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Derendorf L, Kusch M, Stock S, Lemmen C. Assessing the implementation of a comprehensive quality management system for cross-sectoral psycho-oncology in Germany. J Healthc Qual Res 2024; 39:32-40. [PMID: 37981471 DOI: 10.1016/j.jhqr.2023.10.007] [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: 09/20/2023] [Revised: 10/17/2023] [Accepted: 10/24/2023] [Indexed: 11/21/2023]
Abstract
INTRODUCTION Quality management in healthcare is essential for safe, effective, and patient-centered services. Quality management systems (QMS) monitor and improve healthcare quality. Integrating QMS is crucial for optimal quality of care, but previous studies show gaps in integration. This study aims to assess program adherence to a QMS in cross-sectoral psycho-oncological care and to develop strategies for better integration, ultimately improving healthcare quality. MATERIALS AND METHODS The study used a utility analysis to assess the program adherence of a cross-sectoral psycho-oncology care program using a 5-point scale. The evaluation process involved breaking down the program into distinct areas, and used key figures and developed indicators to assess adherence. Descriptive statistics were used. RESULTS The study conducted a comprehensive assessment of program adherence in a complex care program, analysing 4460 evaluation cases based on 128 quality indicators. The results showed a score of 4.2 out of 5 points (84%), indicating a highly effective implementation of the QMS. Notably, the study observed successful implementation of top-down elements, while encountering more challenges in integrating bottom-up aspects. CONCLUSION The study demonstrates effective implementation of a comprehensive QMS. Successful integration was observed in areas such as care concept, care management, quality assurance, and IT-based documentation, while challenges remain in quality development and indicators. Active leadership involvement, staff training, data collection, and a learning culture are essential for successful implementation. Future research should assess the impact and cost-effectiveness of QMSs and develop tailored approaches to sustain healthcare professionals' motivation in quality improvement efforts.
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Affiliation(s)
- L Derendorf
- Institute for Health Economics and Clinical Epidemiology (IGKE), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | - M Kusch
- Center of Integrated Oncology ABCD, University Hospital of Cologne, Cologne, Germany
| | - S Stock
- Institute for Health Economics and Clinical Epidemiology (IGKE), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - C Lemmen
- Institute for Health Economics and Clinical Epidemiology (IGKE), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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Scheckel B, Naumann M, Simic D, Stock S, Loose O, Breig M, Albrecht K, Braun K, Kucher R, Deininger S, Schmid L, John M, Grohnert A, Giertz C, Wirth T. Supplementary orthopaedic screening for children and adolescents to prevent permanent skeletal deformities - protocol for the "OrthoKids" study. BMC Musculoskelet Disord 2023; 24:887. [PMID: 37964234 PMCID: PMC10647053 DOI: 10.1186/s12891-023-07023-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/06/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Skeletal deformities (SD) in children and adolescents can lead to arthritic conditions, impairment of quality of life, and high treatment costs in the long term. However, comprehensive data on the prevalence of SDs in children and adolescents are limited and it remains therefore unclear whether there is a healthcare gap. "OrthoKids" is a project that addresses this evidence gap by implementing an orthopaedic screening for children and adolescents that supplements existing detection examinations within statutory standard care in Germany. OBJECTIVE To detect SDs so that they can be treated as needed at an early stage. METHODS The implementation of the supplementary orthopaedic screening will be evaluated through an exploratory cohort study that is set up in the German state Baden-Wuerttemberg. 20,000 children and adolescents aged 10 to 14 years will be recruited as a prospective cohort. A retrospective control cohort will be formed based on claims data provided by two cooperating statutory health insurances (SHIs). Participating children and adolescents receive a one-time orthopaedic screening. If at least one SD is diagnosed, treatment will be provided as part of the statutory standard care. Within the scope of the project, a follow-up examination will be performed after one year. An IT-platform will complement the study. The primary outcome measure is the point prevalence of scoliosis, genu varum/valgum, hip dysplasia, and flat feet. Secondary outcome measures are (i) the point prevalence of further less common SDs, (ii) health-related quality of life (HRQoL), (iii) sports ability based on activity (physical/athletic), physical constraints, and (sports) injuries, as well as (iv) monetary consequences of the orthopaedic screenings' implementation. Implementation determinants will be evaluated, too. DISCUSSION If the supplementary orthopaedic screening proves to be viable, it could be considered as a supplementary examination for children and adolescents within the frame of SHI in Germany. This could relieve the burden of disease among children and adolescents with SDs. In addition, it could disburden SHIs in the medium to long term. TRIAL REGISTRATION The OrthoKids study was registered in the German Clinical Trials Registry (Deutsches Register Klinischer Studien (DRKS)) on 26th July 2022 under the number 00029057.
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Affiliation(s)
- B Scheckel
- Institute for Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine, University Hospital Cologne, University of Cologne, Gleueler Straße 176-178, 50935, Cologne, Germany.
| | - M Naumann
- Institute for Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine, University Hospital Cologne, University of Cologne, Gleueler Straße 176-178, 50935, Cologne, Germany.
| | - D Simic
- Institute for Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine, University Hospital Cologne, University of Cologne, Gleueler Straße 176-178, 50935, Cologne, Germany
| | - S Stock
- Institute for Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine, University Hospital Cologne, University of Cologne, Gleueler Straße 176-178, 50935, Cologne, Germany
| | - O Loose
- Department of Orthopaedics, Olgahospital, Klinikum Stuttgart, Kriegsbergstraße 62, 70174, Stuttgart, Germany
| | - M Breig
- Department of Orthopaedics, Olgahospital, Klinikum Stuttgart, Kriegsbergstraße 62, 70174, Stuttgart, Germany
| | - K Albrecht
- Department of Orthopaedics, Olgahospital, Klinikum Stuttgart, Kriegsbergstraße 62, 70174, Stuttgart, Germany
| | - K Braun
- Association of Statutory Health Insurance Physicians Baden-Wuerttemberg (KVBW), Albstadtweg 11, 70567, Stuttgart, Germany
| | - R Kucher
- Association of Statutory Health Insurance Physicians Baden-Wuerttemberg (KVBW), Albstadtweg 11, 70567, Stuttgart, Germany
| | - S Deininger
- Association of Statutory Health Insurance Physicians Baden-Wuerttemberg (KVBW), Albstadtweg 11, 70567, Stuttgart, Germany
| | - L Schmid
- Association of Statutory Health Insurance Physicians Baden-Wuerttemberg (KVBW), Albstadtweg 11, 70567, Stuttgart, Germany
| | - M John
- Fraunhofer Institute for Open Communication Systems (FOKUS), Kaiserin-Augusta-Allee 31, 10589, Berlin, Germany
| | - A Grohnert
- Fraunhofer Institute for Open Communication Systems (FOKUS), Kaiserin-Augusta-Allee 31, 10589, Berlin, Germany
| | - C Giertz
- Fraunhofer Institute for Open Communication Systems (FOKUS), Kaiserin-Augusta-Allee 31, 10589, Berlin, Germany
| | - T Wirth
- Department of Orthopaedics, Olgahospital, Klinikum Stuttgart, Kriegsbergstraße 62, 70174, Stuttgart, Germany
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Goulding A, McQuaid F, Lindsay L, Agrawal U, Auyeung B, Calvert C, Carruthers J, Denny C, Donaghy J, Hillman S, Hopcroft L, Hopkins L, McCowan C, McLaughlin T, Moore E, Ritchie L, Simpson CR, Taylor B, Fenton L, Pollock L, Gale C, Kurinczuk JJ, Robertson C, Sheikh A, Stock S, Wood R. Confirmed SARS-CoV-2 infection in Scottish neonates 2020-2022: a national, population-based cohort study. Arch Dis Child Fetal Neonatal Ed 2023; 108:367-372. [PMID: 36609412 PMCID: PMC10313998 DOI: 10.1136/archdischild-2022-324713] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/10/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To examine neonates in Scotland aged 0-27 days with SARS-CoV-2 infection confirmed by viral testing; the risk of confirmed neonatal infection by maternal and infant characteristics; and hospital admissions associated with confirmed neonatal infections. DESIGN Population-based cohort study. SETTING AND POPULATION All live births in Scotland, 1 March 2020-31 January 2022. RESULTS There were 141 neonates with confirmed SARS-CoV-2 infection over the study period, giving an overall infection rate of 153 per 100 000 live births (141/92 009, 0.15%). Among infants born to women with confirmed infection around the time of birth, the confirmed neonatal infection rate was 1812 per 100 000 live births (15/828, 1.8%). Two-thirds (92/141, 65.2%) of neonates with confirmed infection had an associated admission to neonatal or (more commonly) paediatric care. Six of these babies (6/92, 6.5%) were admitted to neonatal and/or paediatric intensive care; however, none of these six had COVID-19 recorded as their main diagnosis. There were no neonatal deaths among babies with confirmed infection. IMPLICATIONS AND RELEVANCE Confirmed neonatal SARS-CoV-2 infection was uncommon over the first 23 months of the pandemic in Scotland. Secular trends in the neonatal confirmed infection rate broadly followed those seen in the general population, although at a lower level. Maternal confirmed infection at birth was associated with an increased risk of neonatal confirmed infection. Two-thirds of neonates with confirmed infection had an associated admission to hospital, with resulting implications for the baby, family and services, although their outcomes were generally good. Ascertainment of confirmed infection depends on the extent of testing, and this is likely to have varied over time and between groups: the extent of unconfirmed infection is inevitably unknown.
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Affiliation(s)
| | - Fiona McQuaid
- Department of Child Life and Health, University of Edinburgh, Edinburgh, UK
| | | | - Utkarsh Agrawal
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Bonnie Auyeung
- School of Philosophy, Psychology and Language Sciences, The University of Edinburgh, Edinburgh, UK
| | - Clara Calvert
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | | | | | - Sam Hillman
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Lisa Hopcroft
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Colin McCowan
- School of Medicine, University of St Andrews, St Andrews, UK
| | | | | | - Lewis Ritchie
- Academic Primary Care, University of Aberdeen, Aberdeen, UK
| | - Colin R Simpson
- Usher Institute, University of Edinburgh, Edinburgh, UK
- School of Health, Victoria University of Wellington, Wellington, New Zealand
| | | | | | - Louisa Pollock
- Child Health, University of Glasgow, Glasgow, UK
- Department of Paediatric Infectious Diseases and Immunology, Royal Hospital for Children, Glasgow, UK
| | - Chris Gale
- Academic Neonatal Medicine, Imperial College London, London, UK
| | | | - Chris Robertson
- Public Health Scotland, Edinburgh, UK
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Sarah Stock
- Public Health Scotland, Edinburgh, UK
- Obstetrics and Gynaecology, MRC Centre for Reproductive Health University of Edinburgh, Edinburgh, UK
| | - Rachael Wood
- Public Health Scotland, Edinburgh, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
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Song B, Yang K, Viswanathan VS, Wang X, Lee J, Stock S, Fu P, Lu C, Koyfman S, Lewis JS, Madabhushi A. CT radiomic signature predicts survival and chemotherapy benefit in stage I and II HPV-associated oropharyngeal carcinoma. NPJ Precis Oncol 2023; 7:53. [PMID: 37268691 DOI: 10.1038/s41698-023-00404-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 05/23/2023] [Indexed: 06/04/2023] Open
Abstract
Chemoradiation is a common therapeutic regimen for human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC). However, not all patients benefit from chemotherapy, especially patients with low-risk characteristics. We aim to develop and validate a prognostic and predictive radiomic image signature (pRiS) to inform survival and chemotherapy benefit using computed tomography (CT) scans from 491 stage I and II HPV-associated OPSCC, which were divided into three cohorts D1-D3. The prognostic performance of pRiS was evaluated on two test sets (D2, n = 162; D3, n = 269) using concordance index. Patients from D2 and D3 who received either radiotherapy alone or chemoradiation were used to validate pRiS as predictive of added benefit of chemotherapy. Seven features were selected to construct pRiS, which was found to be prognostic of overall survival (OS) on univariate analysis in D2 (hazard ratio [HR] = 2.14, 95% confidence interval [CI], 1.1-4.16, p = 0.02) and D3 (HR = 2.74, 95% CI, 1.34-5.62, p = 0.006). Chemotherapy was associated with improved OS for high-pRiS patients in D2 (radiation vs chemoradiation, HR = 4.47, 95% CI, 1.73-11.6, p = 0.002) and D3 (radiation vs chemoradiation, HR = 2.99, 95% CI, 1.04-8.63, p = 0.04). In contrast, chemotherapy did not improve OS for low-pRiS patients, which indicates these patients did not derive additional benefit from chemotherapy and could be considered for treatment de-escalation. The proposed radiomic signature was prognostic of patient survival and informed benefit from chemotherapy for stage I and II HPV-associated OPSCC patients.
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Affiliation(s)
- Bolin Song
- Center for Computational Imaging and Personalized Diagnostics, Emory University, Atlanta, GA, USA
| | - Kailin Yang
- Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH, USA
| | - Vidya Sankar Viswanathan
- Center for Computational Imaging and Personalized Diagnostics, Emory University, Atlanta, GA, USA
| | - Xiangxue Wang
- School of Automation, Nanjing University of Information Science and Technology, Nanjing, China
| | - Jonathan Lee
- Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sarah Stock
- Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Pingfu Fu
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Cheng Lu
- Center for Computational Imaging and Personalized Diagnostics, Emory University, Atlanta, GA, USA
| | - Shlomo Koyfman
- Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH, USA
| | - James S Lewis
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Anant Madabhushi
- Center for Computational Imaging and Personalized Diagnostics, Emory University, Atlanta, GA, USA.
- Louis Stokes Cleveland Veterans Administration Medical Center, Cleveland, OH, USA.
