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Bernstein D, Taylor A, Nill S, Imseeh G, Kothari G, Llewelyn M, De Paepe KN, Rockall A, Shiarli AM, Oelfke U. An Inter-observer Study to Determine Radiotherapy Planning Target Volumes for Recurrent Gynaecological Cancer Comparing Magnetic Resonance Imaging Only With Computed Tomography-Magnetic Resonance Imaging. Clin Oncol (R Coll Radiol) 2021; 33:307-313. [PMID: 33640196 PMCID: PMC8051139 DOI: 10.1016/j.clon.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/11/2021] [Accepted: 02/05/2021] [Indexed: 11/25/2022]
Abstract
AIMS Target delineation uncertainty is arguably the largest source of geometric uncertainty in radiotherapy. Several factors can affect it, including the imaging modality used for delineation. It is accounted for by applying safety margins to the target to produce a planning target volume (PTV), to which treatments are designed. To determine the margin, the delineation uncertainty is measured as the delineation error, and then a margin recipe used. However, there is no published evidence of such analysis for recurrent gynaecological cancers (RGC). The aims of this study were first to quantify the delineation uncertainty for RGC gross tumour volumes (GTVs) and to calculate the associated PTV margins and then to quantify the difference in GTV, delineation uncertainty and PTV margin, between a computed tomography-magnetic resonance imaging (CT-MRI) and MRI workflow. MATERIALS AND METHODS Seven clinicians delineated the GTV for 20 RGC tumours on co-registered CT and MRI datasets (CT-MRI) and on MRI alone. The delineation error, the standard deviation of distances from each clinician's outline to a reference, was measured and the required PTV margin determined. Differences between using CT-MRI and MRI alone were assessed. RESULTS The overall delineation error and the resulting margin were 3.1 mm and 8.5 mm, respectively, for CT-MRI, reducing to 2.5 mm and 7.1 mm, respectively, for MRI alone. Delineation errors and therefore the theoretical margins, varied widely between patients. MRI tumour volumes were on average 15% smaller than CT-MRI tumour volumes. DISCUSSION This study is the first to quantify delineation error for RGC tumours and to calculate the corresponding PTV margin. The determined margins were larger than those reported in the literature for similar patients, bringing into question both current margins and margin calculation methods. The wide variation in delineation error between these patients suggests that applying a single population-based margin may result in PTVs that are suboptimal for many. Finally, the reduced tumour volumes and safety margins suggest that patients with RGC may benefit from an MRI-only treatment workflow.
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Wu X, Rabei R, Keller E, King B, Kothary N, Kohi M, Taylor A, Heller M. Abstract No. 500 Tunneled peritoneal catheter versus repeated paracenteses for recurrent malignant ascites: a cost-effectiveness analysis. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Bermúdez JR, Metian M, Oberhänsli F, Taylor A, Swarzenski PW. Preferential grazing and repackaging of small polyethylene microplastic particles (≤ 5 μm) by the ciliate Sterkiella sp. MARINE ENVIRONMENTAL RESEARCH 2021; 166:105260. [PMID: 33550172 DOI: 10.1016/j.marenvres.2021.105260] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 06/12/2023]
Abstract
Microplastic (MP) particles are pollutants of global concern and are ubiquitously distributed in the ocean by physical and biological processes. It has been shown that zooplankton can ingest MP yet the interaction between ciliates and MP is still poorly understood. The discrimination and preferential uptake of MP rather than algal prey by ciliates was assessed in this study. The ciliate Sterkiella sp. was fed a diet that consisted of only Isochrysis galbana or a mixture of the same algae and similarly sized polyethylene beads in a 1:3 ratio. Significant, preferential MP grazing was observed in the Plastic-Algae treatment, which is the first reported evidence of proto-zooplankton preferentially ingesting MP over algal food. The mixed treatment contained fecal pellets with embedded MP. Preferential uptake of MP suggests that Sterkiella sp. is capable of ingesting and then "repackaging" MP that would otherwise be too small for larger taxa. This process would thus offer a mechanism for the reintroduction of MP into different compartments of the marine food web. As a consequence, it is necessary to account for small-sized MP (<5 μm) particles, that may have additional and yet unknown, impacts on marine food webs.
