Care After Pregnancy (eMCAP), a community-based program, to address health care disparities and enhance access to care for the 12 months after birth. The team also evaluated the ability of Z codes (ICD-10 codes for social determinants of health) to identify patients with health-related social needs. KEY INSIGHTS AND SURPRISES The eMCAP program demonstrated improvement in attendance and quality of postpartum care for women living in underserved areas with CHTN and DM. For both CHTN and DM, eMCAP patients were matched 1:2 to controls outside of the eMCAP target region with similar comorbidities for maternal age ± 4 years, Black race, and delivery date ± 45 days. Compared to matched controls who were provided standard referrals, follow-up postpartum attendance for eMCAP women with CHTN was significantly better at 2 weeks and 1, 3, 6, 9, and 12 months (all p < 0.001). Similarly, eMCAP women with DM had significantly better follow-up at 2 weeks (p = 0.04), 1 month (p = 0.002), and 3 months (p = 0.049), resulting in HbA1c values for DM being significantly lower (p < 0.05) throughout the postpartum period. Despite the health system leading in reporting of Z codes, nearly 99% of applicable Z codes were not recorded, underscoring a public health opportunity. Through the eMCAP program, this initiative has demonstrated improved clinical performance for health care outcomes relevant to postpartum patients that can be deployed elsewhere to improve maternal health in underserved communities.
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Martin R, Belahsen Y, Noujeim J, Lefebvre Y, Deforche M, Lemort M, Sirtaine N, Roumeguere T, Peltier A, Diamand R. Optimizing multiparametric magnetic resonance imaging-targeted biopsy and detection of clinically significant prostate cancer: The role of core number and location. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00341-x] [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: 02/12/2023]
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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 V, Al Mahmeed WAR, Kzhdryan H, Dumont C, Geppert A, Bajramovic NS, Cader FA, Beauloye C, Quesada D, Hlinomaz O, Liebetrau C, Marandi T, Shokry K, Bueno H, Kovacevic M, Crnomarkovic B, Cankovic M, Dabovic D, Jarakovic M, Pantic T, Trajkovic M, Pupic L, Ruzicic D, Cvetanovic D, Mansourati J, Obradovic I, Stankovic M, Loh PH, Kong W, Poh KK, Sia CH, Saw K, Liška D, Brozmannová D, Gbur M, Gale CP, Maxian R, Kovacic D, Poznic NG, Keric T, Kotnik G, Cercek M, Steblovnik K, Sustersic M, Cercek AC, Djokic I, Maisuradze D, Drnovsek B, Lipar L, Mocilnik M, Pleskovic A, Lainscak M, Crncic D, Nikojajevic I, Tibaut M, Cigut M, Leskovar B, Sinanis T, Furlan T, Grilj V, Rezun M, Mateo VM, Anguita MJF, Bustinza ICM, Quintana RB, Cimadevilla OCF, Fuertes J, Lopez F, Dharma S, Martin MD, Martinez L, Barrabes JA, Bañeras J, Belahnech Y, Ferreira-Gonzalez I, Jordan P, Lidon RM, Mila L, Sambola A, Orvin K, Sionis A, Bragagnini W, Cambra AD, Simon C, Burdeus MV, Ariza-Solé A, Alegre O, Alsina M, Ferrando JIL, Bosch X, Sinha A, Vidal P, Izquierdo M, Marin F, Esteve-Pastor MA, Tello-Montoliu A, Lopez-Garcia C, Rivera-Caravaca JM, Gil-Pérez P, Nicolas-Franco S, Keituqwa I, Farhan HA, Silva L, Blasco A, Escudier JM, Ortega J, Zamorano JL, Sanmartin M, Pereda DC, Rincon LM, Gonzalez P, Casado T, Sadeghipour P, Lopez-Sendon JL, Manjavacas AMI, Marin LAM, Sotelo LR, Rodriguez SOR, Bueno H, Martin R, Maruri R, Moreno G, Moris C, Gudmundsdottir I, Avanzas P, Ayesta A, Junco-Vicente A, Cubero-Gallego H, Pascual I, Sola NB, Rodriguez OA, Malagon L, Martinez-Basterra J, Arizcuren AM, Indolfi C, Romero J, Calleja AG, Fuertes DG, Crespín Crespín M, Bernal FJC, Ojeda FB, Padron AL, Cabeza MM, Vargas CM, Yanes G, Kitai T, Gonzalez MJG, Gonzalez Gonzalez J, Jorge P, De La Fuente B, Bermúdez MG, Perez-Lopez CMB, Basiero AB, Ruiz AC, Pamias RF, Chamero PS, Mirrakhimov E, Hidalgo-Urbano R, Garcia-Rubira JC, Seoane-Garcia T, Arroyo-Monino DF, Ruiz AB, Sanz-Girgas E, Bonet G, Rodríguez-López J, Scardino C, De Sousa D, Gustiene O, Elbasheer E, Humida A, Mahmoud H, Mohamed A, Hamid E, Hussein S, Abdelhameed M, Ali T, Ali Y, Eltayeb M, Philippe F, Ali M, Almubarak E, Badri M, Altaher S, Alla MD, Dellborg M, Dellborg H, Hultsberg-Olsson G, Marjeh YB, Abdin A, Erglis A, Alhussein F, Mgazeel F, Hammami R, Abid L, Bahloul A, Charfeddine S, Ellouze T, Canpolat U, Oksul M, Muderrisoglu H, Popovici M, Karacaglar E, Akgun A, Ari H, Ari S, Can V, Tuncay B, Kaya H, Dursun L, Kalenderoglu K, Tasar O, Kalpak O, Kilic S, Kucukosmanoglu M, Aytekin V, Baydar O, Demirci Y, Gürsoy E, Kilic A, Yildiz Ö, Arat-Ozkan A, Sinan UY, Dagva M, Gungor B, Sekerci SS, Zeren G, Erturk M, Demir AR, Yildirim C, Can C, Kayikcioglu M, Yagmur B, Oney S, Xuereb RG, Sabanoglu C, Inanc IH, Ziyrek M, Sen T, Astarcioglu MA, Kahraman F, Utku O, Celik A, Surmeli AO, Basaran O, Ahmad WAW, Demirbag R, Besli F, Gungoren F, Ingabire P, Mondo C, Ssemanda S, Semu T, Mulla AA, Atos JS, Wajid I, Appelman Y, Al Mahmeed WAR, Atallah B, Bakr K, Garrod R, Makia F, Eldeeb F, Abdekader R, Gomaa A, Kandasamy S, Maruthanayagam R, Nadar SK, Nakad G, Nair R, Mota P, Prior P, Mcdonald S, Rand J, Schumacher N, Abraheem A, Clark M, Coulding M, Qamar N, Turner V, Negahban AQ, Crew A, Hope S, Howson J, Jones S, Lancaster N, Nicholson A, Wray G, Donnelly P, Gierlotka M, Hammond L, Hammond S, Regan S, Watkin R, Papadopoulos C, Ludman P, Hutton K, Macdonald S, Nilsson A, Roberts S, Monteiro S, Garg S, Balachandran K, Mcdonald J, Singh R, Marsden K, Davies K, Desai H, Goddard W, Iqbal N, Chalil S, Dan GA, Galasko G, Assaf O, Benham L, Brown J, Collins S, Fleming C, Glen J, Mitchell M, Preston S, Uttley A, Radovanovic M, Lindsay S, Akhtar N, Atkinson C, Vinod M, Wilson A, Clifford P, Firoozan S, Yashoman M, Bowers N, Chaplin J, Reznik EV, Harvey S, Kononen M, Lopesdesousa G, Saraiva F, Sharma S, Cruddas E, Law J, Young E, Hoye A, Harper P, Balghith M, Rowe K, Been M, Cummins H, French E, Gibson C, Abraham JA, Hobson S, Kay A, Kent M, Wilkinson A, Mohamed A, Clark S, Duncan L, Ahmed IM, Khatiwada D, Mccarrick A, Wanda I, Read P, Afsar A, Rivers V, Theobald T, Cercek M, Bell S, Buckman C, Francis R, Peters G, Stables R, Morgan M, Noorzadeh M, Taylor B, Twiss S, Widdows P, Brozmannová D, Wilkinson V, Black M, Clark A, Clarkson N, Currie J, George L, Mcgee C, Izzat L, Lewis T, Omar Z, Aytekin V, Phillips S, Ahmed F, Mackie S, Oommen A, Phillips H, Sherwood M, Aleti S, Charles T, Jose M, Kolakaluri L, Ingabire P, Karoudi RA, Deery J, Hazelton T, Knight A, Price C, Turney S, Kardos A, Williams F, Wren L, Bega G, Alyavi B, Scaletta D, Kunadian V, Cullen K, Jones S, Kirkup E, Ripley DP, Matthews IG, Mcleod A, Runnett C, Thomas HE, Cartasegna L, Gunarathne A, Burton J, King R, Quinn J, Sobolewska J, Munt S, Porter J, Christenssen V, Leng K, Peachey T, Gomez VN, Temple N, Wells K, Viswanathan G, Taneja A, Cann E, Eglinton C, Hyams B, Jones E, Reed F, Smith J, Beltrano C, Affleck DC, Turner A, Ward T, Wilmshurst N, Stirrup J, Brunton M, Whyte A, Smith S, Murray V, Walker R, Novas V, Weston C, Brown C, Collier D, Curtis K, Dixon K, Wells T, Trim F, Ghosh J, Mavuri M, Barman L, Dumont C, Elliott K, Harrison R, Mallinson J, Neale T, Smith J, Toohie J, Turnbull A, Parker E, Hossain R, Cheeseman M, Balparda H, Hill J, Hood M, Hutchinson D, Mellows K, Pendlebury C, Storey RF, Barker J, Birchall K, Denney H, Housley K, Cardona M, Middle J, Kukreja N, Gati S, Kirk P, Lynch M, Srinivasan M, Szygula J, Baker P, Cruz C, Derigay J, Cigalini C, Lamb K, Nembhard S, Price A, Mamas M, Massey I, Wain J, Delaney J, Junejo S, Martin K, Obaid D, Hoyle V, Brinkworth E, Davies C, Evans D, Richards S, Thomas C, Williams M, Dayer M, Mills H, Roberts K, Goodchild F, Dámaso ES, Greig N, Kundu S, Donaldson D, Tonks L, Beekes M, Button H, Hurford F, Motherwell N, Summers-Wall J, Felmeden D, Tapia V, Keeling P, Sheikh U, Yonis A, Felmeden L, Hughes D, Micklewright L, Summerhayes A, Sutton J, Panoulas V, Prendergast C, Poghosyan K, Rogers P, Barker LN, Batin P, Conway D, Exley D, Fletcher A, Wright J, Nageh T, Hadebe B, Kunhunny S, Mkhitaryan S, Mshengu E, Karthikeyan VJ, Hamdan H, Cooper J, Dandy C, Parkinson V, Paterson P, Reddington S, Taylor T, Tierney C, Adamyan M, Jones KV, Broadley A, Beesley K, Buckley C, Hellyer C, Pippard L, Pitt-Kerby T, Azam J, Hayes C, Freshwater K, Boyadjian S, Johnson L, Mcgill Y, Redfearn H, Russell M, Alyavi A, Alyavi B, Uzokov J, Hayrapetyan H, Azaryan K, Tadevosyan M, Poghosyan H, Kzhdryan H, Vardanyan A, Huber K, Geppert A, Ahmed A, Weidinger F, Derntl M, Hasun M, Schuh-Eiring T, Riegler L, Haq MM, Cader FA, Dewan MAM, Fatema ME, Hasan AS, Islam MM, Khandoker F, Mayedah R, Nizam SU, Azam MG, Arefin MM, Jahan J, Schelfaut D, De Raedt H, Wouters S, Aerts S, Batjoens H, Beauloye C, Dechamps M, Pierard S, Van Caenegem O, Sinnaeve F, Claeys MJ, Snepvangers M, Somers V, Gevaert S, Schaubroek H, Vervaet P, Buysse M, Renders F, Dumoulein M, Hiltrop N, De Coninck M, Naessens S, Senesael I, Hoffer E, Pourbaix S, Beckers J, Dugauquier C, Jacquet S, Malmendier D, Massoz M, Evrard P, Collard L, Brunner P, Carlier S, Blockmans M, Mayne D, Timiras E, Guédès A, Demeure F, Hanet C, Domange J, Jourdan K, Begic E, Custovic F, Dozic A, Hrvat E, Kurbasic I, Mackic D, Subo A, Durak-Nalbantic A, Dzubur A, Rebic D, Hamzic-Mehmedbasic A, Redzepovic A, Djokic-Vejzovic A, Hodzic E, Hujdur M, Musija E, Gljiva-Gogic Z, Serdarevic N, Bajramovic NS, Brigic L, Halilcevic M, Cibo