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Klotz S, Ketels G, Petersen J, Stock S, Girdauskas E. Interdisciplinary and cross-sectoral perioperative care model in cardiac surgery: Implementation in the setting of minimally-invasive heart valve surgery (increase) – Study protocol for a randomized controlled trial. Clin Nutr ESPEN 2022. [DOI: 10.1016/j.clnesp.2022.06.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Drews A, Kempin M, Stock S, von Klitzing R, Petzold M, Kraume M. Design and Separation of w/o Pickering Emulsions for L/L Catalysis. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- A. Drews
- HTW Berlin Verfahrenstechnik in Life Science Engineering Wilhelminenhofstr. 75A 12459 Berlin Germany
| | - M. V. Kempin
- HTW Berlin Verfahrenstechnik in Life Science Engineering Wilhelminenhofstr. 75A 12459 Berlin Germany
| | - S. Stock
- TU Darmstadt Institut für Physik kondensierter Materie Hochschulstr. 8 64289 Darmstadt Germany
| | - R. von Klitzing
- TU Darmstadt Institut für Physik kondensierter Materie Hochschulstr. 8 64289 Darmstadt Germany
| | - M. Petzold
- TU Berlin FG Verfahrenstechnik Straße des 17. Juni 135 10623 Berlin Germany
| | - M. Kraume
- TU Berlin FG Verfahrenstechnik Straße des 17. Juni 135 10623 Berlin Germany
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Majjouti K, Küppers L, Thielmann A, Redaélli M, Vitinius F, Funke C, van der Arend I, Pilic L, Hessbrügge M, Stock S, Weltermann B, Wild D. Family doctors’ attitudes toward peer support programs for type 2 diabetes and/or coronary artery disease: an exploratory survey among German practitioners. BMC Prim Care 2022; 23:220. [PMID: 36045339 PMCID: PMC9427433 DOI: 10.1186/s12875-022-01827-3] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022]
Abstract
Background Type 2 diabetes (T2D) and coronary artery disease (CAD) are chronic illnesses where adherence to a healthy lifestyle is crucial. If organisational and cultural factors are well managed, Peer support programs (PSP) can improve self-management, quality of life, and health outcomes. In preparation for launching a PSP, we surveyed family doctors (FD) about their attitudes toward such a program and about potential barriers, and facilitators. Methods In March 2020 we surveyed 896 FDs from five university teaching practice networks in North-Rhine Westphalia, Germany, via an anonymous web-based survey. The questionnaire addressed details of PSPs, including suitable patients and FDs‘role. Data were analysed using descriptive and inferential statistics; qualitative material underwent content analysis by two researchers. Results A total of 165 FDs responded (response rate: 18.4%), 97% were practice owners. Respondents viewed PSPs positively (T2D: 92.0%, CAD 89.9%), especially for patients with poor self-structuring (82.7%), low motivation (76.3%) and few social contacts (67.6%). On average, FDs were able to identify 4.0 ± 3.2 patients as potential group leaders. Major facilitators reported included motivation by peers (92.5%), exercise (79.1%), and social contacts (70.1%). Waning interest over time (73.1%) and poor motivation (70.9%) were considered barriers. The majority of FDs would recommend PSPs to their patients (89.5%). They considered such a program a valuable addition to current care (79.7%). The percentage of FDs’ who expected long-term benefits for their workload was relatively low (37.6%). Conclusions In an exploratory survey among German FDs on PSPs, respondents viewed PSPs as a valuable add-on for T2D and CAD patients, while not expecting a positive impact on their workload. Communication with FDs on PSPs may need to highlight anticipated implementation outcomes such as benefits of PSPs to the practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01827-3.
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Lee MY, Lee J, Stock S, Belfiglio M, Matia B, Koyfman S, Joshi NP, Burkey BB, Lamarre E, Prendes B, Scharpf J, Lorenz RR, Woody NM, Adelstein DJ, Geiger JL, Chute DJ, Ku JA. Prognostic value of computed tomography scan detection of cartilage invasion in advanced laryngeal cancer treated with primary total laryngectomy. Head Neck 2022; 44:2220-2227. [PMID: 35801556 PMCID: PMC9544100 DOI: 10.1002/hed.27133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/19/2022] [Accepted: 06/16/2022] [Indexed: 11/25/2022] Open
Abstract
Background We sought to determine whether detection of cartilage invasion (CI) by computed tomography predicts oncologic outcomes after primary total laryngectomy. Methods Retrospective cohort study comparing oncologic outcomes between radiologic versus pathologic diagnosis. Results Assessment of clear CI versus gestalt CI resulted in 84% versus 48% specificity, 90.9% versus 80.3% positive predictive value (PPV), 60.6% versus 80.3% sensitivity, 44.7% versus 48% negative predictive value (NPV), respectively. Disease‐free survival (DFS) was similar between cT4a and cT3/cT2 patients (p = 0.87). DFS trended towards superiority among pT3/pT2 versus pT4a patients (p = 0.18). DFS was similar among patients with CI on radiologist gestalt versus no CI (p = 0.94). Histologically confirmed CI was associated with a hazard ratio (HR) of 1.46 (p = 0.27), gestalt CI 1.13 (p = 0.70), and clear CI 1.61 (p = 0.10) for DFS. Conclusion Gestalt determination of CI results in high sensitivity but low specificity, while clear determination of CI results in moderate sensitivity and high specificity.
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Affiliation(s)
- Maxwell Y Lee
- Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jonathan Lee
- Department of Diagnostic Radiology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sarah Stock
- Department of Diagnostic Radiology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Mario Belfiglio
- Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Brian Matia
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | - Shlomo Koyfman
- Department of Radiation Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA
| | - Nikhil P Joshi
- Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois, USA
| | - Brian B Burkey
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | - Eric Lamarre
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | - Brandon Prendes
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | - Joseph Scharpf
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | - Robert R Lorenz
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | - Neil M Woody
- Department of Radiation Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA
| | - David J Adelstein
- Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA
| | - Jessica L Geiger
- Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA
| | - Deborah J Chute
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jamie A Ku
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
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Lee J, Kaht D, Ali S, Johnson S, Bullen J, Karakasis C, Lamarre E, Geiger J, Koyfman S, Stock S. Performance of the Neck Imaging Reporting and Data System as applied by general neuroradiologists to predict recurrence of head and neck cancers. Head Neck 2022; 44:2257-2264. [PMID: 35801334 DOI: 10.1002/hed.27138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/04/2022] [Accepted: 06/16/2022] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The Neck Imaging Reporting and Data System (NI-RADS) is used to assess imaging after head and neck cancer treatment. We evaluated NI-RADS with general neuroradiologists rather than with head and neck subspecialists. METHODS Computed tomography and magnetic resonance imaging examinations with/without positron emission tomography from May 2018 to September 2020 were retrospectively identified. NI-RADS scores at the primary site and lymph nodes were provided by 21 neuroradiologists. Recurrence status was based on clinical and imaging findings. Area under the curve (AUC) was used to assess accuracy. RESULTS We assessed 608 scans from 464 patients. For NI-RADS categories 1, 2, and 3, primary site recurrence rates were 5%, 29%, and 65% with AUC of 0.765, while lymph node recurrence rates were 3%, 10%, and 80% with AUC of 0.820. CONCLUSIONS NI-RADS as used by general neuroradiologists is effective in separating head and neck cancers into discrete categories for predicting recurrent disease.
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Affiliation(s)
- Jonathan Lee
- Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Dagan Kaht
- Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Syed Ali
- Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Scott Johnson
- Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jennifer Bullen
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | | | - Eric Lamarre
- Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jessica Geiger
- Hematology and Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, Ohio, USA
| | - Shlomo Koyfman
- Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sarah Stock
- Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Saracco JF, Cormier RL, Humple DL, Stock S, Taylor R, Siegel RB. Demographic responses to climate-driven variation in habitat quality across the annual cycle of a migratory bird species. Ecol Evol 2022; 12:e8934. [PMID: 35784033 PMCID: PMC9188024 DOI: 10.1002/ece3.8934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 04/16/2022] [Accepted: 04/28/2022] [Indexed: 12/02/2022] Open
Abstract
The demography and dynamics of migratory bird populations depend on patterns of movement and habitat quality across the annual cycle. We leveraged archival GPS‐tagging data, climate data, remote‐sensed vegetation data, and bird‐banding data to better understand the dynamics of black‐headed grosbeak (Pheucticus melanocephalus) populations in two breeding regions, the coast and Central Valley of California (Coastal California) and the Sierra Nevada mountain range (Sierra Nevada), over 28 years (1992–2019). Drought conditions across the annual cycle and rainfall timing on the molting grounds influenced seasonal habitat characteristics, including vegetation greenness and phenology (maturity dates). We developed a novel integrated population model with population state informed by adult capture data, recruitment rates informed by age‐specific capture data and climate covariates, and survival rates informed by adult capture–mark–recapture data and climate covariates. Population size was relatively variable among years for Coastal California, where numbers of recruits and survivors were positively correlated, and years of population increase were largely driven by recruitment. In the Sierra Nevada, population size was more consistent and showed stronger evidence of population regulation (numbers of recruits and survivors negatively correlated). Neither region showed evidence of long‐term population trend. We found only weak support for most climate–demographic rate relationships. However, recruitment rates for the Coastal California region were higher when rainfall was relatively early on the molting grounds and when wintering grounds were relatively cool and wet. We suggest that our approach of integrating movement, climate, and demographic data within a novel modeling framework can provide a useful method for better understanding the dynamics of broadly distributed migratory species.
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Affiliation(s)
| | | | | | - Sarah Stock
- Division of Resources Management and Science Yosemite National Park El Portal California USA
| | - Ron Taylor
- The Institute for Bird Populations Petaluma California USA
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Hoebers F, Yu E, O'Sullivan B, Postma AA, Palm WM, Bartlett E, Lee J, Stock S, Koyfman S, Su J, Xu W, Huang SH. Augmenting inter-rater concordance of radiologic extranodal extension in HPV-positive oropharyngeal carcinoma: A multicenter study. Head Neck 2022; 44:2361-2369. [PMID: 35766141 DOI: 10.1002/hed.27130] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/23/2022] [Accepted: 06/16/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To assess intra- and inter-institutional concordance and identify methods to increase precision in radiologic extranodal extension (rENE) ascertainment in HPV+ oropharyngeal carcinoma. METHODS Six radiologists, blinded to clinical outcomes, from three centers assessed rENE in two phases: Phase-I (20 cases) utilized each individual's a priori appreciation of the literature. Phase-II (30 additional cases) was performed after deliberating experience and consolidating operating definitions. Intra- and inter-institutional Kappa were calculated at >50% and >75% certainty levels, respectively. RESULTS The Phase-I intra-institutional kappa was 0.76, 0.32, and 0.44 at >50% certainty and improved to 0.89, 0.61, and 0.66 at >75% certainty. Inter-institutional Fleiss' kappa also improved with higher certainty (from 0.40 to 0.57, p = 0.039). The Phase-II inter-rater kappa was significantly higher than Phase-I at the same certainty level (both p < 0.001). CONCLUSION A learning curve exists for rENE assessment. Strategies to augment reliability include high certainty for declaration, consolidated operating definitions, and sharing experience among radiologists.
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Affiliation(s)
- Frank Hoebers
- Department of Radiation Oncology (Maastro), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Eugene Yu
- Department of Neuroradiology and Head and Neck Imaging, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Brian O'Sullivan
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology - Head & Neck Surgery, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Alida A Postma
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.,School for Mental Health and Sciences, Maastricht University, Maastricht, the Netherlands
| | - Walter M Palm
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Eric Bartlett
- Department of Neuroradiology and Head and Neck Imaging, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Jonathan Lee
- Department of Neuroradiology and Head and Neck Imaging, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA
| | - Sarah Stock
- Department of Neuroradiology and Head and Neck Imaging, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA
| | - Shlomo Koyfman
- Department of Radiation Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA
| | - Jie Su
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Wei Xu
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Shao Hui Huang
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology - Head & Neck Surgery, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
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Stock S, Al Wheibi S, Topal A, Gross TS, Müller L, Owais T, Kloth B, Girdauskas E. Implementation of Standardized ERAS Protocol in Patients Undergoing Minimally Invasive Heart Surgery. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742797] [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: 10/19/2022]
Affiliation(s)
- S. Stock
- Department of Cardiac and Thoracic Surgery, University Hospital Augsburg, Augsburg, Deutschland
| | - S. Al Wheibi
- Department of Cardiac and Thoracic Surgery, University Hospital Augsburg, Augsburg, Deutschland
| | - A. Topal
- Department of Cardiac and Thoracic Surgery, University Hospital Augsburg, Augsburg, Deutschland
| | - T.M. Sequeira Gross
- Department of Cardiac and Thoracic Surgery, University Hospital Augsburg, Augsburg, Deutschland
| | - L. Müller
- Department of Cardiac and Thoracic Surgery, University Hospital Augsburg, Augsburg, Deutschland
| | - T. Owais
- Department of Cardiac and Thoracic Surgery, University Hospital Augsburg, Augsburg, Deutschland
| | - B. Kloth
- Department of Cardiac and Thoracic Surgery, University Hospital Augsburg, Augsburg, Deutschland
| | - E. Girdauskas
- Department of Cardiac and Thoracic Surgery, University Hospital Augsburg, Augsburg, Deutschland
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Kerr S, Joy M, Torabi F, Bedston S, Akbari A, Agrawal U, Beggs J, Bradley D, Chuter A, Docherty AB, Ford D, Hobbs R, Katikireddi SV, Lowthian E, de Lusignan S, Lyons R, Marple J, McCowan C, McGagh D, McMenamin J, Moore E, Murray JLK, Owen RK, Pan J, Ritchie L, Shah SA, Shi T, Stock S, Tsang RSM, Vasileiou E, Woolhouse M, Simpson CR, Robertson C, Sheikh A. First dose ChAdOx1 and BNT162b2 COVID-19 vaccinations and cerebral venous sinus thrombosis: A pooled self-controlled case series study of 11.6 million individuals in England, Scotland, and Wales. PLoS Med 2022; 19:e1003927. [PMID: 35192598 PMCID: PMC8863261 DOI: 10.1371/journal.pmed.1003927] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 01/21/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Several countries restricted the administration of ChAdOx1 to older age groups in 2021 over safety concerns following case reports and observed versus expected analyses suggesting a possible association with cerebral venous sinus thrombosis (CVST). Large datasets are required to precisely estimate the association between Coronavirus Disease 2019 (COVID-19) vaccination and CVST due to the extreme rarity of this event. We aimed to accomplish this by combining national data from England, Scotland, and Wales. METHODS AND FINDINGS We created data platforms consisting of linked primary care, secondary care, mortality, and virological testing data in each of England, Scotland, and Wales, with a combined cohort of 11,637,157 people and 6,808,293 person years of follow-up. The cohort start date was December 8, 2020, and the end date was June 30, 2021. The outcome measure we examined was incident CVST events recorded in either primary or secondary care records. We carried out a self-controlled case series (SCCS) analysis of this outcome following first dose vaccination with ChAdOx1 and BNT162b2. The observation period consisted of an initial 90-day reference period, followed by a 2-week prerisk period directly prior to vaccination, and a 4-week risk period following vaccination. Counts of CVST cases from each country were tallied, then expanded into a full dataset with 1 row for each individual and observation time period. There was a combined total of 201 incident CVST events in the cohorts (29.5 per million person years). There were 81 CVST events in the observation period among those who a received first dose of ChAdOx1 (approximately 16.34 per million doses) and 40 for those who received a first dose of BNT162b2 (approximately 12.60 per million doses). We fitted conditional Poisson models to estimate incidence rate ratios (IRRs). Vaccination with ChAdOx1 was associated with an elevated risk of incident CVST events in the 28 days following vaccination, IRR = 1.93 (95% confidence interval (CI) 1.20 to 3.11). We did not find an association between BNT162b2 and CVST in the 28 days following vaccination, IRR = 0.78 (95% CI 0.34 to 1.77). Our study had some limitations. The SCCS study design implicitly controls for variables that are constant over the observation period, but also assumes that outcome events are independent of exposure. This assumption may not be satisfied in the case of CVST, firstly because it is a serious adverse event, and secondly because the vaccination programme in the United Kingdom prioritised the clinically extremely vulnerable and those with underlying health conditions, which may have caused a selection effect for individuals more prone to CVST. Although we pooled data from several large datasets, there was still a low number of events, which may have caused imprecision in our estimates. CONCLUSIONS In this study, we observed a small elevated risk of CVST events following vaccination with ChAdOx1, but not BNT162b2. Our analysis pooled information from large datasets from England, Scotland, and Wales. This evidence may be useful in risk-benefit analyses of vaccine policies and in providing quantification of risks associated with vaccination to the general public.
