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Chandrasekar B, Smith S, Rauf A, Mukherjee R. 1242 A Surfacing Staghorn: Spontaneous Expulsion of a Large Renal Calculus from A Nephrocutaneous Fistula. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.364] [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]
Abstract
Abstract
An 83-year-old lady presented to the urology department with right flank pain in the context of a previously known right renal staghorn calculus. On examination, she was found to have a visible discharging sinus in her right flank, and the renal calculus had become visible at the skin surface. Non-contrast CT imaging confirmed that her staghorn calculus had eroded through the skin via a nephrocutaneous fistula. The stone was manually extracted percutaneously on the ward, and she was treated with intravenous antibiotics. She subsequently passed a further stone through the tract and made a good recovery.
This is a highly unusual presentation of nephrolithiasis in a developed country in the 21st century. Review of the literature suggests that surgical management is almost always indicated in patients with staghorn calculi. However surgical management options are not without risk and conservative management of staghorn disease may be appropriate in select patient groups: those with multiple co-morbidities at high risk for GA, in cases of patient refusal of surgery, or in patients with aberrant anatomical factors
Our case highlights a potential complication of conservatively managed staghorn stone disease. To our knowledge our case is the first of spontaneous expulsion of renal stone of this size to be reported in the developed world.
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Liu H, Burn T, Jackson J, Howell M, Santos L, Alavi A, Smith S. 049 Janus Kinase 1 Inhibitor INCB054707 Modulates Disease-Associated Markers and Pathways in Hidradenitis Suppurativa. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.051] [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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Sikes KJ, Andrie KM, McConnell A, Wist S, Smith S, Cole B, Frisbie DD, Santangelo KS. Clinical and Histologic Manifestations of a Novel Rectus Femoris Myotendinous Junction Injury in Rats. Muscles Ligaments Tendons J 2021; 11:600-613. [PMID: 38111789 PMCID: PMC10726684 DOI: 10.32098/mltj.04.2021.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background Animal models of muscle injury have primarily relied on methods which do not mimic the chronic scarring that typically occurs adjacent to the myotendinous junction (MTJ). The goal of this study was three-fold: (i) to create a strain-induced in vivo model of rectus femoris MTJ injury in rats; (ii) to document clinical manifestations of injury using longitudinal tracking of individual animals via voluntary and compulsory (treadmill) mobility analyses and (iii) to validate and assess the model for persistent scarring through serial histologic assessment and development of a semi-quantitative grading scheme to characterize injury response over time. Methods Strain-induced MTJ injury was generated in male Sprague Dawley rats via needle tension directed along the transverse axis between the rectus femoris muscle and distal tendon that attaches to the patella. Animals received mobility assessments (gait analysis using a DigiGait Treadmill System and weight bearing using a Tekscan Rodent Walkway System) at days 0, 1, 3, 6, 13, 20, and 27 of the experimental protocol. Rats were euthanized at 1, 3, 7, 14, and 28 days post-injury (n = 6 rats per time-point) and hindlimbs were processed for histology. Results Significant changes in locomotor parameters included injured and contralateral limb paw area, max dA/dt (limb deceleration/breaking time), stride time, stance time, force time impulse, and fore/hind symmetry, and injured limb maximum force. The most significant and consistent histologic finding was a pathologic fibrotic adhesive lesion at the muscle and tendon interface along the proximal aspect of the patella just distal to the injury site. This lesion was composed of reactive fibroblasts, disorganized collagen fibers, vascular profiles, and a myxomatous ground substance stroma. Conclusions This work is the first to characterize the clinical and pathologic development of a chronic model of rectus femoris MTJ injury, which resulted in altered mobility likely caused by a strain-induced fibrotic scar along the anterior patella. Notably, both the functional and pathologic changes recapitulated the course of injury progression similar to what is described in humans. This work provides a unique model to study MTJ injury mechanisms for the identification of enhanced treatment options for patients who suffer from activity-related muscle conditions.
