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Griffiths AD, Islim MS, Herrnsdorf J, McKendry JJD, Henderson R, Haas H, Gu E, Dawson MD. CMOS-integrated GaN LED array for discrete power level stepping in visible light communications. OPTICS EXPRESS 2017; 25:A338-A345. [PMID: 28437920 DOI: 10.1364/oe.25.00a338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
We report a CMOS integrated micro-LED array capable of generating discrete optical output power levels. A 16 × 16 array of individually addressable pixels are on-off controlled through parallel logic signals. With carefully selected groups of LEDs driven together, signals suitable for discrete transmission schemes are produced. The linearity of the device is assessed, and data transmission using pulse amplitude modulation (PAM) and orthogonal frequency division multiplexing (OFDM) is performed. Error-free transmission at a symbol rate of 100 MSamples/s is demonstrated with 4-PAM, yielding a data rate of 200 Mb/s. For 8-PAM, encoding is required to overcome the baseline wander from the receiver, reducing the data rate to 150 Mb/s. We also present an experimental proof-of-concept demonstration of discrete-level OFDM, achieving a spectral efficiency of 3.96 bits/s/Hz.
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Henderson R. Expert’s comment concerning Grand Rounds case entitled “Intracardiac bone cement embolism as a complication of vertebroplasty: management strategy” by Hatzantonis C, Czyz M, Pyzik R, Boszczyk BM. (Eur Spine J; 2016. doi:10.1007/s00586-016-4695-x). EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2017; 26:3206-3208. [DOI: 10.1007/s00586-017-5089-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 04/03/2017] [Indexed: 12/14/2022]
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Henderson R. “Opening the Heart”: An Interview with Steve Parker. PSYCHOLOGICAL PERSPECTIVES-A QUARTERLY JOURNAL OF JUNGIAN THOUGHT 2017. [DOI: 10.1080/00332925.2017.1314700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Warburton R, Aniculaesei C, Clerici M, Altmann Y, Gariepy G, McCracken R, Reid D, McLaughlin S, Petrovich M, Hayes J, Henderson R, Faccio D, Leach J. Observation of laser pulse propagation in optical fibers with a SPAD camera. Sci Rep 2017; 7:43302. [PMID: 28266554 PMCID: PMC5339868 DOI: 10.1038/srep43302] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 01/24/2017] [Indexed: 11/09/2022] Open
Abstract
Recording processes and events that occur on sub-nanosecond timescales poses a difficult challenge. Conventional ultrafast imaging techniques often rely on long data collection times, which can be due to limited device sensitivity and/or the requirement of scanning the detection system to form an image. In this work, we use a single-photon avalanche detector array camera with pico-second timing accuracy to detect photons scattered by the cladding in optical fibers. We use this method to film supercontinuum generation and track a GHz pulse train in optical fibers. We also show how the limited spatial resolution of the array can be improved with computational imaging. The single-photon sensitivity of the camera and the absence of scanning the detection system results in short total acquisition times, as low as a few seconds depending on light levels. Our results allow us to calculate the group index of different wavelength bands within the supercontinuum generation process. This technology can be applied to a range of applications, e.g., the characterization of ultrafast processes, time-resolved fluorescence imaging, three-dimensional depth imaging, and tracking hidden objects around a corner.
