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Cooper L, Dezube AR, De León LE, Kucukak S, Mazzola E, Dumontier C, Mamon H, Enzinger P, Jaklitsch MT, Frain LN, Wee JO. Outcomes of trimodality CROSS regimen in older adults with locally advanced esophageal cancer. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2021; 47:2667-2674. [PMID: 33895020 PMCID: PMC8448942 DOI: 10.1016/j.ejso.2021.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/29/2021] [Accepted: 04/11/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Chemoradiotherapy for Esophageal cancer followed by Surgery (CROSS regimen) is standard of care for locally-advanced esophageal cancer. We evaluated CROSS completion rates, toxicity, and postoperative outcomes between older and younger adults receiving trimodality therapy. METHODS Retrospective analysis of patients with locally-advanced esophageal cancer who underwent CROSS regimen from May 2016 to January 2020 at a single academic center. Outcomes of those aged ≥70-years-old and <70 years-old were analyzed. RESULTS Of 201 patients, 136 were <70 and 65 were ≥70 years. Older adults were more likely to be male (91% vs. 79%; p = 0.045), have higher ECOG scores (median 1 vs. 0; p = 0.003), Charlson-comorbidity index (median 6 vs. 4; p < 0.001), and undergo open procedures (20% vs. 8% p = 0.008). Most completed CROSS regimen (78% vs. 84% respectively) with similar rates of treatment discontinuation and dose reduction (all p > 0.05). Time to surgery following neoadjuvant therapy was similar between age groups, except in those ≥80-years-old as compared to <70-years-old (p < 0.05). Overall toxicity rates were similar (68% vs. 71% respectively; p = 0.676). Only rates of delirium (19% vs. 5%) and urinary retention (9% vs. 0%) were higher in older adults (both p < 0.05). Length of stay, discharge disposition, mortality, and overall survival were similar. Age was not an independent risk factor for complication, neoadjuvant toxicity or completion, surgery timing, nor worse overall or recurrence-free survival (p > 0.05). CONCLUSION Trimodality CROSS regimen for esophageal cancer in older adults is feasible, with similar completion rates and postoperative outcomes as compared to their younger counterparts.
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Haffner EA, Bagheri M, Higham JE, Cooper L, Rowan S, Stanford C, Mashayek F, Mirbod P. An experimental approach to analyze aerosol and splatter formations due to a dental procedure. EXPERIMENTS IN FLUIDS 2021; 62:202. [PMID: 34566249 PMCID: PMC8449526 DOI: 10.1007/s00348-021-03289-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/20/2021] [Accepted: 08/22/2021] [Indexed: 05/16/2023]
Abstract
Throughout 2020 and beyond, the entire world has observed a continuous increase in the infectious spread of the novel coronavirus (SARS-CoV-2) otherwise known as COVID-19. The high transmission of this airborne virus has raised countless concerns regarding safety measures employed in the working conditions for medical professionals. Specifically, those who perform treatment procedures on patients which intrinsically create mists of fine airborne droplets, i.e., perfect vectors for this and other viruses to spread. The present study focuses on understanding the splatter produced due to a common dentistry technique to remove plaque buildup on teeth. This technique uses a high-speed dentistry instrument, e.g., a Cavitron ultrasonic scaler, to scrape along the surface of a patient's teeth. This detailed understanding of the velocity and the trajectory of the droplets generated by the splatter will aid in the development of hygiene mechanisms to guarantee the safety of those performing these procedures and people in clinics or hospitals. Optical flow tracking velocimetry (OFTV) method was employed to obtain droplet velocity and trajectory in a two-dimensional plane. Multiple data collection planes were taken in different orientations around a model of adult mandibular teeth. This technique provided pseudo-three-dimensional velocity information for the droplets within the splatter developed from this high-speed dental instrument. These results indicated that within the three-dimensional splatter produced there were high velocities (1-2 m/s) observed directly below the intersection point between the front teeth and the scaler. The splatter formed a cone-shape structure that propagated 10-15 mm away from the location of the scaler tip. From the droplet trajectories, it was observed that high velocity isolated droplets propagate away from the bulk of the splatter. It is these droplets which are concerning for health safety to those performing the medical procedures. Using a shadowgraphy technique, we further characterize the individual droplets' size and their individual velocity. We then compare these results to previously published distributions. The obtained data can be used as a first step to further examine flow and transport of droplets in clinics/dental offices.
