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Klein J, Boyle JA, Kirkham R, Connors C, Whitbread C, Oats J, Barzi F, McIntyre D, Lee I, Luey M, Shaw J, Brown ADH, Maple-Brown LJ. Preconception care for women with type 2 diabetes mellitus: A mixed-methods study of provider knowledge and practice. Diabetes Res Clin Pract 2017; 129:105-115. [PMID: 28521194 DOI: 10.1016/j.diabres.2017.03.035] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 02/03/2017] [Accepted: 03/28/2017] [Indexed: 11/18/2022]
Abstract
AIMS Preconception care may decrease adverse pregnancy outcomes associated with pre-existing diabetes mellitus. Aboriginal Australians are at high risk of type 2 diabetes mellitus (T2DM), with earlier onset. We explored practitioner views on preconception care delivery for women with T2DM in the Northern Territory, where 31% of births are to Aboriginal women. METHODS Mixed-methods study including cross-sectional survey of 156 health practitioners and 11 semi-structured interviews. RESULTS Practitioners reported low attendance for preconception care however, 51% provided counselling on an opportunistic basis. Rural/remote practitioners were most likely to find counselling feasible. The majority (69%) utilised appropriate guidelines and addressed lifestyle modifications including smoking (81%), weight management (79%), and change medications appropriately such as ceasing ACE inhibitors (69%). Fewer (40%) prescribed the recommended dose of folate (5mg) or felt comfortable recommending delaying pregnancy to achieve optimal preconception glucose control (42%). Themes identified as barriers to care included the complexity of care setting and infrequent preconception consultations. There was a focus on motivation of women to make informed choices about conception, including birth spacing, timing and contraception. Preconception care enablers included cross-cultural communication, a multi-disciplinary care team and strong client-based relationships. CONCLUSIONS Health practitioners are keen to provide preconception counselling and reported knowledge of evidence-based guidelines. Improvements are needed in recommending high dose folate and optimising glucose control. Cross-cultural communication and team-based care were reported as fundamental to successful preconception care in women with T2DM. Continued education and policy changes are required to support practitioners in opportunities to enhance pregnancy planning.
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Shaw J, Sadowski C, Silvius J, Chelak K, Turner J, Tannenbaum C. WHAT POLICIES ARE IN USE ACROSS CANADA TO REDUCE INAPPROPRIATE MEDICATION USE IN OLDER ADULTS? Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tannenbaum C, Morgan S, Farrell B, Trimble J, Currie J, Shaw J, Silvius J. ENABLING KNOWLEDGE TRANSLATION THROUGH THE CANADIAN DEPRESCRIBING NETWORK. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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79
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Shaw J, de Wit C, Le Gal G, Carrier M. Thrombotic and bleeding outcomes following perioperative interruption of direct oral anticoagulants in patients with venous thromboembolic disease. J Thromb Haemost 2017; 15:925-930. [PMID: 28296069 DOI: 10.1111/jth.13670] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 03/04/2017] [Indexed: 11/29/2022]
Abstract
Essentials Studies evaluating the procedural interruption of direct oral anticoagulants (DOACs) are lacking. We conducted a study of the interruption of DOACs for prior venous thromboembolic disease (VTE). The post-operative risks of recurrent VTE and major bleeding are low in this patient population. A scheme based on half-life and procedure-related bleeding appears safe and efficacious. SUMMARY Background Direct oral anticoagulants (DOACs) are increasingly being used in the setting of venous thromboembolic disease (VTE). There is little evidence to guide the peri-procedural interruption of DOACs in this patient population. A number of studies have evaluated the perioperative interruption of DOACs based on half-life of the anticoagulant and the underlying procedural bleeding risk in patient with atrial fibrillation, but it remains unclear whether these findings can be extended to patients with VTE. Objective Evaluate thrombotic and bleeding outcomes following the perioperative interruption of direct oral anticoagulation in patients with prior VTE. Methods We conducted a retrospective analysis of consecutive patients on a DOAC for prior VTE requiring temporary interruption of anticoagulation for an invasive procedure. The primary efficacy outcome was the 30-day symptomatic VTE rate, and the primary safety outcome was the 30-day major bleeding rate. Secondary outcomes included overall mortality and the rate of clinically relevant non-major bleeding. Results A total of 190 patients were included in the analysis. The 30-day VTE rate was 1.05% (95% CI, 0.29-3.8%) and the 30-day major bleeding rate was 0.53% (95% CI, 0.09-2.93%). There were no deaths during the 30-day follow-up period. The rate of clinically relevant non-major bleeding was 3.16% (95%CI , 1.46-6.72%). Conclusions The perioperative interruption of DOACs in the setting of VTE, using a strategy that considers the half-life of the DOAC and the underlying procedural bleeding risk, appears to be both safe and effective.