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Jones JR, Cairns DA, Gregory WM, Collett C, Pawlyn C, Sigsworth R, Striha A, Henderson R, Kaiser MF, Jenner M, Cook G, Russell NH, Williams C, Pratt G, Kishore B, Lindsay J, Drayson MT, Davies FE, Boyd KD, Owen RG, Jackson GH, Morgan GJ. Second malignancies in the context of lenalidomide treatment: an analysis of 2732 myeloma patients enrolled to the Myeloma XI trial. Blood Cancer J 2016; 6:e506. [PMID: 27935580 PMCID: PMC5223149 DOI: 10.1038/bcj.2016.114] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 10/24/2016] [Indexed: 12/26/2022] Open
Abstract
We have carried out the largest randomised trial to date of newly diagnosed myeloma patients, in which lenalidomide has been used as an induction and maintenance treatment option and here report its impact on second primary malignancy (SPM) incidence and pathology. After review, 104 SPMs were confirmed in 96 of 2732 trial patients. The cumulative incidence of SPM was 0.7% (95% confidence interval (CI) 0.4–1.0%), 2.3% (95% CI 1.6–2.7%) and 3.8% (95% CI 2.9–4.6%) at 1, 2 and 3 years, respectively. Patients receiving maintenance lenalidomide had a significantly higher SPM incidence overall (P=0.011). Age is a risk factor with the highest SPM incidence observed in transplant non-eligible patients aged >74 years receiving lenalidomide maintenance. The 3-year cumulative incidence in this group was 17.3% (95% CI 8.2–26.4%), compared with 6.5% (95% CI 0.2–12.9%) in observation only patients (P=0.049). There was a low overall incidence of haematological SPM (0.5%). The higher SPM incidence in patients receiving lenalidomide maintenance therapy, especially in advanced age, warrants ongoing monitoring although the benefit on survival is likely to outweigh risk.
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Haile M, Sarwar O, Henderson R, Smith R, Grunlan JC. Polyelectrolyte Coacervates Deposited as High Gas Barrier Thin Films. Macromol Rapid Commun 2016; 38. [PMID: 27859856 DOI: 10.1002/marc.201600594] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 10/21/2016] [Indexed: 01/10/2023]
Abstract
Multilayer coatings consisting of oppositely charged polyelectrolytes have proven to be extraordinarily effective oxygen barriers but require many processing steps to fabricate. In an effort to prepare high oxygen barrier thin films more quickly, a polyelectrolyte complex coacervate composed of polyethylenimine and polyacrylic acid is prepared. The coacervate fluid is applied as a thin film using a rod coating process. With humidity and thermal post-treatment, a 2 µm thin film reduces the oxygen transmission rate of 0.127 mm poly(ethylene terephthalate) by two orders of magnitude, rivalling conventional oxygen barrier technologies. These films are fabricated in ambient conditions using low-cost, water-based solutions, providing a tremendous opportunity for single-step deposition of polymeric high barrier thin films.
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Henderson R, Gandhi G, Sevart N, Gragg S, Phebus R, Amamcharla JK. 0714 Use of ozonated water in removing Bacillus cereus biofilms from the dairy membranes. J Anim Sci 2016. [DOI: 10.2527/jam2016-0714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Talman P, Duong T, Vucic S, Mathers S, Venkatesh S, Henderson R, Rowe D, Schultz D, Edis R, Needham M, Macdonnell R, McCombe P, Birks C, Kiernan M. Identification and outcomes of clinical phenotypes in amyotrophic lateral sclerosis/motor neuron disease: Australian National Motor Neuron Disease observational cohort. BMJ Open 2016; 6:e012054. [PMID: 27694488 PMCID: PMC5051496 DOI: 10.1136/bmjopen-2016-012054] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To capture the clinical patterns, timing of key milestones and survival of patients presenting with amyotrophic lateral sclerosis/motor neuron disease (ALS/MND) within Australia. METHODS Data were prospectively collected and were timed to normal clinical assessments. An initial registration clinical report form (CRF) and subsequent ongoing assessment CRFs were submitted with a completion CRF at the time of death. DESIGN Prospective observational cohort study. PARTICIPANTS 1834 patients with a diagnosis of ALS/MND were registered and followed in ALS/MND clinics between 2005 and 2015. RESULTS 5 major clinical phenotypes were determined and included ALS bulbar onset, ALS cervical onset and ALS lumbar onset, flail arm and leg and primary lateral sclerosis (PLS). Of the 1834 registered patients, 1677 (90%) could be allocated a clinical phenotype. ALS bulbar onset had a significantly lower length of survival when compared with all other clinical phenotypes (p<0.004). There were delays in the median time to diagnosis of up to 12 months for the ALS phenotypes, 18 months for the flail limb phenotypes and 19 months for PLS. Riluzole treatment was started in 78-85% of cases. The median delays in initiating riluzole therapy, from symptom onset, varied from 10 to 12 months in the ALS phenotypes and 15-18 months in the flail limb phenotypes. Percutaneous endoscopic gastrostomy was implemented in 8-36% of ALS phenotypes and 2-9% of the flail phenotypes. Non-invasive ventilation was started in 16-22% of ALS phenotypes and 21-29% of flail phenotypes. CONCLUSIONS The establishment of a cohort registry for ALS/MND is able to determine clinical phenotypes, survival and monitor time to key milestones in disease progression. It is intended to expand the cohort to a more population-based registry using opt-out methodology and facilitate data linkage to other national registries.
