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Dutch M, Cheng A, Kiely P, Seed C. Revised nucleic acid test window periods: Applications and limitations in organ donation practice. Transpl Infect Dis 2024; 26:e14180. [PMID: 37885419 DOI: 10.1111/tid.14180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/10/2023] [Accepted: 10/15/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Nucleic acid test window periods for HIV, HCV, and HBV facilitate estimation of the residual risk of unexpected disease transmission and assist clinicians in determining the timeframe in which a recently acquired infection is at risk of nondetection. OBJECTIVES Firstly, to provide revised estimates of the NAT window periods based on a currently used triplex NAT assay. Secondly, to examine their validity in organ donation and transplantation practice. METHOD Estimates were based on the Procleix Ultrio Elite Assay (Grifols Diagnostic Solutions Inc. California, USA). The manufacturer's X50 and X95 limits of detection (LOD) were utilised. Viral doubling times of 0.85, 0.45, and 2.56 days and conversion factors for IU per ml to copies per mL of 0.6, 3.4, and 5 were assumed for HIV, HCV, and HBV respectively. Window periods were derived from the X50 and X95 LODs, based on a range of potential inoculum volumes. RESULTS Calculated X50 window periods were 5.1 (4.5-5.8), 2.7 (2.4-2.9), and 16.6 (14.2-19.1) days for HIV, HCV, and HBV respectively. Calculated X50 window periods, based on whole body plasma volume, were 11.8 (10.3-13.3), 6.2 (5.6-6.8) and 36.7 (31.3-42.1) days respectively. CONCLUSION X50 NAT window periods were significantly shorter for HBV and HCV and sit at the lower range of previously published estimates for HIV . Current modeling assumptions may not account for all unexpected transmission events and may no longer be suitable for application to organ donation and transplantation.
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Affiliation(s)
- Martin Dutch
- Emergency Department, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia
| | - Anthea Cheng
- Pathology and Clinical Governance, Australian Red Cross Lifeblood, West Melbourne, Victoria, Australia
| | - Philip Kiely
- Pathology and Clinical Governance, Australian Red Cross Lifeblood, West Melbourne, Victoria, Australia
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Prahran, Victoria, Australia
| | - Clive Seed
- Pathology and Clinical Governance, Australian Red Cross Lifeblood, West Melbourne, Victoria, Australia
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Dutch M, Cheng A, Kiely P, Seed C. 311.6: Procleix® Ultrio Elite®Assay: Revised nucleic acid test window periods and applications in organ donation. Transplantation 2023; 107:74. [PMID: 37845959 DOI: 10.1097/01.tp.0000993416.32044.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Affiliation(s)
- Martin Dutch
- Emergency Department, Royal Melbourne Hospital, Melbourne, Australia
- Department of Critical Care, University of Melbourne, Melbourne, Australia
| | - Anthea Cheng
- Department of Critical Care, University of Melbourne, Melbourne, Australia
| | - Philip Kiely
- Clinical Services and Research, Australian Red Cross Blood Service, Melbourne, Australia
| | - Clive Seed
- Clinical Services and Research, Australian Red Cross Blood Service, Perth, Australia
- Medical School, University of Western Australia, Crawley, Australia
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Cheng A, Das A, Chaw K, Dennington PM, Styles CE, Gosbell IB. Safety Analysis of Extended Platelet Shelf-Life with Large-Volume Delayed Sampling on BACT/ALERT ® VIRTUO ® in Australia. Microorganisms 2023; 11:2346. [PMID: 37764190 PMCID: PMC10535894 DOI: 10.3390/microorganisms11092346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Transfusion-transmitted bacterial infection (TTBI) is the leading cause of transfusion-transmitted infections. Platelet components are more likely to be associated with bacterial contamination due to their storage requirements. Australian Red Cross Lifeblood introduced the bacterial contamination screening (BCS) of all platelet components in 2008. The process was recently updated with the use of BACT/ALERT® VIRTUO®, a large-volume delayed sampling (LVDS) protocol and extending platelet shelf-life to seven days. This article describes the results from the routine BCS of platelet components in Australia. Use of VIRTUO has resulted in lower false-positive rates, reducing wastage and improving platelet inventory. Our findings show that the combination of LVDS and VIRTUO improves the safety of platelet transfusions through earlier time to detection, especially for pathogenic bacterial species. Pathogenic bacteria grew within 24 h of incubation with a clear delineation between pathogenic and non-pathogenic species. The data show this protocol is very safe, with no TTBI cases during this time. There were no TTBI reports in recipients of platelet components that subsequently had a positive culture with Cutibacterium species, probably due to the low pathogenic potential of these organisms and slow replication in aerobic platelet bags. We conclude there is no advantage in incubating culture bottles beyond five days.
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Affiliation(s)
- Anthea Cheng
- Donor and Product Safety Policy Unit, Australian Red Cross Lifeblood, West Melbourne, VIC 3003, Australia
| | - Anindita Das
- Donor and Product Safety Policy Unit, Australian Red Cross Lifeblood, West Melbourne, VIC 3003, Australia
- Clinical Microbiology, ACT Pathology, Garran, ACT 2606, Australia
- Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
| | - Khin Chaw
- Donor and Product Safety Policy Unit, Australian Red Cross Lifeblood, West Melbourne, VIC 3003, Australia
- MetroSouth Public Health Unit, Eight Mile Plains, QLD 4113, Australia
| | - Peta M Dennington
- Pathology Services, Australian Red Cross Lifeblood, Alexandria, NSW 2015, Australia
| | - Claire E Styles
- Donor and Product Safety Policy Unit, Australian Red Cross Lifeblood, West Melbourne, VIC 3003, Australia
| | - Iain B Gosbell
- Donor and Product Safety Policy Unit, Australian Red Cross Lifeblood, West Melbourne, VIC 3003, Australia
- School of Medicine, Western Sydney University, Penrith, NSW 2747, Australia
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Chan ATC, Lee VHF, Hong RL, Ahn MJ, Chong WQ, Kim SB, Ho GF, Caguioa PB, Ngamphaiboon N, Ho C, Aziz MASA, Ng QS, Yen CJ, Soparattanapaisarn N, Ngan RKC, Kho SK, Tiambeng MLA, Yun T, Sriuranpong V, Algazi AP, Cheng A, Massarelli E, Swaby RF, Saraf S, Yuan J, Siu LL. Pembrolizumab monotherapy versus chemotherapy in platinum-pretreated, recurrent or metastatic nasopharyngeal cancer (KEYNOTE-122): an open-label, randomized, phase III trial. Ann Oncol 2023; 34:251-261. [PMID: 36535566 DOI: 10.1016/j.annonc.2022.12.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/22/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Pembrolizumab previously demonstrated robust antitumor activity and manageable safety in a phase Ib study of patients with heavily pretreated, programmed death ligand 1 (PD-L1)-positive, recurrent or metastatic nasopharyngeal carcinoma (NPC). The phase III KEYNOTE-122 study was conducted to further evaluate pembrolizumab versus chemotherapy in patients with platinum-pretreated, recurrent and/or metastatic NPC. Final analysis results are presented. PATIENTS AND METHODS KEYNOTE-122 was an open-label, randomized study conducted at 29 sites, globally. Participants with platinum-pretreated recurrent and/or metastatic NPC were randomly assigned (1 : 1) to pembrolizumab or chemotherapy with capecitabine, gemcitabine, or docetaxel. Randomization was stratified by liver metastasis (present versus absent). The primary endpoint was overall survival (OS), analyzed in the intention-to-treat population using the stratified log-rank test (superiority threshold, one-sided P = 0.0187). Safety was assessed in the as-treated population. RESULTS Between 5 May 2016 and 28 May 2018, 233 participants were randomly assigned to treatment (pembrolizumab, n = 117; chemotherapy, n = 116); Most participants (86.7%) received study treatment in the second-line or later setting. Median time from randomization to data cut-off (30 November 2020) was 45.1 months (interquartile range, 39.0-48.8 months). Median OS was 17.2 months [95% confidence interval (CI) 11.7-22.9 months] with pembrolizumab and 15.3 months (95% CI 10.9-18.1 months) with chemotherapy [hazard ratio, 0.90 (95% CI 0.67-1.19; P = 0.2262)]. Grade 3-5 treatment-related adverse events occurred in 12 of 116 participants (10.3%) with pembrolizumab and 49 of 112 participants (43.8%) with chemotherapy. Three treatment-related deaths occurred: 1 participant (0.9%) with pembrolizumab (pneumonitis) and 2 (1.8%) with chemotherapy (pneumonia, intracranial hemorrhage). CONCLUSION Pembrolizumab did not significantly improve OS compared with chemotherapy in participants with platinum-pretreated recurrent and/or metastatic NPC but did have manageable safety and a lower incidence of treatment-related adverse events.
