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Deckert A, Anders S, Morales I, De Allegri M, Nguyen HT, Souares A, McMahon S, Meurer M, Burk R, Lou D, Brugnara L, Sand M, Koeppel L, Maier-Hein L, Ross T, Adler TJ, Brenner S, Dyer C, Herbst K, Ovchinnikova S, Marx M, Schnitzler P, Knop M, Bärnighausen T, Denkinger CM. Correction: Comparison of Four Active SARS-CoV-2 Surveillance Strategies in Representative Population Sample Points: Two-Factor Factorial Randomized Controlled Trial. JMIR Public Health Surveill 2024; 10:e57203. [PMID: 38364221 PMCID: PMC10907930 DOI: 10.2196/57203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 02/07/2024] [Indexed: 02/18/2024] Open
Abstract
[This corrects the article DOI: 10.2196/44204.].
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Affiliation(s)
| | - Simon Anders
- Center for Molecular Biology HeidelbergHeidelbergGermany
| | - Ivonne Morales
- Division of Infectious Disease and Tropical Medicine, Heidelberg University HospitalHeidelbergGermany
| | | | | | | | | | | | - Robin Burk
- Center for Molecular Biology HeidelbergHeidelbergGermany
| | - Dan Lou
- Center for Molecular Biology HeidelbergHeidelbergGermany
| | - Lucia Brugnara
- evaplan GmbH at the University HospitalHeidelbergGermany
| | - Matthias Sand
- GESIS Leibniz-Institute for the Social SciencesMannheimGermany
| | - Lisa Koeppel
- Division of Infectious Disease and Tropical Medicine, Heidelberg University HospitalHeidelbergGermany
| | - Lena Maier-Hein
- Division of Computer Assisted Medical Interventions, German Cancer Research CentreHeidelbergGermany
| | - Tobias Ross
- Division of Computer Assisted Medical Interventions, German Cancer Research CentreHeidelbergGermany
| | - Tim J Adler
- Division of Computer Assisted Medical Interventions, German Cancer Research CentreHeidelbergGermany
| | | | | | - Konrad Herbst
- Center for Molecular Biology HeidelbergHeidelbergGermany
| | | | - Michael Marx
- evaplan GmbH at the University HospitalHeidelbergGermany
| | - Paul Schnitzler
- Center of Infectious Diseases, Virology, Heidelberg University HospitalHeidelbergGermany
| | - Michael Knop
- Center for Molecular Biology HeidelbergHeidelbergGermany
| | | | - Claudia M Denkinger
- Division of Infectious Disease and Tropical Medicine, Heidelberg University HospitalHeidelbergGermany
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Deckert A, Anders S, Morales I, De Allegri M, Nguyen HT, Souares A, McMahon S, Meurer M, Burk R, Lou D, Brugnara L, Sand M, Koeppel L, Maier-Hein L, Ross T, Adler TJ, Brenner S, Dyer C, Herbst K, Ovchinnikova S, Marx M, Schnitzler P, Knop M, Bärnighausen T, Denkinger CM. Comparison of Four Active SARS-CoV-2 Surveillance Strategies in Representative Population Sample Points: Two-Factor Factorial Randomized Controlled Trial. JMIR Public Health Surveill 2023; 9:e44204. [PMID: 37235704 PMCID: PMC10437130 DOI: 10.2196/44204] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/30/2023] [Accepted: 05/24/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic is characterized by rapid increases in infection burden owing to the emergence of new variants with higher transmissibility and immune escape. To date, monitoring the COVID-19 pandemic has mainly relied on passive surveillance, yielding biased epidemiological measures owing to the disproportionate number of undetected asymptomatic cases. Active surveillance could provide accurate estimates of the true prevalence to forecast the evolution of the pandemic, enabling evidence-based decision-making. OBJECTIVE This study compared 4 different approaches of active SARS-CoV-2 surveillance focusing on feasibility and epidemiological outcomes. METHODS A 2-factor factorial randomized controlled trial was conducted in 2020 in a German district with 700,000 inhabitants. The epidemiological outcome comprised SARS-CoV-2 prevalence and its precision. The 4 study arms combined 2 factors: individuals versus households and direct testing versus testing conditioned on symptom prescreening. Individuals aged ≥7 years were eligible. Altogether, 27,908 addresses from 51 municipalities were randomly allocated to the arms and 15 consecutive recruitment weekdays. Data collection and logistics were highly digitized, and a website in 5 languages enabled low-barrier registration and tracking of results. Gargle sample collection kits were sent by post. Participants collected a gargle sample at home and mailed it to the laboratory. Samples were analyzed with reverse transcription loop-mediated isothermal amplification (RT-LAMP); positive and weak results were confirmed with real-time reverse transcription-polymerase chain reaction (RT-PCR). RESULTS Recruitment was conducted between November 18 and December 11, 2020. The response rates in the 4 arms varied between 34.31% (2340/6821) and 41.17% (2043/4962). The prescreening classified 16.61% (1207/7266) of the patients as COVID-19 symptomatic. Altogether, 4232 persons without prescreening and 7623 participating in the prescreening provided 5351 gargle samples, of which 5319 (99.4%) could be analyzed. This yielded 17 confirmed SARS-CoV-2 infections and a combined prevalence of 0.36% (95% CI 0.14%-0.59%) in the arms without prescreening and 0.05% (95% CI 0.00%-0.108%) in the arms with prescreening (initial contacts only). Specifically, we found a prevalence of 0.31% (95% CI 0.06%-0.58%) for individuals and 0.35% (95% CI 0.09%-0.61%) for households, and lower estimates with prescreening (0.07%, 95% CI 0.0%-0.15% for individuals and 0.02%, 95% CI 0.0%-0.06% for households). Asymptomatic infections occurred in 27% (3/11) of the positive cases with symptom data. The 2 arms without prescreening performed the best regarding effectiveness and accuracy. CONCLUSIONS This study showed that postal mailing of gargle sample kits and returning home-based self-collected liquid gargle samples followed by high-sensitivity RT-LAMP analysis is a feasible way to conduct active SARS-CoV-2 population surveillance without burdening routine diagnostic testing. Efforts to improve participation rates and integration into the public health system may increase the potential to monitor the course of the pandemic. TRIAL REGISTRATION Deutsches Register Klinischer Studien (DRKS) DRKS00023271; https://tinyurl.com/3xenz68a. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s13063-021-05619-5.
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Affiliation(s)
| | - Simon Anders
- Center for Molecular Biology Heidelberg, Heidelberg, Germany
| | - Ivonne Morales
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Hoa Thi Nguyen
- Heidelberg Institute of Global Health, Heidelberg, Germany
| | | | | | - Matthias Meurer
- Center for Molecular Biology Heidelberg, Heidelberg, Germany
| | - Robin Burk
- Center for Molecular Biology Heidelberg, Heidelberg, Germany
| | - Dan Lou
- Center for Molecular Biology Heidelberg, Heidelberg, Germany
| | - Lucia Brugnara
- evaplan GmbH at the University Hospital, Heidelberg, Germany
| | - Matthias Sand
- GESIS Leibniz-Institute for the Social Sciences, Mannheim, Germany
| | - Lisa Koeppel
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Lena Maier-Hein
- Division of Computer Assisted Medical Interventions, German Cancer Research Centre, Heidelberg, Germany
| | - Tobias Ross
- Division of Computer Assisted Medical Interventions, German Cancer Research Centre, Heidelberg, Germany
| | - Tim J Adler
- Division of Computer Assisted Medical Interventions, German Cancer Research Centre, Heidelberg, Germany
| | | | | | - Konrad Herbst
- Center for Molecular Biology Heidelberg, Heidelberg, Germany
| | | | - Michael Marx
- evaplan GmbH at the University Hospital, Heidelberg, Germany
| | - Paul Schnitzler
- Center of Infectious Diseases, Virology, Heidelberg University Hospital, Heidelberg, Germany
| | - Michael Knop
- Center for Molecular Biology Heidelberg, Heidelberg, Germany
| | | | - Claudia M Denkinger
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
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Loron CC, Rodriguez Dzul E, Orr PJ, Gromov AV, Fraser NC, McMahon S. Molecular fingerprints resolve affinities of Rhynie chert organic fossils. Nat Commun 2023; 14:1387. [PMID: 36914650 PMCID: PMC10011563 DOI: 10.1038/s41467-023-37047-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 03/01/2023] [Indexed: 03/16/2023] Open
Abstract
The affinities of extinct organisms are often difficult to resolve using morphological data alone. Chemical analysis of carbonaceous specimens can complement traditional approaches, but the search for taxon-specific signals in ancient, thermally altered organic matter is challenging and controversial, partly because suitable positive controls are lacking. Here, we show that non-destructive Fourier Transform Infrared Spectroscopy (FTIR) resolves in-situ molecular fingerprints in the famous 407 Ma Rhynie chert fossil assemblage of Aberdeenshire, Scotland, an important early terrestrial Lagerstätte. Remarkably, unsupervised clustering methods (principal components analysis and K-mean) separate the fossil spectra naturally into eukaryotes and prokaryotes (cyanobacteria). Additional multivariate statistics and machine-learning approaches also differentiate prokaryotes from eukaryotes, and discriminate eukaryotic tissue types, despite the overwhelming influence of silica. We find that these methods can clarify the affinities of morphologically ambiguous taxa; in the Rhynie chert for example, we show that the problematic "nematophytes" have a plant-like composition. Overall, we demonstrate that the famously exquisite preservation of cells, tissues and organisms in the Rhynie chert accompanies similarly impressive preservation of molecular information. These results provide a compelling positive control that validates the use of infrared spectroscopy to investigate the affinity of organic fossils in chert.
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Affiliation(s)
- C C Loron
- UK Centre for Astrobiology, School of Physics and Astronomy, University of Edinburgh, Edinburgh, UK.
| | - E Rodriguez Dzul
- UK Centre for Astrobiology, School of Physics and Astronomy, University of Edinburgh, Edinburgh, UK
| | - P J Orr
- UCD School of Earth Sciences, University College Dublin, Dublin, Ireland
| | - A V Gromov
- EastCHEM and School of Chemistry, University of Edinburgh, Edinburgh, UK
| | - N C Fraser
- Natural Sciences Department, National Museums Scotland, Edinburgh, UK
| | - S McMahon
- UK Centre for Astrobiology, School of Physics and Astronomy, University of Edinburgh, Edinburgh, UK. .,School of Geosciences, University of Edinburgh, Edinburgh, UK.
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Röhr F, Uellner F, Deckert A, Anders S, Burk R, Knop M, Brugnara L, Bärnighausen T, Jahn A, McMahon S, Souares A. From disgusting and complicated to simple and brilliant: Implementation perspectives and lessons learned from users and rejectors of mail-in SARS-CoV-2 gargle tests. Front Public Health 2023; 10:1024525. [PMID: 36684995 PMCID: PMC9850099 DOI: 10.3389/fpubh.2022.1024525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 11/17/2022] [Indexed: 01/07/2023] Open
Abstract
Background Despite the important role of testing as a measure against the COVID-19 pandemic, user perspectives on SARS-CoV-2 tests remain scarce, inhibiting an improvement of testing approaches. As the world enters the third year of the pandemic, more nuanced perspectives of testing, and opportunities to expand testing in a feasible and affordable manner merit consideration. Methods Conducted amid the second pandemic wave (late 2020-early 2021) during and after a multi-arm trial evaluating SARS-CoV-2 surveillance strategies in the federal state Baden-Württemberg, Germany, this qualitative sub-study aimed to gain a deeper understanding of how test users and test rejectors perceived mail-in SARS-CoV-2 gargle tests. We conducted 67 semi-structured in-depth interviews (mean duration: 60 min) via telephone or video call. Interviews were audio-recorded, transcribed verbatim and analyzed inductively using thematic analysis. The Consolidated Framework for Implementation Research guided the findings' presentation. Results Respondents generally described gargle sampling as simple and comfortable. However, individual perceptions of the testing method and its feasibility varied widely from disgusting and complicated to simple and brilliant. Self-sampling was appreciated for lowering infection risks during testing, but also considered more complex. Gargle-sampling increased participants' self-efficacy to sample correctly. Communication (first contact, quantity and content of information, reminders, support system) and trust (in the study, its institutional affiliation and test method) decisively influenced the intervention's acceptability. Conclusion User-driven insights on how to streamline testing include: consider communication, first impressions of tests and information as key for successful mail-in testing; pay attention to the role of mutual trust between those taking and administering tests; implement gargle self-sampling as a pleasant alternative to swab testing; offer multiple test methods to increase test up-take.