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Thompson D, Henderson R, Moore W, Liasis A, Keenan J, Bowman R. Retinal microcysts associated with optic atrophy in children - visual electrophysiology studies. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0445] [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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Smallcombe J, Moukaddam M, Evitts LJ, Garnsworthy AB, Hallam S, Andreoiu C, Ball GC, Bolton C, Caballero-Folch R, Constable M, Cross DS, Garrett PE, Hackman G, Henderson J, Henderson R, Ketelhut S, Kruecken R, Kurchaninov L, Park J, Pore JL, Rand ET, Ruotsalainen P, Smith JK, Svensson CE, Williams M. SPectrometer for Internal Conversion Electrons (SPICE) at TRIUMF-ISAC. EPJ WEB OF CONFERENCES 2016. [DOI: 10.1051/epjconf/201612304005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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O'Callaghan C, Henderson R, Masel P, Tay G, Tsang B. Adult‐onset Pompe's disease presenting with insidious hypercapnic respiratory failure. Respirol Case Rep 2016; 4:e00178. [PMID: 28127431 PMCID: PMC5256953 DOI: 10.1002/rcr2.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 06/01/2016] [Accepted: 06/21/2016] [Indexed: 11/06/2022] Open
Abstract
Orthopnoea is commonly attributed to heart failure but can be caused by diaphragm weakness, which, when severe, is often associated with hypercapnic respiratory failure. Bilateral diaphragm weakness is generally due to systemic nerve or muscle disease and usually occurs in the setting of severe generalized muscle weakness, but the diaphragm can be the initial or only muscle involved. Here, we report the case of a 39‐year‐old female who presented with slowly progressive orthopnoea and daytime somnolence. Pulmonary function studies and polysomnogram confirmed bilateral diaphragm weakness complicated by nocturnal hypoventilation and she was subsequently diagnosed with adult‐onset Pompe's disease, a rare metabolic myopathy.