M, Hadžibegic N, Kukavica N, Begic A, Iglica A, Osmanagic A, Resic N, Grgurevic MV, Zvizdic F, Pojskic B, Mujaric E, Selimovic H, Ejubovic M, Pojskic L, Stimjanin E, Sut M, Zapata PS, Munoz CG, Andrade LAF, Upegui MPT, Perez LE, Chavarria J, Quesada D, Alvarado K, Zaputovic L, Tomulic V, Gobic D, Jakljevic T, Lulic D, Bacic G, Bastiancic L, Avraamides P, Eftychiou C, Eteocleous N, Ioannou A, Lambrianidi C, Drakomathioulakis M, Groch L, Hlinomaz O, Rezek M, Semenka J, Sitar J, Beranova M, Kramarikova P, Pesl L, Sindelarova S, Tousek F, Warda HM, Ghaly I, Habiba S, Habib A, Gergis MN, Bahaa H, Samir A, Taha HSE, Adel M, Algamal HM, Mamdouh M, Shaker AF, Shokry K, Konsoah A, Mostafa AM, Ibrahim A, Imam A, Hafez B, Zahran A, Abdelhamid M, Mahmoud K, Mostafa A, Samir A, Abdrabou M, Kamal A, Sallam S, Ali A, Maghraby K, Atta AR, Saad A, Ali M, Lotman EM, Lubi R, Kaljumäe H, Uuetoa T, Kiitam U, Durier C, Ressencourt O, El Din AA, Guiatni A, Bras ML, Mougenot E, Labeque JN, Banos JL, Capendeguy O, Mansourati J, Fofana A, Augagneur M, Bahon L, Pape AL, Batias-Moreau L, Fluttaz A, Good F, Prieur F, Boiffard E, Derien AS, Drapeau I, Roy N, Perret T, Dubreuil O, Ranc S, Rio S, Bonnet JL, Bonnet G, Cuisset T, Deharo P, Mouret JP, Spychaj JC, Blondelon A, Delarche N, Decalf V, Guillard N, Hakme A, Roger MP, Biron Y, Druelles P, Loubeyre C, Lucon A, Hery P, Nejjari M, Digne F, Huchet F, Neykova A, Tzvetkov B, Larrieu M, Quaino G, Armangau P, Sauguet A, Bonfils L, Dumonteil N, Fajadet J, Farah B, Honton B, Monteil B, Philippart R, Tchetche D, Cottin M, Petit F, Piquart A, Popovic B, Varlot J, Maisuradze D, Sagirashvili E, Kereselidze Z, Totladze L, Ginturi T, Lagvilava D, Hamm C, Liebetrau C, Haas M, Hamm C, Koerschgen T, Weferling M, Wolter JS, Maier K, Nickenig G, Sedaghat A, Zachoval C, Lampropoulos K, Mpatsouli A, Sakellaropoulou A, Tyrovolas K, Zibounoumi N, Argyropoulos K, Toulgaridis F, Kolyviras A, Tzanis G, Tzifos V, Milkas A, Papaioannou S, Kyriazopoulos K, Pylarinou V, Kontonassakis I, Kotakos C, Kourgiannidis G, Ntoliou P, Parzakonis N, Pipertzi A, Sakalidis A, Ververeli CL, Kafkala K, Sinanis T, Diakakis G, Grammatikopoulos K, Papoutsaki E, Patialiatos T, Mamaloukaki M, Papadaki ST, Kanellos IE, Antoniou A, Tsinopoulos G, Goudis C, Giannadaki M, Daios S, Petridou M, Skantzis P, Koukis P, Dimitriadis F, Savvidis M, Styliadis I, Sachpekidis V, Pilalidou A, Stamatiadis N, Fotoglidis A, Karakanas A, Ruzsa Z, Becker D, Nowotta F, Gudmundsdottir I, Libungan B, Skuladottir FB, Halldorsdottir H, Shetty R, Iyengar S, Bs C, G S, Lakshmana S, S R, Tripathy N, Sinha A, Choudhary B, Kumar A, Kumar A, Raj R, Roy RS, Dharma S, Siswanto BB, Farhan HA, Yaseen IF, Al-Zaidi M, Dakhil Z, Amen S, Rasool B, Rajeeb A, Amber K, Ali HH, Al-Kinani T, Almyahi MH, Al-Obaidi F, Masoumi G, Sadeghi M, Heshmat-Ghahdarijani K, Roohafza H, Sarrafzadegan N, Shafeie M, Teimouri-Jervekani Z, Noori F, Kyavar M, Sadeghipour P, Firouzi A, Alemzadeh-Ansari MJ, Ghadrdoost B, Golpira R, Ghorbani A, Ahangari F, Salarifar M, Jenab Y, Biria A, Haghighi S, Mansouri P, Yadangi S, Kornowski R, Orvin K, Eisen A, Oginetz N, Vizel R, Kfir H, Pasquale GD, Casella G, Cardelli LS, Filippini E, Zagnoni S, Donazzan L, Ermacora D, Indolfi C, Polimeni A, Curcio A, Mongiardo A, De Rosa S, Sorrentino S, Spaccarotella C, Landolina M, Marino M, Cacucci M, Vailati L, Bernabò P, Montisci R, Meloni L, Marchetti MF, Biddau M, Garau E, Barbato E, Morisco C, Strisciuglio T, Canciello G, Lorenzoni G, Casu G, Merella P, Novo G, D'Agostino A, Di Lisi D, Di Palermo A, Evola S, Immordino F, Rossetto L, Spica G, Pavan D, Mattia AD, Belfiore R, Grandis U, Vendrametto F, Spagnolo C, Carniel L, Sonego E, Gaudio C, Barillà F, Biccire FG, Bruno N, Ferrari I, Paravati V, Torromeo C, Galasso G, Peluso A, Prota C, Radano I, Benvenga RM, Ferraioli D, Anselmi M, Frigo GM, Sinagra G, Merlo M, Perkan A, Ramani F, Altinier A, Fabris E, Rinaldi M, Usmiani T, Checco L, Frea S, Mussida M, Matsukawa R, Sugi K, Kitai T, Furukawa Y, Masumoto A, Miyoshi Y, Nishino S, Assembekov B, Amirov B, Chernokurova Y, Ibragimova F, Mirrakhimov E, Ibraimova A, Murataliev T, Radzhapova Z, Uulu ES, Zhanyshbekova N, Zventsova V, Erglis A, Bondare L, Zaliunas R, Gustiene O, Dirsiene R, Marcinkeviciene J, Sakalyte G, Virbickiene A, Baksyte G, Bardauskiene L, Gelmaniene R, Salkauskaite A, Ziubryte G, Kupstyte-Kristapone N, Badariene J, Balciute S, Kapleriene L, Lizaitis M, Marinskiene J, Navickaite A, Pilkiene A, Ramanauskaite D, Serpytis R, Silinskiene D, Simbelyte T, Staigyte J, Philippe F, Degrell P, Camus E, Ahmad WAW, Kassim ZA, Xuereb RG, Buttigieg LL, Camilleri W, Pllaha E, Xuereb S, Popovici M, Ivanov V, Plugaru A, Moscalu V, Popovici I, Abras M, Ciobanu L, Litvinenco N, Fuior S, Dumanschi C, Ivanov M, Danila T, Grib L, Filimon S, Cardaniuc L, Batrinac A, Tasnic M, Cozma C, Revenco V, Sorici G, Dagva M, Choijiljav G, Dandar E, Khurelbaatar MU, Tsognemekh B, Appelman Y, Den Hartog A, Kolste HJT, Van Den Buijs D, Van'T Hof A, Pustjens T, Houben V, Kasperski I, Ten Berg J, Azzahhafi J, Bor W, Yin DCP, Mbakwem A, Amadi C, Kushimo O, Kilasho M, Oronsaye E, Bakracheski N, Bashuroska EK, Mojsovska V, Tupare S, Dejan M, Jovanoska J, Razmoski D, Marinoski T, Antovski A, Jovanovski Z, Kocho S, Markovski R, Ristovski V, Samir AB, Biserka S, Kalpak O, Peovska IM, Taleska BZ, Pejkov H, Busljetik O, Zimbakov Z, Grueva E, Bojovski I, Tutic M, Poposka L, Vavlukis M, Al-Riyami A, Nadar SK, Abdelmottaleb W, Ahmed S, Mujtaba MS, Al-Mashari S, Al-Riyami H, Laghari AH, Faheem O, Ahmed SW, Qamar N, Furnaz S, Kazmi K, Saghir T, Aneel A, Asim A, Madiha F, Sobkowicz B, Tycinska A, Kazimierczyk E, Szyszkowska A, Mizia-Stec K, Wybraniec M, Bednarek A, Glowacki K, Prokopczuk J, Babinski W, Blachut A, Kosiak M, Kusinska A, Samborski S, Stachura J, Szastok H, Wester A, Bartoszewska D, Sosnowska-Pasiarska B, Krzysiek M, Legutko J, Nawrotek B, Kasprzak JD, Klosinska M, Wiklo K, Kurpesa M, Rechcinski T, Cieslik-Guerra U, Gierlotka M, Bugajski J, Feusette P, Sacha J, Przybylo P, Krzesinski P, Ryczek R, Karasek A, Kazmierczak-Dziuk A, Mielniczuk M, Betkier-Lipinska K, Roik M, Labyk A, Krakowian M, Machowski M, Paczynska M, Potepa M, Pruszczyk P, Budaj A, Ambroziak M, Omelanczuk-Wiech E, Torun A, Opolski G, Glowczynska R, Fojt A, Kowalik R, Huczek Z, Jedrzejczyk S, Roleder T, Brust K, Gasior M, Desperak P, Hawranek M, Farto-Abreu P, Santos M, Baptista S, Brizida L, Faria D, Loureiro J, Magno P, Monteiro C, Nédio M, Tavares J, Sousa C, Almeida I, Almeida S, Miranda H, Santos H, Santos AP, Goncalves L, Monteiro S, Baptista R, Ferreira C, Ferreira J, Goncalves F, Lourenço C, Monteiro P, Picarra B, Santos AR, Guerreiro RA, Carias M, Carrington M, Pais J, de Figueiredo MP, Rocha AR, Mimoso J, De Jesus I, Fernandes R, Guedes J, Mota T, Mendes M, Ferreira J, Tralhão A, Aguiar CT, Strong C, Da Gama FF, Pais G, Timóteo AT, Rosa SAO, Mano T, Reis J, Selas M, Mendes DE, Satendra M, Pinto P, Queirós C, Oliveira I, Reis L, Cruz I, Fernandes R, Torres S, Luz A, Campinas A, Costa R, Frias A, Oliveira M, Martins V, Castilho B, Coelho C, Moura AR, Cotrim N, Dos Santos RC, Custodio P, Duarte R, Gomes R, Matias F, Mendonca C, Neiva J, Rabacal C, Almeida AR, Caeiro D, Queiroz P, Silva G, Pop-Moldovan AL, Darabantiu D, Mercea S, Dan GA, Dan AR, Dobranici M, Popescu RA, Adam C, Sinescu CJ, Andrei CL, Brezeanu R, Samoila N, Baluta MM, Pop D, Tomoaia R, Istratoaie O, Donoiu I, Cojocaru A, Oprita OC, Rocsoreanu A, Grecu M, Ailoaei S, Popescu MI, Cozma A, Babes EE, Rus M, Ardelean A, Larisa R, Moisi M, Ban E, Buzle A, Filimon G, Dobreanu D, Lupu S, Mitre A, Rudzik R, Sus I, Opris D, Somkereki C, Mornos C, Petrescu L, Betiu A, Volcescu A, Ioan O, Luca C, Maximov D, Mosteoru S, Pascalau L, Roman C, Brie D, Crisan S, Erimescu C, Falnita L, Gaita D, Gheorghiu M, Levashov S, Redkina M, Novitskii N, Dementiev E, Baglikov A, Zateyshchikov D, Zubova E, Rogozhina A, Salikov A, Nikitin I, Reznik EV, Komissarova MS, Shebzukhova M, Shitaya K, Stolbova S, Larina V, Akhmatova F, Chuvarayan G, Arefyev MN, Averkov OV, Volkova AL, Sepkhanyan MS, Vecherko VI, Meray I, Babaeva L, Goreva L, Pisaryuk A, Potapov P, Teterina M, Ageev F, Silvestrova G, Fedulaev Y, Pinchuk T, Staroverov I, Kalimullin D, Sukhinina T, Zhukova N, Ryabov V, Kruchinkina E, Vorobeva D, Shevchenko I, Budyak V, Elistratova O, Fetisova E, Islamov R, Ponomareva E, Khalaf H, Shaimaa AA, Kamal W, Alrahimi J, Elshiekh A, Balghith M, Ahmed A, Attia N, Jamiel AA, 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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Hayes B, Vabistsevits M, Robinson T, Martin R, Lawlor D, Richmond R. Orienting causal relationships between sleep and adiposity traits using Mendelian randomisation. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Murphy C, Bray X, Martin R. Recruitment and organising 3rd year pharmacy undergraduates into summer placements in primary care in Southwest England. International Journal of Pharmacy Practice 2022. [DOI: 10.1093/ijpp/riac089.040] [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: 12/03/2022]
Abstract
Abstract
Introduction
Primary care is facing a workforce shortage, especially in Southwest England (SW).1 Funding for clinical pharmacist roles in GP has an impact on community pharmacy with pharmacists leaving to take up PCN positions.2 SW has higher rate of vacancies in than nationally.3 Oriel data showed that fill rate for split foundation training placements in GP is high, however, in SW is significantly low.