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Affiliation(s)
- Freda Röhr
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Ferdinand Uellner
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Andreas Deckert
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Simon Anders
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Heidelberg, Germany
- Bioquant Center, University of Heidelberg, Heidelberg, Germany
| | - Robin Burk
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Heidelberg, Germany
| | - Michael Knop
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Heidelberg, Germany
- German Cancer Research Center (DKFZ)-ZMBH Alliance, Heidelberg, Germany
| | - Lucia Brugnara
- Evaplan Ltd. at the University Hospital Heidelberg, Heidelberg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Albrecht Jahn
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Shannon McMahon
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany
- International Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Aurélia Souares
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany
- German Center for Infection Research Heidelberg Site, Heidelberg, Germany
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Jabbarian J, Werner LK, Kagoné M, Lemp JM, McMahon S, Horstick O, Kazianga H, Kobiané JF, Fink G, De Neve JW. "It's the poverty"-Stakeholder perspectives on barriers to secondary education in rural Burkina Faso. PLoS One 2022; 17:e0277822. [PMID: 36395341 PMCID: PMC9671424 DOI: 10.1371/journal.pone.0277822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 11/04/2022] [Indexed: 11/18/2022] Open
Abstract
Universal primary and secondary education is a key target of the Sustainable Development Goals. While substantial gains have been made at the primary school level, progress towards universal secondary education has slowed, particularly in sub-Saharan Africa. In this study, we aimed to determine perceived barriers of secondary schooling in rural Burkina Faso, where secondary school completion is among the lowest globally (<10%). We conducted a two-stage qualitative study using semi-structured interviews (N = 49). In the first stage, we sampled enrolled students (n = 10), out-of-school adolescents (n = 9), parents of enrolled students (n = 5), parents of out-of-school adolescents (n = 5) and teachers (n = 10) from a random sample of five secondary schools. In a second stage, we interviewed key informants knowledgeable of the school context using snowball sampling (n = 10). Systematic analysis of the pooled sample was based on a reading of interview transcripts and coding of the narratives in NVivo12 using the diathesis-stress model. Recurring themes were classified using a priori developed categories of hypothesized barriers to secondary schooling. Major reported barriers included school-related expenses and the lack of school infrastructure and resources. Insufficient and heterogeneous French language skills (the official language of instruction in Burkina Faso) were seen as a major barrier to secondary schooling. Forced marriages, adolescent pregnancies, and the low perceived economic benefits of investing in secondary schooling were reported as key barriers among young women. Our results guide future interventions and policy aimed at achieving universal secondary education and gender equity in the region.
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Affiliation(s)
- Jan Jabbarian
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Luisa Katharina Werner
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
- Faculty of Medicine, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany
| | - Moubassira Kagoné
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
- Health Research Center of Nouna (Centre de Recherche en Santé de Nouna—CRSN), Ministry of Health, Nouna, Burkina Faso
| | - Julia Margarete Lemp
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Shannon McMahon
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
| | - Olaf Horstick
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Harounan Kazianga
- Department of Economics and Legal Studies in Business, Spears School of Business, Oklahoma State University, Stillwater, OK, United States of America
| | - Jean-François Kobiané
- Institut Supérieur des Sciences de la Population (ISSP), Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
| | - Günther Fink
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jan-Walter De Neve
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
- * E-mail:
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Proietti M, Romiti GF, Vitolo M, Harrison SL, Lane DA, Fauchier L, Marin F, Näbauer M, Potpara TS, Dan GA, Maggioni AP, Cesari M, Boriani G, Lip GYH, Ekmekçiu U, Paparisto V, Tase M, Gjergo H, Dragoti J, Goda A, Ciutea M, Ahadi N, el Husseini Z, Raepers M, Leroy J, Haushan P, Jourdan A, Lepiece C, Desteghe L, Vijgen J, Koopman P, Van Genechten G, Heidbuchel H, Boussy T, De Coninck M, Van Eeckhoutte H, Bouckaert N, Friart A, Boreux J, Arend C, Evrard P, Stefan L, Hoffer E, Herzet J, Massoz M, Celentano C, Sprynger M, Pierard L, Melon P, Van Hauwaert B, Kuppens C, Faes D, Van Lier D, Van Dorpe A, Gerardy A, Deceuninck O, Xhaet O, Dormal F, Ballant E, Blommaert D, Yakova D, Hristov M, Yncheva T, Stancheva N, Tisheva S, Tokmakova M, Nikolov F, Gencheva D, Shalganov T, Kunev B, Stoyanov M, Marchov D, Gelev V, Traykov V, Kisheva A, Tsvyatkov H, Shtereva R, Bakalska-Georgieva S, Slavcheva S, Yotov Y, Kubíčková M, Marni Joensen A, Gammelmark A, Hvilsted Rasmussen L, Dinesen P, Riahi S, Krogh Venø S, Sorensen B, Korsgaard A, Andersen K, Fragtrup Hellum C, Svenningsen A, Nyvad O, Wiggers P, May O, Aarup A, Graversen B, Jensen L, Andersen M, Svejgaard M, Vester S, Hansen S, Lynggaard V, Ciudad M, Vettus R, Muda P, Maestre A, Castaño S, Cheggour S, Poulard J, Mouquet V, Leparrée S, Bouet J, Taieb J, Doucy A, Duquenne H, Furber A, Dupuis J, Rautureau J, Font M, Damiano P, Lacrimini M, Abalea J, Boismal S, Menez T, Mansourati J, Range G, Gorka H, Laure C, Vassalière C, Elbaz N, Lellouche N, Djouadi K, Roubille F, Dietz D, Davy J, Granier M, Winum P, Leperchois-Jacquey C, Kassim H, Marijon E, Le Heuzey J, Fedida J, Maupain C, Himbert C, Gandjbakhch E, Hidden-Lucet F, Duthoit G, Badenco N, Chastre T, Waintraub X, Oudihat M, Lacoste J, Stephan C, Bader H, Delarche N, Giry L, Arnaud D, Lopez C, Boury F, Brunello I, Lefèvre M, Mingam R, Haissaguerre M, Le Bidan M, Pavin D, Le Moal V, Leclercq C, Piot O, Beitar T, Martel I, Schmid A, Sadki N, Romeyer-Bouchard C, Da Costa A, Arnault I, Boyer M, Piat C, Fauchier L, Lozance N, Nastevska S, Doneva A, Fortomaroska Milevska B, Sheshoski B, Petroska K, Taneska N, Bakrecheski N, Lazarovska K, Jovevska S, Ristovski V, Antovski A, Lazarova E, Kotlar I, Taleski J, Poposka L, Kedev S, Zlatanovik N, Jordanova S, Bajraktarova Proseva T, Doncovska S, Maisuradze D, Esakia A, Sagirashvili E, Lartsuliani K, Natelashvili N, Gumberidze N, Gvenetadze R, Etsadashvili K, Gotonelia N, Kuridze N, Papiashvili G, Menabde I, Glöggler S, Napp A, Lebherz C, Romero H, Schmitz K, Berger M, Zink M, Köster S, Sachse J, Vonderhagen E, Soiron G, Mischke K, Reith R, Schneider M, Rieker W, Boscher D, Taschareck A, Beer A, Oster D, Ritter O, Adamczewski J, Walter S, Frommhold A, Luckner E, Richter J, Schellner M, Landgraf S, Bartholome S, Naumann R, Schoeler J, Westermeier D, William F, Wilhelm K, Maerkl M, Oekinghaus R, Denart M, Kriete M, Tebbe U, Scheibner T, Gruber M, Gerlach A, Beckendorf C, Anneken L, Arnold M, Lengerer S, Bal Z, Uecker C, Förtsch H, Fechner S, Mages V, Martens E, Methe H, Schmidt T, Schaeffer B, Hoffmann B, Moser J, Heitmann K, Willems S, Willems S, Klaus C, Lange I, Durak M, Esen E, Mibach F, Mibach H, Utech A, Gabelmann M, Stumm R, Ländle V, Gartner C, Goerg C, Kaul N, Messer S, Burkhardt D, Sander C, Orthen R, Kaes S, Baumer A, Dodos F, Barth A, Schaeffer G, Gaertner J, Winkler J, Fahrig A, Aring J, Wenzel I, Steiner S, Kliesch A, Kratz E, Winter K, Schneider P, Haag A, Mutscher I, Bosch R, Taggeselle J, Meixner S, Schnabel A, Shamalla A, Hötz H, Korinth A, Rheinert C, Mehltretter G, Schön B, Schön N, Starflinger A, Englmann E, Baytok G, Laschinger T, Ritscher G, Gerth A, Dechering D, Eckardt L, Kuhlmann M, Proskynitopoulos N, Brunn J, Foth K, Axthelm C, Hohensee H, Eberhard K, Turbanisch S, Hassler N, Koestler A, Stenzel G, Kschiwan D, Schwefer M, Neiner S, Hettwer S, Haeussler-Schuchardt M, Degenhardt R, Sennhenn S, Steiner S, Brendel M, Stoehr A, Widjaja W, Loehndorf S, Logemann A, Hoskamp J, Grundt J, Block M, Ulrych R, Reithmeier A, Panagopoulos V, Martignani C, Bernucci D, Fantecchi E, Diemberger I, Ziacchi M, Biffi M, Cimaglia P, Frisoni J, Boriani G, Giannini I, Boni S, Fumagalli S, Pupo S, Di Chiara A, Mirone P, Fantecchi E, Boriani G, Pesce F, Zoccali C, Malavasi VL, Mussagaliyeva A, Ahyt B, Salihova Z, Koshum-Bayeva K, Kerimkulova A, Bairamukova A, Mirrakhimov E, Lurina B, Zuzans R, Jegere S, Mintale I, Kupics K, Jubele K, Erglis A, Kalejs O, Vanhear K, Burg M, Cachia M, Abela E, Warwicker S, Tabone T, Xuereb R, Asanovic D, Drakalovic D, Vukmirovic M, Pavlovic N, Music L, Bulatovic N, Boskovic A, Uiterwaal H, Bijsterveld N, De Groot J, Neefs J, van den Berg N, Piersma F, Wilde A, Hagens V, Van Es J, Van Opstal J, Van Rennes B, Verheij H, Breukers W, Tjeerdsma G, Nijmeijer R, Wegink D, Binnema R, Said S, Erküner Ö, Philippens S, van Doorn W, Crijns H, Szili-Torok T, Bhagwandien R, Janse P, Muskens A, van Eck M, Gevers R, van der Ven N, Duygun A, Rahel B, Meeder J, Vold A, Holst Hansen C, Engset I, Atar D, Dyduch-Fejklowicz B, Koba E, Cichocka M, Sokal A, Kubicius A, Pruchniewicz E, Kowalik-Sztylc A, Czapla W, Mróz I, Kozlowski M, Pawlowski T, Tendera M, Winiarska-Filipek A, Fidyk A, Slowikowski A, Haberka M, Lachor-Broda M, Biedron M, Gasior Z, Kołodziej M, Janion M, Gorczyca-Michta I, Wozakowska-Kaplon B, Stasiak M, Jakubowski P, Ciurus T, Drozdz J, Simiera M, Zajac P, Wcislo T, Zycinski P, Kasprzak J, Olejnik A, Harc-Dyl E, Miarka J, Pasieka M, Ziemińska-Łuć M, Bujak W, Śliwiński A, Grech A, Morka J, Petrykowska K, Prasał M, Hordyński G, Feusette P, Lipski P, Wester A, Streb W, Romanek J, Woźniak P, Chlebuś M, Szafarz P, Stanik W, Zakrzewski M, Kaźmierczak J, Przybylska A, Skorek E, Błaszczyk H, Stępień M, Szabowski S, Krysiak W, Szymańska M, Karasiński J, Blicharz J, Skura M, Hałas K, Michalczyk L, Orski Z, Krzyżanowski K, Skrobowski A, Zieliński L, Tomaszewska-Kiecana M, Dłużniewski M, Kiliszek M, Peller M, Budnik M, Balsam P, Opolski G, Tymińska A, Ozierański K, Wancerz A, Borowiec A, Majos E, Dabrowski R, Szwed H, Musialik-Lydka A, Leopold-Jadczyk A, Jedrzejczyk-Patej E, Koziel M, Lenarczyk R, Mazurek M, Kalarus Z, Krzemien-Wolska K, Starosta P, Nowalany-Kozielska E, Orzechowska A, Szpot M, Staszel M, Almeida S, Pereira H, Brandão Alves L, Miranda R, Ribeiro L, Costa F, Morgado F, Carmo P, Galvao Santos P, Bernardo R, Adragão P, Ferreira da Silva G, Peres M, Alves M, Leal M, Cordeiro A, Magalhães P, Fontes P, Leão S, Delgado A, Costa A, Marmelo B, Rodrigues B, Moreira D, Santos J, Santos L, Terchet A, Darabantiu D, Mercea S, Turcin Halka V, Pop Moldovan A, Gabor A, Doka B, Catanescu G, Rus H, Oboroceanu L, Bobescu E, Popescu R, Dan A, Buzea A, Daha I, Dan G, Neuhoff I, Baluta M, Ploesteanu R, Dumitrache N, Vintila M, Daraban A, Japie C, Badila E, Tewelde H, Hostiuc M, Frunza S, Tintea E, Bartos D, Ciobanu A, Popescu I, Toma N, Gherghinescu C, Cretu D, Patrascu N, Stoicescu C, Udroiu C, Bicescu G, Vintila V, Vinereanu D, Cinteza M, Rimbas R, Grecu M, Cozma A, Boros F, Ille M, Tica O, Tor R, Corina A, Jeewooth A, Maria B, Georgiana C, Natalia C, Alin D, Dinu-Andrei D, Livia M, Daniela R, Larisa R, Umaar S, Tamara T, Ioachim Popescu M, Nistor D, Sus I, Coborosanu O, Alina-Ramona N, Dan R, Petrescu L, Ionescu G, Popescu I, Vacarescu C, Goanta E, Mangea M, Ionac A, Mornos C, Cozma D, Pescariu S, Solodovnicova E, Soldatova I, Shutova J, Tjuleneva L, Zubova T, Uskov V, Obukhov D, Rusanova G, Soldatova I, Isakova N, Odinsova S, Arhipova T, Kazakevich E, Serdechnaya E, Zavyalova O, Novikova T, Riabaia I, Zhigalov S, Drozdova E, Luchkina I, Monogarova Y, Hegya D, Rodionova L, Rodionova L, Nevzorova V, Soldatova I, Lusanova O, Arandjelovic A, Toncev D, Milanov M, Sekularac N, Zdravkovic M, Hinic S, Dimkovic S, Acimovic T, Saric J, Polovina M, Potpara T, Vujisic-Tesic B, Nedeljkovic M, Zlatar M, Asanin M, Vasic V, Popovic Z, Djikic D, Sipic M, Peric V, Dejanovic B, Milosevic N, Stevanovic A, Andric A, Pencic B, Pavlovic-Kleut M, Celic V, Pavlovic M, Petrovic M, Vuleta M, Petrovic N, Simovic S, Savovic Z, Milanov S, Davidovic G, Iric-Cupic V, Simonovic D, Stojanovic M, Stojanovic S, Mitic V, Ilic V, Petrovic D, Deljanin Ilic M, Ilic S, Stoickov V, Markovic