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Calvert PA, Northridge DB, Malik IS, Shapiro L, Ludman P, Qureshi SA, Mullen M, Henderson R, Turner M, Been M, Walsh KP, Casserly I, Morrison L, Walker NL, Thomson J, Spence MS, Mahadevan VS, Hoye A, MacCarthy PA, Daniels MJ, Clift P, Davies WR, Adamson PD, Morgan G, Aggarwal SK, Ismail Y, Ormerod JOM, Khan HR, Chandran SS, de Giovanni J, Rana BS, Ormerod O, Hildick-Smith D. Percutaneous Device Closure of Paravalvular Leak: Combined Experience From the United Kingdom and Ireland. Circulation 2016; 134:934-44. [PMID: 27587432 DOI: 10.1161/circulationaha.116.022684] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 08/05/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Paravalvular leak (PVL) occurs in 5% to 17% of patients following surgical valve replacement. Percutaneous device closure represents an alternative to repeat surgery. METHODS All UK and Ireland centers undertaking percutaneous PVL closure submitted data to the UK PVL Registry. Data were analyzed for association with death and major adverse cardiovascular events (MACE) at follow-up. RESULTS Three hundred eight PVL closure procedures were attempted in 259 patients in 20 centers (2004-2015). Patient age was 67±13 years; 28% were female. The main indications for closure were heart failure (80%) and hemolysis (16%). Devices were successfully implanted in 91% of patients, via radial (7%), femoral arterial (52%), femoral venous (33%), and apical (7%) approaches. Nineteen percent of patients required repeat procedures. The target valve was mitral (44%), aortic (48%), both (2%), pulmonic (0.4%), or transcatheter aortic valve replacement (5%). Preprocedural leak was severe (61%), moderate (34%), or mild (5.7%) and was multiple in 37%. PVL improved postprocedure (P<0.001) and was none (33.3%), mild (41.4%), moderate (18.6%), or severe (6.7%) at last follow-up. Mean New York Heart Association class improved from 2.7±0.8 preprocedure to 1.6±0.8 (P<0.001) after a median follow-up of 110 (7-452) days. Hospital mortality was 2.9% (elective), 6.8% (in-hospital urgent), and 50% (emergency) (P<0.001). MACE during follow-up included death (16%), valve surgery (6%), late device embolization (0.4%), and new hemolysis requiring transfusion (1.6%). Mitral PVL was associated with higher MACE (hazard ratio [HR], 1.83; P=0.011). Factors independently associated with death were the degree of persisting leak (HR, 2.87; P=0.037), New York Heart Association class (HR, 2.00; P=0.015) at follow-up and baseline creatinine (HR, 8.19; P=0.001). The only factor independently associated with MACE was the degree of persisting leak at follow-up (HR, 3.01; P=0.002). CONCLUSION Percutaneous closure of PVL is an effective procedure that improves PVL severity and symptoms. Severity of persisting leak at follow-up is independently associated with both MACE and death. Percutaneous closure should be considered as an alternative to repeat surgery.
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Abstract
Direct electron detectors have played a key role in the recent increase in the power of single-particle electron cryomicroscopy (cryoEM). In this chapter, we summarize the background to these recent developments, give a practical guide to their optimal use, and discuss future directions.
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Choudhary F, Kirby R, Peter C, Henderson R. 216 Does Aortic Stenosis Effect Platelet Closure Time and Von Willebrand Factor Activity?: Abstract 216 Table 1. BRITISH HEART JOURNAL 2016. [DOI: 10.1136/heartjnl-2016-309890.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Pandor A, Pollard D, Chico T, Henderson R, Stevenson M. Rivaroxaban for Preventing Atherothrombotic Events in People with Acute Coronary Syndrome and Elevated Cardiac Biomarkers: An Evidence Review Group Perspective of a NICE Single Technology Appraisal. PHARMACOECONOMICS 2016; 34:463-477. [PMID: 26689783 DOI: 10.1007/s40273-015-0351-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