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Lithgow K, Venkataraman H, Hughes S, Shah H, Kemp-Blake J, Vickrage S, Smith S, Humphries S, Elshafie M, Taniere P, Diaz-Cano S, Dasari BVM, Almond M, Ford S, Ayuk J, Shetty S, Shah T, Geh I. Well-differentiated gastroenteropancreatic G3 NET: findings from a large single centre cohort. Sci Rep 2021; 11:17947. [PMID: 34504148 PMCID: PMC8429701 DOI: 10.1038/s41598-021-97247-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 06/21/2021] [Indexed: 11/14/2022] Open
Abstract
Neuroendocrine neoplasms are known to have heterogeneous biological behavior. G3 neuroendocrine tumours (NET G3) are characterized by well-differentiated morphology and Ki67 > 20%. The prognosis of this disease is understood to be intermediate between NET G2 and neuroendocrine carcinoma (NEC). Clinical management of NET G3 is challenging due to limited data to inform treatment strategies. We describe clinical characteristics, treatment, and outcomes in a large single centre cohort of patients with gastroenteropancreatic NET G3. Data was reviewed from 26 cases managed at Queen Elizabeth Hospital, Birmingham, UK, from 2012 to 2019. Most commonly the site of the primary tumour was unknown and majority of cases with identifiable primaries originated in the GI tract. Majority of cases demonstrated somatostatin receptor avidity. Median Ki67 was 30%, and most cases had stage IV disease at diagnosis. Treatment options included surgery, somatostatin analogs (SSA), and chemotherapy with either platinum-based or temozolomide-based regimens. Estimated progression free survival was 4 months following initiation of SSA and 3 months following initiation of chemotherapy. Disease control was observed following treatment in 5/11 patients treated with chemotherapy. Estimated median survival was 19 months; estimated 1 year survival was 60% and estimated 2 year survival was 13%. NET G3 is a heterogeneous group of tumours and patients which commonly have advanced disease at presentation. Prognosis is typically poor, though select cases may respond to treatment with SSA and/or chemotherapy. Further study is needed to compare efficacy of different treatment strategies for this disease.
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Rosmarin D, Smith S, Shrom D, Burge R, See K, McKean‐Matthews M, Ridenour T, Lin C, Gorelick J. Clinical outcomes at 1 year in early Psoriasis Area and Severity Index responders compared with non-responders: Subgroup analysis of UNCOVER-3 trial. SKIN HEALTH AND DISEASE 2021; 1:e43. [PMID: 35663140 PMCID: PMC9060090 DOI: 10.1002/ski2.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Subbiah V, Bhadri V, Bui N, Batty K, Strach M, Zakharian M, Smith S, Yee N, Srinivasan S, Saville M, Mejía Oneto J, Guminski A. 547P Early pharmacokinetic data from a phase I study of SQ3370 in patients with advanced solid tumors provides proof-of-concept for the click chemistry-based CAPAC platform. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1069] [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] Open
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Bargeman M, Smith S, Wekerle C. Trauma-informed care as a rights-based "standard of care": A critical review. CHILD ABUSE & NEGLECT 2021; 119:104762. [PMID: 33046264 DOI: 10.1016/j.chiabu.2020.104762] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/23/2020] [Accepted: 09/23/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND A growing body of literature on the concept of trauma-informed care (TIC) has emerged in response to greater recognition of the prevalence of childhood trauma. Currently, no review has examined the conceptualization of TIC in various child-serving systems, specifically TIC as a standard of care, the outcomes examined relevant to care, and whether child rights are part of the TIC discourse. METHOD A systematic search of 12 health and non-health databases, reviewed for relevance to children and youth specifically, was conducted to form a critical review of the literature. RESULTS Forty-nine documents were selected, which included articles from child welfare (n = 16), education (n = 15), juvenile justice (n = 8), health (n = 7), and multiple sectors (n = 3). A common theme across all sectors was a lack of clear understanding regarding what is TIC and how to implement it. While trauma symptoms are seemingly a good-fit outcome and reflective of a right to rehabilitative health, validated assessment tools were not commonly used. Few studies explicitly included a child rights perspective within TIC. CONCLUSION Emerging evidence encourages systematic inquiry into the operationalization of TIC to better assess whether it is an established model with consistent measurement. Empirical studies need to embrace established intervention methodology (e.g., improvement from baseline, control groups). From this expanded rigor, the issue as to whether TIC can evolve to a rights-based standard of care can be addressed.