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Affiliation(s)
- Steven Kerr
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Fatemeh Torabi
- Population Data Science, Swansea University Medical School, Swansea, United Kingdom
| | - Stuart Bedston
- Population Data Science, Swansea University Medical School, Swansea, United Kingdom
| | - Ashley Akbari
- Population Data Science, Swansea University Medical School, Swansea, United Kingdom
| | - Utkarsh Agrawal
- School of Medicine, University of St. Andrews, St Andrews, United Kingdom
| | - Jillian Beggs
- BREATHE–The Health Data Research Hub for Respiratory Health, University of Edinburgh, Edinburgh, United Kingdom
| | - Declan Bradley
- Queen’s University Belfast, Belfast, United Kingdom
- Public Health Agency, Belfast, United Kingdom
| | - Antony Chuter
- BREATHE–The Health Data Research Hub for Respiratory Health, University of Edinburgh, Edinburgh, United Kingdom
| | | | - David Ford
- Population Data Science, Swansea University Medical School, Swansea, United Kingdom
| | - Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Emily Lowthian
- Population Data Science, Swansea University Medical School, Swansea, United Kingdom
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Ronan Lyons
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - James Marple
- Royal Infirmary of Edinburgh, NHS Lothian and Anaesthesia, Critical Care and Pain Medicine, The University of Edinburgh, Edinburgh, United Kingdom
| | - Colin McCowan
- School of Medicine, University of St. Andrews, St Andrews, United Kingdom
| | - Dylan McGagh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Emily Moore
- Public Health Scotland, Glasgow, United Kingdom
| | | | - Rhiannon K. Owen
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Jiafeng Pan
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, United Kingdom
| | - Lewis Ritchie
- Academic Primary Care, University of Aberdeen School of Medicine and Dentistry, Aberdeen, United Kingdom
| | - Syed Ahmar Shah
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Ting Shi
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Sarah Stock
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Ruby S. M. Tsang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Mark Woolhouse
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Colin R. Simpson
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, New Zealand
| | - Chris Robertson
- Public Health Scotland, Glasgow, United Kingdom
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, United Kingdom
| | - Aziz Sheikh
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
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14
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Song B, Yang K, Garneau J, Lu C, Li L, Lee J, Stock S, Braman NM, Koyuncu CF, Toro P, Fu P, Koyfman SA, Lewis JS, Madabhushi A. Radiomic Features Associated With HPV Status on Pretreatment Computed Tomography in Oropharyngeal Squamous Cell Carcinoma Inform Clinical Prognosis. Front Oncol 2021; 11:744250. [PMID: 34557418 PMCID: PMC8454409 DOI: 10.3389/fonc.2021.744250] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/16/2021] [Indexed: 12/18/2022] Open
Abstract
Purpose There is a lack of biomarkers for accurately prognosticating outcome in both human papillomavirus-related (HPV+) and tobacco- and alcohol-related (HPV-) oropharyngeal squamous cell carcinoma (OPSCC). The aims of this study were to i) develop and evaluate radiomic features within (intratumoral) and around tumor (peritumoral) on CT scans to predict HPV status; ii) investigate the prognostic value of the radiomic features for both HPV- and HPV+ patients, including within individual AJCC eighth edition-defined stage groups; and iii) develop and evaluate a clinicopathologic imaging nomogram involving radiomic, clinical, and pathologic factors for disease-free survival (DFS) prediction for HPV+ patients. Experimental Design This retrospective study included 582 OPSCC patients, of which 462 were obtained from The Cancer Imaging Archive (TCIA) with available tumor segmentation and 120 were from Cleveland Clinic Foundation (CCF, denoted as SCCF) with HPV+ OPSCC. We subdivided the TCIA cohort into training (ST, 180 patients) and validation (SV, 282 patients) based on an approximately 3:5 ratio for HPV status prediction. The top 15 radiomic features that were associated with HPV status were selected by the minimum redundancy-maximum relevance (MRMR) using ST and evaluated on SV. Using 3 of these 15 top HPV status-associated features, we created radiomic risk scores for both HPV+ (RRSHPV+) and HPV- patients (RRSHPV-) through a Cox regression model to predict DFS. RRSHPV+ was further externally validated on SCCF. Nomograms for the HPV+ population (Mp+RRS) were constructed. Both RRSHPV+ and Mp+RRS were used to prognosticate DFS for the AJCC eighth edition-defined stage I, stage II, and stage III patients separately. Results RRSHPV+ was prognostic for DFS for i) the whole HPV+ population [hazard ratio (HR) = 1.97, 95% confidence interval (CI): 1.35-2.88, p < 0.001], ii) the AJCC eighth stage I population (HR = 1.99, 95% CI: 1.04-3.83, p = 0.039), and iii) the AJCC eighth stage II population (HR = 3.61, 95% CI: 1.71-7.62, p < 0.001). HPV+ nomogram Mp+RRS (C-index, 0.59; 95% CI: 0.54-0.65) was also prognostic of DFS (HR = 1.86, 95% CI: 1.27-2.71, p = 0.001). Conclusion CT-based radiomic signatures are associated with both HPV status and DFS in OPSCC patients. With additional validation, the radiomic signature and its corresponding nomogram could potentially be used for identifying HPV+ OPSCC patients who might be candidates for therapy deintensification.
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Affiliation(s)
- Bolin Song
- Center for Computational Imaging and Personalized Diagnostics, Case Western Reserve University, Cleveland, OH, United States
| | - Kailin Yang
- Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH, United States
| | - Jonathan Garneau
- Department of Otolaryngology and Head and Neck Surgery, University of Virginia, Charlottesville, VA, United States
| | - Cheng Lu
- Center for Computational Imaging and Personalized Diagnostics, Case Western Reserve University, Cleveland, OH, United States
| | - Lin Li
- Center for Computational Imaging and Personalized Diagnostics, Case Western Reserve University, Cleveland, OH, United States
| | - Jonathan Lee
- Imaging Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Sarah Stock
- Imaging Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Nathaniel M Braman
- Center for Computational Imaging and Personalized Diagnostics, Case Western Reserve University, Cleveland, OH, United States
| | - Can Fahrettin Koyuncu
- Center for Computational Imaging and Personalized Diagnostics, Case Western Reserve University, Cleveland, OH, United States
| | - Paula Toro
- Center for Computational Imaging and Personalized Diagnostics, Case Western Reserve University, Cleveland, OH, United States
| | - Pingfu Fu
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Shlomo A Koyfman
- Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH, United States
| | - James S Lewis
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Anant Madabhushi
- Center for Computational Imaging and Personalized Diagnostics, Case Western Reserve University, Cleveland, OH, United States.,Louis Stokes Cleveland Veterans Administration Medical Center, Cleveland, OH, United States
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15
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Isselhard A, Töpper M, Steckelberg A, Berger-Höger B, Vitinius F, Köberlein-Neu J, Manderscheid L, Wiedemann R, Rhiem K, Schmutzler R, Stock S. Workshop: Corona Pandemie – Herausforderungen nicht nur für die Grundlagenwissenschaften. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732141] [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 Isselhard
- Institut für Gesundheitsökonomie und klinische Epidemiologie, Universitätsklinikum Köln
| | - M Töpper
- Institut für Gesundheitsökonomie und klinische Epidemiologie, Universitätsklinikum Köln
| | - A Steckelberg
- Instituts für Gesundheits- und Pflegewissenschaft, Martin-Luther-Universität Halle-Wittenberg
| | - B Berger-Höger
- Instituts für Gesundheits- und Pflegewissenschaft, Martin-Luther-Universität Halle-Wittenberg
| | - F Vitinius
- Klinik und Poliklinik für Psychosomatik und Psychotherapie, Universitätsklinikum Köln
| | - J Köberlein-Neu
- Bergisches Kompetenzzentrum für Gesundheitsökonomik und Versorgungsforschung, Bergische Universität Wuppertal
| | - L Manderscheid
- Bergisches Kompetenzzentrum für Gesundheitsökonomik und Versorgungsforschung, Bergische Universität Wuppertal
| | - R Wiedemann
- Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum Köln
| | - K Rhiem
- Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum Köln
| | - R Schmutzler
- Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum Köln
| | - S Stock
- Institut für Gesundheitsökonomie und klinische Epidemiologie, Universitätsklinikum Köln
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Krebs F, Lorenz L, Lück I, Nawabi F, Alayli A, Bau AM, Stock S. Empfehlungen für eine erfolgreiche Rekrutierung in Versorgungsforschungsprojekten – Eine Studie zur Rekrutierung von niedergelassenen Leistungserbringern. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732231] [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)
- F Krebs
- Institut für Gesundheitsökonomie und Klinische Epidemiologie, Uniklinik Köln
| | - L Lorenz
- Institut für Gesundheitsökonomie und Klinische Epidemiologie, Uniklinik Köln
| | - I Lück
- Plattform Ernährung und Bewegung e.V
| | - F Nawabi
- Institut für Gesundheitsökonomie und Klinische Epidemiologie, Uniklinik Köln
| | - A Alayli
- Institut für Gesundheitsökonomie und Klinische Epidemiologie, Uniklinik Köln
- Bundeszentrale für gesundheitliche Aufklärung
| | - AM Bau
- Plattform Ernährung und Bewegung e.V
| | - S Stock
- Institut für Gesundheitsökonomie und Klinische Epidemiologie, Uniklinik Köln
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17
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Könnecke H, Giesen L, Goetz J, Redaèlli M, Konerding U, van der Arend I, Heßbrügge M, Biallas B, Wilm S, Vitinius F, Nacak Y, Lehmann L, Stock S. Personalisiertes Selbstmanagement Unterstützungsprogramm (P-SUP) für Patient*innen mit Diabetes mellitus Typ 2 und/oder koronarer Herzkrankheit. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732053] [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]
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Shah SA, Moore E, Robertson C, McMenamin J, Katikireddi SV, Simpson CR, Shi T, Agrawal U, McCowan C, Stock S, Ritchie LD, Sheikh A. Predicted COVID-19 positive cases, hospitalisations, and deaths associated with the Delta variant of concern, June-July, 2021. Lancet Digit Health 2021; 3:e539-e541. [PMID: 34384736 PMCID: PMC8352493 DOI: 10.1016/s2589-7500(21)00175-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 07/29/2021] [Indexed: 01/19/2023]
Affiliation(s)
| | | | | | | | | | | | - Ting Shi
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Uktarsh Agrawal
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Colin McCowan
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Sarah Stock
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK.
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19
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Hodgetts-Morton V, Hewitt CA, Jones L, Leighton L, Pilarski N, Molloy E, Hinshaw K, Norman J, Waugh J, Stock S, Thornton J, Toozs-Hobson P, Johnston T, Coomarasamy A, Thangaratinam S, Mol B, Pajkrt E, Marlow N, Roberts T, Middleton L, Brocklehurst P, Morris K. C-STICH2: emergency cervical cerclage to prevent miscarriage and preterm birth-study protocol for a randomised controlled trial. Trials 2021; 22:529. [PMID: 34380528 PMCID: PMC8356468 DOI: 10.1186/s13063-021-05464-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 07/16/2021] [Indexed: 11/30/2022] Open
Abstract
Background Cervical cerclage is a recognised treatment to prevent late miscarriage and pre-term birth (PTB). Emergency cervical cerclage (ECC) for cervical dilatation with exposed unruptured membranes is less common and the potential benefits of cerclage are less certain. A randomised control trial is needed to accurately assess the effectiveness of ECC in preventing pregnancy loss compared to an expectant approach. Methods C-STICH2 is a multicentre randomised controlled trial in which women presenting with cervical dilatation and unruptured exposed membranes at 16 + 0 to 27 + 6 weeks gestation are randomised to ECC or expectant management. Trial design includes 18 month internal pilot with embedded qualitative process evaluation, minimal data set and a within-trial health economic analysis. Inclusion criteria are ≥16 years, singleton pregnancy, exposed membranes at the external os, gestation 16 + 0–27 + 6 weeks, and informed consent. Exclusion criteria are contraindication to cerclage, cerclage in situ or previous cerclage in this pregnancy. Randomisation occurs via an online service in a 1:1 ratio, using a minimisation algorithm to reduce chance imbalances in key prognostic variables (site, gestation and dilatation). Primary outcome is pregnancy loss; a composite including miscarriage, termination of pregnancy and perinatal mortality defined as stillbirth and neonatal death in the first week of life. Secondary outcomes include all core outcomes for PTB. Two-year development outcomes will be assessed using general health and Parent Report of Children’s Abilities-Revised (PARCA-R) questionnaires. Intended sample size is 260 participants (130 each arm) based on 60% rate of pregnancy loss in the expectant management arm and 40% in the ECC arm, with 90% power and alpha 0.05. Analysis will be by intention-to-treat. Discussion To date there has been one small trial of ECC in 23 participants which included twin and singleton pregnancies. This small trial along with the largest observational study (n = 161) found ECC to prolong pregnancy duration and reduce deliveries before 34 weeks gestation. It is important to generate high quality evidence on the effectiveness of ECC in preventing pregnancy loss, and improve understanding of the prevalence of the condition and frequency of complications associated with ECC. An adequately powered RCT will provide the highest quality evidence regarding optimum care for these women and their babies. Trial registration ISRCTN Registry ISRCTN12981869. Registered on 13th June 2018.
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Affiliation(s)
| | | | | | | | | | | | - Kim Hinshaw
- City Hospitals Sunderland NHS Foundation Trust, Sunderland, UK
| | | | - Jason Waugh
- University of Auckland, Auckland, New Zealand
| | | | | | | | | | | | | | - Ben Mol
- University of Adelaide, Adelaide, UK
| | | | | | | | | | | | - Katie Morris
- Birmingham Clinical Trials Unit, Birmingham, UK. .,Institute of Applied Health Research, University of Birmingham, B15 2TT, Birmingham, UK.
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20
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Mol BW, Li W, Lai S, Stock S. Effectiveness of antenatal corticosteroids at term: Can we trust the data that 'inform' us? Eur J Obstet Gynecol Reprod Biol 2021; 261:144-147. [PMID: 33940424 DOI: 10.1016/j.ejogrb.2021.04.031] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 10/21/2022]
Abstract
Randomized controlled trials (RCTs) are a cornerstone for the assessment of the effectiveness of interventions. Appropriate randomization, design, sample size, statistical analyses, and conduct that reduces the risk of bias, enhance the chance they will deliver true research findings. The credibility of RCTs is difficult to assess without objective evidence of compliance with Good Clinical Practice standards. Remarkably, no mechanisms are in place both in the initial peer review process and during meta-analysis to assess these, and little guidance on how to assess data where research integrity cannot be confirmed (e.g. where data originated from a setting without established infrastructure or an era preceding current standards). We describe the case of the use of antenatal steroids. When these drugs are used in early preterm birth, their benefits outweigh the harms. However, later in pregnancy, and specifically at term, this balance is less clear. We describe that the four randomised clinical trials that inform clinical practice through the Cochrane meta-analysis, for various reasons, lack clear governance which makes it difficult to verify provenance and reliability of the data. We conclude that transparency and assessment of data credibility need to be inbuilt both at the time of publication and at the time of meta-analysis. This will drive up standards and encourage appropriate interpretation of results and the context from which they were derived.
