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Quinn KG, Walsh JL, Johnson A, Edwards T, Takahashi L, Dakin A, Bouacha N, Voisin D. Police Violence Experienced by Black Gay and Bisexual Men: The Effects on HIV Care Engagement and Medication Adherence. AIDS Behav 2024; 28:1642-1649. [PMID: 38315300 PMCID: PMC11070282 DOI: 10.1007/s10461-024-04278-2] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
Black men face high rates of police violence, including direct victimization and indirect exposure to or knowledge of harmful policing. This violence can result in death and physical harm, as well as in numerous poor mental health outcomes. There has been little research examining experiences of police violence experienced by Black gay and bisexual men or the effects of police brutality on HIV continuum of care outcomes. To address this important gap, in this exploratory study, we examined the effects of police brutality on engagement in HIV care and adherence to antiretroviral medications. Cross-sectional survey data were collected from 107 Black gay and bisexual men living with HIV. The path analysis showed that men with greater exposure to police violence had increased symptoms of post-traumatic stress disorder and were more likely to have missed HIV care appointments in the past year. Additionally, there was a significant indirect effect of exposure to police violence on missed medication doses via PTSD symptoms.
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Affiliation(s)
- Katherine G Quinn
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin Center for AIDS Intervention Research, 2071 N. Summit Ave, Milwaukee, WI, 53202, USA.
| | - Jennifer L Walsh
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin Center for AIDS Intervention Research, 2071 N. Summit Ave, Milwaukee, WI, 53202, USA
| | - Anthony Johnson
- School of Social Work, Loyola University Chicago, Chicago, IL, USA
| | - Travonne Edwards
- School of Child and Youth Care, Toronto Metropolitan University, Toronto, ON, Canada
| | - Lois Takahashi
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA
| | | | | | - Dexter Voisin
- School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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Voisin DR, Takahashi L, Walsh JL, DiFranceisco W, Johnson A, Dakin A, Bouacha N, Brown K, Quinn KG. An exploratory study of community violence and HIV care engagement among Black gay and bisexual men. AIDS Care 2024:1-8. [PMID: 38648523 DOI: 10.1080/09540121.2024.2331221] [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: 08/14/2023] [Accepted: 03/08/2024] [Indexed: 04/25/2024]
Abstract
This study examined the relationship between exposure to community violence and HIV care engagement among 107 Black gay or bisexual men living with HIV in Chicago. Measures assessed the importance of demographic covariates (age, annual income, health insurance status, and years living with HIV), community violence exposures, mental health, social support, in explaining variations in missed doses of antiretroviral therapy (ART) medication and missed HIV care appointments. Results showed that participants who reported higher rates of exposure to community violence were two times more likely to have missed ART doses and HIV care appointments. Participants who reported depression scores were two times more likely to have greater non-ART adherence. Finally, older participants were more likely to report fewer missed ART doses. More research is needed to clarify the mechanisms between age or depression and ART adherence given community violence exposure. Health care providers should screen for depression when attempting to promote better ART adherence and keeping HIV care appointments for Black gay and bisexual men living with HIV. Younger Black gay and bisexual men living with HIV may be more vulnerable than older men for missed ART doses and may require additional screening and follow-up.
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Affiliation(s)
- Dexter R Voisin
- Jack Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Lois Takahashi
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA
| | | | | | - Anthony Johnson
- School of Social Work, Loyola University Chicago, Chicago, IL, USA
| | | | | | - Khalil Brown
- Jack Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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Bergh EP, Mann LK, Won JH, Nobles A, Johnson A, Papanna R. Anchoring device to prevent membrane detachment and preterm premature rupture of membranes after fetal intervention. Ultrasound Obstet Gynecol 2024. [PMID: 38514967 DOI: 10.1002/uog.27646] [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] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 03/07/2024] [Accepted: 03/12/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVE Anchoring the fetal membrane to the uterine wall via a novel suture delivery system could reduce the risk of preterm premature rupture of membranes (PPROM) after fetoscopic surgery. This study assesses the feasibility of using a novel device designed for minimally invasive suturing to anchor fetal membranes to the uterine wall and to close surgical defects after fetoscopy. METHODS We tested the suturing device both ex vivo and in vivo. In the ex vivo studies, 12-French trocar defects were created with a fetoscope in five specimens of human uterine tissue with fetal membranes attached. Specimens were examined for integrity of the anchoring stitch. For in vivo studies, trocar defects were created in the two uterine horns of three pregnant ewes, each carrying twins at ~79-90 days gestation. One trocar defect in each ewe was repaired using the suture device, and the other was left unrepaired as a control. The repair sites were examined for membrane anchoring integrity when the defect was created and at delivery. RESULTS Fetal membranes were successfully anchored to the uterine myometrium using this device in all five trials performed ex vivo. The in vivo trials also revealed successful membrane anchoring compared with controls both at the time of device deployment and five-to-eight weeks after the procedure. CONCLUSIONS We successfully anchored amniotic membranes to the underlying myometrium via suturing device both ex vivo and in vivo. Further studies are needed to evaluate the efficacy of the device and to determine whether it can successfully anchor fetal membranes percutaneously in human subjects. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- E P Bergh
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal-Fetal Medicine, McGovern Medical School at UTHealth Houston, The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
| | - L K Mann
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal-Fetal Medicine, McGovern Medical School at UTHealth Houston, The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
| | - J H Won
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal-Fetal Medicine, McGovern Medical School at UTHealth Houston, The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
| | - A Nobles
- HeartStitch, Inc., Fountain Valley, CA, USA
| | - A Johnson
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal-Fetal Medicine, McGovern Medical School at UTHealth Houston, The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
| | - R Papanna
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal-Fetal Medicine, McGovern Medical School at UTHealth Houston, The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
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Espinoza J, Agarwal N, Johnson A, Hernandez-Andrade E, Backley S, Papanna R, Bergh EP. Risk stratification for donor twin fetal death by evaluating middle cerebral artery in twin-to-twin transfusion syndrome in absence of twin anemia polycythemia sequence. Ultrasound Obstet Gynecol 2024. [PMID: 38437460 DOI: 10.1002/uog.27629] [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] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/29/2024] [Accepted: 02/18/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVE To determine the association of high middle cerebral artery peak systolic velocity (MCA-PSV) with fetal demise in donor twins among pregnancies complicated by twin-to-twin transfusion syndrome (TTTS) in the absence of twin anemia polycythemia sequence (TAPS). METHODS This prospective cohort study included TTTS cases that underwent laser surgery between 2011 and 2022 at a single center. TAPS cases were excluded from the study. The primary objective was to explore the association of high MCA-PSV (>1.5 multiples of the median) with fetal demise of the donor twin among pregnancies complicated by TTTS. Secondary objectives were: 1) to evaluate if donor or recipient MCA-PSV is associated with an increased risk for their corresponding fetal death using receiving operator characteristic curve analysis; and 2) to compare the proportion of fetuses with low MCA pulsatility index among donor twins with high MCA-PSV and in those with normal MCA-PSV to evaluate the contribution of blood flow redistribution to high MCA-PSV. Multivariable and Poisson regression analysis were performed to explore the association of isolated high donor MCA-PSV and fetal demise, adjusted for TTTS stage, selective fetal growth restriction (sFGR), and other confounders. p<0.05 was considered significant. RESULTS Out of 660 TTTS cases, donor MCA-PSV was unavailable in 48 (7.3%) cases. Of the remaining 612 patients, 9 (1.5%) were lost to follow-up, and 96 TAPS cases were excluded. High donor MCA-PSV was seen in 6.5% (33/507) of the study population. High donor MCA-PSV was an independent risk factor for donor fetal demise (adjusted relative risk (aRR) of 4.52; 95% CI: 2.72-7.50), adjusted for confounders. Regression analysis restricted to each Quintero TTTS stage demonstrated that high donor MCA-PSV was an independent risk factor for donor fetal demise in Quintero stage II (aRR of 14.21; 95% CI: 1.09-186.2) and Quintero stage III (aRR of 3.41; 95% CI: 1.82-6.41). Donor MCA-PSV was associated with donor fetal demise (AUC: 0.69; p<0.001), but recipient MCA-PSV was not associated with its corresponding fetal demise (AUC: 0.54; p=0.44). A higher proportion of donor twins in the group with high MCA-PSV had a low MCA pulsatility index than in those with normal MCA-PSV (33.3% vs. 15.5%; p=0.016). CONCLUSIONS Elevated donor MCA-PSV without TAPS prior to laser surgery is associated with a 4-fold increased risk for donor fetal demise, adjusted for sFGR, TTTS stage, and other confounders. Doppler evaluation of donor MCA-PSV prior to laser surgery can further stratify TTTS staging to evaluate the risk for donor fetal demise. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- J Espinoza
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - N Agarwal
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - A Johnson
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - E Hernandez-Andrade
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - S Backley
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - R Papanna
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - E P Bergh
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
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Bergh E, Baschat AA, Cortes MS, Hedrick HL, Ryan G, Lim FY, Zaretsky MV, Schenone MH, Crombleholme TM, Ruano R, Gosnell KA, Johnson A. Fetoscopic Endoluminal Tracheal Occlusion for Severe, Left-Sided Congenital Diaphragmatic Hernia: The North American Fetal Therapy Network Fetoscopic Endoluminal Tracheal Occlusion Consortium Experience. Obstet Gynecol 2024; 143:440-448. [PMID: 38128107 PMCID: PMC10863657 DOI: 10.1097/aog.0000000000005491] [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: 09/14/2023] [Revised: 11/01/2023] [Accepted: 11/09/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To report the outcomes of fetoscopic endoluminal tracheal occlusion in a multicenter North American cohort of patients with isolated, left-sided congenital diaphragmatic hernia (CDH) and to compare neonatal mortality and morbidity in patients with severe left-sided congenital diaphragmatic hernia who underwent fetoscopic endoluminal tracheal occlusion with those expectantly managed. METHODS We analyzed data from 10 centers in the NAFTNet (North American Fetal Therapy Network) FETO (Fetoscopic Endoluminal Tracheal Occlusion) Consortium registry, collected between November 1, 2008, and December 31, 2020. In addition to reporting procedure-related surgical outcomes of fetoscopic endoluminal tracheal occlusion, we performed a comparative analysis of fetoscopic endoluminal tracheal occlusion compared with contemporaneous expectantly managed patients. RESULTS Fetoscopic endoluminal tracheal occlusion was successfully performed in 87 of 89 patients (97.8%). Six-month survival in patients with severe left-sided congenital diaphragmatic hernia did not differ significantly between patients who underwent fetoscopic endoluminal tracheal occlusion and those managed expectantly (69.8% vs 58.1%, P =.30). Patients who underwent fetoscopic endoluminal tracheal occlusion had higher rates of preterm prelabor rupture of membranes (54.0% vs 14.3%, P <.001), earlier gestational age at delivery (median 35.0 weeks vs 38.3 weeks, P <.001), and lower birth weights (mean 2,487 g vs 2,857 g, P =.001). On subanalysis, in patients for whom all recorded observed-to-expected lung/head ratio measurements were below 25%, patients with fetoscopic endoluminal tracheal occlusion required fewer days of extracorporeal membrane oxygenation (ECMO) (median 9.0 days vs 17.0 days, P =.014). CONCLUSION In this cohort, fetoscopic endoluminal tracheal occlusion was successfully implemented across several North American fetal therapy centers. Although survival was similar among patients undergoing fetoscopic endoluminal tracheal occlusion and those expectantly managed, fetoscopic endoluminal tracheal occlusion in North American centers may reduce morbidity, as suggested by fewer days of ECMO in those patients with persistently reduced lung volumes (observed-to-expected lung/head ratio below 25%).