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Bates J, Shrestha S, Liu Q, Smith S, Mulrooney D, Leisenring W, Gibson T, Robison L, Chow E, Oeffinger K, Armstrong G, Constine L, Hoppe B, Lee C, Yasui Y, Howell R. OC-0208 Cardiac substructure dosimetry and late cardiac arrhythmia in the Childhood Cancer Survivor Study. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06823-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Holden S, Mcwilliams D, Smith S, Walsh D. OP0084 CENTRAL MECHANISMS TRAIT PREDICTS PERSISTENT KNEE OSTEOARTHRITIS PAIN AT 24-MONTHS: DATA FROM THE OSTEOARTHRITIS INITIATIVE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:In the UK, 10% of men and 18% of women over the age of 60 suffer from symptomatic osteoarthritis (OA), and rising. OA knee pain can worsen without significant radiographic changes and pain remains a major problem for up to 20% of patients after total knee joint replacement. Chronic knee OA pain is augmented by central pain mechanisms, including central sensitisation. Measures of the level of central involvement in pain could inform clinical decision making. Self-report characteristics of depression, anxiety, cognitive difficulties, catastrophizing, sleep disturbance, fatigue, and widespread pain distribution together contribute to a Central Mechanisms Trait which is associated with central sensitisation and OA knee painObjectives:Using self-report questionnaire data from the Osteoarthritis Initiative Cohort Study (OAI) we aimed to evaluate the prognostic performance of baseline CMT for pain at 24-months.Methods:OAI participants with knee OA or at risk of knee OA with pain in the same knee at both index time point (48-months) and one year prior to that date were included (n=1984). Knee pain was measured using the Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) pain sub-scale, by reference to the index knee (the knee with the highest WOMAC pain sub-scale score at baseline). Questionnaire items were selected to assess the 7 available characteristics identified by Akin-Akinyosoye et al.[1], from which a single CMT factor was calculated by confirmatory factor analysis. Anxiety, fatigue and cognitive difficulties were assessed by single items, depression and sleep disturbance represented by multiple items, and catastrophising by using the Coping Strategies Questionnaire – Catastrophising sub-scale. Pain distribution was defined as a sum of other painful joints at or below the hip. A CMT factor was derived from the 7 characteristics using confirmatory factor analysis. The association between the CMT factor score and 24-month pain (adjusted for baseline pain, radiographic OA (Kellgren-Lawrence (KL) scale) and demographic confounders) was investigated using generalised linear regression with a negative binomial link function.Results:At baseline, participants had a mean (SD) age 65(9) years, a BMI 29.6(5.1) kg/m2, 60% were female, 19.8% were African American, KL score was 1.92(1.35) indicating that the majority of the cohort had radiographic OA. Model diagnostics informed the CMT model, with the final model having an RMSEA of 0.073 (90%CI 0.070-0.076). Data were consistent with a single factor model for CMT. In the multivariable model, higher baseline CMT scores were significantly associated with 24-month WOMAC pain scores, with or without adjustment for baseline pain and other covariates, including KL score (multivariable model; std beta=0.173 (SE=0.027), p=0.004). Association of baseline CMT was of similar strength, and over and above association of KL score with 24-month pain (std beta=0.164 (SE=0.038), p=<0.001). Adjusted regression coefficients and associated p-values are shown in Table 1.Table 1.Adjusted regression coefficients for analysed variables against WOMAC pain at 24-monthsVariablesStd beta (SE)PSex-0.096 (0.101)0.344Age, y-0.001 (0.006)0.881BMI, kg/m20.017 (0.010)0.088Index Knee Kellgren-Lawrence Score0.164 (0.038)<0.001CMT Factor Score0.173 (0.060)0.004Baseline Pain0.857 (0.035)<0.001n=1421, rows in bold indicate significant association (p<0.05), associations adjusted for race and ethnicityConclusion:CMT predicts worse pain prognosis with a similar magnitude to radiographic OA even after adjustment for other factors. A self-report tool which included items relevant to the characteristics included in the CMT may help to select people with OA knee pain with unfavourable pain prognosis. Poor outcomes related to central pain mechanisms or to joint structural damage might be amenable to treatments addressing central or peripheral pain mechanisms respectively.References:[1]Akin-Akinyosoye et al., PAIN, 2018. 