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Affiliation(s)
- A T C Chan
- State Key Laboratory in Translational Oncology, Sir YK Pao Centre for Cancer, The Chinese University of Hong Kong, Hong Kong, China.
| | - V H F Lee
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China
| | - R-L Hong
- National Taiwan University Hospital, Taipei, Taiwan
| | - M-J Ahn
- Samsung Medical Centre, Seoul, South Korea
| | - W Q Chong
- National University Cancer Institute, Singapore, Singapore
| | - S-B Kim
- Asan Medical Centre, University of Ulsan College of Medicine, Seoul, South Korea
| | - G F Ho
- Clinical Oncology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - P B Caguioa
- St. Luke's Medical Center, University of Santo Tomas Faculty of Medicine and Surgery, Manila, Philippines
| | - N Ngamphaiboon
- Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - C Ho
- BC Cancer, University of British Columbia, Vancouver, Canada
| | - M A S A Aziz
- Gleneagles Penang Clinical Research Center, Gleneagles Hospital Penang, Penang, Malaysia
| | - Q S Ng
- National Cancer Centre Singapore, Singapore, Singapore
| | - C-J Yen
- National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | | | - R K-C Ngan
- Queen Elizabeth Hospital, Kowloon, Hong Kong, China
| | - S K Kho
- Hospital Umum Sarawak, Kuching, Malaysia
| | - M L A Tiambeng
- Cardinal Santos Medical Center, San Juan City, Philippines
| | - T Yun
- National Cancer Center, Goyang-si, South Korea
| | - V Sriuranpong
- Chulalongkorn University and the King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | | | - A Cheng
- Princess Margaret Hospital, Hong Kong, China
| | - E Massarelli
- City of Hope Comprehensive Cancer Center, Duarte, USA
| | | | - S Saraf
- Merck & Co., Inc., Rahway, USA
| | - J Yuan
- Merck & Co., Inc., Rahway, USA
| | - L L Siu
- Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
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Taheri N, Hong Y, Abdelwahab M, Huang A, Fleury T, Liu S, Cheng A. Achieving Reduced Treatment Time for Obstructive Sleep Apnea Utilizing Surgery First Approach: A Comparison of Traditional versus Novel Techniques. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Ren Z, Li Z, Zhang T, Fang W, Hu S, Pan H, Yen C, Hou J, Chen Y, Shao G, Hsu C, Bai Y, Meng Z, Hou M, Xie C, Liu Y, Wu J, Li B, Chica-Duque S, Cheng A. P-25 Tislelizumab monotherapy for patients with previously treated advanced hepatocellular carcinoma (HCC): RATIONALE-208 Chinese subpopulation. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Leung WC, Lo R, Teoh JYC, Cheng A, Wong MCS, Leung GKK. Well-being of Academy Fellows and specialty trainees: what is the problem? Hong Kong Med J 2021; 27:324-325. [PMID: 34607971 DOI: 10.12809/hkmj215123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- W C Leung
- Honorary Secretary, Hong Kong Academy of Medicine
| | - R Lo
- Honorary Advisor, Task Force on Well-being, Hong Kong Academy of Medicine
| | - J Y C Teoh
- Chair, Young Fellows Chapter, Hong Kong Academy of Medicine
| | - A Cheng
- Chief Executive Officer, Hong Kong Academy of Medicine
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Lynch N, Liau I, Cheng A, Duke P. Rehabilitation of severe hereditary gingival hyperplasia with virtual surgical planning and computer-assisted surgery. Advances in Oral and Maxillofacial Surgery 2021. [DOI: 10.1016/j.adoms.2021.100095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Wong H, Lim F, Cheng A. PO-1174 3-weekly paclitaxel-carboplatin with radiation for stage III NSCLC – option during COVID-19 pandemic. Radiother Oncol 2021. [PMCID: PMC8629141 DOI: 10.1016/s0167-8140(21)07625-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Punjabi A, Barrett E, Cheng A, Mulla A, Walls G, Johnston D, McAleese J, Moore K, Hicks J, Blyth K, Denholm M, Magee L, Gilligan D, Silverman S, Qureshi M, Clinch H, Hatton M, Philipps L, Brown S, O'Brien M, McDonald F, Faivre-Finn C, Hiley C, Evison M. Neutrophil-Lymphocyte Ratio and Absolute Lymphocyte Count as Prognostic Markers in Patients Treated with Curative-intent Radiotherapy for Non-small Cell Lung Cancer. Clin Oncol (R Coll Radiol) 2021; 33:e331-e338. [PMID: 33863615 DOI: 10.1016/j.clon.2021.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 02/27/2021] [Accepted: 03/24/2021] [Indexed: 12/21/2022]
Abstract
AIMS The neutrophil-lymphocyte ratio (NLR) and the absolute lymphocyte count (ALC) have been proposed as prognostic markers in non-small cell lung cancer (NSCLC). The objective of this study was to examine the association of NLR/ALC before and after curative-intent radiotherapy for NSCLC on disease recurrence and overall survival. MATERIALS AND METHODS A retrospective study of consecutive patients who underwent curative-intent radiotherapy for NSCLC across nine sites in the UK from 1 October 2014 to 1 October 2016. A multivariate analysis was carried out to assess the ability of pre-treatment NLR/ALC, post-treatment NLR/ALC and change in NLR/ALC, adjusted for confounding factors using the Cox proportional hazards model, to predict disease recurrence and overall survival within 2 years of treatment. RESULTS In total, 425 patients were identified with complete blood parameter values. None of the NLR/ALC parameters were independent predictors of disease recurrence. Higher pre-NLR, post-NLR and change in NLR plus lower post-ALC were all independent predictors of worse survival. Receiver operator curve analysis found a pre-NLR > 2.5 (odds ratio 1.71, 95% confidence interval 1.06-2.79, P < 0.05), a post-NLR > 5.5 (odds ratio 2.36, 95% confidence interval 1.49-3.76, P < 0.001), a change in NLR >3.6 (odds ratio 2.41, 95% confidence interval 1.5-3.91, P < 0.001) and a post-ALC < 0.8 (odds ratio 2.86, 95% confidence interval 1.76-4.69, P < 0.001) optimally predicted poor overall survival on both univariate and multivariate analysis when adjusted for confounding factors. Median overall survival for the high-versus low-risk groups were: pre-NLR 770 versus 1009 days (P = 0.34), post-NLR 596 versus 1287 days (P ≤ 0.001), change in NLR 553 versus 1214 days (P ≤ 0.001) and post-ALC 594 versus 1287 days (P ≤ 0.001). CONCLUSION NLR and ALC, surrogate markers for systemic inflammation, have prognostic value in NSCLC patients treated with curative-intent radiotherapy. These simple and readily available parameters may have a future role in risk stratification post-treatment to inform the intensity of surveillance protocols.
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Affiliation(s)
- A Punjabi
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - E Barrett
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - A Cheng
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - A Mulla
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - G Walls
- Queen's University Belfast, Belfast, UK
| | - D Johnston
- Northern Ireland Cancer Centre, Belfast, UK
| | - J McAleese
- Northern Ireland Cancer Centre, Belfast, UK
| | - K Moore
- NHS Greater Glasgow & Clyde, Glasgow, UK
| | - J Hicks
- NHS Greater Glasgow & Clyde, Glasgow, UK
| | - K Blyth
- NHS Greater Glasgow & Clyde, Glasgow, UK
| | - M Denholm
- Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - L Magee
- Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - D Gilligan
- Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - S Silverman
- University College London Hospital, London, UK
| | - M Qureshi
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - H Clinch
- The University of Sheffield Medical School, Sheffield, UK
| | - M Hatton
- Weston Park Hospital, Sheffield, UK
| | | | - S Brown
- The University of Manchester, Manchester, UK
| | | | | | - C Faivre-Finn
- The University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | - C Hiley
- CRUK Lung Cancer Centre of Excellence, UCL Cancer Institute, London, UK
| | - M Evison
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
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Hiley C, Punjabi A, Barrett E, Cheng A, Mulla A, Walls G, Johnston D, McAleese J, Moore K, Hicks J, Blyth K, Denholm M, Magee L, Gilligan D, Silverman S, Qureshi M, Clinch H, Hatton M, Philips L, Brown S, O’Brien M, Macdonald F, Faivre-Finn C, Evison M. PH-0274 NLR & ALC as prognostic markers in patients treated with curative intent radiotherapy for NSCLC. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07289-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Li D, Cheng A, Lim H, Llovet J, Zhu Y, Hatogai K, Siegel A, Kudo M. P-135 Pembrolizumab/quavonlimab coformulation in combination with lenvatinib in advanced hepatocellular carcinoma: Phase 2 trial in progress. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Chen S, Lai H, Tsou H, Shao Y, Chang C, Su T, Liu T, Chen L, Cheng A, Hsu C. P-126 Atezolizumab plus bevacizumab for patients with advanced hepatocellular carcinoma and chronic hepatitis B virus infection with high viral load. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Cheng A, Eppich W, Epps C, Kolbe M, Meguerdichian M, Grant V. Embracing informed learner self-assessment during debriefing: the art of plus-delta. Adv Simul (Lond) 2021; 6:22. [PMID: 34090514 PMCID: PMC8180042 DOI: 10.1186/s41077-021-00173-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/16/2021] [Indexed: 11/29/2022] Open
Abstract
The healthcare simulation field has no shortage of debriefing options. Some demand considerable skill which serves as a barrier to more widespread implementation. The plus-delta approach to debriefing offers the advantages of conceptual simplicity and ease of implementation. Importantly, plus-delta promotes learners' capacity for a self-assessment, a skill vital for safe clinical practice and yet a notorious deficiency in professional practice. The plus-delta approach confers the benefits of promoting uptake of debriefing in time-limited settings by educators with both fundamental but also advanced skills, and enhancing essential capacity for critical self-assessment informed by objective performance feedback. In this paper, we describe the role of plus-delta in debriefing, provide guidance for incorporating informed learner self-assessment into debriefings, and highlight four opportunities for improving the art of the plus delta: (a) exploring the big picture vs. specific performance issues, (b) choosing between single vs. double-barreled questions, (c) unpacking positive performance, and (d) managing perception mismatches.
