26
|
Chappell A, Allison GT, Gibson N, Williams G, Morris S. The effect of a low-load plyometric running intervention on leg stiffness in youth with cerebral palsy: A randomised controlled trial. Gait Posture 2021; 90:441-448. [PMID: 34600178 DOI: 10.1016/j.gaitpost.2021.09.194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/14/2021] [Accepted: 09/22/2021] [Indexed: 02/02/2023]
Abstract
AIM To determine whether a running intervention utilising plyometric activities improved leg stiffness in youth with cerebral palsy (CP), GMFCS levels I and II. METHOD This stratified randomised controlled trial examined the lower limb kinetics and kinematics of a sample of youths with CP during sub-maximal hopping and running, prior to and immediately following a 12-week running intervention that incorporated low load plyometric training. Included participants were 13 in the control group (mean age 13 years 2 months [SD 2 years 7 months]; six males; nine GMFCS level I; six unilateral) and 18 in the intervention group (mean age 12 years 9 months [SD 2 years 10 months]; 13 males; 11 GMFCS level I; nine unilateral). Derived variables included three-dimensional leg stiffness as well as resultant ground reaction force and change in leg length. Generalised linear mixed models were developed for statistical analysis. RESULTS At follow-up the intervention group had greater leg stiffness than the control group during submaximal hopping (Intervention median = 3278Nm-1; Control median = 1556Nm-1; p < 0.01). At follow-up, participants in the intervention group in GMFCS Level I had greater leg stiffness than the control group during jogging (Intervention mean=38.84 (SD=25.55); Control mean=29.38 (SD=11.11); t = 2.61 p = 0.01). INTERPRETATION A running training intervention which includes plyometric activities can improve leg stiffness in young people with CP, especially those in GMFCS level I.
Collapse
|
27
|
Tang S, Johnson JC, Jarto I, Smith B, Morris S. Milk Components by In-Line Fiber Optic Probe-Based FT-NIR: Commercial Scale Evaluation of a Potential Alternative Measurement Approach for Milk Payment. J AOAC Int 2021; 104:1328-1337. [PMID: 34263310 DOI: 10.1093/jaoacint/qsaa146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/24/2020] [Accepted: 10/01/2020] [Indexed: 11/13/2022]
Abstract
BACKGROUND Mid-infrared (MIR) spectroscopy has traditionally been used to determine the macronutrients in bovine milk, as the basis of milk payment. Recent studies have demonstrated that NIR/FT-NIR spectroscopic systems can not only achieve MIR measurement performance, but are also generally simpler, more robust, and thus much more amenable to actual industrial process applications. OBJECTIVE The goal of this unique study was to investigate the feasibility of in-line FT-NIR spectroscopy for milk fat, protein, and total solids (TS) determination in a large industrial dairy processing facility, as an alternative basis for milk payment. METHOD Multivariant chemometric models using partial least squares (PLS) regression were built to predict the milk components. Over 1000 composite FT-NIR results gathered from the milk unloading process were compared directly to independent third-party FT-IR results. RESULTS Accuracy, precision, and linearity of the method were shown by Standard Error of Prediction (SEP) and Range/SEP of individual components. The SEP for fat, protein, and TS models were 0.09, 0.11, and 0.52, respectively. Range/SEP were 25.10, 12.60, and 6.40 for fat, protein, and TS, respectively. Accuracy and precision for the three components were further evaluated by the mean differences (0.01, 0.05, and 0.51) from dairy FT-IR results and the standard deviations of the mean difference (0.09, 0.09, and 0.13). Robustness was demonstrated by evaluating milk with natural variation over 6 months and using multiple instrumentation setups. The repeatability was also evaluated. CONCLUSIONS Overall, the in-line FT-NIR technology was found to have accurate, reliable, consistent performance similar to dairy FT-IR technology.
