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Smith J, Kim J, Spilchuk V, Tran V, Singhal S. Letter to the Editor, "Sources of SARS-CoV-2 and Other Microorganisms in Dental Aerosols". J Dent Res 2021; 101:237. [PMID: 34928740 DOI: 10.1177/00220345211037659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Bennie J, Diallo T, Lubans D, Smith J, Tomkinson G. Factors associated with adolescents’ adherence to the World Health Organization (WHO) muscle-strengthening activity guideline. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.135] [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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Boyer J, Dascombe B, Eather N, Kennedy S, Leahy A, Lubans D, Shields N, Smith J, Thomas M. Feasibility of a teacher facilitated physical activity intervention for adolescents with disability: Findings from the Burn 2 Learn adapted pilot study. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dos Santos G, Estabrooks P, Kennedy S, Lubans D, Morgan P, Nathan N, Noetel M, Salmon J, Smith J. State-wide dissemination of the Resistance Training for Teens program: An evaluation guided by the RE-AIM framework. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Eather N, Morgan P, Smith J, Yan J. A systematic review investigating the effects of implementing game-based approaches in school-based Physical Education and Sport among Primary school children. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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de Bruijn AGM, van der Fels IMJ, Renken RJ, Königs M, Meijer A, Oosterlaan J, Kostons DDNM, Visscher C, Bosker RJ, Smith J, Hartman E. Differential effects of long-term aerobic versus cognitively-engaging physical activity on children's visuospatial working memory related brain activation: A cluster RCT. Brain Cogn 2021; 155:105812. [PMID: 34716033 DOI: 10.1016/j.bandc.2021.105812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/19/2022]
Abstract
Different types of physical activity are thought to differentially affect children's brain activation, via physiological mechanisms, or by activating similar brain areas during physical and cognitive tasks. Despite many behavioral studies relying on these mechanisms, they have been rarely studied. This study looks at both mechanisms simultaneously, by examining effects of two physical activity interventions (aerobic vs. cognitively-engaging) on children's brain activation. Functional Magnetic Resonance Imaging (fMRI) data of 62 children (48.4% boys, mean age 9.2 years) was analyzed. Children's visuospatial working memory related brain activity patterns were tested using a Spatial Span Task before and after the 14-week interventions consisting of four physical education lessons per week. The control group followed their regular program of two lessons per week. Analyses of activation patterns in SPM 12.0 revealed no activation changes between pretest and posttest (p > .05), and no differences between the three conditions in pretest-posttest changes in brain activation (p > .05). Large inter-individual differences were found, suggesting that not every child benefited from the interventions in the same way. To get more insight into the assumed mechanisms, further research is needed to understand whether, when, for whom, and how physical activity results in changed brain activation patterns.
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Lu IN, Yu SK, Smith J, Woodcock-Smith J, Jalaludeen N, Cheriyan J, Wilkinson I, McEniery C. The association between central ambulatory blood pressure and end-organ damage. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2349] [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: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Central blood pressure (BP) measured in the clinic relates more strongly to end-organ damage and may be superior to brachial BP in predicting cardiovascular events. Measurement of central ambulatory BP (ABP) is now possible and emerging data suggest that central ABP is better correlated with left ventricular mass index (LVMI) than brachial ABP.1,2 However, the association between central ABP and other measures of end-organ damage remains unclear.
Purpose
We investigated the association between brachial or central ABP and end-organ damage, in a large community-based population of untreated individuals.
Method
1091 participants (mean age 45±18 years; 589 females) had simultaneous measurements of brachial and central ABP over 24 hours, using the Mobil-O-Graph device. Central ABP was derived using two waveform calibration methods (1: mean/diastolic BP; 2: systolic/diastolic BP). Participants also underwent measurement of aortic pulse wave velocity (aPWV; SphygmoCor device) in the clinic. In a subset of 675 individuals, LVMI was assessed by echocardiography and in 610 individuals, carotid intima-media thickness (CIMT) was measured, using ultrasound. 24-hour and daytime brachial and central ambulatory systolic BP (ASBP) and pulse pressure (APP) were considered.
Results
The Pearson's coefficient for each correlation is listed in Table 1. LVMI was most strongly correlated with 24-hour central ASBP, using calibration method 1 (MAP/DBP; r=0.403, P<0.001). CIMT was most strongly correlated with daytime central ASBP, again derived from calibration method 1 (r=0.341, p<0.001), whereas aPWV measured in the clinic, was most strongly correlated with 24-hour central ASBP, derived from calibration method 2 (SBP/DBP; r=0.441, P<0.001). Based on z statistics, all correlations reported above were significantly stronger than equivalent correlations using brachial ASBP (P<0.001 for all three comparisons of correlation coefficients).