As part of its Single Technology Appraisal process, the National Institute for Health and Care Excellence (NICE) invited the company that manufactures rivaroxaban (Xarelto, Bayer) to submit evidence of the clinical and cost effectiveness of rivaroxaban for the prevention of adverse outcomes in patients after the acute management of acute coronary syndrome (ACS). The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group (ERG). The ERG produced a critical review of the evidence for the clinical and cost effectiveness of the technology, based upon the company's submission to NICE. The evidence was derived mainly from a randomised, double-blind, phase III, placebo-controlled trial of rivaroxaban (either 2.5 or 5 mg twice daily) in patients with recent ACS [unstable angina, non-ST segment elevation myocardial infarction (NSTEMI) or ST segment elevation myocardial infarction (STEMI)]. In addition, all patients received antiplatelet therapy [aspirin alone or aspirin and a thienopyridine either as clopidogrel (approximately 99 %) or ticlopidine (approximately 1 %) according to national or local guidelines]. The higher dose of rivaroxaban (5 mg twice daily) did not form part of the marketing authorisation. A post hoc subgroup analysis of the licensed patients who had ACS with elevated cardiac biomarkers (that is, patients with STEMI and NSTEMI) without prior stroke or transient ischaemic stroke showed that compared with standard care, the addition of rivaroxaban (2.5 mg twice daily) to existing antiplatelet therapy reduced the composite endpoint of cardiovascular mortality, myocardial infarction or stroke, but increased the risk of major bleeding and intracranial haemorrhage. However, there were a number of limitations in the evidence base that warrant caution in its interpretation. In particular, the evidence may be confounded because of the post hoc subgroup analysis, modified intention-to-treat analyses, high dropout rates and missing vital status data. Results from the company's economic evaluation showed that the deterministic incremental cost-effectiveness ratio (ICER) for rivaroxaban in combination with aspirin plus clopidogrel or with aspirin alone compared with aspirin plus clopidogrel or aspirin alone was £6203 per quality-adjusted life-year (QALY) gained. In contrast, the ERG's preferred base case estimate was £5622 per QALY gained. The ICER did not rise above £10,000 per QALY gained in any of the sensitivity analyses undertaken by the ERG, although the inflexibility of the company's economic model precluded the ERG from formally undertaking all desired exploratory analyses. As such, only a crude exploration of the impact of additional bleeding events could be undertaken. The NICE Appraisal Committee concluded that the ICERs presented were all within the range that could be considered cost effective and that the results of the ERG's exploratory sensitivity and scenario analyses suggested that the ICER was unlikely to increase to the extent that it would become unacceptable. The Appraisal Committee therefore concluded that rivaroxaban in combination with aspirin plus clopidogrel, or with aspirin alone, was a cost-effective use of National Health Service (NHS) resources for preventing atherothrombotic events in people with ACS and elevated cardiac biomarkers.
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Clerici M, Spalding GC, Warburton R, Lyons A, Aniculaesei C, Richards JM, Leach J, Henderson R, Faccio D. Observation of image pair creation and annihilation from superluminal scattering sources. SCIENCE ADVANCES 2016; 2:e1501691. [PMID: 27152347 PMCID: PMC4846444 DOI: 10.1126/sciadv.1501691] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 03/20/2016] [Indexed: 06/05/2023]
Abstract
The invariance of the speed of light is one of the foundational pillars of our current understanding of the universe. It implies a series of consequences related to our perception of simultaneity and, ultimately, of time itself. Whereas these consequences are experimentally well studied in the case of subluminal motion, the kinematics of superluminal motion lack direct evidence or even a clear experimental approach. We investigate kinematic effects associated with the superluminal motion of a light source. By using high-temporal-resolution imaging techniques, we directly demonstrate that if the source approaches an observer at superluminal speeds, the temporal ordering of events is inverted and its image appears to propagate backward. Moreover, for a source changing its speed and crossing the interface between subluminal and superluminal propagation regions, we observe image pair annihilation and creation, depending on the crossing direction. These results are very general and show that, regardless of the emitter speed, it is not possible to unambiguously determine the kinematics of an event from imaging and time-resolved measurements alone. This has implications not only for light, but also, for example, for sound and other wave phenomena.
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Haile M, Leistner M, Sarwar O, Toler CM, Henderson R, Grunlan JC. A wash-durable polyelectrolyte complex that extinguishes flames on polyester–cotton fabric. RSC Adv 2016. [DOI: 10.1039/c6ra03637f] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Polyester–cotton (PECO) blends were rendered flame retardant by depositing a stable polyelectrolyte complex as a wash-durable coating.