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Affiliation(s)
- Eric Bergh
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Medicine, UTHealth Houston, the University of Texas McGovern Medical School, and the Fetal Center at Children's Memorial Hermann Hospital, and the Division of Fetal Therapy and Surgery, Department of Obstetrics and Gynecology, Texas Children's Hospital Fetal Center, Baylor College of Medicine, Houston, Texas; the Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland; The Richard Wood Jr. Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; the Ontario Fetal Centre, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada; the Center for Fetal, Cellular & Molecular Therapy, Cincinnati Fetal Center, Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; the Fetal Care Center, Children's Hospital Colorado, Aurora, Colorado; the Division of Maternal and Fetal Medicine, Department of Obstetrics & Gynecology, Mayo Clinic, Rochester, Minnesota; the Fetal Care Center Dallas, Dallas, Texas; and the Fetal Treatment Center, University of California, San Francisco, San Francisco, California
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Krispin E, Javinani A, Odibo A, Carreras E, Emery SP, Sepulveda Gonzalez G, Habli M, Hecher K, Ishii K, Miller J, Papanna R, Johnson A, Khalil A, Kilby MD, Lewi L, Bennasar Sans M, Otaño L, Zaretsky MV, Sananes N, Turan OM, Slaghekke F, Stirnemann J, Van Mieghem T, Welsh AW, Yoav Y, Chmait R, Shamshirsaz AA. Consensus protocol for management of early and late twin-twin transfusion syndrome: Delphi study. Ultrasound Obstet Gynecol 2024; 63:371-377. [PMID: 37553800 DOI: 10.1002/uog.27446] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/11/2023] [Accepted: 07/21/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE Fetoscopic laser photocoagulation (FLP) is a well-established treatment for twin-twin transfusion syndrome (TTTS) between 16 and 26 weeks' gestation. High-quality evidence and guidelines regarding the optimal clinical management of very early (prior to 16 weeks), early (between 16 and 18 weeks) and late (after 26 weeks) TTTS are lacking. The aim of this study was to construct a structured expert-based clinical consensus for the management of early and late TTTS. METHODS A Delphi procedure was conducted among an international panel of experts. Participants were chosen based on their clinical expertise, affiliation and relevant publications. A four-round Delphi survey was conducted using an online platform and responses were collected anonymously. In the first round, a core group of experts was asked to answer open-ended questions regarding the indications, timing and modes of treatment for early and late TTTS. In the second and third rounds, participants were asked to grade each statement on a Likert scale (1, completely disagree; 5, completely agree) and to add any suggestions or modifications. At the end of each round, the median score for each statement was calculated. Statements with a median grade of 5 without suggestions for change were accepted as the consensus. Statements with a median grade of 3 or less were excluded from the Delphi process. Statements with a median grade of 4 were modified according to suggestions and reconsidered in the next round. In the last round, participants were asked to agree or disagree with the statements, and those with more than 70% agreement without suggestions for change were considered the consensus. RESULTS A total of 122 experts met the inclusion criteria and were invited to participate, of whom 53 (43.4%) agreed to take part in the study. Of those, 75.5% completed all four rounds. A consensus on the optimal management of early and late TTTS was obtained. FLP can be offered as early as 15 weeks' gestation for selected cases, and can be considered up to 28 weeks. Between 16 and 18 weeks, management should be tailored according to Doppler findings. CONCLUSIONS A consensus-based treatment protocol for early and late TTTS was agreed upon by a panel of experts. This protocol should be modified at the discretion of the operator, according to their experience and the specific demands of each case. This should advance the quality of future studies, guide clinical practice and improve patient care. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- E Krispin
- Maternal Fetal Care Center (MFCC), Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - A Javinani
- Maternal Fetal Care Center (MFCC), Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - A Odibo
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, MO, USA
| | - E Carreras
- Maternal-Fetal Medicine Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S P Emery
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - G Sepulveda Gonzalez
- Instituto de Salud Fetal (ISF), Hospital Regional Materno Infantil, Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, México
| | - M Habli
- Department of Pediatric Surgery, Fetal Care Center of Cincinnati, Good Samaritan Hospital, Cincinnati, OH, USA
| | - K Hecher
- Department of Obstetrics and Prenatal Medicine, University Medical Center Eppendorf, Hamburg, Germany
| | - K Ishii
- Maternal-Fetal Medicine, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
| | - J Miller
- The Johns Hopkins Center for Fetal Therapy, Department of Gynecology and Obstetrics, Baltimore, MD, USA
| | - R Papanna
- Fetal Center, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas McGovern Medical School at Houston, Houston, TX, USA
| | - A Johnson
- Fetal Center, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas McGovern Medical School at Houston, Houston, TX, USA
| | - A Khalil
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
- Fetal Medicine Unit, Liverpool Women's Hospital, Liverpool, UK
| | - M D Kilby
- Fetal Medicine Center, Birmingham Women's and Children's Foundation Trust, Birmingham, UK
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Illumina UK, Great Abbington, Cambridge, UK
| | - L Lewi
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - M Bennasar Sans
- BCNatal, Maternal-Fetal Medicine Center, Hospital Clínic i Hospital Sant Joan de Déu, Barcelona, Spain
| | - L Otaño
- Maternal-Fetal Medicine Unit, Obstetric Division, Hospital Italiano de Buenos Aires, Instituto Universitario Hospital Italiano, Buenos Aires, Argentina
| | - M V Zaretsky
- Colorado Fetal Care Center, Children's Hospital of Colorado, University of Colorado, Denver, CO, USA
| | - N Sananes
- Obstetrics and Gynecology Department, Strasbourg University Hospital, Strasbourg, France
- Inserm 1121 'Biomaterials and Bioengineering', Strasbourg University, Strasbourg, France
| | - O M Turan
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - F Slaghekke
- Department of Obstetrics, Fetal Medicine Unit, Leiden University Medical Center, Leiden, The Netherlands
| | - J Stirnemann
- Department of Obstetrics and Maternal-Fetal Medicine, Necker-Enfants Malades Hospital, University of Paris, Paris, France
| | - T Van Mieghem
- Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Mount Sinai Hospital and University of Toronto, Toronto, Canada
| | - A W Welsh
- Maternal-Fetal Medicine, Royal Hospital for Women, University of New South Wales, Sydney, Australia
| | - Y Yoav
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Chmait
- Los Angeles Fetal Surgery, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - A A Shamshirsaz
- Maternal Fetal Care Center (MFCC), Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
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Puvvula PK, Martinez-Medina L, Cinar M, Feng L, Pisarev A, Johnson A, Bernal-Mizrachi L. A retrotransposon-derived DNA zip code internalizes myeloma cells through Clathrin-Rab5a-mediated endocytosis. Front Oncol 2024; 14:1288724. [PMID: 38463228 PMCID: PMC10920344 DOI: 10.3389/fonc.2024.1288724] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/29/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction We have demonstrated that transposons derived from ctDNA can be transferred between cancer cells. The present research aimed to investigate the cellular uptake and intracellular trafficking of Multiple Myeloma-zip code (MM-ZC), a cell-specific zip code, in myeloma cell lines. We demonstrated that MM-ZC uptake by myeloma cells was concentration-, time- and cell-type-dependent. Methods Flow cytometry and confocal microscopy methods were used to identify the level of internalization of the zip codes in MM cells. To screen for the mechanism of internalization, we used multiple inhibitors of endocytosis. These experiments were followed by biotin pulldown and confocal microscopy for validation. Single interference RNA (siRNA) targeting some of the proteins involved in endocytosis was used to validate the role of this pathway in ZC cell internalization. Results Endocytosis inhibitors identified that Monensin and Chlorpromazine hydrochloride significantly reduced MM-ZC internalization. These findings suggested that Clathrin-mediated endocytosis and endosomal maturation play a crucial role in the cellular uptake of MM-ZC. Biotin pulldown and confocal microscopic studies revealed the involvement of proteins such as Clathrin, Rab5a, Syntaxin-6, and RCAS1 in facilitating the internalization of MM-ZC. Knockdown of Rab5a and Clathrin proteins reduced cellular uptake of MM-ZC and conclusively demonstrated the involvement of Clathrin-Rab5a pathways in MM-ZC endocytosis. Furthermore, both Rab5a and Clathrin reciprocally affected their association with MM-ZC when we depleted their proteins by siRNAs. Additionally, the loss of Rab5a decreased the Syntaxin-6 association with MMZC but not vice versa. Conversely, MM-ZC treatment enhanced the association between Clathrin and Rab5a. Conclusion Overall, the current study provides valuable insights into the cellular uptake and intracellular trafficking of MM-ZC in myeloma cells. Identifying these mechanisms and molecular players involved in MM-ZC uptake contributes to a better understanding of the delivery and potential applications of cell-specific Zip-Codes in gene delivery and drug targeting in cancer research.
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Affiliation(s)
| | | | - Munevver Cinar
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, United States
| | - Lei Feng
- Kodikaz Therapeutic Solutions, New York, NY, United States
| | - Andrey Pisarev
- Kodikaz Therapeutic Solutions, New York, NY, United States
| | | | - Leon Bernal-Mizrachi
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, United States
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Quinn KG, Walsh JL, DiFranceisco W, Edwards T, Takahashi L, Johnson A, Dakin A, Bouacha N, Voisin DR. The Inherent Violence of Anti-Black Racism and its Effects on HIV Care for Black Sexually Minoritized Men. J Urban Health 2024; 101:23-30. [PMID: 38158546 PMCID: PMC10897081 DOI: 10.1007/s11524-023-00823-x] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
The goal of this study was to examine the effects of racial discrimination, depression, and Black LGBTQ community support on HIV care outcomes among a sample of Black sexually minoritized men living with HIV. We conducted a cross-sectional survey with 107 Black sexually minoritized men living with HIV in Chicago. A path model was used to test associations between racial discrimination, Black LGBTQ community support, depressive symptoms, and missed antiretroviral medication doses and HIV care appointments. Results of the path model showed that men who had experienced more racism had more depressive symptoms and subsequently, missed more doses of HIV antiretroviral medication and had missed more HIV care appointments. Greater Black LGBTQ community support was associated with fewer missed HIV care appointments in the past year. This research shows that anti-Black racism may be a pervasive and harmful determinant of HIV inequities and a critical driver of racial disparities in ART adherence and HIV care engagement experienced by Black SMM. Black LGBTQ community support may buffer against the effects of racial discrimination on HIV care outcomes by providing safe, inclusive, supportive spaces for Black SMM.
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Affiliation(s)
- Katherine G Quinn
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Jennifer L Walsh
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Wayne DiFranceisco
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Travonne Edwards
- School of Child and Youth Care, Toronto Metropolitan University, Toronto, Canada
| | - Lois Takahashi
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA
| | - Anthony Johnson
- School of Social Work, Loyola University Chicago, Chicago, IL, USA
| | | | | | - Dexter R Voisin
- School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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Backley S, Bergh E, Garnett J, Li R, Maroufy V, Jain R, Fletcher S, Tsao K, Austin M, Johnson A, Papanna R. Fetal cardiovascular changes during open and fetoscopic in-utero spina bifida closure. Ultrasound Obstet Gynecol 2024. [PMID: 38207160 DOI: 10.1002/uog.27579] [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] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/30/2023] [Accepted: 12/21/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE Laparotomy-assisted fetoscopic closure of spina bifida utilizing heated-humidified carbon dioxide gas has been associated with less maternal morbidity than open in-utero spina bifida closure. Fetal cardiovascular changes during these surgical interventions are not well defined. Our objective was to compare fetal bradycardia (defined as fetal heart rate (FHR)<110 bpm over 10 minutes) and changes in umbilical artery Doppler parameters throughout open in-utero closure with those observed during laparotomy-assisted fetoscopic closure. METHODS We conducted a prospective cohort study of 22 open and 46 fetoscopic consecutive in-utero closures between 2019 and 2023. Both cohorts had similar preoperative counseling and clinical management. FHR and umbilical artery velocimetry were systematically obtained during preoperative assessment, every 5 minutes during the intraoperative period, and in the postoperative assessment. FHR, pulsatility indexes and end-diastolic flows were segmented into hourly periods during surgery, and the lowest values were averaged for analysis. Umbilical vein maximum velocities were measured in the fetoscopic cohort. Each fetal heart rate recording time point was correlated to maternal parameters, including heart rate, systolic and diastolic blood pressures. RESULTS Fetal bradycardia occurred in 4/22 cases (18.2%) of open in-utero closure and in 21/46 cases (45.7%) of fetoscopic closure. FHR gradually decreased in both cohorts after general anesthesia and decreased further during surgery. FHR were significantly lower after two hours of surgery in the fetoscopic closure than in the open in-utero closure group. In addition, the FHR (BPM) change in the final stages of the fetal surgery from the baseline FHR was significantly lower in the fetoscopic cohort (-32.3 (-35.7, -29.1)) compared to the open cohort (-23.5 (-28.1, -18.8)) (p=0.002). Abnormal end-diastolic flow (defined as absent or reversed end-diastolic flow) in the umbilical artery Doppler velocity occurred in 3/22 (13.6%) of the open closure cohort and in 23/46 (50%) of the fetoscopic closure cohort (p=0.004). There were no differences in umbilical artery end-diastolic flow and pulsatility index between closure techniques during the various stages of assessment. CONCLUSIONS We observed a decrease in the FHR and abnormalities in umbilical artery Doppler parameters in both open in-utero and fetoscopic closure groups. Fetal bradycardia was more prominent during fetoscopic closure following heated-humidified carbon dioxide insufflation, but the FHR recovered after cessation of the heated-humidified carbon dioxide. Changes in FHR and umbilical artery Doppler parameters during in-utero spina bifida closure were observed to be transient, no cases required emergency delivery and no fetoscopic closure were converted to open closure. These observations should inform algorithms for perioperative management of fetal bradycardia associated with in-utero spina bifida closure. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- S Backley
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
- The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
| | - E Bergh
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
- The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
| | - J Garnett
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
- The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
| | - R Li
- Department of Biostatistics and Data Science, UTHealth School of Public Health, Houston, Texas, USA
| | - V Maroufy
- Department of Biostatistics and Data Science, UTHealth School of Public Health, Houston, Texas, USA
| | - R Jain
- The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
- Division of Pediatric Anesthesia, Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - S Fletcher
- The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
- Division of Pediatric Neurosurgery, Departments of Pediatric Surgery and Neurosurgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - K Tsao
- The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
- Department of Pediatric Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - M Austin
- The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
- Department of Pediatric Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - A Johnson
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
- The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
| | - R Papanna
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
- The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
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Huntley ES, Hernandez-Andrade E, Papanna R, Bergh E, Espinoza J, Soto E, Lopez SM, Harting MT, Johnson A. Abnormal Shape and Size of the Cardiac Ventricles Are Associated with a Higher Risk of Neonatal Death in Fetuses with Isolated Left Congenital Diaphragmatic Hernia. Fetal Diagn Ther 2024; 51:191-202. [PMID: 38194948 DOI: 10.1159/000536171] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 01/03/2024] [Indexed: 01/11/2024]
Abstract
INTRODUCTION The objective of this study was to evaluate the association between fetal cardiac deformation analysis (CDA) and cardiac function with severe adverse perinatal outcomes in fetuses with isolated left congenital diaphragmatic hernia (CDH). METHODS CDA in each ventricle (contractility, size, and shape), evaluated by speckle tracking and novel FetalHQ software, and markers of cardiac function (E/A ratios, pulmonary and aortic peak systolic velocities, and sigmoid annular valve diameters), were evaluated in fetuses with isolated left CDH. Two evaluations were performed: at referral (CDA and function) and within 3 weeks of delivery (CDA). Severe adverse neonatal outcomes were considered neonatal death (ND) or survival with CDH-associated pulmonary hypertension (CDH-PH). Differences and associations between CDA, cardiac function, and severe adverse outcomes were estimated. RESULTS Fifty fetuses were included, and seventeen (34%) had severe adverse neonatal outcomes (11 ND and 6 survivors with CDH-PH). At first evaluation, the prevalence of a small left ventricle was 34% (17/50) with a higher prevalence among neonates presenting severe adverse outcomes (58.8 [10/17] vs. 21.2% [7/33]; p = 0.01; OR, 5.03 [1.4-19.1; p = 0.01]) and among those presenting with neonatal mortality (8/11 [72.7] vs. 9/39 [23.0%]; p = 0.03; OR, 8.9 [1.9-40.7; p = 0.005]). No differences in cardiac function or strain were noted between fetuses with or without severe adverse outcomes. Within 3 weeks of delivery, the prevalence of small left ventricle was higher (19/34; 55.8%) with a more globular shape (reduced transverse/longitudinal ratio). A globular right ventricle was significantly associated with ND or survival with CDH-PH (OR, 14.2 [1.5-138.3]; p = 0.02). CONCLUSION Fetuses with isolated CDH at risk of perinatal death or survival with CDH-PH had a higher prevalence of a small left ventricle and abnormal shape of the right ventricle.
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Affiliation(s)
- Erin S Huntley
- Department of Obstetrics and Gynecology and Reproductive Sciences, Divisions of McGovern Medical School at The University of Texas, Health Science Center at Houston, Houston, Texas, USA
- Fetal Intervention and McGovern Medical School at The University of Texas, Health Science Center at Houston, Houston, Texas, USA
| | - Edgar Hernandez-Andrade
- Department of Obstetrics and Gynecology and Reproductive Sciences, Divisions of McGovern Medical School at The University of Texas, Health Science Center at Houston, Houston, Texas, USA
- Fetal Intervention and McGovern Medical School at The University of Texas, Health Science Center at Houston, Houston, Texas, USA
| | - Ramesha Papanna
- Department of Obstetrics and Gynecology and Reproductive Sciences, Divisions of McGovern Medical School at The University of Texas, Health Science Center at Houston, Houston, Texas, USA
- Fetal Intervention and McGovern Medical School at The University of Texas, Health Science Center at Houston, Houston, Texas, USA
| | - Eric Bergh
- Department of Obstetrics and Gynecology and Reproductive Sciences, Divisions of McGovern Medical School at The University of Texas, Health Science Center at Houston, Houston, Texas, USA
- Fetal Intervention and McGovern Medical School at The University of Texas, Health Science Center at Houston, Houston, Texas, USA
| | - Jimmy Espinoza
- Department of Obstetrics and Gynecology and Reproductive Sciences, Divisions of McGovern Medical School at The University of Texas, Health Science Center at Houston, Houston, Texas, USA
- Fetal Intervention and McGovern Medical School at The University of Texas, Health Science Center at Houston, Houston, Texas, USA
| | - Eleazar Soto
- Department of Obstetrics and Gynecology and Reproductive Sciences, Divisions of McGovern Medical School at The University of Texas, Health Science Center at Houston, Houston, Texas, USA
- Maternal Fetal Medicine, McGovern Medical School at The University of Texas, Health Science Center at Houston, Houston, Texas, USA
| | - Suzanne M Lopez
- Department of Pediatrics, McGovern Medical School at The University of Texas, Health Science Center at Houston, Houston, Texas, USA
| | - Matthew T Harting
- Department of Pediatric Surgery, McGovern Medical School at The University of Texas, Health Science Center at Houston, Houston, Texas, USA
| | - Anthony Johnson
- Department of Obstetrics and Gynecology and Reproductive Sciences, Divisions of McGovern Medical School at The University of Texas, Health Science Center at Houston, Houston, Texas, USA
- Fetal Intervention and McGovern Medical School at The University of Texas, Health Science Center at Houston, Houston, Texas, USA
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Rajit D, Johnson A, Callander E, Teede H, Enticott J. Learning health systems and evidence ecosystems: a perspective on the future of evidence-based medicine and evidence-based guideline development. Health Res Policy Syst 2024; 22:4. [PMID: 38178086 PMCID: PMC10768258 DOI: 10.1186/s12961-023-01095-2] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 12/14/2023] [Indexed: 01/06/2024] Open
Abstract
Despite forming the cornerstone of modern clinical practice for decades, implementation of evidence-based medicine at scale remains a crucial challenge for health systems. As a result, there has been a growing need for conceptual models to better contextualise and pragmatize the use of evidence-based medicine, particularly in tandem with patient-centred care. In this commentary, we highlight the emergence of the learning health system as one such model and analyse its potential role in pragmatizing both evidence-based medicine and patient-centred care. We apply the learning health system lens to contextualise the key activity of evidence-based guideline development and implementation, and highlight how current inefficiencies and bottlenecks in the evidence synthesis phase of evidence-based guideline development threaten downstream adherence. Lastly, we introduce the evidence ecosystem as a complementary model to learning health systems, and propose how innovative developments from the evidence ecosystem may be integrated with learning health systems to better enable health impact at speed and scale.