159(6): p. 1035-1044.Acknowledgements:This abstract was prepared using an Osteoarthritis Initiative (OAI) public use data set and does not necessarily reflect the opinions or views of the OAI investigators, the NIH, or the private funding partners. The authors wish to thank the participants, principal investigators, co-investigators and staff of all the hospitals who have contributed data to the OAI. The OAI is a public-private partnership comprised of five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health.Disclosure of Interests:Samuel Holden: None declared, Daniel McWilliams Grant/research support from: Pfizer and Eli Lilly, Stephanie Smith: None declared, David Walsh Consultant of: Pfizer, Eli Lilly, AbbVie and GlaxoSmithKline, Grant/research support from: Pfizer and Eli Lilly
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Tordoff M, Smith S, Lopez Isac E, Morris A, Eyre S, Thomson W, Bowes J. OP0014 HLA ASSOCIATIONS IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS ASSOCIATED UVEITIS AND CLINICAL SUBTYPES. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Juvenile idiopathic arthritis (JIA) is a childhood onset rheumatic disease which is classified into seven different clinical subtypes based upon the ILAR classification criteria. The most common extra articular manifestation of JIA is its associated uveitis (JIAU); particularly chronic anterior uveitis (CAU). Uveitis is a serious complication with the potential to lead to visual impairment and blindness. The rheumatoid factor negative polyarthritis and oligoarthritis ILAR subtypes, often referred to as the “polygo” subgroup, are at a higher risk for developing JIAU, with up to 30% of polygos afflicted by CAU. The HLA region has long been reported as a genetic risk factor for JIA susceptibility, with evidence suggesting that different amino acids of HLA genes infer risk to different JIA subtypes.Objectives:Investigate the association of amino acids and genetic variants in the HLA region with susceptibility to JIAU and the ILAR clinical subtypes.Methods:Samples were genotyped using the Illumina Infinium CoreExome and Infinium Onmiexpress arrays. Samples were excluded based on <98% call rate, discrepancy between genetically inferred sex and database records, inferred relatedness (identify-by-descent) and ancestral outliers based on principal component analysis (PCA). SNPs were excluded based on <0.01 minor allele frequency (MAF), and call rate <98%. SNP2HLA was used to impute HLA amino acids, SNPs and alleles. Analysis was then executed on markers with an information score >0.9 and MAF >.01 using logistic regression or an omnibus test for multiallelic markers, including 3 PCs as covariates. Independent associations were identified using forward stepwise logistic regression including previously identified variants as covariates. Comparison of regression models was performed using a likelihood ratio test (LRT).Results:We analysed 7425 markers within the HLA region in 450 JIAU and 2024 JIA cases without uveitis. The most significant association was to amino acid positions 13 of HLA-DRB1 (p=2.9×10-30). Conditional analysis on DRB1 position 13 revealed an independent signal at DRB1 position 67 (p=2.4×10-6). Conditioning on all DRB1 alleles revealed an independent signal at HLA-DPB1 position 69 (p=5.3×10-7). As expected, ILAR subtype was found to be associated with JIAU (p=1.58×10-6). We used LRT to test if genetics provided further information above ILAR subtype alone and found that including residues at DRB1 