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Leibovici Weissman Y, Cooper L, Sternbach N, Ashkenazi-Hoffnung L, Yahav D. Clinical efficacy and safety of high dose trivalent influenza vaccine in adults and immunosuppressed populations - A systematic review and meta-analysis. J Infect 2021; 83:444-451. [PMID: 34425161 DOI: 10.1016/j.jinf.2021.08.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 08/14/2021] [Accepted: 08/17/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Influenza is associated with significant morbidity and mortality, especially in older and immunocompromised patients. Few data are available on the clinical benefit of high dose trivalent influenza vaccine (TIV). We aimed to assess the clinical efficacy and safety of high dose TIV. METHODS We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), evaluating high dose versus standard dose TIV for prevention of seasonal influenza in adult population. Primary outcome was laboratory-confirmed influenza. Subgroups analyses included older adults and immunocompromised patients. RESULTS We included 16 trials, 47,857 patients; 10 included older adults and three immunocompromised patients. Laboratory confirmed influenza was significantly reduced with high dose TIV (relative risk 0.76, 95% confidence interval 0.64 to 0.9). This outcome stemmed mainly from one trial in older adults. Specifically, A(H3N2) laboratory confirmed influenza, but not A(H1N1) or B lineages, was reduced. No difference in mortality or hospitalizations was demonstrated. Immunological response was significantly higher with high dose vaccine. Serious adverse events were significantly less common in the high dose group. CONCLUSIONS High dose TIV lowers the rates of laboratory confirmed influenza, mainly A (H3N2), in older adults vs. standard dose. Further studies should address immunocompromised patients and report clinical outcomes.
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Parikh S, Cooper L, Matthews W, Khan M, Syed S, Vasudevan SP, Brosnan C, Barr L, Loeffler M. Safety of emergency, elective and day case operating during the winter period at East Suffolk and North Essex NHS Foundation Trust: lessons from the outcomes of 4,254 surgical patients from the first COVID-19 wave. Ann R Coll Surg Engl 2021; 103:478-480. [PMID: 34192500 DOI: 10.1308/rcsann.2021.0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND There is limited evidence on perioperative outcomes of surgical patients during the COVID-19 pandemic to inform continued operating into the winter period. METHODS We retrospectively analysed the rate of 30-day COVID-19 transmission and mortality of all surgical patients in the three hospitals in our trust in the East of England during the first lockdown in March 2020. All patients who underwent a swab were swabbed on or 24 hours prior to admission. RESULTS There were 4,254 patients and an overall 30-day mortality of 0.99%. The excess surgical mortality in our region was 0.29%. There were 39 patients who were COVID-19 positive within 30 days of admission, 12 of whom died. All 12 were emergency admissions with a length of stay longer than 24 hours. There were three deaths among those who underwent day case surgery, one of whom was COVID-19 negative, and the other two were not swabbed but not suspected to have COVID-19. There were two COVID-19 positive elective cases and none in day case elective or emergency surgery. There were no COVID-19 positive deaths in elective or day case surgery. CONCLUSIONS There was a low rate of COVID-19 transmission and mortality in elective and day case operations. Our data have allowed us to guide patients in the consent process and provided the evidence base to restart elective and day case operating with precautions and regular review. A number of regions will be similarly affected and should perform a review of their data for the winter period and beyond.
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Gallagher M, Cooper L, Mata JI. 82 A Case of Recurrent Calcifying Aponeurotic Fibroma of the Hand: Managing a Rare Hand Tumour in an Evolving Healthcare Landscape. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Calcifying Aponeurotic Fibroma (CAF) is a rare benign tumour originating from the aponeuroses of tendons and their bony insertions. Our case illustrates the technical challenges and considerations of removing a large, recurrent CAF of the hand.