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Affiliation(s)
- A. Cheng
- KidSIM Simulation Program, Alberta Children’s Hospital, Departments of Pediatrics and Emergency Medicine, Cumming School of Medicine, University of Calgary, 28 Oki Drive NW, Calgary, T3B 6A8 Canada
| | - W. Eppich
- RSCI SIM Centre for Simulation Education and Research RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - C. Epps
- Departments of Anesthesiology and Interprofessional Education, University of Tennessee Health Science Center, Memphis, USA
| | - M. Kolbe
- Simulation Center, UniversitatsSpital Zurich, Ramistrasse 100, 8091 Zurich, Switzerland
| | - M. Meguerdichian
- Department of Emergency Medicine, NYC Health + Hospitals/Harlem, NYC Health + Hospitals/Simulation Center, Columbia University, New York, USA
| | - V. Grant
- KidSIM Simulation Program, Alberta Children’s Hospital, Departments of Pediatrics and Emergency Medicine, Cumming School of Medicine, University of Calgary, 28 Oki Drive NW, Calgary, T3B 6A8 Canada
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Ablatt S, Wang X, Sahil S, Cheng A, Kirchhoff-Rowald A, Shepherd J, Sutkin G. 50 Reoperation rates of stress incontinence surgery in rural versus urban hospitals. Am J Obstet Gynecol 2021. [DOI: 10.1016/j.ajog.2021.04.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Vogel A, Zhu A, Cheng A, Yau T, Zhou J, Kim E, Malhotra U, Siegel A, Kudo M. Abstract No. 210 KEYNOTE-937 trial in progress: adjuvant pembrolizumab for hepatocellular carcinoma and complete radiologic response after surgical resection or local ablation. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Sangro B, Harding J, Johnson M, Palmer D, Edeline J, Abou-Alfa G, Cheng A, Decaens T, El-Khoueiry A, Finn R, Galle P, Park J, Yau T, Begic D, Shen Y, Neely J, Sama A, Kudo M. Abstract No. 117 A phase 3, double-blind, randomized study of nivolumab and Ipilimumab), nivolumab monotherapy, or placebo plus transarterial chemoembolization in patients with intermediate-stage hepatocellular carcinoma. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Evison M, Barrett E, Cheng A, Mulla A, Walls G, Johnston D, McAleese J, Moore K, Hicks J, Blyth K, Denholm M, Magee L, Gilligan D, Silverman S, Hiley C, Qureshi M, Clinch H, Hatton M, Philipps L, Brown S, O'Brien M, McDonald F, Faivre-Finn C. Predicting the Risk of Disease Recurrence and Death Following Curative-intent Radiotherapy for Non-small Cell Lung Cancer: The Development and Validation of Two Scoring Systems From a Large Multicentre UK Cohort. Clin Oncol (R Coll Radiol) 2021; 33:145-154. [PMID: 32978027 DOI: 10.1016/j.clon.2020.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/30/2020] [Accepted: 09/02/2020] [Indexed: 12/26/2022]
Abstract
AIMS There is a paucity of evidence on which to produce recommendations on neither the clinical nor the imaging follow-up of lung cancer patients after curative-intent radiotherapy. In the 2019 National Institute for Health and Care Excellence lung cancer guidelines, further research into risk-stratification models to inform follow-up protocols was recommended. MATERIALS AND METHODS A retrospective study of consecutive patients undergoing curative-intent radiotherapy for non-small cell lung cancer from 1 October 2014 to 1 October 2016 across nine UK trusts was carried out. Twenty-two demographic, clinical and treatment-related variables were collected and multivariable logistic regression was used to develop and validate two risk-stratification models to determine the risk of disease recurrence and death. RESULTS In total, 898 patients were included in the study. The mean age was 72 years, 63% (562/898) had a good performance status (0-1) and 43% (388/898), 15% (134/898) and 42% (376/898) were clinical stage I, II and III, respectively. Thirty-six per cent (322/898) suffered disease recurrence and 41% (369/898) died in the first 2 years after radiotherapy. The ASSENT score (age, performance status, smoking status, staging endobronchial ultrasound, N-stage, T-stage) was developed, which stratifies the risk for disease recurrence within 2 years, with an area under the receiver operating characteristic curve (AUROC) for the total score of 0.712 (0.671-0.753) and 0.72 (0.65-0.789) in the derivation and validation sets, respectively. The STEPS score (sex, performance status, staging endobronchial ultrasound, T-stage, N-stage) was developed, which stratifies the risk of death within 2 years, with an AUROC for the total score of 0.625 (0.581-0.669) and 0.607 (0.53-0.684) in the derivation and validation sets, respectively. CONCLUSIONS These validated risk-stratification models could be used to inform follow-up protocols after curative-intent radiotherapy for lung cancer. The modest performance highlights the need for more advanced risk prediction tools.
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Affiliation(s)
- M Evison
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
| | - E Barrett
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - A Cheng
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - A Mulla
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - G Walls
- Northern Ireland Cancer Centre, Belfast, UK
| | - D Johnston
- Cancer Centre Belfast City Hospital, Belfast, UK
| | - J McAleese
- Cancer Centre Belfast City Hospital, Belfast, UK
| | - K Moore
- NHS Greater Glasgow & Clyde, Glasgow, UK
| | - J Hicks
- NHS Greater Glasgow & Clyde, Glasgow, UK
| | - K Blyth
- NHS Greater Glasgow & Clyde, Glasgow, UK
| | - M Denholm
- Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - L Magee
- Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - D Gilligan
- Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - S Silverman
- University College London Hospital, London, UK
| | - C Hiley
- CRUK Lung Cancer Centre of Excellence, UCL Cancer Institute, London, UK
| | | | - H Clinch
- The University of Sheffield Medical School, Sheffield, UK
| | - M Hatton
- Weston Park Hospital, Sheffield, UK
| | | | - S Brown
- The Christie NHS Foundation Trust, Manchester, UK
| | | | | | - C Faivre-Finn
- The Christie NHS Foundation Trust, Manchester, UK; The University of Manchester, Manchester, UK
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Baker O, Cheng A, Barker H, Grogono D, Johnson C, Haworth C, Hill S, Hill. U. P165 Improvement in antibiotic usage and ppFEV1 with compassionate use of elexacaftor, tezacaftor and ivacaftor (ETI) for patients with cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01191-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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20
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Lovelock T, Cheng A, Doi A, Zimmet A, Gooi J, Fitzgerald M. Blunt bronchial injury management with veno-venous extracorporeal membrane oxygenation providing a peri-operative 'survival bridge'. Trauma Case Rep 2020; 31:100388. [PMID: 33364296 PMCID: PMC7750647 DOI: 10.1016/j.tcr.2020.100388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- T Lovelock
- Department of Cardiothoracic Surgery, Alfred Hospital, Melbourne, VIC 3004, Australia
| | - A Cheng
- Department of Cardiothoracic Surgery, Alfred Hospital, Melbourne, VIC 3004, Australia
| | - A Doi
- Department of Cardiothoracic Surgery, Alfred Hospital, Melbourne, VIC 3004, Australia
| | - A Zimmet
- Department of Cardiothoracic Surgery, Alfred Hospital, Melbourne, VIC 3004, Australia
| | - J Gooi
- Department of Cardiothoracic Surgery, Alfred Hospital, Melbourne, VIC 3004, Australia
| | - M Fitzgerald
- Trauma Service, The Alfred Hospital, Melbourne, Australia
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21
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Mesfin Y, Buttery J, Cheng A. The utility of telephone helpline data for real-time syndromic surveillance of adverse events following immunization: Retrospective evaluation. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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22
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Cha Y, Metzl M, Canby R, Fruechte E, Duggal M, Exner D, Chung E, Singh J, O'Donnell D, Zimmerman P, Landman S, Lexcen D, Laager V, Schaber D, Cheng A. RV Pacing Percentage. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Chronic right ventricular pacing (RVP) has been associated with dyssynchrony, leading to increased mortality. However, there have been discrepancies in previous reports in the effect of RVP levels.
Objective
To sub-stratify mortality risk by age for different RVP level groups within a large real-world ICD cohort.
Methods
Optum® de-identified electronic health records were linked to the Medtronic Carelink data to identify dual chamber ICD recipients (2007–2017). RVP level was based on median daily pacing during the first 90 days post-implant and categorized either into groups with a cutoff of 40%, or with groups of 0–9%, 10–19%, 20–29%, 30–39%, 40–49%, and 50–100%. The endpoint was death more than 90 days post-implant. Kaplan-Meier survival curves, log-rank tests, and Cox regression were used to analyze the relationship between RVP and risk of death.