Collapse
|
28
|
Beeken RJ, Leurent B, Vickerstaff V, Wilson R, Croker H, Morris S, Omar RZ, Nazareth I, Wardle J. Correction to: A brief intervention for weight control based on habit-formation theory delivered through primary care: results from a randomised controlled trial. Int J Obes (Lond) 2021; 45:2137-2138. [PMID: 34099843 PMCID: PMC8380537 DOI: 10.1038/s41366-021-00862-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
29
|
Gibson K, Sharp R, Ullman A, Morris S, Kleidon T, Esterman A. Risk factors for umbilical vascular catheter-related adverse events: A scoping review. Aust Crit Care 2021; 35:89-101. [PMID: 34088575 DOI: 10.1016/j.aucc.2021.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/24/2021] [Accepted: 02/28/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Adverse events associated with umbilical catheters include malposition, bloodstream infections, thrombosis, tip migration, and extravasation, resulting in loss of vascular access and increased risk of morbidity and mortality. There is a need for greater understanding of risk factors associated with adverse events to inform safe practice. OBJECTIVES The aim of the study was to summarise the existing evidence regarding risk factors for umbilical catheter-related adverse events to inform the undertaking of future research. REVIEW METHOD USED A scoping review of peer-reviewed original research and theses was performed. DATA SOURCES The US National Library of Medicine National Institutes of Health, Embase, EMcare, and ProQuest Dissertations and Theses were the data sources. REVIEW METHODS Informed by the Joanna Briggs Institute Reviewer's Manual, all types of original research studies reporting adverse events published in English from 2009 to 2020 were eligible for inclusion. Studies where umbilical artery catheter and umbilical venous catheter data could not be extracted separately were excluded. RESULTS Searching identified 1954 publications and theses, 1533 were excluded at screening, and 418 were assessed for eligibility at full text. A total of 89 studies met the inclusion criteria. A range of potential risk factors for umbilical arterial and venous catheters were identified. Longer dwell time and prematurity were associated with increased risk of bloodstream infection and thrombosis in cohort studies. Case studies detailed analogous factors such as insertion techniques and lack of catheter surveillance during dwell warrant further investigation. CONCLUSIONS We identified a vast range of patient, device, and provider risk factors that warrant further investigation. There was a lack of large cohort studies and randomised controlled trials to demonstrate the significance of these risk factors. Improvement in methods to ensure correct catheter tip location and to detect adverse events early is essential. In addition, policy needs to be developed to guide clinicians in catheter surveillance measures to reduce the risk of adverse events.
Collapse
|
30
|
Gould JF, Roberts RM, Anderson PJ, Makrides M, Sullivan TR, Gibson RA, McPhee AJ, Doyle LW, Opie G, Travadi J, Cheong JLY, Davis PG, Sharp M, Simmer K, Tan K, Morris S, Lui K, Bolisetty S, Liley H, Stack J, Best KP, Collins CT. Protocol for assessing if behavioural functioning of infants born <29 weeks' gestation is improved by omega-3 long-chain polyunsaturated fatty acids: follow-up of a randomised controlled trial. BMJ Open 2021; 11:e044740. [PMID: 33952546 PMCID: PMC8103387 DOI: 10.1136/bmjopen-2020-044740] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 03/10/2021] [Accepted: 03/17/2021] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION During the last trimester of pregnancy, the fetal brain undergoes a rapid growth spurt and accumulates essential nutrients including docosahexaenoic acid (DHA). This takes place ex-utero for infants born <29 weeks' gestation, without the in-utero provisions of DHA. Infants born <29 weeks' are more likely to experience behavioural and emotional difficulties than their term-born counterparts. It has been hypothesised that supplementing preterm infants with dietary DHA may alleviate insufficiency and subsequently prevent or minimise behavioural problems. This protocol describes a follow-up of infants born <29 weeks gestation who were enrolled in a randomised controlled trial (RCT) of DHA supplementation. We aim to determine whether DHA supplementation improves the behaviour, and general health of these infants. METHODS AND ANALYSIS Infants born <29 weeks' gestation were enrolled in a multicentre blinded RCT of enteral DHA supplementation. Infants were randomised to receive an enteral emulsion that provided 60 mg/kg/day of DHA or a control emulsion commenced within the first 3 days of enteral feeding, until 36 weeks' postmenstrual age or discharge home, whichever occurred first. Families of surviving children (excluding those who withdrew from the study) from the Australian sites (up to 955) will be invited to complete a survey. The survey will include questions regarding child behavioural and emotional functioning, executive functioning, respiratory health and general health. We hypothesise that the DHA intervention will have a benefit on the primary outcome, parent-rated behaviour and emotional status as measured using the Total Difficulties score of the Strengths and Difficulties Questionnaire. Detecting a 2-point difference between groups (small effect size of 0.25 SD) with 90% power will require follow-up of 676 participants. ETHICS AND DISSEMINATION The Women's and Children Health Network Human Research Ethics Committee reviewed and approved the study (HREC/16/WCHN/184). Results will be disseminated in peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER ACTRN12612000503820.