position 13 significantly improved the fit of a model based on ILAR subtype alone (LRT p = 3.6×10-27). The reciprocal analysis, adding ILAR subtype to a model based on DRB1 position 13 alone, did not significantly improve the fit of a model (LRT p=0.83). Exploring associations in the polygo subgroup (n=1646) we found significant associations to the three previously described amino acids and JIAU (DRB1 position 13 p=3.4×10-20, DRB1 position 67 p=3.3×10-4, DPB1 position 69 p=2.2×10-6).Conclusion:This is largest analysis of HLA markers in JIAU patients to date and we identify two independent associations to amino acids in HLA-DRB1 and a further independent association to HLA-DPB1. This analysis demonstrates that including data on genetic risk factors adds further information to that captured by ILAR subtype alone. It also reveals that the previously validated associations at position 13 of HLA-DRB1 are also correlated with JIAU in the polygo subtype suggesting that genetic risk factors will help refine risk within clinical subtypes. Conditioning on DRB1 alleles reveals that the secondary independent DRB1 position 69 association is also strongly associated in the polygo subset of this cohort. Together these results highlight the potential future use of genetics risk factors for risk classification for uveitis in patients with JIADisclosure of Interests:None declared
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Kelly D, Haugh C, O’Gorman L, Smith S. P.57 Retrospective review of conduct of general anaesthesia for caesarean section in a tertiary maternity unit. Int J Obstet Anesth 2021. [DOI: 10.1016/j.ijoa.2021.103055] [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: 11/30/2022]
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Muscat DM, Smith J, Mac O, Cadet T, Giguere A, Housten AJ, Langford AT, Smith S, Durand MA, McCaffery K. Addressing Health Literacy in Patient Decision Aids: An Update from the International Patient Decision Aid Standards. Med Decis Making 2021; 41:848-869. [PMID: 34053361 DOI: 10.1177/0272989x211011101] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is increasing recognition of the importance of addressing health literacy in patient decision aid (PtDA) development. PURPOSE An updated review as part of IPDAS 2.0 examined the extent to which PtDAs are designed to meet the needs of people with low health literacy/socially-disadvantaged populations. DATA SOURCES Reference lists of Cochrane reviews of randomized controlled trials (RCTs) of PtDAs (2014, 2017, and upcoming 2021 versions). STUDY SELECTION RCTs that assessed the impact of PtDAs on low health literacy or other socially-disadvantaged groups (i.e., ≥50% participants from socially-disadvantaged groups and/or subgroup analysis in socially-disadvantaged group/s). DATA EXTRACTION Two researchers independently extracted data into a standardized form including PtDA development and evaluation details. We searched online repositories and emailed authors to access PtDAs to verify grade reading level, understandability, and actionability. DATA SYNTHESIS Twenty-five of 213 RCTs met the inclusion criteria, illustrating that only 12% of studies addressed the needs of low health literacy or other socially-disadvantaged groups. Grade reading level was calculated in 8 of 25 studies (33%), which is recommended in previous IPDAS guidelines. We accessed and independently assessed 11 PtDAs. None were written at sixth-grade level or below. Ten PtDAs met the recommended threshold for understandability, but only 5 met the recommended threshold for actionability. We also conducted a post hoc subgroup meta-analysis and found that knowledge improvements after receiving a PtDA were greater in studies that reported using strategies to reduce cognitive demand in PtDA development compared with studies that did not (χ2 = 14.11, P = 0.0002, I2 = 92.9%). LIMITATIONS We were unable to access 13 of 24 PtDAs. Conclusions. Greater attention to health literacy and socially-disadvantaged populations is needed in the field of PtDAs to ensure equity in decision support.