Results
Among 14,832 ICD patients (median age 67; 74.0% male), there were 2,602 deaths within 10 years after implant. In unadjusted comparisons, high RVP (>40%) increased the risk of death relative to low RVP (≤40%) (p<0.001). This effect remained significant in older cohort (≥67 years old at implant) (p<0.001), but not in younger cohort (<67 years old) (p=0.955) (Figure). After controlling for age, gender, pacing mode, MI, SCA, HF hospitalization, diabetes, and renal dysfunction, similar or increased risk was associated with higher pacing groups relative to the 0–9% pacing group in the older cohort, but not in the younger cohort.
Conclusions
Our data from a large contemporaneous real-world source suggests that older age or characteristics associated with age make patients more sensitive to chronic RVP effects. These results help reconcile differences observed in prior studies.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Medtronic, Inc.
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Affiliation(s)
- Y.M Cha
- Mayo Clinic, Rochester, United States of America
| | - M.D Metzl
- Evanston Hospital Northshore, Evanston, United States of America
| | - R.C Canby
- Texas Cardiac Arrhythmia Research, Austin, United States of America
| | - E.M Fruechte
- North Memorial Heart and Vascular Institute, Robbinsdale, United States of America
| | - M Duggal
- Advocate Christ Medical Center, Oak Lawn, United States of America
| | - D.V Exner
- University of Calgary, Libin Cardiovascular Institute, Calgary, Canada
| | - E.S Chung
- The Christ Hospital, Cincinnati, United States of America
| | - J.P Singh
- Harvard Medical School, Boston, United States of America
| | | | - P Zimmerman
- Medtronic, Inc., Mounds View, United States of America
| | - S Landman
- Medtronic, Inc., Mounds View, United States of America
| | - D.R Lexcen
- Medtronic, Inc., Mounds View, United States of America
| | - V Laager
- Medtronic, Inc., Mounds View, United States of America
| | - D Schaber
- Medtronic, Inc., Mounds View, United States of America
| | - A Cheng
- Medtronic, Inc., Mounds View, United States of America
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23
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Schnaubelt S, Monsieurs KG, Semeraro F, Schlieber J, Cheng A, Bigham BL, Garg R, Finn JC, Greif R. Clinical outcomes from out-of-hospital cardiac arrest in low-resource settings - A scoping review. Resuscitation 2020; 156:137-145. [PMID: 32920113 DOI: 10.1016/j.resuscitation.2020.08.126] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/06/2020] [Accepted: 08/31/2020] [Indexed: 02/07/2023]
Abstract
AIM OF THE SCOPING REVIEW Scientific recommendations on resuscitation are typically formulated from the perspective of an ideal resource environment, with little consideration of applicability in lower-income countries. We aimed to determine clinical outcomes from out-of-hospital cardiac arrest (OHCA) in low-resource countries, to identify shortcomings related to resuscitation in these areas and possible solutions, and to suggest future research priorities. DATA SOURCES This scoping review was part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation (ILCOR), and was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. We identified low-resource countries as countries with a low- or middle gross national income per capita (World Bank data). We performed a literature search on outcomes after OHCA in these countries, and we extracted data on the outcome. We applied descriptive statistics and conducted a post-hoc correlation analysis of cohort size and ROSC rates. RESULTS We defined 24 eligible studies originating from middle-income countries, but none from low-income regions, suggesting a reporting bias. The number of reported patients in these studies ranged from 54 to 3214. Utstein-style reporting was rarely used. Return of spontaneous circulation varied from 0% to 62%. Fifteen studies reported on survival to hospital discharge (between 1.0 and 16.7%) or favourable neurological outcome (between 1.0 and 9.3%). An inverse correlation was found for study cohort size and the rate of return of spontaneous circulation (ρ = -0.48, p = 0.034). CONCLUSION Studies of OHCA outcomes in low-resource countries are heterogeneous and may be compromised by reporting bias. Minimum cardiopulmonary resuscitation standards for low-resource settings should be developed collaboratively involving local experts, respecting culture and context while balancing competing health priorities.
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Affiliation(s)
- S Schnaubelt
- Department of Emergency Medicine, Medical University of Vienna, Austria.
| | - K G Monsieurs
- Department of Emergency Medicine, Antwerp University Hospital and University of Antwerp, Belgium
| | - F Semeraro
- Department of Anaesthesia, Intensive Care and EMS, Maggiore Hospital Bologna, Italy
| | - J Schlieber
- Department of Anaesthesia and Intensive Care, Allgemeine Unfallversicherungsanstalt, Trauma Centre Salzburg, Salzburg, Austria
| | - A Cheng
- Departments of Paediatrics and Emergency Medicine, University of Calgary, Calgary, Canada
| | - B L Bigham
- Department of Medicine, Stanford University, CA, USA
| | - R Garg
- Department of Onco-Anaesthesia and Palliative Medicine, Dr Braich, All India Institute of Medical Sciences, New Delhi, India
| | - J C Finn
- Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Australia
| | - R Greif
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Switzerland; School of Medicine, Sigmund Freud University Vienna, Vienna, Austria
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Jiang B, Zhang W, Liu P, Yang C, Wang M, Jia R, Zhu D, Liu M, Yang Q, Wu Y, Zhao X, Cheng A, Chen S. The prokaryotic expression, polyclonal antibody preparation, and subcellular localization of the transmembrane protein NS2A of the duck Tembusu virus. Acta Virol 2020; 64:380-385. [PMID: 32985208 DOI: 10.4149/av_2020_308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Duck Tembusu virus (DTMUV) is a single-stranded, positive-sense RNA arbovirus, belonging to the genus Flavivirus, the family Flaviviridae. As a transmembrane protein, non-structural protein 2A (NS2A) plays an important role in virion assembly, replication complex and antagonizing host immune response. Since NS2A protein contains many hydrophobic amino acids, it is hard to gain the full-length protein of NS2A for prokaryotic expression. Therefore, to make a deep study, prokaryotic expression and polyclonal antibody preparation of truncated DTMUV NS2A was performed. The truncated NS2A gene (178-450 bp) was obtained, and sub-cloned into the prokaryotic vector pGEX-4T-1 (pGEX-4T-1-NS2A178-450bp). Subsequently, the recombinant GST-NS2A60-150aa protein was successfully expressed in E. coli BL21 (DE3) with the induction by 0.3 mmol/l isopropyl β-D-thiogalactoside (IPTG) for 6 h at 37°C. The GST-NS2A60-150aa protein was extracted from the gel. The BALB/c mice were immunized with the purified recombinant NS2A protein to prepare polyclonal antibodies against the truncated NS2A protein. The titer of the polyclonal antibodies, determined by ELISA analysis, was 1:128,000. The specificity of the polyclonal antibodies (mPAb-DTMUV-NS2A60-150aa) were verified by Western blot analysis. Furthermore, the indirect immunofluorescence (IFA) was performed to explore the subcellular localization of NS2A. NS2A protein was, in the transfected cells, located mainly around nucleus in the endoplasmatic reticulum. Taken together, our study provided a useful tool for the further exploration of the biological functions and molecular mechanism of DTMUV NS2A. Keywords: duck Tembusu virus; non-structural protein 2A; prokaryotic expression; polyclonal antibodies; subcellular location.