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Aoun SM, Breen LJ, Howting D, Edis R, Oliver D, Henderson R, O’Connor M, Harris R, Birks C. Receiving the news of a diagnosis of motor neuron disease: What does it take to make it better? Amyotroph Lateral Scler Frontotemporal Degener 2015; 17:168-78. [DOI: 10.3109/21678421.2015.1111907] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Nam J, Briggs A, Layland J, Oldroyd KG, Curzen N, Sood A, Balachandran K, Das R, Junejo S, Eteiba H, Petrie MC, Lindsay M, Watkins S, Corbett S, O'Rourke B, O'Donnell A, Stewart A, Hannah A, McConnachie A, Henderson R, Berry C. Fractional flow reserve (FFR) versus angiography in guiding management to optimise outcomes in non-ST segment elevation myocardial infarction (FAMOUS-NSTEMI) developmental trial: cost-effectiveness using a mixed trial- and model-based methods. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2015; 13:19. [PMID: 26578850 PMCID: PMC4647286 DOI: 10.1186/s12962-015-0045-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 10/31/2015] [Indexed: 11/10/2022] Open
Abstract
Background In the Fractional flow reserve (FFR) versus angiography in guiding management to optimise outcomes in non-ST elevation myocardial infarction (FAMOUS) clinical trial, FFR was shown to significantly reduce coronary revascularisation, compared to visual interpretation of standard coronary angiography without FFR. We estimated the cost-effectiveness from a UK National Health Service perspective, based on the results of FAMOUS. Methods A mixed trial- and model-based approach using decision and statistical modelling was used. Within-trial (1-year) costs and QALYs were assembled at the individual level and then modelled on subsequent management strategy [coronary artery bypass graft (CABG), percutaneous coronary intervention (PCI) or medical therapy (MT)] and major adverse coronary events (death, MI, stroke and revascularisation). One-year resource uses included: material, hospitalisation, medical, health professional service use and events. Utilities were derived from individual EQ5D responses. Unit costs were derived from the literature. Outcomes were extended to a lifetime on the basis of MACE during the 1st year. Costs and QALYs were modelled using generalized linear models whilst MACE was modelled using logistic regression. The analysis adopted a payer perspective. Costs and outcomes were discounted at 3.5 %. Results Costs were related to the subsequent management strategy and MACE whilst QALYs were not. FFR led to a modest cost increase, albeit an imprecise increase, over both the trial [£112 (−£129 to £357)] and lifetime horizons [£133 (−£199 to £499)]. FFR led to a small, albeit imprecise, increase in QALYs over both the trial [0.02 (−0.03 to 0.06)] and lifetime horizons [0.03 (−0.21 to 0.28)]. The mean ICER was £7516/QALY and £4290/QALY over the trial and lifetime horizons, respectively. Decision remained high; FFR had 64 and 59 % probability of cost-effectiveness over trial and lifetime horizons, respectively. Conclusions FFR was cost-effective at the mean, albeit with considerable decision uncertainty. Uncertainty can be reduced with more information on long-term health events. Electronic supplementary material The online version of this article (doi:10.1186/s12962-015-0045-9) contains supplementary material, which is available to authorized users.
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Elgmati E, Fiaccone RL, Henderson R, Matthews JNS. Penalised logistic regression and dynamic prediction for discrete-time recurrent event data. LIFETIME DATA ANALYSIS 2015; 21:542-560. [PMID: 25626559 DOI: 10.1007/s10985-015-9321-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 01/07/2015] [Indexed: 06/04/2023]
Abstract
We consider methods for the analysis of discrete-time recurrent event data, when interest is mainly in prediction. The Aalen additive model provides an extremely simple and effective method for the determination of covariate effects for this type of data, especially in the presence of time-varying effects and time varying covariates, including dynamic summaries of prior event history. The method is weakened for predictive purposes by the presence of negative estimates. The obvious alternative of a standard logistic regression analysis at each time point can have problems of stability when event frequency is low and maximum likelihood estimation is used. The Firth penalised likelihood approach is stable but in removing bias in regression coefficients it introduces bias into predicted event probabilities. We propose an alterative modified penalised likelihood, intermediate between Firth and no penalty, as a pragmatic compromise between stability and bias. Illustration on two data sets is provided.