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Affiliation(s)
- Ben W Mol
- Department of Obstetrics and Gynaecology, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.
| | - Wentao Li
- Department of Obstetrics and Gynaecology, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Shimona Lai
- Monash Women's, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria, 3168, Australia
| | - Sarah Stock
- University of Edinburgh Usher Institute, NINE Edinburgh BioQuarter, 9 Little France Road, Edinburgh, EH16 4UX, UK
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21
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O'Neill A, Stapley E, Stock S, Merrick H, Humphrey N. Adolescents' Understanding of What Causes Emotional Distress: A Qualitative Exploration in a Non-clinical Sample Using Ideal-Type Analysis. Front Public Health 2021; 9:673321. [PMID: 34109149 PMCID: PMC8181134 DOI: 10.3389/fpubh.2021.673321] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/21/2021] [Indexed: 11/16/2022] Open
Abstract
Background: There is increased interest in early intervention and prevention of mental health difficulties during adolescence; thus, we are seeing increased efforts to optimize well-being during this epoch. Positive emotional experiences are a central component of overall well-being. However, research exploring what adolescents perceive to be the cause(s) of their emotional difficulties is lacking. Improving understanding of this issue within non-clinical adolescent groups may provide useful insight into how to develop strategies to support young people as they navigate emotional difficulties. Objectives: The aim of this research was to explore if meaningful categories of perceived cause(s) for emotional distress exist for non-clinical adolescent groups. Methods: The data for this study were drawn from interviews across 6 sites in England conducted as part of the 5-year national evaluation of the HeadStart Learning Programme. The sample comprised of 32 young people aged 11–12 years from the first annual wave of qualitative data collection in 2017. Ideal type analysis—a qualitative form of person-centered analysis—was used to construct a typology of adolescents perceived cause(s) for emotional distress. Findings: We identified five distinct categories of perceived cause: (1) perceived lack of control; (2) unfair treatment; (3) others, their actions and judgements as the catalyst; (4) concerns for self and others; and, (5) self as cause. Conclusions: Our findings illustrate that distinct categories for perceived cause of emotional distress exist among adolescents considered to be “at risk” of developing mental health difficulties, which provides a foundation for future necessary work seeking to investigate the possible link between perceived cause for emotional distress and help-seeking behavior among sub-clinical groups.
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Affiliation(s)
- Alisha O'Neill
- Department of Education, The University of Manchester, Manchester, United Kingdom
| | - Emily Stapley
- Evidence Based Practice Unit (Anna Freud National Centre for Children and Families and University College London), London, United Kingdom
| | - Sarah Stock
- Evidence Based Practice Unit (Anna Freud National Centre for Children and Families and University College London), London, United Kingdom
| | - Hannah Merrick
- Evidence Based Practice Unit (Anna Freud National Centre for Children and Families and University College London), London, United Kingdom
| | - Neil Humphrey
- Department of Education, The University of Manchester, Manchester, United Kingdom
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22
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Vasileiou E, Simpson CR, Shi T, Kerr S, Agrawal U, Akbari A, Bedston S, Beggs J, Bradley D, Chuter A, de Lusignan S, Docherty AB, Ford D, Hobbs FR, Joy M, Katikireddi SV, Marple J, McCowan C, McGagh D, McMenamin J, Moore E, Murray JL, Pan J, Ritchie L, Shah SA, Stock S, Torabi F, Tsang RS, Wood R, Woolhouse M, Robertson C, Sheikh A. Interim findings from first-dose mass COVID-19 vaccination roll-out and COVID-19 hospital admissions in Scotland: a national prospective cohort study. Lancet 2021. [PMID: 33901420 DOI: 10.1016/s0140-6734(21)00677-2] [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] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
BACKGROUND The BNT162b2 mRNA (Pfizer-BioNTech) and ChAdOx1 nCoV-19 (Oxford-AstraZeneca) COVID-19 vaccines have shown high efficacy against disease in phase 3 clinical trials and are now being used in national vaccination programmes in the UK and several other countries. Studying the real-world effects of these vaccines is an urgent requirement. The aim of our study was to investigate the association between the mass roll-out of the first doses of these COVID-19 vaccines and hospital admissions for COVID-19. METHODS We did a prospective cohort study using the Early Pandemic Evaluation and Enhanced Surveillance of COVID-19-EAVE II-database comprising linked vaccination, primary care, real-time reverse transcription-PCR testing, and hospital admission patient records for 5·4 million people in Scotland (about 99% of the population) registered at 940 general practices. Individuals who had previously tested positive were excluded from the analysis. A time-dependent Cox model and Poisson regression models with inverse propensity weights were fitted to estimate effectiveness against COVID-19 hospital admission (defined as 1-adjusted rate ratio) following the first dose of vaccine. FINDINGS Between Dec 8, 2020, and Feb 22, 2021, a total of 1 331 993 people were vaccinated over the study period. The mean age of those vaccinated was 65·0 years (SD 16·2). The first dose of the BNT162b2 mRNA vaccine was associated with a vaccine effect of 91% (95% CI 85-94) for reduced COVID-19 hospital admission at 28-34 days post-vaccination. Vaccine effect at the same time interval for the ChAdOx1 vaccine was 88% (95% CI 75-94). Results of combined vaccine effects against hospital admission due to COVID-19 were similar when restricting the analysis to those aged 80 years and older (83%, 95% CI 72-89 at 28-34 days post-vaccination). INTERPRETATION Mass roll-out of the first doses of the BNT162b2 mRNA and ChAdOx1 vaccines was associated with substantial reductions in the risk of hospital admission due to COVID-19 in Scotland. There remains the possibility that some of the observed effects might have been due to residual confounding. FUNDING UK Research and Innovation (Medical Research Council), Research and Innovation Industrial Strategy Challenge Fund, Health Data Research UK.
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Affiliation(s)
| | - Colin R Simpson
- Usher Institute, The University of Edinburgh, Edinburgh, UK; School of Health, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Ting Shi
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Steven Kerr
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Utkarsh Agrawal
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Ashley Akbari
- Population Data Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - Stuart Bedston
- Population Data Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - Jillian Beggs
- The Health Data Research Hub for Respiratory Health, Edinburgh, UK
| | - Declan Bradley
- Public Health Agency, Belfast, UK; Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Antony Chuter
- Usher Institute, The University of Edinburgh, Edinburgh, UK; The Health Data Research Hub for Respiratory Health, Edinburgh, UK
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - David Ford
- Health Informatics, Health Informatics Group, College of Medicine, Swansea University, Swansea, UK
| | - Fd Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - James Marple
- Royal Infirmary of Edinburgh, NHS Lothian and Anaesthesia, Critical Care and Pain Medicine, The University of Edinburgh, Edinburgh, UK
| | - Colin McCowan
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Dylan McGagh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | | | | | - Jiafeng Pan
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - Lewis Ritchie
- Academic Primary Care, University of Aberdeen School of Medicine and Dentistry, Aberdeen, UK
| | | | - Sarah Stock
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Fatemeh Torabi
- Population Data Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - Ruby Sm Tsang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Rachael Wood
- Clinical and Public Health Intelligence team, Public Health Scotland, Edinburgh, UK
| | - Mark Woolhouse
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Chris Robertson
- Public Health Scotland, Glasgow UK; Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - Aziz Sheikh
- Usher Institute, The University of Edinburgh, Edinburgh, UK.
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23
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Vasileiou E, Simpson CR, Shi T, Kerr S, Agrawal U, Akbari A, Bedston S, Beggs J, Bradley D, Chuter A, de Lusignan S, Docherty AB, Ford D, Hobbs FR, Joy M, Katikireddi SV, Marple J, McCowan C, McGagh D, McMenamin J, Moore E, Murray JL, Pan J, Ritchie L, Shah SA, Stock S, Torabi F, Tsang RS, Wood R, Woolhouse M, Robertson C, Sheikh A. Interim findings from first-dose mass COVID-19 vaccination roll-out and COVID-19 hospital admissions in Scotland: a national prospective cohort study. Lancet 2021; 397:1646-1657. [PMID: 33901420 PMCID: PMC8064669 DOI: 10.1016/s0140-6736(21)00677-2] [Citation(s) in RCA: 376] [Impact Index Per Article: 125.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/12/2021] [Accepted: 03/17/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The BNT162b2 mRNA (Pfizer-BioNTech) and ChAdOx1 nCoV-19 (Oxford-AstraZeneca) COVID-19 vaccines have shown high efficacy against disease in phase 3 clinical trials and are now being used in national vaccination programmes in the UK and several other countries. Studying the real-world effects of these vaccines is an urgent requirement. The aim of our study was to investigate the association between the mass roll-out of the first doses of these COVID-19 vaccines and hospital admissions for COVID-19. METHODS We did a prospective cohort study using the Early Pandemic Evaluation and Enhanced Surveillance of COVID-19-EAVE II-database comprising linked vaccination, primary care, real-time reverse transcription-PCR testing, and hospital admission patient records for 5·4 million people in Scotland (about 99% of the population) registered at 940 general practices. Individuals who had previously tested positive were excluded from the analysis. A time-dependent Cox model and Poisson regression models with inverse propensity weights were fitted to estimate effectiveness against COVID-19 hospital admission (defined as 1-adjusted rate ratio) following the first dose of vaccine. FINDINGS Between Dec 8, 2020, and Feb 22, 2021, a total of 1 331 993 people were vaccinated over the study period. The mean age of those vaccinated was 65·0 years (SD 16·2). The first dose of the BNT162b2 mRNA vaccine was associated with a vaccine effect of 91% (95% CI 85-94) for reduced COVID-19 hospital admission at 28-34 days post-vaccination. Vaccine effect at the same time interval for the ChAdOx1 vaccine was 88% (95% CI 75-94). Results of combined vaccine effects against hospital admission due to COVID-19 were similar when restricting the analysis to those aged 80 years and older (83%, 95% CI 72-89 at 28-34 days post-vaccination). INTERPRETATION Mass roll-out of the first doses of the BNT162b2 mRNA and ChAdOx1 vaccines was associated with substantial reductions in the risk of hospital admission due to COVID-19 in Scotland. There remains the possibility that some of the observed effects might have been due to residual confounding. FUNDING UK Research and Innovation (Medical Research Council), Research and Innovation Industrial Strategy Challenge Fund, Health Data Research UK.
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Affiliation(s)
| | - Colin R Simpson
- Usher Institute, The University of Edinburgh, Edinburgh, UK; School of Health, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Ting Shi
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Steven Kerr
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Utkarsh Agrawal
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Ashley Akbari
- Population Data Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - Stuart Bedston
- Population Data Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - Jillian Beggs
- The Health Data Research Hub for Respiratory Health, Edinburgh, UK
| | - Declan Bradley
- Public Health Agency, Belfast, UK; Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Antony Chuter
- Usher Institute, The University of Edinburgh, Edinburgh, UK; The Health Data Research Hub for Respiratory Health, Edinburgh, UK
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - David Ford
- Health Informatics, Health Informatics Group, College of Medicine, Swansea University, Swansea, UK
| | - Fd Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - James Marple
- Royal Infirmary of Edinburgh, NHS Lothian and Anaesthesia, Critical Care and Pain Medicine, The University of Edinburgh, Edinburgh, UK
| | - Colin McCowan
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Dylan McGagh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | | | | | - Jiafeng Pan
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - Lewis Ritchie
- Academic Primary Care, University of Aberdeen School of Medicine and Dentistry, Aberdeen, UK
| | | | - Sarah Stock
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Fatemeh Torabi
- Population Data Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - Ruby Sm Tsang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Rachael Wood
- Clinical and Public Health Intelligence team, Public Health Scotland, Edinburgh, UK
| | - Mark Woolhouse
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Chris Robertson
- Public Health Scotland, Glasgow UK; Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - Aziz Sheikh
- Usher Institute, The University of Edinburgh, Edinburgh, UK.
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24
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Trifonov T, Caballero JA, Morales JC, Seifahrt A, Ribas I, Reiners A, Bean JL, Luque R, Parviainen H, Pallé E, Stock S, Zechmeister M, Amado PJ, Anglada-Escudé G, Azzaro M, Barclay T, Béjar VJS, Bluhm P, Casasayas-Barris N, Cifuentes C, Collins KA, Collins KI, Cortés-Contreras M, de Leon J, Dreizler S, Dressing CD, Esparza-Borges E, Espinoza N, Fausnaugh M, Fukui A, Hatzes AP, Hellier C, Henning T, Henze CE, Herrero E, Jeffers SV, Jenkins JM, Jensen ELN, Kaminski A, Kasper D, Kossakowski D, Kürster M, Lafarga M, Latham DW, Mann AW, Molaverdikhani K, Montes D, Montet BT, Murgas F, Narita N, Oshagh M, Passegger VM, Pollacco D, Quinn SN, Quirrenbach A, Ricker GR, Rodríguez López C, Sanz-Forcada J, Schwarz RP, Schweitzer A, Seager S, Shporer A, Stangret M, Stürmer J, Tan TG, Tenenbaum P, Twicken JD, Vanderspek R, Winn JN. A nearby transiting rocky exoplanet that is suitable for atmospheric investigation. Science 2021; 371:1038-1041. [PMID: 33674491 DOI: 10.1126/science.abd7645] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 02/02/2021] [Indexed: 11/02/2022]
Abstract
Spectroscopy of transiting exoplanets can be used to investigate their atmospheric properties and habitability. Combining radial velocity (RV) and transit data provides additional information on exoplanet physical properties. We detect a transiting rocky planet with an orbital period of 1.467 days around the nearby red dwarf star Gliese 486. The planet Gliese 486 b is 2.81 Earth masses and 1.31 Earth radii, with uncertainties of 5%, as determined from RV data and photometric light curves. The host star is at a distance of ~8.1 parsecs, has a J-band magnitude of ~7.2, and is observable from both hemispheres of Earth. On the basis of these properties and the planet's short orbital period and high equilibrium temperature, we show that this terrestrial planet is suitable for emission and transit spectroscopy.