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Shaffer VA, Brodney S, Gavaruzzi T, Zisman-Ilani Y, Munro S, Smith S, Thomas E, Valentine KD, Bekker HL. Do Personal Stories Make Patient Decision Aids More Effective? An Update from the International Patient Decision Aids Standards. Med Decis Making 2021; 41:897-906. [PMID: 34027739 DOI: 10.1177/0272989x211011100] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND This article evaluates the evidence for the inclusion of patient narratives in patient decision aids (PtDAs). We define patient narratives as stories, testimonials, or anecdotes that provide illustrative examples of the experiences of others that are relevant to the decision at hand. METHOD To evaluate the evidence for the effectiveness of narratives in PtDAs, we conducted a narrative scoping review of the literature from January 2013 through June 2019 to identify relevant literature published since the last International Patient Decision Aid Standards (IPDAS) update in 2013. We considered research articles that examined the impact of narratives on relevant outcomes or described relevant theoretical mechanisms. RESULTS The majority of the empirical work on narratives did not measure concepts that are typically found in the PtDA literature (e.g., decisional conflict). Yet, a few themes emerged from our review that can be applied to the PtDA context, including the impact of narratives on relevant outcomes (knowledge, behavior change, and psychological constructs), as well as several theoretical mechanisms about how and why narratives work that can be applied to the PtDA context. CONCLUSION Based on this evidence update, we suggest that there may be situations when narratives could enhance the effectiveness of PtDAs. The recent theoretical work on narratives has underscored the fact that narratives are a multifaceted construct and should no longer be considered a binary option (include narratives or not). However, the bottom line is that the evidence does not support a recommendation for narratives to be a necessary component of PtDAs.
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Borgarelli M, Ferasin L, Lamb K, Chiavegato D, Bussadori C, D'Agnolo G, Migliorini F, Poggi M, Santilli RA, Guillot E, Garelli-Paar C, Toschi Corneliani R, Farina F, Zani A, Dirven M, Smets P, Guglielmini C, Oliveira P, Di Marcello M, Porciello F, Crosara S, Ciaramella P, Piantedosi D, Smith S, Vannini S, Dall'Aglio E, Savarino P, Quintavalla C, Patteson M, Silva J, Locatelli C, Baron Toaldo M. The predictive value of clinical, radiographic, echocardiographic variables and cardiac biomarkers for assessing risk of the onset of heart failure or cardiac death in dogs with preclinical myxomatous mitral valve disease enrolled in the DELAY study. J Vet Cardiol 2021; 36:77-88. [PMID: 34118562 DOI: 10.1016/j.jvc.2021.04.009] [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: 06/01/2020] [Revised: 04/27/2021] [Accepted: 04/29/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To identify the predictive value on time to onset of heart failure (HF) or cardiac death of clinical, radiographic, and echocardiographic variables, as well as cardiac biomarkers N-terminal pro brain natriuretic peptide (NT-proBNP) and cardiac troponin I in dogs with preclinical myxomatous mitral valve disease (MMVD). ANIMALS One hundred sixty-eight dogs with preclinical MMVD and left atrium to aortic root ratio ≥1.6 (LA:Ao) and normalized left ventricular end-diastolic diameter ≥1.7 were included. METHODS Prospective, randomized, multicenter, single-blinded, placebo-controlled study. Clinical, radiographic, echocardiographic variables and plasma cardiac biomarkers concentrations were compared at different time points. Using receiving operating curves analysis, best cutoff for selected variables was identified and the risk to develop the study endpoint at six-month intervals was calculated. RESULTS Left atrial to aortic root ratio >2.1 (hazard ratio [HR] 3.2, 95% confidence interval [95% CI] 1.9-5.6), normalized left ventricular end-diastolic diameter > 1.9 (HR: 6.3; 95% CI: 3.3-11.8), early transmitral peak velocity (E peak) > 1 m/sec (HR: 3.9; 95% CI: 2.3-6.7), and NT-proBNP > 1500 ρmol/L (HR: 5.7; 95% CI: 3.3-9.5) were associated with increased risk of HF or cardiac death. The best fit model to predict the risk to reach the endpoint was represented by the plasma NT-proBNP concentrations adjusted for LA:Ao and E peak. CONCLUSIONS Logistic and survival models including echocardiographic variables and NT-proBNP can be used to identify dogs with preclinical MMVD at higher risk to develop HF or cardiac death.