S, Kovacevic S, García Fernandez A, Perez Cabeza A, Anguita M, Tercedor Sanchez L, Mau E, Loayssa J, Ayarra M, Carpintero M, Roldán Rabadan I, Leal M, Gil Ortega M, Tello Montoliu A, Orenes Piñero E, Manzano Fernández S, Marín F, Romero Aniorte A, Veliz Martínez A, Quintana Giner M, Ballesteros G, Palacio M, Alcalde O, García-Bolao I, Bertomeu Gonzalez V, Otero-Raviña F, García Seara J, Gonzalez Juanatey J, Dayal N, Maziarski P, Gentil-Baron P, Shah D, Koç M, Onrat E, Dural IE, Yilmaz K, Özin B, Tan Kurklu S, Atmaca Y, Canpolat U, Tokgozoglu L, Dolu AK, Demirtas B, Sahin D, Ozcan Celebi O, Diker E, Gagirci G, Turk UO, Ari H, Polat N, Toprak N, Sucu M, Akin Serdar O, Taha Alper A, Kepez A, Yuksel Y, Uzunselvi A, Yuksel S, Sahin M, Kayapinar O, Ozcan T, Kaya H, Yilmaz MB, Kutlu M, Demir M, Gibbs C, Kaminskiene S, Bryce M, Skinner A, Belcher G, Hunt J, Stancombe L, Holbrook B, Peters C, Tettersell S, Shantsila A, Lane D, Senoo K, Proietti M, Russell K, Domingos P, Hussain S, Partridge J, Haynes R, Bahadur S, Brown R, McMahon S, Y H Lip G, McDonald J, Balachandran K, Singh R, Garg S, Desai H, Davies K, Goddard W, Galasko G, Rahman I, Chua Y, Payne O, Preston S, Brennan O, Pedley L, Whiteside C, Dickinson C, Brown J, Jones K, Benham L, Brady R, Buchanan L, Ashton A, Crowther H, Fairlamb H, Thornthwaite S, Relph C, McSkeane A, Poultney U, Kelsall N, Rice P, Wilson T, Wrigley M, Kaba R, Patel T, Young E, Law J, Runnett C, Thomas H, McKie H, Fuller J, Pick S, Sharp A, Hunt A, Thorpe K, Hardman C, Cusack E, Adams L, Hough M, Keenan S, Bowring A, Watts J, Zaman J, Goffin K, Nutt H, Beerachee Y, Featherstone J, Mills C, Pearson J, Stephenson L, Grant S, Wilson A, Hawksworth C, Alam I, Robinson M, Ryan S, Egdell R, Gibson E, Holland M, Leonard D, Mishra B, Ahmad S, Randall H, Hill J, Reid L, George M, McKinley S, Brockway L, Milligan W, Sobolewska J, Muir J, Tuckis L, Winstanley L, Jacob P, Kaye S, Morby L, Jan A, Sewell T, Boos C, Wadams B, Cope C, Jefferey P, Andrews N, Getty A, Suttling A, Turner C, Hudson K, Austin R, Howe S, Iqbal R, Gandhi N, Brophy K, Mirza P, Willard E, Collins S, Ndlovu N, Subkovas E, Karthikeyan V, Waggett L, Wood A, Bolger A, Stockport J, Evans L, Harman E, Starling J, Williams L, Saul V, Sinha M, Bell L, Tudgay S, Kemp S, Brown J, Frost L, Ingram T, Loughlin A, Adams C, Adams M, Hurford F, Owen C, Miller C, Donaldson D, Tivenan H, Button H, Nasser A, Jhagra O, Stidolph B, Brown C, Livingstone C, Duffy M, Madgwick P, Roberts P, Greenwood E, Fletcher L, Beveridge M, Earles S, McKenzie D, Beacock D, Dayer M, Seddon M, Greenwell D, Luxton F, Venn F, Mills H, Rewbury J, James K, Roberts K, Tonks L, Felmeden D, Taggu W, Summerhayes A, Hughes D, Sutton J, Felmeden L, Khan M, Walker E, Norris L, O’Donohoe L, Mozid A, Dymond H, Lloyd-Jones H, Saunders G, Simmons D, Coles D, Cotterill D, Beech S, Kidd S, Wrigley B, Petkar S, Smallwood A, Jones R, Radford E, Milgate S, Metherell S, Cottam V, Buckley C, Broadley A, Wood D, Allison J, Rennie K, Balian L, Howard L, Pippard L, Board S, Pitt-Kerby T. Epidemiology and impact of frailty in patients with atrial fibrillation in Europe. Age Ageing 2022; 51:6670566. [PMID: 35997262 DOI: 10.1093/ageing/afac192] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Frailty is a medical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors. Data regarding the relationship between frailty and atrial fibrillation (AF) are still inconsistent. OBJECTIVES We aim to perform a comprehensive evaluation of frailty in a large European cohort of AF patients. METHODS A 40-item frailty index (FI) was built according to the accumulation of deficits model in the AF patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Association of baseline characteristics, clinical management, quality of life, healthcare resources use and risk of outcomes with frailty was examined. RESULTS Among 10,177 patients [mean age (standard deviation) 69.0 (11.4) years, 4,103 (40.3%) females], 6,066 (59.6%) were pre-frail and 2,172 (21.3%) were frail, whereas only 1,939 (19.1%) were considered robust. Baseline thromboembolic and bleeding risks were independently associated with increasing FI. Frail patients with AF were less likely to be treated with oral anticoagulants (OACs) (odds ratio 0.70, 95% confidence interval 0.55-0.89), especially with non-vitamin K antagonist OACs and managed with a rhythm control strategy, compared with robust patients. Increasing frailty was associated with a higher risk for all outcomes examined, with a non-linear exponential relationship. The use of OAC was associated with a lower risk of outcomes, except in patients with very/extremely high frailty. CONCLUSIONS In this large cohort of AF patients, there was a high burden of frailty, influencing clinical management and risk of adverse outcomes. The clinical benefit of OAC is maintained in patients with high frailty, but not in very high/extremely frail ones.
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Affiliation(s)
- Marco Proietti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giulio Francesco Romiti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Translational and Precision Medicine, Sapienza - University of Rome, Italy
| | - Marco Vitolo
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Stephanie L Harrison
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Tours, France
| | - Francisco Marin
- Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBER-CV, Murcia, Spain
| | - Michael Näbauer
- Department of Cardiology, Ludwig-Maximilians-University, Munich, Germany
| | - Tatjana S Potpara
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Clinical Center of Serbia, Belgrade, Serbia
| | - Gheorghe-Andrei Dan
- University of Medicine, 'Carol Davila', Colentina University Hospital, Bucharest, Romania
| | - Aldo P Maggioni
- ANMCO Research Center, Heart Care Foundation, Florence, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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McMahon S. SP-0840 Modelling the production of lethal DSBs. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)04035-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yu H, Du R, Wang M, Yu F, Yang J, Jiao L, Wang Z, Liu H, Wu P, Bärnighausen T, Xue L, Wang C, McMahon S, Geldsetzer P, Chen S. The provision of COVID-19 vaccines developed in China to other countries: A cross-sectional online survey on the views of the Chinese public. JMIR Public Health Surveill 2022; 8:e33484. [PMID: 35483084 PMCID: PMC9177168 DOI: 10.2196/33484] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 02/22/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND COVID-19 vaccines are in short supply globally. China was among the first countries to pledge supplies of the COVID-19 vaccine as a global public product, and to date the country has provided more than 600 million vaccines to more than 200 countries and regions with low COVID-19 vaccination rates. Understanding the public's attitude in China towards the global distribution of COVID-19 vaccines could inform global and national decisions, policies and debates. OBJECTIVE The aim of this study was to determine the attitudes of adults living in China regarding the global allocation of COVID-19 vaccines developed in China, and how these attitudes vary across provinces and by sociodemographic characteristics. METHODS We conducted a cross-sectional online survey among adults registered with the survey company KuRunData. The survey asked participants 31 questions on their attitudes regarding the global allocation of COVID-19 vaccines developed in China. We disaggregated responses by province and sociodemographic characteristics. All analyses used survey sampling weights. RESULTS A total of 10,000 participants completed the questionnaire. Participants generally favored providing COVID-19 vaccines to foreign countries before fully fulfilling domestic needs (75.6%, 95% CI: 74.6% - 76.5%). Women (76.8%, OR = 1.18, 95% CI: 1.07 - 1.32, P = .002) and those living in rural areas (76.8%, OR = 1.13, 95% CI: 1.01 - 1.27, P = .03) were especially likely to hold this opinion. Most respondents preferred providing financial support through international platforms rather than directly offering support to individual countries (72.1%, 95% CI: 71.0% - 73.1%), while for vaccine products they preferred direct provision to relevant countries instead of via a delivery platform such as COVAX (77.3%, 95% CI: 76.3% - 78.2%). CONCLUSIONS Among our survey sample, we find that adults are generally supportive of the international distribution of COVID-19 vaccines, which may encourage policy makers to support and implement the distribution of COVID-19 vaccines developed in China globally. Conducting similar surveys in other countries could help align policymakers' actions on COVID-19 vaccine distribution with the preferences of their constituencies. CLINICALTRIAL
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Affiliation(s)
- Hanzhi Yu
- School of Public Affairs, Zhejiang University, Hangzhou, CN
| | - Runming Du
- Department of Global Health, School of Public Health, Peking University, Beijing, CN
| | - Minmin Wang
- Peking University Cancer Hospital & Institute, Beijing, CN
| | - Fengyun Yu
- State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, CN
| | - Juntao Yang
- State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, CN
| | | | - Zhuoran Wang
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, CN
| | - Haitao Liu
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, CN
| | - Peixin Wu
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, CN
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Postfach 10 57 60 69047 Heidelberg, Heidelberg, DE
| | - Lan Xue
- School of Public Policy and Management, Tsinghua University, Beijing, CN
| | - Chen Wang
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, CN
| | - Shannon McMahon
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Postfach 10 57 60 69047 Heidelberg, Heidelberg, DE
| | - Pascal Geldsetzer
- Division of Primary Care and Population Health, Department of Medicine, Stanford University, Stanford, US
| | - Simiao Chen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Postfach 10 57 60 69047 Heidelberg, Heidelberg, DE
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Chen S, Forster S, Yang J, Yu F, Jiao L, Gates J, Wang Z, Liu H, Chen Q, Geldsetzer P, Wu P, Wang C, McMahon S, Bärnighausen T, Adam M. Animated, video entertainment-education to improve vaccine confidence globally during the COVID-19 pandemic: an online randomized controlled experiment with 24,000 participants. Trials 2022; 23:161. [PMID: 35183238 PMCID: PMC8857749 DOI: 10.1186/s13063-022-06067-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 01/29/2022] [Indexed: 12/31/2022] Open
Abstract
Background Science-driven storytelling and entertainment-education (E-E) media demonstrate potential for promoting improved attitudes and behavioral intent towards health-related practices. Months after the outbreak of coronavirus disease 2019 (COVID-19), emerging research highlights the essential role of interventions to improve public confidence in the COVID-19 vaccine. To improve vaccine confidence, we designed three short, animated videos employing three research-informed pedagogical strategies. These can be distributed globally through social media platforms, because of their wordless and culturally accessible design. However, the effectiveness of short, animated storytelling videos, deploying various pedagogic strategies, needs to be explored across different global regions. Methods/design The present study is a multi-site, parallel group, randomized controlled trial (RCT) comparing the effectiveness of (i) a storytelling-instructional-humor approach, (ii) a storytelling-analogy approach, (iii) a storytelling-emotion-focused approach, and (iv) no video. For our primary outcomes, we will measure vaccine hesitancy, and for secondary outcomes, we will measure behavioral intent to seek vaccination and hope. Using online platforms, we will recruit 12,000 participants (aged 18–59 years) from the USA and China, respectively, yielding a total sample size of 24,000. Discussion This trial uses innovative online technology, reliable randomization algorithms, validated survey instruments, and list experiments to establish the effectiveness of three short, animated videos employing various research-informed pedagogical strategies. Results will be used to scientifically support the broader distribution of these short, animated video as well as informing the design of future videos for rapid, global public health communication. Trial registration German Clinical Trials Register DRKS #00023650. Date of registration: 2021/02/09. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06067-5.