Aim
To increase recruitment of future pharmacists in SW by offering pharmacy undergraduates paid 5-week summer placements in GP or GP/community pharmacy partnership, gaining primary care experience, showcasing benefits of cross-sector working and encouraging development of partnerships for increased cross-sector training placements.
Objectives
Students enjoy SW area placement, Students recommend placement to other students, Students preference GP foundation placement, Supervisors express interest in a summer placement for 2022, Supervisors express interest in the GP split trainee pharmacist programme.
Methods
Expressions of interest (EOIs) sought from primary care placements in SW and 16 sites selected. Applicants shortlisted and interviewed online. 16 offered placements based on preference of location. Funding by HEE South reimbursed for student’s wages. Planning booklets provided to GPs, workbooks to students and online induction attended. During the placement, students completed an audit and case-based discussion, shadowed healthcare professionals, assisted administration and pharmacy tasks and practised basic procedural skills. Students attended end-of-placement event to share learning and sent questionnaire focusing on enjoyment of the placement and likelihood of returning to the Southwest and primary care for future employment. Supervisors sent questionnaire separately focusing on likelihood to partake in future. Questionnaires were sent, completed and analysed via Jisc. Ethics approval was not required.
Results
10 students and 11 supervisors completed the survey. 60% students enjoyed SW. 90% students would recommend placement to other students and 90% would like to see them in other areas. 70% students very likely to or definitely would apply for GP foundation placement. 63% supervisors benefitted from having a student and 81% would recommend having summer placement student. 55% supervisors would definitely EOI in future summer placement programme and 55% would definitely EOI in GP split foundation programme. 25% students chose GP/Community placements in SW, 18% other placements in SW, 12% GP placements in other regions. Oriel fill rates in SW increased from 36.67% in 2020 to 39.30% in 2021, GP/Community placements remained the same in 2021 at 28.2% and community placements increased in from 18.14% in 2020 to 18.75% in 2021.
Discussion/Conclusion
The students enjoyed their placements and would recommend to other students. Supervisors found having students useful and would have a student in the future. Although some students were successful in securing a placement in SW for foundation training, due to nature of Oriel it’s not possible to determine how many preferenced SW and GP split programme, this is a limitation to the evaluation. Oriel fill rates didn’t increase for SW community/GP placements as desired, however this was a very small cohort. This pilot will be repeated summer 2022 so fill rates can be evaluated in 2023.
References
1. NHS. The NHS Long Term Plan. Long Term Plan. [Online] 2019. Available from: https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf.
2. BMA. Investment and Evolution: A five year gramework for GP contract reform to implement the NHS long term plan. England NHS. [Online] 2019. Available from: https://www.england.nhs.uk/wp-content/uploads/2019/01/gp-contract-2019.pdf.
3. Community Pharmacy Workforce Development Group. A Review of the Community Pharmacy Workforce. Community Pharmacy Workforce. [Online] 2021. Available from: https://communitypharmacyworkforce.files.wordpress.com/2021/06/cpwdg-report-a-review-of-the-community-pharmacy-workforce-final.pdf.
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Mahon CM, Ryan M, Kennelly SM, Martin R. 204 DEDICATED NURSING HOME SERVICE IN A TERTIARY HOSPITAL: EFFECT ON ADMISSION NUMBERS AND LENGTH OF STAY. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In 2019 a dedicated Nursing Home (NH) in-patient service was established in a tertiary hospital, comprising a Consultant Geriatrician, clinical nurse specialist, NCHD and administrative support. All NH residents over 65 with medical diagnoses were admitted by the NH team who also provide a consult service for NH residents under other specialties.
Methods
Data were sourced from the Hospital Inpatient Enquiry system on length of stay of patients identified as admitted from a nursing home compared to those admitted under the NH team and their average lengths of stay over 2019-2021.
Results
In 2019, 749 NH residents were admitted to hospital with an average length of stay (ALOS) of 7.93 days, the NH inpatient service was established in July 2019 and showed a reduction of ALOS from 9.25 to 6.6 days in the 6 months following its establishment (29% difference.) In 2020, 707 NH residents were admitted with 352 admitted under the NH team. The ALOS of NH residents admitted under the NH team was 5.66 days in 2020 compared to 8.65 overall (35% difference.) In 2021, 765 NH residents were admitted with 402 under the NH team. ALOS of NH residents admitted under the NH team was 5.33 days in 2021 compared to 8.28 overall (36% difference.)
Conclusion
Within six months of its commencement the dedicated NH service had decreased length of stay by 29%. The average length of stay across all services has decreased year on year from 6.6 to 5.3 days from 2019 to 2021. The ALOS in the total cohort (including residents admitted surgically and those under 65) was 29-36% higher. Though difficult to accurately compare these cohorts due to different presenting diagnoses and medical backgrounds in those admitted surgically or those under 65, the overall reduction in length of stay over the three years does highlight the benefit from this dedicated service.
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Affiliation(s)
- CM Mahon
- Connolly Hospital, Blanchardstown , Dublin, Ireland
| | - M Ryan
- Connolly Hospital, Blanchardstown , Dublin, Ireland
| | - SM Kennelly
- Royal College of Surgeons Ireland , Dublin, Ireland
| | - R Martin
- Connolly Hospital, Blanchardstown , Dublin, Ireland
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Mahon CM, Dunne A, Garcia R, Martin R, Kennelly SM. 203 TRANSITIONS TO LONG-TERM CARE: EXPERIENCE OF A COHORT OF COMMUNITY-DWELLING OLDER ADULTS RECEIVING INTEGRATED CARE. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.175] [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
Data from the Nursing Home support scheme 2018 (NHSS) shows the majority of applications to the NHSS come from acute hospitals (44%) followed by referrals from the community (38%). We examined this transition in a cohort of community dwelling older adults to assess how many transition from home to nursing home and, when admission to nursing home from hospital occurred, the indications for same.
Methods
Retrospective examination of Integrated Care Team (ICT) and Acute Hospital data from 2019 in respect of a cohort of older adults. Transitions in care to nursing home including residence at time of admission, last acute hospital presentation prior to nursing home admission and commencement of NHSS application recorded.
Results
319 patients referred to the integrated care service in 2019, average age 81 and 58% female, predominantly from outpatient clinics in the Medicine for the Older Person’s service. 47 patients had moved to nursing home; within this cohort 14 (29.7%) transitioned from home, 28 (59.6%) transitioning after acute hospital admission. Main reasons for presentation to hospital were: Intercurrent acute illness (n=11); Falls (n=6); progression of dementia (n=4). Fair Deal application commenced in community by ICT in 20 of the 47 (42.5%) patients including 8 of 28 patients (28.5%) admitted to hospital prior to moving to nursing home.
Conclusion
This preliminary evaluation highlights the importance of advance care planning in this population when acute hospital admissions can be difficult to predict. Involvement of the ICT can help this transition and lead to shorter hospital stays.
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Affiliation(s)
- CM Mahon
- Connolly Hospital, Blanchardstown , Dublin, Ireland
| | - A Dunne
- Connolly Hospital, Blanchardstown , Dublin, Ireland
| | - R Garcia
- Connolly Hospital, Blanchardstown , Dublin, Ireland
| | - R Martin
- Connolly Hospital, Blanchardstown , Dublin, Ireland
| | - SM Kennelly
- Royal College of Surgeons Ireland , Dublin, Ireland
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Brar SK, Sheehan O, Martin R, Rasheed M. 160 A CLOSED-LOOP AUDIT EXAMINING THE USE OF PROPHYLACTIC ANTI-COAGULATION IN OLDER ADULTS ADMITTED TO A SPECIALIST GERIATRIC SERVICE. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.136] [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
Guidelines recommend prescription of Prophylactic Anticoagulation (PA) to all hospitalized older adults unless a contraindication exits. In many cases this does not happen at the time of admission increasing the risk of thromboembolic events. We aimed to assess the use of PA across the medicine for the geriatric service of a level 3 hospital (average daily census of service 120) then use quality improvement to achieve our goal of 95% prescription of prophylactic anticoagulation when appropriate.
Methods
Medication kardexes and clinical notes were reviewed to collect variables including age, length of stay, creatinine clearance, weight, mobility status, use and dose of antithrombotic medications and documentation of reason if not prescribed. Following initial data collection, cause and effect analysis was performed to identify reasons for under-prescription and small tests of change were conducted across 4 PDSA cycles before data collection was repeated.
Results
Initial data collection revealed that only 80% of older adults admitted to the service were receiving prophylactic anticoagulation. Cause and effect analysis identified many reasons for failure to prescribe PA including inadequate history taking, lack of clinician education and training, poor documentation, lack of handover between clinicians, failure to complete medication reconciliation on admission and lack of pharmacy support on some wards. Each of these contributory factors were addressed in turn. After a month of QI activities prescription of PA improved to 83% and by 3 months 98.1% (104/106) of patients were receiving PA with only 2 patients for whom PA was not prescribed without clear documentation of the reason.