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Griesinger F, Choi YL, Chou TY, Gregg J, Hui R, Leighl N, Marchetti A, Navani N, Bailey T, Silvey M, Makin R, Kahangire D, Chau M, Taylor A, Subramanian J. 144P Delays in epidermal growth factor receptor mutation (EGFRm) testing in advanced (stage IIIb/ IIIc/ IV) non-small cell lung cancer (NSCLC) patients and their impact on the use of first line tyrosine kinase inhibitor (TKIs) in a real-world setting. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01986-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Subramanian J, Choi YL, Chou TY, Gregg J, Hui R, Leighl N, Marchetti A, Navani N, Bailey T, Silvey M, Makin R, Kahangire D, Chau M, Taylor A, Griesinger F. 135P The real-world use of tyrosine kinase inhibitors (TKIs) in epidermal growth factor receptor mutated (EGFRm) advanced (stage IIIb/IIIc/IV) non-small cell lung cancer (NSCLC) patients. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01977-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Jakobsen E, Taylor A, Ehrenstein V. 65P EGFR mutation (EGFRm) prevalence and mortality in patients with stage IB–IIIA NSCLC: A cohort study in Denmark. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01907-9] [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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Davis-Bollard H, Taylor A, Ali J. P244 Moving from paediatric to adult care: resources to support transition. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01269-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Noaman S, Neil C, O'Brien J, Frenneaux M, Hare J, Shaw J, Gay A, Bloom J, Stub D, Walton A, Cox N, Wang B, Duffy S, Taylor A, Kaye D, Chan W. Effect of Upstream Doxycycline During Primary Percutaneous Coronary Intervention (PCI) for ST-Elevation Myocardial Infarction (STEMI) on Infarct Size and Left Ventricular (LV) Remodelling: the SALVAGE MI Randomised Trial. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Dawson L, Bloom J, Lefkovits J, Taylor A, Duffy S, Stub D. Timing of Oral P2Y12 Inhibitors in Non-ST-Elevation Acute Coronary Syndromes: A Systematic Review and Meta-Analysis of Randomised Trials. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sugumar H, Nanayakkara S, Vizi D, Chieng D, Leet A, Mariani J, Taylor A, Kalman J, Kistler P, Ling L. Impact of catheter ablation on HFpEF in people with comorbid atrial fibrillation and HFpEF using invasive haemodynamic testing. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0892] [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: 11/12/2022] Open
Abstract
Abstract
Background
The impact of catheter ablation (CA) for atrial fibrillation (AF) in patients with heart failure with preserved ejection fraction (HFpEF) is unknown.
Objectives
To determine whether CA for AF reverses adverse haemodynamic changes associated with HFpEF.
Methods
Consecutive consenting patients with EF ≥50% scheduled for index CA underwent baseline exercise right heart catheterisation (exRHC), cardiac output (CO) measurement, cardiac MRI, echocardiogram, QOL questionnaires and BNP testing. HFpEF was defined by resting pulmonary capillary wedge pressure (PCWP) ≥15mmHg or peak exercise PCWP ≥25 mmHg during exRHC. Patients with HFpEF were offered follow-up exRHC ≥6 months post-CA.
Results
Of 252 patients scheduled for CA between April 2017 and Sept 2019, 131 (51.9%) qualified for inclusion, 65 (49.6%) consented to exRHC and 11 (16.9%) were excluded due to a subsequent decrease in EF (10) and uncontrolled hypertension (1). Fifty-four underwent exRHC, with 35 (65%) meeting criteria for HFpEF. Of them 26 (74.3%) who underwent CA, 20 (77%) had a follow up exRHC at 12±6 months follow-up, showing an overall decrease in peak exercise PCWP from 30.3±4.2 to 26.8±4.7 mmHg (p<0.05). Patients without arrhythmia recurrence showed significant improvements in peak exercise PCWP (29.2±3.7 to 22.9±2.0 mmHg (p<0.01). Their cardiac output increased from 10.3±3.0 to 12.1±4.0 mmHg p=0.1), and BNP decreased from (94.6±101.6 to 38.0±34.0 mmHg (p=0.06),whereas those with arrhythmia recurrence did not. Overall, 9 patients (45.0%) no longer met criteria for HFpEF.