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Affiliation(s)
- T Trifonov
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany.
| | - J A Caballero
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas - Instituto Nacional de Técnica Aeroespacial), E-28692 Villanueva de la Cañada, Madrid, Spain
| | - J C Morales
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), E-08193 Bellaterra, Barcelona, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - A Seifahrt
- Department of Astronomy and Astrophysics, University of Chicago, Chicago, IL 60637, USA
| | - I Ribas
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), E-08193 Bellaterra, Barcelona, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - A Reiners
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - J L Bean
- Department of Astronomy and Astrophysics, University of Chicago, Chicago, IL 60637, USA
| | - R Luque
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - H Parviainen
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - E Pallé
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - S Stock
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - M Zechmeister
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - P J Amado
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - G Anglada-Escudé
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), E-08193 Bellaterra, Barcelona, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - M Azzaro
- Centro Astronómico Hispano-Alemán, Observatorio de Calar Alto, E-04550 Gérgal, Almería, Spain
| | - T Barclay
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA.,University of Maryland, Baltimore County, Baltimore, MD 21250, USA
| | - V J S Béjar
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - P Bluhm
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - N Casasayas-Barris
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - C Cifuentes
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas - Instituto Nacional de Técnica Aeroespacial), E-28692 Villanueva de la Cañada, Madrid, Spain
| | - K A Collins
- Center for Astrophysics, Harvard & Smithsonian, Cambridge, MA 02138, USA
| | - K I Collins
- Department of Physics and Astronomy, George Mason University, Fairfax, VA 22030, USA
| | - M Cortés-Contreras
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas - Instituto Nacional de Técnica Aeroespacial), E-28692 Villanueva de la Cañada, Madrid, Spain
| | - J de Leon
- Department of Astronomy, Graduate School of Science, University of Tokyo, Tokyo 113-0033, Japan
| | - S Dreizler
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - C D Dressing
- Astronomy Department, University of California at Berkeley, Berkeley, CA 94720, USA
| | - E Esparza-Borges
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - N Espinoza
- Space Telescope Science Institute, Baltimore, MD 21218, USA
| | - M Fausnaugh
- Department of Physics and Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - A Fukui
- Department of Earth and Planetary Science, Graduate School of Science, University of Tokyo, Tokyo 113-0033, Japan.,Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain
| | - A P Hatzes
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - C Hellier
- Astrophysics Group, Keele University, Staffordshire ST5 5BG, UK
| | - Th Henning
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - C E Henze
- NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - E Herrero
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), E-08193 Bellaterra, Barcelona, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - S V Jeffers
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany.,Max-Planck-Institut für Sonnensystemforschung, D-37077, Göttingen, Germany
| | - J M Jenkins
- NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - E L N Jensen
- Department of Physics and Astronomy, Swarthmore College, Swarthmore, PA 19081, USA
| | - A Kaminski
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - D Kasper
- Department of Astronomy and Astrophysics, University of Chicago, Chicago, IL 60637, USA
| | - D Kossakowski
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - M Kürster
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - M Lafarga
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), E-08193 Bellaterra, Barcelona, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - D W Latham
- Center for Astrophysics, Harvard & Smithsonian, Cambridge, MA 02138, USA
| | - A W Mann
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - K Molaverdikhani
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - D Montes
- Departamento de Física de la Tierra y Astrofísica and Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - B T Montet
- School of Physics, University of New South Wales, Sydney NSW 2052, Australia
| | - F Murgas
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - N Narita
- Komaba Institute for Science, University of Tokyo, Tokyo 153-8902, Japan.,Japan Science and Technology Agency, Precursory Research for Embryonic Science and Technology, Tokyo 153-8902, Japan.,Astrobiology Center, Tokyo 181-8588, Japan.,Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain
| | - M Oshagh
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - V M Passegger
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany.,Homer L. Dodge Department of Physics and Astronomy, University of Oklahoma, Norman, OK 73019, USA
| | - D Pollacco
- Department of Physics, University of Warwick, Coventry CV4 7AL, UK
| | - S N Quinn
- Center for Astrophysics, Harvard & Smithsonian, Cambridge, MA 02138, USA
| | - A Quirrenbach
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - G R Ricker
- Department of Physics and Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - C Rodríguez López
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - J Sanz-Forcada
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas - Instituto Nacional de Técnica Aeroespacial), E-28692 Villanueva de la Cañada, Madrid, Spain
| | - R P Schwarz
- Patashnick Voorheesville Observatory, Voorheesville, NY 12186, USA
| | - A Schweitzer
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - S Seager
- Department of Physics and Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.,Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.,Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - A Shporer
- Department of Physics and Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - M Stangret
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - J Stürmer
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - T G Tan
- Perth Exoplanet Survey Telescope, Perth WA 6010, Australia
| | - P Tenenbaum
- Department of Physics and Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - J D Twicken
- Search for Extraterrestrial Intelligence Institute, Mountain View, CA 94043, USA.,NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - R Vanderspek
- Department of Physics and Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - J N Winn
- Department of Astrophysical Sciences, Princeton University, Princeton, NJ 08544, USA
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25
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Borghei-Razavi H, Lee J, Ibrahim B, Muhsen BA, Raghavan A, Wu I, Poturalski M, Stock S, Karakasis C, Adada B, Kshettry V, Recinos P. Accuracy and Interrater Reliability of CISS Versus Contrast-Enhanced T1-Weighted VIBE for the Presence of Optic Canal Invasion in Tuberculum Sellae Meningiomas. World Neurosurg 2021; 148:e502-e507. [PMID: 33444830 DOI: 10.1016/j.wneu.2021.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The magnetic resonance imaging sequence used to assess optic canal invasion by tuberculum sella meningiomas (TSMs) has not been standardized. Both constructive interference in steady state (CISS) and contrast-enhanced T1-weighted volume-interpolated breath-hold examination (VIBE) sequences are frequently used. The aim of the present study was to compare the accuracy and interrater reliability of these sequences in predicting optic canal invasion by TSMs. METHODS In the present retrospective study of 27 patients (54 optic canals) who had undergone endoscopic transtuberculum transplanum resection of TSMs, images from preoperative CISS and contrast-enhanced T1-weighted VIBE sequences were assessed by 5 neuroradiologists who were unaware of the operative findings. The readers evaluated the optic canal in 4 quadrants at 2 locations (the posterior tip of the anterior clinoid process and the optic strut). A quadrant was considered positive for tumor invasion if invasion was present at either of these 2 locations. The reference standard was intraoperative observation of gross optic canal invasion. RESULTS The interrater agreement was good for the presence or absence of tumor involvement in a particular quadrant (CISS, 0.635; VIBE, 0.643; 95% confidence interval for the difference, -0.086 to 0.010). The mean sensitivity and specificity for optic nerve invasion were 0.643 and 0.438 with CISS and 0.643 and 0.454 with VIBE, respectively. No significant differences were seen between the sequences in terms of reader accuracy when the intraoperative findings were used as the reference standard. CONCLUSION CISS and VIBE sequences both have good accuracy in predicting for optic canal tumor invasion by TMEs.
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Affiliation(s)
- Hamid Borghei-Razavi
- Department of Neurosurgery, Cleveland Clinic Florida Egil and Pauline Braathen Center, Neurological Institute, Cleveland Clinic, Weston, Florida, USA.
| | - Jonathan Lee
- Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Bilal Ibrahim
- Department of Neurosurgery, Cleveland Clinic Florida Egil and Pauline Braathen Center, Neurological Institute, Cleveland Clinic, Weston, Florida, USA
| | - Baha'eddin A Muhsen
- Department of Neurosurgery, Cleveland Clinic Florida Egil and Pauline Braathen Center, Neurological Institute, Cleveland Clinic, Weston, Florida, USA
| | - Alankrita Raghavan
- Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Ingrid Wu
- Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Matthew Poturalski
- Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sarah Stock
- Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Christopher Karakasis
- Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Badih Adada
- Department of Neurosurgery, Cleveland Clinic Florida Egil and Pauline Braathen Center, Neurological Institute, Cleveland Clinic, Weston, Florida, USA
| | - Varun Kshettry
- Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Pablo Recinos
- Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Yiasemidou M, Mushtaq F, Basheer M, Galli R, Panagiotou D, Stock S, Preston N, Mon-Williams M, Jayne DG, Miskovic D. Patient-specific mental rehearsal with three-dimensional models before low anterior resection: randomized clinical trial. BJS Open 2020. [PMCID: PMC7944490 DOI: 10.1093/bjsopen/zraa004] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background It was hypothesized that preparing for a surgical procedure, taking into account individual patient characteristics, may facilitate the procedure and improve surgical quality. The aim of this study was to compare different case-specific, preoperative mental rehearsal methods before minimally invasive rectal cancer surgery. Methods In this RCT, patients were allocated in a 1 : 1 : 1 : 1 ratio to four groups: systematic mental rehearsal (SMR) using MRI scans; SMR and three-dimensional (3D) virtual models; SMR and synthetic 3D printed models; and routine practice (control group). Surgeons operating on all but the control group underwent mental rehearsal with the visual aids, including axial MRI scans of the pelvis, interactive 3D virtual models reconstructed from axial MRIs, and synthetic models, manufactured by 3D printing. Operations were video-recorded and assessed by two experts blinded to allocation using two validated scores, the Competency Assessment Tool (CAT) and Objective Clinical Human Reliability Analysis (OCHRA). The primary outcome of the study was surgical performance, measured by the CAT. Results Forty-nine patients were randomized and allocated to the four groups. There were 12 participants in each of the control, MRI and SMR, and virtual and SMR groups, whereas the SMR using physical models and simulation group included 13. No difference was observed between groups in median CAT scores (control 30.50, MRI 34.25, virtual 31.75, physical 34.00; P = 0.748, partial η2 <0.001, where pη2 is indicative of effect size) or OCHRA scores (anterior, posterior, right and left lateral planes, transection P>0.200, pη2 =0.052–0.088). Time spent not performing dissection was significantly shorter for the SMR with MRI group than for the control (57.5 versus 42 respectively; P < 0.001, pη2 =0.212). Conclusion Mental rehearsal did not affect CAT and OCHRA scores of consultant surgeons. Reference number: ISRCTN 75603704 (https://www.isrctn.com).
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Affiliation(s)
- M Yiasemidou
- Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, St James’s University Hospital, Leeds, UK
- Academic Surgery, University of Hull, Hull, UK
| | - F Mushtaq
- School of Psychology, University of Leeds, Leeds, UK
| | - M Basheer
- Department of Colorectal Surgery, Pinderfields Hospital, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
| | - R Galli
- Department of Colorectal Surgery, St James’s University Hospital, Leeds Teaching Hospitals, Leeds, UK
| | - D Panagiotou
- General Surgery, York Teaching Hospital, York, UK
| | - S Stock
- General and Trauma Surgery, World Mate Emergency Hospital, Battambang, Cambodia
| | - N Preston
- School of Psychology, University of Leeds, Leeds, UK
| | | | - D G Jayne
- Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, St James’s University Hospital, Leeds, UK
- Department of Colorectal Surgery, St James’s University Hospital, Leeds Teaching Hospitals, Leeds, UK
| | - D Miskovic
- Department of Colorectal Surgery, St Mark’s Hospital, Harrow, London, UK
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Winter I, Stock S, Reddy C, Fleming C, Joshi N, Woody N, Burkey B, Ku J, Lamarre E, Lorenz R, Prendes B, Scharpf J, Adelstein D, Geiger J, Schwartzman L, Koyfman S, Lee J. Adverse Radiologic Features associated with Worse Outcomes in cN2b-N3 (by AJCC 7th Ed) HPV- Head and Neck Cancers. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.360] [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: 11/29/2022]
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Nawabi F, Lorenz L, Krebs F, Alayli A, Lück I, Bau AM, Stock S. Protocol of a study to evaluate a lifestyle intervention during pregnancy. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The risk of developing obesity and chronic diseases (e.g. diabetes mellitus) in children is influenced by the mother's lifestyle during pregnancy (prenatal programming). This study evaluates a computer-assisted preventive lifestyle counseling carried out during prenatal visits and infant check-ups. GeMuKi (acronym for 'strengthening health promotion: enhanced check-up visits for mother and child') is a complex intervention consisting of multiple components implemented by different cooperating healthcare providers.
Methods
GeMuKi supplements regular prenatal visits and infant check-ups with an additional counseling regarding physical activity, nutrition and alcohol and tobacco use. Providers, who carry out the counseling, receive communication training using motivational interviewing techniques. Pregnant women in 4 intervention regions in Germany receive GeMuKi from gynecologists, midwives and pediatricians, while participants in the 4 control regions receive standard care. As part of a hybrid effectiveness-implementation trial with 1860 participants, questionnaires are filled in at 4 time points. Weight development and health data of the mother and child are recorded. Health services use will be analyzed using statutory health insurance claims data. Interviews will be conducted to evaluate the implementation process.
Results
Targeted preventive measures at the beginning of pregnancy intend to reduce the risk of inadequate gestational weight gain (primary outcome). Secondary endpoints are amongst others maternal lifestyle, infant weight development and body composition.
Conclusions
GeMuKi is set up as a long-term, low-threshold, multimodal intervention in living environments and existing structures. Findings will add to the evidence on lifestyle interventions during pregnancy to reduce the risk for overweight and obesity. Results will contribute to the prevention of early programming of chronic disease and will inform decisions about scale up and public funding.
Key messages
Lifestyle interventions provided from the beginning of pregnancy intent to be beneficial for the health of both mother and child to prevent obesity and chronic diseases. Low-threshold interventions embedded in regular prenatal visits are accessible for the complete pregnant population, including vulnerable groups.
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Affiliation(s)
- F Nawabi
- Institute of Health Economics and Clinical Epidemiology, University Hospital Cologne, Cologne, Germany
| | - L Lorenz
- Institute of Health Economics and Clinical Epidemiology, University Hospital Cologne, Cologne, Germany
| | - F Krebs
- Institute of Health Economics and Clinical Epidemiology, University Hospital Cologne, Cologne, Germany
| | - A Alayli
- Institute of Health Economics and Clinical Epidemiology, University Hospital Cologne, Cologne, Germany
- Federal Centre for Health Education, Cologne, Germany
| | - I Lück
- Platform Nutrition and Physical Activity, Berlin, Germany
| | - A M Bau
- Platform Nutrition and Physical Activity, Berlin, Germany
| | - S Stock
- Institute of Health Economics and Clinical Epidemiology, University Hospital Cologne, Cologne, Germany
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Nambiema A, Bodin J, Fouquet N, Bertrais S, Stock S, Aublet-Cuvelier A, Descatha A, Roquelaure Y. Troubles musculo-squelettiques du membre supérieur : combien de cas peuvent être évités ? Estimations à partir de la cohorte Cosali pour la région française des Pays de la Loire. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Giesen L, Könnecke H, Redaèlli M, Simic D, Heßbrügge M, Vitinius F, van der Arend I, Graf C, Biallas B, Stock S. Peer support program (P-SUP) to strengthen self-management in patients with chronic conditions. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1122] [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
Chronic care programmes (CCPs) ensure a standardised, evidence based and structured patient care. In Germany, CCPs are successful in improving quality of care and making care more patient-centred. Regarding self-management support, however, the programs only feature patient education and shared decisions on treatment goals. Peer support has proven to be a successful component in outpatient care to enhance self-management. The aim of this study is to support patients with type 2 diabetes and coronary artery disease in conducting successful self-management through a multimodal program.
Methods
This randomized controlled trial (RCT) is set up for 27 months and will include a study population of approximately 1800 patients, beginning in summer 2020. The primary outcome (PO) is the reduction of hospital admissions. In addition to the PO, secondary outcomes include motivational and knowledge-based aspects. Furthermore, health-competitive and health-economic data will be collected. The formative evaluation will review the processes for implementation. The central element of the intervention will be peer support groups, in which the group will participate in physical activities and educational lectures on nutrition, exercise or disease related knowledge. Additionally, a specially designed online platform, personalized feedback for patients on medical outcomes from their family doctors, and regular telephone coaching to increase intrinsic motivation and activation will be provided.
Results
In addition to the primary outcome (reduction of hospital admissions), increased motivation levels, improved quality of life and increased health literacy are expected.