Collapse
|
31
|
Howarth AR, Apea V, Michie S, Morris S, Sachikonye M, Mercer CH, Evans A, Delpech VC, Sabin C, Burns FM. The association between use of chemsex drugs and HIV clinic attendance among gay and bisexual men living with HIV in London. HIV Med 2021; 22:641-649. [PMID: 33949070 DOI: 10.1111/hiv.13103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 11/27/2020] [Accepted: 03/02/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To investigate the association between chemsex drug use and HIV clinic attendance among gay and bisexual men in London. METHODS A cross-sectional survey of adults (> 18 years) diagnosed with HIV for > 4 months, attending seven London HIV clinics (May 2014 to August 2015). Participants self-completed an anonymous questionnaire linked to clinical data. Sub-optimal clinic attenders had missed one or more HIV clinic appointments in the past year, or had a history of non-attendance for > 1 year. RESULTS Over half (56%) of the 570 men who identified as gay or bisexual reported taking recreational drugs in the past 5 years and 71.5% of these men had used chemsex drugs in the past year. Among men reporting chemsex drug use (past year), 32.1% had injected any drugs in the past year. Sub-optimal clinic attenders were more likely than regular attenders to report chemsex drug use (past year; 46.9% vs. 33.2%, P = 0.001), injecting any drugs (past year; 17.1% vs. 8.9%, P = 0.011) and recreational drug use (past 5 years; 65.5% vs. 48.8%, P < 0.001). One in five sub-optimal attenders had missed an HIV clinic appointment because of taking recreational drugs (17.4% vs. 1.8%, P < 0.001). In multivariable logistic regression, chemsex drug use was significantly associated with sub-optimal clinic attendance (adjusted odds ratio = 1.71, 95% confidence interval: 1.10-2.65, P = 0.02). CONCLUSIONS Our findings highlight the importance of systematic assessment of drug use and development of tools to aid routine assessment. We suggest that chemsex drug use should be addressed when developing interventions to improve engagement in HIV care among gay and bisexual men.
Collapse
|
32
|
Banjoko A, Boylan C, Kumar H, McCabe H, Morris S. 557 A Novel Peer-Led Anatomage-Based Teaching Programme for Medical Students. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.149] [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
Anatomical knowledge is an essential part of surgical practice. However, its delivery lacks a standardised approach across medical school curricula. A student-led anatomy programme was implemented at a single institution, using near-peer teaching and Anatomage virtual dissection. This study aims to describe the methodology of this programme and determine the benefit of a near-peer taught anatomy course.
Method
The programme was organised by senior medical students, utilising Anatomage virtual dissection and techniques in line with Bigg’s constructive alignment. Attendees were asked to complete questionnaires with Likert scales (0-10) and open answer text to determine learners’ benefit. Both quantitative and qualitative analyses are presented.