Conclusion
Sustained quality improvement resulted in a culture change across our service improving rates of appropriate prescription of PA and raising the quality of care delivered to older adults. This model of quality improvement is now being replicated across our department to address other gaps in service delivery.
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Affiliation(s)
- SK Brar
- Connolly Hospital Royal College of Surgeons in Ireland Hospitals Group, , Dublin, Ireland
| | - O Sheehan
- Connolly Hospital Royal College of Surgeons in Ireland Hospitals Group, , Dublin, Ireland
| | - R Martin
- Connolly Hospital Royal College of Surgeons in Ireland Hospitals Group, , Dublin, Ireland
| | - M Rasheed
- Connolly Hospital Royal College of Surgeons in Ireland Hospitals Group, , Dublin, Ireland
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Aboushaar O, Martin R. An Unusual Case Of A Calcaneal Stress Fracture. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000879212.59460.b7] [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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Ndlovu N, Ochara NM, Martin R. Influence of digital government innovation on transformational government in resource-constrained contexts. JSTPM 2022. [DOI: 10.1108/jstpm-11-2021-0173] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this study was to examine the influence of digital government innovation on transformational government. Digital government innovation is ordinarily implemented as means for the creation of public value. However, realisation of benefits from the digital government platforms has proved to be a challenge, and great discrepancy has been observed in the extent of public value generated, pointing to lack of innovativeness in resource-constrained environments. This research investigates the influence of digital government ambidexterity as an innovation strategy in enhancing transformational government (T-Gov). The authors develop hypotheses relating to digital government ambidexterity with two factors of innovation for enhancing T-Gov: exploitation incremental digital innovation and exploration radical digital innovation.
Design/methodology/approach
The hypotheses are tested using a sample size of 690 citizens interacting through digital government platforms. The authors identify exploitation incremental digital innovation and exploration radical digital innovation as factors, and how these factors of digital government ambidexterity influence information quality for public value creation. The success of T-Gov is associated to the implementation of digital government policy which moderate the relationship between digital government ambidexterity and information quality.
Findings
The empirical outcomes suggest that exploitation incremental digital innovation and exploration radical digital innovation positively influence information quality, thereby leading to public value, and this result become successful if there is implementation of digital government policy. Treating the two factors of digital government innovation as complementary leads to public value creation.
Research limitations/implications
Limited time and funds to conduct a country comparative study. The study only focused on urban municipalities, of which it would be interesting to explore rural municipalities.
Practical implications
Adoption of MunINFORQUAL model for promoting digital government platform utilisation by citizens.
Social implications
The utilisation of digital government platforms would improve citizens’ lives in a number of ways. For instance, citizen municipal interaction for service delivery and social benefits through instant notifications of developmental projects.
Originality/value
This paper contributes to the research literature on digital government innovation particularly from resource-constrained environments. Also, the study provides new empirical test using a data set of 690 citizens interacting through digital government platforms.
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Ruperto N, Chertok E, Dehoorne J, Horneff G, Kallinich T, Louw I, Compeyrot-Lacassagne S, Lauwerys B, Martin N, Marzan K, Knibbe W, Martin R, Zhu X, Whelan S, Pricop L, Martini A, Lovell DJ, Brunner H. OP0221 EFFICACY OF SECUKINUMAB IN ENTHESITIS-RELATED ARTHRITIS: RESULTS FROM A RANDOMISED, DOUBLE-BLIND, PLACEBO-CONTROLLED, TREATMENT WITHDRAWAL, PHASE 3 STUDY (JUNIPERA). Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.126] [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: 11/04/2022]
Abstract
BackgroundEnthesitis-related Arthritis (ERA) is a category of juvenile idiopathic arthritis (JIA) characterised by heterogeneous and insidious manifestations comprising axial and/or peripheral arthritis, and enthesitis.1 Secukinumab (SEC) demonstrated efficacy and safety in both ERA and juvenile psoriatic arthritis (JPsA) in the JUNIPERA trial.2ObjectivesTo evaluate the rate of flare risk reduction and efficacy of SEC on axial and peripheral manifestations in patients (pts) with active ERA.MethodsERA pts (2 to <18 years of age) with active disease (both ≥3 active joints and ≥1 active enthesitis site) were included. In the open-label (OL) treatment-period (TP)1, s.c. SEC (75/150 mg in pts <50/ ≥50 kg) was administered at baseline (BL), and at Week (Wk) 1–4, 8 and 12. Pts who achieved at least JIA-ACR30 response at Wk 12 were randomised into the double-blinded TP2 to continue SEC or placebo (PBO) every 4 wk until a disease flare, or up to Wk 100. The primary endpoint was time to flare in ERA and JPsA pts. The juvenile spondyloarthritis disease activity Index (JSpADA) is a disease activity assessment tool that contains 8 items to measure axial and peripheral disease activity.3 Evaluation of axial and peripheral manifestations at the end of TP1 and TP2 in pts who experienced these symptoms at BL included modified Schober test (lumbar flexion), inflammatory back pain, FABER (Flexion, ABduction, External Rotation) test, JIA-ACR responses, Juvenile Arthritis Disease Activity Score (JADAS)-27, and resolution of enthesitis and dactylitis for peripheral disease. These outcomes were also used to assess JIA disease course at the end of TP2.ResultsA total of 52/86 (60.5%) pts with ERA were enrolled in the OL period TP1 (mean age, 13.7 years; male, 78.8%). In total, 51/52 (98.1%) pts completed TP1 and 41/44 (93.2%) completed TP2. At BL, mean JADAS-27 was 14.8, mean JSpADA index was 3.9, mean enthesitis and dactylitis counts were 2.7 and 0.4, respectively, mean number of active joints was 6.2 and of mean joints with limited range of motion 4.9. The relative risk reduction of experiencing a disease flare in TP2 was 55% (HR 0.45, 95% CI: 0.16–1.28, p=0.075) in ERA pts (Figure 1). The overall axial and peripheral disease symptoms improved over time and are presented in the Table 1. At the end of TP1, 84.6% (44/52) of pts achieved JIA-ACR 30 and 65.4% (34/52) achieved JIA-ACR 70. Clinically relevant reduction of functional ability as assessed by Childhood Health Assessment Questionnaire (CHAQ) also occurred (see Table 1).Table 1.Resolution of axial and peripheral disease symptoms and JIA ACR responses at the end of TP1 and 2Clinical response, mean (SD) change from BL (unless otherwise stated)TP1-Wk 12End of TP2*SEC (N=52)SEC (N=22)PBO (N=22)JSpADA index−2.4 (1.7)−2.7 (1.7)−2.3 (2.1)JSpADA Schöber, %58.3100.0100.0Inflammatory back pain, %77.8100.050.0FABER test, %52.6100.083.3Clinical sacroiliitis, %53.3100.050.0Enthesitis−2.2 (1.9)−2.5 (2.1)−1.3 (1.8)Dactylitis−0.2 (0.8)−0.2 (1)−0.1 (0.4)JIA ACR30, %84.690.968.2JIA ACR50, %78.881.868.2JIA ACR70, %65.468.254.5JIA ACR90, %32.745.550.0JIA ACR100, %26.936.445.5Inactive disease, %38.550.050.0CHAQ−0.5 (0.5)−0.6 (0.7)−0.4 (0.5)CRP, median (SD) change from BL−1.8 (38.7)−5.8 (38.3)0 (35.9)JADAS-27−9.6 (7.5)−11.0 (8.9)−7.6 (8.9)Resolution of enthesitis#, %72.378.683.3Resolution of dactylitis#, %5066.70*End of TP2 is based on individual pts’ last visit at TP2. #At BL, in TP1, enthesitis (n= 46); dactylitis (n=5). In TP2, no. of pts who had presence at BL and showed complete resolution at the end of TP2: enthesitis, SEC 14, PBO 18; dactylitis, SEC 3, PBO, 0. CRP, C-reactive proteinConclusionIn pts with ERA, SEC demonstrated longer time to disease flare vs PBO and exhibited rapid and sustained improvement of axial and peripheral manifestations up to Wk 104.References[1]Pagnini I, et al. Front Med 2021;8:6673052.[2]Brunner H, et al. Arthritis Rheumatol 2021;73 (suppl 10).[3]Weiss PF, et al. Arthritis Care Res 2014;66:1775-82.Disclosure of InterestsNicolino Ruperto Speakers bureau: Eli Lilly, GlaxoSmith and Kline, Pfizer, SOBI and UCB, Paid instructor for: Eli Lilly and Pfizer, Consultant of: Ablynx, Amgen, Astrazeneca-Medimmune, Aurinia, Bayer, Bristol Myers and Squibb, Cambridge Healthcare Research (CHR), Celegene, Domain therapeutic, Eli Lilly, EMD Serono, GlaxoSmith and Kline, Idorsia, Janssen, Novartis, Pfizer, SOBI and UCB, Grant/research support from: Bristol Myers and Squibb, Eli Lilly, F Hoffmann-La Roche, Novartis, Pfizer and SOBI, Elena Chertok: None declared, Joke Dehoorne Speakers bureau: Abbvie, Roche, Consultant of: Abbvie, Roche, Pfizer, Grant/research support from: Abbvie, Roche, Gerd Horneff Speakers bureau: Novartis, Pfizer, Janssen, Grant/research support from: Pfizer, Novartis, Roche, MSD, Tilmann Kallinich Speakers bureau: Roche, Ingrid Louw Speakers bureau: Pfizer, Abbvie, BMS, Consultant of: Pfizer, Abbvie, Janssen, Amgen and Cipla, Sandrine Compeyrot-Lacassagne: None declared, Bernard Lauwerys Employee of: UCB Pharma, Neil Martin: None declared, Katherine Marzan Grant/research support from: Novartis, Sanofi, William Knibbe Speakers bureau: Novartis, Amgen, UCB, Abbvie, Ruvie Martin Shareholder of: Novartis, Employee of: Novartis, Xuan Zhu Shareholder of: Novartis, Employee of: Novartis, sarah whelan Shareholder of: Novartis, Employee of: Novartis, Luminita Pricop Shareholder of: Novartis, Employee of: Novartis, Alberto Martini Speakers bureau: Aurinia, Bristol Myers and Squibb, Eli Lilly, EMD, Janssen, Pfizer, Roche and Serono, Consultant of: Aurinia, Bristol Myers and Squibb, Eli Lilly and EMD, Daniel J Lovell Consultant of: Astra Zeneca, Boehringer Ingelheim, GSK, Hoffman LaRoche, Novartis, UBC, Grant/research support from: Astra Zeneca, Boehringer Ingelheim, GSK, Hoffman LaRoche, Novartis, UBC, Hermine Brunner Consultant of: Novartis, Grant/research support from: Novartis
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Martin R, Vincent B, Olivier P, Marie-Agnès G, Ulricke S, François L. PO-1265 Title: DLCO decrease in a prospective cohort of VMAT-treated lung cancer patients (NCT03931356). Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03229-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bye T, Martin R. Static postural differences between male and female equestrian riders on a riding simulator. Comparative Exercise Physiology 2022. [DOI: 10.3920/cep210003] [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: 11/19/2022]
Abstract
This study aimed to compare static posture of male and female riders on a riding simulator. Ten female and five male riders underwent a 5 min standardised exercise programme on the simulator, they were then videoed for 10 s from each the left, right, and rear views whilst stationary on the simulator. Two-dimensional kinematic analysis of the videos showed that male riders had a more neutrally positioned pelvis in the sagittal plane (median left: 6.47°, right: 5.24°) with females demonstrating a posterior pelvic tilt (L: 14.04°, R: 13.55°). Females showed significantly greater pelvic obliquity (median female: 1.99°, male: 0.73°), trunk lean (F: 1.60°, M: 0.43°), and shoulder tilt (F: 1.79°, M: 0.57°) in the frontal plane, demonstrating an overall greater postural asymmetry. Previous studies of elite riders have shown a more anteriorly rotated pelvis to be more desirable. Symmetry of riding position is favourable as it allows movements to be performed with ease and ensures even force distribution through the saddle to the horse. Male riders may therefore have a biomechanical advantage over females when it comes to maintaining a desirable riding position. This research should now be extended to study riders on the horse in motion.