Conclusions
This project, funded by the Federal Joint Committee (establishment of statutory health insurance funds and medical providers in Germany), can serve as a blueprint for future implementations of public health approaches and accessible care models for patients with chronic conditions.
Key messages
Peer support as a successful method to enhance self-management in patients with type 2 diabetes and coronary artery disease. A multimodal program, consisting of peer support groups, an online platform, personalized medical feedback and telephone coaching, aiming to improve quality of life in patients with chronic conditions.
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Affiliation(s)
- L Giesen
- Institute of Health Economics and Clinical Epidemiology, The University Hospital of Cologne, Cologne, Germany
| | - H Könnecke
- Institute of Health Economics and Clinical Epidemiology, The University Hospital of Cologne, Cologne, Germany
| | - M Redaèlli
- Institute of Health Economics and Clinical Epidemiology, The University Hospital of Cologne, Cologne, Germany
| | - D Simic
- Institute of Health Economics and Clinical Epidemiology, The University Hospital of Cologne, Cologne, Germany
| | - M Heßbrügge
- Institute of General Medicine, Essen University Hospital, Essen, Germany
| | - F Vitinius
- Department of Psychosomatics and Psychotherapy, The University Hospital of Cologne, Cologne, Germany
| | | | - C Graf
- Department Healthcare Management and Disease Prevention, BEK, Düsseldorf, Germany
| | - B Biallas
- Institute for Movement-Oriented Prevention & Rehabilitation, German Sports University Cologne, Cologne, Germany
| | - S Stock
- Institute of Health Economics and Clinical Epidemiology, The University Hospital of Cologne, Cologne, Germany
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Isselhard A, Töpper M, Berger-Höger B, Steckelberg A, Fischer H, Vitinius F, Beifus K, Köberlein-Neu J, Wiedemann R, Rhiem K, Schmutzler R, Stock S. Implementation and evaluation of a nurse-led decision-coaching program for healthy breast cancer susceptibility gene (BRCA1/2) mutation carriers: a study protocol for the randomized controlled EDCP-BRCA study. Trials 2020; 21:501. [PMID: 32513307 PMCID: PMC7278068 DOI: 10.1186/s13063-020-04431-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/19/2020] [Indexed: 12/16/2022] Open
Abstract
Background Female BRCA mutation carriers have an increased lifetime risk for breast and ovarian cancer compared to the general population. Women who carry this mutation have several options to deal with their cancer risk, such as risk-reducing surgeries or intensified breast cancer screening. Previous research has shown that preferences in this scenario are highly dependent on affected women’s personalities and value systems. To support these women in the decision-making process, a structured decision support consisting of decision coaching combined with a decision aid might be helpful. Methods/design A randomized controlled trial will be conducted in order to compare usual care with structured decision support alongside usual care. The decision support program entails nurse-led decision coaching as well as an evidence-based patient decision aid. Nurses are qualified by a 4-day training program in informed decision-making and decision coaching. Six centers for Familial Breast and Ovarian Cancer in Germany will be included in the study, with a planned sample size of 398 women. The primary outcome is the congruence between the preferred and the actual played role in the decision-making process as measured by the Control Preferences Scale. It is hypothesized that the structured decision support will enable women to play the preferred role in the decision-making process. Secondary outcomes include the knowledge and attitudes about preventive options, decisional conflict, depression and anxiety, coping self-efficacy, impact of event, and self-concept. A process evaluation will accompany the study. Discussion The EDCP-BRCA study is the first study to implement and evaluate decision coaching combined with a decision aid for healthy BRCA mutation carriers worldwide. Trial registration {2a} DRKS-ID: DRKS00015527. Registered 30 October 2019.
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Affiliation(s)
- A Isselhard
- Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne, Cologne, Germany.
| | - M Töpper
- Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne, Cologne, Germany
| | - B Berger-Höger
- Institute for Health and Nursing Science, Faculty of Medicine, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - A Steckelberg
- Institute for Health and Nursing Science, Faculty of Medicine, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - H Fischer
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - F Vitinius
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - K Beifus
- Center for Health Economics and Health Services Research, Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany
| | - J Köberlein-Neu
- Center for Health Economics and Health Services Research, Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany
| | - R Wiedemann
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - K Rhiem
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - R Schmutzler
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - S Stock
- Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne, Cologne, Germany
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Abstract
IMPORTANCE Twin pregnancies account for 3% of live births but experience substantially more perinatal morbidity and mortality than singleton pregnancies. Optimizing the timing of birth is a key strategy in improving twin pregnancy outcomes. Current UK and US policies are based on observational studies of perinatal mortality and not on longer-term effects. The association of timing of birth with long-term childhood outcomes among twins is uncertain. OBJECTIVE To identify the optimal gestation week for birth of twin infants by calculating the week of birth associated with the lowest risk of short-term and long-term adverse outcomes (perinatal mortality and special educational need [SEN] at school). DESIGN, SETTING, AND PARTICIPANTS This population-based, data-linkage cohort study included 43 133 twin infants born at a gestational age of 34 weeks onward between January 1, 1980, and December 31, 2015, in Scotland. The data were analyzed from June 1, 2017, to March 1, 2019. EXPOSURES Gestational age (in weeks) at the time of birth. MAIN OUTCOMES AND MEASURES The primary outcomes were extended perinatal mortality and a record of SEN (≥1 of intellectual disabilities, dyslexia, physical or motor impairment, language or speech disorder, autistic spectrum disorder, and social, emotional, or behavioral difficulties) at school (children aged 4-18 years). To infer the consequence of the gestational age at birth, clinical outcomes of twin infants born at each week of gestation from 34 weeks onward were compared with those of twin infants remaining in utero thereafter. RESULTS Of the total 43 133 twin infants included in the study, 21 696 (50.3%) were females. Although maternity records were available for all infants, 9519 sex-discordant twin children were linked to their educational data, of whom 1069 (13.8%) had a record of SEN. Compared with twins remaining in utero (n = 26 172), birth at any gestational age from 34 to 37 weeks was associated with increased odds of perinatal death (ie, adjusted odds ratio [AOR], 1.99; 95% CI, 1.53-2.69 at 36 weeks [n = 8056]) and increased risk of SEN at school (AOR, 1.39; 95% CI, 1.11-1.74, for birth at 36 weeks compared with 37 weeks). In a competing risk analysis, the risks of stillbirth and neonatal death were balanced at 37 weeks (risk difference, 2.05; 95% CI, 0.8-3.3). CONCLUSIONS AND RELEVANCE The findings of this study suggest that, in the absence of a medical complication, twins should not be routinely delivered before 37 completed weeks of gestation. These findings may help optimize shared decision-making around the timing of twin birth.
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Affiliation(s)
- Sarah Murray
- MRC Centre for Reproductive Health, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, Scotland
| | - Daniel MacKay
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Sarah Stock
- MRC Centre for Reproductive Health, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, Scotland
| | - Jill Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Jane Norman
- Faculty of Health Sciences, University of Bristol, Bristol, England
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Wastnedge E, Vogel J, Been JV, Bannerman-Gyamfi C, Schuit E, Roberts D, Reynolds RM, Stock S. An evaluation of the benefits and harms of antenatal corticosteroid treatment for women at risk of imminent preterm birth or prior to elective Caesarean-section: Study protocol for an individual participant data meta-analysis. Wellcome Open Res 2020; 5:38. [PMID: 32529039 PMCID: PMC7268149 DOI: 10.12688/wellcomeopenres.15661.1] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2020] [Indexed: 12/19/2022] Open
Abstract
Background: Antenatal corticosteroid treatment (ACT) has been widely accepted as a safe, beneficial treatment which improves outcomes following preterm birth. It has been shown to reduce respiratory distress syndrome and neonatal mortality and is commonly used in threatened or planned preterm delivery, as well as prior to elective Caesarean-section at term. There are some concerns however, that in some cases, ACT is used in patients where clinical benefit has not been established, or may potentially increase harm. Many women who receive ACT do not deliver preterm and the long-term consequences of ACT treatment are unclear. This study aims to evaluate the benefits and harms of ACT using latest trial evidence to allow refinement of current practice. Methods: This study will compare ACT with placebo or non-treatment. Inclusion criteria are: Randomised Controlled Trials (RCT) comparing ACT vs. no ACT (with or without placebo) in all settings. Exclusion criteria are: non-randomised or quasi-randomised studies and studies comparing single vs. multiple courses of ACT. Main outcomes are to evaluate, for women at risk of preterm birth or undergoing planned Caesarean- section, the benefits and harms of ACT, on maternal, fetal, newborn, and long-term offspring health outcomes. The individual participant data (IPD) of identified RCTs will be collected and consecutively synthesised using meta-analysis with both a one-stage model where all IPD is analysed together and a two-stage model where treatment effect estimates are calculated for each trial individually first and thereafter pooled in a meta-analysis. Sub-group analysis will be performed to identify heterogeneous effects of ACT across predefined risk groups. Discussion: Co-opt is the Consortium for the Study of Pregnancy Treatments and aims to complete a robust evaluation of the benefits and harms of ACT. This IPD meta-analysis will contribute to this by allowing detailed interrogation of existing trial datasets. PROSPERO registration: CRD42020167312 (03/02/2020).
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Affiliation(s)
| | - Joshua Vogel
- Maternal and Child Health Program, Burnet Institute, Melbourne, Australia
| | - Jasper V. Been
- Division of Neonatology, Department of Paediatrics, Division of Obstetrics and Gynaecology and Department of Publisc Health, Erasmus MC, Rotterdam, The Netherlands
| | | | - Ewoud Schuit
- Julian Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Rebecca M. Reynolds
- Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Sarah Stock
- Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Co_Opt collaboration
- Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
- Maternal and Child Health Program, Burnet Institute, Melbourne, Australia
- Division of Neonatology, Department of Paediatrics, Division of Obstetrics and Gynaecology and Department of Publisc Health, Erasmus MC, Rotterdam, The Netherlands
- Department of Obstetrics and Gynaecology, Columbia University, New York, USA
- Julian Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Liverpool Women's Hospital NHS Foundation Trust, Liverpool, UK
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
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Khalil A, Sharp A, Cornforth C, Jackson R, Mousa H, Stock S, Harrold J, Turner MA, Kenny LC, Baker PN, Johnstone ED, Von Dadelszen P, Magee L, Papageorghiou AT, Alfirevic Z. Effect of sildenafil on maternal hemodynamics in pregnancies complicated by severe early-onset fetal growth restriction: planned subgroup analysis from a multicenter randomized placebo-controlled double-blind trial. Ultrasound Obstet Gynecol 2020; 55:198-209. [PMID: 31432556 DOI: 10.1002/uog.20851] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 07/07/2019] [Accepted: 08/09/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Fetal growth restriction (FGR) is associated with maternal cardiovascular changes. Sildenafil, a phosphodiesterase type-5 inhibitor, potentiates the actions of nitric oxide, and it has been suggested that it alters maternal hemodynamics, potentially improving placental perfusion. Recently, the Dutch STRIDER trial was stopped prematurely owing to excess neonatal mortality secondary to pulmonary hypertension. The main aim of this study was to investigate the effect of sildenafil on maternal hemodynamics in pregnancies with severe early-onset FGR. METHODS This was a cardiovascular substudy within a UK multicenter, placebo-controlled trial, in which 135 women with a singleton pregnancy and severe early-onset FGR (defined as a combination of estimated fetal weight or abdominal circumference below the 10th centile and absent/reversed end-diastolic flow in the umbilical artery on Doppler velocimetry, diagnosed between 22 + 0 and 29 + 6 weeks' gestation) were assigned randomly to receive either 25 mg sildenafil three times daily or placebo until 32 + 0 weeks' gestation or delivery. Maternal blood pressure (BP), heart rate (HR), augmentation index, pulse wave velocity (PWV), cardiac output, stroke volume (SV) and total peripheral resistance were recorded before randomization, 1-2 h and 48-72 h post-randomization, and 24-48 h postnatally. For continuous data, analysis was performed using repeated measures ANOVA methods including terms for timepoint, treatment allocation and their interaction. RESULTS Included were 134 women assigned randomly to sildenafil (n = 69) or placebo (n = 65) who had maternal BP and HR recorded at baseline. At 1-2 h post-randomization, compared with baseline values, sildenafil increased maternal HR by 4 bpm more than did placebo (mean difference, 5.00 bpm (95% CI, 1.00-12.00 bpm) vs 1.25 bpm (95% CI, -5.38 to 7.88 bpm); P = 0.004) and reduced systolic BP by 1 mmHg more (mean difference, -4.13 mmHg (95% CI, -9.94 to 1.44 mmHg) vs -2.75 mmHg (95% CI, -7.50 to 5.25 mmHg); P = 0.048). Even after adjusting for maternal mean arterial pressure, sildenafil reduced aortic PWV by 0.60 m/s more than did placebo (mean difference, -0.90 m/s (95% CI, -1.31 to -0.51 m/s) vs -0.26 m/s (95% CI, -0.75 to 0.59 m/s); P = 0.001). Sildenafil was associated with a non-significantly greater decrease in SV index after 1-2 h post-randomization than was placebo (mean difference, -5.50 mL/m2 (95% CI, -11.00 to -0.50 mL/m2 ) vs 0.00 mL/m2 (95% CI, -5.00 to 4.00 mL/m2 ); P = 0.056). CONCLUSIONS Sildenafil in a dose of 25 mg three times daily increases HR, reduces BP and reduces arterial stiffness in pregnancies complicated by severe early-onset FGR. These changes are short term, modest and consistent with the anticipated vasodilatory effect. They have no short- or long-term clinical impact on the mother. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- A Khalil
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - A Sharp
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - C Cornforth
- Liverpool Clinical Trials Unit, University of Liverpool, Liverpool, UK
| | - R Jackson
- Liverpool Clinical Trials Unit, University of Liverpool, Liverpool, UK
| | - H Mousa
- Fetal Medicine Unit, University of Leicester, Leicester, UK
| | - S Stock
- The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - J Harrold
- Liverpool Clinical Trials Unit, University of Liverpool, Liverpool, UK
| | - M A Turner
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - L C Kenny
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - P N Baker
- College of Life Sciences, University of Leicester, Leicester, UK
| | - E D Johnstone
- Maternal & Fetal Health Research Centre, University of Manchester, Manchester, UK
| | - P Von Dadelszen
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - L Magee
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - A T Papageorghiou
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - Z Alfirevic
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
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Lamarca A, Santos A, Utpatel K, La Casta A, Stock S, Forner A, Adeva Alfonso J, Folseraas T, Fabris L, Macias R, Krawczyk M, Krawczyk M, Cardinale V, Braconi C, Alvaro D, Evert M, Bañales J, Valle J. Liver metastases (LM) from intrahepatic cholangiocarcinoma (iCCA): Outcomes from the European Network for the study of cholangiocarcinoma (ENS-CCA) registry and implications on current American Joint Committee on Cancer (AJCC) staging. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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36
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Morales JC, Mustill AJ, Ribas I, Davies MB, Reiners A, Bauer FF, Kossakowski D, Herrero E, Rodríguez E, López-González MJ, Rodríguez-López C, Béjar VJS, González-Cuesta L, Luque R, Pallé E, Perger M, Baroch D, Johansen A, Klahr H, Mordasini C, Anglada-Escudé G, Caballero JA, Cortés-Contreras M, Dreizler S, Lafarga M, Nagel E, Passegger VM, Reffert S, Rosich A, Schweitzer A, Tal-Or L, Trifonov T, Zechmeister M, Quirrenbach A, Amado PJ, Guenther EW, Hagen HJ, Henning T, Jeffers SV, Kaminski A, Kürster M, Montes D, Seifert W, Abellán FJ, Abril M, Aceituno J, Aceituno FJ, Alonso-Floriano FJ, Ammler-von Eiff M, Antona R, Arroyo-Torres B, Azzaro M, Barrado D, Becerril-Jarque S, Benítez D, Berdiñas ZM, Bergond G, Brinkmöller M, Del Burgo C, Burn R, Calvo-Ortega R, Cano J, Cárdenas MC, Guillén CC, Carro J, Casal E, Casanova V, Casasayas-Barris N, Chaturvedi P, Cifuentes C, Claret A, Colomé J, Czesla S, Díez-Alonso E, Dorda R, Emsenhuber A, Fernández M, Fernández-Martín A, Ferro IM, Fuhrmeister B, Galadí-Enríquez D, Cava IG, Vargas MLG, Garcia-Piquer A, Gesa L, González-Álvarez E, Hernández JIG, González-Peinado R, Guàrdia J, Guijarro A, de Guindos E, Hatzes AP, Hauschildt PH, Hedrosa RP, Hermelo I, Arabi RH, Otero FH, Hintz D, Holgado G, Huber A, Huke P, Johnson EN, de Juan E, Kehr M, Kemmer J, Kim M, Klüter J, Klutsch A, Labarga F, Labiche N, Lalitha S, Lampón M, Lara LM, Launhardt R, Lázaro FJ, Lizon JL, Llamas M, Lodieu N, López Del Fresno M, Salas JFL, López-Santiago J, Madinabeitia HM, Mall U, Mancini L, Mandel H, Marfil E, Molina JAM, Martín EL, Martín-Fernández P, Martín-Ruiz S, Martínez-Rodríguez H, Marvin CJ, Mirabet E, Moya A, Naranjo V, Nelson RP, Nortmann L, Nowak G, Ofir A, Pascual J, Pavlov A, Pedraz S, Medialdea DP, Pérez-Calpena A, Perryman MAC, Rabaza O, Ballesta AR, Rebolo R, Redondo P, Rix HW, Rodler F, Trinidad AR, Sabotta S, Sadegi S, Salz M, Sánchez-Blanco E, Carrasco MAS, Sánchez-López A, Sanz-Forcada J, Sarkis P, Sarmiento LF, Schäfer S, Schlecker M, Schmitt JHMM, Schöfer P, Solano E, Sota A, Stahl O, Stock S, Stuber T, Stürmer J, Suárez JC, Tabernero HM, Tulloch SM, Veredas G, Vico-Linares JI, Vilardell F, Wagner K, Winkler J, Wolthoff V, Yan F, Osorio MRZ. A giant exoplanet orbiting a very-low-mass star challenges planet formation models. Science 2019; 365:1441-1445. [PMID: 31604272 DOI: 10.1126/science.aax3198] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 08/27/2019] [Indexed: 01/03/2023]
Abstract
Surveys have shown that super-Earth and Neptune-mass exoplanets are more frequent than gas giants around low-mass stars, as predicted by the core accretion theory of planet formation. We report the discovery of a giant planet around the very-low-mass star GJ 3512, as determined by optical and near-infrared radial-velocity observations. The planet has a minimum mass of 0.46 Jupiter masses, very high for such a small host star, and an eccentric 204-day orbit. Dynamical models show that the high eccentricity is most likely due to planet-planet interactions. We use simulations to demonstrate that the GJ 3512 planetary system challenges generally accepted formation theories, and that it puts constraints on the planet accretion and migration rates. Disk instabilities may be more efficient in forming planets than previously thought.