Results
73 students attended eight sessions from January to March 2020. Students reported a statistically significant (p < 0.01) increase in confidence after the sessions of 3.74±1.83. The quality and relevance of the teaching also scored highly (9.32±0.89 and 9.47±0.86 respectively). Qualitatively, students praised the "informal learning environment”, the structure of the sessions, the handout provided, and the interactivity of anatomage technology.
Conclusions
This study demonstrates how virtual dissection technology and near-peer teaching can derive significant benefit to undergraduate students, in line with previously published data.
Collapse
|
33
|
Gonzalez Vaz R, Jones E, Begum R, Dobson A, Morris S, De Francesco I. PO-0266 Dosimetric comparison of brachytherapy and tomotherapy for a large SCC on the scalp. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06425-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
34
|
Rivera G, Butka E, Jindal K, Kong W, Waye S, Hoffmann C, Kamimoto K, Morris S. 631 Lineage tracing at single-cell resolution unveils complex differentiation trajectories of adipocyte precursors in the skin. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
35
|
Makita M, Mas-Bleda A, Morris S, Thelwall M. Mental Health Discourses on Twitter during Mental Health Awareness Week. Issues Ment Health Nurs 2021; 42:437-450. [PMID: 32926796 DOI: 10.1080/01612840.2020.1814914] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Promoting health-related campaigns on Twitter has increasingly become a world-wide choice to raise awareness and disseminate health information. Data retrieved from Twitter are now being used to explore how users express their views, attitudes and personal experiences of health-related issues. We focused on Twitter discourse reproduced during Mental Health Awareness Week 2017 by examining 1,200 tweets containing the keywords 'mental health', 'mental illness', 'mental disorders' and '#MHAW'. The analysis revealed 'awareness and advocacy', 'stigmatization', and 'personal experience of mental health/illness' as the central discourses within the sample. The article concludes with some recommendations for future research on digitally-mediated health communication.
Collapse
|
36
|
Peters S, Dafni U, Perol M, Felip E, Polito L, Pal N, Ton T, Merritt D, Morris S, Stahel R. VP2-2021: Effectiveness of PD-(L)1 inhibitors alone or in combination with platinum-doublet chemotherapy in first-line (1L) non-squamous non-small cell lung cancer (Nsq-NSCLC) with high PD-L1 expression using real-world data. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.195] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
37
|
Reck M, Horn L, Mok T, Mansfield A, De Boer R, Losonczy G, Sugawara S, Dziadziuszko R, Krzakowski M, Smolin A, Hochmair M, Garassino M, Castro G, Bischoff H, Cardona A, Morris S, Liu S. OA11.06 IMpower133: Exploratory Analysis of Maintenance Therapy in Patients With Extensive-Stage Small-Cell Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
38
|
Ong ELH, Paolino A, Grandi V, Morris S, Martin B, Calonje E. An unusual nodule in a patient with Kaposi sarcoma. Clin Exp Dermatol 2021; 46:764-768. [PMID: 33645856 DOI: 10.1111/ced.14604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2020] [Indexed: 11/26/2022]
|
39
|
Cheema P, Ton T, Lambert P, Merritt D, Morris S, Shankar G, Ganti A. TT01.01 Real-World Outcomes in Patients with EGFR/ALK-Positive NSCLC Treated with Chemotherapy Following 1 or 2 Lines of TKI Therapy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.090] [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]
|
40
|
Devlin L, Millar S, Morris S, Sadozye A, Harrand R, Graham K, Kerr A, Duncanson C, Duffton A. PO-1882: The risk of pelvic insufficiency fractures after radiotherapy using planned dose analysis. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01900-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
41
|
Farrent S, Coppin B, Morris S. Call for infant formula reconstitution uniformity and improvements in manufacturer feeding guides. Med J Aust 2020; 214:107-110.e1. [PMID: 32920875 DOI: 10.5694/mja2.50760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
42
|
Hughes AJ, Feeley IH, Ahern DP, Dodds MK, Cassidy N, Timlin M, Morris S, Synnott K, Butler JS. New Technologies in the Field of Orthopaedic and Spine Surgery - Navigating the Learning Curve. IRISH MEDICAL JOURNAL 2020; 113:148. [PMID: 34520659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