Case Report
A 15-year-old student presented to his GP with a one-year history of a progressively enlarging painless swelling on the dorsum of the middle phalanx of the left middle finger. Plain radiographs identified a calcified soft tissue swelling with no bony involvement. The lesion was excised by the local paediatric orthopaedic service and recurred rapidly. Histology confirmed the diagnosis. He was referred to our specialist hand surgery service and the lesion was excised with the overlying skin (which demonstrated histological but not clinical disease). At six months, there was no clinical evidence of recurrence.
Conclusions
CAF may present atypically, and a high index of suspicion is warranted with calcified soft tissue hand lesions. Excision with conservative margins, and we newly suggest, the overlying skin, is recommended to preserve hand function but minimise recurrence (very common). Hand surgery provision in the UK is changing with adoption of the hub and spoke model and hand tumours may be more appropriately managed at specialist centres.
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Simonis M, Rúa M, Cooper L, Wenstrup J, Lei D, Hartzler L. Captive Big Brown Bats (
Eptesicus fuscus
) Display Hypothermia and Hypometabolism. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.04249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Cooper L, Lee I, Waldron Lechner D. COVID-19 pandemic response varies by clinical trial sponsor type. J Clin Transl Sci 2021; 5:e111. [PMID: 34192064 PMCID: PMC8220021 DOI: 10.1017/cts.2021.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has impacted millions of lives globally. To learn more about this disease and find potential diagnostic, therapeutic, and preventative products, the healthcare community has initiated a staggering number of clinical trials. METHODS ClinicalTrials.gov was reviewed to determine if trial sponsor type had a relationship to time to COVID-19 response, which was defined as the date from disease discovery in Wuhan, China to ClinicalTrials.gov study "First Posted" date. RESULTS A total of 673 United States (US) sponsored, interventional study listings were retrieved, of which 293 (43.5%) were Industry-sponsored, 349 (51.9%) were Academic sponsored, and 31 (4.6%) were Other sponsor types. Of the Academic studies, 181 (51.9%) were Clinical and Translational Science Award (CTSA) hubs. The average response time for all sponsor types was 189 days, with Academic sponsors having the shortest average response time of 172.6 days (P < 0.001). CTSA hubs had a significantly (P < 0.001) shorter average response time (168.1 days) compared to all other sponsor types (197.4 days). However, while shorter in duration by 9.4 days, response time was not significantly different from non-CTSA sponsors (177.5 days; P = 0.238). Additionally, ANOVA indicated significant relationships (P < 0.001) between funding type, study phase, number of sites, and enrollment size on response time. CONCLUSIONS Studies posted with the shortest response time were Academic-sponsored trials and included smaller sized investigations of repurposed approved or investigational drugs for the treatment of COVID-19 symptoms. A small second wave of study postings occurred approximately 4 months later, and included small, unique therapies targeting prevention or treatment of COVID-19.
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Loewenthal J, DuMontier C, Cooper L, Frain L, Waldman LS, Streiter S, Cardin K, Tulebaev S, Javedan H, Orkaby AR, Hshieh T. Adaptation of the comprehensive geriatric assessment to a virtual delivery format. Age Ageing 2021; 50:597-598. [PMID: 33284967 DOI: 10.1093/ageing/afaa257] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/25/2020] [Accepted: 10/26/2020] [Indexed: 11/14/2022] Open
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Parry M, Bjørnnes A, Clarke H, Cooper L, Gordon A, Harvey P, Lalloo C, Leegaard M, LeFort S, McFetridge-Durdle J, McGillion M, O`Keffe-McCarthy S, Price J, Stinson J, Victor J, Watt-Watson J. An integrated mixed methods systematic review to summarize research evidence related to self-management programs for women with cardiac pain. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2020.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Bugaevsky Y, Levy Y, Hershkovitz A, Ocheretny I, Nissenholtz A, Cooper L, Weissman YL, Weiss A, Velkes S, Beloosesky Y. Characteristics and Outcomes of Hip Fracture Patients Hospitalized in an Orthogeriatric Unit Versus an Orthopedic Department: A Retrospective Cohort Study. Geriatr Orthop Surg Rehabil 2021; 12:2151459320986299. [PMID: 33489431 PMCID: PMC7804357 DOI: 10.1177/2151459320986299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/12/2020] [Accepted: 12/02/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction: Hip fractures are a significant health risk in older adults and a major cause
of morbidity, functional decline and mortality. Our aim was to compare
clinical outcomes of older patients hospitalized in an ortho-geriatric (OG)
unit to those hospitalized in an orthopedic department (OD) for surgical
treatment of a hip fracture. Methods: A retrospective cohort study of hip fractured patients hospitalized between
2015-2016 in a single tertiary university-affiliated medical center.