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Byrne K, Waller J, Piercy J, Shaw J, Dastani H. P02.03 Real-world treatment patterns in glioblastoma multiforme (GBM). Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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81
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Shaw J, Leonard C, Chaudhuri N. Feather bedding as a cause of hypersensitivity pneumonitis. QJM 2017; 110:233-234. [PMID: 28062740 DOI: 10.1093/qjmed/hcx010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Indexed: 11/14/2022] Open
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82
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Shillington A, Macahilig C, Shaw J, Dastani H. P02.02 Treatment and Outcomes in Glioblastoma Multiforme: A multi-country chart review study. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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83
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Byrne K, Waller J, Piercy J, Shaw J, Dastani H. P18.10 Impact of glioblastoma multiforme (GBM) on patients’ quality of life (QoL). Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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84
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Murphy MJ, Newby JM, Butow P, Kirsten L, Allison K, Loughnan S, Price MA, Shaw J, Shepherd H, Smith J, Andrews G. iCanADAPT Early protocol: randomised controlled trial (RCT) of clinician supervised transdiagnostic internet-delivered cognitive behaviour therapy (iCBT) for depression and/or anxiety in early stage cancer survivors -vs- treatment as usual. BMC Cancer 2017; 17:193. [PMID: 28298187 PMCID: PMC5353884 DOI: 10.1186/s12885-017-3182-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 03/08/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND This RCT with two parallel arms will evaluate the efficacy of an internet-delivered transdiagnostic cognitive behavioural therapy (iCBT) intervention for the treatment of clinical depression and/or anxiety in early stage cancer survivors. METHODS/DESIGN Early stage cancer survivors will be recruited via the research arm of a not-for-profit clinical research unit and randomised to an intervention (iCBT) group or a 'treatment as usual' (TAU) control group. The minimum sample size for each group is 45 people (assuming effect size > 0.6, power of 80%, and alpha at .05), but 10% more will be recruited to account for attrition. A solitary or cumulative diagnosis(es) of Major Depressive Episode (current), Generalised Anxiety Disorder, Illness Anxiety Disorder, Panic Disorder, Agoraphobia, and/or Adjustment disorder will be determined using modules from the Anxiety Disorders Interview Schedule for DSM-5. Depression and anxiety levels with be measured via the total score of the Hospital Anxiety and Depression scale (HADS-T), the primary outcome measure. Secondary measures will include the Kessler 10 to measure general distress, the Fear of Cancer Recurrence Inventory (FCRI) to measure the specific fear of cancer recurrence and the Functional Assessment of Cancer Therapy, General Version 4 (FACT-G) for self-report of physical, social, emotional and functional well-being. iCBT participants will complete the measures before lessons 1 and 5, at post-treatment and at 3-month follow-up. The TAU group will complete similar measures at weeks 1, 8 and 16 of the waiting period. Program efficacy will be determined using intent-to-treat mixed models. Maintenance of gains will be assessed at 3-month follow-up. Mediation analyses using PROCESS will be used to examine the association between change in depressive and anxious symptoms over time and changes in FCRI and FACT-G QOL in separate analysis. DISCUSSION This is the first RCT looking at iCBT specifically for clinical depression and/or anxiety in a cancer population. Findings will help to direct the role of iCBT in streamlined psycho-social care pathways. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12616000231448, registered 19th February 2016 ( www.anzctr.org.au ). This trial protocol is in compliance with the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines.