Conclusion
Measurement of central ABP relates more closely to end-organ damage than equivalent measures based on brachial ABP. Central ABP may provide valuable additional information concerning cardiovascular risk above and beyond brachial ABP.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): British Heart Foundation
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Grace D, Lee HS, Smith J. Introduction - Veterinary Services in a changing world: climate change and other external factors. REV SCI TECH OIE 2021; 40:371-382. [PMID: 34542108 DOI: 10.20506/rst.40.2.3230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kendall N, Smith J, Whistance L, Stergiadis S, Stoate C, Chesshire H, Smith A. Trace element composition of tree fodder and potential nutritional use for livestock. Livest Sci 2021. [DOI: 10.1016/j.livsci.2021.104560] [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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Hania A, Rahmani L, Smith J. P.118 Postoperative monitoring following neuraxial opioid administration for caesarean sections across maternity units in the Republic of Ireland: A national survey. Int J Obstet Anesth 2021. [DOI: 10.1016/j.ijoa.2021.103116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Maki S, Baskaradas A, Smith J. 243 Thromboprophylaxis In Elective Arthroplasty Patients: Assessing DVT Rates. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.248] [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]
Abstract
Abstract
Introduction
Deep vein thrombosis (DVT) in elective hip and knee arthroplasty range from 1-25%. The NICE Guidelines for Venous Thromboembolism (VTE) advise offering chemical prophylaxis with anti-embolism stockings (AES) as VTE prophylaxis. The aim of this study was to assess the role of anti-embolism stockings, by analysing the rates of DVT in patients who had chemical VTE prophylaxis in combination with anti-embolism stockings compared to patients who had chemical prophylaxis alone.
Method
Retrospective data analysis of patients who underwent elective primary hip or knee replacements from April 2018 to April 2019. Patient records were reviewed for each patient to identify any subsequent DVT diagnosis.
Results
759 patients were identified. 595 patients had combined chemical VTE prophylaxis and AES. 164 patients did not have AES. 12 patients who received the combined therapy presented to A+E with suspected DVT, which was confirmed in two patients. Of the patients who did not receive AES, there were no cases of DVT.
Conclusions
There was no increase in DVT rates in patients who were not offered anti-embolic stockings. Taking into account the risks associated with AES and the costs incurred, the routine prescription of stockings must be carefully reviewed by orthopaedic departments.
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Butt MA, Lee A, Smith J. 327 Rare Synchronous Volvulus of Sigmoid Colon and Caecum, Management of Two Cases. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.259] [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
Colonic volvulus accounts for approximately 5% of cases of large bowel obstruction. Sigmoid volvulus is commonest (75%), followed caecal volvulus (15%). Synchronous volvulus of the caecum and sigmoid is rare, with five reported cases in the literature. We report two cases in a London teaching hospital managed within 6 months. Both male patients (aged 72 and 79 years) had presented to the emergency department on multiple occasions (2-5 times in the preceding 1-8 months), with obstructive symptoms including tender abdominal distension and constipation. On all occasions, sigmoid volvulus was diagnosed based on plain abdominal films and flatus tubes were inserted, with initial clinical resolution. On their final presentation, both patients were admitted for definitive surgery. CT scans of the abdomen and pelvis were consistently reported as showing only sigmoid volvulus. Only intra-operatively was the diagnosis of synchronous caecal and sigmoid volvulus appreciated. Complete symptom resolution was achieved with subtotal colectomy and ileostomy formation. The key learning points from these cases are: 1) synchronous large bowel volvulus is a rare and easily missed diagnosis, 2) conservative management is unlikely to be successful, 3) radiological appearances may only suggest one type of large bowel volvulus and 4) definitive diagnosis is made intra-operatively.