Included were patients aged 65 and older who had undergone hip fracture
surgery and were admitted to either a geriatric or orthopedic ward. Results: 441 patients met the inclusion criteria (195 in the OG unit, 246 in the OD);
257 were transferred to an affiliated geriatric center hospital (107 from
the OG unit and 127 from the OD) for rehabilitation. Patients in the OG unit
were older, more cognitively and functionally impaired and with more
comorbidities. The 1-year mortality rate was significantly lower in the OD
group (OR 0.32, CI 95% 0.19-0.53, p < 0.001), however, after propensity
matching, the 30-day and 1 year mortality rates were similar in both groups.
No difference was found in the rehabilitation length of stay between the
groups. The functional independence measure improvement was similar in both
groups, with a non-significant trend toward better functional improvement
among OG unit patients. Conclusions: Despite the higher complexity of patients, worse baseline functional capacity
in the OG unit, improvement after rehabilitation was similar in both groups.
These results demonstrate the advantages of the OG unit in treating and
stabilizing frail older adults, thus maximizing their chances for a
successful recovery after hip fractures. Level of Evidence: Level IV
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McDaid L, Cooper L, Edwards T, McPartlin A, Bonington S, Eccles C. PO-1876: A visual grading analysis-based audit for MR simulation sequence development. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01894-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Limkakeng A, Zhbannikov I, Douglas P, Hoffman U, Ferencik M, Shah S, Kraus W, Cooper L, Voora D, Ginsburg G. 302 Biomarker Profiling for Obstructive Coronary Artery Disease: A PROMISE Substudy. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cooper L, Siam B, Sagee A, Orgad R, Levi Y, Wasserberg N, Beloosesky Y, Kashtan H. Some Nursing Screening Tools Can Be Used to Assess High-Risk Older Adults Who Undergo Colorectal Surgery for Cancer. Clin Interv Aging 2020; 15:1505-1511. [PMID: 32921996 PMCID: PMC7458272 DOI: 10.2147/cia.s258992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/03/2020] [Indexed: 11/23/2022] Open
Abstract
Aim Life expectancy and incidence of cancer among older adults are increasing. The aim of this study was to assess whether routinely used nursing screening tools can predict surgical outcomes in older adults with colorectal cancer. Methods Data of patients who underwent elective colorectal cancer surgery at Rabin Medical Center during the years 2014-2016 were collected retrospectively. Patients were divided into study group (age 80-89 y), and control group (age 60-69 y) for comparing surgical outcomes and six-month mortality. In the study group, screening tool scores were evaluated as potential predictors of surgical outcomes. These included Malnutrition Universal Screening Tool (MUST), Admission Norton Scale Scores (ANSS), Morse Fall Scale (MFS), and Charlson Co-morbidity Index (CCI). Results The study group consisted of 77 patients, and the control group consisted of 129 patients. Postoperative mortality and morbidity were similar in both groups. Nursing screening tools did not predict immediate postoperative outcomes in the study group. MUST and CCI were predictors for six-month mortality. CCI score was 9.43±2.44 in those who died within six months from surgery compared to 7.07 ±1.61 in those who were alive after six months (p<0.05). Post-operative complications were not associated with increased 30-day mortality. Advanced grade complications were associated with an increased six-month mortality (RR=1.37, 95% CI 0.95-1.98, p=0.013). Conclusion Different screening tools for high-risk older adults who are candidates for surgery have been developed, with the caveat of necessitating skilled physicians and resources such as time. Routinely used nursing screening tools may be helpful in better patient selection and informed decision making. These tools, specifically MUST and CCI who were found to predict six-month survival, can be used to additionally identify high-risk patients by the nursing staff and promote further evaluation. This can be a valuable tool in multidisciplinary and patient-centered care.