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Affiliation(s)
- D Rajit
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Level 1, 43-51 Kanooka Grove, Melbourne, VIC, 3168, Australia
| | - A Johnson
- Monash Partners Academic Health Sciences Centre, Melbourne, VIC, Australia
| | - E Callander
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Level 1, 43-51 Kanooka Grove, Melbourne, VIC, 3168, Australia
- Monash Partners Academic Health Sciences Centre, Melbourne, VIC, Australia
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - H Teede
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Level 1, 43-51 Kanooka Grove, Melbourne, VIC, 3168, Australia
- Monash Partners Academic Health Sciences Centre, Melbourne, VIC, Australia
- Monash Health Endocrinology and Diabetes Departments, Melbourne, Australia
| | - J Enticott
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Level 1, 43-51 Kanooka Grove, Melbourne, VIC, 3168, Australia.
- Monash Partners Academic Health Sciences Centre, Melbourne, VIC, Australia.
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Deutsch A, Johnson A, Sargent C, Gregory K, Ring D. Maintaining Joy in Orthopaedic Practice. J Am Acad Orthop Surg 2024; 32:2-8. [PMID: 37432982 DOI: 10.5435/jaaos-d-23-00058] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/11/2023] [Indexed: 07/13/2023] Open
Abstract
Orthopaedic surgeons may, at times, derive less enjoyment from their work. Limited engagement can arise, on the one hand, from limited autonomy, burdens of care, and reduced reimbursement. On the other hand, surgeons may enjoy their work less if they feel less able to help people. For instance, people with pressing medical, mental, and social health opportunities may place inordinate hope on what an orthopaedic surgeon can do to improve their lives. Pressure to provide tests and treatment with more potential for harm than benefit can, at times, contribute to a sense of futility and emotional exhaustion. There may, at times, be small and large pressures that can induce surgeons to compromise respect for evidence and lapse in adherence to ethical principles, placing them at risk for moral injury. These aspects of orthopaedic practice seem important given the association between limited joy in practice and self-harm, abandoning medical practice, and errors and patient harm. There are things to consider when working on joy in practice, including recognizing and naming the unsavory parts of practice; making improvement in the area for creativity, innovation, and personal growth; and developing strategies to limit and alleviate stress.
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Affiliation(s)
- Allen Deutsch
- From the Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas, Austin, TX (Deutsch, Johnson, Sargent, and Ring), and The Center for Resiliency, Dell Children's Medical Center, Austin, TX (Gregory)
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Miller JL, Baschat AA, Rosner M, Blumenfeld YJ, Moldenhauer JS, Johnson A, Schenone MH, Zaretsky MV, Chmait RH, Gonzalez JM, Miller RS, Moon-Grady AJ, Bendel-Stenzel E, Keiser AM, Avadhani R, Jelin AC, Davis JM, Warren DS, Hanley DF, Watkins JA, Samuels J, Sugarman J, Atkinson MA. Neonatal Survival After Serial Amnioinfusions for Bilateral Renal Agenesis: The Renal Anhydramnios Fetal Therapy Trial. JAMA 2023; 330:2096-2105. [PMID: 38051327 PMCID: PMC10698620 DOI: 10.1001/jama.2023.21153] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/28/2023] [Indexed: 12/07/2023]
Abstract
Importance Early anhydramnios during pregnancy, resulting from fetal bilateral renal agenesis, causes lethal pulmonary hypoplasia in neonates. Restoring amniotic fluid via serial amnioinfusions may promote lung development, enabling survival. Objective To assess neonatal outcomes of serial amnioinfusions initiated before 26 weeks' gestation to mitigate lethal pulmonary hypoplasia. Design, Setting, and Participants Prospective, nonrandomized clinical trial conducted at 9 US fetal therapy centers between December 2018 and July 2022. Outcomes are reported for 21 maternal-fetal pairs with confirmed anhydramnios due to isolated fetal bilateral renal agenesis without other identified congenital anomalies. Exposure Enrolled participants initiated ultrasound-guided percutaneous amnioinfusions of isotonic fluid before 26 weeks' gestation, with frequency of infusions individualized to maintain normal amniotic fluid levels for gestational age. Main Outcomes and Measures The primary end point was postnatal infant survival to 14 days of life or longer with dialysis access placement. Results The trial was stopped early based on an interim analysis of 18 maternal-fetal pairs given concern about neonatal morbidity and mortality beyond the primary end point despite demonstration of the efficacy of the intervention. There were 17 live births (94%), with a median gestational age at delivery of 32 weeks, 4 days (IQR, 32-34 weeks). All participants delivered prior to 37 weeks' gestation. The primary outcome was achieved in 14 (82%) of 17 live-born infants (95% CI, 44%-99%). Factors associated with survival to the primary outcome included a higher number of amnioinfusions (P = .01), gestational age greater than 32 weeks (P = .005), and higher birth weight (P = .03). Only 6 (35%) of the 17 neonates born alive survived to hospital discharge while receiving peritoneal dialysis at a median age of 24 weeks of life (range, 12-32 weeks). Conclusions and Relevance Serial amnioinfusions mitigated lethal pulmonary hypoplasia but were associated with preterm delivery. The lower rate of survival to discharge highlights the additional mortality burden independent of lung function. Additional long-term data are needed to fully characterize the outcomes in surviving neonates and assess the morbidity and mortality burden. Trial Registration ClinicalTrials.gov Identifier: NCT03101891.
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Affiliation(s)
- Jena L. Miller
- Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland
| | - Ahmet A. Baschat
- Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland
| | - Mara Rosner
- Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland
| | - Yair J. Blumenfeld
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California
| | - Julie S. Moldenhauer
- Center for Fetal Diagnosis and Treatment, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Anthony Johnson
- The Fetal Center, Department of Obstetrics and Gynecology, University of Texas Health Center, Houston
| | - Mauro H. Schenone
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota
| | | | - Ramen H. Chmait
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles
| | - Juan M. Gonzalez
- Department of Obstetrics and Gynecology, University of California, San Francisco
| | - Russell S. Miller
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York
| | - Anita J. Moon-Grady
- Division of Cardiology, Department of Pediatrics, University of California, San Francisco
| | - Ellen Bendel-Stenzel
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Amaris M. Keiser
- Division of Neonatology, Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland
| | - Radhika Avadhani
- Division of Brain Injury Outcomes, Johns Hopkins University, Baltimore, Maryland
| | - Angie C. Jelin
- Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland
| | - Jonathan M. Davis
- Tufts Clinical and Translational Science Institute, Division of Newborn Medicine, Tufts Children’s Hospital, Tufts University, Boston, Massachusetts
| | - Daniel S. Warren
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Daniel F. Hanley
- Division of Brain Injury Outcomes, Johns Hopkins University, Baltimore, Maryland
| | - Joslynn A. Watkins
- Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Joshua Samuels
- Division of Pediatric Nephrology and Hypertension, McGovern School at the University of Texas Health Science Center, Houston
| | - Jeremy Sugarman
- Berman Institute of Bioethics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Meredith A. Atkinson
- Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Agarwal N, Papanna R, Bergh EP, Hernandez-Andrade E, Backley S, Salazar A, Johnson A, Espinoza J. Management of large placental chorioangioma: two-port laser approach for fetal intervention. Ultrasound Obstet Gynecol 2023; 62:882-890. [PMID: 37448172 DOI: 10.1002/uog.26307] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/09/2023] [Accepted: 05/12/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVES There is a paucity of literature providing evidence-based guidelines for the management of large placental chorioangioma (≥ 4 cm in diameter). The objectives of this study were to compare outcomes between patients managed expectantly and those undergoing in-utero intervention and to describe the different in-utero techniques used for cessation of blood flow to the tumor and the associated outcome. METHODS This was a retrospective cohort study of 34 patients referred for the management of large placental chorioangioma in a single center between January 2011 and December 2022, who were managed expectantly or underwent in-utero intervention. In-utero intervention was performed when the fetus developed any signs of impending compromise, including high combined cardiac output (CCO), worsening polyhydramnios or abnormal fetal Doppler velocimetry findings. Interventions included radiofrequency ablation (RFA), interstitial laser ablation (ILA) and single-port or two-port fetoscopic laser photocoagulation (FLP). Treatment selection was dependent on the proximity of the tumor to the umbilical cord insertion (UCI) and placental location. The two-port technique was performed in patients with a chorioangioma with large feeding vessels (≥ 3 mm) located in the posterior placenta, in which one port was used for occlusion using bipolar forceps and the other port was used for laser photocoagulation of the feeding vessels downstream. The single-port technique was used for chorioangioma with small feeding vessels (< 3 mm) located in the posterior placenta. ILA or RFA was performed in cases with an anterior placenta. Supportive treatments, including amnioreduction and intrauterine transfusion (IUT), were performed for worsening polyhydramnios and suspected fetal anemia based on middle cerebral artery Doppler flow studies, respectively. Comparative statistical analysis between cases undergoing expectant management vs in-utero intervention was performed. Descriptive details were provided for patients who underwent in-utero intervention. RESULTS Thirty-four cases of large chorioangioma were evaluated, of which 25 (73.5%) were managed expectantly and nine (26.5%) underwent intervention. The frequency of polyhydramnios was significantly higher in the intervention group compared with the expectant-management group (66.7% vs 8.0%, P < 0.001). The live-birth rate among expectantly managed cases with large chorioangioma was significantly higher compared with that in cases that underwent in-utero intervention (96.0% vs 62.5%, P = 0.01). In the intervention group, preoperative CCO was elevated in all cases with available information and preoperative hydrops was present in 33.3% (3/9) of cases. One patient experienced fetal demise following IUT prior to planned FLP. Among the remaining eight patients, four underwent two-port FLP, two underwent single-port FLP, one underwent ILA and one underwent both ILA and RFA. All three cases in which hydrops was present at the time of intervention resulted in fetal demise. CONCLUSIONS In-utero interventions aimed at cessation of blood flow in the feeding vessels are a therapeutic option for the management of cases with large chorioangioma. The two-port percutaneous technique appears to improve the efficiency of FLP when a large chorioangioma with large feeding vessels is located in the posterior placenta. We propose that in-utero interventions for large chorioangioma should be initiated prior to the development of fetal hydrops. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- N Agarwal
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - R Papanna
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - E P Bergh
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - E Hernandez-Andrade
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - S Backley
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - A Salazar
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - A Johnson
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - J Espinoza
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
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Adachi I, Adamczyk K, Aggarwal L, Aihara H, Akopov N, Aloisio A, Anh Ky N, Asner DM, Atmacan H, Aushev T, Aushev V, Aversano M, Babu V, Bae H, Bahinipati S, Bambade P, Banerjee S, Barrett M, Baudot J, Bauer M, Baur A, Beaubien A, Becherer F, Becker J, Behera PK, Bennett JV, Bernlochner FU, Bertacchi V, Bertemes M, Bertholet E, Bessner M, Bettarini S, Bhuyan B, Bianchi F, Bilka T, Biswas D, Bobrov A, Bodrov D, Bolz A, Bondar A, Borah J, Bozek A, Bračko M, Branchini P, Briere RA, Browder TE, Budano A, Bussino S, Campajola M, Cao L, Casarosa G, Cecchi C, Cerasoli J, Chang MC, Chang P, Cheaib R, Cheema P, Chekelian V, Cheon BG, Chilikin K, Chirapatpimol K, Cho HE, Cho K, Choi SK, Choudhury S, Cochran J, Corona L, Cremaldi LM, Das S, Dattola F, De La Cruz-Burelo E, De La Motte SA, De Nardo G, De Nuccio M, De Pietro G, de Sangro R, Destefanis M, Dey S, Dhamija R, Di Canto A, Di Capua F, Dingfelder J, Doležal Z, Domínguez Jiménez I, Dong TV, Dorigo M, Dort K, Dossett D, Dreyer S, Dubey S, Dujany G, Ecker P, Eliachevitch M, Epifanov D, Feichtinger P, Ferber T, Ferlewicz D, Fillinger T, Finck C, Finocchiaro G, Fodor A, Forti F, Frey A, Fulsom BG, Gabrielli A, Ganiev E, Garcia-Hernandez M, Garg R, Garmash A, Gaudino G, Gaur V, Gaz A, Gellrich A, Ghevondyan G, Ghosh D, Ghumaryan H, Giakoustidis G, Giordano R, Giri A, Gobbo B, Godang R, Gogota O, Goldenzweig P, Gradl W, Granderath S, Graziani E, Greenwald D, Gruberová Z, Gu T, Guan Y, Gudkova K, Halder S, Han Y, Hara T, Hayasaka K, Hayashii H, Hazra S, Hearty C, Hedges MT, Heidelbach A, Heredia de la Cruz I, Hernández Villanueva M, Hershenhorn A, Higuchi T, Hill EC, Hoek M, Hohmann M, Horak P, Hsu CL, Iijima T, Inami K, Inguglia G, Ipsita N, Ishikawa A, Ito S, Itoh R, Iwasaki M, Jackson P, Jacobs WW, Jang EJ, Ji QP, Jia S, Jin Y, Johnson A, Junkerkalefeld H, Kaliyar AB, Kandra J, Kang KH, Karyan G, Kawasaki T, Keil F, Ketter C, Kiesling C, Kim CH, Kim DY, Kim KH, Kim YK, Kindo H, Kinoshita K, Kodyš P, Koga T, Kohani S, Kojima K, Konno T, Korobov A, Korpar S, Kovalenko E, Kowalewski R, Kraetzschmar TMG, Križan P, Krokovny P, Kuhr T, Kumar J, Kumar M, Kumara K, Kunigo T, Kuzmin A, Kwon YJ, Lacaprara S, Lai YT, Lam T, Lanceri L, Lange JS, Laurenza M, Leboucher R, Le Diberder FR, Leitl P, Levit D, Lewis PM, Li C, Li LK, Li Y, Libby J, Liu QY, Liu ZQ, Liventsev D, Longo S, Lueck T, Luo T, Lyu C, Ma Y, Maggiora M, Maharana SP, Maiti R, Maity S, Mancinelli G, Manfredi R, Manoni E, Manthei AC, Mantovano M, Marcantonio D, Marcello S, Marinas C, Martel L, Martellini C, Martini A, Martinov T, Massaccesi L, Masuda M, Matsuda T, Matvienko D, Maurya SK, McKenna JA, Mehta R, Meier F, Merola M, Metzner F, Milesi M, Miller C, Mirra M, Miyabayashi K, Mohanty GB, Molina-Gonzalez N, Mondal S, Moneta S, Moser HG, Mrvar M, Mussa R, Nakamura I, Nakazawa Y, Narimani Charan A, Naruki M, Natkaniec Z, Natochii A, Nayak L, Nazaryan G, Nisar NK, Nishida S, Ogawa S, Ono H, Oskin P, Otani F, Pakhlov P, Pakhlova G, Paladino A, Panta A, Paoloni E, Pardi S, Parham K, Park SH, Paschen B, Passeri A, Patra S, Paul S, Pedlar TK, Peruzzi I, Peschke R, Pestotnik R, Pham F, Piccolo M, Piilonen LE, Podesta-Lerma PLM, Podobnik T, Pokharel S, Praz C, Prell S, Prencipe E, Prim MT, Purwar H, Rad N, Rados P, Raeuber G, Raiz S, Reif M, Reiter S, Remnev M, Ripp-Baudot I, Rizzo G, Robertson SH, Roehrken M, Roney JM, Rostomyan A, Rout N, Russo G, Sahoo D, Sandilya S, Sangal A, Santelj L, Sato Y, Savinov V, Scavino B, Schmitt C, Schnepf M, Schwanda C, Seino Y, Selce A, Senyo K, Serrano J, Sevior ME, Sfienti C, Shan W, Sharma C, Shen CP, Shi XD, Shillington T, Shiu JG, Shtol D, Shwartz B, Sibidanov A, Simon F, Singh JB, Skorupa J, Sobie RJ, Sobotzik M, Soffer A, Sokolov A, Solovieva E, Spataro S, Spruck B, Starič M, Stavroulakis P, Stefkova S, Stottler ZS, Stroili R, Strube J, Sumihama M, Sumisawa K, Sutcliffe W, Svidras H, Takahashi M, Takizawa M, Tamponi U, Tanida K, Tenchini F, Thaller A, Tittel O, Tiwary R, Tonelli D, Torassa E, Toutounji N, Trabelsi K, Tsaklidis I, Uchida M, Ueda I, Uematsu Y, Uglov T, Unger K, Unno Y, Uno K, Uno S, Urquijo P, Ushiroda Y, Vahsen SE, van Tonder R, Varner GS, Varvell KE, Veronesi M, Vismaya VS, Vitale L, Vobbilisetti V, Volpe R, Wach B, Waheed E, Wakai M, Wallner S, Wang E, Wang MZ, Wang Z, Warburton A, Watanabe M, Watanuki S, Welsch M, Wessel C, Xu XP, Yabsley BD, Yamada S, Yan W, Yang SB, Yin JH, Yoshihara K, Yuan CZ, Zani L, Zhang Y, Zhilich V, Zhou JS, Zhou QD, Zhukova VI, Žlebčík R. Tests of Light-Lepton Universality in Angular Asymmetries of B^{0}→D^{*-}ℓν Decays. Phys Rev Lett 2023; 131:181801. [PMID: 37977641 DOI: 10.1103/physrevlett.131.181801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/29/2023] [Indexed: 11/19/2023]
Abstract
We present the first comprehensive tests of the universality of the light leptons in the angular distributions of semileptonic B^{0}-meson decays to charged spin-1 charmed mesons. We measure five angular-asymmetry observables as functions of the decay recoil that are sensitive to lepton-universality-violating contributions. We use events where one neutral B is fully reconstructed in ϒ(4S)→BB[over ¯] decays in data corresponding to 189 fb^{-1} integrated luminosity from electron-positron collisions collected with the Belle II detector. We find no significant deviation from the standard model expectations.