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Aseem R, Cribb E, Liccardo F, Daulatzai N, Smith J, Pawa N. 698 A Systematic Review of Smartphone Applications for Enhanced Recovery After Surgery (ERAS) Following Colorectal Surgery. Br J Surg 2021. [PMCID: PMC8135972 DOI: 10.1093/bjs/znab134.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Introduction Length of stay (LOS) following colorectal surgery has reduced due to enhanced recovery after surgery (ERAS) programs. Telemedicine has shown potential for patients to remotely access support, communicate progress with their medical team and enhance patient empowerment. We conducted a systematic review of smartphone applications for ERAS following colorectal surgery measuring patient outcomes and experience. Method The review was performed adhering to PRISMA guidelines, using search terms pertaining to ERAS, colorectal surgery, and mobile applications via electronic databases. All peer-reviewed English articles were assessed for inclusion and quality by two reviewers. A qualitative analysis was conducted to evaluate methodologies, patient experience, and outcomes. Results 206 abstracts were identified from which 5 articles (2 RCTs and 3 cohorts) were included in the analysis. Studies surveyed patient adherence to ERAS, LOS, readmission, intra and postoperative complications. Four studies recorded patient satisfaction, whilst one assessed quality of life and application validation. Conclusions The review highlights paucity in the use of smartphone applications after ERAS in colorectal surgery but demonstrates high patient satisfaction levels. Service delivery in the NHS has increasingly moved to a virtual platform during the coronavirus pandemic. More research and engagement in the development and use of smartphone applications would enhance care for patients.
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Norrington M, Kumar S, Islim A, Smith J, Husband D, Mills S, Jenkinson M. 630 Management and Outcomes of Primary Central Nervous System Lymphoma – Time to Improve the Patient Pathway. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.564] [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
The clinical and radiological presentation of PCNSL is diverse. Biopsy is required prior to commencing oncological therapy. Steroids administration or inconclusive histopathology may delay diagnosis. This study aimed to assess outcomes of patients managed under clinical oncology and haematology, and investigate factors related to survival.
Method
Retrospective cohort study (2004-2019) of 104 patients. Univariate analysis, using Kaplan Meier curves and multivariate Cox regression analysis were performed.
Results
Median WHO performance status was 1. 12 patients (11.5%) required repeat biopsy. 40 cases were managed under oncology, 25 males (median age 67 years; IQR 60-71). Median time from imaging to diagnosis (TTD) was 18 days (range 8-227). Median time from diagnosis to treatment (TTT) was 19 days (range 3-63). Median overall survival (OS) was 5 months (95% CI 0-15.6). 61 cases were managed under haematology, 32 males (median age 65 years; IQR 54-71). Median TTD was 25 days (range 10-233). Median TTT was 14 days (range 2-96). Median OS was 5 months (95% CI 2.1-7.9). No significant prognostic indicators of OS were identified on multivariate analysis.
Conclusions
PCNSL carries a poor prognosis regardless of treatment team. The wide range in time to treatment suggests that the management pathway needs streamlining to improve outcomes.
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Cho A, Tomihama R, Chen R, Cooper K, Malit A, Jin D, Fujimoto S, Kassir M, Smith J. Abstract No. 135 Point-of-care ultrasound (POCUS) versus conventional ultrasound imaging quality. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.141] [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] Open
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Smith J. Abstract No. 101 Tibial-pedal artery access for uterine artery embolization. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.107] [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] Open
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Sawhney R, Ingram J, Smith J. P8: A COMPARATIVE EVALUATION OF INTENSIVE OUT-OF-TERM AND CONVENTIONAL TERM-TIME MENTORING SCHEMES IN PREPARING MEDICAL STUDENTS FOR A CAREER IN SURGERY. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.093] [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
Mentoring schemes have been established to mitigate these concerns and improve interest in surgery among medical students; however, there is a paucity of research on whether conventional term-time (CTT) mentoring or more intensive out-of-term (IOT) mentoring is more meaningful in promoting surgical careers.
Method
Most surgical societies in the UK offer CTT schemes (ca. one-to-three mentoring during the academic year) to their members. In addition to this, a student-led surgical society piloted an IOT scheme (one-to-one mentoring during the summer break). Students completed a ten-point questionnaire at the end of the academic year evaluating the scheme(s) they participated in.
Result
Of the 35 students that completed a questionnaire, 74% participated in either CTT or IOT (1:1), and 26% participated in both. Students that participated in one scheme considered that scheme to be superior in increasing interest in surgery (CTT 69%; IOT 79%), while students that participated in both favoured IOT (78%). With regards to increasing preparedness for surgical careers, IOT was universally preferred. According to previously determined levels of engagement, maximum engagement was achieved by 61.5% of students in a single week of IOT, compared to only 7.7% of students after a full academic year of CTT.
Conclusion
IOT outperforms CTT with regards to boosting interest in surgery and preparedness for surgical careers. This suggests that introduction of IOT schemes nationally may be a valuable advance in the future of surgical mentoring.