|
43
|
Liu S, Horn L, Mok T, Mansfield A, De Boer R, Losonczy G, Sugawara S, Dziadziuszko R, Krzakowski M, Smolin A, Hochmair M, Garassino M, Lam S, McCleland M, Cardona A, Morris S, Reck M. 1781MO IMpower133: Characterisation of long-term survivors treated first-line with chemotherapy ± atezolizumab in extensive-stage small cell lung cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
44
|
Ó Doinn T, Hughes AJ, Ahern DP, McDonnell J, Kavanagh E, Morris S, Butler JS. Auto-Decompression - Preserved Neurological Function in Bilateral Cervical Facet Dislocations. IRISH MEDICAL JOURNAL 2020; 113:131. [PMID: 33205644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Introduction Bilateral cervical facet dislocation (BCFD) is an uncommon injury with a high incidence of severe neurological impairment. We describe 4 cases of BCFD with preserved neurological function. Cases Case 1: A 78-year-old female who suffered two ground level falls (GLFs). Pre-operative American Spinal Injury Association (ASIA) Score was C5D. Imaging revealed a BCFD at C6/C7 and a C6 laminar fracture. Case 2: A 63-year-old male suffered a fall down 14 steps. Pre-operative ASIA score was E. Imaging demonstrated a BCFD at C7/T1, and a C6 laminar fracture. Case 3: A 46-year-old male collided with a tree while descending a hill on a bicycle. Pre-operative ASIA score was C6D. Imaging revealed a BCFD at C7/T1 and a C7 laminar fracture. Case 4: A 67-year-old male suffered a GLF while exiting a stationary car. Pre-operative ASIA score on admission was E. Imaging revealed a BCFD at C6/C7 with bilateral laminar fractures at C5 and C6. Outcome All cases underwent 2-stage surgical fixation. All cases maintained or had an improved ASIA score post-operatively. Conclusion In all cases, the presence of concurrent laminar fractures resulted in an auto-decompression of the spinal canal, preserving neurological function.
Collapse
|
45
|
Rivera G, Kamimoto K, Butka E, Kong W, Morris S. 829 Single-cell approaches to uncover adipocyte precursor heterogeneity and differentiation mechanisms in the skin. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
46
|
Chappell A, Allison GT, Williams G, Gibson N, Morris S. The effect of a running training intervention on ankle power generation in children and adolescents with cerebral palsy: A randomized controlled trial. Clin Biomech (Bristol, Avon) 2020; 76:105024. [PMID: 32416406 DOI: 10.1016/j.clinbiomech.2020.105024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 04/09/2020] [Accepted: 04/28/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Children and adolescents with cerebral palsy who are classified as Gross Motor Function Classification Scale level I or II are usually able to run but lack ankle power generation for push-off. The aim of this study was to analyze the efficacy of a running training program in improving ankle power generation in children and adolescents with cerebral palsy. METHODS This randomized controlled trial compared kinematic and spatiotemporal data collected during running from 38 children and adolescents with unilateral or bilateral cerebral palsy before and after a 12-week running program. Normalized speed, stride length, cadence, foot strike pattern, peak ankle power generation, peak hip flexor power generation in swing and propulsion strategy were calculated. Linear mixed models were developed to analyze differences between groups. FINDINGS At follow-up the intervention group had increased normalized speed of running (t = -3.68 p < .01) while the control group got slower (t = 3.17 p < .01). In running, children in Gross Motor Function Classification Scale level II in the intervention group increased ankle power (t = 2.49 p = .01) while the control group did not change (t = 0.38 p = .71). In sprinting, children in Gross Motor Function Classification Scale levels I and II in the intervention group maintained ankle power (level I t = 0.32 p = .75; level II t = 1.56 p = .12) while those in the control group decreased ankle power (level I t = 4.69 p < .01; level II t = 2.52 p = .01). Most within-group differences did not result in significant between-group differences at follow-up. INTERPRETATION Power generation for running may be responsive to targeted intervention in children with cerebral palsy.