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Abstract
Acute ST-segment-elevation myocardial infarction (STEMI) results from complete obstruction to coronary artery blood flow accompanied by the appearance of ST-segment-elevation on the electrocardiogram. Emergency treatment is required to restore coronary perfusion, thereby limiting the extent of damage to the myocardium and the likelihood of early death or future heart failure. This concise guideline summarises key recommendations from the National Institute for Health and Care Excellence clinical guideline on acute management of STEMI (CG167), of relevance to all healthcare professionals involved. Guidance is presented on choice of reperfusion strategies, procedural aspects, use of additional drugs before and alongside reperfusion therapies, and treatment of patients who are unconscious or in cardiogenic shock.
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Leung J, Macleod C, McLaughlin D, Woods LM, Henderson R, Watson A, Kyle RG, Hubbard G, Mullen R, Atherton I. Screening mammography uptake within Australia and Scotland in rural and urban populations. Prev Med Rep 2015; 2:559-62. [PMID: 26844118 PMCID: PMC4721451 DOI: 10.1016/j.pmedr.2015.06.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective To test the hypothesis that rural populations had lower uptake of screening mammography than urban populations in the Scottish and Australian setting. Method Scottish data are based upon information from the Scottish Breast Screening Programme Information System describing uptake among women residing within the NHS Highland Health Board area who were invited to attend for screening during the 2008 to 2010 round (N = 27,416). Australian data were drawn from the 2010 survey of the 1946–51 cohort of the Australian Longitudinal Study on Women's Health (N = 9890 women). Results Contrary to our hypothesis, results indicated that women living in rural areas were not less likely to attend for screening mammography compared to women living in urban areas in both Scotland (OR for rural = 1.17, 95% CI = 1.06–1.29) and Australia (OR for rural = 1.15, 95% CI = 1.01–1.31). Conclusions The absence of rural–urban differences in attendance at screening mammography demonstrates that rurality is not necessarily an insurmountable barrier to screening mammography. Scotland and Australia provide free screening mammography for their populations. Women living in rural areas can attend screening mammography via mobile units. We examined rural–urban breast screening rates in Scotland and Australia. Rural women were not less likely to attend screening mammography than urban women. Rurality is not necessarily an insurmountable barrier to health service access.
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Çalışkan B, Peterson J, Henderson R. PET/CT Imaging of a Rare Presentation of Mantle Cell Lymphoma with Testicular Involvement. Mol Imaging Radionucl Ther 2015. [DOI: 10.4274/mirt.15807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Leung J, Macleoad C, McLaughlin D, Woods L, Henderson R, Watson A, Kyle R, Hubbard G, Mullen R, Atherton I. P001. Rural-urban differences in screening mammography uptake in Australia and Scotland. Eur J Surg Oncol 2015. [DOI: 10.1016/j.ejso.2015.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Patel KM, Manrique O, Sosin M, Hashmi MA, Poysophon P, Henderson R. Lymphatic mapping and lymphedema surgery in the breast cancer patient. Gland Surg 2015; 4:244-56. [PMID: 26161309 PMCID: PMC4461704 DOI: 10.3978/j.issn.2227-684x.2015.03.02] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Accepted: 03/05/2015] [Indexed: 12/18/2022]
Abstract
Upper limb lymphedema can be an unfortunate sequela following the oncologic treatment of breast cancer. The surgical treatment of lymphedema has had a recent renewed clinical interest paralleling innovative descriptions of surgical techniques and imaging modalities. In addition, an improved understanding of the physiology and pathophysiology of lymphedema has allowed improved translation to the clinical condition. Various surgical options exist to decrease the symptom-burden of upper limb lymphedema, including vascularized lymph node (VLN) transfer, lymphovenous bypass (LVB), liposuction, lymphatic grafting, and excisional procedures. Modern imaging techniques help to improve the consistency and accuracy of these surgical treatment options. A multi-modal treatment plan utilizing non-operative and surgical therapies has the potential to improve various factors related to overall patient quality of life. This review details all of the current operative treatment strategies and modern imaging modalities used in the treatment of lymphedema.
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