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Sileo FG, Accurti V, Baschat A, Binder J, Carreras E, Chianchiano N, Cruz-Martinez R, D'Antonio F, Gielchinsky Y, Hecher K, Johnson A, Lopriore E, Massoud M, Nørgaard LN, Papaioannou G, Prefumo F, Salsi G, Simões T, Umstad M, Vavilala S, Yinon Y, Khalil A. Perinatal outcome of monochorionic triamniotic triplet pregnancy: multicenter cohort study. Ultrasound Obstet Gynecol 2023; 62:540-551. [PMID: 37204929 DOI: 10.1002/uog.26256] [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] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/21/2023]
Abstract
OBJECTIVE Monochorionic (MC) triplet pregnancies are extremely rare and information on these pregnancies and their complications is limited. We aimed to investigate the risk of early and late pregnancy complications, perinatal outcome and the timing and methods of fetal intervention in these pregnancies. METHODS This was a multicenter retrospective cohort study of MC triamniotic (TA) triplet pregnancies managed in 21 participating centers around the world from 2007 onwards. Data on maternal age, mode of conception, diagnosis of major fetal structural anomalies or aneuploidy, gestational age (GA) at diagnosis of anomalies, twin-to-twin transfusion syndrome (TTTS), twin anemia-polycythemia sequence (TAPS), twin reversed arterial perfusion (TRAP) sequence and or selective fetal growth restriction (sFGR) were retrieved from patient records. Data on antenatal interventions were collected, including data on selective fetal reduction (three to two or three to one), laser surgery and any other active fetal intervention (including amniodrainage). Data on perinatal outcome were collected, including numbers of live birth, intrauterine demise, neonatal death, perinatal death and termination of fetus or pregnancy (TOP). Neonatal data such as GA at birth, birth weight, admission to neonatal intensive care unit and neonatal morbidity were also collected. Perinatal outcomes were assessed according to whether the pregnancy was managed expectantly or underwent fetal intervention. RESULTS Of an initial cohort of 174 MCTA triplet pregnancies, 11 underwent early TOP, three had an early miscarriage, six were lost to follow-up and one was ongoing at the time of writing. Thus, the study cohort included 153 pregnancies, of which the majority (92.8%) were managed expectantly. The incidence of pregnancy affected by one or more fetal structural abnormality was 13.7% (21/153) and that of TRAP sequence was 5.2% (8/153). The most common antenatal complication related to chorionicity was TTTS, which affected just over one quarter (27.6%; 42/152, after removing a pregnancy with TOP < 24 weeks for fetal anomalies) of the pregnancies, followed by sFGR (16.4%; 25/152), while TAPS (spontaneous or post TTTS with or without laser treatment) occurred in only 4.6% (7/152) of pregnancies. No monochorionicity-related antenatal complication was recorded in 49.3% (75/152) of pregnancies. Survival was apparently associated largely with the development of these complications: there was at least one survivor beyond the neonatal period in 85.1% (57/67) of pregnancies without antenatal complications, in 100% (25/25) of those complicated by sFGR and in 47.6% (20/42) of those complicated by TTTS. The overall rate of preterm birth prior to 28 weeks was 14.5% (18/124) and that prior to 32 weeks' gestation was 49.2% (61/124). CONCLUSION Monochorionicity-related complications, which can impact adversely perinatal outcome, occur in almost half of MCTA triplet pregnancies, creating a challenge with regard to counseling, surveillance and management. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- F G Sileo
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Prenatal Medicine Unit, Obstetrics and Gynecology Unit, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy
- Department of Biomedical, Metabolic and Neural Sciences, International Doctorate School in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - V Accurti
- Fetal Medicine and Surgery Service, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - A Baschat
- Johns Hopkins Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD, USA
| | - J Binder
- Department of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, Vienna, Austria
| | - E Carreras
- Maternal-Fetal Medicine Unit, Department of Obstetrics and Reproductive Medicine, Grup de Recerca en Medicina Materna I Fetal, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - N Chianchiano
- Fetal Medicine Unit, Bucchieri La Ferla-Fatebenefratelli Hospital, Palermo, Italy
| | - R Cruz-Martinez
- Fetal Surgery Center, Instituto Medicina Fetal México, Queretaro/Guadalajara, Jalisco, Mexico
| | - F D'Antonio
- Center for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University 'G. d'Annunzio' of Chieti-Pescara, Chieti, Italy
| | - Y Gielchinsky
- Fetal Medicine Center, Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikvah, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - K Hecher
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Johnson
- Department of Obstetrics and Gynecology, The Fetal Center at Children's Memorial Hermann Hospital, University of Texas Health Science Center, McGovern Medical School, Houston, TX, USA
| | - E Lopriore
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - M Massoud
- Department of Obstetrics and Fetal Medicine, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - L N Nørgaard
- Center of Fetal Medicine and Pregnancy, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - G Papaioannou
- Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Athens, Greece
| | - F Prefumo
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - G Salsi
- Obstetric Unit, Department of Medical and Surgical Sciences, University of Bologna and IRCCS Azienda Ospedaliero-Universitaria S.Orsola-Malpighi, Bologna, Italy
| | - T Simões
- Department of Maternal-Fetal Medicine and Maternity Dr. Alfredo da Costa, Nova Medica School, Lisbon, Portugal
| | - M Umstad
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - S Vavilala
- Department of Fetal Medicine, Fernandez Hospital, Hyderabad, Telangana, India
| | - Y Yinon
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
| | - A Khalil
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
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Quinn KG, Edwards T, Johnson A, Takahashi L, Dakin A, Bouacha N, Voisin D. Understanding the impact of police brutality on Black sexually minoritized men. Soc Sci Med 2023; 334:116191. [PMID: 37666095 PMCID: PMC10565611 DOI: 10.1016/j.socscimed.2023.116191] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/06/2023]
Abstract
Young Black gay, bisexual, and other sexually minoritized men (SMM) face high levels of police brutality and other negative, unwarranted encounters with the police. Such interactions have known health consequences. The purpose of this study was to understand the health, mental health, and social consequences of police brutality experienced by young Black SMM. We conducted in-depth interviews with 31 Black, cisgender men, ages of 16-30 and analyzed the data using thematic analysis. Our primary results are summarized in four themes: 1) Police brutality is built into the system and diminishes trust; 2) Videos and social media make visible violence that has long existed; 3) Police brutality contributes to anxiety and other psychosocial effects; and 4) Violence reduces feelings of safety and contributes to avoidance of police. Our results highlight the direct and vicarious police brutality participants are subjected to and sheds light on the effects of such violence on trust, perceived safety, anxiety, and trauma symptoms. Results from this study contribute to the needed public health conversation around police brutality against Black men, specifically shedding light on the experiences of Black SMM.
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Affiliation(s)
- Katherine G Quinn
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Travonne Edwards
- School of Child and Youth Care, Toronto Metropolitan University, Canada
| | - Anthony Johnson
- School of Social Work, Loyola University Chicago, Chicago, IL, USA
| | - Lois Takahashi
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA
| | | | | | - Dexter Voisin
- School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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Adachi I, Adamczyk K, Aggarwal L, Ahmed H, Aihara H, Akopov N, Aloisio A, Anh Ky N, Asner DM, Atmacan H, Aushev T, Aushev V, Aversano M, Babu V, Bae H, Bahinipati S, Bambade P, Banerjee S, Bansal S, Barrett M, Baudot J, Bauer M, Baur A, Beaubien A, Becker J, Behera PK, Bennett JV, Bernieri E, Bernlochner FU, Bertacchi V, Bertemes M, Bertholet E, Bessner M, Bettarini S, Bhardwaj V, Bhuyan B, Bianchi F, Bilka T, Bilokin S, Biswas D, Bobrov A, Bodrov D, Bolz A, Borah J, Bozek A, Bračko M, Branchini P, Browder TE, Budano A, Bussino S, Campajola M, Cao L, Casarosa G, Cecchi C, Cerasoli J, Chang MC, Chang P, Cheaib R, Cheema P, Chekelian V, Chen YQ, Cheon BG, Chilikin K, Chirapatpimol K, Cho HE, Cho K, Cho SJ, Choi SK, Choudhury S, Cinabro D, Cochran J, Corona L, Cremaldi LM, Cunliffe S, Czank T, Das S, Dattola F, De La Cruz-Burelo E, De La Motte SA, de Marino G, De Nardo G, De Nuccio M, De Pietro G, de Sangro R, Destefanis M, Dey S, De Yta-Hernandez A, Dhamija R, Di Canto A, Di Capua F, Dingfelder J, Doležal Z, Domínguez Jiménez I, Dong TV, Dorigo M, Dort K, Dossett D, Dreyer S, Dubey S, Dujany G, Ecker P, Eliachevitch M, Epifanov D, Feichtinger P, Ferber T, Ferlewicz D, Fillinger T, Finck C, Finocchiaro G, Fodor A, Forti F, Frey A, Fulsom BG, Gabrielli A, Ganiev E, Garcia-Hernandez M, Garmash A, Gaudino G, Gaur V, Gaz A, Gellrich A, Ghevondyan G, Ghosh D, Ghumaryan H, Giakoustidis G, Giordano R, Giri A, Glazov A, Gobbo B, Godang R, Gogota O, Goldenzweig P, Gradl W, Grammatico T, Granderath S, Graziani E, Greenwald D, Gruberová Z, Gu T, Guan Y, Gudkova K, Guilliams J, Halder S, Han Y, Hara T, Hayasaka K, Hayashii H, Hazra S, Hearty C, Hedges MT, Heredia de la Cruz I, Hernández Villanueva M, Hershenhorn A, Higuchi T, Hill EC, Hirata H, Hoek M, Hohmann M, Hsu CL, Humair T, Iijima T, Inami K, Inguglia G, Ipsita N, Ishikawa A, Ito S, Itoh R, Iwasaki M, Jackson P, Jacobs WW, Jaffe DE, Jang EJ, Ji QP, Jia S, Jin Y, Johnson A, Joo KK, Junkerkalefeld H, Kakuno H, Kaleta M, Kalita D, Kaliyar AB, Kandra J, Kang KH, Kang S, Karl R, Karyan G, Kawasaki T, Keil F, Ketter C, Kiesling C, Kim CH, Kim DY, Kim KH, Kim YK, Kindo H, Kodyš P, Koga T, Kohani S, Kojima K, Konno T, Korobov A, Korpar S, Kovalenko E, Kowalewski R, Kraetzschmar TMG, Križan P, Krokovny P, Kuhr T, Kumar J, Kumar M, Kumar R, Kumara K, Kunigo T, Kuzmin A, Kwon YJ, Lacaprara S, Lai YT, Lam T, Lanceri L, Lange JS, Laurenza M, Lautenbach K, Leboucher R, Le Diberder FR, Leitl P, Levit D, Lewis PM, Li C, Li LK, Li YB, Libby J, Lieret K, Liu QY, Liu ZQ, Liventsev D, Longo S, Lozar A, Lueck T, Lyu C, Ma Y, Maggiora M, Maharana SP, Maiti R, Maity S, Manfredi R, Manoni E, Manthei AC, Mantovano M, Marcantonio D, Marcello S, Marinas C, Martel L, Martellini C, Martini A, Martinov T, Massaccesi L, Masuda M, Matsuda T, Matsuoka K, Matvienko D, Maurya SK, McKenna JA, Mehta R, Merola M, Metzner F, Milesi M, Miller C, Mirra M, Miyabayashi K, Miyake H, Mizuk R, Mohanty GB, Molina-Gonzalez N, Mondal S, Moneta S, Moser HG, Mrvar M, Mussa R, Nakamura I, Nakamura KR, Nakao M, Nakayama H, Nakazawa H, Nakazawa Y, Narimani Charan A, Naruki M, Narwal D, Natkaniec Z, Natochii A, Nayak L, Nayak M, Nazaryan G, Niebuhr C, Nisar NK, Nishida S, Ogawa S, Ono H, Onuki Y, Oskin P, Otani F, Pakhlov P, Pakhlova G, Paladino A, Panta A, Paoloni E, Pardi S, Parham K, Park J, Park SH, Paschen B, Passeri A, Patra S, Paul S, Pedlar TK, Peruzzi I, Peschke R, Pestotnik R, Pham F, Piccolo M, Piilonen LE, Pinna Angioni G, Podesta-Lerma PLM, Podobnik T, Pokharel S, Polat L, Praz C, Prell S, Prencipe E, Prim MT, Purwar H, Rad N, Rados P, Raeuber G, Raiz S, Ramirez Morales A, Reif M, Reiter S, Remnev M, Ripp-Baudot I, Rizzo G, Rizzuto LB, Robertson SH, Rodríguez Pérez D, Roehrken M, Roney JM, Rostomyan A, Rout N, Russo G, Sahoo D, Sanders DA, Sandilya S, Sangal A, Santelj L, Sato Y, Savinov V, Scavino B, Schnepf M, Schueler J, Schwanda C, Seino Y, Selce A, Senyo K, Serrano J, Sevior ME, Sfienti C, Shan W, Sharma C, Shen CP, Shi XD, Shillington T, Shiu JG, Shtol D, Shwartz B, Sibidanov A, Simon F, Singh JB, Skorupa J, Sobie RJ, Sobotzik M, Soffer A, Sokolov A, Solovieva E, Spataro S, Spruck B, Starič M, Stavroulakis P, Stefkova S, Stottler ZS, Stroili R, Strube J, Sue Y, Sumihama M, Sumisawa K, Sutcliffe W, Suzuki SY, Svidras H, Takahashi M, Takizawa M, Tamponi U, Tanaka S, Tanida K, Tanigawa H, Tenchini F, Thaller A, Tiwary R, Tonelli D, Torassa E, Toutounji N, Trabelsi K, Tsaklidis I, Uchida M, Ueda I, Uematsu Y, Uglov T, Unger K, Unno Y, Uno K, Uno S, Urquijo P, Ushiroda Y, Vahsen SE, van Tonder R, Varner GS, Varvell KE, Vinokurova A, Vismaya VS, Vitale L, Vobbilisetti V, Volpe R, Vossen A, Wach B, Wakai M, Wakeling HM, Wallner S, Wang E, Wang MZ, Wang XL, Wang Z, Warburton A, Watanabe M, Watanuki S, Welsch M, Wessel C, Won E, Xu XP, Yabsley BD, Yamada S, Yan W, Yang SB, Ye H, Yelton J, Yin JH, Yook YM, Yoshihara K, Yuan CZ, Yusa Y, Zani L, Zhai Y, Zhang Y, Zhilich V, Zhou JS, Zhou QD, Zhou XY, Zhukova VI, Žlebčík R. Search for a τ^{+}τ^{-} Resonance in e^{+}e^{-}→μ^{+}μ^{-}τ^{+}τ^{-} Events with the Belle II Experiment. Phys Rev Lett 2023; 131:121802. [PMID: 37802942 DOI: 10.1103/physrevlett.131.121802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/08/2023] [Indexed: 10/08/2023]
Abstract
We report the first search for a nonstandard-model resonance decaying into τ pairs in e^{+}e^{-}→μ^{+}μ^{-}τ^{+}τ^{-} events in the 3.6-10 GeV/c^{2} mass range. We use a 62.8 fb^{-1} sample of e^{+}e^{-} collisions collected at a center-of-mass energy of 10.58 GeV by the Belle II experiment at the SuperKEKB collider. The analysis probes three different models predicting a spin-1 particle coupling only to the heavier lepton families, a Higgs-like spin-0 particle that couples preferentially to charged leptons (leptophilic scalar), and an axionlike particle, respectively. We observe no evidence for a signal and set exclusion limits at 90% confidence level on the product of cross section and branching fraction into τ pairs, ranging from 0.7 to 24 fb, and on the couplings of these processes. We obtain world-leading constraints on the couplings for the leptophilic scalar model for masses above 6.5 GeV/c^{2} and for the axionlike particle model over the entire mass range.