Collapse
|
47
|
Khaykin Y, Alipour P, Azizi Z, Avoulov A, Jansen C, Donegan S, Morris S, Nath S, Tamjidi S, Varah N, Pantano A, Verma A, Weaver B, Hunter TD. P1409Effectiveness of atrial fibrillation ablation using a contact force stability module with contact force or non-contact force catheter. Europace 2020. [DOI: 10.1093/europace/euaa162.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
This study was funded by Biosense Webster, Inc.
Background
Catheter ablation is a mainstream treatment option for atrial fibrillation (AF). Recently, contact force (CF) enabled ablation catheters and a stability module were developed to allow for real-time CF sensing and improvement of catheter-tissue stability, which is important for achieving an optimal clinical outcome. We assessed the relative effectiveness of these new technologies, as well as the optimal CF stability parameters, in a real-world setting.
Purpose
To compare the clinical effectiveness of AF ablations performed with a CF catheter using location stability settings of 2.5 mm maximum distance for 12 s minimum (2.5/12) vs. a non-CF catheter with settings of 3 mm for 7 s (3/7).
Methods
Within 1/14–4/18, 176 de novo AF ablations using either a CF catheter with stability settings of 2.5/12 (n = 92, 5/16–4/18) or a non-CF catheter with stability settings of 3/7 (n = 84, 1/14–3/14) were performed by a single operator at a Canadian medical center. Patients routinely wore 48 hour Holter monitors every three months through the first year. The primary measures of effectiveness were Kaplan-Meier (KM) survival estimates of freedom from AF/atrial tachycardia (AT)/atrial flutter (AFL) recurrence after a 3-month blanking period and reablation.
Results
The CF group was 62.9 ± 10.0 years old, 57.6% male, and 66.3% paroxysmal (PAF). The non-CF group was 61.6 ± 9.9 years old, 63.1% male, and 76.2% PAF. Procedural complications consisted of a single vascular access complication in the non-CF group. The 12-month estimate of freedom from AF/AT/AFL recurrence was 79.4% in the CF group vs. 64.8% in the non-CF group (p = 0.058 for difference in survival over time). 12-month freedom from reablation was 90.4% in the CF group vs. 70.5% in the non-CF group (p = 0.002).
Conclusion
CF ablation with more stringent stability settings of 2.5/12 was more effective than non-CF ablation with stability settings of 3/7, likely attributable to the CF catheter enabling visualization of catheter-tissue contact and the stability module facilitating maintenance of CF stability during ablation.
Abstract Figure.
Collapse
|
48
|
Rosenberg R, Babson K, Menno D, Morris S, Baladi M, Hyman D, Black J. 0751 Epworth Sleepiness Scale Test-Retest Reliability Analysis In Solriamfetol Studies. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.747] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The Epworth Sleepiness Scale (ESS) measures excessive daytime sleepiness. This analysis examined test-retest reliability of ESS scores in participants with narcolepsy or obstructive sleep apnea (OSA) in solriamfetol studies.
Methods
Intraclass correlation coefficient (ICC) estimates and 95% confidence intervals (CIs) for ESS scores from two 12-week, placebo-controlled trials (1 narcolepsy; 1 OSA), and one long-term open-label extension (OLE) trial (narcolepsy or OSA) were calculated separately for each trial, based on assessments (at time-point pairs) when scores were expected to be stable (at weeks 4 and 8, 8 and 12, and 4 and 12 in the 12-week trials, and weeks 14 and 26/27, 26/27 and 39/40, and 14 and 39/40 in the OLE). ICCs were analyzed for the overall population in each trial and by treatment and adherence to primary OSA therapy. An ICC >0.7 has been recommended as a quality criterion for acceptable test-retest reliability.