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Kong H, Francois S, Smith S, Spraker M, Lawley L, Lee G, Chen K, Roberts J, Chen S. 300 Comparison of ItchyQuant, KidsItchyQoL and TweenItchyQoL: Pruritus assessment tools for 6-7-year-olds vs. 8-17 year olds. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.322] [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]
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Sherman S, Chen W, Blewett TA, Smith S, Middleton E, Garman E, Schlekat C, McGeer JC. Complexation reduces nickel toxicity to purple sea urchin embryos (Strongylocentrotus purpuratus), a test of biotic ligand principles in seawater. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 216:112156. [PMID: 33823367 DOI: 10.1016/j.ecoenv.2021.112156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 03/12/2021] [Accepted: 03/13/2021] [Indexed: 06/12/2023]
Abstract
The potential for Ni toxicity in seawater is of concern because of mining and processing activities in coastal regions. Determining Ni speciation is vital to understanding and predicting Ni toxicity and for bioavailability-based nickel risk assessment. The goal of this study was to characterize the complexation of Ni in relation to toxicity using embryological development of purple sea urchin (S. purpuratus). It was predicted that free ion [Ni2+] would be a better predictor of toxicity than total dissolved Ni concentrations (NiD). Synthetic ligands with known logKf values (Ethylenediaminetetraacetic acid (EDTA), Nitrilotriacetic acid (NTA), tryptophan (TRP), glutamic acid (GA), histidine (HD), and citric acid (CA)) were used to test the assumptions of the biotic ligand model (BLM) for Ni in seawater. [NiD] was measured by graphite furnace atomic absorption spectroscopy (GFAAS) and Ni2+ was first quantified using the ion-exchange technique (IET) and then concentrations were measured by GFAAS; [Ni2+] was also estimated using aquatic geochemistry modelling software (Visual Minteq). The mean EC50 values for [NiD] in unmodified artificial seawater control was 3.6 µM (95% CI 3.0-4.5) [211 µg/L 95% CI 176-264] and the addition of ligands provided protection, up to 6.5-fold higher [NiD] EC50 for EDTA. Compared to the control, measured EC50 values based on total dissolved nickel were higher in the presence of ligands. As predicted by BLM theory, [Ni2+] was a better predictor of Ni toxicity with 17% variability in EDTA and CA media while there was 72% variability in the prediction of Ni toxicity with total dissolved Ni. The results of this research provide support for the application of BLM- based prediction models for estimating Ni impacts in seawater.