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Affiliation(s)
- T.L. Bye
- University Centre Bishop Burton, York Road, Bishop Burton, East Yorkshire, HU17 8QG, United Kingdom
- School of Sport, Health and Exercise Sciences, Loughborough University, Epinal Way, Loughborough, Leicestershire, LE11 3TU, United Kingdom
| | - R. Martin
- University Centre Bishop Burton, York Road, Bishop Burton, East Yorkshire, HU17 8QG, United Kingdom
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Martin R, Ambia AM, Holcomb DS, Wells C, Nambiar A, Roberts SW, McIntire DD, Harms M, Duryea EL, Nelson DB. Home Blood Pressure Monitoring in Women with Severe Hypertension Utilizing Audio-Only and In-Person Postpartum Encounters. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.11.391] [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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Lafferty A, Duryea EL, Martin R, Moseley L, Wafford M, McIntire DD, Spong CY, Nelson DB. A Prospective Study of Social Needs Associated with Mental Health Among Mothers Living in Poverty. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.11.979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Suarez JD, Snackey Alvarez K, Anderson S, King H, Kirkpatrick E, Harms M, Martin R, Adhikari E. Decreasing Chlamydial Reinfections in a Female Urban Population. Sex Transm Dis 2021; 48:919-924. [PMID: 34117187 PMCID: PMC8594511 DOI: 10.1097/olq.0000000000001500] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/04/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chlamydia is the most reported bacterial sexually transmitted infection (STI). The rates of chlamydia rose by 19% between 2011 and 2018. The STI National Strategic Plan (2021-2025), encourages coordinated solutions to address STIs and reduce disparities in disadvantaged populations. METHODS We implemented institutional policy changes, clinical decision support, including a Best Practice Advisory, and defaulted SmartSet with provider and patient education for women's health clinics at a large county health system. The advisory prompted providers to follow best practices when treating Chlamydia trachomatis infections. New C. trachomatis diagnosis cohorts were compared preintervention and postintervention for 6-month reinfection rates and patient and expedited partner treatment (EPT) practices. RESULTS Five hundred and nineteen women were included in the final analysis. Six-month chlamydia reinfection was lower in the postintervention cohort after adjusting for age (12.3% [26/211] vs 6.5% [20/308], P = 0.02). There was an increase in directly observed therapy of primary patients (17.5% [37/211] vs 77.3% [238/308], P < 0.001), an increase in EPT prescriptions written (4.3% [9/211] vs 79.5% [245/308], P < 0.0001), and a decrease of partners referred out for treatment (61.6% [130/211] vs 5.2% [16/308], P < 0.001) when compared with the control group. The majority of EPT was patient-delivered partner therapy postintervention (3.3% [7/211] vs 69.2% [213/308], P < 0.001). CONCLUSIONS A multifaceted, streamlined approach was effective in changing provider practices in the treatment of C. trachomatis. Increased rates of directly observed therapy for primary patient treatment and increased rates of patient-delivered partner therapy were observed postimplementation in addition to lower 6-month reinfection rates in a public women's health clinic setting.
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Affiliation(s)
| | - Kristin Snackey Alvarez
- Center for Innovation and Value, Parkland Health & Hospital System
- Division of Infectious Diseases, Department of Internal Medicine
| | | | - Helen King
- Division of Infectious Diseases, Department of Internal Medicine
| | | | - Michael Harms
- Center for Innovation and Value, Parkland Health & Hospital System
| | - Robert Martin
- Center for Innovation and Value, Parkland Health & Hospital System
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Emily Adhikari
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of Texas Southwestern Medical Center, Dallas, TX
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McDuffie E, Martin R, Yin H, Brauer M. Global Burden of Disease from Major Air Pollution Sources (GBD MAPS): A Global Approach. Res Rep Health Eff Inst 2021; 2021:1-45. [PMID: 36148817 PMCID: PMC9501767] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
Ambient fine particulate matter (particles <2.5 μm in aerodynamic diameter [PM2.5]) is the world's leading environmental health risk factor. Reducing the PM2.5 disease burden requires specific strategies that target dominant sources across multiple spatial scales. The Global Burden of Disease from Major Air Pollution Sources (GBD MAPS) project provides a contemporary and comprehensive evaluation of contributions to the ambient PM2.5 disease burden from source sectors and fuels across 21 regions, 204 countries, and 200 subnational areas. We first derived quantitative contributions from 24 emission sensitivity simulations using an updated global atmospheric chemistry-transport model, input with a newly developed detailed anthropogenic emissions dataset that includes emissions specific to source sector and fuels. These simulation results were integrated with newly available high-resolution satellite-derived PM2.5 exposure estimates and disease-specific concentration-response relationships consistent with the GBD project to quantify contributions of specific source sector and fuel to the ambient PM2.5 disease burden across all regions, countries, and subnational areas. To improve the transparency and reproducibility of this and future work, we publicly provided the global atmospheric chemistry-transport model source code, emissions dataset and emissions model source code, analysis scripts, and source sensitivity results, and further described the emissions dataset and source contribution results in two publications. We found that nearly 1.05 million (95% uncertainty interval [UI]: 0.74-1.36 million) deaths worldwide (27.3% of the total mortality attributable to PM2.5) would be avoidable by eliminating fossil fuel combustion, with coal contributing over half of that burden. Residential (19.2%; 736,000 deaths [95% UI: 521,000-955,000]), industrial (11.7%; 448,000 deaths [95% UI: 318,000-582,000]), and energy (10.2%; 391,000 deaths [95% UI: 277,000-507,000]) sector emissions are among the dominant global sources Uncertainty in these estimates reflects those of the input datasets. Regions with the largest anthropogenic contributions generally have the highest numbers of attributable deaths, which clearly demonstrates the importance of reducing these emissions to realize reductions in global air pollution and its disease burden.
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Affiliation(s)
- E McDuffie
- Washington University in St. Louis, St. Louis, Missouri, U.S.A
| | - R Martin
- Washington University in St. Louis, St. Louis, Missouri, U.S.A
- co-principal investigator
| | - H Yin
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - M Brauer
- The University of British Columbia, Vancouver, British Columbia, Canada
- co-principal investigator
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Rahmani M, Ortiz-Toquero S, Martin R. Referral pattern and co-management of keratoconus patients in primary eye care: A survey of three European countries. Cont Lens Anterior Eye 2021; 45:101518. [PMID: 34772626 DOI: 10.1016/j.clae.2021.101518] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To explore current primary care practices in keratoconus management in Portugal and compare with previous reported results in two European countries (the UK and Spain), with a special focus on interdisciplinary collaboration and referral practice patterns. METHODS An online survey adapted to European professional practice was distributed (via newsletters) by the Portuguese Optometrist Association to explore keratoconus patient management and referral practice patterns among Portuguese practitioners. RESULTS Responses of 119 optometrists were compared with previous reported of 464 eye-care practitioners (126 in the UK and 338 in Spain). Most respondents (79% in Portugal, 71% in the UK and 76% in Spain; p = 0.31) had < 5 new keratoconus patients each year. No accepted referral criterion was found (p < 0.01) because small number of the respondents (14%) in Portugal referred out at initial diagnosis (50% in the UK and Spain); 32% referred out when progression was detected (17% in the UK and 30% in Spain); and a minority (10% in Portugal, 9% in the UK, and 6% in Spain) referred out when visual acuity was affected. A majority of respondents (83%) in Portugal reported no co-management with ophthalmologists (60% in the UK and 73% in Spain; p < 0.01). CONCLUSION The results of this study suggest that it is necessary to encourage interdisciplinary collaboration between practitioners to improve referral of patients with suspected keratoconus to an ophthalmology specialist to change the course of this disease, to reduce keratoconus progression and visual acuity impairment and to minimize the impact of this disease on patients' quality of life.
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Affiliation(s)
- M Rahmani
- Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA), Paseo de Belén 17 - Campus Miguel Delibes, 47011 Valladolid, Spain
| | - S Ortiz-Toquero
- Ramón y Cajal Hospital, Department of Ophthalmology, Ctra. Colmenar Viejo, Km. 9, 28034 Madrid, Spain
| | - R Martin
- Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA), Paseo de Belén 17 - Campus Miguel Delibes, 47011 Valladolid, Spain; Universidad de Valladolid, Departamento de Física Teórica, Atómica y Óptica. Paseo de Belén, 7 - Campus Miguel Delibes, 47011 Valladolid, Spain; Optometry Research Group, IOBA Eye Institute. School of Optometry, University of Valladolid. Valladolid, Spain; Faculty of Health and Human Sciences, Plymouth University, Derriford Road, PL6 8BH Plymouth, United Kingdom.
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Vazquez F, Marrufo O, Solis-Najera SE, Martin R, Rodriguez AO. External Waveguide Magnetic Resonance Imaging for lower limbs at 3 T. Med Phys 2021; 49:158-168. [PMID: 34633673 DOI: 10.1002/mp.15281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/01/2021] [Accepted: 09/21/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION We report a method based on the travelling-wave MRI approach, in order to acquire images of human lower limbs with an external waveguide at 3 T. METHOD We use a parallel-plate waveguide and an RF surface coil for reception, while a whole-body birdcage is used for transmission. The waveguide and the surface coil are located right outside the magnet, in the MR conditional devices zone. We ran numerical simulations to investigate the B1 field generated by the surface coil located at one of the waveguides, as well as a saline-solution phantom positioned on the opposite side (150 cm away) inside the magnet. RESULTS We obtained phantom images by varying the distance between the coil and the phantom, in order to investigate the signal-to-noise ratio and to validate our numerical simulations. Lower limb images of a healthy volunteer were also acquired, demonstrating the viability of this approach. Standard pulse sequences were used and no physical modifications were made to the MR imager. CONCLUSIONS These numerical and experimental results show that travelling-wave MRI can produce high-quality images with only a simple waveguide and an RF coil located outside the magnet. This can be particularly favorable when acquiring images of lower limbs requiring a larger field of view.