Take-home message
Adopting an intensive out-of-term mentoring scheme has shown a positive outcome in terms of both increasing preparedness for, and interest in, surgical careers. This suggests implementing such time intensive schemes nationally could be a sensible future-step in surgical mentoring.
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Heft Neal ME, Gensterblum-Miller E, Bhangale AD, Kulkarni A, Zhai J, Smith J, Brummel C, Foltin SK, Thomas D, Jiang H, McHugh JB, Brenner JC. Integrative sequencing discovers an ATF1-motif enriched molecular signature that differentiates hyalinizing clear cell carcinoma from mucoepidemoid carcinoma. Oral Oncol 2021; 117:105270. [PMID: 33827033 DOI: 10.1016/j.oraloncology.2021.105270] [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: 11/16/2020] [Revised: 03/16/2021] [Accepted: 03/20/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Salivary gland tumors are comprised of a diverse group of malignancies with widely varying prognoses. These cancers can be difficult to differentiate, especially in cases with limited potential for immunohistochemistry (IHC)-based characterization. Here, we sought to define the molecular profile of a rare salivary gland cancer called hyalinizing clear cell carcinoma (HCCC), and identify a molecular gene signature capable of distinguishing between HCCC and the histopathologically similar disease, mucoepidermoid carcinoma (MEC). MATERIALS AND METHODS We performed the first integrated full characterization of five independent HCCC cases. RESULTS We discovered insulin-like growth factor alterations and aberrant IGF2 and/or IGF1R expression in HCCC tumors, suggesting a potential dependence on this pathway. Further, we identified a 354 gene signature that differentiated HCCC from MEC, and was significantly enriched for genes with an ATF1 binding motif in their promoters, supporting a transcriptional pathogenic mechanism of the characteristic EWSR1-ATF1 fusion found in these tumors. Of the differentially expressed genes, IGF1R, SGK1 and SGK3 were found to be elevated in the HCCCs relative to MECs. Finally, analysis of immune checkpoints and subsequent IHC demonstrated that CXCR4 protein was elevated in several of the HCCC cases. CONCLUSION Collectively, our data identify an ATF1-motif enriched gene signature that may have clinical utility for molecular differentiation of HCCCs from other salivary gland tumors and discover potential actionable alterations that may benefit the clinical care of recurrent HCCC patients.
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Charity RJ, Webb TB, Elson JM, Hoff DEM, Pruitt CD, Sobotka LG, Brown KW, Cerizza G, Estee J, Lynch WG, Manfredi J, Morfouace P, Santamaria C, Sweany S, Tsang CY, Tsang MB, Zhang Y, Zhu K, Kuvin SA, McNeel D, Smith J, Wuosmaa AH, Chajecki Z. Observation of the Exotic Isotope ^{13}F Located Four Neutrons beyond the Proton Drip Line. PHYSICAL REVIEW LETTERS 2021; 126:132501. [PMID: 33861136 DOI: 10.1103/physrevlett.126.132501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/22/2021] [Accepted: 02/24/2021] [Indexed: 06/12/2023]
Abstract
A ^{13}F resonance was observed following a charge-exchange reaction between a fast ^{13}O beam and a ^{9}Be target. The resonance was found in the invariant-mass distribution of 3p+^{10}C events and probably corresponds to a 5/2^{+} excited state. The ground state was also expected to be populated, but was not resolved from the background. The observed level decays via initial proton emissions to both the ground and first 2^{+} state of ^{12}O, which subsequently undergo 2p decay. In addition, there may also be a significant proton decay branch to the second 2^{+} level in ^{12}O. The wave function associated with the observed level may be collectivized due to coupling to the continuum as is it located just above the threshold for proton decay to the 2_{2}^{+} state of ^{12}O.