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Nissenholtz A, Levy Y, Cooper L, Bugaevsky Y, Weiss A, Beloosesky Y. [ANEMIA IN PATIENTS AFTER HIP FRACTURE REPAIR SURGERY]. HAREFUAH 2020; 159:689-693. [PMID: 32955813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Hip fractures (HF) are common among the elderly. The prevalence increases with age and occurs more frequently among females. Up to 30% mortality rates have been observed during the first year following HF, with or without surgery. Additional implications may include functional and cognitive decline and significant morbidity. Many factors are associated with morbidity and mortality after HF repair surgery, including anemia. Anemia is present in approximately 50% of these patients upon admission to the hospital and its incidence increases further following surgery. The mean reduction in the hemoglobin level after surgery is estimated at 0.7-2.5 g/dL. There are several causes of anemia, some are patient dependent and some are related to the type of fracture and surgery. Anemia has a significant effect on the elderly patient in general, and on the patient's condition post-HF in particular. Anemia on admission is associated with short and long-term mortality, in addition to the length of stay, amount of blood transfusions, repeated hospitalizations, post-operative complications, poor functioning and a reduced quality of life. The most common treatment for anemic patients before and after HF repair surgery is the administration of blood transfusions. It has been common practice to administer blood transfusions when hemoglobin reaches a level of 8g/dL, however the effectiveness of this approach in older patients is not conclusive. Regarding other modalities, i.e., iron, erythropoietin and tranexamic acid, there are currently no clear guidelines in the literature and their effectiveness has not been fully established. Further research is needed to address these issues.
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Cooper L, Frain L, Jaklitsch MT. Prehabilitation vs Postoperative Rehabilitation for Frail Patients. JAMA Surg 2020; 155:898-899. [PMID: 32584938 DOI: 10.1001/jamasurg.2020.1813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Cooper L, Levy Y, Nissenholtz A, Bugaevsky Y, Kashtan H, Beloosesky Y. [EVALUATION OF THE ELDERLY PATIENT WITH CANCER]. HAREFUAH 2020; 159:678-682. [PMID: 32955811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In recent years, there has been a significant increase in the number of adult patients with malignant diseases. These patients are a major therapeutic challenge due to a high incidence of comorbidities, lower functional status and often a diagnosis of the disease at a relatively advanced stage. The preferred approach to the treatment of cancer is a multidisciplinary approach. In the last decade, we have witnessed the integration of geriatricians as part of the multidisciplinary team in order to better assess patients' ability to withstand oncological or surgical treatment and, if necessary, to prepare them better for these treatments. In this article we review the use of various geriatric tools, such as generalized geriatric assessment, fragility and sarcopenia, and their effect on the decision-making process of the treating physicians and on the outcomes of the various treatments, including the outcomes of the operations. We show that comprehensive geriatric assessment is the basis for the evaluation of the adult oncology patients, and proper preparation for treatment in order to improve the outcomes of the treatment and reduce its complications. The rapid growth rate of the elderly population in Israel, together with the continuous development of oncology and cancer treatments, indicate the need to allocate resources and efforts to treat this unique population. We recommend an integration of geriatricians in the multidisciplinary team that treats this population.