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Phillips B, Shaw J, Turco L, McDonald D, Carey J, Balters M, Wagner M, Bertellotti R, Cornell DL, Agrawal DK, Asensio JA. Traumatic pulmonary pseudocyst: An underreported entity. Injury 2017; 48:214-220. [PMID: 27986273 DOI: 10.1016/j.injury.2016.12.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 12/11/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Traumatic pulmonary pseudocysts (TPP) are underreported cavitary lesions of the pulmonary parenchyma that can develop following blunt chest trauma. Although the occurrence of traumatic pulmonary pseudocyst is rare, this condition should be considered in the differential diagnosis of any cavitary lesion. Awareness of this injury and its clinical significance is important for successful management in order to avoid medical errors in the course of treatment. METHODS A literature search was conducted through Medline using the key phrases "traumatic pulmonary pseudocyst" and "traumatic pneumatocele." Relevant articles, especially those with focus on diagnosis and management of traumatic pneumatocele in adults, were selected. Due to the scarcity of literature and lack of Level I evidence on this subject, studies published in any year were considered. RESULTS A search of "traumatic pulmonary pseudocyst" and "traumatic pneumatocele" yielded 114 studies. Most of these were excluded based on inclusion and exclusion criteria. Thirty-five articles were reviewed. The majority of these were individual case studies; only eight articles were considered large case studies (greater than eight patients). CONCLUSION Traumatic pulmonary pseudocysts are lesions that occur secondary to blunt chest trauma. Diagnosis is based on a history of trauma and appearance of a cystic lesion on CT. Accurate diagnosis of traumatic pulmonary pseudocyst is imperative to achieve successful outcomes. Failure to do so may lead to unnecessary procedures and complications.
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Kantharia S, Cornish N, Portnow L, Brichkov I, Shaw J, Harris L, Honig S, Sobolevsky S. Radiofrequency ablation for primary lung carcinomas: a retrospective review at a community hospital. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.1094] [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] Open
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87
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Shaw J, Bajaj JS. Editorial: should the inappropriate use of proton pump inhibitors be a quality assurance issue in cirrhotic patients? Aliment Pharmacol Ther 2017; 45:476-477. [PMID: 28043093 DOI: 10.1111/apt.13875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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88
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Dawson L, Dagan M, Walton A, Stub D, Duffy S, Shaw J. Significance of Iliac Vessel Disease and Coronary Artery Disease in Patients with Severe Aortic Stenosis being Considered for Transcatheter Aortic Valve Implantation. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.436] [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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89
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Cartledge S, Finn J, Bray J, Case R, Barker L, Missen D, Shaw J, Stub D. Incorporating Cardiopulmonary Resuscitation Training into a Cardiac Rehabilitation Program: A Feasibility Study. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.705] [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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90
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Biswas S, Duffy S, Lefkovits J, Andrianopoulos N, Brennan A, Walton A, Shaw J, Chan W, Ajani A, Clark D, Freeman M, Hiew C, Oqueli E, Reid C, Stub D. Impact of Socioeconomic Status on Risk Factors, Treatment and Clinical Outcomes in Patients Undergoing Percutaneous Coronary Intervention (PCI) for ST-Elevation Myocardial Infarction (STEMI). Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.687] [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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91
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Dagan M, Dawson L, Shaw J. Angiographic Severity of Peripheral Artery Disease Does Not Correlate with Severity of Coronary Artery Disease. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.059] [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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92
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Dolatshad H, Pellagatti A, Liberante FG, Llorian M, Repapi E, Steeples V, Roy S, Scifo L, Armstrong RN, Shaw J, Yip BH, Killick S, Kušec R, Taylor S, Mills KI, Savage KI, Smith CWJ, Boultwood J. Cryptic splicing events in the iron transporter ABCB7 and other key target genes in SF3B1-mutant myelodysplastic syndromes. Leukemia 2016; 30:2322-2331. [PMID: 27211273 PMCID: PMC5029572 DOI: 10.1038/leu.2016.149] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 05/04/2016] [Accepted: 05/16/2016] [Indexed: 02/08/2023]
Abstract
The splicing factor SF3B1 is the most frequently mutated gene in myelodysplastic syndromes (MDS), and is strongly associated with the presence of ring sideroblasts (RS). We have performed a systematic analysis of cryptic splicing abnormalities from RNA sequencing data on hematopoietic stem cells (HSCs) of SF3B1-mutant MDS cases with RS. Aberrant splicing events in many downstream target genes were identified and cryptic 3' splice site usage was a frequent event in SF3B1-mutant MDS. The iron transporter ABCB7 is a well-recognized candidate gene showing marked downregulation in MDS with RS. Our analysis unveiled aberrant ABCB7 splicing, due to usage of an alternative 3' splice site in MDS patient samples, giving rise to a premature termination codon in the ABCB7 mRNA. Treatment of cultured SF3B1-mutant MDS erythroblasts and a CRISPR/Cas9-generated SF3B1-mutant cell line with the nonsense-mediated decay (NMD) inhibitor cycloheximide showed that the aberrantly spliced ABCB7 transcript is targeted by NMD. We describe cryptic splicing events in the HSCs of SF3B1-mutant MDS, and our data support a model in which NMD-induced downregulation of the iron exporter ABCB7 mRNA transcript resulting from aberrant splicing caused by mutant SF3B1 underlies the increased mitochondrial iron accumulation found in MDS patients with RS.