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Berner-Rodoreda A, McMahon S, Eyal N, Hossain P, Rabbani A, Barua M, Sarker M, Metta E, Mmbaga E, Leshabari M, Wikler D, Bärnighausen T. Consent Requirements for Testing Health Policies: An Intercontinental Comparison of Expert Opinions. J Empir Res Hum Res Ethics 2022; 17:346-361. [PMID: 35617114 PMCID: PMC9136368 DOI: 10.1177/15562646221076764] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Individual informed consent is a central requirement for clinical research on
human subjects, yet whether and how consent requirements should apply to health
policy experiments (HPEs) remains unclear. HPEs test and evaluate public health
policies prior to implementation. We interviewed 58 health experts in Tanzania,
Bangladesh and Germany on informed consent requirements for HPEs. Health experts
across all countries favored a strong evidence base, prior information to the
affected populations, and individual consent for ‘risky’ HPEs. Differences
pertained to individual risk perception, how and when consent by group
representatives should be obtained and whether HPEs could be treated as health
policies. The study adds to representative consent options for HPEs, yet shows
that more research is needed in this field – particularly in the present
Covid-19 pandemic which has highlighted the need for HPEs nationally and
globally.
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Affiliation(s)
| | - Shannon McMahon
- Heidelberg Institute of Global Health, Heidelberg University, Germany
- Social and Behavioral Interventions, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Nir Eyal
- Department of Health, Behavior, Society and Policy, Rutgers University, Piscataway, USA
- Center for Population-Level Bioethics, New Brunswick, USA
| | - Puspita Hossain
- McMaster University, Hamilton, Canada
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Atonu Rabbani
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Department of Economics, University of Dhaka, Dhaka, Bangladesh
| | - Mrittika Barua
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Radboud Universiteit, Nijmegen, Netherlands
| | - Malabika Sarker
- Heidelberg Institute of Global Health, Heidelberg University, Germany
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Emmy Metta
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Elia Mmbaga
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Melkizedeck Leshabari
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Daniel Wikler
- Harvard T.H. Chan School of Public Health, Department of Global Health and Population, Boston, USA
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University, Germany
- Harvard T.H. Chan School of Public Health, Department of Global Health and Population, Boston, USA
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11
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McMahon S, Matthews JJ, Brasier A, Still J. Late Ediacaran life on land: desiccated microbial mats and large biofilm streamers. Proc Biol Sci 2021; 288:20211875. [PMID: 34727717 PMCID: PMC8564610 DOI: 10.1098/rspb.2021.1875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/14/2021] [Indexed: 12/18/2022] Open
Abstract
The Ediacaran period witnessed transformational change across the Earth-life system, but life on land during this interval is poorly understood. Non-marine/transitional Ediacaran sediments preserve a variety of probable microbially induced sedimentary structures and fossil matgrounds, and the ecology, biogeochemistry and sedimentological impacts of the organisms responsible are now ripe for investigation. Here, we report well-preserved fossils from emergent siliciclastic depositional environments in the Ediacaran of Newfoundland, Canada. These include exquisite, mouldically preserved microbial mats with desiccation cracks and flip-overs, abundant Arumberia-type fossils and, most notably, assemblages of centimetre-to-metre-scale, subparallel, branching, overlapping, gently curving ribbon-like features preserved by aluminosilicate and phosphate minerals, with associated filamentous microfossils. We present morphological, petrographic and taphonomic evidence that the ribbons are best interpreted as fossilized current-induced biofilm streamers, the earliest record of an important mode of life (macroscopic streamer formation) for terrestrial microbial ecosystems today. Their presence shows that late Ediacaran terrestrial environments could produce substantial biomass, and supports recent interpretations of Arumberia as a current-influenced microbial mat fossil, which we here suggest existed on a 'streamer-arumberiamorph spectrum'. Finally, the absence of classic Ediacaran macrobiota from these rocks despite evidently favourable conditions for soft tissue preservation upholds the consensus that those organisms were exclusively marine.
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Affiliation(s)
- S. McMahon
- UK Centre for Astrobiology, School of Physics and Astronomy, University of Edinburgh, James Clerk Maxwell Building, Edinburgh EH9 3FD, UK
- School of Geosciences, Grant Institute, University of Edinburgh, Edinburgh EH9 3FE, UK
| | - J. J. Matthews
- Oxford University Museum of Natural History, Parks Road, Oxford OX1 3PW, UK
| | - A. Brasier
- School of Geosciences, University of Aberdeen, King's College, Aberdeen AB24 3UE, UK
| | - J. Still
- School of Geosciences, University of Aberdeen, King's College, Aberdeen AB24 3UE, UK
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12
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Deckert A, Anders S, De Allegri M, Nguyen HT, Souares A, McMahon S, Meurer M, Burk R, Sand M, Koeppel L, Hein LM, Roß T, Adler T, Siems T, Brugnara L, Brenner S, Herbst K, Kirrmaier D, Duan Y, Ovchinnikova S, Boerner K, Marx M, Kräusslich HG, Knop M, Bärnighausen T, Denkinger C. Effectiveness and cost-effectiveness of four different strategies for SARS-CoV-2 surveillance in the general population (CoV-Surv Study): study protocol for a two-factorial randomized controlled multi-arm trial with cluster sampling. Trials 2021; 22:656. [PMID: 34565421 PMCID: PMC8474710 DOI: 10.1186/s13063-021-05619-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 09/13/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND To achieve higher effectiveness in population-based SARS-CoV-2 surveillance and to reliably predict the course of an outbreak, screening, and monitoring of infected individuals without major symptoms (about 40% of the population) will be necessary. While current testing capacities are also used to identify such asymptomatic cases, this rather passive approach is not suitable in generating reliable population-based estimates of the prevalence of asymptomatic carriers to allow any dependable predictions on the course of the pandemic. METHODS This trial implements a two-factorial, randomized, controlled, multi-arm, prospective, interventional, single-blinded design with cluster sampling and four study arms, each representing a different SARS-CoV-2 testing and surveillance strategy based on individuals' self-collection of saliva samples which are then sent to and analyzed by a laboratory. The targeted sample size for the trial is 10,000 saliva samples equally allocated to the four study arms (2500 participants per arm). Strategies differ with respect to tested population groups (individuals vs. all household members) and testing approach (without vs. with pre-screening survey). The trial is complemented by an economic evaluation and qualitative assessment of user experiences. Primary outcomes include costs per completely screened person, costs per positive case, positive detection rate, and precision of positive detection rate. DISCUSSION Systems for active surveillance of the general population will gain more importance in the context of pandemics and related disease prevention efforts. The pandemic parameters derived from such active surveillance with routine population monitoring therefore not only enable a prospective assessment of the short-term course of a pandemic, but also a more targeted and thus more effective use of local and short-term countermeasures. TRIAL REGISTRATION ClinicalTrials.gov DRKS00023271 . Registered November 30, 2020, with the German Clinical Trials Register (Deutsches Register Klinischer Studien).
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Affiliation(s)
- Andreas Deckert
- Heidelberg Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
| | - Simon Anders
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Im Neuenheimer Feld 282, 69120 Heidelberg, Germany
| | - Manuela De Allegri
- Heidelberg Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
| | - Hoa Thi Nguyen
- Heidelberg Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
| | - Aurélia Souares
- Heidelberg Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
| | - Shannon McMahon
- Heidelberg Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
| | - Matthias Meurer
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Im Neuenheimer Feld 282, 69120 Heidelberg, Germany
| | - Robin Burk
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Im Neuenheimer Feld 282, 69120 Heidelberg, Germany
| | - Matthias Sand
- GESIS Leibniz-Institute for the Social Sciences, B2/1, 68159 Mannheim, Germany
| | - Lisa Koeppel
- Division of Clinical Tropical Medicine, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
| | - Lena Maier Hein
- Division of Computer Assisted Medical Interventions (CAMI), German Cancer Research Centre (DKFZ), Im Neuenheimer Feld 223, 69120 Heidelberg, Germany
| | - Tobias Roß
- Division of Computer Assisted Medical Interventions (CAMI), German Cancer Research Centre (DKFZ), Im Neuenheimer Feld 223, 69120 Heidelberg, Germany
| | - Tim Adler
- Division of Computer Assisted Medical Interventions (CAMI), German Cancer Research Centre (DKFZ), Im Neuenheimer Feld 223, 69120 Heidelberg, Germany
| | - Tobias Siems
- Institute for Applied Mathematics, University of Heidelberg, Berliner Str. 41-49, 69120 Heidelberg, Germany
| | - Lucia Brugnara
- Heidelberg Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
- evaplan GmbH at the University Hospital, Ringstr.19b, 69115 Heidelberg, Germany
| | - Stephan Brenner
- Heidelberg Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
| | - Konrad Herbst
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Im Neuenheimer Feld 282, 69120 Heidelberg, Germany
| | - Daniel Kirrmaier
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Im Neuenheimer Feld 282, 69120 Heidelberg, Germany
| | - Yuanqiang Duan
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Im Neuenheimer Feld 282, 69120 Heidelberg, Germany
| | - Svetlana Ovchinnikova
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Im Neuenheimer Feld 282, 69120 Heidelberg, Germany
| | - Kathleen Boerner
- Department of Infectious Diseases, Virology, University of Heidelberg, Im Neuenheimer Feld 267, 69120 Heidelberg, Germany
| | - Michael Marx
- Heidelberg Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
- evaplan GmbH at the University Hospital, Ringstr.19b, 69115 Heidelberg, Germany
| | - Hans-Georg Kräusslich
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Im Neuenheimer Feld 282, 69120 Heidelberg, Germany
| | - Michael Knop
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Im Neuenheimer Feld 282, 69120 Heidelberg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
| | - Claudia Denkinger
- Division of Clinical Tropical Medicine, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
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13
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Mbonigaba E, Nderu D, Chen S, Denkinger C, Geldsetzer P, McMahon S, Bärnighausen T. Childhood vaccine uptake in Africa: threats, challenges, and opportunities. Journal of Global Health Reports 2021. [DOI: 10.29392/001c.26312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Edward Mbonigaba
- Heidelberg Institute of Global Health, University of Heidelberg, Germany; College of Medicine, School of Public Health- University of Rwanda, Rwanda
| | - David Nderu
- School of Health Sciences, Kirinyaga University, Kirinyaga, Kenya
| | - Simiao Chen
- Heidelberg Institute of Global Health, University of Heidelberg, Germany; Chinese Academy of Medical Sciences and Peking Union Medical College, China
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Madan R, Gandhy S, Karzai F, Bilusic M, McMahon S, Strauss J, Marte J, Weisman A, Perk T, Yip S, Lindenberg L, Mena Gonzalez E, Turkbey B, Figg W, Arlen P, Choyke P, Dahut W, Gulley J. 605P Analysis of serial PET imaging and paired Tc99 scans in metastatic castration resistant prostate cancer (mCRPC) treated with enzalutamide. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1118] [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: 10/20/2022] Open
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15
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McMahon S, Bergink S, Kampinga HH, Ecroyd H. DNAJB chaperones suppress destabilised protein aggregation via a region distinct from that used to inhibit amyloidogenesis. J Cell Sci 2021; 134:237814. [PMID: 33674449 DOI: 10.1242/jcs.255596] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 02/22/2021] [Indexed: 01/03/2023] Open
Abstract
Disturbances to protein homeostasis (proteostasis) can lead to protein aggregation and inclusion formation, processes associated with a variety of neurodegenerative disorders. DNAJB proteins are molecular chaperones that have been identified as potent suppressors of disease-related protein aggregation. In this work, a destabilised isoform of firefly luciferase (R188Q/R261Q Fluc; termed FlucDM) was overexpressed in cells to assess the capacity of DNAJBs to inhibit inclusion formation. Co-expression of all DNAJB proteins tested significantly inhibited the intracellular aggregation of FlucDM. Moreover, we show that DNAJB proteins suppress aggregation by supporting the Hsp70 (HSPA)-dependent degradation of FlucDM via the proteasome. The serine-rich stretch in DNAJB6 and DNAJB8, essential for preventing fibrillar aggregation, is not involved in the suppression of FlucDM inclusion formation. Conversely, deletion of the C-terminal TTK-LKS motif in DNAJB6 and DNAJB8, a region not required to suppress polyglutamine aggregation, abolished the ability to inhibit inclusion formation by FlucDM. Thus, our data suggest that DNAJB6 and DNAJB8 possess two distinct regions for binding substrates, one that is responsible for binding β-hairpins that form during amyloid formation and another that interacts with exposed hydrophobic patches in aggregation-prone clients. This article has an associated First Person interview with the first author of the paper.
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Affiliation(s)
- Shannon McMahon
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia.,Molecular Horizons and School of Chemistry and Molecular Bioscience, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Steven Bergink
- University Medical Center Groningen, University of Groningen, Department of Cell Biology, 9713 AV Groningen, The Netherlands
| | - Harm H Kampinga
- University Medical Center Groningen, University of Groningen, Department of Cell Biology, 9713 AV Groningen, The Netherlands
| | - Heath Ecroyd
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia.,Molecular Horizons and School of Chemistry and Molecular Bioscience, University of Wollongong, Wollongong, NSW 2522, Australia
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16
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O'Donoghue G, McMahon S, Holt A, Nedai M, Nybo T, Peiris CL. Obesity bias and stigma, attitudes and beliefs among entry-level physiotherapy students in the Republic of Ireland: a cross sectional study. Physiotherapy 2021; 112:55-63. [PMID: 34051594 DOI: 10.1016/j.physio.2021.03.016] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To explore entry-level physiotherapy students' attitudes and beliefs relating to weight bias and stigmatisation in healthcare. DESIGN Cross sectional survey of physiotherapy students. METHODS All final year physiotherapy students (n = 215) enrolled in entry-level physiotherapy programmes in the Republic of Ireland were invited to participate. Each received a questionnaire, consisting of 72 questions, within four key sections. Descriptive statistics and frequencies were used to analyse the data. RESULTS A response rate of 83% (179/215) was achieved. Whilst physiotherapy students, overall, had a positive attitude towards people with obesity, 29% had a negative attitude towards people with obesity, 24% had a negative attitude towards managing this population and most (74%) believed obesity was caused by behavioural and individual factors. Over one third of students (35%) reported that they would not be confident in managing patients with obesity and more than half (54%) felt treating patients with obesity was not worthwhile. CONCLUSION This study provides preliminary findings to suggest that weight stigma-reduction efforts are warranted for physiotherapy students. Helping students to understand that obesity is a complex, chronic condition with multiple aspects requiring a multi-faceted approach to its management might be the first step towards dispelling these negative attitudes towards patients living with obesity. Inclusion of a formal obesity curriculum should perhaps now be part of the contemporary physiotherapy students' education.