Conclusion
There is a high prevalence of HFpEF in people referred for AF ablation. Successful CA for AF reverses the adverse haemodynamic changes associated with HFpEF
Changes in PCWP following AF ablation
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): NHMRC, NHF, RACP
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Lee J, Kim YC, Lee S, Yoo S, Davis K, Nagar S, Sawyer W, Yu N, Taylor A. 413P South Korean real-world treatment patterns in patients with EGFRm NSCLC. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Werner-Wasik M, DeGregorio N, Babinsky L, Taylor A, Hurwitz M, Koffer P, Begnoche M, DiPetrillo T. Implementation of the Electronic Health Record-Embedded Radiation Oncology Pathways in Two Institutions. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Taylor A, Hodgson D. PO-1926: Defining compassion in cancer care: a coproduction approach. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01943-5] [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]
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Goyal M, Yoshimura S, Milot G, Fiehler J, Jayaraman M, Dorn F, Taylor A, Liu J, Albuquerque F, Jensen ME, Nogueira R, Fraser JF, Chapot R, Thibault L, Majoie C, Yang P, Sakai N, Kallmes D, Orlov K, Arthur A, Brouwer P, Ospel JM. Considerations for Antiplatelet Management of Carotid Stenting in the Setting of Mechanical Thrombectomy: A Delphi Consensus Statement. AJNR Am J Neuroradiol 2020; 41:2274-2279. [PMID: 33122218 DOI: 10.3174/ajnr.a6888] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 07/17/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE There are only few data and lack of consensus regarding antiplatelet management for carotid stent placement in the setting of endovascular stroke treatment. We aimed to develop a consensus-based algorithm for antiplatelet management in acute ischemic stroke patients undergoing endovascular treatment and simultaneous emergent carotid stent placement. MATERIALS AND METHODS We performed a literature search and a modified Delphi approach used Web-based questionnaires that were sent in several iterations to an international multidisciplinary panel of 19 neurointerventionalists from 7 countries. The first round included open-ended questions and formed the basis for subsequent rounds, in which closed-ended questions were used. Participants continuously received feedback on the results from previous rounds. Consensus was defined as agreement of ≥70% for binary questions and agreement of ≥50% for questions with >2 answer options. The results of the Delphi process were then summarized in a draft manuscript that was circulated among the panel members for feedback. RESULTS A total of 5 Delphi rounds were performed. Panel members preferred a single intravenous aspirin bolus or, in jurisdictions in which intravenous aspirin is not available, a glycoprotein IIb/IIIa receptor inhibitor as intraprocedural antiplatelet regimen and a combination therapy of oral aspirin and a P2Y12 inhibitor in the postprocedural period. There was no consensus on the role of platelet function testing in the postprocedural period. CONCLUSIONS More and better data on antiplatelet management for carotid stent placement in the setting of endovascular treatment are urgently needed. Panel members preferred intravenous aspirin or, alternatively, a glycoprotein IIb/IIIa receptor inhibitor as an intraprocedural antiplatelet agent, followed by a dual oral regimen of aspirin and a P2Y12 inhibitor in the postprocedural period.
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Ospel JM, Brouwer P, Dorn F, Arthur A, Jensen ME, Nogueira R, Chapot R, Albuquerque F, Majoie C, Jayaraman M, Taylor A, Liu J, Fiehler J, Sakai N, Orlov K, Kallmes D, Fraser JF, Thibault L, Goyal M. Antiplatelet Management for Stent-Assisted Coiling and Flow Diversion of Ruptured Intracranial Aneurysms: A DELPHI Consensus Statement. AJNR Am J Neuroradiol 2020; 41:1856-1862. [PMID: 32943417 DOI: 10.3174/ajnr.a6814] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/30/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE There is a paucity of data regarding antiplatelet management strategies in the setting of stent-assisted coiling/flow diversion for ruptured intracranial aneurysms. This study aimed to identify current challenges in antiplatelet management during stent-assisted coiling/flow diversion for ruptured intracranial aneurysms and to outline possible antiplatelet management strategies. MATERIALS AND METHODS The modified DELPHI approach with an on-line questionnaire was sent in several iterations to an international, multidisciplinary panel of 15 neurointerventionalists. The first round consisted of open-ended questions, followed by closed-ended questions in the subsequent rounds. Responses were analyzed in an anonymous fashion and summarized in the final manuscript draft. The statement received endorsement from the World Federation of Interventional and Therapeutic Neuroradiology, the Japanese Society for Neuroendovascular Therapy, and the Chinese Neurosurgical Society. RESULTS Data were collected from December 9, 2019, to March 13, 2020. Panel members achieved consensus that platelet function testing may not be necessary and that antiplatelet management for stent-assisted coiling and flow diversion of ruptured intracranial aneurysms can follow the same principles. Preprocedural placement of a ventricular drain was thought to be beneficial in cases with a high risk of hydrocephalus. A periprocedural dual, intravenous, antiplatelet regimen with aspirin and a glycoprotein IIb/IIIa inhibitor was preferred as a standard approach. The panel agreed that intravenous medication can be converted to oral aspirin and an oral P2Y12 inhibitor within 24 hours after the procedure. CONCLUSIONS More and better data on antiplatelet management of patients with ruptured intracranial aneurysms undergoing stent-assisted coiling or flow diversion are urgently needed. Panel members in this DELPHI consensus study preferred a periprocedural dual-antiplatelet regimen with aspirin and a glycoprotein IIb/IIIa inhibitor.