Results
In the 12-week narcolepsy trial, ICCs (95% CI) were 0.83 (0.79, 0.87) for weeks 4 and 8 (n=199), 0.87 (0.83, 0.90) for weeks 8 and 12 (n=196), and 0.81 (0.76, 0.85) for weeks 4 and 12 (n=196). In the 12-week OSA trial, ICCs (95% CI) were 0.74 (0.69, 0.78) for weeks 4 and 8 (n=416), 0.80 (0.76, 0.83) for weeks 8 and 12 (n=405), and 0.74 (0.69, 0.78) for weeks 4 and 12 (n=405). In the OLE trial, ICCs (95% CI) were 0.82 (0.79, 0.85) for weeks 14 and 27/26 (n=495), 0.85 (0.82, 0.87) for weeks 27/26 and 40/39 (n=463), and 0.78 (0.74, 0.81) for weeks 14 and 40/39 (n=463). Treatment (solriamfetol combined/placebo) or adherence to primary OSA therapy did not impact reliability.
Conclusion
In 3 large clinical trials of participants with narcolepsy or OSA, the ESS demonstrated an acceptable level of test-retest reliability.
Support
Jazz Pharmaceuticals
Collapse
|
49
|
Evans R, Taylor S, Kalasthry J, Sakai N, Miles A, Aboagye A, Agoramoorthy L, Ahmed S, Amadi A, Anand G, Atkin G, Austria A, Ball S, Bazari F, Beable R, Beare S, Beedham H, Beeston T, Bharwani N, Bhatnagar G, Bhowmik A, Blakeway L, Blunt D, Boavida P, Boisfer D, Breen D, Bridgewater J, Burke S, Butawan R, Campbell Y, Chang E, Chao D, Chukundah S, Clarke C, Collins B, Collins C, Conteh V, Couture J, Crosbie J, Curtis H, Daniel A, Davis L, Desai K, Duggan M, Ellis S, Elton C, Engledow A, Everitt C, Ferdous S, Frow A, Furneaux M, Gibbons N, Glynne-Jones R, Gogbashian A, Goh V, Gourtsoyianni S, Green A, Green L, Green L, Groves A, Guthrie A, Hadley E, Halligan S, Hameeduddin A, Hanid G, Hans S, Hans B, Higginson A, Honeyfield L, Hughes H, Hughes J, Hurl L, Isaac E, Jackson M, Jalloh A, Janes S, Jannapureddy R, Jayme A, Johnson A, Johnson E, Julka P, Kalasthry J, Karapanagiotou E, Karp S, Kay C, Kellaway J, Khan S, Koh D, Light T, Limbu P, Lock S, Locke I, Loke T, Lowe A, Lucas N, Maheswaran S, Mallett S, Marwood E, McGowan J, Mckirdy F, Mills-Baldock T, Moon T, Morgan V, Morris S, Morton A, Nasseri S, Navani N, Nichols P, Norman C, Ntala E, Nunes A, Obichere A, O'Donohue J, Olaleye I, Oliver A, Onajobi A, O'Shaughnessy T, Padhani A, Pardoe H, Partridge W, Patel U, Perry K, Piga W, Prezzi D, Prior K, Punwani S, Pyers J, Rafiee H, Rahman F, Rajanpandian I, Ramesh S, Raouf S, Reczko K, Reinhardt A, Robinson D, Rockall A, Russell P, Sargus K, Scurr E, Shahabuddin K, Sharp A, Shepherd B, Shiu K, Sidhu H, Simcock I, Simeon C, Smith A, Smith D, Snell D, Spence J, Srirajaskanthan R, Stachini V, Stegner S, Stirling J, Strickland N, Tarver K, Teague J, Thaha M, Train M, Tulmuntaha S, Tunariu N, van Ree K, Verjee A, Wanstall C, Weir S, Wijeyekoon S, Wilson J, Wilson S, Win T, Woodrow L, Yu D. Patient deprivation and perceived scan burden negatively impact the quality of whole-body MRI. Clin Radiol 2020; 75:308-315. [PMID: 31836179 DOI: 10.1016/j.crad.2019.10.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/30/2019] [Indexed: 01/26/2023]
Abstract