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Adachi I, Adamczyk K, Aggarwal L, Ahmed H, Aihara H, Akopov N, Aloisio A, Anh Ky N, Asner DM, Atmacan H, Aushev T, Aushev V, Aversano M, Babu V, Bae H, Bahinipati S, Bambade P, Banerjee S, Barrett M, Baudot J, Bauer M, Baur A, Beaubien A, Becker J, Behera PK, Bennett JV, Bertacchi V, Bertemes M, Bertholet E, Bessner M, Bettarini S, Bhuyan B, Bianchi F, Bilka T, Biswas D, Bodrov D, Bondar A, Borah J, Bozek A, Bračko M, Branchini P, Briere RA, Browder TE, Budano A, Bussino S, Campajola M, Cao L, Casarosa G, Cecchi C, Cerasoli J, Chang P, Cheaib R, Cheema P, Chekelian V, Chen C, Cheon BG, Chilikin K, Chirapatpimol K, Cho HE, Cho K, Cho SJ, Choi SK, Choudhury S, Cochran J, Corona L, Cremaldi LM, Das S, Dattola F, De La Cruz-Burelo E, De La Motte SA, de Marino G, De Nuccio M, De Pietro G, de Sangro R, Destefanis M, De Yta-Hernandez A, Dhamija R, Di Canto A, Di Capua F, Dingfelder J, Doležal Z, Domínguez Jiménez I, Dong TV, Dorigo M, Dort K, Dreyer S, Dubey S, Dujany G, Ecker P, Eliachevitch M, Feichtinger P, Ferber T, Ferlewicz D, Fillinger T, Finck C, Finocchiaro G, Fodor A, Forti F, Fulsom BG, Gabrielli A, Ganiev E, Garcia-Hernandez M, Garg R, Garmash A, Gaudino G, Gaur V, Gaz A, Gellrich A, Ghosh D, Giakoustidis G, Giordano R, Giri A, Glazov A, Gobbo B, Godang R, Goldenzweig P, Gradl W, Grammatico T, Granderath S, Graziani E, Greenwald D, Gruberová Z, Gu T, Guan Y, Gudkova K, Halder S, Han Y, Hara K, Hara T, Hayasaka K, Hayashii H, Hazra S, Hearty C, Hedges MT, Heredia de la Cruz I, Hernández Villanueva M, Hershenhorn A, Higuchi T, Hill EC, Hoek M, Hohmann M, Hsu CL, Humair T, Iijima T, Inami K, Ipsita N, Ishikawa A, Ito S, Itoh R, Iwasaki M, Jackson P, Jacobs WW, Jang EJ, Ji QP, Jia S, Jin Y, Johnson A, Joo KK, Junkerkalefeld H, Kaleta M, Kaliyar AB, Kandra J, Kang KH, Kang S, Kar S, Karyan G, Kawasaki T, Keil F, Ketter C, Kiesling C, Kim CH, Kim DY, Kim KH, Kim YK, Kindo H, Kodyš P, Koga T, Kohani S, Kojima K, Korobov A, Korpar S, Kovalenko E, Kowalewski R, Kraetzschmar TMG, Križan P, Krokovny P, Kuhr T, Kumar J, Kumar M, Kumara K, Kunigo T, Kuzmin A, Kwon YJ, Lacaprara S, Lai YT, Lam T, Lange JS, Laurenza M, Leboucher R, Le Diberder FR, Leitl P, Levit D, Li C, Li LK, Libby J, Liu QY, Liu ZQ, Liventsev D, Longo S, Lueck T, Luo T, Lyu C, Ma Y, Maggiora M, Maharana SP, Maiti R, Maity S, Mancinelli G, Manfredi R, Manoni E, Mantovano M, Marcantonio D, Marcello S, Marinas C, Martel L, Martellini C, Martinov T, Massaccesi L, Masuda M, Matsuda T, Matsuoka K, Matvienko D, Maurya SK, McKenna JA, Mehta R, Meier F, Merola M, Metzner F, Milesi M, Miller C, Mirra M, Miyabayashi K, Mizuk R, Mohanty GB, Molina-Gonzalez N, Mondal S, Moneta S, Moser HG, Mrvar M, Mussa R, Nakamura I, Nakazawa Y, Narimani Charan A, Naruki M, Natochii A, Nayak L, Nayak M, Nazaryan G, Nisar NK, Nishida S, Ono H, Onuki Y, Oskin P, Pakhlov P, Pakhlova G, Paladino A, Paoloni E, Pardi S, Parham K, Park H, Park SH, Passeri A, Patra S, Paul S, Pedlar TK, Peschke R, Pestotnik R, Pham F, Piccolo M, Piilonen LE, Podesta-Lerma PLM, Podobnik T, Pokharel S, Praz C, Prell S, Prencipe E, Prim MT, Purwar H, Rad N, Rados P, Raeuber G, Raiz S, Reif M, Reiter S, Remnev M, Ripp-Baudot I, Rizzo G, Robertson SH, Roehrken M, Roney JM, Rostomyan A, Rout N, Russo G, Sahoo D, Sandilya S, Sangal A, Santelj L, Sato Y, Savinov V, Scavino B, Schmitt C, Schwanda C, Schwartz AJ, Seino Y, Selce A, Senyo K, Serrano J, Sevior ME, Sfienti C, Shan W, Sharma C, Shi XD, Shillington T, Shiu JG, Shtol D, Sibidanov A, Simon F, Singh JB, Skorupa J, Sobie RJ, Sobotzik M, Soffer A, Sokolov A, Solovieva E, Spataro S, Spruck B, Starič M, Stavroulakis P, Stefkova S, Stottler ZS, Stroili R, Sumihama M, Sumisawa K, Sutcliffe W, Svidras H, Takahashi M, Takizawa M, Tamponi U, Tanaka S, Tanida K, Tenchini F, Thaller A, Tittel O, Tiwary R, Tonelli D, Torassa E, Trabelsi K, Tsaklidis I, Uchida M, Ueda I, Uglov T, Unger K, Unno Y, Uno K, Uno S, Urquijo P, Ushiroda Y, Vahsen SE, van Tonder R, Varner GS, Varvell KE, Vinokurova A, Vismaya VS, Vitale L, Wach B, Wakai M, Wakeling HM, Wallner S, Wang E, Wang MZ, Wang Z, Warburton A, Watanabe M, Watanuki S, Welsch M, Wessel C, Won E, Xu XP, Yabsley BD, Yamada S, Yan W, Yang SB, Yin JH, Yoshihara K, Yuan CZ, Yusa Y, Zani L, Zhang Y, Zhilich V, Zhou QD, Zhukova VI. Measurement of CP Violation in B^{0}→K_{S}^{0}π^{0} Decays at Belle II. Phys Rev Lett 2023; 131:111803. [PMID: 37774261 DOI: 10.1103/physrevlett.131.111803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/26/2023] [Indexed: 10/01/2023]
Abstract
We report a measurement of the CP-violating parameters C and S in B^{0}→K_{S}^{0}π^{0} decays at Belle II using a sample of 387×10^{6} BB[over ¯] events recorded in e^{+}e^{-} collisions at a center-of-mass energy corresponding to the ϒ(4S) resonance. These parameters are determined by fitting the proper decay-time distribution of a sample of 415 signal events. We obtain C=-0.04_{-0.15}^{+0.14}±0.05 and S=0.75_{-0.23}^{+0.20}±0.04, where the first uncertainties are statistical and the second are systematic.
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Premkumar A, Doggalli N, Rudraswamy S, Manjunatha BS, Peeran SW, Johnson A, Patil K. Sex determination using mandibular ramus flexure in South Indian population - A retrospective study. J Forensic Odontostomatol 2023; 41:2-9. [PMID: 37634171 PMCID: PMC10473455] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Sex determination or sex estimation from a single or fragment of bone is always difficult in the absence of other bones from the same individual. The current study was an attempt to estimate the sex of an individual from the posterior ramus of mandible or the mandibular ramus flexure. A retrospective study was conducted using orthopantomographs (OPGs) of 200 males and 200 females between the age group of 20 - 70 years. Each radiographic image was examined for the presence of a flexure or notching on the posterior border of the ramus in relation to occlusal plane as the method followed by Loth & Henneberg 1996.The study resulted in samples that were correctly classified as females 59.5% and males 57.5 %. The overall correct sex estimation was achieved in 58.5% of the cases. The predictive accuracy or assessment was higher for females compared to males. Consequently, the posterior ramus of mandible or mandibular ramus flexure can be considered as supplementary rather than a definitive means of sex determination. Hence, it is preferable to include as many parameters as possible to attain optimal accuracy.
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Affiliation(s)
- A Premkumar
- Dept. of forensic odontology, Dental College and Hospital, JSSAHER, Mysore. India
| | - N Doggalli
- Dept. Of Oral Medicine and Radiology, Dental College and Hospital, JSSAHER, Mysore. India
| | - S Rudraswamy
- Dept. Of Public Health Dentistry, Dental College and Hospital, JSSAHER, Mysore. India
| | - B S Manjunatha
- Faculty of Dentistry, Taif University, Taif, Kingdom of Saudi Arabia
| | - S W Peeran
- Armed Forces Hospital, Jizan, Kingdom of Saudi Arabia
| | - A Johnson
- School of Forensic Science, National Forensic Sciences University, Gujarat
| | - K Patil
- Dept. of forensic odontology, Dental College and Hospital, JSSAHER, Mysore. India
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Molina-Giraldo S, Torres-Valencia N, Johnson A, Lewi L, Ryan G, Sepúlveda W. The Management of Acardiac Twinning: Twin Reverse Arterial Perfusion Sequence - An International Survey. Fetal Diagn Ther 2023; 50:446-453. [PMID: 37536303 DOI: 10.1159/000531791] [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: 02/26/2023] [Accepted: 06/27/2023] [Indexed: 08/05/2023]
Abstract
INTRODUCTION The optimal approach and therapy method for the acardiac twin with a reverse arterial perfusion sequence has not yet been established. The aim of this study was to determine the clinical practice patterns among international fetal therapy units in their management of these cases. METHODS A survey was sent to fetal centers across the world via email between December 2020 and December 2021. RESULTS Responses were obtained from 77% contacted centers. The most frequent ultrasound variables used in the evaluation of twin reverse arterial perfusion sequence include echocardiographic assessment of the pump twin and umbilical artery Doppler waveforms in the acardiac and pump twins, in 90% and 80% of the centers, respectively. Most centers in Europe and Latin America propose an in utero intervention in all cases. Most centers in Europe and Latin America prefer interstitial laser ablation, whereas radiofrequency ablation (RFA) is preferred in North America. The earliest gestational age for an intervention is on mean 13 weeks in Europe, which is earlier than the other geographic areas (p = 0.001). CONCLUSIONS Most centers agreed that antenatal evaluation should include echocardiography along with the UA Doppler waveform measurements, and the most frequently used interventions were interstitial laser ablation or RFA at a median between 14 and 26 weeks.
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Affiliation(s)
- Saulo Molina-Giraldo
- Section of Fetal Therapy and Fetal Surgery Unit, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology Hospital de San José, Department of Obstetrics and Gynecology Fundación Universitaria de Ciencias de la Salud - FUCS, Bogota, Colombia
- Fetal Therapy and Surgery Network - FetoNetwork, Bogota, Colombia
- Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics Faculty of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
| | - Natalia Torres-Valencia
- Section of Fetal Therapy and Fetal Surgery Unit, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology Hospital de San José, Department of Obstetrics and Gynecology Fundación Universitaria de Ciencias de la Salud - FUCS, Bogota, Colombia,
- Fetal Therapy and Surgery Network - FetoNetwork, Bogota, Colombia,
| | - Anthony Johnson
- The Fetal Center, Children's Memorial Hospital, University of Texas Health Science Center, Houston, Texas, USA
| | - Liesbeth Lewi
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Universitaire Ziekenhuizen, Leuven, Belgium
- Department of Development and Regeneration, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Greg Ryan
- Fetal Medicine Unit, Ontario Fetal Centre, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Waldo Sepúlveda
- FETALMED-Maternal-Fetal Diagnostic Center, Fetal Imaging Unit, Santiago, Chile
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Brock CO, Bergh EP, Fishel Bartal M, Johnson A, Hernandez-Andrade EA, Garnett J, Tsao K, Austin MT, Fletcher SA, Johnston JH, Hughes KS, Patel R, Papanna R. The significance of hindbrain herniation reversal following prenatal repair of neural tube defects. J Neurosurg Pediatr 2023; 32:106-114. [PMID: 36964730 DOI: 10.3171/2023.2.peds22457] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/08/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVE The aim of this study was to determine whether reversal of hindbrain herniation (HBH) on MRI following prenatal repair of neural tube defects (NTDs) is associated with reduced rates of ventriculoperitoneal (VP) shunt placement or endoscopic third ventriculostomy (ETV) within the 1st year of life. METHODS This is a secondary analysis of prospectively collected data from all patients who had prenatal open repair of a fetal NTD at a single tertiary care center between 2012 and 2020. Patients were offered surgery according to inclusion criteria from the Management of Myelomeningocele Study (MOMS). Patients were excluded if they were lost to follow-up, did not undergo postnatal MRI, or underwent postnatal MRI without a report assessing hindbrain status. Patients with HBH reversal were compared with those without HBH reversal. The primary outcome assessed was surgical CSF diversion (i.e., VP shunt or ETV) within the first 12 months of life. Secondary outcomes included CSF leakage, repair dehiscence, CSF diversion prior to discharge from the neonatal intensive care unit (NICU), and composite neonatal morbidity. Demographic, prenatal sonographic, and operative characteristics as well as outcomes were assessed using standard univariate statistical methods. Multivariate logistic regression models were fit to assess for independent contributions to the primary and secondary outcomes. RESULTS Following exclusions, 78 patients were available for analysis. Of these patients, 38 (48.7%) had HBH reversal and 40 (51.3%) had persistent HBH on postnatal MRI. Baseline demographic and preoperative ultrasound characteristics were similar between groups. The primary outcome of CSF diversion within the 1st year of life was similar between the two groups (42.1% vs 57.5%, p = 0.17). All secondary outcomes were also similar between groups. Patients who had occurrence of the primary outcome had greater presurgical lateral ventricle width than those who did not (16.1 vs 12.1 mm, p = 0.02) when HBH was reversed, but not when HBH was persistent (12.5 vs 10.7 mm, p = 0.49). In multivariate analysis, presurgical lateral ventricle width was associated with increased rates of CSF diversion before 12 months of life (adjusted OR 1.18, 95% CI 1.03-1.35) and CSF diversion prior to NICU discharge (adjusted OR 1.18, 95% CI 1.02-1.37). CONCLUSIONS HBH reversal was not associated with decreased rates of CSF diversion in this cohort. Predictive accuracy of the anticipated benefits of prenatal NTD repair may not be augmented by the observation of HBH reversal on MRI.