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Affiliation(s)
- J C Morales
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain. .,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - A J Mustill
- Lund Observatory, Department of Astronomy and Theoretical Physics, Lund University, Box 43, SE-221 00 Lund, Sweden
| | - I Ribas
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - M B Davies
- Lund Observatory, Department of Astronomy and Theoretical Physics, Lund University, Box 43, SE-221 00 Lund, Sweden
| | - A Reiners
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - F F Bauer
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - D Kossakowski
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - E Herrero
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - E Rodríguez
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - M J López-González
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - C Rodríguez-López
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - V J S Béjar
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - L González-Cuesta
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - R Luque
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - E Pallé
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - M Perger
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - D Baroch
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - A Johansen
- Lund Observatory, Department of Astronomy and Theoretical Physics, Lund University, Box 43, SE-221 00 Lund, Sweden
| | - H Klahr
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - C Mordasini
- Physikalisches Institut, Universität Bern, CH-3012 Bern, Switzerland
| | - G Anglada-Escudé
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain.,School of Physics and Astronomy, Queen Mary University of London, London E1 4NS, UK
| | - J A Caballero
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain
| | - M Cortés-Contreras
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain
| | - S Dreizler
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - M Lafarga
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - E Nagel
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - V M Passegger
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - S Reffert
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - A Rosich
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - A Schweitzer
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - L Tal-Or
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany.,Department of Geophysics, Raymond and Beverly Sackler Faculty of Exact Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
| | - T Trifonov
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - M Zechmeister
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - A Quirrenbach
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - P J Amado
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - E W Guenther
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - H-J Hagen
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - T Henning
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - S V Jeffers
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - A Kaminski
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - M Kürster
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - D Montes
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - W Seifert
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - F J Abellán
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Departamento de Astronomía y Astrofísica, Universidad de Valencia, E-46100 Burjassot, Spain
| | - M Abril
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - J Aceituno
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain.,Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - F J Aceituno
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - F J Alonso-Floriano
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Leiden Observatory, Leiden University, 2300 RA Leiden, Netherlands
| | - M Ammler-von Eiff
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany.,Max Planck Institute for Solar System Research, D-37077 Göttingen, Germany
| | - R Antona
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - B Arroyo-Torres
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - M Azzaro
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - D Barrado
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain
| | - S Becerril-Jarque
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - D Benítez
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - Z M Berdiñas
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain.,Departamento de Astronomía, Universidad de Chile, Camino El Observatorio, 1515 Las Condes, Santiago, Chile
| | - G Bergond
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - M Brinkmöller
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - C Del Burgo
- Instituto Nacional de Astrofísica, Óptica y Electrónica, Santa María Tonantzintla, Puebla, Mexico
| | - R Burn
- Physikalisches Institut, Universität Bern, CH-3012 Bern, Switzerland
| | - R Calvo-Ortega
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - J Cano
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - M C Cárdenas
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - C Cardona Guillén
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - J Carro
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - E Casal
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - V Casanova
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - N Casasayas-Barris
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - P Chaturvedi
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - C Cifuentes
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain.,Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - A Claret
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - J Colomé
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - S Czesla
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - E Díez-Alonso
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Departamento de Explotación y Prospeción de Minas, Escuela de Minas, Energía y Materiales, Universidad de Oviedo, E-33003 Oviedo, Asturias, Spain
| | - R Dorda
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain.,Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - A Emsenhuber
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ 85721, USA
| | - M Fernández
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - A Fernández-Martín
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - I M Ferro
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - B Fuhrmeister
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - D Galadí-Enríquez
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - I Gallardo Cava
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Observatorio Astronómico Nacional (OAN-Instituto Geográfico Nacional), E-28803 Alcalá de Henares, Spain
| | | | - A Garcia-Piquer
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - L Gesa
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - E González-Álvarez
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), E-28850 Torrejón de Ardoz, Madrid, Spain
| | - J I González Hernández
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - R González-Peinado
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - J Guàrdia
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - A Guijarro
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - E de Guindos
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - A P Hatzes
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - P H Hauschildt
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - R P Hedrosa
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - I Hermelo
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - R Hernández Arabi
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - F Hernández Otero
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - D Hintz
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - G Holgado
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain.,Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - A Huber
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - P Huke
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - E N Johnson
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - E de Juan
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - M Kehr
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - J Kemmer
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - M Kim
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany.,Institut für Theoretische Physik und Astrophysik, D-24118 Kiel, Germany
| | - J Klüter
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany.,Zentrum für Astronomie der Universität Heidelberg, Astronomisches Rechen-Institut, D-69120 Heidelberg, Germany
| | - A Klutsch
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Institut für Astronomie und Astrophysik, Eberhard Karls Universität, D-72076 Tübingen, Germany
| | - F Labarga
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - N Labiche
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - S Lalitha
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - M Lampón
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - L M Lara
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - R Launhardt
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - F J Lázaro
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - J-L Lizon
- European Organisation for Astronomical Research in the Southern Hemisphere, D-85748 Garching bei München, Germany
| | - M Llamas
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - N Lodieu
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - M López Del Fresno
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain
| | - J F López Salas
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - J López-Santiago
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Department of Signal Theory and Communications, Universidad Carlos III de Madrid, E-28911 Leganés, Madrid, Spain.,Gregorio Marañón Health Research Institute, E-28007 Madrid, Spain
| | - H Magán Madinabeitia
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain.,Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - U Mall
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - L Mancini
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany.,Department of Physics, University of Rome Tor Vergata, I-00133 Roma, Italy.,Istituto Nazionale di Astrofisica-Osservatorio Astrofisico di Torino, I-10025 Pino Torinese, Italy.,International Institute for Advanced Scientific Studies, I-84019 Vietri sul Mare (SA), Italy
| | - H Mandel
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - E Marfil
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - J A Marín Molina
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - E L Martín
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), E-28850 Torrejón de Ardoz, Madrid, Spain
| | - P Martín-Fernández
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - S Martín-Ruiz
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - H Martínez-Rodríguez
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Department of Physics and Astronomy and Pittsburgh Particle Physics, Astrophysics and Cosmology Center, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - C J Marvin
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - E Mirabet
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain.,Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - A Moya
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain.,School of Physics and Astronomy, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.,Stellar Astrophysics Centre, Department of Physics and Astronomy, Aarhus University, DK-8000 Aarhus C, Denmark
| | - V Naranjo
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - R P Nelson
- School of Physics and Astronomy, Queen Mary University of London, London E1 4NS, UK
| | - L Nortmann
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - G Nowak
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - A Ofir
- Department of Earth and Planetary Sciences, Weizmann Institute of Science, Rehovot 76100, Israel
| | - J Pascual
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - A Pavlov
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - S Pedraz
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - D Pérez Medialdea
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | | | - M A C Perryman
- School of Physics, University College Dublin, Belfield Downs, Dublin D14 YH57, Ireland
| | - O Rabaza
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain.,Dpto. Ingeniería Civil, Universidad de Granada, E-18071 Granada, Spain
| | - A Ramón Ballesta
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - R Rebolo
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - P Redondo
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain
| | - H-W Rix
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - F Rodler
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain.,European Southern Observatory, Vitacura, Casilla 19001, Santiago de Chile
| | - A Rodríguez Trinidad
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - S Sabotta
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - S Sadegi
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany.,Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - M Salz
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | | | - M A Sánchez Carrasco
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - A Sánchez-López
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - J Sanz-Forcada
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain
| | - P Sarkis
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - L F Sarmiento
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - S Schäfer
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - M Schlecker
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - J H M M Schmitt
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - P Schöfer
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - E Solano
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain
| | - A Sota
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - O Stahl
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - S Stock
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - T Stuber
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - J Stürmer
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany.,Department of Astronomy and Astrophysics, University of Chicago, Chicago, IL 60637, USA
| | - J C Suárez
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain.,Dpto. Física Teórica y del Cosmos, Universidad de Granada, E-18071 Granada, Spain
| | - H M Tabernero
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), E-28850 Torrejón de Ardoz, Madrid, Spain
| | - S M Tulloch
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, UK
| | - G Veredas
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - J I Vico-Linares
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - F Vilardell
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - K Wagner
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - J Winkler
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - V Wolthoff
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - F Yan
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - M R Zapatero Osorio
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), E-28850 Torrejón de Ardoz, Madrid, Spain
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Zheng L, Hong W, Geng W, Stock S, Pan J. A comparison of the BISAP score and Amylase and BMI (CAB) score versus for predicting severe acute pancreatitis. Acta Gastroenterol Belg 2019; 82:397-400. [PMID: 31566327] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND AIMS Early prediction of severe acute pancreatitis (SAP)would be helpful for triaging patients to the appropriate level of care and intervention. The aim of this study is to compare the performance of the Change in Amylase And Body mass index (CAB) score and BISAP score for predicting SAP. PATIENTS AND METHODS A total of 406 with AP were enrolled. The age, gender, body mass index(BMI), blood urea nitrogen determined at the time of admission and serum amylase determined on day 1 and day 2 after hospitalization were collected and analyzed statistically. RESULTS Multivariable analysis confirmed that blood urea nitrogen (OR 1.06; 95%CI 1.03-1.09) and percentage change in amylase day 2 (OR 0.75; 95%CI 0.65-0.87) were independently associated with development of SAP. No statistically significant association was observed between BMI (OR 1.04; 95%CI 0.951.13) and severity of acute pancreatitis. The area under the receiver operating characteristic curve for Body mass index (BMI), percentage change in amylase day 2, BISAP score and CAB score were 0.57±0.05, 0.68±0.04, 0.84±0.03 and0.53±0.05, respectively. CONCLUSION BISAP is more accurate for predicting the severity of acute pancreatitis than the CAB score.