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Affiliation(s)
- G O'Donoghue
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Ireland.
| | - S McMahon
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Ireland.
| | - A Holt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Ireland.
| | - M Nedai
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Ireland.
| | - T Nybo
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Ireland.
| | - C L Peiris
- La Trobe University, School of Allied Health, Human Services and Sport, Physiotherapy, Melbourne, Victoria, Australia.
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17
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Bennett ER, Snyder S, Cusano J, McMahon S, Zijdel M, Camerer K, Howley C. Supporting survivors of campus dating and sexual violence during COVID-19: A social work perspective. Soc Work Health Care 2021; 60:106-116. [PMID: 33555991 DOI: 10.1080/00981389.2021.1885566] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/05/2021] [Accepted: 01/31/2021] [Indexed: 06/12/2023]
Abstract
The issue of dating and sexual violence (DSV) on college campuses has received increased attention nationwide as a criminal justice and public health issue. College and university employed social workers play a critical role in preventing and responding to campus DSV through direct clinical services to students as well as prevention through educational programming and training. COVID-19 has negative implications for DSV student victims, as well as service delivery and accessibility. This paper examines the innovative methods used by university employed social work clinicians and educators to meet evolving mental health care needs and continue violence prevention services during COVID-19.
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Affiliation(s)
| | - S Snyder
- Social Work, Rutgers University, New Brunswick, New Jersey, USA
| | - J Cusano
- Social Work, Rutgers University, New Brunswick, New Jersey, USA
| | - S McMahon
- Social Work, Rutgers University, New Brunswick, New Jersey, USA
| | - M Zijdel
- Student Affairs, Rutgers University, New Brunswick, New Jersey, USA
| | - K Camerer
- Student Affairs, Rutgers University, New Brunswick, New Jersey, USA
| | - C Howley
- Student Affairs, Rutgers University, Newark, New Jersey, USA
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18
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Reñosa MDC, Mwamba C, Meghani A, West NS, Hariyani S, Ddaaki W, Sharma A, Beres LK, McMahon S. Selfie consents, remote rapport, and Zoom debriefings: collecting qualitative data amid a pandemic in four resource-constrained settings. BMJ Glob Health 2021; 6:bmjgh-2020-004193. [PMID: 33419929 PMCID: PMC7798410 DOI: 10.1136/bmjgh-2020-004193] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/26/2020] [Accepted: 12/03/2020] [Indexed: 11/03/2022] Open
Abstract
In-person interactions have traditionally been the gold standard for qualitative data collection. The COVID-19 pandemic required researchers to consider if remote data collection can meet research objectives, while retaining the same level of data quality and participant protections. We use four case studies from the Philippines, Zambia, India and Uganda to assess the challenges and opportunities of remote data collection during COVID-19. We present lessons learned that may inform practice in similar settings, as well as reflections for the field of qualitative inquiry in the post-COVID-19 era. Key challenges and strategies to overcome them included the need for adapted researcher training in the use of technologies and consent procedures, preparation for abbreviated interviews due to connectivity concerns, and the adoption of regular researcher debriefings. Participant outreach to allay suspicions ranged from communicating study information through multiple channels to highlighting associations with local institutions to boost credibility. Interviews were largely successful, and contained a meaningful level of depth, nuance and conviction that allowed teams to meet study objectives. Rapport still benefitted from conventional interviewer skills, including attentiveness and fluency with interview guides. While differently abled populations may encounter different barriers, the included case studies, which varied in geography and aims, all experienced more rapid recruitment and robust enrollment. Reduced in-person travel lowered interview costs and increased participation among groups who may not have otherwise attended. In our view, remote data collection is not a replacement for in-person endeavours, but a highly beneficial complement. It may increase accessibility and equity in participant contributions and lower costs, while maintaining rich data collection in multiple study target populations and settings.
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Affiliation(s)
- Mark Donald C Reñosa
- Heidelberg Institute of Global Health, Ruprechts-Karls-Universität Heidelberg, Heidelberg, Germany
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Department of Health, Manila, Philippines
| | - Chanda Mwamba
- On behalf of the Social & Behavioural Science Group, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Ankita Meghani
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nora S West
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Shreya Hariyani
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Johns Hopkins India Private Limited (JHIPL), Delhi, India
| | - William Ddaaki
- On behalf of the Social & Behavioral Sciences Team, The Rakai Health Sciences Program, Rakai, Uganda
| | - Anjali Sharma
- On behalf of the Social & Behavioural Science Group, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Laura K Beres
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Shannon McMahon
- Heidelberg Institute of Global Health, Ruprechts-Karls-Universität Heidelberg, Heidelberg, Germany
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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19
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Deckert A, Anders S, de Allegri M, Nguyen HT, Souares A, McMahon S, Boerner K, Meurer M, Herbst K, Sand M, Koeppel L, Siems T, Brugnara L, Brenner S, Burk R, Lou D, Kirrmaier D, Duan Y, Ovchinnikova S, Marx M, Kräusslich HG, Knop M, Bärnighausen T, Denkinger C. Effectiveness and cost-effectiveness of four different strategies for SARS-CoV-2 surveillance in the general population (CoV-Surv Study): a structured summary of a study protocol for a cluster-randomised, two-factorial controlled trial. Trials 2021; 22:39. [PMID: 33419461 PMCID: PMC7791150 DOI: 10.1186/s13063-020-04982-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 11/24/2022] Open
Abstract
Objectives In this cluster-randomised controlled study (CoV-Surv Study), four different “active” SARS-CoV-2 testing strategies for general population surveillance are evaluated for their effectiveness in determining and predicting the prevalence of SARS-CoV-2 infections in a given population. In addition, the costs and cost-effectiveness of the four surveillance strategies will be assessed. Further, this trial is supplemented by a qualitative component to determine the acceptability of each strategy. Findings will inform the choice of the most effective, acceptable and affordable strategy for SARS-CoV-2 surveillance, with the most effective and cost-effective strategy becoming part of the local public health department’s current routine health surveillance activities. Investigating its everyday performance will allow us to examine the strategy’s applicability to real time prevalence prediction and the usefulness of the resulting information for local policy makers to implement countermeasures that effectively prevent future nationwide lockdowns. The authors would like to emphasize the importance and relevance of this study and its expected findings in the context of population-based disease surveillance, especially in respect to the current SARS-CoV-2 pandemic. In Germany, but also in many other countries, COVID-19 surveillance has so far largely relied on passive surveillance strategies that identify individuals with clinical symptoms, monitor those cases who then tested positive for the virus, followed by tracing of individuals in close contact to those positive cases. To achieve higher effectiveness in population surveillance and to reliably predict the course of an outbreak, screening and monitoring of infected individuals without major symptoms (about 40% of the population) will be necessary. While current testing capacities are also used to identify such asymptomatic cases, this rather passive approach is not suitable in generating reliable population-based estimates of the prevalence of asymptomatic carriers to allow any dependable predictions on the course of the pandemic. To better control and manage the SARS-CoV-2 pandemic, current strategies therefore need to be complemented by an active surveillance of the wider population, i.e. routinely conducted testing and monitoring activities to identify and isolate infected individuals regardless of their clinical symptoms. Such active surveillance strategies will enable more effective prevention of the spread of the virus as they can generate more precise population-based parameters during a pandemic. This essential information will be required in order to determine the best strategic and targeted short-term countermeasures to limit infection spread locally. Trial design This trial implements a cluster-randomised, two-factorial controlled, prospective, interventional, single-blinded design with four study arms, each representing a different SARS-CoV-2 testing and surveillance strategy. Participants Eligible are individuals age 7 years or older living in Germany’s Rhein-Neckar Region who consent to provide a saliva sample (all four arms) after completion of a brief questionnaire (two arms only). For the qualitative component, different samples of study participants and non-participants (i.e. eligible for study, but refuse to participate) will be identified for additional interviews. For these interviews, only individuals age 18 years or older are eligible. Intervention and comparator Of the four surveillance strategies to be assessed and compared, Strategy A1 is considered the gold standard for prevalence estimation and used to determine bias in other arms. To determine the cost-effectiveness, each strategy is compared to status quo, defined as the currently practiced passive surveillance approach. Strategy A1: Individuals (one per household) receive information and study material by mail with instructions on how to produce a saliva sample and how to return the sample by mail. Once received by the laboratory, the sample is tested for SARS-CoV-2 using Reverse Transcription Loop-mediated Isothermal Amplification (RT-LAMP). Strategy A2: Individuals (one per household) receive information and study material by mail with instructions on how to produce their own as well as saliva samples from each household member and how to return these samples by mail. Once received by the laboratory, the samples are tested for SARS-CoV-2 using RT-LAMP. Strategy B1: Individuals (one per household) receive information by mail on how to complete a brief pre-screening questionnaire which asks about COVID-19 related clinical symptoms and risk exposures. Only individuals whose pre-screening score crosses a defined threshold, will then receive additional study material by mail with instructions on how to produce a saliva sample and how to return the sample by mail. Once received by the laboratory, the saliva sample is tested for SARS-CoV-2 using RT-LAMP. Strategy B2: Individuals (one per household) receive information by mail on how to complete a brief pre-screening questionnaire which asks about COVID-19 related clinical symptoms. Only individuals whose pre-screening score crosses a defined threshold, will then receive additional study material by mail with instructions how to produce their own as well as saliva samples from each household member and how to return these samples by mail. Once received by the laboratory, the samples are tested for SARS-CoV-2 using RT-LAMP. In each strategy, RT-LAMP positive samples are additionally analyzed with qPCR in order to minimize the number of false positives. Main outcomes The identification of the one best strategy will be determined by a set of parameters. Primary outcomes include costs per correctly screened person, costs per positive case, positive detection rate, and precision of positive detection rate. Secondary outcomes include participation rate, costs per asymptomatic case, prevalence estimates, number of asymptomatic cases per study arm, ratio of symptomatic to asymptomatic cases per study arm, participant satisfaction. Additional study components (not part of the trial) include cost effectiveness of each of the four surveillance strategies compared to passive monitoring (i.e. status quo), development of a prognostic model to predict hospital utilization caused by SARS-CoV-2, time from test shipment to test application and time from test shipment to test result, and perception and preferences of the persons to be tested with regard to test strategies. Randomisation Samples are drawn in three batches of three continuous weeks. Randomisation follows a two-stage process. First, a total of 220 sampling points have been allocated to the three different batches. To obtain an integer solution, the Cox-algorithm for controlled rounding has been used. Afterwards, sample points have been drawn separately per batch, following a probability proportional to size (PPS) random sample. Second, for each cluster the same number of residential addresses is randomly sampled from the municipal registries (self-weighted sample of individuals). The 28,125 addresses drawn per municipality are then randomly allocated to the four study arms A1, A2, B1, and B2 in the ratio 5 to 2.5 to 14 to 7 based on the expected response rates in each arm and the sensitivity and specificity of the pre-screening tool as applied in strategy B1 and B2. Based on the assumptions, this allocation should yield 2500 saliva samples in each strategy. Although a municipality can be sampled by multiple batches and the overall number of addresses per municipality might vary, the number of addresses contacted in each arm is kept constant. Blinding (masking) The design is single-blinded, meaning the staff conducting the SARS-CoV-2 tests are unaware of the study arm assignment of each single participant and test sample. Sample sizes Total sample size for the trial is 10,000 saliva samples equally allocated to the four study arms (i.e. 2,500 participants per arm). For the qualitative component, up to 60 in-depth interviews will be conducted with about 30 study participants (up to 15 in each arm A and B) and 30 participation refusers (up to 15 in each arm A and B) purposefully selected from the quantitative study sample to represent a variety of gender and ages to explore experiences with admission or rejection of study participation. Up to 25 asymptomatic SARS-CoV-2 positive study participants will be purposefully selected to explore the way in which asymptomatic men and women diagnosed with SARS-CoV-2 give meaning to their diagnosis and to the dialectic between feeling concurrently healthy and yet also being at risk for transmitting COVID-19. In addition, 100 randomly selected study participants will be included to explore participants’ perspective on testing processes and implementation. Trial Status Final protocol version is “Surveillance_Studienprotokoll_03Nov2020_v1_2” from November 3, 2020. Recruitment started November 18, 2020 and is expected to end by or before December 31, 2020. Trial registration The trial is currently being registered with the German Clinical Trials Register (Deutsches Register Klinischer Studien), DRKS00023271 (https://www.drks.de/drks_web/navigate.do?navigationId=trial. HTML&TRIAL_ID=DRKS00023271). Retrospectively registered 30 November 2020. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.