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Dezube AR, Cooper L, Jaklitsch MT. Prehabilitation of the Thoracic Surgery Patient. Thorac Surg Clin 2020; 30:249-258. [DOI: 10.1016/j.thorsurg.2020.04.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Cooper L, Abbett SK, Feng A, Bernacki RE, Cooper Z, Urman RD, Frain LN, Edwards AF, Blitz JD, Javedan H, Bader AM. Launching a Geriatric Surgery Center: Recommendations from the Society for Perioperative Assessment and Quality Improvement. J Am Geriatr Soc 2020; 68:1941-1946. [DOI: 10.1111/jgs.16681] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 12/14/2022]
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Cooper L, Bunnefeld L, Hearn J, Cook JM, Lohse K, Stone GN. Low-coverage genomic data resolve the population divergence and gene flow history of an Australian rain forest fig wasp. Mol Ecol 2020; 29:3649-3666. [PMID: 32567765 DOI: 10.1111/mec.15523] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/09/2020] [Accepted: 06/12/2020] [Indexed: 12/16/2022]
Abstract
Population divergence and gene flow are key processes in evolution and ecology. Model-based analysis of genome-wide data sets allows discrimination between alternative scenarios for these processes even in nonmodel taxa. We used two complementary approaches (one based on the blockwise site frequency spectrum [bSFS], the second on the pairwise sequentially Markovian coalescent [PSMC]) to infer the divergence history of a fig wasp, Pleistodontes nigriventris. Pleistodontes nigriventris and its fig tree mutualist Ficus watkinsiana are restricted to rain forest patches along the eastern coast of Australia and are separated into The Northern population is to the north of the Southern populations by two dry forest corridors (the Burdekin and St. Lawrence Gaps). We generated whole genome sequence data for two haploid males per population and used the bSFS approach to infer the timing of divergence between northern and southern populations of P. nigriventris, and to discriminate between alternative isolation with migration (IM) and instantaneous admixture (ADM) models of postdivergence gene flow. Pleistodontes nigriventris has low genetic diversity (π = 0.0008), to our knowledge one of the lowest estimates reported for a sexually reproducing arthropod. We find strongest support for an ADM model in which the two populations diverged ca. 196 kya in the late Pleistocene, with almost 25% of northern lineages introduced from the south during an admixture event ca. 57 kya. This divergence history is highly concordant with individual population demographies inferred from each pair of haploid males using PSMC. Our analysis illustrates the inferences possible with genome-level data for small population samples of tiny, nonmodel organisms and adds to a growing body of knowledge on the population structure of Australian rain forest taxa.
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Bentley C, Cooper L, Foster M, Fallowfield J. Reflecting on success in trauma research: experiences from the SGCNS and SIR studies. BMJ Mil Health 2020; 167:118-121. [PMID: 32487676 PMCID: PMC8005801 DOI: 10.1136/bmjmilitary-2020-001467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 11/04/2022]
Abstract
The inclusion of British Service Personnel (SP) lacking capacity into research studies from the point of injury through to medium-term rehabilitation had not previously been undertaken until work to support operations in Afghanistan (2001-2014). The Surgeon General's Casualty Nutrition Study and the Steroids and Immunity from Injury through to Rehabilitation Study sought to address the nutrition, endocrine and immune responses in a military patient cohort. A fundamental part of research is to feedback to patients, their relatives and ward staff on data collection and outcomes, and how future research may be improved to better support both injured SP and trauma patients in the UK. This paper will provide an experiential view on the delivery, operations and infrastructure requirements that should be considered when developing military research at a role-3 facility, before, during and after a study.
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Pandey A, Cooper L, Zrebiec J, Spadola C, Bennett RL, Rosenthal MM, Littlewood K. 1044 Adequate Sleep is Associated with Improved Diabetes Knowledge and HbA1c. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Although 55 % of the people with T2DM have low quality of sleep that may affect their physical and emotional wellbeing, and present challenges to the management of their condition, many Diabetes Self-Management Education Programs (DSME) that aim to improve knowledge of T2DM, don’t include information on healthy sleep. This study will examine the relationship between adequate sleep on improved T2DM knowledge and diabetes maintenance (HbA1c).