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Affiliation(s)
- F Vazquez
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - O Marrufo
- Department of Neuroimage, Instituto Nacional de Neurologia y Neurocirugia MVS, Mexico City, 14269, Mexico
| | - S E Solis-Najera
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - R Martin
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - A O Rodriguez
- Department of Electrical Engineering, Universidad Autonoma Metropolitama Iztapalapa, Mexico City, 09340, Mexico
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Swain A, Martin R, Vignesh KR, Rajaraman G, Murray KS, Langley SK. Enhancing the barrier height for magnetization reversal in 4d/4f RuIII2LnIII2 "butterfly" single molecule magnets (Ln = Gd, Dy) via targeted structural alterations. Dalton Trans 2021; 50:12265-12274. [PMID: 34519749 DOI: 10.1039/d1dt01770e] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A series of 4d-4f {RuIII2DyIII2} and {RuIII2GdIII2} 'butterfly' (rhombohedral) complexes have been synthesized and characterized and their magnetic properties investigated. Earlier, we have reported the first 4d/4f SMM - [RuIII2DyIII2(OMe)2(O2CPh)4(mdea)2(NO3)2] (1Dy) with a Ueff value of 10.7 cm-1. As the structural distortion around the DyIII centres and the RuIII⋯DyIII exchange interactions are key to enhancing the anisotropy, in this work we have synthesised three more {Ru2Dy2} butterfly complexes where structural alteration around the DyIII centres and alterations to the bridging groups are performed with an aim to improve the magnetic properties. The new complexes reported here are [Ru2Dy2(OMe)2(O2C(4-Me-Ph)4(mdea)2(MeOH)4], 2Dy, [Ru2Dy2(OMe)2(O2C(2-Cl,4,5-F-Ph)4(mdea)2(NO3)2], 3Dy, and an acac derivative [Ru2Dy2(OMe)2(acac)4(NO3)2(edea)2], 4Dy, where acac- = acetylacetonate, edea2- = N-ethyldiethanolamine dianion. Complex 2Dy describes alteration in the DyIII centers, while complexes 3Dy and 4Dy are aimed to alter the RuIII⋯DyIII exchange pathways. To ascertain the 4d-4f exchange, the Gd-analogues of 1Dy and 4Dy were synthesised [Ru2Gd2(OMe)2(O2CPh)4(mdea)2(NO3)2], 1Gd, [Ru2Gd2(OMe)2(acac)4(NO3)2(edea)2], 4Gd. Both ac and dc susceptibility studies were performed on all these complexes, and out-of-phase signals were observed for 3Dy in zero-field while 2Dy and 4Dy show out-of-phase signals in the presence of an applied field. Complex 3Dy reveals a barrier height Ueff of 45 K. To understand the difference in the magnetic dynamic behavior compared to our earlier reported {RuIII2DyIII2} analogue, detailed theoretical calculations based on ab initio CASSCF/RASSI-SO calculations have been performed. Calculations reveal that the JRu⋯Dy value varies from -1.8 cm-1 (4Dy) to -2.4 cm-1 (3Dy). These values are also affirmed by DFT calculations performed on the corresponding GdIII analogues. The origin of the largest barrier and observation of slow magnetic relaxation in 3Dy is routed back to the stronger single-ion anisotropy and stronger JRu⋯Dy exchange which quenches the QTM effects more efficiently. This study thus paves the way forward to tune local structure around the LnIII center and the exchange pathway to enhance the SMM characteristics in other {3d-4f}/{4d-4f} SMMs.
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Affiliation(s)
- Abinash Swain
- Department of Chemistry, Indian Institute of Technology Bombay, Mumbai-400076, India.
| | - Robert Martin
- School of Science and the Environment, Division of Chemistry, Manchester Metropolitan University, Manchester, M15 6BH, UK.
| | - Kuduva R Vignesh
- Department of Chemistry, Indian Institute of Technology Bombay, Mumbai-400076, India.
| | - Gopalan Rajaraman
- Department of Chemistry, Indian Institute of Technology Bombay, Mumbai-400076, India.
| | - Keith S Murray
- School of Chemistry, 17 Rainforest Walk, Monash University, Clayton, Victoria 3800, Australia.
| | - Stuart K Langley
- School of Science and the Environment, Division of Chemistry, Manchester Metropolitan University, Manchester, M15 6BH, UK.
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Prost A, Handel T, Rothmaler K, Schreiber M, Martin R, Urban D, Geisler D, Lippmann S, JB T, Iacovazzi D, Claßen J, Ivanova G, Michalski D. Der PostStroke-Manager: Entwicklung eines eHealth-basierten und durch Schlaganfalllotsen unterstützen Schlaganfallnachsorge-Konzepts. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732742] [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: 10/20/2022]
Affiliation(s)
- A Prost
- Klinik und Poliklinik für Neurologie, Universität Leipzig/Medizinische Fakultät
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Leipzig
| | - T Handel
- Institut für Angewandte Informatik (InfAI)
| | - K Rothmaler
- Institut für Angewandte Informatik (InfAI)
- Max-Planck-Institut für Kognitions- und Neurowissenschaften
| | | | - R Martin
- Institut für Angewandte Informatik (InfAI)
| | - D Urban
- Klinik und Poliklinik für Neurologie, Universität Leipzig/Medizinische Fakultät
| | - D Geisler
- Klinik und Poliklinik für Neurologie, Universität Leipzig/Medizinische Fakultät
| | - S Lippmann
- Selbstständige Abteilung für Allgemeinmedizin, Universität Leipzig
| | - Tylcz JB
- Institut für Angewandte Informatik (InfAI)
| | | | - J Claßen
- Klinik und Poliklinik für Neurologie, Universität Leipzig/Medizinische Fakultät
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Leipzig
| | - G Ivanova
- Institut für Angewandte Informatik (InfAI)
- Innovation Center Computer Assisted Surgery (ICCAS), Universität Leipzig/Medizinische Fakultät
| | - D Michalski
- Klinik und Poliklinik für Neurologie, Universität Leipzig/Medizinische Fakultät
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Leipzig
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Murtagh E, Shalash A, Martin R, Abu Rmeileh N. Measurement and prevalence of adult physical activity levels in Arab countries. Public Health 2021; 198:129-140. [PMID: 34418764 DOI: 10.1016/j.puhe.2021.07.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/14/2021] [Accepted: 07/09/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVES This study aims to examine the reported prevalence of sufficient physical activity among adults in Arab countries and to determine the use of validated instruments for assessing physical activity. STUDY DESIGN This is a systematic literature review. METHODS This review follows recommendations outlined in the Meta-Analysis of Observational Studies in Epidemiology guidelines. The protocol for this study was preregistered with PROSPERO. Cross-sectional, cohort and intervention studies with a minimum of 300 adults aged ≥18 years assessing physical activity using a questionnaire or other self-report measure in the Arabic language were identified from seven electronic databases (MEDLINE, Embase, Cochrane Database of Systematic Reviews, CINAHL, PsycINFO, SPORTDiscu and PubMed). Databases were searched from 1st January 2008 to 17th September 2018. Descriptive analysis was performed using frequency and percentages. The prevalence of physical activity was calculated as the average prevalence for the reported percentages from the studies with similar tools. RESULTS Fifty studies involving 298,242 participants were included in this review. The mean (range) sample size was 5964.8.1 (323-197,681). Data were collected from participants in 16 of the 22 Arab countries. Great variation exists across the studies in determining whether adults were sufficiently active or not. Twenty studies reported usable data from the Global Physical Activity Questionnaire and the International Physical Activity Questionnaire (moderate & high categories). In these studies, prevalence of physical activity ranged from 34.2 to 96.9%. It was not possible to compare the other studies owing to variation in instruments used to assess physical activity and in the case definition used for 'physically active'. CONCLUSIONS This study highlights the need for wider reporting of physical activity and the adoption of valid and reliable instruments to support the development of evidence-informed policy and programmes at both country and regional level. International tools need to be correctly validated, or context-specific tools must be developed to accurately measure physical activity.
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Affiliation(s)
- E Murtagh
- Department of Physical Education and Sport Sciences, University of Limerick, Ireland; Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Ireland.
| | - A Shalash
- Institute of Community and Public Health, Birzeit University, Palestine; School of Medicine, University of Limerick, Ireland
| | - R Martin
- Mary Immaculate College, Limerick, Ireland
| | - N Abu Rmeileh
- Institute of Community and Public Health, Birzeit University, Palestine
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Goupille P, Behrens F, Coates LC, Gratacos-Masmitja J, Mease PJ, Gladman DD, Nash P, Kavanaugh A, Martin R, Bao W, Gaillez C, Mcinnes I. POS1044 EFFECT OF SECUKINUMAB VERSUS ADALIMUMAB ON ACR CORE COMPONENTS AND HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH PSORIATIC ARTHRITIS: RESULTS FROM THE EXCEED STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1562] [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: 11/03/2022]
Abstract
Background:EXCEED (NCT02745080) was the first fully blinded head-to-head trial to evaluate the efficacy and safety of secukinumab (SEC) versus (vs) adalimumab (ADA) monotherapy in patients with active psoriatic arthritis (PsA) with a primary endpoint of American College of Rheumatology (ACR) 20 at Week 52. Although SEC narrowly missed statistical significance for superiority vs ADA, numerically higher response for other musculoskeletal endpoints and composite indices were observed with SEC.1Objectives:To explore the effect of SEC and ADA on ACR core components, function and Health-related Quality of Life (HRQoL) outcomes.Methods:Patients were randomised 1:1 to receive SEC 300 mg (N=426) subcutaneous (s.c.) at baseline, Week 1-4, followed by every 4 weeks until Week 48 or ADA 40 mg (N=427) s.c. at baseline followed by same dosing every 2 weeks until Week 50. The primary, key secondary and some exploratory endpoints at Week 52 were previously reported.1 A supportive analysis for ACR50 response using logistic regression model and trimmed means model for Health Assessment Questionnaire-Disability Index (HAQ-DI) with gender and smoking status as factors was performed to adjust for imbalances in baseline characteristics. An exploratory analysis of ACR core components with SEC vs ADA at Week 52 was conducted using a mixed-effects repeated measures model that included tender and swollen joint counts, patient and physician global assessment, PsA pain (VAS) and erythrocyte sedimentation rate. HRQoL variables were also exploratory and assessed based on Short Form Health Survey Physical/Mental Component Summary (SF-36 PCS/MCS) scores and Dermatology Life Quality Index (DLQI).Results:The demographic and baseline disease characteristics were comparable across treatment groups, except for an imbalance in sex (females: 51.2% vs 46.4%) and smoking status (yes: 21.8% vs 17.8%) in SEC and ADA group, respectively. At Week 52, ACR50 responses were 49.0% and 44.8% (P=0.0929) and HAQ-DI mean change from baseline were −0.69 and −0.58 (P=0.0314) in SEC and ADA treatment groups, respectively after adjusting for gender and smoking status. No major difference across ACR core components was observed in both treatment groups at Week 52 (Table 1). At Week 52, SEC presented similar improvement in SF-36 PCS/MCS score and numerically higher improvement in DLQI compared to ADA (Figure 1).Conclusion:Secukinumab provided similar improvements in ACR core components and SF-36 based quality of life at Week 52 with adalimumab. Greater improvement in HAQ-DI response and DLQI was demonstrated with secukinumab compared to adalimumab.References:[1]McInnes IB, et al. Lancet. 2020; 395:1496–505.Table 1.ACR Core Components at Week 52VariablesSecukinumab 300 mg(N=426)Adalimumab 40 mg(N=427)P-valueBL, mean ± SELSM change from BL ± SEBL, mean ± SELSM change from BL ± SETender joint score(based on 78 joints)19.4 ± 13.86−14.27 ± 0.4420.6 ± 14.81−13.90 ± 0.450.5549Swollen joint score(based on 76 joints)9.7 ± 7.30−8.41 ± 0.1910.2 ± 7.86−8.06 ± 0.200.1962Patients global assessment64.0 ± 19.67−33.81 ± 1.1461.9 ± 20.75−31.61 ± 1.190.1825Physicians global assessment60.0 ± 17.12−46.24 ± 0.8061.4 ± 15.92−43.63 ± 0.840.0243Psoriatic arthritis pain (VAS)58.6 ± 23.49−30.21 ± 1.1857.9 ± 22.42−29.44 ± 1.230.6500Erythrocyte sedimentation rate (mm/h)23.8 ± 18.93−9.63 ± 0.6223.9 ± 17.99−9.28 ± 0.640.7029LS mean and nominal P-values are from a mixed-effects repeated measures model with treatment group, analysis visit as factors, weight and BL score as covariates, and by treatment and BL score as interaction terms, unstructured covariance structure. ACR, American College of Rheumatology; BL, baseline; LSM, least squares mean; N, total number of randomised patients; SE, standard error; VAS, visual analogue scaleFigure 1.HRQoL Analysis at Week 52Disclosure of Interests:Philippe Goupille Speakers bureau: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Janssen, Eli Lilly, Medac, MSD, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Consultant of: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Janssen, Eli Lilly, Medac, MSD, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Grant/research support from: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Janssen, Eli Lilly, Medac, MSD, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Frank Behrens Paid instructor for: Eli Lilly, Consultant of: Pfizer, AbbVie, Sanofi, Eli Lilly, Novartis, Genzyme, Boehringer Ingelheim, Janssen, MSD, Celgene, Roche and Chugai, Grant/research support from: Pfizer, Janssen, Chugai, Celgene and Roche, Laura C Coates Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Biogen, BMS, Celgene, Domain, Eli Lilly, Gilead, GSK, Janssen, Medac, Novartis, Pfizer, Serac and UCB, Grant/research support from: AbbVie, Amgen, Celgene, Eli Lilly, Janssen, Novartis, Pfizer and UCB, Jordi Gratacos-Masmitja Speakers bureau: AbbVie, Amgen, BMS, Celgene, Janssen, Eli Lilly, Novartis and Pfizer, Consultant of: AbbVie, Amgen, BMS, Celgene, Janssen, Eli Lilly, Novartis and Pfizer, Grant/research support from: AbbVie, Amgen, BMS, Celgene, Janssen, Eli Lilly, Novartis and Pfizer, Philip J Mease Speakers bureau: AbbVie, Amgen, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Boehringer Ingelheim, Galapagos, Celgene, Genentech, Gilead, Janssen, Eli Lilly, Novartis, Pfizer, SUN Pharma, and UCB, Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Galapagos, Genentech, Gilead, Janssen, Eli Lilly, Merck, Novartis, Pfizer, SUN Pharma, and UCB, Dafna D Gladman Consultant of: Amgen, AbbVie, BMS, Celgene, Eli Lilly, Gilead, Galapagos, Janssen, Novartis, Pfizer and UCB, Grant/research support from: Amgen, AbbVie, Celgene, Eli Lilly, Janssen, Novartis, Pfizer and UCB, Peter Nash Speakers bureau: Novartis, Abbvie, Roche, Pfizer, BMS, Janssen, Celgene, UCB, Eli Lilly, MSD, Sanofi, Gilead, Consultant of: Novartis, Abbvie, Roche, Pfizer, BMS, Janssen, Celgene, UCB, Eli Lilly, MSD, Sanofi, Gilead, Grant/research support from: Novartis, Abbvie, Roche, Pfizer, BMS, Janssen, Celgene, UCB, Eli Lilly, MSD, Sanofi, Gilead, Arthur Kavanaugh Consultant of: AbbVie, Amgen, Celgene, Eli Lilly, Janssen, Novartis, and UCB, Grant/research support from: AbbVie, Amgen, Celgene, Eli Lilly, Janssen, Novartis, and UCB, Ruvie Martin Shareholder of: Novartis, Employee of: Novartis, Weibin Bao Shareholder of: Novartis, Employee of: Novartis, Corine Gaillez Shareholder of: Novartis and BMS, Employee of: Novartis, Iain McInnes Speakers bureau: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Janssen, Eli Lilly, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Janssen, Eli Lilly, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Janssen, Eli Lilly, Novartis, Pfizer, and UCB.