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Affiliation(s)
- Clifton O Brock
- 1Midwest Fetal Care Center, Children's Minnesota, Minneapolis, Minnesota
- Departments of2Obstetrics, Gynecology, and Reproductive Sciences
| | - Eric P Bergh
- Departments of2Obstetrics, Gynecology, and Reproductive Sciences
| | | | - Anthony Johnson
- Departments of2Obstetrics, Gynecology, and Reproductive Sciences
| | | | - Jeannine Garnett
- Departments of2Obstetrics, Gynecology, and Reproductive Sciences
| | | | | | | | - Jennifer H Johnston
- 5Diagnostic and Interventional Imaging: Pediatrics, University of Texas Health Science Center at Houston; and
| | - Katrina S Hughes
- 5Diagnostic and Interventional Imaging: Pediatrics, University of Texas Health Science Center at Houston; and
| | - Rajan Patel
- 6Department of Radiology: Pediatric Radiology, Texas Children's Hospital, Houston, Texas
| | - Ramesha Papanna
- Departments of2Obstetrics, Gynecology, and Reproductive Sciences
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Quinn KG, Edwards T, Takahashi L, Johnson A, Spector A, Dakin A, Bouacha N, Valadez-Tapia S, Voisin D. "The Fight is Two Times as Hard": A Qualitative Examination of a Violence Syndemic Among Young Black Sexual Minority Men. J Interpers Violence 2023; 38:8162-8186. [PMID: 36803199 PMCID: PMC10714286 DOI: 10.1177/08862605231153891] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Young Black men who have sex with men (YBMSM) are disproportionately impacted by violence, including violence rooted in anti-Black racism, sexual identity bullying, and neighborhood violence rooted in structural racism and inequities. These multiple forms of violence are frequently co-occurring and interactive creating syndemic conditions that can negatively impact HIV care. This qualitative study is based on in-depth interviews with 31 YBMSM, aged 16-30 years, living with HIV in Chicago, IL, to examine how violence has impacted their lives. Using thematic analysis, we identified five themes that reflect how YBMSM experience violence at the intersection of racism, homonegativity, socioeconomic status, and HIV status: (a) the experience of intersectional violence; (b) long histories of violence contributed to hypervigilance, lack of safety, and lack of trust; (c) making meaning of violence and the importance of strength; (d) normalizing violence for survival; and (e) the cyclical nature of violence. Our study highlights how multiple forms of violence can accumulate across an individual's life and contribute to social and contextual situations that further contribute to violence and negatively impact mental health and HIV care.
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Affiliation(s)
- Katherine G. Quinn
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Travonne Edwards
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
| | - Lois Takahashi
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA
| | - Anthony Johnson
- School of Social Work, Loyola University Chicago, Chicago, IL
| | - Antoinette Spector
- Department of Physical Therapy, Rehabilitation Sciences & Technology, University of Wisconsin, Milwaukee, Milwaukee, WI
| | | | | | | | - Dexter Voisin
- School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH
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Huntley ES, Hernandez-Andrade E, Fishel Bartal M, Papanna R, Bergh EP, Lopez S, Soto E, Harting MT, Johnson A. Does Prediction of Neonatal Mortality by the Observed/Expected Lung-To-Head Ratio Change during Pregnancy in Fetuses with Left Congenital Diaphragmatic Hernia? Fetal Diagn Ther 2023; 50:438-445. [PMID: 37285832 DOI: 10.1159/000531406] [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: 12/02/2022] [Accepted: 05/25/2023] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate prediction of neonatal mortality in fetuses with isolated left congenital diaphragmatic hernia (CDH) when the observed/expected lung-to-head ratio (O/E LHR) was estimated at two different gestational time points during pregnancy. METHODS Forty-four (44) fetuses with isolated left CDH were included. O/E LHR was estimated at the time of referral (first scan) and before delivery (last scan). The main outcome was neonatal death due to respiratory complications. RESULTS There were 10/44 (22.7%) perinatal deaths. The areas under (AU) the ROC curves were: first scan, 0.76, best O/E LHR cut-off 35.5% with 76% sensitivity and 70% specificity; last scan, AU-ROC 0.79, best O/E LHR cut-off 35.2%, with 79.0% sensitivity and 80% specificity. Considering an O/E LHR cut-off ≤35% to define high-risk fetuses at any examination, prediction for perinatal mortality showed: 80% sensitivity, 73.5% specificity, 47.1% positive and 92.6% negative predictive values, and 3.02 (95% CI 1.59-5.73) positive and 0.27 (95% CI 0.08-0.96) negative likelihood ratios. Prediction was similar in the two evaluations as 16/21 (76.2%) of fetuses considered at risk had an O/E LHR ≤35% in the two examinations; in the remaining 5 cases, two were identified only in the first and three only in the last scan. CONCLUSION The O/E LHR is a good predictor of perinatal death in fetuses with left isolated CDH. Approximately 80% of fetuses at risk of perinatal death can be identified with an O/E LHR ≤35%, and 90% of them will have similar O/E LHR values at the first and at the last ultrasound examinations prior to delivery. In general, 88.6% of all CDH fetuses have a similar severity classification based on the O/E LHR at the first diagnostic ultrasound or at the ultrasound examination prior to delivery.
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Affiliation(s)
- Erin S Huntley
- Department of Obstetrics and Gynecology and Reproductive Sciences, Maternal Fetal Medicine Division, McGovern Medical School at The University of Texas, Health Science Center, Houston, Texas, USA
| | - Edgar Hernandez-Andrade
- Department of Obstetrics and Gynecology and Reproductive Sciences, Maternal Fetal Medicine Division, McGovern Medical School at The University of Texas, Health Science Center, Houston, Texas, USA
| | - Michal Fishel Bartal
- Department of Obstetrics and Gynecology and Reproductive Sciences, Maternal Fetal Medicine Division, McGovern Medical School at The University of Texas, Health Science Center, Houston, Texas, USA
| | - Ramesha Papanna
- Department of Obstetrics and Gynecology and Reproductive Sciences, Maternal Fetal Medicine Division, McGovern Medical School at The University of Texas, Health Science Center, Houston, Texas, USA
| | - Eric P Bergh
- Department of Obstetrics and Gynecology and Reproductive Sciences, Maternal Fetal Medicine Division, McGovern Medical School at The University of Texas, Health Science Center, Houston, Texas, USA
| | - Suzanne Lopez
- Department of Pediatrics Neonatology services, McGovern Medical School at The University of Texas, Health Science Center, Houston, Texas, USA
| | - Eleazar Soto
- Department of Obstetrics and Gynecology and Reproductive Sciences, Maternal Fetal Medicine Division, McGovern Medical School at The University of Texas, Health Science Center, Houston, Texas, USA
| | - Matthew T Harting
- Department of Pediatric Surgery, McGovern Medical School at The University of Texas, Health Science Center, Houston, Texas, USA
| | - Anthony Johnson
- Department of Obstetrics and Gynecology and Reproductive Sciences, Maternal Fetal Medicine Division, McGovern Medical School at The University of Texas, Health Science Center, Houston, Texas, USA
- Department of Pediatrics Neonatology services, McGovern Medical School at The University of Texas, Health Science Center, Houston, Texas, USA
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Papanna R, Agarwal N, Bergh EP, Brock C, Espinoza J, Johnson A. Fetoscopic laser ablation in pregnancies with Type-II vasa previa. Ultrasound Obstet Gynecol 2023; 61:779-781. [PMID: 36609872 DOI: 10.1002/uog.26153] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/30/2022] [Accepted: 12/16/2022] [Indexed: 06/03/2023]
Affiliation(s)
- R Papanna
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UT Health Houston, Houston, TX, USA
| | - N Agarwal
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UT Health Houston, Houston, TX, USA
| | - E P Bergh
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UT Health Houston, Houston, TX, USA
| | - C Brock
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UT Health Houston, Houston, TX, USA
| | - J Espinoza
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UT Health Houston, Houston, TX, USA
| | - A Johnson
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UT Health Houston, Houston, TX, USA
- Midwest Fetal Center, Minneapolis, MN, USA
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De Zoysa MY, Brock CO, Bergh EP, Johnson A, Hernandez-Andrade E, Nobles A, Papanna RM. Quincke versus Diamond-Tip Needles for Entry in Placental Laser Surgery for Twin-to-Twin Transfusion Syndrome. Fetal Diagn Ther 2023; 50:196-205. [PMID: 37037188 DOI: 10.1159/000530548] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/30/2023] [Indexed: 04/12/2023]
Abstract
INTRODUCTION Chorioamniotic membrane separation (CAS), preterm prelabor rupture of membranes (PPROM), and preterm delivery (PTD) remain as major complications of fetoscopic laser photocoagulation (FLP) for twin-to-twin transfusion syndrome (TTTS). We sought to examine whether use of Quincke-tip needles for initial entry during FLP reduces the risk of these complications. METHODS This is a secondary analysis of prospectively collected data from patients that had FLP for TTTS at a single tertiary care center (2011-2021). We excluded patients for whom direct trocar entry was used. Patients for whom a Quincke-tip needle was used were compared to those for whom a diamond-tip needle was used during Seldinger entry. Demographics, ultrasound findings and operative characteristics were compared between groups. Postoperative outcomes and complications (including CAS, PPROM, and PTD) were also compared. Multivariate logistic regression models were fit to assess independent risk factors for complications. RESULTS 386 patients met inclusion criteria; Quincke-tip needles were used in 81 (21.0%) cases, while diamond-tip needles were used in 305 (79.0%). Rates of CAS (11.1 vs. 9.5%, p = 0.67) and PPROM (44.4 vs. 41.0%, p = 0.57) were similar between groups. Patients in the Quincke-tip group delivered 1.5 weeks earlier than those in the diamond-tip group (30.5 vs. 32.0 weeks, p = 0.01). However, these patients were more likely to be delivered for maternal (35.9 vs. 19.0%) and fetal (23.1 vs. 15.3%) indications (p < 0.01). In multivariate analysis, needle type was not identified as an independent risk factor for PPROM. However, Quincke-tip needle use was associated with PTD less than 32 weeks (aOR 1.74, 95% CI: 1.02-2.97, p = 0.043). CONCLUSION Membrane complications following FLP were not associated with the needle type used for entry. Earlier delivery in the Quincke-tip group was likely attributable to higher rates of delivery for maternal and fetal indications, and not membrane complications. The needle chosen for entry is likely best determined by operator preference.
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Affiliation(s)
- Madushka Y De Zoysa
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California, USA
| | - Clifton O Brock
- Midwest Fetal Care Center, Children's Minnesota, Minneapolis, Minnesota, USA,
| | - Eric P Bergh
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas, McGovern Medical School, Houston, Texas, USA
| | - Anthony Johnson
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas, McGovern Medical School, Houston, Texas, USA
| | - Edgar Hernandez-Andrade
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas, McGovern Medical School, Houston, Texas, USA
| | | | - Ramesha M Papanna
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas, McGovern Medical School, Houston, Texas, USA
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Buckle I, Johnson A, Rojas IL, Weinert V, Sester DP, Radford K, Guillerey C. High dimensional analysis reveals distinct NK cell subsets but conserved response to stimulation in umbilical cord blood and adult peripheral blood. Eur J Immunol 2023:e2250118. [PMID: 37025016 DOI: 10.1002/eji.202250118] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 03/09/2023] [Accepted: 04/05/2023] [Indexed: 04/08/2023]
Abstract
Growing interest surrounds adoptive cellular therapies utilising Natural Killer (NK) cells, which can be obtained from various sources, including umbilical cord blood (UCB) and adult peripheral blood (APB). Understanding NK cell receptor expression and diversity in such cellular sources will guide future therapeutic designs. We used a 20-colour flow cytometry panel to compare unstimulated and cytokine-activated UCB and APB NK cells. Our analysis showed that UCB NK cells express slightly higher levels of the immune checkpoints PD-1, TIGIT and CD96 compared to their APB counterparts. Unsupervised hierarchical clustering and dimensionality reduction analyses revealed an enrichment in CD56neg as well as mature NKp46neg and CD56+ CD16+ NK cell populations in UCB whereas CD57+ terminally differentiated NK cells with variable expression of KIRs and CD16 were found in APB. These populations were conserved following stimulation with IL-12, IL-15, and IL-18. Cytokine stimulation was associated with the downregulation of TIGIT and CD16 on multiple NK cell subsets in UCB and APB. Among UCB CD16- NK cell populations, TIGIT+ NK cells produced more IFN-γ than their TIGIT- counterparts. Our data demonstrate higher immune checkpoint expression on UCB NK cells compared to APB. However, expression of TIGIT immune checkpoint is not indicative of NK cell exhaustion. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Irina Buckle
- Cancer Immunotherapies Laboratory, Mater Research Institute, University of Queensland, Translational Research Institute, Brisbane, Queensland, Australia
| | - Anthony Johnson
- Cancer Immunotherapies Laboratory, Mater Research Institute, University of Queensland, Translational Research Institute, Brisbane, Queensland, Australia
| | - Ingrid Leal Rojas
- Cancer Immunotherapies Laboratory, Mater Research Institute, University of Queensland, Translational Research Institute, Brisbane, Queensland, Australia
| | - Vicky Weinert
- Cancer Immunotherapies Laboratory, Mater Research Institute, University of Queensland, Translational Research Institute, Brisbane, Queensland, Australia
| | - David P Sester
- TRI Flow cytometry suite, Translational Research Institute, 37 Kent Street, Woolloongabba, QLD, 4102, Australia
- Hugh Green Cytometry Centre, Malaghan Institute of Medical Research, Wellington, New Zealand
| | - Kristen Radford
- Cancer Immunotherapies Laboratory, Mater Research Institute, University of Queensland, Translational Research Institute, Brisbane, Queensland, Australia
| | - Camille Guillerey
- Cancer Immunotherapies Laboratory, Mater Research Institute, University of Queensland, Translational Research Institute, Brisbane, Queensland, Australia
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Friedman S, Varga-Szemes A, Schoepf U, Johnson A, Johnson J, Baxley R, Houston B, Litwin S, Atkins J, Tedford R. Effect of Dobutamine on Rv Contractility and Rv-Pa Coupling in the Normal Rv. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.867] [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: 04/05/2023] Open
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Kim E, Kopp B, Kortlever JT, Johnson A, Ring D. Correlation of defect size with fatty infiltration on MRIs of rotator cuff tendinopathy. J Orthop 2023; 36:125-129. [PMID: 36748092 PMCID: PMC9898575 DOI: 10.1016/j.jor.2023.01.007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 01/21/2023] Open
Abstract
Introduction Sizable rotator cuff defects with limited muscle atrophy and fat replacement may represent acute traumatic ruptures that are less likely to recur after surgery to close the defect, while closure of defects with poor quality muscle are associated with defect recurrence. These distinct lesions are both referred to as tears. We analyzed the relationship between rotator cuff defect size and muscle quality to determine the relative proportion of sizable defects associated with good muscle and factors associated with muscle deterioration. Material and methods A cohort of 230 consecutive shoulder MRIs in patients with full-thickness rotator cuff tendon defects, limited acromioclavicular arthrosis (to avoid hindrance of defect measurement), and a duration of symptoms in the radiology report from a large urban center in the United States was evaluated for the measured distance between the supraspinatus tendon edge and the greater tuberosity medial to lateral (coronal plane defect size), anterior to posterior (sagittal plane defect width), and fatty infiltration (Goutallier classification), and atrophy (Warner classification) of the supraspinatus. We sought factors independently associated with fatty infiltration and muscle atrophy in multivariable logistic regression analyses. Results Forty-nine of 109 shoulders (45%) with a coronal plane defect >20 mm had reasonable muscle quality as defined by Goutallier grade less than 2 and Warner grade less than 2. Both greater fatty infiltration of the supraspinatus muscle and greater supraspinatus muscle atrophy were associated with older age and greater coronal plane defect size. Conclusion The observation that supraspinatus muscle health deteriorates with age and defect size, but nearly half of the largest defects had good muscle, suggests an important distinction between relatively recent traumatic ruptures and old untreated rupture or gradual attrition that may be obfuscated by referring to all lesions as tears. Level of evidence Level III; Retrospective diagnostic cohort.