Methods
The Sleep Integrated with Diabetes Education (SLIDE) Trial tests whether including four brief healthy sleep hygiene sessions within an existing traditional Diabetes Self-Management Education Program improves healthy sleep, motivation for change, and biopsychosocial outcomes for 50 patients with DM who are under and uninsured. This study uses descriptive and ANOVAs to examine the relationship between adequate sleep and change in diabetes knowledge (Diabetes Knowledge Test) using self-report. EMR was used to link HbA1c and other biological measures.
Results
Fifty patients with T2DM (mean HbA1c = 8.79 ± 2.42) participating in a DSME Program at a southern urban community nonprofit hospital were randomly assigned to DSME classes or DSME classes + four 15-minute presentations (video and powerpoint) highlighting healthy sleep hygiene practices. The majority of these patients were obese (mean BMI=38.56±8.20). Only 11% reported normal sleep, with 41% reporting short sleep (<6 hours) and 7% long sleep (>8 hours). Patients who reported adequate sleep were more likely to improve diabetes knowledge (81% score vs. 68% score, p<.001) and HbA1c (1.1 vs. -.03, p<.001).
Conclusion
There is a relationship between adequate sleep and improving diabetes knowledge and maintenance for patients with T2DM. Future research could further explore this relationship and determine barriers and facilitators to adequate sleep and what role adequate sleep plays in improving T2DM knowledge and maintenance.
Support
Bon Sequor Foundation
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Waddell D, Cooper L, Kavanagh J. Fam83d is Induced During Neurogenic Skeletal Muscle Atrophy and Modulates MAP Kinase and AKT Signaling. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.06737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Alvidrez J, Nápoles AM, Bernal G, Lloyd J, Cargill V, Godette D, Cooper L, Horse Brave Heart MY, Das R, Farhat T. Building the Evidence Base to Inform Planned Intervention Adaptations by Practitioners Serving Health Disparity Populations. Am J Public Health 2020; 109:S94-S101. [PMID: 30699023 DOI: 10.2105/ajph.2018.304915] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Many evidence-based interventions (EBIs) have been developed to prevent or treat major health conditions. However, many EBIs have exhibited limited adoption, reach, and sustainability when implemented in diverse community settings. This limitation is especially pronounced in low-resource settings that serve health disparity populations. Often, practitioners identify problems with existing EBIs originally developed and tested with populations different from their target population and introduce needed adaptations to make the intervention more suitable. Although some EBIs have been extensively adapted for diverse populations and evaluated, most local adaptations to improve fit for health disparity populations are not well documented or evaluated. As a result, empirical evidence is often lacking regarding the potential effectiveness of specific adaptations practitioners may be considering. We advocate an expansion in the emphasis of adaptation research from researcher-led interventions to research that informs practitioner-led adaptations. By presenting a research vision and strategies needed to build this area of science, we aim to inform research that facilitates successful adaptation and equitable implementation and delivery of EBIs that reduce health disparities.
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Silbernagel KM, Lindberg KG, Ary M, Bannach B, Barbour M, Battista K, Bauten H, Beatty S, Bogar S, Buczek L, Bulthau M, Burnett T, Carver C, Cha K, Cooper L, D’Andrea L, Davis B, Fain A, Feiler B, Fender M, Hirt W, Iannucci M, Jackson JK, Jensen D, Johnson K, Julien-Davis G, Kempf A, Krone P, Kusch S, LaPointe A, Leiva BR, Lewandowski V, Lewis J, Maycock L, Mebs D, McCann T, Moulsoff M, Newcomer C, Ooya M, O’Shea P, Otten N, Reed J, Remes A, Resutek J, Rukamp B, Rukamp S, Saito A, Shafie A, Smith A, Tabatt J, Tanaka H, Torrance H, VandeVoort M, Wang D, Windsor S, Xiong Y, Zebchuck A. Petrifilm™ Rapid S. aureus Count Plate Method for Rapid Enumeration of Staphylococcus aureus in Selected Foods: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/84.5.1431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A rehydratable dry-film plating method for Staphylococcus aureusin foods, the 3M™ Petrifilm™ Rapid S. aureus Count Plate method, was compared with AOAC® Official MethodSM 975.55 (Staphylococcus aureus in Foods). Nine foods—instant nonfat dried milk, dry seasoned vegetable coating, frozen hash browns, frozen cooked chicken patty, frozen ground raw pork, shredded cheddar cheese, fresh green beans, pasta filled with beef and cheese, and egg custard—were analyzed for S. aureus by 13 collaborating laboratories. For each food tested, the collaborators received 8 blind test samples consisting of a control sample and 3 levels of inoculated test sample, each in duplicate. The mean log counts for the methods were comparable for pasta filled with beef and cheese; frozen hash browns; cooked chicken patty; egg custard; frozen ground raw pork; and instant nonfat dried milk. The repeatability and reproducibility variances of the Petrifilm Rapid S. aureus Count Plate method were similar to those of the standard method.