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Vlachos K, Denis A, Kitamura T, Takigawa M, Frontera A, Martin R, Bourier F, Martin CA, Cheniti G, Pambrun T, Sacher F, Hocini M, Haissaguerre M, Jais P, Derval N. The role of marshall bundle epicardial connections in atrial tachycardias after atrial fibrillation ablation. Europace 2021. [DOI: 10.1093/europace/euab116.096] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Atrial tachycardias (ATs) are often seen in the context of AF ablation.
Objectives
We evaluated the role of the Marshall bundle (MB) network in left atrial (LA) ATs using high-density high-spatial resolution 3D mapping.
Methods
199 post-AF ablation LA tachycardias were mapped in 140 consecutive patients (112 (80%) males, mean age: 61.8 years); 133 (66.8%) were macro-reentrant and 66 (33.2%) were scar-related re-entry. MB-dependent perimitral AT (PMAT) was diagnosed where the difference between the post pacing interval and the tachycardia cycle length (PPI-TCL) was <20ms in parts of the expected MB-dependent perimitral circuit (within the VOM, the ridge between the left pulmonary veins and LA appendage (LAA), the anterior LA and between 6- and 11-o’clock of the mitral annulus) and the PPI-TCL was >20ms in areas bypassed by the VOM (the distal coronary sinus (CS), the posterior LA and the mitral isthmus). MB-related re-entry was diagnosed by PPI-TCL <20ms at the left lateral ridge, posterior base of LAA, inferolateral LA or VOM ostium; and PPI-TCL >20ms in the septal annulus. Typically, in MB-dependent localized re-entry, the earliest activation was found along the MB-LA endocardial connection or MB-CS epicardial connection.
Results
The MB network was found to participate in 60 (30.2%) re-entrant ATs, 31 PMATs and 29 localized re-entries. High-frequency multiphasic fragmented electrograms with long duration were often recorded endocardially or epicardially at the MB-LA or MB-CS connections. The amplitude and duration of these signals were 0.5 ± 0.79 mV and 65 ± 40 ms for MB-PMATs and 0.26 ± 0.28mV and 122 ± 67 ms for MB-localized re-entries. Unipolar EGMs at the site of endocardial-epicardial breakthrough had a rS pattern in all MB-related ATs. Of 60 MB-related ATs, 49 (81.6%) terminated with RF ablation, 44 (73.3%) at the MB-LA junction and 5 (8.3%) at the MB-CS junction, while 9 (15%) terminated after 2.5-5 cc of alcohol infusion inside the vein of Marshall (VOM). Of the 31 MB-related macroreentrant ATs, 17 (54.8%) terminated at the MB-LA junction, 5 (16.1%) at the MB-CS junction and 7 (22.6%) with alcohol infusion inside the VOM. Two macroreentries (6.5%) using the MB did not terminate with RF energy either endocardially at the MB-LA junction or epicardially at the MB-CS junction, and we were unable to identify or cannulate the VOM for ethanol infusion. Of the 29 localized re-entrant ATs using the MB, 27 (93.1%) terminated at the MB-LA junction, none terminated at the MB-CS junction and 2 (6.9%) terminated after alcohol infusion. After a mean follow up of 12 months, only 4 patients (6.7%) had AT recurrence.
Conclusions
MB re-entrant ATs accounted for up to 29% of the left ATs after AF ablation. Ablation of the MB-LA or CS-MB connections or alcohol infusion inside the VOM is required to treat these arrhythmias. Abstract Figure.
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Affiliation(s)
- K Vlachos
- University of Bordeaux, Bordeaux, France
| | - A Denis
- University of Bordeaux, Bordeaux, France
| | - T Kitamura
- University of Bordeaux, Bordeaux, France
| | - M Takigawa
- University of Bordeaux, Bordeaux, France
| | - A Frontera
- University of Bordeaux, Bordeaux, France
| | - R Martin
- University of Bordeaux, Bordeaux, France
| | - F Bourier
- University of Bordeaux, Bordeaux, France
| | - CA Martin
- University of Bordeaux, Bordeaux, France
| | - G Cheniti
- University of Bordeaux, Bordeaux, France
| | - T Pambrun
- University of Bordeaux, Bordeaux, France
| | - F Sacher
- University of Bordeaux, Bordeaux, France
| | - M Hocini
- University of Bordeaux, Bordeaux, France
| | | | - P Jais
- University of Bordeaux, Bordeaux, France
| | - N Derval
- University of Bordeaux, Bordeaux, France
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Semelka C, Seachrist K, Semelka C, Martin R, Miller D, Provchy J, Shada V. Improving Transitions of Care After Discharge from Skilled Nursing Facility. J Am Med Dir Assoc 2021; 22:B14. [PMID: 34287152 DOI: 10.1016/j.jamda.2021.01.032] [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: 10/22/2022]
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Vazquez F, Solis-Najera SE, Lazovic J, Zopf LM, Martin R, Medina L, Marrufo O, Rodriguez AO. Remote RF excitation for small-bore MR imager at 15.2 T. J Magn Reson 2021; 323:106896. [PMID: 33412512 DOI: 10.1016/j.jmr.2020.106896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/09/2020] [Accepted: 12/16/2020] [Indexed: 06/12/2023]
Abstract
We report a method for remote excitation of the RF signal for preclinical-equivalent ultra high field Magnetic Resonance Imaging (MRI). A parallel-plate waveguide together with a bio-inspired surface coil were used to perform remote excitation experiments to acquire images with a small-bore MR imager at 15.2 T. The imager bore size limits the RF coil transmitter dimensions, so the Gielis super-formula was used to design an RF coil with small dimensions. Electromagnetic simulations of the principal mode were run to study the waveguide filled with air and loaded with a saline solution-filled tube. Radiation patterns were also computed in a semi-anechoic chamber for the same scenarios as above. A saline solution-filled spherical phantom and a formaldehyde-fixed mouse phantom were used to acquire images. Radiation patterns showed an omnidirectional distribution with no side lobes, and a very smooth behaviour with almost no loss of information in the saline solution-filled tube and without. The theoretical wave impedance was calculated and compared with simulated results showing an excellent correspondence. Spherical phantom image data and simulation results of B1 were contrasted and showed an important correlation. Ex vivo mouse images were of high quality and exhibited clear delineation of anatomical structures. These imaging results are in very good agreement with the simulations. Numerical, theoretical and experimental results validate this approach, using a bio-inspired surface coil with a simple waveguide for preclinical small-bore MRI at ultra high field.
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Affiliation(s)
- F Vazquez
- Departamento de Física, Facultad de Ciencias, Universidad Nacional Autónoma de México, CdMx 04510, Mexico
| | - S E Solis-Najera
- Departamento de Física, Facultad de Ciencias, Universidad Nacional Autónoma de México, CdMx 04510, Mexico
| | - J Lazovic
- Campus Science Support Facilities GmbH, Vienna 1030, Austria
| | - L M Zopf
- Campus Science Support Facilities GmbH, Vienna 1030, Austria
| | - R Martin
- Departamento de Física, Facultad de Ciencias, Universidad Nacional Autónoma de México, CdMx 04510, Mexico
| | - L Medina
- Departamento de Física, Facultad de Ciencias, Universidad Nacional Autónoma de México, CdMx 04510, Mexico
| | - O Marrufo
- Department of Neuroimage, Instituto Nacional de Neurologia y Neurociruga MVS, CdMx 14269, Mexico
| | - A O Rodriguez
- Department of Electrical Engineering, Universidad Autonoma Metropolitana Iztapalapa, CdMx 09340, Mexico.
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Antony P, Fournel S, Zoll J, Mantz JM, Befort K, Massotte D, Giégé P, Céraline J, Metzger D, Becker H, Drouard L, Florentz C, Martin R, Nébigil C, Potier S, Schaefer A, Schaeffer E, Schuster C, Bresson A, Quéméneur E, Choulier L, Matt N, Monassier L, Lugnier C, Freysz L, Hoffmann J, Dreyfus H, Romier C. La Société de Biologie de Strasbourg : 100 ans au service de la science et de la société. Biol Aujourdhui 2020; 214:137-148. [PMID: 33357372 DOI: 10.1051/jbio/2020018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Indexed: 11/14/2022]
Abstract
Founded in 1919, the Society of Biology of Strasbourg (SBS) is a learned society whose purpose is the dissemination and promotion of scientific knowledge in biology. Subsidiary of the Society of Biology, the SBS celebrated its Centenary on Wednesday, the 16th of October 2019 on the Strasbourg University campus and at the Strasbourg City Hall. This day allowed retracing the various milestones of the SBS, through its main strengths, its difficulties and its permanent goal to meet scientific and societal challenges. The common thread of this day was the transmission of knowledge related to the past, the present, but also the future. At the start of the 21st century, the SBS must continue to reinvent itself to pursue its objective of transmitting scientific knowledge in biology and beyond. Scientific talks performed by senior scientists and former SBS thesis prizes awardees, a round table, and informal discussions reflected the history and the dynamism of the SBS association. All SBS Centennial participants have set the first milestone for the SBS Bicentennial.