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Cathcart P, Smith S, Clayton G. Strengths and limitations of video-conference multidisciplinary management of breast disease during the COVID-19 pandemic. Br J Surg 2021; 108:e20-e21. [PMID: 33640926 PMCID: PMC7799240 DOI: 10.1093/bjs/znaa046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/20/2020] [Indexed: 11/18/2022]
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68
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Dardenne E, Padilla F, Rasmussen S, Yang S, Mentes A, Ogawa L, Fiorenza R, Trombino A, Smith S, Romashko D, Ishiyama N, Chevtsova M, Thakur S, Rosfjord E, Buck E, Roberts C, Lucas M, Lin TA. 35MO Discovery and characterization of selective, FGFR1-sparing, inhibitors of FGFR2/3 oncogenic mutations for the treatment of cancers. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.01.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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69
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Han YC, Ng P, Schulz R, Yang S, Lelo A, Ogawa L, O'Connor M, Ishiyama N, Jewett I, Romashko D, Salomatov A, Thakur S, Smith S, Buck E, Roberts C, Lucas M, Lin TA. 43P Pre-clinical evaluation of potent and orally bioavailable next-generation inhibitors targeting the family of mutants that drive oncogenic BRAF dimer formation. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.01.058] [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] Open
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70
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Chen Y, Mcivor F, Smith S, Naidoo R. M14 The Impact of Cardiopulmonary Bypass and Cross-Clamp Time on Patient Outcomes. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.03.023] [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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71
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Goh S, Smith S, Pearse B, Margale S, Smith I, Thomson B, Tesar P. R44 The Impact of Targeted Bleeding Management on Blood Component Therapy in Heart Transplant Recipients. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.03.202] [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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72
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Dermedgoglou A, Smith S, Kennedy B, Poulgrain S, Paavola M, Minto T, Luc M, Liu Y, Starmer G, Hanson J. The Cardiovascular Manifestations of Severe Leptospirosis in Far North Queensland. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.337] [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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73
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McLeod A, Hutchinson SJ, Smith S, Leen C, Clifford S, McAuley A, Wallace LA, Barclay ST, Bramley P, Dillon JF, Fraser A, Gunson RN, Hayes PC, Kennedy N, Peters E, Templeton K, Goldberg DJ. Increased case-finding and uptake of direct-acting antiviral treatment essential for micro-elimination of hepatitis C among people living with HIV: a national record linkage study. HIV Med 2020; 22:334-345. [PMID: 33350049 DOI: 10.1111/hiv.13032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Micro-elimination of hepatitis C virus (HCV) in people living with HIV (PLHIV) and co-infected with HCV has been proposed as a key contribution to the overall goal of HCV elimination. While other studies have examined micro-elimination in HIV-treated cohorts, few have considered HCV micro-elimination among those not treated for HIV or at a national level. METHODS Through data linkage of national and sentinel surveillance data, we examined the extent of HCV testing, diagnosis and treatment among a cohort of PLHIV in Scotland identified through the national database of HIV-diagnosed individuals, up to the end of 2017. RESULTS Of 5018 PLHIV, an estimated 797 (15%) had never been tested for HCV and 70 (9%) of these had undiagnosed chronic HCV. The odds of never having been tested for HCV were the highest in those not on HIV treatment [adjusted odds ratio (aOR) = 7.21, 95% confidence interval (CI): 5.15-10.10). Overall HCV antibody positivity was 11%, and it was at its highest among people who inject drugs (49%). Most of those with chronic HCV (91%) had attended an HCV treatment clinic but only half had been successfully treated (54% for those on HIV treatment, 12% for those not) by the end of 2017. The odds of never having been treated for HCV were the highest in those not on HIV treatment (aOR = 3.60, 95% CI: 1.59-8.15). CONCLUSIONS Our data demonstrate that micro-elimination of HCV in PLHIV is achievable but progress will require increased effort to engage and treat those co-infected, including those not being treated for their HIV.
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Romanelli M, Coelho R, Coster D, Ferreira J, Fleury L, Henderson S, Hollocombe J, Imbeaux F, Jonsson T, Kogan L, Meneghini O, Merle A, Pinches SD, Sauter O, Tardini G, Yadykin D, Smith S, Strand P, WPCD Team. Code Integration, Data Verification, and Models Validation Using the ITER Integrated Modeling and Analysis System (IMAS) in EUROfusion. FUSION SCIENCE AND TECHNOLOGY 2020. [DOI: 10.1080/15361055.2020.1819751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Gupta A, Qiao Y, Shrestha S, Owens C, Lee C, Ditty C, Smith S, Weathers R, Howell R. PO-1330: On the Implementation and Validation of 3D Computational Pediatric Phantoms in Commercial TPS. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01348-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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