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Affiliation(s)
- Eugene Kim
- Department of Surgery and Perioperative Care, Dell Medical School – the University of Texas at Austin, 1701 Trinity Street, Austin, TX, 78705, USA
| | - Benjamin Kopp
- Department of Surgery and Perioperative Care, Dell Medical School – the University of Texas at Austin, 1701 Trinity Street, Austin, TX, 78705, USA
| | - Joost T.P. Kortlever
- Department of Surgery and Perioperative Care, Dell Medical School – the University of Texas at Austin, 1701 Trinity Street, Austin, TX, 78705, USA
| | - Anthony Johnson
- Department of Surgery and Perioperative Care, Dell Medical School – the University of Texas at Austin, 1701 Trinity Street, Austin, TX, 78705, USA
| | - David Ring
- Department of Surgery and Perioperative Care, Dell Medical School – the University of Texas at Austin, 1701 Trinity Street, Austin, TX, 78705, USA
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Zhu A, Srivastava A, Dibianco J, Qi J, Dhir A, Maruf M, Ferrante S, Johnson A, Semerjian A, Davenport M, Mammen L, Dabaja A, Lane B, Ginsburg K, Witzke K, George A. Negative predictive value of prostate MRI in real world practice: Results from a statewide surgical collaborative in the United States. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00940-5] [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: 02/12/2023]
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Hernandez-Andrade E, Huntley ES, Bartal MF, Soto E, Johnson A. Fetal coronary circulation: the middle cardiac vein. Ultrasound Obstet Gynecol 2023; 61:269-270. [PMID: 36056766 DOI: 10.1002/uog.26060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/05/2022] [Accepted: 08/24/2022] [Indexed: 05/27/2023]
Affiliation(s)
- E Hernandez-Andrade
- The Fetal Center, Department of Obstetrics and Gynecology and Reproductive Sciences, Division of Fetal Intervention, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - E S Huntley
- The Fetal Center, Department of Obstetrics and Gynecology and Reproductive Sciences, Division of Fetal Intervention, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - M F Bartal
- The Fetal Center, Department of Obstetrics and Gynecology and Reproductive Sciences, Division of Fetal Intervention, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - E Soto
- The Fetal Center, Department of Obstetrics and Gynecology and Reproductive Sciences, Division of Fetal Intervention, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - A Johnson
- The Fetal Center, Department of Obstetrics and Gynecology and Reproductive Sciences, Division of Fetal Intervention, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
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Bergh EP, Baschat AA, Hedrick H, Lim FY, Magee K, Ryan G, Cortes MS, Schenone M, Zaretsky MV, Johnson A. Fetoscopic endoluminal tracheal occlusion (FETO) versus expectant care of severe left-diaphragmatic hernia in north america. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.060] [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: 01/08/2023]
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Shamshirsaz AA, Chmait RH, Stirnemann J, Habli MA, Johnson A, Hessami K, Mostafaei S, Nassr AA, Donepudi RV, Sanz Cortes M, Espinoza J, Krispin E, Belfort MA. Solomon versus selective fetoscopic laser photocoagulation for twin-twin transfusion syndrome: A systematic review and meta-analysis. Prenat Diagn 2023; 43:72-83. [PMID: 36184777 DOI: 10.1002/pd.6246] [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] [Received: 05/02/2022] [Revised: 09/07/2022] [Accepted: 09/28/2022] [Indexed: 01/27/2023]
Abstract
This meta-analysis aims to compare the perinatal outcome of twin-twin transfusion syndrome (TTTS) pregnancies undergoing selective versus vascular equator (Solomon) fetoscopic laser photocoagulation (FLP). We performed a systematic search in PubMed and Web of Science from inception up to 25 July 2021. Studies comparing the Solomon and selective techniques of FLP for treatment of TTTS pregnancies were eligible. Random-effects or fixed-effect models were used to pool standardized mean differences (SMD) and log odds ratio. Seven studies with a total of 1664 TTTS pregnancies (n = 671 undergoing Solomon and n = 993 selective techniques) were included. As compared to the selective FLP, Solomon was associated with a lower risk of recurrent TTTS compared to the selective technique (Log odds ratio [OR]: -1.167; 95% credible interval [CrI]: -2.01, -0.33; p = 0.021; I2 : 67%). In addition, Solomon was significantly associated with a higher risk of placental abruption than the selective technique (Log [OR]: 1.44; 95% CrI: 0.45, 2.47; p = 0.012; I2 : 0.0%). Furthermore, a trend for the higher risk of preterm premature rupture of membranes was observed among those undergoing Solomon (Log [OR]: 0.581; 95% CrI: -0.43, 1.49; p = 0.131; I2 : 17%). As compared to selective FLP, the Solomon technique for TTTS pregnancies is associated with a significantly lower recurrence of TTTS; however, it significantly increases the risk of placental abruption.
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Affiliation(s)
- Alireza A Shamshirsaz
- Maternal Fetal Care Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ramen H Chmait
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Julien Stirnemann
- Department of Obstetrics and Maternal-Fetal Medicine, Hôpital Necker-Enfants Malades, Université de Paris, Paris, France
| | - Mounira A Habli
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Good Samaritan Hospital, Cincinnati, Ohio, USA
| | - Anthony Johnson
- Department of Obstetrics and Gynecology, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Kamran Hessami
- Maternal Fetal Care Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Shayan Mostafaei
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinksa Institutet, Stockholm, Sweden
| | - Ahmed A Nassr
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
| | - Roopali V Donepudi
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
| | - Magdalena Sanz Cortes
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
| | - Jimmy Espinoza
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
| | - Eyal Krispin
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
| | - Michael A Belfort
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
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Garnett J, Bergh EP, Mann L, Tsao K, Austin M, Johnson A, Northrup H, Au KS, Miller B, Fletcher SA, Papanna R. Differences between myelomeningocele and myeloschisis lesions in patients undergoing open in-utero spina bifida repair. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.669] [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: 01/09/2023]
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Miller JL, Baschat AA, Rosner M, Blumenfeld YJ, Moldenhauer J, Johnson A, Schenone M, Zaretsky MV, Chmait RH, Velez JG, Miller RS, Moon-Grady AJ, Bendel-Stenzel EM, Keiser A, Avadhani R, Jelin A, Davis J, Warren D, Hanley D, Atkinson M. Neonatal survival after serial amnioinfusions for fetal bilateral renal agenesis: report from the raft trial. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.1307] [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: 01/09/2023]
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Papanna R, Fletcher SA, Mann L, Garnett J, Bergh EP, Austin M, Miller B, Refuerzo J, Johnson A, Jain R, Tsao K. Fetoscopic myelomeningocele (fMMC) repair with human umbilical cord (fMMC-HUC) compared with open in-utero MMC repair (oMMC). Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.059] [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: 01/09/2023]
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Moldenhauer JS, Johnson A, Van Mieghem T. International Society for Prenatal Diagnosis 2022 DEBATE: There should be formal accreditation and ongoing quality assurance/review for units offering fetal therapy that includes public reporting of outcomes. Prenat Diagn 2022; 43:411-420. [PMID: 36522853 DOI: 10.1002/pd.6286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022]
Abstract
The field of fetal therapy has so far escaped from formal accreditation and quality control. Despite that, current published evidence shows that outcomes of interventions in younger fetal therapy centers are similar to what is achieved in more experienced centers and outcomes of interventions have improved over time. The question however remains what is not being published and what should be the standard of care, given the lack of level 1 evidence from randomized controlled trials for many interventions. Formal collaborative networks such as NAFTnet and others allow for anonymized benchmarking of center outcomes, without publicly shaming (and financially punishing) underperforming centers. Large registries also allow for tracking of rare complications and may result in improved patient outcomes over time. Core outcome sets, which could serve as a basis for outcome reporting, are available for some conditions, but certainly not for all, resulting in communication difficulties between centers. Formal accreditation, quality control, and outcome reporting are hard to implement, expensive, and may result in decreasing access to care by pushing smaller centers out of the market. Despite the existing difficulties, international societies have committed to quality improvement, and fetal therapy programs are strongly recommended to participate in voluntary outcome tracking.
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Affiliation(s)
| | - Anthony Johnson
- The Fetal Center Department of Obstetrics and Gynecology and Reproductive Sciences Division of Fetal Intervention McGovern Medical School at The University of Texas Health Science Center Houston Texas USA
| | - Tim Van Mieghem
- Department of Obstetrics and Gynaecology Fetal Medicine Unit and Ontario Fetal Centre Mount Sinai Hospital and University of Toronto Toronto Ontario Canada
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Johnson A, Eltahir M, Xu Y. Histologic Features of a Solitary Fibrous Tumor in the Region of Oral Cavity and Maxillofacial Complex with Recurrence and Distant Metastasis: a Rare Case Report. Am J Clin Pathol 2022. [DOI: 10.1093/ajcp/aqac126.061] [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: 11/11/2022] Open
Abstract
Abstract
Introduction/Objective
Solitary fibrous tumor (SFT) is an uncommon mesenchymal neoplasm, and may involve many anatomic locations. Approximately 0.6% of SFTs in the oral cavity and maxillofacial complex may recur and/or develop distant metastasis. Here we report a case of SFT in oral cavity with local recurrence and distant metastasis.
Methods/Case Report
The patient was a 66-year-old male with a past medical history of left buccal mass status post excision with an unclear diagnosis in a foreign country 6 years ago. He presented with a recurrence of the left buccal mass. Computerized tomography (CT) of the head and chest demonstrated a 9 cm expansile mass centered in the left pterygopalatine fossa and a 1.7 cm mass in left upper lobe of the lung, respectively. Biopsy of the lung mass was performed first and displayed a hypercellular mesenchymal tumor, composed of spindle cells arranged in vague short fascicles, and scant fibrous stroma with thin-walled and staghorn-like vasculature. The tumor cells had mild nuclear atypia with 5 mitoses/10 high power fields. No necrosis is identified. There were trapped benign pneumocytes and bronchial epithelial cells in the tumor. The tumor is positive for CD34, CD99, Bcl-2 and STAT6 immunostains. The large left buccal mass was biopsied later and showed similar morphology. The diagnoses of metastatic SFT in the lung and recurrent SFT were rendered, respectively.
Results (if a Case Study enter NA)
NA.
Conclusion
The histologic findings of the recurrent SFT and the pulmonary metastasis are similar in our case. Although marked cellular atypia and necrosis are not observed in either tumor, other features including the large size of recurrent tumor, hypercellularity, and increased mitotic activity are associated with malignant behavior in this report, and warrant the need for long-term follow-up.
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Affiliation(s)
- A Johnson
- Pathology & Immunology, Baylor College of Medicine , Houston, Texas , United States
| | - M Eltahir
- Pathology & Immunology, Baylor College of Medicine , Houston, Texas , United States
| | - Y Xu
- Pathology & Immunology, Baylor College of Medicine , Houston, Texas , United States
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Moody JD, Pollock BB, Sio H, Strozzi DJ, Ho DDM, Walsh CA, Kemp GE, Lahmann B, Kucheyev SO, Kozioziemski B, Carroll EG, Kroll J, Yanagisawa DK, Angus J, Bachmann B, Bhandarkar SD, Bude JD, Divol L, Ferguson B, Fry J, Hagler L, Hartouni E, Herrmann MC, Hsing W, Holunga DM, Izumi N, Javedani J, Johnson A, Khan S, Kalantar D, Kohut T, Logan BG, Masters N, Nikroo A, Orsi N, Piston K, Provencher C, Rowe A, Sater J, Skulina K, Stygar WA, Tang V, Winters SE, Zimmerman G, Adrian P, Chittenden JP, Appelbe B, Boxall A, Crilly A, O'Neill S, Davies J, Peebles J, Fujioka S. Increased Ion Temperature and Neutron Yield Observed in Magnetized Indirectly Driven D_{2}-Filled Capsule Implosions on the National Ignition Facility. Phys Rev Lett 2022; 129:195002. [PMID: 36399755 DOI: 10.1103/physrevlett.129.195002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
The application of an external 26 Tesla axial magnetic field to a D_{2} gas-filled capsule indirectly driven on the National Ignition Facility is observed to increase the ion temperature by 40% and the neutron yield by a factor of 3.2 in a hot spot with areal density and temperature approaching what is required for fusion ignition [1]. The improvements are determined from energy spectral measurements of the 2.45 MeV neutrons from the D(d,n)^{3}He reaction, and the compressed central core B field is estimated to be ∼4.9 kT using the 14.1 MeV secondary neutrons from the D(T,n)^{4}He reactions. The experiments use a 30 kV pulsed-power system to deliver a ∼3 μs current pulse to a solenoidal coil wrapped around a novel high-electrical-resistivity AuTa_{4} hohlraum. Radiation magnetohydrodynamic simulations are consistent with the experiment.