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Affiliation(s)
- Andreas Deckert
- Heidelberg Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany.
| | - Simon Anders
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Im Neuenheimer Feld 282, 69120, Heidelberg, Germany
| | - Manuela de Allegri
- Heidelberg Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 130.1, 69120, Heidelberg, Germany
| | - Hoa Thi Nguyen
- Heidelberg Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 365, 69120, Heidelberg, Germany
| | - Aurélia Souares
- Heidelberg Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 130.1, 69120, Heidelberg, Germany
| | - Shannon McMahon
- Heidelberg Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 130.1, 69120, Heidelberg, Germany
| | - Kathleen Boerner
- Department of Infectious Diseases, Virology, University of Heidelberg, Im Neuenheimer Feld 267, 69120, Heidelberg, Germany
| | - Matthias Meurer
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Im Neuenheimer Feld 282, 69120, Heidelberg, Germany
| | - Konrad Herbst
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Im Neuenheimer Feld 282, 69120, Heidelberg, Germany
| | - Matthias Sand
- GESIS Leibniz-Institute for the Social Sciences, B2/1, 68159, Mannheim, Germany
| | - Lisa Koeppel
- Section Clinical Tropical Medicine, University of Heidelberg, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | - Tobias Siems
- Institute for Applied Mathematics, University of Heidelberg, Berliner Str. 41-49, 69120, Heidelberg, Germany
| | - Lucia Brugnara
- evaplan GmbH, University of Heidelberg, Ringstr.19b, 69115, Heidelberg, Germany
| | - Stephan Brenner
- Heidelberg Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 130.1, 69120, Heidelberg, Germany
| | - Robin Burk
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Im Neuenheimer Feld 282, 69120, Heidelberg, Germany
| | - Dan Lou
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Im Neuenheimer Feld 282, 69120, Heidelberg, Germany
| | - Daniel Kirrmaier
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Im Neuenheimer Feld 282, 69120, Heidelberg, Germany
| | - Yuanqiang Duan
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Im Neuenheimer Feld 282, 69120, Heidelberg, Germany
| | - Svetlana Ovchinnikova
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Im Neuenheimer Feld 282, 69120, Heidelberg, Germany
| | - Michael Marx
- Heidelberg Institute of Global Health/evaplan GmbH, University of Heidelberg, Im Neuenheimer Feld 130.1, 69120, Heidelberg, Germany
| | - Hans Georg Kräusslich
- Center for Integrative Infectious Disease Research (CIID), University of Heidelberg, Im Neuenheimer Feld 344, 69120, Heidelberg, Germany
| | - Michael Knop
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Im Neuenheimer Feld 282, 69120, Heidelberg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 130.1, 69120, Heidelberg, Germany
| | - Claudia Denkinger
- Section Clinical Tropical Medicine, University of Heidelberg, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
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Shore AJ, Wood RA, Butler IB, Zhuravlev AY, McMahon S, Curtis A, Bowyer FT. Ediacaran metazoan reveals lophotrochozoan affinity and deepens root of Cambrian Explosion. Sci Adv 2021; 7:7/1/eabf2933. [PMID: 33523867 PMCID: PMC7775780 DOI: 10.1126/sciadv.abf2933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 11/09/2020] [Indexed: 05/12/2023]
Abstract
Through exceptional preservation, we establish a phylogenetic connection between Ediacaran and Cambrian metazoans. We describe the first three-dimensional, pyritized soft tissue in Namacalathus from the Ediacaran Nama Group, Namibia, which follows the underlying form of a stalked, cup-shaped, calcitic skeleton, with six radially arranged lobes projecting into an apical opening and lateral lumens. A thick body wall and probable J-shaped gut are present within the cup, and the middle layer of the often-spinose skeleton and skeletal pores are selectively pyritized, supporting an organic-rich composition and tripartite construction with possible sensory punctae. These features suggest a total group lophotrochozoan affinity. These morphological data support molecular phylogenies and demonstrates that the origin of modern lophotrochozoan phyla, and their ability to biomineralize, had deep roots in the Ediacaran.
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Affiliation(s)
- A J Shore
- School of GeoSciences, University of Edinburgh, James Hutton Road, Edinburgh EH9 3FE, UK.
| | - R A Wood
- School of GeoSciences, University of Edinburgh, James Hutton Road, Edinburgh EH9 3FE, UK
| | - I B Butler
- School of GeoSciences, University of Edinburgh, James Hutton Road, Edinburgh EH9 3FE, UK
| | - A Yu Zhuravlev
- Department of Biological Evolution, Faculty of Biology, Lomonosov Moscow State University, Leninskie Gory, Moscow 119991, Russia
| | - S McMahon
- School of GeoSciences, University of Edinburgh, James Hutton Road, Edinburgh EH9 3FE, UK
- UK Centre for Astrobiology, School of Physics and Astronomy, University of Edinburgh, James Clerk Maxwell Building, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK
| | - A Curtis
- School of GeoSciences, University of Edinburgh, James Hutton Road, Edinburgh EH9 3FE, UK
| | - F T Bowyer
- School of GeoSciences, University of Edinburgh, James Hutton Road, Edinburgh EH9 3FE, UK
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Butterworth K, Williams K, Van Herk M, McWilliam A, Aznar M, McMahon S, Vasques Osorio E, Edgar K, Walls G, Gill E, Ghita M. OC-0196: Cardiac sub-volume targeting demonstrates regional radiosensitivity in the mouse heart. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00220-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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McMahon S, Parnell J, Reekie PBR. Mars-Analog Calcium Sulfate Veins Record Evidence of Ancient Subsurface Life. Astrobiology 2020; 20:1212-1223. [PMID: 32985907 DOI: 10.1089/ast.2019.2172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Ancient veins of calcium sulfate minerals (anhydrite, bassanite, and gypsum) deposited by subsurface aqueous fluids crosscut fluviolacustrine sedimentary rocks at multiple localities on Mars. Although these veins have been considered an attractive target for astrobiological investigation, their potential to preserve biosignatures is poorly understood. Here, we report the presence of biogenic authigenic pyrite in a fibrous gypsum vein of probable Cenozoic emplacement age from Permian lacustrine rocks in Northwest England. Pyrite occurs at the vein margins and displays a complex interfingering boundary with the surrounding gypsum suggestive of replacive authigenic growth. Gypsum-entombed carbonaceous material of probable organic origin was also identified by Raman spectroscopic microscopy in close proximity to the pyrite. Spatially resolved ion microprobe (SIMS) measurements reveal that the pyrite sulfur isotope composition is consistently very light (δ34SVCDT = -30.7‰). Comparison with the sulfate in the vein gypsum (δ34SVCDT = +8.5‰) indicates a fractionation too large to be explained by nonbiological (thermochemical) sulfate reduction. We infer that the pyrite was precipitated by microorganisms coupling the reduction of vein-derived sulfate with the oxidation of wall-derived organic matter. This is the first evidence that such veins can incorporate biosignatures that remain stable over geological time, which could be detected in samples returned from Mars.
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Affiliation(s)
- S McMahon
- UK Centre for Astrobiology, School of Physics and Astronomy, University of Edinburgh, Edinburgh, UK
- School of Geosciences, Grant Institute, University of Edinburgh, Edinburgh, UK
| | - J Parnell
- School of Geosciences, University of Aberdeen, King's College, Aberdeen, UK
| | - P B R Reekie
- UK Centre for Astrobiology, School of Physics and Astronomy, University of Edinburgh, Edinburgh, UK
- School of Geosciences, Grant Institute, University of Edinburgh, Edinburgh, UK
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Gandhy S, Gonzales E, Karzai F, Marte J, Bilusic M, McMahon S, Strauss J, Steinberg S, Gill A, Tubbs A, Schonhoft J, Choyke P, Turkbey B, Lindenberg L, Figg W, Arlen P, Dahut W, Gulley J, Madan R. 643P Evaluating biomarkers in metastatic castration resistant prostate cancer (mCRPC) patients (Pts) treated with enzalutamide (Enza): PSA, circulating tumor cell (CTC) counts, AR-V7 status, PET imaging vs. CT & Tc99 scans. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Redman J, Gandhy S, Gatti-Mays M, Sater HA, Tsai Y, Donahue R, Cordes L, Steinberg S, Marte J, McMahon S, Madan R, Karzai F, Bilusic M, Rabizadeh S, Lee J, Soon-Shiong P, Kim S, Marshall J, Weinberg B, Schlom J, Gulley J, Strauss J. SO-28 A randomized phase II trial of mFOLFOX6-based standard of care alone or in combination with Ad-CEA vaccine plus avelumab in patients with previously untreated metastatic colorectal cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Tzatzairis T, McMahon S, Shilpa J, Maizen C. Safety and efficacy of tranexamic acid in children with cerebral palsy undergoing femoral varus derotational osteotomy: a double cohort study. Eur J Orthop Surg Traumatol 2020; 30:1039-1044. [DOI: 10.1007/s00590-020-02663-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 03/26/2020] [Indexed: 12/28/2022]
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Cheung C, Talley KM, McMahon S, Schorr E, Wyman JF. Knowledge of Physical Activity Guidelines and Its Association with Physical Activity and Physical Function in Older Adults. Activities, Adaptation & Aging 2020. [DOI: 10.1080/01924788.2019.1591152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- C. Cheung
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - K. M Talley
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - S. McMahon
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - E. Schorr
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - J. F. Wyman
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
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Petross C, McMahon S, Lohmann J, Chase RP, Muula AS, De Allegri M. Intended and unintended effects: community perspectives on a performance-based financing programme in Malawi. BMJ Glob Health 2020; 5:e001894. [PMID: 32337084 PMCID: PMC7170427 DOI: 10.1136/bmjgh-2019-001894] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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] [Received: 08/06/2019] [Revised: 01/20/2020] [Accepted: 01/27/2020] [Indexed: 11/04/2022] Open
Abstract
Background Several performance-based financing (PBF) evaluations have been undertaken in low-income countries, yet few have examined community perspectives of care amid PBF programme implementation. We assessed community members' perspectives of Support for Service Delivery Integration - Performance-Based Incentives ('SSDI-PBI'), a PBF intervention in Malawi, and explored some of the unintended effects that emerged amid implementation. Methods We conducted 30 focus group discussions: 17 with community leaders and 13 with mothers within catchment areas of SSDI-PBI implementing facilities. We analysed data using the framework approach. Results Community leaders and women had mixed impressions regarding the effect of SSDI-PBI on service delivery in facilities. They highlighted several improvements (including improved dialogue between staff and community, and cleaner, better-equipped facilities with enhanced privacy), but also persisting challenges (including inadequate and overworked staff, overcrowded facilities and long distances to facilities) related to services in SSDI-PBI-implementing facilities. Further, respondents described how four targeted service indicators related to maternal risk factor management, antenatal care (ANC) in the first trimester, skilled birth attendance and couple's HIV testing sparked unintended negative effects as experienced by women and communities. The unintended effects included women returning home for delivery, women feeling uncertain about their pregnancy status, women feeling betrayed or frustrated by the quality of care provided and partnerless women being denied ANC. Conclusion PBF programmes such as SSDI-PBI may improve some aspects of service delivery. However, to achieve system improvement, not only should necessary tools (such as medicines, equipment and human resources) be in place, but also programme priorities must be congruent with cultural expectations. Finally, facilities must be better supported to expect and then address increases in client load and heightened expectations in relation to services.
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Affiliation(s)
- Chisomo Petross
- University of Malawi, Kamuzu College of Nursing, Private Bag 1, Lilongwe, Malawi
- Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Baden-Württemberg, Germany
| | - Shannon McMahon
- Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Baden-Württemberg, Germany
| | - Julia Lohmann
- Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Baden-Württemberg, Germany
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, Keppel Street, London WC1E 7HT, UK
| | - Rachel P Chase
- Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Baden-Württemberg, Germany
| | - Adamson S. Muula
- Department of Public health, University of Malawi, College of Medicine, Blantyre 3, Malawi
- Africa Center of Excellence in Public Health, University of Malawi, College of Medicine, Blantyre, Malawi
| | - Manuela De Allegri
- Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Baden-Württemberg, Germany
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Reñosa MD, Dalglish S, Bärnighausen K, McMahon S. Key challenges of health care workers in implementing the integrated management of childhood illnesses (IMCI) program: a scoping review. Glob Health Action 2020; 13:1732669. [PMID: 32114968 PMCID: PMC7067189 DOI: 10.1080/16549716.2020.1732669] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 02/14/2020] [Indexed: 11/03/2022] Open
Abstract
Background: Several evaluative studies demonstrate that a well-coordinated Integrated Management of Childhood Illnesses (IMCI) program can reduce child mortality. However, there is dearth of information on how frontline providers perceive IMCI and how, in their view, the program is implemented and how it could be refined and revitalized.Purpose: To determine the key challenges affecting IMCI implementation from the perspective of health care workers (HCWs) in primary health care facilities.Methods: A scoping review based on the five-step framework of Arskey and O'Malley was utilized to identify key challenges faced by HCWs implementing the IMCI program in primary health care facilities. A comprehensive search of peer-reviewed literature through PubMed, ScienceDirect, EBSCOhost and Google Scholar was conducted. A total of 1,475 publications were screened for eligibility and 41 publications identified for full-text evaluation. Twenty-four (24) published articles met our inclusion criteria, and were investigated to tease out common themes related to challenges of HCWs in terms of implementing the IMCI program.Results: Four key challenges emerged from our analysis: 1) Insufficient financial resources to fund program activities, 2) Lack of training, mentoring and supervision from the tertiary level, 3) Length of time required for effective and meaningful IMCI consultations conflicts with competing demands and 4) Lack of planning and coordination between policy makers and implementers resulting in ambiguity of roles and accountability. Although the IMCI program can provide substantial benefits, more information is still needed regarding implementation processes and acceptability in primary health care settings.Conclusion: Recognizing and understanding insights of those enacting health programs such as IMCI can spark meaningful strategic recommendations to improve IMCI program effectiveness. This review suggests four domains that merit consideration in the context of efforts to scale and expand IMCI programs.