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Windfuhr K, While D, Kapur N, Ashcroft DM, Kontopantelis E, Carr MJ, Shaw J, Appleby L, Webb RT. Suicide risk linked with clinical consultation frequency, psychiatric diagnoses and psychotropic medication prescribing in a national study of primary-care patients. Psychol Med 2016; 46:3407-3417. [PMID: 27650367 DOI: 10.1017/s0033291716001823] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Little is known about the precursors of suicide risk among primary-care patients. This study aimed to examine suicide risk in relation to patterns of clinical consultation, psychotropic drug prescribing, and psychiatric diagnoses. METHOD Nested case-control study in the Clinical Practice Research Datalink (CPRD), England. Patients aged ⩾16 years who died by suicide during 2002-2011 (N = 2384) were matched on gender, age and practice with up to 20 living control patients (N = 46 899). RESULTS Risk was raised among non-consulting patients, and increased sharply with rising number of consultations in the preceding year [⩾12 consultations v. 1: unadjusted odds ratio (OR) 6.0, 95% confidence interval (CI) 4.9-7.3]. Markedly elevated risk was also associated with the prescribing of multiple psychotropic medication types (⩾5 types v. 0: OR 62.6, CI 44.3-88.4) and with having several psychiatric diagnoses (⩾4 diagnoses v. 0: OR 31.1, CI 19.3-50.1). Risk was also raised among patients living in more socially deprived localities. The confounding effect of multiple psychotropic drug types largely accounted for the rising risk gradient observed with increasing consultation frequency. CONCLUSIONS A greater proportion of patients with several psychiatric diagnoses, those prescribed multiple psychotropic medication types, and those who consult at very high frequency might be considered for referral to mental health services by their general practitioners. Non-consulters are also at increased risk, which suggests that conventional models of primary care may not be effective in meeting the needs of all people in the community experiencing major psychosocial difficulties.
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Aoun J, Shaw J, Eisenstein D, Tsafrir Z. Diagnosis of Occult Hernia in Women with Unexplained Chronic Pelvic Pain. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.046] [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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95
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Harrington K, Ferris R, Shaw J, Taylor F, Derosa M, Turner-Bowker D, Morrissey L, Cocks K, Kiyota N, Gillison M, Guigay J. head and neck cancer Patient-reported outcomes (PROs) in recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN) treated with nivolumab (nivo) or investigator’s choice (IC): CheckMate 141. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw435.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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96
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Argiris A, Gillison M, Ferris R, Harrington K, Sanchez T, Baudelet C, Geese W, Shaw J, Haddad R. A randomized, open-label, phase 3 study of nivolumab in combination with ipilimumab vs extreme regimen (cetuximab + cisplatin/carboplatin + fluorouracil) as first-line therapy in patients with recurrent or metastatic squamous cell carcinoma of the head and neck-CheckMate 651. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw376.68] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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97
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Dawson L, Broughton A, Taylor A, Shaw J. Trends in the Procedural Characteristics and Clinical Outcomes in Patients Undergoing Percutaneous Revascularisation for the Treatment of ST Elevation Myocardial Infection. A Single Centre Experience. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.159] [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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98
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Cartledge S, Bray J, Stub D, Ngu P, Straney L, Stewart M, Keech W, Patsamanis H, Shaw J, Finn J. Factors Associated with Emergency Medical Service Use for Acute Coronary Syndrome Patients in Victoria. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.103] [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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99
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Peck K, Wang J, Shaw J, Dart A. Aortic Valve Area (AVA) and Dimensionless Performance Index (DPI) Predicts Progression of Aortic Stenosis. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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100
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Leask S, Jack R, McKee C, Shaw J, Regan L. The implementation of a patient-focused database for search and rescue patients retrieved by the newly established national search and rescue service. Rural Remote Health 2016. [DOI: 10.22605/rrh4120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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