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Affiliation(s)
- L Zheng
- Department of Gastroenterology and Hepatology, the First Affiliated Hospital of Wenzhou Medical University, 325000 Wenzhou, Zhejiang, People's Republic of China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - W Hong
- Department of Gastroenterology and Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - W Geng
- Department of Anesthesiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - S Stock
- Department of Surgery, World Mate Emergency Hospital, Battambang, Cambodia
| | - J Pan
- Intensive Care Unit, the First Affiliated Hospital of Wenzhou Medical University,Wenzhou, Zhejiang, People's Republic of China
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Keijsers L, Houkes I, Stock S, de Rijk A. Working with depression is experienced as a constant balancing act that includes presenteeism. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky213.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- L Keijsers
- Maastricht University, Maastricht, Netherlands
| | - I Houkes
- Maastricht University, Maastricht, Netherlands
| | - S Stock
- University Hospital of Cologne, Cologne, Germany
| | - A de Rijk
- Maastricht University, Maastricht, Netherlands
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Nawabi F, Lorenz L, Krebs F, Bau AM, Stock S. GeMuKi – Gemeinsam Gesund: Vorsorge plus für Mutter und Kind. Neue Versorgungsform zur perinatalen Adipositasprävention im Rahmen eines Innovationsfondsprojektes in Baden-Württemberg. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671427] [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: 10/28/2022] Open
Affiliation(s)
- F Nawabi
- Institut für Gesundheitsökonomie und Klinische Epidemiologie, Köln, Deutschland
| | - L Lorenz
- Institut für Gesundheitsökonomie und Klinische Epidemiologie, Köln, Deutschland
| | - F Krebs
- Institut für Gesundheitsökonomie und Klinische Epidemiologie, Köln, Deutschland
| | - AM Bau
- Plattform Ernährung und Bewegung e.V., Berlin, Deutschland
| | - S Stock
- Institut für Gesundheitsökonomie und Klinische Epidemiologie, Köln, Deutschland
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40
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Khalil A, Sharp A, Cornforth C, Jackson R, Mousa H, Stock S, Harrold J, Turner M, Kenny L, Baker P, Johnstone E, von Dadelszen P, Magee L, Papageorghiou A, Alfirevic Z. 81. Maternal cardiovascular changes secondary to sildenafil intake in pregnancies complicated by severe fetal growth restriction: STRIDER trial. Pregnancy Hypertens 2018. [DOI: 10.1016/j.preghy.2018.08.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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41
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Ansmann L, Hillen H, Kuntz L, Stock S, Vennedey V, Hower K. Merkmale und Determinanten patientenorientierter Versorgung aus Sicht von Versorgungsorganisationen. Psychother Psych Med 2018. [DOI: 10.1055/s-0038-1668003] [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] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- L Ansmann
- Carl von Ossietzky Universität Oldenburg, Fakultät für Medizin und Gesundheitswissenschaften, Abteilung Organisationsbezogene Versorgungsforschung, Oldenburg, Deutschland
| | - H Hillen
- Universität zu Köln, Wirtschafts- und Sozialwissenschaftliche Fakultät, Seminar für ABWL und Management im Gesundheitswesen, Köln, Deutschland
| | - L Kuntz
- Universität zu Köln, Wirtschafts- und Sozialwissenschaftliche Fakultät, Seminar für ABWL und Management im Gesundheitswesen, Köln, Deutschland
| | - S Stock
- Universität zu Köln, Fakultät für Medizin und Gesundheitswissenschaften, Institut für Gesundheitsökonomie und Klinische Epidemiologie (IGKE), Köln, Deutschland Köln, Deutschland
| | - V Vennedey
- Universität zu Köln, Fakultät für Medizin und Gesundheitswissenschaften, Institut für Gesundheitsökonomie und Klinische Epidemiologie (IGKE), Köln, Deutschland Köln, Deutschland
| | - K Hower
- Universität zu Köln, Fakultät für Medizin und Gesundheitswissenschaften, Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaften (IMVR), Köln, Deutschland
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42
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Subbiah V, Velcheti V, Tuch BB, Ebata K, Busaidy NL, Cabanillas ME, Wirth LJ, Stock S, Smith S, Lauriault V, Corsi-Travali S, Henry D, Burkard M, Hamor R, Bouhana K, Winski S, Wallace RD, Hartley D, Rhodes S, Reddy M, Brandhuber BJ, Andrews S, Rothenberg SM, Drilon A. Selective RET kinase inhibition for patients with RET-altered cancers. Ann Oncol 2018; 29:1869-1876. [PMID: 29912274 PMCID: PMC6096733 DOI: 10.1093/annonc/mdy137] [Citation(s) in RCA: 276] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Background Alterations involving the RET kinase are implicated in the pathogenesis of lung, thyroid and other cancers. However, the clinical activity of multikinase inhibitors (MKIs) with anti-RET activity in RET-altered patients appears limited, calling into question the therapeutic potential of targeting RET. LOXO-292 is a selective RET inhibitor designed to inhibit diverse RET fusions, activating mutations and acquired resistance mutations. Patients and methods Potent anti-RET activity, high selectivity, and central nervous system coverage were confirmed preclinically using a variety of in vitro and in vivo RET-dependent tumor models. Due to clinical urgency, two patients with RET-altered, MKI-resistant cancers were treated with LOXO-292, utilizing rapid dose-titration guided by real-time pharmacokinetic assessments to achieve meaningful clinical exposures safely and rapidly. Results LOXO-292 demonstrated potent and selective anti-RET activity preclinically against human cancer cell lines harboring endogenous RET gene alterations; cells engineered to express a KIF5B-RET fusion protein -/+ the RET V804M gatekeeper resistance mutation or the common RET activating mutation M918T; and RET-altered human cancer cell line and patient-derived xenografts, including a patient-derived RET fusion-positive xenograft injected orthotopically into the brain. A patient with RET M918T-mutant medullary thyroid cancer metastatic to the liver and an acquired RET V804M gatekeeper resistance mutation, previously treated with six MKI regimens, experienced rapid reductions in tumor calcitonin, CEA and cell-free DNA, resolution of painful hepatomegaly and tumor-related diarrhea and a confirmed tumor response. A second patient with KIF5B-RET fusion-positive lung cancer, acquired resistance to alectinib and symptomatic brain metastases experienced a dramatic response in the brain, and her symptoms resolved. Conclusions These results provide proof-of-concept of the clinical actionability of RET alterations, and identify selective RET inhibition by LOXO-292 as a promising treatment in heavily pretreated, multikinase inhibitor-experienced patients with diverse RET-altered tumors.
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Affiliation(s)
- V Subbiah
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - V Velcheti
- The Cleveland Clinic Foundation, Cleveland, USA
| | - B B Tuch
- Loxo Oncology, Inc., Stamford, USA
| | - K Ebata
- Loxo Oncology, Inc., Stamford, USA
| | - N L Busaidy
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - M E Cabanillas
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - L J Wirth
- Massachusetts General Hospital Cancer Center, Boston, USA
| | - S Stock
- The Cleveland Clinic Foundation, Cleveland, USA
| | - S Smith
- Loxo Oncology, Inc., Stamford, USA
| | | | | | - D Henry
- Loxo Oncology, Inc., Stamford, USA
| | | | - R Hamor
- Array BioPharma, Inc., Boulder, USA
| | | | - S Winski
- Array BioPharma, Inc., Boulder, USA
| | | | | | - S Rhodes
- Array BioPharma, Inc., Boulder, USA
| | - M Reddy
- Array BioPharma, Inc., Boulder, USA
| | | | | | | | - A Drilon
- Memorial Sloan Kettering Cancer Center, New York, USA.
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Seleznova Y, Stock S, Alayli A, Müller D. Methodische Herausforderungen gesundheitsökonomischer Evaluationen von Angeboten zur Gesundheitsförderung und Prävention – ein Overview systematischer Übersichtsarbeiten. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667624] [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: 10/28/2022]
Affiliation(s)
- Y Seleznova
- Institut für Gesundheitsökonomie und Klinische Epidemiologie, Köln, Deutschland
| | - S Stock
- Institut für Gesundheitsökonomie und Klinische Epidemiologie, Köln, Deutschland
| | - A Alayli
- Bundeszentrale für gesundheitliche Aufklärung, Köln, Deutschland
| | - D Müller
- Institut für Gesundheitsökonomie und Klinische Epidemiologie, Köln, Deutschland
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Yip BHK, Leonard H, Stock S, Stoltenberg C, Francis RW, Gissler M, Gross R, Schendel D, Sandin S. Caesarean section and risk of autism across gestational age: a multi-national cohort study of 5 million births. Int J Epidemiol 2018; 46:429-439. [PMID: 28017932 DOI: 10.1093/ije/dyw336] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2016] [Indexed: 12/16/2022] Open
Abstract
Background The positive association between caesarean section (CS) and autism spectrum disorder (ASD) may be attributed to preterm delivery. However, due to lack of statistical power, no previous study thoroughly examined this association across gestational age. Moreover, most studies did not differentiate between emergency and planned CS. Methods Using population-based registries of four Nordic countries and Western Australia, our study population included 4 987 390 singletons surviving their first year of life, which included 671 646 CS deliveries and 31 073 ASD children. We used logistic regression to estimate odds ratios (OR) and their 95% confidence intervals (CI) for CS, adjusted for gestational age, site, maternal age and birth year. Stratified analyses were conducted by both gestational age subgroups and by week of gestation. We compared emergency versus planned CS to investigate their potential difference in the risk of ASD. Results Compared with vaginal delivery, the overall adjusted OR for ASD in CS delivery was 1.26 (95% CI 1.22-1.30). Stratified ORs were 1.25 (1.15-1.37), 1.16 (1.09-1.23), 1.34 (1.28-1.40) and 1.17 (1.04-1.30) for subgroups of gestational weeks 26-36, 37-38, 39-41 and 42-44, respectively. CS was significantly associated with risk of ASD for each week of gestation, from week 36 to 42, consistently across study sites (OR ranged 1.16-1.38). There was no statistically significant difference between emergency and planned CS in the risk of ASD. Conclusion Across the five countries, emergency or planned CS is consistently associated with a modest increased risk of ASD from gestational weeks 36 to 42 when compared with vaginal delivery.
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Affiliation(s)
- Benjamin Hon Kei Yip
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Helen Leonard
- Telethon Kids Institute.,Centre for Child Health Research, University of Western Australia, Crawley, WA, Australia
| | - Sarah Stock
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,MRC Centre for Reproductive Health, University of Edinburgh Queen's Medical Research Institute, Edinburgh, UK.,Norwegian Institute of Public Health, Oslo, Norway
| | - Camilla Stoltenberg
- Norwegian Institute of Public Health, Oslo, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Richard W Francis
- Telethon Kids Institute.,Centre for Child Health Research, University of Western Australia, Crawley, WA, Australia
| | - Mika Gissler
- National Institute for Health and Welfare, Helsinki, Finland.,Department of Child Psychiatry, Turku University and Turku University Hospital, Turku, Finland
| | - Raz Gross
- Department of Epidemiology and Preventive Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Diana Schendel
- Department of Public Health, Institute of Epidemiology and Social Medicine, Aarhus University, Aarhus, Denmark.,Department of Economics and Business, National Centre for Register-based Research, Aarhus, Denmark.,Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus University, Aarhus, Denmark
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA and
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45
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Stock S, Scharfschwerdt M, Warnecke R, Richardt D, Tsvelodub S, Sievers H. New Device for the Treatment of Ischemic Mitral Regurgitation: Proof-of-Concept in an in Vitro Model. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627901] [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: 10/28/2022]
Affiliation(s)
- S. Stock
- Department of Cardiac and Thoracic Vascular Surgery, University of Luebeck, Luebeck, Germany
| | - M. Scharfschwerdt
- Department of Cardiac and Thoracic Vascular Surgery, University of Luebeck, Luebeck, Germany
| | - R. Warnecke
- Department of Cardiac and Thoracic Vascular Surgery, University of Luebeck, Luebeck, Germany
| | - D. Richardt
- Department of Cardiac and Thoracic Vascular Surgery, University of Luebeck, Luebeck, Germany
| | - S. Tsvelodub
- Department of Cardiac and Thoracic Vascular Surgery, University of Luebeck, Luebeck, Germany
| | - H. Sievers
- Department of Cardiac and Thoracic Vascular Surgery, University of Luebeck, Luebeck, Germany
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46
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Nasseri B, Richardt D, Bucsky B, Stock S, Stierle U, Sievers H. Mid- and Long-term Follow up Comparing Straight versus Sinus Prosthesis for Reimplantation of the Aortic Valve. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627853] [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: 10/28/2022]
Affiliation(s)
- B. Nasseri
- Department of Cardiac and Thoracic Vascular Surgery, UKSH- Campus Lübeck, Lübeck, Germany
| | - D. Richardt
- Department of Cardiac and Thoracic Vascular Surgery, UKSH- Campus Lübeck, Lübeck, Germany
| | - B. Bucsky
- Department of Cardiac and Thoracic Vascular Surgery, UKSH- Campus Lübeck, Lübeck, Germany
| | - S. Stock
- Department of Cardiac and Thoracic Vascular Surgery, UKSH- Campus Lübeck, Lübeck, Germany
| | - U. Stierle
- Department of Cardiac and Thoracic Vascular Surgery, UKSH- Campus Lübeck, Lübeck, Germany
| | - H. Sievers
- Department of Cardiac and Thoracic Vascular Surgery, UKSH- Campus Lübeck, Lübeck, Germany
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47
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Klotz S, Desch S, Karluss A, Stock S, Sievers H. Outflow Graft Occlusion with Vascular Plug as Interventional Alternative for LVAD Discontinuation. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628078] [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: 10/28/2022]
Affiliation(s)
- S. Klotz
- Klinik für Herz- und thorakale Gefäßchirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - S. Desch
- Klinik für Kardiologie, Angiologie und Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - A. Karluss
- Klinik für Herz- und thorakale Gefäßchirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - S. Stock
- Klinik für Herz- und thorakale Gefäßchirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - H. Sievers
- Klinik für Herz- und thorakale Gefäßchirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
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48
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Stock S, Stierle U, Petersen M, Bucsky B, Richardt D, Sievers H. Comparison of the Ross Procedure in Patients with Endocarditis and Noninfective Valve Disease: Long-term Follow-up of 641 Patients. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627982] [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: 10/28/2022]
Affiliation(s)
- S. Stock
- Department of Cardiac and Thoacic Vascular Surgery, University of Luebeck, Luebeck, Germany
| | - U. Stierle
- Department of Cardiac and Thoacic Vascular Surgery, University of Luebeck, Luebeck, Germany
| | - M. Petersen
- Department of Cardiac and Thoacic Vascular Surgery, University of Luebeck, Luebeck, Germany
| | - B. Bucsky
- Department of Cardiac and Thoacic Vascular Surgery, University of Luebeck, Luebeck, Germany
| | - D. Richardt
- Department of Cardiac and Thoacic Vascular Surgery, University of Luebeck, Luebeck, Germany
| | - H. Sievers
- Department of Cardiac and Thoacic Vascular Surgery, University of Luebeck, Luebeck, Germany
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Klotz S, Petersen M, Bucsky B, Stock S, Sievers H. Outcome of Valve-sparing vs Bentall Procedure in Acute Type A Aortic Dissection. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627851] [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: 10/28/2022]
Affiliation(s)
- S. Klotz
- Campus Lübeck, Klinik für Herz- und thorakale Gefäßchirurgie, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
| | - M. Petersen
- Campus Lübeck, Klinik für Herz- und thorakale Gefäßchirurgie, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
| | - B. Bucsky
- Campus Lübeck, Klinik für Herz- und thorakale Gefäßchirurgie, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
| | - S. Stock
- Campus Lübeck, Klinik für Herz- und thorakale Gefäßchirurgie, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
| | - H. Sievers
- Campus Lübeck, Klinik für Herz- und thorakale Gefäßchirurgie, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
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50
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Stock S, Sievers H, Bucsky B, Richardt D, Klotz S. Minimally Invasive Aortic Valve Replacement: Is It Safe in Surgical Training? Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628018] [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: 10/28/2022]
Affiliation(s)
- S. Stock
- Department of Cardiac and Thoacic Vascular Surgery, University of Luebeck, Luebeck, Germany
| | - H. Sievers
- Department of Cardiac and Thoacic Vascular Surgery, University of Luebeck, Luebeck, Germany
| | - B. Bucsky
- Department of Cardiac and Thoacic Vascular Surgery, University of Luebeck, Luebeck, Germany
| | - D. Richardt
- Department of Cardiac and Thoacic Vascular Surgery, University of Luebeck, Luebeck, Germany
| | - S. Klotz
- Department of Cardiac and Thoacic Vascular Surgery, University of Luebeck, Luebeck, Germany
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