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25
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Cheng A, Yip E, Tsang J, Chan P, Choi A, Yiu B, Kam J, Young G, So K, Zuo Z, Cheung Y, Zhou K, Lam T. PCN10 ORAL H2RA for Taxane Hypersensitivity Prevention: A Pharmacokinetic-Guided Decision. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Conley A, Demetri G, Doebele R, Drilon A, Paz-Ares L, Cassier P, Siena S, Ahn MJ, Buchschacher G, Seto T, Chee C, Krzakowski M, Ou SH, Grohé C, Zagonel V, Spira A, Cheng A, Kapre A, Piault E, Rolfo C. 539P Patient-reported outcomes (PROs) from patients (Pts) with NTRK fusion-positive (NTRK-fp) solid tumours receiving entrectinib in the global phase II STARTRK-2 study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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27
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Sangro B, Park J, Finn R, Cheng A, Mathurin P, Edeline J, Kudo M, Han K, Harding J, Merle P, Rosmorduc O, Wyrwicz L, Schott E, Choo S, Kelley R, Begic D, Chen G, Neely J, Tschaika M, Yau T. LBA-3 CheckMate 459: Long-term (minimum follow-up 33.6 months) survival outcomes with nivolumab versus sorafenib as first-line treatment in patients with advanced hepatocellular carcinoma. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.078] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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28
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Styles CE, Cheng A, Hoad VC, Kiely P, Watson M, Seed CR. Excluding Occult Hepatitis B Infection before Assigning False-Positive Status to Non-Repeatable NAT Reactivity: Concerning Stolz et al. "Safe-Testing Algorithm for Individual-Donation Nucleic Acid Testing: 10 Years of Experience in a Low-Prevalence Country" [Transfus Med Hemother. 2019 Apr;46(2):104-10]. Transfus Med Hemother 2020; 47:272-274. [PMID: 32595432 PMCID: PMC7315221 DOI: 10.1159/000502552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 08/06/2019] [Indexed: 12/12/2022] Open
Affiliation(s)
- Claire E. Styles
- Clinical Services and Research, Australian Red Cross Blood Service, Perth, Washington, Australia
| | - Anthea Cheng
- Clinical Services and Research, Australian Red Cross Blood Service, Perth, Washington, Australia
| | - Veronica C. Hoad
- Clinical Services and Research, Australian Red Cross Blood Service, Perth, Washington, Australia
| | - Philip Kiely
- Clinical Services and Research, Australian Red Cross Blood Service, Melbourne, Victoria, Australia
| | - Michael Watson
- Clinical Services and Research, Australian Red Cross Blood Service, Perth, Washington, Australia
| | - Clive R. Seed
- Clinical Services and Research, Australian Red Cross Blood Service, Perth, Washington, Australia
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29
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Grundy WM, Bird MK, Britt DT, Cook JC, Cruikshank DP, Howett CJA, Krijt S, Linscott IR, Olkin CB, Parker AH, Protopapa S, Ruaud M, Umurhan OM, Young LA, Dalle Ore CM, Kavelaars JJ, Keane JT, Pendleton YJ, Porter SB, Scipioni F, Spencer JR, Stern SA, Verbiscer AJ, Weaver HA, Binzel RP, Buie MW, Buratti BJ, Cheng A, Earle AM, Elliott HA, Gabasova L, Gladstone GR, Hill ME, Horanyi M, Jennings DE, Lunsford AW, McComas DJ, McKinnon WB, McNutt RL, Moore JM, Parker JW, Quirico E, Reuter DC, Schenk PM, Schmitt B, Showalter MR, Singer KN, Weigle GE, Zangari AM. Color, composition, and thermal environment of Kuiper Belt object (486958) Arrokoth. Science 2020; 367:science.aay3705. [PMID: 32054693 DOI: 10.1126/science.aay3705] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 01/22/2020] [Indexed: 11/02/2022]
Abstract
The outer Solar System object (486958) Arrokoth (provisional designation 2014 MU69) has been largely undisturbed since its formation. We studied its surface composition using data collected by the New Horizons spacecraft. Methanol ice is present along with organic material, which may have formed through irradiation of simple molecules. Water ice was not detected. This composition indicates hydrogenation of carbon monoxide-rich ice and/or energetic processing of methane condensed on water ice grains in the cold, outer edge of the early Solar System. There are only small regional variations in color and spectra across the surface, which suggests that Arrokoth formed from a homogeneous or well-mixed reservoir of solids. Microwave thermal emission from the winter night side is consistent with a mean brightness temperature of 29 ± 5 kelvin.
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Affiliation(s)
- W M Grundy
- Lowell Observatory, Flagstaff, AZ 86001, USA. .,Department of Astronomy and Planetary Science, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - M K Bird
- Argelander-Institut für Astronomie, University of Bonn, D-53121 Bonn, Germany.,Rheinisches Institut für Umweltforschung, Universität zu Köln, 50931 Cologne, Germany
| | - D T Britt
- University of Central Florida, Orlando, FL 32816, USA
| | - J C Cook
- Pinhead Institute, Telluride, CO 81435, USA
| | | | - C J A Howett
- Southwest Research Institute, Boulder, CO 80302, USA
| | - S Krijt
- Steward Observatory, University of Arizona, Tucson, AZ 85719, USA
| | | | - C B Olkin
- Southwest Research Institute, Boulder, CO 80302, USA
| | - A H Parker
- Southwest Research Institute, Boulder, CO 80302, USA
| | - S Protopapa
- Southwest Research Institute, Boulder, CO 80302, USA
| | - M Ruaud
- NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - O M Umurhan
- NASA Ames Research Center, Moffett Field, CA 94035, USA.,Carl Sagan Center, SETI Institute, Mountain View, CA 94043, USA
| | - L A Young
- Southwest Research Institute, Boulder, CO 80302, USA
| | - C M Dalle Ore
- NASA Ames Research Center, Moffett Field, CA 94035, USA.,Carl Sagan Center, SETI Institute, Mountain View, CA 94043, USA
| | - J J Kavelaars
- National Research Council, Victoria, BC V9E 2E7, Canada.,Department of Physics and Astronomy, University of Victoria, Victoria, BC V8W 2Y2, Canada
| | - J T Keane
- California Institute of Technology, Pasadena, CA 91125, USA
| | - Y J Pendleton
- NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - S B Porter
- Southwest Research Institute, Boulder, CO 80302, USA
| | - F Scipioni
- NASA Ames Research Center, Moffett Field, CA 94035, USA.,Carl Sagan Center, SETI Institute, Mountain View, CA 94043, USA
| | - J R Spencer
- Southwest Research Institute, Boulder, CO 80302, USA
| | - S A Stern
- Southwest Research Institute, Boulder, CO 80302, USA
| | - A J Verbiscer
- University of Virginia, Charlottesville, VA 22904, USA
| | - H A Weaver
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - R P Binzel
- Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - M W Buie
- Southwest Research Institute, Boulder, CO 80302, USA
| | - B J Buratti
- NASA Jet Propulsion Laboratory, La Cañada Flintridge, CA 91011, USA
| | - A Cheng
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - A M Earle
- Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - H A Elliott
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - L Gabasova
- Institut de Planétologie et d'Astrophysique de Grenoble, Centre National de la Recherche Scientifique, Université Grenoble Alpes, Grenoble, France
| | - G R Gladstone
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - M E Hill
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M Horanyi
- University of Colorado, Boulder, CO 80309, USA
| | - D E Jennings
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - A W Lunsford
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - D J McComas
- Princeton University, Princeton, NJ 08544, USA
| | | | - R L McNutt
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - J M Moore
- NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - J W Parker
- Southwest Research Institute, Boulder, CO 80302, USA
| | - E Quirico
- Institut de Planétologie et d'Astrophysique de Grenoble, Centre National de la Recherche Scientifique, Université Grenoble Alpes, Grenoble, France
| | - D C Reuter
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - P M Schenk
- Lunar and Planetary Institute, Houston, TX 77058, USA
| | - B Schmitt
- Institut de Planétologie et d'Astrophysique de Grenoble, Centre National de la Recherche Scientifique, Université Grenoble Alpes, Grenoble, France
| | - M R Showalter
- Carl Sagan Center, SETI Institute, Mountain View, CA 94043, USA
| | - K N Singer
- Southwest Research Institute, Boulder, CO 80302, USA
| | - G E Weigle
- Big Head Endian LLC, Leawood, KS 67019, USA
| | - A M Zangari
- Southwest Research Institute, Boulder, CO 80302, USA
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30
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Enero R, Obillos S, Yao P, Dizon E, Choa V, Go L, Cheng A, Carreon A. P1445 DORv and window: a case of an uncorrected double outlet right ventricle with d-transposition of great arteries with concomitant aortopulmonary window in a 31-year-old female. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
none
Double outlet right ventricle (DORV) is a rare type of ventriculo-arterial connection occurring in about 1-3% of congenital heart defects. Moreover, transposition of the great arteries, wherein the aorta is anterior and to the right of the pulmonary artery (D-TGA), accounts for only 26% of cases of DORV. An aortopulmonary window, on the other hand, represents approximately only 0.2% of all congenital cardiac lesions. A case of DORV with D-TGA and pulmonary stenosis with a concomitant aortopulmonary window has never been reported, particularly in an adult in the third decade of life and without any history of surgical repair.
We present the case of a 31-year-old female who had sought consult for left-sided weakness. On physical examination, a grade IV/VI systolic murmur was heard at the left anterior chest and cyanosis of the digits of the upper and lower extremities were noted. Transthoracic echocardiogram revealed a non-restrictive ventricular septal defect (VSD) and segmental approach showed atrial and visceral situs solitus, levocardia, and atrioventricular concordance. However, there was ventriculoarterial discordance with fusiform aneurysmal dilatation of the aorta, which was noted to be at the right of and anterior to the pulmonary artery. Both great vessels arose from the right ventricle. Other echocardiographic findings included dilated right atrium, dilated and hypertrophied right ventricle with volume and pressure overload, global left ventricular hypokinesia with mild systolic dysfunction, and moderate to severe aortic regurgitation. The above complex congenital anomalies were confirmed via transesophageal echocardiogram and cardiac magnetic resonance imaging (MRI). Furthermore, pulmonary valve stenosis and aortopulmonary window, that was 3.5 centimeters in length located at the level of the proximal ascending aorta and main pulmonary artery, were seen on the MRI.
Various cardiac imaging modalities aided in cinching the diagnosis for this very rare complex congenital case in an adult reaching the third decade of life. Palliative care was deemed best for this patient due to the severity of her cardiac condition.
Abstract P1445 Figure 1.