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Thurmer J, Taylor A. Internal Return Migration and the Northern Territory: New Migration Analysis for Understanding Population Prospects for Sparsely Populated Areas. POPULATION RESEARCH AND POLICY REVIEW 2020. [DOI: 10.1007/s11113-020-09616-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Subramanian J, Gregg J, Wang H, Sun P, Yu B, Shenolikar R, Chau M, Taylor A, Leighl N. 1402P Epidermal growth factor receptor mutation (EGFRm) testing in advanced non-small cell lung cancer (aNSCLC) in a real-world setting. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Ledoux T, Cepni A, Taylor A, Crumbley C, Thompson D, Moran N, Olvera N, O'Connor D. Exploring Parent Feeding Practices, the Home Environment, and Toddler Diet. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.06.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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69
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McKendrick M, Sadler A, Taylor A, Seeley J, Filipescu T, Mustafa A, McKendrick G, Halcrow J, Raju P, McLeod GA. The effect of an ultrasound-activated needle tip tracker needle on the performance of sciatic nerve block on a soft embalmed Thiel cadaver. Anaesthesia 2020; 76:209-217. [PMID: 32797700 DOI: 10.1111/anae.15211] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2020] [Indexed: 12/12/2022]
Abstract
In this study, we measured the performance of medical students and anaesthetists using a new tracker needle during simulated sciatic nerve block on soft embalmed cadavers. The tracker needle incorporates a piezo element near its tip that generates an electrical signal in response to insonation. A circle, superimposed on the ultrasound image surrounding the needle tip, changes size and colour according to the position of the piezo element within the ultrasound beam. Our primary objective was to compare sciatic block performance with the tracker switched on and off. Our secondary objectives were to record psychometrics, procedure efficiency, participant self-regulation and focused attention using eye-tracking technology. Our primary outcome measures were the number of steps successfully performed and the number of errors committed during each block. Videos were scored by trained experts using validated checklists. Sequential tracker activation and deactivation was randomised equally within subjects. With needle activation, steps improved in 10 (25%) subjects and errors reduced in six (15%) subjects. The most important steps were: needle tip identification before injection, OR (95%CI) 2.12 (1.61-2.80; p < 0.001); and needle tip identification before advance of the needle, 1.80 (1.36-2.39; p < 0.001). The most important errors were: failure to identify the needle tip before injection, 2.40 (1.78-3.24; p < 0.001); and failure to quickly regain needle tip position when tip visibility was lost, 2.03 (1.5-2.75; p < 0.001). In conclusion, needle-tracking technology improved performance in a quarter of subjects.
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Klempíř O, Krupička R, Krůšek J, Dittert I, Petráková V, Petrák V, Taylor A. Application of spike sorting algorithm to neuronal signals originated from boron doped diamond micro-electrode arrays. Physiol Res 2020; 69:529-536. [PMID: 32469239 DOI: 10.33549/physiolres.934366] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
In this work we report on the implementation of methods for data processing signals from microelectrode arrays (MEA) and the application of these methods for signals originated from two types of MEAs to detect putative neurons and sort them into subpopulations. We recorded electrical signals from firing neurons using titanium nitride (TiN) and boron doped diamond (BDD) MEAs. In previous research, we have shown that these methods have the capacity to detect neurons using commercially-available TiN-MEAs. We have managed to cultivate and record hippocampal neurons for the first time using a newly developed custom-made multichannel BDD-MEA with 20 recording sites. We have analysed the signals with the algorithms developed and employed them to inspect firing bursts and enable spike sorting. We did not observe any significant difference between BDD- and TiN-MEAs over the parameters, which estimated spike shape variability per each detected neuron. This result supports the hypothesis that we have detected real neurons, rather than noise, in the BDD-MEA signal. BDD materials with suitable mechanical, electrical and biocompatibility properties have a large potential in novel therapies for treatments of neural pathologies, such as deep brain stimulation in Parkinson's disease.
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Ali J, Bollard HD, Taylor A. P382 Development of a new information resource on body image for people with cystic fibrosis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30710-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Crane SC, Taylor A, Wesley KL, Simon SL. 0886 Changes in Parent Knowledge and Self-Efficacy and Association With Adherence Following the Steps Towards Achieving Restful Sleep (STARS) Pediatric PAP Therapy Desensitization Program. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Obstructive sleep apnea (OSA) presents in 2-5 % of youth and has been consistently linked to sleepiness, cognitive deficits, behavior difficulties, and cardiovascular morbidity. PAP effectively treats OSA, however, nonadherence is the most common cause of PAP treatment failure in children. Few adherence interventions have been empirically studied for youth with OSA. The STARS (Steps Towards Achieving Restful Sleep) Clinic is a behavioral program to optimize child tolerance to PAP therapy through a parent class, and in vivo practice. The goal of the study was to examine parent knowledge and self-efficacy following participation in STARS, and associations with subsequent PAP adherence.