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Affiliation(s)
- Pierre Antony
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Sylvie Fournel
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Joffrey Zoll
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Jean-Marie Mantz
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Katia Befort
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Dominique Massotte
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Philippe Giégé
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Jocelyn Céraline
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Daniel Metzger
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Hubert Becker
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Laurence Drouard
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Catherine Florentz
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Robert Martin
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Canan Nébigil
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Serge Potier
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Adrien Schaefer
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Evelyne Schaeffer
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Catherine Schuster
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Anne Bresson
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Eric Quéméneur
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Laurence Choulier
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Nicolas Matt
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Laurent Monassier
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Claire Lugnier
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Louis Freysz
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Jules Hoffmann
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Henri Dreyfus
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
| | - Christophe Romier
- Société de Biologie de Strasbourg, 1 rue Laurent Fries, 67404 Illkirch, France
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Surette S, Narang A, Bae R, Hong H, Thomas Y, Cadieu C, Chaudhry A, Martin R, Rubenson D, Goldstein S, Little S, Lang R, Weissman N, Thomas J. Artificial intelligence-guided image acquisition on patients with implanted electrophysiological devices: results from a pivotal prospective multi-center clinical trial. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0006] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
A novel, recently FDA-authorized software uses deep learning (DL) to provide prescriptive transthoracic echocardiography (TTE) guidance, allowing novices to acquire standard TTE views. The DL model was trained by >5,000,000 observations of the impact of probe motion on image orientation/quality. This study evaluated whether novice-acquired TTE images guided by this software were of diagnostic quality in patients with and without implanted electrophysiological (EP) devices, focusing on RV size and function, which were thought to be sensitive to EP devices. Some aspects of the study have previously been presented.
Methods
240 patients (61±16 years old, 58% male, 33% BMI >30 kg/m2, 91% with cardiac pathology) were recruited. 8 nurses without echo experience each acquired 10 view TTEs in 30 patients guided by the software. 235 of the patients were also scanned by a trained sonographer without assistance from the software. 5 Level 3 echocardiographers independently assessed the diagnostic quality of the TTEs acquired by the nurses and sonographers to evaluate the effect of EP devices on DL software performance.
Results
Nurses using the AI-guided acquisition software acquired TTEs of sufficient quality to make qualitative assessments of right ventricular (RV) size and function in greater than 80% of cases for patients with and without implanted EP devices (Table). There was no significant difference between nurse- and sonographer-acquired scans.
Conclusion
These results indicate that new DL software can guide novices to obtain TTEs that enable qualitative assessment of RV size even in the presence of implanted EP devices. The results of the comparison to sonographer-acquired exams indicate the software performance is robust to presence of pacemaker/ICD leads visible in the images (Figure).
Nurse-acquired TTE with visible ICD lead
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Caption Health, Inc.
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Affiliation(s)
- S Surette
- Caption Health, Brisbane, United States of America
| | - A Narang
- Northwestern University, Chicago, United States of America
| | - R Bae
- Minneapolis Heart Institute Foundation, Minneapolis, United States of America
| | - H Hong
- Caption Health, Brisbane, United States of America
| | - Y Thomas
- Caption Health, Brisbane, United States of America
| | - C Cadieu
- Caption Health, Brisbane, United States of America
| | - A Chaudhry
- Caption Health, Brisbane, United States of America
| | - R Martin
- Caption Health, Brisbane, United States of America
| | - D Rubenson
- Scripps Clinic, La Jolla, United States of America
| | - S Goldstein
- MedStar Washington Hospital Center, Washington, United States of America
| | - S Little
- Houston Methodist, Houston, United States of America
| | - R Lang
- The University of Chicago, Chicago, United States of America
| | - N Weissman
- MedStar Health Research Institute, Washington, United States of America
| | - J.D Thomas
- Northwestern University, Chicago, United States of America
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Lancet J, Lin T, Hogge D, Solomon S, Schiller G, Wieduwilt M, Martin R, Faderl S, Chang Y, Cortes J. FIVE-YEAR FINAL RESULTS OF A PHASE 3 STUDY OF CPX-351 VERSUS 7+3 IN OLDER ADULTS WITH NEWLY DIAGNOSED HIGH-RISK/SECONDARY ACUTE MYELOID LEUKEMIA (AML). Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.10.257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Martin R, Garcia-Arumí C, Andrade A, Bisbe L. Endothelial deposits of exfoliative material imaged by slit lamp photography and high definition anterior segment optical coherence tomography. J Fr Ophtalmol 2020; 44:284-286. [PMID: 33127180 DOI: 10.1016/j.jfo.2020.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 02/14/2020] [Indexed: 10/23/2022]
Affiliation(s)
- R Martin
- Department of ophthalmology, Hospital Universitario Vall d'Hebron, Passeig Vall d'Hebron 119, 08035 Barcelona, Spain.
| | - C Garcia-Arumí
- Department of ophthalmology, Hospital Universitario Vall d'Hebron, Passeig Vall d'Hebron 119, 08035 Barcelona, Spain
| | - A Andrade
- Department of ophthalmology, Hospital Universitario Vall d'Hebron, Passeig Vall d'Hebron 119, 08035 Barcelona, Spain
| | - L Bisbe
- Department of ophthalmology, Hospital Universitario Vall d'Hebron, Passeig Vall d'Hebron 119, 08035 Barcelona, Spain
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Goereci Y, Schweitzer F, Wellstein A, Silling S, Borchmann S, Tresckow B, Adams O, Martin R, Schlamann M, Schroeter M, Fink GR, Wattjes MP, Warnke C. Clearance of JC polyomavirus from cerebrospinal fluid following treatment with interleukin‐2 and pembrolizumab in an individual with progressive multifocal leukoencephalopathy and no underlying immune deficiency syndrome. Eur J Neurol 2020; 27:2375-2377. [DOI: 10.1111/ene.14435] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/26/2020] [Indexed: 01/13/2023]
Affiliation(s)
- Y. Goereci
- Department of Neurology Medical Faculty University Hospital of Köln Köln Germany
| | - F. Schweitzer
- Department of Neurology Medical Faculty University Hospital of Köln Köln Germany
| | - A. Wellstein
- Georgetown University Medical School Washington DC USA
| | - S. Silling
- Institute for Virology Medical Faculty University Hospital of Köln KölnGermany
| | - S. Borchmann
- Department of Haematology Medical Faculty University Hospital of Köln KölnGermany
| | - B. Tresckow
- Department of Haematology University Hospital Essen EssenGermany
| | - O. Adams
- Institute for Virology Medical Faculty University Hospital of Düsseldorf Düsseldorf Germany
| | - R. Martin
- Department of Neurology University Medical Center Zürich Zürich Switzerland
| | - M. Schlamann
- Department of Radiology Medical Faculty University Hospital of Köln KölnGermany
| | - M. Schroeter
- Department of Neurology Medical Faculty University Hospital of Köln Köln Germany
| | - G. R. Fink
- Department of Neurology Medical Faculty University Hospital of Köln Köln Germany
- Cognitive Neuroscience Institute of Neuroscience and Medicine (INM‐3) Research Centre Jülich JülichGermany
| | - M. P. Wattjes
- Department of Diagnostic and Interventional Neuroradiology Hannover Medical School Hannover Germany
| | - C. Warnke
- Department of Neurology Medical Faculty University Hospital of Köln Köln Germany
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50
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Bird JP, Martin R, Akçakaya HR, Gilroy J, Burfield IJ, Garnett ST, Symes A, Taylor J, Şekercioğlu ÇH, Butchart SHM. Generation lengths of the world's birds and their implications for extinction risk. Conserv Biol 2020; 34:1252-1261. [PMID: 32058610 DOI: 10.1111/cobi.13486] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/05/2020] [Accepted: 02/10/2020] [Indexed: 06/10/2023]
Abstract
Birds have been comprehensively assessed on the International Union for Conservation of Nature (IUCN) Red List more times than any other taxonomic group. However, to date, generation lengths have not been systematically estimated to scale population trends when undertaking assessments, as required by the criteria of the IUCN Red List. We compiled information from major databases of published life-history and trait data for all birds and imputed missing life-history data as a function of species traits with generalized linear mixed models. Generation lengths were derived for all species, based on our modeled values of age at first breeding, maximum longevity, and annual adult survival. The resulting generation lengths varied from 1.42 to 27.87 years (median 2.99). Most species (61%) had generation lengths <3.33 years, meaning that the period of 3 generations-over which population declines are assessed under criterion A-was <10 years, which is the value used for IUCN Red List assessments of species with short generation times. For these species, our trait-informed estimates of generation length suggested that 10 years is a robust precautionary value for threat assessment. In other cases, however, for whole families, genera, or individual species, generation length had a substantial impact on their estimated extinction risk, resulting in higher extinction risk in long-lived species than in short-lived species. Although our approach effectively addressed data gaps, generation lengths for some species may have been underestimated due to a paucity of life-history data. Overall, our results will strengthen future extinction-risk assessments and augment key databases of avian life-history and trait data.
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Affiliation(s)
- Jeremy P Bird
- BirdLife International, David Attenborough Building, Pembroke Street, Cambridge, CB2 3QZ, U.K
- Centre for Biodiversity and Conservation Science, University of Queensland, St Lucia, QLD 4072, Australia
| | - Robert Martin
- BirdLife International, David Attenborough Building, Pembroke Street, Cambridge, CB2 3QZ, U.K
| | - H Reşit Akçakaya
- Department of Ecology and Evolution, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, U.S.A
- IUCN Species Survival Commission, IUCN, Rue Mauverney 28, Gland, 1196, Switzerland
| | - James Gilroy
- School of Environmental Sciences, University of East Anglia, Norwich, NR4 7TJ, U.K
| | - Ian J Burfield
- BirdLife International, David Attenborough Building, Pembroke Street, Cambridge, CB2 3QZ, U.K
| | - Stephen T Garnett
- Research Institute for the Environment and Livelihoods, Charles Darwin University, Casuarina, Darwin, Northern Territory, 0909, Australia
| | - Andy Symes
- BirdLife International, David Attenborough Building, Pembroke Street, Cambridge, CB2 3QZ, U.K
| | - Joseph Taylor
- BirdLife International, David Attenborough Building, Pembroke Street, Cambridge, CB2 3QZ, U.K
| | - Çağan H Şekercioğlu
- School of Biological Sciences, University of Utah, 257 S 1400 E, Salt Lake City, UT, 84112, U.S.A
- Department of Molecular Biology and Genetics, Koç University, Istanbul, Turkey
- KuzeyDoğa Derneği, Ortakapı Mah. Şehit Yusuf Bey Cad. No: 93 Kars, Turkey
- Department of Zoology, University of Cambridge, Downing Street, Cambridge, CB2 3EJ, U.K
| | - Stuart H M Butchart
- BirdLife International, David Attenborough Building, Pembroke Street, Cambridge, CB2 3QZ, U.K
- Department of Zoology, University of Cambridge, Downing Street, Cambridge, CB2 3EJ, U.K
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