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Affiliation(s)
- R Enero
- Cardinal Santos Medical Center, Manila, Philippines
| | - S Obillos
- Cardinal Santos Medical Center, Manila, Philippines
| | - P Yao
- Cardinal Santos Medical Center, Manila, Philippines
| | - E Dizon
- Cardinal Santos Medical Center, Manila, Philippines
| | - V Choa
- Cardinal Santos Medical Center, Manila, Philippines
| | - L Go
- Cardinal Santos Medical Center, Manila, Philippines
| | - A Cheng
- Cardinal Santos Medical Center, Manila, Philippines
| | - A Carreon
- Cardinal Santos Medical Center, Manila, Philippines
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31
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Pandit C, Pellen G, Waters K, Fitzgerald D, Cheng A. Use of non-invasive ventilation in children with congenital tracheal stenosis: a 10-year retrospective review. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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32
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Han J, Liau I, Bayetto K, May B, Goss A, Sambrook P, Cheng A. The financial burden of acute odontogenic infections: the South Australian experience. Aust Dent J 2019; 65:39-45. [PMID: 31618789 DOI: 10.1111/adj.12726] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Acute odontogenic infections are a common surgical emergency managed by public hospitals in Australia which cause considerable patient morbidity and occasionally, mortality. Despite posing a significant public health burden, Australian data evaluating the cost of the management of these patients are lacking. This study assessed the patient and treatment variables associated with inpatient management of deep odontogenic infections, and their respective financial impact, at a statewide Oral & Maxillofacial service. METHODS A retrospective audit was carried out of patients with deep odontogenic infections at our institution, over a 7-year period. The primary outcome was the total cost of admission. Secondary outcomes included treatment received, operating room time, return-to-theatre, length of admission (LOS), and intensive care unit (ICU) use. Cost variables were assessed against the total LOS and ICU use to determine clinical predictors affecting outcome. RESULTS Four hundred and sixty two patients met the inclusion criteria. The average cost per patient was $12 228 Australian Dollars. After multivariate analysis, variables most significantly associated with increased cost of care and LOS were high-risk infections with airway compromise, high admission white cell count and age. CONCLUSION Hospital-based management of deep-space odontogenic infections engender significant costs compared to early primary care intervention such as a dental extraction ($181/extraction).
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Affiliation(s)
- J Han
- Department of General Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - I Liau
- Oral & Maxillofacial Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - K Bayetto
- Oral & Maxillofacial Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - B May
- Oral & Maxillofacial Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - A Goss
- School of Dentistry, University of Adelaide, Adelaide, South Australia, Australia
| | - P Sambrook
- Oral & Maxillofacial Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,School of Dentistry, University of Adelaide, Adelaide, South Australia, Australia
| | - A Cheng
- Oral & Maxillofacial Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,School of Dentistry, University of Adelaide, Adelaide, South Australia, Australia
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Ghosh-Swaby OR, Goodman SG, Leiter LA, Cheng A, Connelly K, Fitchett D, Juni P, Farkouh ME, Udell JA. 4113Glucose lowering drugs or strategies, major adverse cardiovascular events and heart failure outcomes, and association with weight loss - meta-analysis of large cardiovascular outcome trials. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Glucose lowering drugs or strategies (GLDS) have varied effects on major adverse cardiovascular events (MACE) and heart failure (HF) in cardiovascular outcomes trials. Mechanisms driving cardiovascular risk reduction remain elusive.
Methods
We searched MEDLINE, PubMed, and meeting abstracts up to 11/21/2018 for large GLDS cardiovascular outcome trials (CVOTs) in patients with or at risk for type 2 diabetes. Primary endpoints of MACE and HF were evaluated with random effects risk ratios (RR) and explored by baseline CVD subgroups and meta-regression by weight change across treatment arms.
Results
In 27 GLDS CVOTs, a total 207,820 patients, median age 63 years, 64% male, 64% CVD and 11% with prior HF were studied over a mean 3.8 years with 20,118 (10%) patients having MACE and 7,212 (4%) a HF event. Compared with standard care, GLDS overall lowered MACE (RR 0.92, P<0.ehz745.01171) but not HF (RR 1.01, P=0.91). Across GLDS, the magnitude and directionality varied modestly for MACE RR (P-int=0.07) but markedly for HF (P-int<0.ehz745.01171). Meta-regression showed a change in HF RR by 6% (95% CI 3%-9%) per 1 kg weight gain/loss between treatment arms (P=0.0006; Figure). In 9 trials of GLDS that achieved marked weight loss (lifestyle, GLP1 agonists, SGLT2 inhibitors), MACE benefit was confined to patients with baseline CVD (RR 0.89 [0.84–0.95] versus without (RR 1.02 [0.91–1.15]; P-int=0.01) with consistent HF effect (RR 0.80 [0.72–0.88] vs RR 0.76 [0.56–1.03]; P-int=0.74).
Heart Failure Risk and Changes in Weight
Conclusion
HF outcomes were improved with GLDS that lower weight. Among diabetes GLDS that lower weight, there was a robust risk reduction in atherothrombotic and heart failure events, with the MACE benefit confined to patients with established CVD.
Acknowledgement/Funding
Heart and Stroke Foundation
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Affiliation(s)
| | - S G Goodman
- St. Michael's Hospital, Cardiology, University of Toronto, Toronto, Canada
| | - L A Leiter
- St. Michael's Hospital, Cardiology, University of Toronto, Toronto, Canada
| | - A Cheng
- University of Toronto, Endocrinology, Toronto, Canada
| | - K Connelly
- St. Michael's Hospital, Cardiology, University of Toronto, Toronto, Canada
| | - D Fitchett
- St. Michael's Hospital, Cardiology, University of Toronto, Toronto, Canada
| | - P Juni
- St. Michael's Hospital, Cardiology, University of Toronto, Toronto, Canada
| | - M E Farkouh
- UHN - University of Toronto, Peter Munk Cardiac Institute, Toronto, Canada
| | - J A Udell
- Women's College Hospital, University of Toronto, Peter Munk Cardiac Institute, Toronto, Canada
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Garg A, Koneru JN, Fagan D, Stromberg K, El-Chami MF, Piccini JP, Roberts PR, Soejima K, Cheng A, Ellenbogen KA. 5970Morbidity and mortality in patients precluded for transvenous pacemaker implantation: experience with the Micra transcatheter pacemaker. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The Micra transcatheter pacemaker has proven to be a safe and effective alternative to transvenous pacemakers (TVPs). However, the safety profile after Micra implantation in patients deemed poor candidates for TVPs is poorly understood.
Purpose
To evaluate the safety and all-cause mortality outcomes in Micra recipients stratified by whether or not they were precluded for therapy with TVP.
Methods
Micra patients from the Micra Transcatheter Pacing (IDE) Study, Continued Access (CA) study, and Post-Approval Registry (PAR) were divided into groups based upon whether or not the implanting physician considered the patient to be precluded from receiving a transvenous pacing system. All-cause mortality was compared between the Micra patient groups and patients receiving a single-chamber transvenous pacing system (SC-TVP) since 2010 from the Medtronic product surveillance registry using univariate and multivariate Cox models.
Results
Among 2,819 patients who underwent a Micra implant attempt, the overall major complication rate through 24 months was 3.5%. In these patients, 548 were deemed precluded from TVP implantation. Prior device infection or bacteremia (38.9%), venous access issues (36.1%) and thrombosis (10.2%) were amongst the most common causes of preclusion for TVP implantation. These patients were younger (71.7 vs. 76.7 years), more frequently on hemodialysis (26.3% vs. 2.5%), and more often had a prior CIED implanted (38.4% vs. 4.4%) than non-precluded patients. Over an average follow-up of 13.5±11.1 months, all-cause mortality was significantly higher in precluded Micra patients compared with SC-TVP patients (HR: 2.16, 95% CI: 1.54–3.2, P<0.001) (Figure 1). However, there was no significant difference in all-cause mortality when comparing non-precluded Micra patients and SC-TVP patients (HR: 1.12, 95% CI: 0.86–1.44, P=0.401). Acute all-cause death (within 1 month) among Micra patients was 2.74% and 1.32% in the precluded and non-precluded TVP groups, respectively. The procedure-related death rate was 0.55% for the TVP precluded group and 0.13% for the not precluded group (P=0.092). The major complication rate through 24-months was similar between the two Micra groups (4.0% vs 3.4%, P=0.630).
All-cause mortality for Micra and SC-TVP
Conclusion
The overall safety profile of Micra remains is in line with previously reported data. All-cause mortality risk (both acute and long term) appears to be higher in patients who were precluded from receiving TVP.