Methods
A retrospective chart review was conducted for patients in the STARS program. Items queried included patient demographics, diagnostic and treatment characteristics, pre- and post- STARS responses to a parent self-efficacy and knowledge questionnaire, and polysomnography and PAP adherence data. Paired-samples t-tests examined changes in parent self-efficacy and knowledge pre- to post STARS, and regression analyses examined associations between self-efficacy and knowledge with demographics, treatment-related characteristics, and PAP adherence.
Results
130 patients completed the STARS program from October 2016 to February 2019. Participants were 8.3 years old ±6.3, 63% male, 57% white, 33% Hispanic, with severe OSA (OAHI =22 ±33). Most participants (87%) had at least one medical comorbidity (e.g, Down Syndrome, 41%). Both parent knowledge and self-efficacy increased significantly from pre- to post- STARS. Approximately 60% of patients were adherent following STARS (defined as ≥4 h use and ≥70% of days used). Higher post- knowledge, but not efficacy score, was significantly associated with better PAP adherence.
Conclusion
Parent knowledge and self-efficacy for PAP improved following the STARS program, and greater knowledge was associated with better adherence. Future research evaluating the efficacy and effectiveness of the STARS program is needed but preliminary evidence suggests it may be a promising model for improving youth PAP adherence.
Support
None
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Taylor A, Taylor B, Parkes J, Fagan JJ. How should health resource allocation be applied during the COVID-19 pandemic in South Africa? S Afr Med J 2020; 110:12950. [PMID: 32880316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 05/21/2020] [Indexed: 06/11/2023] Open
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Burke C, Kohlbrenner R, Fidelman N, Heller M, Kolli K, Lam A, Lehrman E, Lokken R, Taylor A, Kumar V, Conrad M, Kohi M. 3:54 PM Abstract No. 105 Percutaneous transhepatic biliary drain placement for reduction of hyperbilirubinemia in malignant biliary obstruction: a bridge to chemotherapy or a bridge to nowhere? J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Morley J, Moayyeri A, Ali L, Taylor A, Feudjo-Tepie M, Hamilton L, Bayly J. Persistence and compliance with osteoporosis therapies among postmenopausal women in the UK Clinical Practice Research Datalink. Osteoporos Int 2020; 31:533-545. [PMID: 31758206 PMCID: PMC7076063 DOI: 10.1007/s00198-019-05228-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 11/06/2019] [Indexed: 12/16/2022]
Abstract
UNLABELLED Gaining full benefits from osteoporosis medications requires long-term treatment. Investigating the real-world persistence of women receiving osteoporosis medications in the UK, we found that most patients stop treatment within a year. To prevent osteoporotic fragility fractures, long-term treatment persistence must be improved. INTRODUCTION Persistence with osteoporosis therapies has historically been poor. To treat this chronic and progressive disease, it is essential that patients receive the full benefit of these medications. We estimated persistence and compliance with osteoporosis therapies in a large sample of postmenopausal women in the UK. METHODS Data were obtained from the Clinical Practice Research Datalink for all women aged 50 years and over or women with early menopause, who received at least one prescription in primary care for any licensed osteoporosis therapy between January 1, 2010 and December 31, 2015. Persistence and compliance at 24 months (primary objective) and at 5 years (exploratory objective) were estimated in three patient cohorts: "All Patients," "Naïve Patients," and "Drug-Specific." RESULTS The All Patients cohort included 72,256 women. Persistence with any therapy was 56.1%, 43.6%, 36.4%, and 31.0% at 6, 12, 18, and 24 months, respectively, and 23.2% and 13.1% at 3 years and 5 years, respectively. Patients were generally more persistent and compliant if evaluated from their first exposure to osteoporosis therapy (Naïve Patients cohort). In the drug-specific analysis, 64% of patients receiving denosumab (administered subcutaneously every 6 months) were persistent at 24 months compared with 28% and 23% of those taking oral bisphosphonates and intravenous bisphosphonates, respectively. CONCLUSIONS Only about one in three patients who received osteoporosis therapy continued to be on treatment after 2 years. There is a need to improve persistence with osteoporosis therapy, especially for high-risk patients.
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