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Cunningham MW, Myers J, Sandel C, Cooper L, Stavrakis S, Fairweather D, White K, Garman L, Wiley G, Montgomery C, Gaffney P. 2418Th17 signature, autoimmunity and differentially expressed genes in cardiomyopathy and heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiomyopathy may occur due to viral infections or drug induced heart damage. Cardiac myosin released from damaged heart has been shown to be a damage associated molecular pattern which binds to TLR2 or TLR8 and can act as an adjuvant to induce a strong autoimmune response against the heart. The result is autoimmunity against the heart which can lead to apoptosis, fibrosis and heart failure.
Purpose
Immune biomarkers of the early stages of heart failure are needed to identify individuals who develop progressive heart failure, do not recover their ejection fraction and may be candidates for immunotherapies.
Methods
Forty-one patients with myocarditis and heart failure <6 months after onset were followed for 12 months and compared to age matched controls. Peripheral blood mononuclear cells were analyzed by FACS analysis and serum analyzed by ELISA for autoantibodies and cytokines. Statistical analysis was determined by Mann Whitney test. Peripheral blood of 10 patients with dilated cardiomyopathy (DCM) vs 19 healthy controls were analyzed for gene expression by RNA sequencing and pathway analysis using Reactome.
Results
Autoantibodies against human cardiac myosin and the beta-adrenergic receptor were significantly elevated in our cohort and functionally acted on cardiomyocytes to activate protein kinase A. Concomitantly, a Th17+ immunophenotype was significantly elevated in blood as well as in cardiac biopsies. CD4+IL17+ T cells (p=0.0008) and Th17-promoting cytokines TGF beta (p<0.0001), IL-6 (p<0.0001), IL-23 (p=0.0001), GMCSF (p=0.0336) and GMCSF-secreting CD4+ T cells (p=0.0006) were significantly elevated in blood. A Th17 immunophenotype was significantly associated with heart failure primarily in males (p=0.029). Persistent heart failure (NYHA class III and IV) and non-recovery of left ventricular function were associated with significantly higher percentages of IL17A-producing T cells at baseline, 6 and 12 months after onset, and IL-17A (p=0.019) and elevated Th17-promoting cytokines IL-6 (p=0.0001) and TGF-beta (p=0.0076). Decreased T regulatory immunosuppressive cells were significantly (p=0.0006) decreased and correlated with elevated Th17 cytokines in heart failure. Overrepresentation analysis of differentially expressed genes (adj p<0.05) in blood of patients with DCM >1year were identified using Reactome which revealed significant (FDR = 1.52E-13) enrichment of neutrophil degranulation (48 genes).
Conclusion
Our study illustrates a strong Th17 signature in more severe heart failure early in disease with elevated anti-cardiac myosin autoantibodies in non-recovery of left ventricular function. We observed a strong correlation with Th17-related neutrophil degranulation pathways in later disease, which may be biomarkers of fibrosis progression and disease severity in patients with heart failure. Cardiomyopathy with a Th17 signature might be treated with preventive immunomodulatory therapies such as anti-IL17A.
Acknowledgement/Funding
National Heart Lung and Blood Institute, Bethesda, MD, USA
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