Acknowledgement/Funding
Supported by Medtronic
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Affiliation(s)
- A Garg
- Virginia Commonwealth University, Richmond, United States of America
| | - J N Koneru
- Virginia Commonwealth University, Richmond, United States of America
| | - D Fagan
- Medtronic, Mounds View, Minnesota, United States of America
| | - K Stromberg
- Medtronic, Mounds View, Minnesota, United States of America
| | - M F El-Chami
- Emory University, Atlanta, United States of America
| | - J P Piccini
- Duke Clinical Research Institute, Durham, United States of America
| | - P R Roberts
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | | | - A Cheng
- Medtronic, Mounds View, Minnesota, United States of America
| | - K A Ellenbogen
- Virginia Commonwealth University, Richmond, United States of America
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Spencer S, Goss A, Cheng A, Stein B, Sambrook P. Mandibular advancement splints for obstructive sleep apnoea – a cautionary tale. Aust Dent J 2019; 64:359-364. [DOI: 10.1111/adj.12712] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2019] [Indexed: 11/29/2022]
Affiliation(s)
- S Spencer
- Oral and Maxillofacial Surgery Unit of South Australia Adelaide South Australia Australia
| | - A Goss
- Oral and Maxillofacial Surgery Unit of South Australia Adelaide South Australia Australia
| | - A Cheng
- Oral and Maxillofacial Surgery Unit of South Australia Adelaide South Australia Australia
| | - B Stein
- Oral and Maxillofacial Surgery Unit of South Australia Adelaide South Australia Australia
| | - P Sambrook
- Oral and Maxillofacial Surgery Unit of South Australia Adelaide South Australia Australia
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Rimassa L, Cheng A, Braiteh F, Benzaghou F, Hazra S, Borgman A, Sinha R, Kayali Z, Zhu A, Kelley R. Phase 3 (COSMIC-312) study of cabozantinib in combination with atezolizumab vs sorafenib in patients with advanced hepatocellular carcinoma (aHCC) who have not received previous systemic anticancer therapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Knox J, Cheng A, Cleary S, Galle P, Kokudo N, Lencioni R, Park J, Zhou J, Mann H, Morgan S, Liu X, Chin S, Vlahovic G, Fan J. A phase 3 study of durvalumab with or without bevacizumab as adjuvant therapy in patients with hepatocellular carcinoma at high risk of recurrence after curative hepatic resection or ablation: EMERALD-2. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.216] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Knox J, Cheng A, Cleary S, Galle P, Kokudo N, Lencioni R, Park J, Zhou J, Mann H, Morgan S, Liu X, Chin S, Vlahovic G, Fan J. A phase 3 study of durvalumab with or without bevacizumab as adjuvant therapy in patients with hepatocellular carcinoma (HCC) who are at high risk of recurrence after curative hepatic resection. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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39
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Miksad R, Cicin I, Chen Y, Klumpen H, Kim S, Lin Z, Youkstetter J, Sen S, Cheng A, Meyer T, Kelley R, Abou-Alfa G. Outcomes based on Albumin‐Bilirubin (ALBI) grade in the phase 3 CELESTIAL trial of cabozantinib versus placebo in patients with advanced hepatocellular carcinoma (HCC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz154.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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40
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Luo X, Liu Y, Jia R, Shen H, Wang X, Wang M, Zhu D, Chen S, Liu M, Zhao X, Wu Y, Yang Q, Yin Z, Cheng A. Ultrastructure of duck Tembusu virus observed by electron microscopy with negative staining. Acta Virol 2019; 62:330-332. [PMID: 30160149 DOI: 10.4149/av_2018_227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Duck Tembusu virus (DTMUV) is a newly emerging enveloped flavivirus. This study shows the ultrastructure of DTMUV using viral purification, negative staining and electron microscopy. Electron microscopic examinations revealed mature DTMUV particles with 50 to 75 nm in diameter and typical enveloped flavivirus structure that consists of the internal nucleocapsid, an inner layer of lipid bilayer and an external layer of E glycoprotein ectodomain. Particles appear to be mostly spherical. In particular, RNA core is deep colored and dense, both capsid and lipid bilayer are clearly visible, the capsid forms regular hexagon, and E glycoprotein ectodomain forms a fringe instead of visible spikes. Thus, this report about the clear ultrastructure of the DTMUV particles will be the major driving forces behind structural biology of DTMUV.
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Zhang JY, He PJ, Cheng A, Zheng WW, Yang M. [Impact of hypoxia-reoxygenation environment on autophagy level of osteoblasts]. Zhonghua Yi Xue Za Zhi 2019; 99:844-849. [PMID: 30893729 DOI: 10.3760/cma.j.issn.0376-2491.2019.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the impact of hypoxia-reoxygenation environment on the level of autophagy in osteoblasts. Methods: Osteoblasts were purified from the skulls of newborn SD rats within 24-48 hours by tissue block adherence culture and differential centrifugation. The osteoblasts were identified by alizarin red staining and alkaline phosphatase staining. The third generation osteoblasts were cultured in normal state and randomly divided into four groups: group A was cultured under normal condition for 36 hours; group B was cultured under normal condition for 18 hours, then under hypoxia for 18 hours; group C was cultured under hypoxia for 36 hours; group D was cultured under hypoxia for 18 hours, and then under normal condition for 18 hours. The ability to form calcium nodules of osteoblasts in the four groups was observed after culture. The proliferation activity of osteoblasts was detected by CCK-8 assay. The expressions of autophagy specified gene Beclin 1, microtubule-associated protein light chain 3(LC3) and collagen Ⅰ(COL-Ⅰ), bone morphogenetic protein 2 (BMP-2) genes were detected by real time polymerase chain reaction (RT-PCR), and the protein expressions of Beclin 1, LC3-Ⅰ,LC3-Ⅱ and P62 were detected by immunoblotting. Results: Alizarin red staining showed that osteoblasts in group A had the strongest calcification ability, and calcification ability of osteoblasts in group B,C and D lowered gradually, and it was lowest in group D. The proliferative activity under the CCK-8 detection in group A, B, C and D was 98%±8%, 90%±8%,82%±9%,76%±8%, respectively (F=35.764, P=0.000). The mRNA expression of Beclin 1, LC3-Ⅱthe 4 groups increased gradurally (group D> group C> group B> group A)(F=38.327, 16.583, both P<0.05); and the mRNA expression of COL-Ⅰ, BMP-2 decreased gradually in the 4 groups (group A> group B> group C> group D) (F=20.387, 12.426, both P<0.05). The protein expression of Beclin 1,LC3-Ⅱ/LC3-Ⅰ increased gradually in the groups (group D>group C>group B>group A) (F=26.843, 28.576, bothP<0.05), and the expression of P62 protein decreased gradually (F=18.946, P=0.011). Conclusions: Hypoxia-reoxygenation environment can reduce the proliferation activity of osteoblasts and up-regulate the expression of autophagy-related genes in osteoblasts. Anoxic reoxygenation environment promotes the increasing of autophagy levels in osteoblasts.
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Affiliation(s)
- J Y Zhang
- Department of Orthopedics and Traumatology, Yijishan Hospital Affiliated to Wannan Medical College, Wuhu 241001, China
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Cheng A, Levy M. Abstract OT2-10-01: Treatment burden and capacity to manage care among patients with breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot2-10-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Patients with breast cancer spend significant time1, effort, and financial resources2 to combat the disease for years after their diagnosis. The large volume of healthcare tasks can cause patients to become overburdened, leading to reduced adherence with care plans and worse outcomes3. On the other hand, certain patient characteristics such as physical resilience, financial well-being, and supportive family environments increase patients' capacity to manage care4. Assessing treatment burden and capacity when prescribing care has been applied to populations such as diabetes patients5. We are investigating this paradigm in treatment of patients with breast cancer. The goal of this preliminary study is to identify significant factors that contribute to treatment burden, capacity to manage care, and outcomes of overburden for patients with breast cancer.
Examples of treatment burden, capacity to manage care, and outcomes of overburden in patients with breast cancerTreatment burdenCapacity to manage careOutcomes of overburdenTraveling long distances for careAccess to reliable transportationReduced spending on food, utilities, or other necessitiesPaying for child care during chemotherapyFlexibility in informal caregivers' schedulesMissed appointment with medical oncologistRemembering to take medications with mealsMedical understanding or knowledgeWorse than expected side effectsReporting adverse eventsProficiency with mobile deviceTrip to emergency room
Through literature review, interviews with survivors, and expert panels of navigators and providers, we will develop a survey instrument given to patients at the time of diagnosis. The survey will assess patient capacity and help providers give treatment options based on attributes of the patient. Additionally, we will attempt to correlate survey results with treatment burden measures derived from electronic health record data at a population level1. With treatment personalized for patient capacity, patients should be better able to adhere to care plans leading to improved quality of life during treatment and beyond.
Acknowledgements: The authors would like to thank Cheryl Jernigan, our patient advocate mentor, for her guidance in this project. We would also like to thank the Susan G. Komen Foundation for their support of this research.
References:
1. Cheng, A. C. & Levy, M. A. Data Driven Approach to Burden of Treatment Measurement: A Study of Patients with Breast Cancer. AMIA Annu. Symp. proceedings. AMIA Symp. 2016, 1756–1763 (2016).
2. Zafar, S. Y. et al. The financial toxicity of cancer treatment: a pilot study assessing out-of-pocket expenses and the insured cancer patient's experience. Oncologist. 18, 381–90 (2013).
3. Mair, F. S. & May, C. R. Thinking about the burden of treatment. BMJ. 349, g6680–g6680 (2014).
4. Boehmer, K. R., Shippee, N. D., Beebe, T. J. & Montori, V. M. Pursuing Minimally Disruptive Medicine: Correlation of patient capacity with disruption from illness and healthcare-related demands. J. Clin. Epidemiol. (2016).
5. Ishii, H. et al. Reproducibility and Validity of a Questionnaire Measuring Treatment Burden on Patients with Type 2 Diabetes: Diabetic Treatment Burden Questionnaire (DTBQ). Diabetes Ther. 9, 1001–1019 (2018).