AIM To evaluate the association between the image quality of cancer staging whole-body magnetic resonance imaging (WB-MRI) and patient demographics, distress, and perceived scan burden. MATERIALS AND METHODS A sample of patients recruited prospectively to multicentre trials comparing WB-MRI with standard scans for staging lung and colorectal cancer were invited to complete two questionnaires. The baseline questionnaire, administered at recruitment, collated data on demographics, distress and co-morbidity. The follow-up questionnaire, completed after staging investigations, measured perceived WB-MRI scan burden (scored 1 low to 7 high). WB-MRI anatomical coverage, and technical quality was graded by a radiographic technician and grading combined to categorise the scan as "optimal", "sub-optimal" or "degraded". A radiologist categorised 30 scans to test interobserver agreement. Data were analysed using the chi-square, Fisher's exact, t-tests, and multinomial regression. RESULTS One hundred and fourteen patients were included in the study (53 lung, 61 colorectal; average age 65.3 years, SD=11.8; 66 men [57.9%]). Overall, 45.6% (n=52), scans were classified as "optimal" quality, 39.5% (n=45) "sub-optimal", and 14.9% (n=17) as "degraded". In adjusted analyses, greater deprivation level and higher patient-reported scan burden were both associated with a higher likelihood of having a sub-optimal versus an optimal scan (odds ratio [OR]: 4.465, 95% confidence interval [CI]: 1.454 to 13.709, p=0.009; OR: 1.987, CI: 1.153 to 3.425, p=0.013, respectively). None of the variables predicted the likelihood of having a degraded scan. CONCLUSIONS Deprivation and patients' perceived experience of the WB-MRI are related to image quality. Tailored protocols and individualised patient management before and during WB-MRI may improve image quality.
Collapse
|
50
|
Kent S, Morris S, Ananth S. Systematic review of thromboprophylaxis in patients having orthognathic surgery. Br J Oral Maxillofac Surg 2020; 58:396-403. [PMID: 32192762 DOI: 10.1016/j.bjoms.2020.01.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 01/13/2020] [Indexed: 11/25/2022]
Abstract
Orthognathic surgery is an elective procedure that is done in healthy individuals so complications such as thromboembolic events are rare. Pharmacological thromboprophylaxis, which reduces the risk of these events, may also increase blood loss and potentially the risk of life-threatening haemorrhage, so a state of clinical equipoise exists about whether it should be given routinely. We systematically reviewed published papers to identify the incidence of venous thromboembolism and haemorrhage in patients treated by orthognathic surgery who were, and were not, given pharmacological thromboprophylaxis. The pooled incidence of thromboembolic events was 0% in those who were, and 0.19% in those who were not. Return to theatre to control bleeding was required in 2.72% of the patients treated at centres where it was given, and in 0.55% at those where it was not. Small sample sizes, the heterogeneity of treatment protocols, and incomplete reporting made further statistical analysis impossible. The incidence of venous thromboembolism in patients who have orthognathic surgery is low when compared with the rest of the hospital population. Although pharmacological thromboprophylaxis may further reduce this, it can also increase blood loss, and uncertainty therefore remains over the best protocol for its routine use. The risk stratification of individual patients, and large randomised controlled trials are now required to establish the best treatment.
Collapse
|