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Affiliation(s)
- Mark Donald Reñosa
- Heidelberg Institute of Global Health, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine - Department of Health, Manila, Philippines
| | - Sarah Dalglish
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kate Bärnighausen
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine - Department of Health, Manila, Philippines
- School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Shannon McMahon
- Heidelberg Institute of Global Health, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Werner LK, Jabbarian J, Kagoné M, McMahon S, Lemp J, Souares A, Fink G, De Neve JW. "Because at school, you can become somebody" - The perceived health and economic returns on secondary schooling in rural Burkina Faso. PLoS One 2019; 14:e0226911. [PMID: 31881049 PMCID: PMC6934330 DOI: 10.1371/journal.pone.0226911] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 12/06/2019] [Indexed: 12/16/2022] Open
Abstract
Background The perceived returns on schooling are critical in schooling decision-making but are not well understood. This study examines the perceived returns on secondary schooling in Burkina Faso, where secondary school completion is among the lowest globally (<10%). Methods We conducted a two-staged qualitative study using semi-structured interviews (N = 49). In the first stage, we sampled students, dropouts, parents and teachers from a random sample of five schools (n = 39). In the second stage, we interviewed key informants knowledgeable of the school context using snowball sampling (n = 10). Systematic analysis was based on a grounded theory approach with a reading of transcripts, followed by coding of the narratives in NVivo 12. Results Respondents nearly universally perceived health benefits to schooling. In particular, key health benefits included improved sexual and reproductive health outcomes, hygiene knowledge and practices, as well as better interactions with the formal health system. Common economic returns on schooling included improved employment opportunities and the provision of support to family members, in addition to generally attaining success and recognition. Indirect and long-term health returns, however, were infrequently mentioned by respondents. Conclusions While respondents reported nearly universally short-term health benefits to schooling, responses with regard to economic as well as indirect and long-term health benefits were more ambiguous. Future intervention studies on the perceived returns on formal education are needed to inform policy and reach education and health targets in the region.
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Affiliation(s)
- Luisa K. Werner
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
- Faculty of Medicine, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany
| | - Jan Jabbarian
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Moubassira Kagoné
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
- Health Research Centre of Nouna (Centre de Recherche en Santé de Nouna—CRSN), Ministry of Health, Nouna, Burkina Faso
| | - Shannon McMahon
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States
| | - Julia Lemp
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Aurélia Souares
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Günther Fink
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jan-Walter De Neve
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
- * E-mail:
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McMahon S, Fortington L. Sport-related exertional heat illness hospitalisations in Victoria, Australia: Incidence and trend over 11 years. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.275] [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: 10/25/2022]
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Bilusic M, Madan R, Karzai F, McMahon S, Donahue R, Strauss J, Gatti-Mays M, Redman J, Cordes L, Palena C, Gabitzsch E, Jones F, Balint J, Soon-Shiong P, Rabizadeh S, Policard M, Schlom J, Gulley J. A phase I study of Ad5 PSA/MUC-1/brachyury vaccine in patients with metastatic castration resistant prostate cancer (mCRPC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.031] [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: 11/12/2022] Open
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McMahon S, Bosak T, Grotzinger JP, Milliken RE, Summons RE, Daye M, Newman SA, Fraeman A, Williford KH, Briggs DEG. A Field Guide to Finding Fossils on Mars. J Geophys Res Planets 2018; 123:1012-1040. [PMID: 30034979 PMCID: PMC6049883 DOI: 10.1029/2017je005478] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 03/28/2018] [Accepted: 04/23/2018] [Indexed: 05/05/2023]
Abstract
The Martian surface is cold, dry, exposed to biologically harmful radiation and apparently barren today. Nevertheless, there is clear geological evidence for warmer, wetter intervals in the past that could have supported life at or near the surface. This evidence has motivated National Aeronautics and Space Administration and European Space Agency to prioritize the search for any remains or traces of organisms from early Mars in forthcoming missions. Informed by (1) stratigraphic, mineralogical and geochemical data collected by previous and current missions, (2) Earth's fossil record, and (3) experimental studies of organic decay and preservation, we here consider whether, how, and where fossils and isotopic biosignatures could have been preserved in the depositional environments and mineralizing media thought to have been present in habitable settings on early Mars. We conclude that Noachian-Hesperian Fe-bearing clay-rich fluvio-lacustrine siliciclastic deposits, especially where enriched in silica, currently represent the most promising and best understood astropaleontological targets. Siliceous sinters would also be an excellent target, but their presence on Mars awaits confirmation. More work is needed to improve our understanding of fossil preservation in the context of other environments specific to Mars, particularly within evaporative salts and pore/fracture-filling subsurface minerals.
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Affiliation(s)
- S. McMahon
- Department of Geology and GeophysicsYale UniversityNew HavenCTUSA
- UK Centre for Astrobiology, School of Physics and AstronomyUniversity of EdinburghEdinburghUK
| | - T. Bosak
- Department of Earth, Atmospheric and Planetary SciencesMassachusetts Institute of TechnologyCambridgeMAUSA
| | - J. P. Grotzinger
- Division of Geological and Planetary SciencesCalifornia Institute of TechnologyPasadenaCAUSA
| | - R. E. Milliken
- Department of Earth, Environmental and Planetary SciencesBrown UniversityProvidenceRIUSA
| | - R. E. Summons
- Department of Earth, Atmospheric and Planetary SciencesMassachusetts Institute of TechnologyCambridgeMAUSA
| | - M. Daye
- Department of Earth, Atmospheric and Planetary SciencesMassachusetts Institute of TechnologyCambridgeMAUSA
| | - S. A. Newman
- Department of Earth, Atmospheric and Planetary SciencesMassachusetts Institute of TechnologyCambridgeMAUSA
| | - A. Fraeman
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - K. H. Williford
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - D. E. G. Briggs
- Department of Geology and GeophysicsYale UniversityNew HavenCTUSA
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Oesten H, Von Neubeck C, Löck S, Enghardt W, Krause M, McMahon S, Grassberger C, Paganetti H, Lühr A. EP-2332: A concept to personalize radiation oncology: Predicting cell-specific survival prior to treatment. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32641-0] [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: 10/14/2022]
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De Allegri M, Bertone MP, McMahon S, Mounpe Chare I, Robyn PJ. Unraveling PBF effects beyond impact evaluation: results from a qualitative study in Cameroon. BMJ Glob Health 2018; 3:e000693. [PMID: 29607103 PMCID: PMC5873544 DOI: 10.1136/bmjgh-2017-000693] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 01/28/2018] [Accepted: 02/14/2018] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Performance-based financing (PBF) has acquired increased prominence as a means of reforming health system purchasing structures in low-income and middle-income countries. A number of impact evaluations have noted that PBF often produces mixed and heterogeneous effects. Still, little systematic effort has been channelled towards understanding what causes such heterogeneity, including looking more closely at implementation processes. METHODS Our qualitative study aimed at closing this gap in knowledge by attempting to unpack the mixed and heterogeneous effects detected by the PBF impact evaluation in Cameroon to inform further implementation as the country scales up the PBF approach. We collected data at all levels of the health system (national, district, facility) and at the community level, using a mixture of in-depth interviews and focus group discussions. We combined deductive and inductive analytical techniques and applied analyst triangulation. RESULTS Our findings indicate that heterogeneity in effects across facilities could be explained by pre-existing infrastructural weaknesses coupled with rigid administrative processes and implementation challenges, while heterogeneity across indicators could be explained by providers' practices, privileging services where demand-side barriers were less substantive. CONCLUSION In light of the country's commitment to scaling up PBF, it follows that substantial efforts (particularly entrusting facilities with more financial autonomy) should be made to overcome infrastructural and demand-side barriers and to smooth implementation processes, thus, enabling healthcare providers to use PBF resources and management models to a fuller potential.
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Affiliation(s)
- Manuela De Allegri
- Institute of Public Health, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Maria Paola Bertone
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
| | - Shannon McMahon
- Institute of Public Health, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | | | - Paul Jacob Robyn
- Health, Nutrition, and Population Unit, The World Bank, Washington, District of Columbia, USA
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Dunn Galvin A, McMahon S, Ponsonby AL, Hsiao KC, Tang MLK. The longitudinal impact of probiotic and peanut oral immunotherapy on health-related quality of life. Allergy 2018; 73:560-568. [PMID: 29052245 DOI: 10.1111/all.13330] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND We previously reported that probiotic and peanut oral immunotherapy (PPOIT) was effective at inducing sustained unresponsiveness compared with placebo in a double-blind, placebo-controlled randomized trial. This study evaluated the impact of PPOIT on health-related quality of life (HRQL). METHOD Fifty-one participants (PPOIT 24; placebo 27) from the PPOIT trial completed Food Allergy Quality of Life Questionnaire (FAQLQ-PF) and Food Allergy Independent Measure (FAIM) at pre-treatment, end-of-treatment and 3 months after end-of-treatment. A total of 42 participants (20 PPOIT; 22 placebo) completed measures at 12 months post-treatment. Changes over time in PPOIT and placebo groups were examined by repeated-measures analysis of variance and paired t tests. RESULTS Probiotic and peanut oral immunotherapy was associated with significant improvement in FAQLQ-PF (F = 3.63, P = .02), with mean difference 0.8 at 3 months post-treatment (P = .05) and 1.3 at 12 months post-treatment (P = .005), exceeding the 0.5 minimal clinically important difference for FAQLQ-PF. For FAIM, mean difference was 0.5 (P = .03) at 3 months and 0.4 (P = .04) at 12 months post-treatment. In placebo group, post-treatment FAQLQ and FAIM remained unchanged from pretreatment. Improvement in FAQLQ-PF and FAIM scores related specifically to acquisition of sustained unresponsiveness rather than to receiving PPOIT treatment or participation in the trial. CONCLUSIONS Probiotic and peanut oral immunotherapy has a sustained beneficial effect on psychosocial impact of food allergy at 3 and 12 months after end-of-treatment. Treatment was not associated with reduced HRQL relative to baseline in either PPOIT or placebo groups, indicating that PPOIT was well tolerated and psychological well-being was not negatively impacted. Improved HRQL was specifically associated with acquisition of sustained unresponsiveness.
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Affiliation(s)
- A. Dunn Galvin
- School of Applied Psychology; University College Cork; Cork Ireland
- Cork University Hospital; University College Cork; Cork Ireland
| | - S. McMahon
- School of Applied Psychology; University College Cork; Cork Ireland
| | - A.-L. Ponsonby
- Murdoch Children's Research Institute; Melbourne Vic. Australia
| | - K.-C. Hsiao
- Murdoch Children's Research Institute; Melbourne Vic. Australia
- The Royal Children's Hospital; Melbourne Vic. Australia
- The University of Melbourne; Melbourne Vic. Australia
| | - M. L. K. Tang
- Murdoch Children's Research Institute; Melbourne Vic. Australia
- The Royal Children's Hospital; Melbourne Vic. Australia
- The University of Melbourne; Melbourne Vic. Australia
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Reuben D, Gazarian P, Storer T, McMahon S, Alexander N, Leipzig R, Duncan P. THE STRIDE INTERVENTION: RISK FACTOR ASSESSMENT AND CO-MANAGEMENT TO REDUCE SERIOUS FALL INJURIES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3658] [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: 11/13/2022] Open
Affiliation(s)
- D.B. Reuben
- Geriatrics, University of California, Los Angeles, Los Angeles, California,
| | - P. Gazarian
- Brigham and Women’s Hospital, Boston, Massachusetts,
| | - T. Storer
- Brigham and Women’s Hospital, Boston, Massachusetts,
| | - S. McMahon
- University of Minnesota, Minneapolis, Minnesota,
| | | | | | - P. Duncan
- Wake Forest Medical School, Winston Salem, North Carolina
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Pierrepont J, Hawdon G, Miles BP, Connor BO, Baré J, Walter LR, Marel E, Solomon M, McMahon S, Shimmin AJ. Variation in functional pelvic tilt in patients undergoing total hip arthroplasty. Bone Joint J 2017; 99-B:184-191. [DOI: 10.1302/0301-620x.99b2.bjj-2016-0098.r1] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 10/25/2016] [Indexed: 11/05/2022]
Abstract
Aims The pelvis rotates in the sagittal plane during daily activities. These rotations have a direct effect on the functional orientation of the acetabulum. The aim of this study was to quantify changes in pelvic tilt between different functional positions. Patients and Methods Pre-operatively, pelvic tilt was measured in 1517 patients undergoing total hip arthroplasty (THA) in three functional positions – supine, standing and flexed seated (the moment when patients initiate rising from a seated position). Supine pelvic tilt was measured from CT scans, standing and flexed seated pelvic tilts were measured from standardised lateral radiographs. Anterior pelvic tilt was assigned a positive value. Results The mean pelvic tilt was 4.2° (-20.5° to 24.5°), -1.3° (-30.2° to 27.9°) and 0.6° (-42.0° to 41.3°) in the three positions, respectively. The mean sagittal pelvic rotation from supine to standing was -5.5° (-21.8° to 8.4°), from supine to flexed seated was -3.7° (-48.3° to 38.6°) and from standing to flexed seated was 1.8° (-51.8° to 39.5°). In 259 patients (17%), the extent of sagittal pelvic rotation could lead to functional malorientation of the acetabular component. Factoring in an intra-operative delivery error of ± 5° extends this risk to 51% of patients. Conclusion Planning and measurement of the intended position of the acetabular component in the supine position may fail to predict clinically significant changes in its orientation during functional activities, as a consequence of individual pelvic kinematics. Optimal orientation is patient-specific and requires an evaluation of functional pelvic tilt pre-operatively. Cite this article: Bone Joint J 2017;99-B:184–91.