Citation Format: Cheng A, Levy M. Treatment burden and capacity to manage care among patients with breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT2-10-01.
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Affiliation(s)
- A Cheng
- Vanderbilt University Medical Center, Nashville, TN
| | - M Levy
- Vanderbilt University Medical Center, Nashville, TN
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Baclig NV, Ngo C, Yeh AC, Chung SH, Cheng A, Grim J, Graf SA, Yang KC. Steroid-Refractory Autoimmune Myocarditis after Pembrolizumab Therapy: Failure of Equine Anti-Thymocyte Globulin to Prevent Heart Failure. J Clin Case Rep 2019; 2:1-4. [PMID: 36712142 PMCID: PMC9881190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
While immune checkpoint inhibitors (ICIs) are improving outcomes for many cancers, they can have severe adverse effects. Though cardiac immune-related adverse effects (irAEs) are rare, they have considerable morbidity and mortality. Prior case studies have demonstrated successful treatment of ICI induced autoimmune myocarditis with a variety of immunosuppressive regimens. This case describes steroid-refractory autoimmune myocarditis after treatment with pembrolizumab. Treatment with equine anti-thymocyte globulin, a regimen previously documented to reverse ICI induced autoimmune myocarditis, temporarily improved clinical status and cardiac biomarkers, however eventually failed to prevent progression to heart failure and cardiovascular death. This case highlights the importance of early stress-dose steroids, identifies troponin as a potential marker of treatment response, and underscores the value of collaboration between oncology and cardiology for optimal management.
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Affiliation(s)
- NV Baclig
- Department of Medicine, University of Washington, USA,Correspondence: Baclig NV, Department of Medicine, University of Washington, 325 Ninth Ave, Seattle, WA, 98104-2420; USA. Tel: (847)-609-2487, Fax: (206) 744-1554l,
| | - C Ngo
- Division of Cardiology, Department of Medicine, University of Washington, USA
| | - AC Yeh
- Division of Hematology, Division of Medical Oncology, Department of Medicine, University of Washington, USA
| | - SH Chung
- Department of Pharmacology, Veterans Affairs Puget Sound Health Care System, USA
| | - A Cheng
- Division of Cardiology, Department of Medicine, University of Washington, USA
| | - J Grim
- Division of Medical Oncology, Department of Medicine, University of Washington, USA
| | - SA Graf
- Division of Medical Oncology, Department of Medicine, University of Washington, USA
| | - KC Yang
- Division of Cardiology, Department of Medicine, University of Washington, USA
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Cheng A, Craig C, Summers Y, Taylor P, Califano R, Cove-Smith L, Woolf D, Duerden R, Sharman A, Lyons J, Crosbie P, Booton R, Evison M. Metachronous oligometastatic non-small cell lung cancer: are we selecting the appropriate patients for radical treatment? Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30128-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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45
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Tu M, Liu P, Liu F, Wang M, Jia R, Zhu D, Liu M, Sun K, Yang Q, Wu Y, Chen X, Cheng A, Chen S. Construction of expression vectors of capsid proteins from goose parvovirus and investigation of the immunogenicity. Acta Virol 2018; 62:415-423. [PMID: 30472872 DOI: 10.4149/av_2018_410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Goose parvovirus (GPV) is a highly contagious and lethal disease in goslings and Muscovy ducklings, and is of concern to the waterfowl industry. With the aim of comparing the cellular immunogenicity of three capsid proteins of GPV, plasmids of pcDNA3.1(+)-VP1, pcDNA3.1(+)-VP2, and pcDNA3.1(+)-VP3 were constructed, and the recombinant protein VPs were expressed using an eukaryotic expression system. We detected the levels of immune-related genes (CD4, CD8α, IL-1β, IL-6, IFNα, IFNγ, and IFNλ) in both goose embryo fibroblasts (GEF) and goose peripheral blood mononuclear cells (PBMCs) cellular models. The immune response conferred by a VP2 DNA vaccine in vivo was observed in a time course. Our data suggested that the cellular immune response to VP2 and VP3 was stronger than that to VP1, while VP2 and VP3 shared similar cellular immune reactivity. In addition, vaccination with VP2 plasmid can induce high level of IgY antibody that continued to increase through 28 days post vaccination. Therefore, our findings shed light on the host cellular immune response against GPV capsid proteins. Keywords: GPV; capsid proteins; cellular immune response; humoral immunity.
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Cheng A, Simon H, Travers C, Hebbar K. 223 Evaluating the Clinical Respiratory Score for Initiating High Flow Nasal Cannula in the Pediatric Emergency Department. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Burford C, Cheng A, Jayne M, Alexander EC, Hall J, Lee KK, Patel AS. 42THE IMPACT OF DEMENTIA ON MORTALITY IN ACUTE MEDICAL ADMISSIONS. Age Ageing 2018. [DOI: 10.1093/ageing/afy121.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Burford
- Faculty of Life Sciences and Medicine, King’s College London
| | - A Cheng
- Faculty of Life Sciences and Medicine, King’s College London
| | - M Jayne
- Faculty of Life Sciences and Medicine, King’s College London
| | - E C Alexander
- Faculty of Life Sciences and Medicine, King’s College London
| | - J Hall
- King’s College Hospital, London, UK
| | - K K Lee
- King’s College Hospital, London, UK
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Cheng A, Alexander EC, Burford C, Jayne M, Hall J, Patel AS, Lee KK. 40THE RELATIONSHIP BETWEEN LIVING ARRANGEMENT, CARE PACKAGES AND INPATIENT DEATHS IN OLDER ADULTS: A RETROSPECTIVE STUDY AT A LONDON TEACHING HOSPITAL. Age Ageing 2018. [DOI: 10.1093/ageing/afy121.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Cheng
- Faculty of Life Sciences and Medicine, King’s College London
| | - E C Alexander
- Faculty of Life Sciences and Medicine, King’s College London
| | - C Burford
- Faculty of Life Sciences and Medicine, King’s College London
| | - M Jayne
- Faculty of Life Sciences and Medicine, King’s College London
| | - J Hall
- King’s College Hospital, London, UK
| | | | - K K Lee
- King’s College Hospital, London, UK
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Wei Y, Chen S, Wang M, Cheng A. Tripartite motif-containing proteins precisely and positively affect host antiviral immune response. Scand J Immunol 2018; 87:e12669. [PMID: 29706026 DOI: 10.1111/sji.12669] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 04/22/2018] [Indexed: 12/17/2022]
Abstract
The tripartite motif-containing proteins (TRIMs) comprise a large family of proteins with over 70 members in humans. Recent studies have shown that TRIMs play unexpected roles in the antiviral immune responses to infections by HIV, MLV, EMCV, AIV and other viruses. There are two mechanisms used by TRIMs in the inhibition of virus infections: (1) TRIMs target the produced viruses for ubiquitination, which induces proteasome-dependent degradation, or they interact with host proteins to inhibit viral infection in various periods of the viral life cycle. (2) TRIMs activate innate immune signalling pathways, such as RLR and TLR, which induce IFN production. In this study, we will review recent studies regarding the means by which TRIMs function as inhibitors in viral infection through the mechanisms described above.
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Affiliation(s)
- Y Wei
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan, China
| | - S Chen
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan, China.,Research Center of Avian Disease, College of Veterinary Medicine of Sichuan Agricultural University, Chengdu, Sichuan, China.,Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan, China
| | - M Wang
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan, China.,Research Center of Avian Disease, College of Veterinary Medicine of Sichuan Agricultural University, Chengdu, Sichuan, China.,Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan, China
| | - A Cheng
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan, China.,Research Center of Avian Disease, College of Veterinary Medicine of Sichuan Agricultural University, Chengdu, Sichuan, China.,Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan, China
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Abstract
BACKGROUND Simulation-based education (SBE) has emerged as an essential modality for health professions education. One of the central tenants of effective SBE is reflective practice, typically guided by a facilitated debriefing. The debriefing conversation has the possibility of becoming a difficult conversation based on learner and situation-related factors. Difficult debriefing situations may threaten the learning environment, thus requiring an appreciation and understanding of the various ways that learners may react adversely to simulation and debriefing. AIM This article provides a review of the various phenotypes of difficult debriefing situations and a toolbox of proactive and reactive strategies to help guide the simulation educator to manage these situations, with the ultimate goal of achieving learning objectives.
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Affiliation(s)
- V J Grant
- a Department of Pediatrics and Emergency Medicine, Cumming School of Medicine , University of Calgary , Calgary , Canada
- b KidSIM Simulation Program , Alberta Children's Hospital , Calgary , Canada
| | - T Robinson
- b KidSIM Simulation Program , Alberta Children's Hospital , Calgary , Canada
| | - H Catena
- b KidSIM Simulation Program , Alberta Children's Hospital , Calgary , Canada
| | - W Eppich
- c Departments of Pediatrics and Medical Education , Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago , Chicago , IL , USA
| | - A Cheng
- a Department of Pediatrics and Emergency Medicine, Cumming School of Medicine , University of Calgary , Calgary , Canada
- b KidSIM Simulation Program , Alberta Children's Hospital , Calgary , Canada
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