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Lushaj E, Fiedler A, Dhingra R, Hermsen J, Smith J. Evaluation of Pain Management in Patients Undergoing LVAD Therapy via Thoracotomy and Median Sternotomy Approach. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1238] [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] Open
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71
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Rai B, Rosse C, Gorder K, Rudick S, Chung E, Raymond T, O'Brien T, Egnaczyk G, Answini G, Griffin J, Smith J, Hasan S, Choo J, Smith T. Left Atrial Veno-Arterial Extracorporeal Membrane Oxygenation (LAVA-ECMO) is a Feasible Option for Patients in Cardiogenic Shock for Whom Impella Offloading is Contraindicated. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2095] [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] Open
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72
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Gray M, Congleton J, Smith J, Smith R. 006 Should Men Presenting with Depression Be Screened For Low Testosterone? J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.076] [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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Smith J, Smith J, Windemuth B. Screening for Inappropriate Polypharmacy Using STOPP Criteria With Assisted Living Residents. J Am Med Dir Assoc 2021; 22:B16. [PMID: 34287158 DOI: 10.1016/j.jamda.2021.01.037] [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]
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Meyer M, Bacha N, Tesfaye T, Alemayehu Y, Abera E, Hundie B, Woldeab G, Girma B, Gemechu A, Negash T, Mideksa T, Smith J, Jaleta M, Hodson D, Gilligan CA. Wheat rust epidemics damage Ethiopian wheat production: A decade of field disease surveillance reveals national-scale trends in past outbreaks. PLoS One 2021; 16:e0245697. [PMID: 33534869 PMCID: PMC7857641 DOI: 10.1371/journal.pone.0245697] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/05/2021] [Indexed: 11/19/2022] Open
Abstract
Wheat rusts are the key biological constraint to wheat production in Ethiopia-one of Africa's largest wheat producing countries. The fungal diseases cause economic losses and threaten livelihoods of smallholder farmers. While it is known that wheat rust epidemics have occurred in Ethiopia, to date no systematic long-term analysis of past outbreaks has been available. We present results from one of the most comprehensive surveillance campaigns of wheat rusts in Africa. More than 13,000 fields have been surveyed during the last 13 years. Using a combination of spatial data-analysis and visualization, statistical tools, and empirical modelling, we identify trends in the distribution of wheat stem rust (Sr), stripe rust (Yr) and leaf rust (Lr). Results show very high infection levels (mean incidence for Yr: 44%; Sr: 34%; Lr: 18%). These recurrent rust outbreaks lead to substantial economic losses, which we estimate to be of the order of 10s of millions of US-D annually. On the widely adopted wheat variety, Digalu, there is a marked increase in disease prevalence following the incursion of new rust races into Ethiopia, which indicates a pronounced boom-and-bust cycle of major gene resistance. Using spatial analyses, we identify hotspots of disease risk for all three rusts, show a linear correlation between altitude and disease prevalence, and find a pronounced north-south trend in stem rust prevalence. Temporal analyses show a sigmoidal increase in disease levels during the wheat season and strong inter-annual variations. While a simple logistic curve performs satisfactorily in predicting stem rust in some years, it cannot account for the complex outbreak patterns in other years and fails to predict the occurrence of stripe and leaf rust. The empirical insights into wheat rust epidemiology in Ethiopia presented here provide a basis for improving future surveillance and to inform the development of mechanistic models to predict disease spread.
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Fecher-Jones I, Grimmett C, Edwards MR, Knight JS, Smith J, Leach H, Moyses H, Jack S, Grocott MPW, Levett DZH. Development and evaluation of a novel pre-operative surgery school and behavioural change intervention for patients undergoing elective major surgery: Fit-4-Surgery School. Anaesthesia 2021; 76:1207-1211. [PMID: 33538015 DOI: 10.1111/anae.15393] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2020] [Indexed: 01/01/2023]
Abstract
Group pre-operative education has usually been limited to conditioning expectations and providing education. Prehabilitation has highlighted modifiable lifestyle factors that are amenable to change and may improve clinical outcomes. We instituted a pre-operative 'Fit-4-Surgery School' for patients scheduled for major surgery, to educate and promote healthy behaviour. We evaluated patients' views having attended the school, and after surgery we asked how it had changed their behaviour with a lifestyle questionnaire. The school was launched in May 2016 and was attended by 586/1017 (58%) of invited patients. Patients who did not attend: lived further away, median (IQR [range]) 8 (4-19 [0-123]) miles vs. 5 (3-14 [0-172]) miles, p < 0.001; and were more deprived, Index of Multiple Deprivation Rank decile median (IQR [range]), 6 (4-8 [1-10]) vs. 7 (4-9 [1-10]), p = 0.04. Of the 492/586 (84%) participants who completed an evaluation questionnaire, 462 (94%) would recommend the school to a friend having surgery and 296 (60%) planned lifestyle changes. After surgery, 232/586 (40%) completed a behavioural change questionnaire, 106 (46%) of whom reported changing at least one lifestyle factor, most commonly by increasing exercise. The pre-operative school was acceptable to patients.
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