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Affiliation(s)
- J. Pierrepont
- The University of Sydney, School of Aerospace,
Mechanical and Mechatronic Engineering, Building J07, Sydney NSW
2006, Australia and Optimized Ortho, 17 Bridge
Street, Pymble NSW 2073, Australia
| | - G. Hawdon
- Malabar Orthopaedic Clinic, 43
The Avenue, Windsor, VIC
3181, Australia
| | - B. P. Miles
- Optimized Ortho, 17
Bridge Street, Pymble NSW 2073, Australia
| | - B. O’ Connor
- Optimized Ortho, 17
Bridge Street, Pymble NSW 2073, Australia
| | - J. Baré
- Melbourne Orthopaedic Group, 33
The Avenue, Windsor, VIC
3191, Australia
| | - L. R. Walter
- Peninsula Orthopaedics, 812
Pittwater Rd, Dee Why, NSW
2099, Australia
| | - E. Marel
- Peninsula Orthopaedics, 812
Pittwater Rd, Dee Why, NSW
2099, Australia
| | - M. Solomon
- Sydney Orthopaedic Specialists, Suite
29, Prince of Wales Private Hospital, Randwick
NSW 2031, Australia
| | - S. McMahon
- Monash University, 43
The Avenue, Windsor VIC 3181, Australia
| | - A. J. Shimmin
- Monash
University, 43 The Avenue, Windsor VIC 3181, Australia and Melbourne
Orthopaedic Group, 33 The Avenue, Windsor, VIC
3191, Australia
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Spencer-Gardner L, Pierrepont J, Topham M, Baré J, McMahon S, Shimmin AJ. Patient-specific instrumentation improves the accuracy of acetabular component placement in total hip arthroplasty. Bone Joint J 2016; 98-B:1342-1346. [DOI: 10.1302/0301-620x.98b10.37808] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 06/02/2016] [Indexed: 01/02/2023]
Abstract
Aims Accurate placement of the acetabular component during total hip arthroplasty (THA) is an important factor in the success of the procedure. However, the reported accuracy varies greatly and is dependent upon whether free hand or navigated techniques are used. The aim of this study was to assess the accuracy of an instrument system that incorporates 3D printed, patient-specific guides designed to optimise the placement of the acetabular component. Patients and Methods A total of 100 consecutive patients were prospectively enrolled and the accuracy of placement of the acetabular component was measured using post-operative CT scans. Results The mean absolute deviation from the planned inclination and anteversion was 3.9° (0.0° to 13.6°) and 3.6° (0.0° to 12.9°), respectively. In 91% of cases the planned target of +/-10° was achieved for both inclination and anteversion. Conclusion Accurate placement of the acetabular component can be achieved using patient-specific guides and is superior to free hand techniques and comparable to navigated and robotic techniques. Cite this article: Bone Joint J 2016;98-B:1342–6.
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Affiliation(s)
- L. Spencer-Gardner
- Melbourne Orthopaedic Group, 33
The Avenue, Windsor, VIC
3181, Australia
| | - J. Pierrepont
- University of Sydney, Building
J07, Level 4. Sydney, NSW
2006, Australia
| | - M. Topham
- Optimized Ortho, 17
Bridge Street Pymble, NSW 2073, Australia
| | - J. Baré
- Melbourne Orthopaedic Group, 33
The Avenue, Windsor, VIC
3181, Australia
| | - S. McMahon
- Monash University, Malabar Orthopaedic
Clinic, 43 The Avenue, Windsor, VIC
3181, Australia
| | - A. J. Shimmin
- Monash University, 33
The Avenue, Windsor 3181, Victoria, Australia
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McMahon S, Knol L, March AL, Bilbrey J, Morgan SL, Lawrence J. Protein Requirements in Illness: Considerations for Acute Care Nurse Practitioners. J Nurse Pract 2016. [DOI: 10.1016/j.nurpra.2016.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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McMahon S. WE-DE-202-03: Modeling of Biological Processes - What Happens After Early Molecular Damage? Med Phys 2016. [DOI: 10.1118/1.4957844] [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: 11/07/2022] Open
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41
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McMahon S, McNamara A, Schuemann J, Prise K, Paganetti H. WE-H-BRA-07: Mechanistic Modelling of the Relative Biological Effectiveness of Heavy Charged Particles. Med Phys 2016. [DOI: 10.1118/1.4957998] [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: 11/07/2022] Open
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42
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Lin Y, Tessa C, Rusek A, McMahon S, Kaminuma T, Held K. SU-C-204-04: Irradiation of Human Cell Lines Using Various Ions. Med Phys 2016. [DOI: 10.1118/1.4955537] [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: 11/07/2022] Open
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Burleigh A, McMahon S, Kiely S. Owned dog and cat populations in remote Indigenous communities in the Northern Territory: a retrospective study. Aust Vet J 2016; 93:145-50. [PMID: 25939259 DOI: 10.1111/avj.12321] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2011] [Revised: 03/19/2013] [Accepted: 04/30/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the population of owned dogs and cats in Indigenous communities in the Northern Territory (NT), and compare the data with those for the average Australian household. METHODS Results of 20 Indigenous community animal health programs were analysed for species present and dog and cat numbers. The female breeding and puppy populations were also identified. RESULTS The average dog population density was significantly higher than the average Australian household, with an average of 24.4 dogs per 10 households, but the average cat population density was similar (3.3 cats per 10 households). Numbers of other species were not determined. The average percentage of puppies in these communities was 17.6% of the treated canine population, the average percentage of breeding canine females was 18.6% of the treated canine population, and the average percentage of breeding feline females was 19.7% of the total feline population. CONCLUSIONS Dog populations in NT Indigenous communities were at least 6.3-fold higher per household compared with data for the rest of Australia. Cat populations per household were similar to the overall population. Factors contributing to the relatively high dog populations in remote Indigenous communities include a lack of veterinary presence, community remoteness, poor socioeconomic factors, poor house and yard designs, cultural reasons, communal beliefs, lack of community animal management and a lack of funding. We believe that animal health programs are an important way of addressing a number of these issues. Other elements that should be addressed include improving house and yard design, increasing education regarding animal health, care and welfare, and increasing the training and presence of health and animal professionals.
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Affiliation(s)
- A Burleigh
- Aboriginal Community Veterinary Services, Katherine, Northern Territory, Australia
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Jackson M, Belton P, McMahon S, Hart M, McCann S, Azevedo D, Hurteau L. The First Record of Aedes (Hulecoeteomyia) japonicus (Diptera: Culicidae) and Its Establishment in Western Canada. J Med Entomol 2016; 53:241-244. [PMID: 26526023 DOI: 10.1093/jme/tjv164] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 09/28/2015] [Indexed: 06/05/2023]
Abstract
The potential disease-carrying mosquito, Aedes japonicus (Theobald) (Diptera: Culicidae), was identified among larvae collected in suburban Vancouver, BC, in July 2014, and over 200 were found at the same site in February 2015 where it presumably had overwintered in the egg stage. In late May 2015, a female was captured taking a bloodmeal 13 km east of the larval site. This population and those in the Washington and Oregon states are clearly disjunct from those in eastern North America, and their origin, probably from one or more different introductions from Asia, is discussed. Key characters of those in British Columbia are examined and match the description of subspecies japonicus, presumably like the others in North America.
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Affiliation(s)
- M Jackson
- Culex Environmental Ltd., #4 4075 Kingsway Ave., Burnaby, British Columbia, Canada V5H 1Y9 (; ; ; )
| | - P Belton
- Department of Biological Sciences, Simon Fraser University, Burnaby, British Columbia, Canada V5A 1S6 (; ; )
| | - S McMahon
- Culex Environmental Ltd., #4 4075 Kingsway Ave., Burnaby, British Columbia, Canada V5H 1Y9 (; ; ; )
| | - M Hart
- Department of Biological Sciences, Simon Fraser University, Burnaby, British Columbia, Canada V5A 1S6 (; ; )
| | - S McCann
- Department of Biological Sciences, Simon Fraser University, Burnaby, British Columbia, Canada V5A 1S6 (; ; )
| | - D Azevedo
- Culex Environmental Ltd., #4 4075 Kingsway Ave., Burnaby, British Columbia, Canada V5H 1Y9 (; ; ; )
| | - L Hurteau
- Culex Environmental Ltd., #4 4075 Kingsway Ave., Burnaby, British Columbia, Canada V5H 1Y9 (; ; ; )
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Battistin M, Berry S, Bitadze A, Bonneau P, Botelho-Direito J, Boyd G, Corbaz F, Crespo-Lopez O, Da Riva E, Degeorge C, Deterre C, DiGirolamo B, Doubek M, Favre G, Godlewski J, Hallewell G, Katunin S, Lefils D, Lombard D, McMahon S, Nagai K, Robinson D, Rossi C, Rozanov A, Vacek V, Zwalinski L. The Thermosiphon Cooling System of the ATLAS Experiment at the CERN Large Hadron Collider. International Journal of Chemical Reactor Engineering 2015. [DOI: 10.1515/ijcre-2015-0022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
The silicon tracker of the ATLAS experiment at CERN Large Hadron Collider will operate around –15°C to minimize the effects of radiation damage. The present cooling system is based on a conventional evaporative circuit, removing around 60 kW of heat dissipated by the silicon sensors and their local electronics. The compressors in the present circuit have proved less reliable than originally hoped, and will be replaced with a thermosiphon. The working principle of the thermosiphon uses gravity to circulate the coolant without any mechanical components (compressors or pumps) in the primary coolant circuit. The fluorocarbon coolant will be condensed at a temperature and pressure lower than those in the on-detector evaporators, but at a higher altitude, taking advantage of the 92 m height difference between the underground experiment and the services located on the surface. An extensive campaign of tests, detailed in this paper, was performed using two small-scale thermosiphon systems. These tests confirmed the design specifications of the full-scale plant and demonstrated operation over the temperature range required for ATLAS. During the testing phase the system has demonstrated unattended long-term stable running over a period of several weeks. The commissioning of the full scale thermosiphon is ongoing, with full operation planned for late 2015.
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Sweet C, Penfold C, McMahon S, Brannan H. Buccal fat augmentation of the velum in revision levatorplasty and treatment of non-cleft velopharyngeal insufficiency (VPI). Br J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.bjoms.2015.08.237] [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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McNamara A, McMahon S, Lin Y, Paganetti H, Kuncic Z, Schuemann J. TU-F-CAMPUS-T-04: Using Gold Nanoparticles to Target Mitochondria in Radiation Therapy. Med Phys 2015. [DOI: 10.1118/1.4925819] [Citation(s) in RCA: 2] [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: 11/07/2022] Open
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Lin Y, Held K, McMahon S, Paganetti H, Schuemann J. SU-E-T-518: Investigation of Gold Nanoparticle Radiosensitization for Carbon Ion Therapy. Med Phys 2015. [DOI: 10.1118/1.4924880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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49
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McMahon S, Paganetti H, Prise K. MO-FG-BRA-06: Material Optimisation for Nanoparticle-Sensitized Radiotherapy. Med Phys 2015. [DOI: 10.1118/1.4925410] [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: 11/07/2022] Open
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50
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Hii SF, Traub RJ, Thompson MF, Henning J, O'Leary CA, Burleigh A, McMahon S, Rees RL, Kopp SR. Canine tick-borne pathogens and associated risk factors in dogs presenting with and without clinical signs consistent with tick-borne diseases in northern Australia. Aust Vet J 2015; 93:58-66. [DOI: 10.1111/avj.12293] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2014] [Indexed: 11/30/2022]
Affiliation(s)
- SF Hii
- School of Veterinary Science; The University of Queensland; Gatton Queensland 4343 Australia
| | - RJ Traub
- Faculty of Veterinary and Agricultural Science; University of Melbourne; Parkville VIC Australia
| | - MF Thompson
- School of Veterinary Science; The University of Queensland; Gatton Queensland 4343 Australia
| | - J Henning
- School of Veterinary Science; The University of Queensland; Gatton Queensland 4343 Australia
| | - CA O'Leary
- School of Veterinary Science; The University of Queensland; Gatton Queensland 4343 Australia
| | - A Burleigh
- Northern Territory Veterinary Services; Katherine NT Australia
| | - S McMahon
- Northern Territory Veterinary Services; Katherine NT Australia
| | - RL Rees
- Bayer Animal Health Tingalpa; QLD Australia
| | - SR Kopp
- School of Veterinary Science; The University of Queensland; Gatton Queensland 4343 Australia
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