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Affiliation(s)
- J D Moody
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B B Pollock
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - H Sio
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D J Strozzi
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D D-M Ho
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - C A Walsh
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - G E Kemp
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Lahmann
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S O Kucheyev
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Kozioziemski
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - E G Carroll
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Kroll
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D K Yanagisawa
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Angus
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Bachmann
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S D Bhandarkar
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J D Bude
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - L Divol
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Ferguson
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Fry
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - L Hagler
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - E Hartouni
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - M C Herrmann
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - W Hsing
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D M Holunga
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - N Izumi
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Javedani
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - A Johnson
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S Khan
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D Kalantar
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - T Kohut
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B G Logan
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - N Masters
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - A Nikroo
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - N Orsi
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - K Piston
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - C Provencher
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - A Rowe
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Sater
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - K Skulina
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - W A Stygar
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - V Tang
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S E Winters
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - G Zimmerman
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - P Adrian
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - J P Chittenden
- Centre for Inertial Fusion Studies, The Blackett Laboratory, Imperial College, London SW7 2AZ, United Kingdom
| | - B Appelbe
- Centre for Inertial Fusion Studies, The Blackett Laboratory, Imperial College, London SW7 2AZ, United Kingdom
| | - A Boxall
- Centre for Inertial Fusion Studies, The Blackett Laboratory, Imperial College, London SW7 2AZ, United Kingdom
| | - A Crilly
- Centre for Inertial Fusion Studies, The Blackett Laboratory, Imperial College, London SW7 2AZ, United Kingdom
| | - S O'Neill
- Centre for Inertial Fusion Studies, The Blackett Laboratory, Imperial College, London SW7 2AZ, United Kingdom
| | - J Davies
- University of Rochester, New York 14623, USA
| | - J Peebles
- Laboratory for Laser Energetics, New York 14623, USA
| | - S Fujioka
- Institute for Laser Engineering, Osaka University, 2-6 Yamada-Oka, Suita, Osaka 565-0871, Japan
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Fishel Bartal M, Bergh EP, Tsao K, Austin MT, Moise KJ, Fletcher SA, Garnett J, Mann L, Hernandez-Andrade E, Johnson A, Papanna R. Primary vs patch-based skin closure for in-utero spina bifida repair. Ultrasound Obstet Gynecol 2022; 60:666-672. [PMID: 35751885 DOI: 10.1002/uog.26018] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/31/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE During in-utero spina bifida (SB) repair, closure of large defects is often challenging, requiring tissue graft for watertight skin closure. No prior studies have compared primary skin closure vs patch-based repair. Our objective was to compare neonatal and 1-year outcomes associated with these two types of skin closure for in-utero SB repair. METHODS This was a prospective cohort study of 102 patients undergoing open prenatal SB repair from September 2011 to August 2021 at a single institution. All patients met the inclusion criteria of the Management of Myelomeningocele Study (MOMS), and the surgical procedure for in-utero SB repair was similar to that described in the MOMS trial. During the surgery, if primary skin approximation was not feasible due to the large size of the defect, the decision was at the discretion of the pediatric neurosurgeon to utilize a patch for closure. Neonatal outcomes at birth and 1-year outcomes were compared between the primary skin and patch-based closure groups. RESULTS Of 102 patients included in the study, 70 (68.6%) underwent primary skin closure and 32 (31.4%) patch-based closure. The patch type included acellular bovine skin matrix (Durepair®; n = 31) and human acellular dermal matrix (Alloderm®; n = 1). Fetuses with myeloschisis were more likely to require patch-based repair than those with myelomeningocele. The median time of fetal repair was 4 min longer for patch-based compared with primary skin closure (37 vs 33 min; P = 0.001). Following patch-based repair, neonates had a longer length of stay in the neonatal intensive care unit (NICU) by 24 days (adjusted risk ratio, 2.40 (95% CI, 1.41-4.29)) compared to those that underwent primary skin closure. There was no difference between the two groups in the other neonatal outcomes, including the need for ventriculoperitoneal shunt placement and cerebrospinal fluid leakage. Outcome at 1 year of age was available for 90 infants. Need for wound revision within their first year after birth was more common in infants who underwent patch-based vs those with primary skin closure (19.4% vs 5.1%; P = 0.05). There was no difference between the two groups in other 1-year outcomes, including the need for ventriculoperitoneal shunt placement by 1 year of age and surgery for tethered cord. CONCLUSIONS Patch-based closure during SB repair is often needed in fetuses with myeloschisis and is associated with prolonged fetal surgery time, long NICU stay and need for wound revision within the first year after birth. Further studies are required to identify optimal patches for SB repair or alternative methods to improve outcome. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- M Fishel Bartal
- The Fetal Center, Children's Memorial Hermann Hospital, Department of Obstetrics and Gynecology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - E P Bergh
- The Fetal Center, Children's Memorial Hermann Hospital, Department of Obstetrics and Gynecology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - K Tsao
- Department of Pediatric Surgery, Children's Memorial Hermann Hospital, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - M T Austin
- Department of Pediatric Surgery, Children's Memorial Hermann Hospital, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - K J Moise
- The Fetal Center, Children's Memorial Hermann Hospital, Department of Obstetrics and Gynecology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - S A Fletcher
- Pediatric Neurosurgery, Department of Pediatric Surgery, Children's Memorial Hermann Hospital, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - J Garnett
- The Fetal Center, Children's Memorial Hermann Hospital, Department of Obstetrics and Gynecology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - L Mann
- The Fetal Center, Children's Memorial Hermann Hospital, Department of Obstetrics and Gynecology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - E Hernandez-Andrade
- The Fetal Center, Children's Memorial Hermann Hospital, Department of Obstetrics and Gynecology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - A Johnson
- The Fetal Center, Children's Memorial Hermann Hospital, Department of Obstetrics and Gynecology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - R Papanna
- The Fetal Center, Children's Memorial Hermann Hospital, Department of Obstetrics and Gynecology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
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Minto T, Abdelrahman T, Jones L, Wheat J, Key T, Shivakumar N, Ansell J, Seddon O, Cronin A, Tomkinson A, Theron A, Trickett RW, Sagua N, Sultana S, Clark A, McKay E, Johnson A, Behera K, Towler J, Kynaston H. Safety of maintaining elective and emergency surgery during the COVID-19 pandemic with the introduction of a Protected Elective Surgical Unit (PESU): A cross-specialty evaluation of 30-day outcomes in 9,925 patients undergoing surgery in a University Health Board. Surg Open Sci 2022; 10:168-173. [PMID: 36211629 PMCID: PMC9531361 DOI: 10.1016/j.sopen.2022.09.005] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/29/2022] [Accepted: 09/12/2022] [Indexed: 11/06/2022] Open
Abstract
Background The COVID-19 pandemic has caused unprecedented health care challenges mandating surgical service reconfiguration. Within our hospital, emergency and elective streams were separated and self-contained Protected Elective Surgical Units were developed to mitigate against infection-related morbidity. Aims of this study were to determine the risk of COVID-19 transmission and mortality and whether the development of Protected Elective Surgical Units can result in significant reduction in risk. Methods A retrospective observational study of consecutive patients from 18 specialties undergoing elective or emergency surgery under general, spinal, or epidural anaesthetic over a 12-month study period was undertaken. Primary outcome measures were 30-day postoperative COVID-19 transmission rate and mortality. Secondary adjusted analyses were performed to ascertain hospital and Protected Elective Surgical Unit transmission rates. Results Between 15 March 2020 and 14 March 2021, 9,925 patients underwent surgery: 6,464 (65.1%) elective, 5,116 (51.5%) female, and median age 57 (39–70). A total of 69.5% of all procedures were performed in Protected Elective Surgical Units. Overall, 30-day postoperative COVID-19 transmission was 2.8% (3.4% emergency vs 1.2% elective P < .001). Protected Elective Surgical Unit postoperative transmission was significantly lower than non–Protected Elective Surgical Unit (0.42% vs 3.2% P < .001), with an adjusted likely in-hospital Protected Elective Surgical Unit transmission of 0.04%. The 30-day all-cause mortality was 1.7% and was 14.6% in COVID-19–positive patients. COVID-19 infection, age > 70, male sex, American Society of Anesthesiologists grade > 2, and emergency surgery were all independently associated with mortality. Conclusion This study has demonstrated that Protected Elective Surgical Units can facilitate high-volume elective surgical services throughout peaks of the COVID-19 pandemic while minimising viral transmission and mortality. However, mortality risk associated with perioperative COVID-19 infection remains high.
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Affiliation(s)
- T Minto
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - T Abdelrahman
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - L Jones
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - J Wheat
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - T Key
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - N Shivakumar
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - J Ansell
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - O Seddon
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - A Cronin
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - A Tomkinson
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - A Theron
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - RW Trickett
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - N Sagua
- School of Medicine, Cardiff University, University Hospital of Wales Main Bldg, Heath Park, Cardiff, United Kingdom CF14 4XN
| | - S Sultana
- School of Medicine, Cardiff University, University Hospital of Wales Main Bldg, Heath Park, Cardiff, United Kingdom CF14 4XN
| | - A Clark
- School of Medicine, Cardiff University, University Hospital of Wales Main Bldg, Heath Park, Cardiff, United Kingdom CF14 4XN
| | - E McKay
- School of Medicine, Cardiff University, University Hospital of Wales Main Bldg, Heath Park, Cardiff, United Kingdom CF14 4XN
| | - A Johnson
- School of Medicine, Cardiff University, University Hospital of Wales Main Bldg, Heath Park, Cardiff, United Kingdom CF14 4XN
| | - Karishma Behera
- School of Medicine, Cardiff University, University Hospital of Wales Main Bldg, Heath Park, Cardiff, United Kingdom CF14 4XN
| | - J Towler
- School of Medicine, Cardiff University, University Hospital of Wales Main Bldg, Heath Park, Cardiff, United Kingdom CF14 4XN
| | - H Kynaston
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW,School of Medicine, Cardiff University, University Hospital of Wales Main Bldg, Heath Park, Cardiff, United Kingdom CF14 4XN,Corresponding author at: School of Medicine, Cardiff University, Cardiff, United Kingdom CF14 4XN.
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Fischer J, Bouhana K, Chicarelli M, Dahlke J, Fell B, Fulton J, Guarnieri A, Haygood L, Jalluri R, Johnson A, McLean B, Max M, Rieger R, Robinson J, Rodriguez M, Sullivan F, Wang Y, Winski S, Zhou Y. In Vivo Pre-clinical characterization of a Novel Series of FGFR2 Selective Inhibitors with Potency Against Clinically Relevant Mutations. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01016-4] [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: 11/03/2022]
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Ngoi N, Pilie P, Piha-Paul S, Dumbrava E, Fu S, Hong D, Karp D, Naing A, Pant S, Rodon Ahnert J, Subbiah V, Tsimberidou A, Salguero C, Brown C, Hoadley W, Johnson A, Yuan Y, Westin S, Meric-Bernstam F, Yap T. DNA Damage Response (DDR) Basket of Baskets (D-BOB) Trial: Phase 1/2 Study of the ATR inhibitor (ATRi) berzosertib and PD-L1 inhibitor avelumab in patients (pts) with advanced solid tumors with DDR molecular alterations. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00828-0] [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: 11/03/2022]
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Olaizola AM, Kuis R, Johnson A, Kingsley D. Stimulated Raman generation of aqueous singlet oxygen without photosensitizers. J Photochem Photobiol B 2022; 235:112562. [PMID: 36095974 DOI: 10.1016/j.jphotobiol.2022.112562] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/23/2022] [Accepted: 09/01/2022] [Indexed: 06/15/2023]
Abstract
Singlet oxygen is traditionally produced via photosensitizer molecules such as methylene blue, which function as catalysts. Here we investigate stimulated Raman generation of singlet oxygen from dissolved oxygen in both water (H2O) and heavy water (D2O) using nanosecond-pulsed visible blue laser light in the 400-440 nm spectral region without singlet oxygen photosensitizers. We report an oxygen-dependent Stokes peak in the red spectrum (600-670 nm) that is identical when produced in H2O and D2O. These red Stokes photons are not detected when an oxygen quencher is present. Temporal photodepletion of the uric acid absorbance peak at 294 nm is consistent with singlet oxygen generation. We postulate that a two-photon stimulated Raman process produces singlet oxygen from O2 dissolved within the solvents. We note that the energy difference between input and output photons of 0.97 eV is precisely the energy needed to excite O2 to its singlet state.
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Affiliation(s)
- Aristides Marcano Olaizola
- Division of Physics, Engineering, Mathematics, and Computer Science, Delaware State University, 1200 North DuPont Highway, Dover, DE 19901, USA.
| | - Robinson Kuis
- Center for Advanced Studies in Photonics Research, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, United States of America
| | - Anthony Johnson
- Center for Advanced Studies in Photonics Research, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, United States of America
| | - David Kingsley
- Residue Chemistry and Predictive Microbiology Research Unit, US Dept. of Agriculture, Agriculture Research Service, Delaware State University, 1200 North DuPont Highway, Dover, DE 19901, United States of America
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Rohrback M, Ramtin S, Abdelaziz A, Matkin L, Ring D, Crijns TJ, Johnson A. Rotator cuff tendinopathy: magnitude of incapability is associated with greater symptoms of depression rather than pathology severity. J Shoulder Elbow Surg 2022; 31:2134-2139. [PMID: 35461981 DOI: 10.1016/j.jse.2022.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/24/2022] [Accepted: 03/06/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Population-based studies have established that rotator cuff tendinopathy develops in most persons during their lifetimes, it is often accommodated, and there is limited correspondence between symptom intensity and pathology severity. To test the relationship between effective accommodation and mental health on its continuum, we studied the relative association of magnitude of capability with symptoms of anxiety or depression compared with quantifications of rotator cuff pathology such as defect size, degree of retraction, and muscle atrophy among patients presenting for specialty care. METHODS We analyzed a retrospective cohort of 71 adults seeking specialty care for symptoms of rotator cuff tendinopathy who underwent a recent magnetic resonance imaging scan of the shoulder and completed the following questionnaires: Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health questionnaire (a measure of symptom intensity and magnitude of capability, consisting of mental and physical health subscores), Generalized Anxiety Disorder questionnaire (measuring symptoms of anxiety), and Patient Health Questionnaire (measuring symptoms of depression). Two independent reviewers measured the sagittal length of the rotator cuff defect and tendon retraction in millimeters on magnetic resonance imaging scans (excellent reliability) and rated rotator cuff muscle atrophy and fatty infiltration (more limited reliability), and we used the average measurement or rating for each patient. Multivariable statistical models were used to identify factors associated with the PROMIS Global Health score and mental and physical health subscores. RESULTS Accounting for potential confounding in multivariable analysis, lower PROMIS Global Health total scores and physical health subscale scores were independently associated with greater symptoms of depression but not with measures of pathology. Lower PROMIS mental health subscale scores were independently associated with greater symptoms of anxiety and greater muscle atrophy. CONCLUSIONS The observation that magnitude of incapability among patients seeking care for symptoms of rotator cuff pathology is associated with symptoms of depression but not with measures of the severity of the rotator cuff pathology suggests that treatment strategies for patients who seek care for symptoms of rotator cuff tendinopathy may be incomplete if they do not anticipate and address mental health.
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Affiliation(s)
| | - Sina Ramtin
- The University of Texas at Austin, Austin, TX, USA
| | | | - Lars Matkin
- The University of Texas at Austin, Austin, TX, USA
| | - David Ring
- The University of Texas at Austin, Austin, TX, USA.
| | - Tom J Crijns
- The University of Texas at Austin, Austin, TX, USA
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Heslop E, Cammish P, McNiff M, Pegg K, Irvin A, Reuben E, Johnson A, Gaeta A, Turner C, Fischer R, Peay H, Muntoni F, Childs A, Straub V, Guglieri M. P.125 DMD Hub: A UK network enabling trials in Duchenne muscular dystrophy. Neuromuscul Disord 2022. [DOI: 10.1016/j.nmd.2022.07.241] [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: 11/05/2022]
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Lee J, Meyer C, To T, Lin CW, Wang S, Kent M, Johnson A, Lee J. 946P Non-examination of lymph nodes (LN) in early-stage non-small cell lung cancer (eNSCLC) is associated with wedge resections and underutilization of adjuvant (adv) chemotherapy. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1071] [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: 11/26/2022] Open
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Das M, Ogale S, Johnson A, Nguyen C, Bhagwakar J, Jovanoski N, Lee J. EP04.01-017 Cost-Effectiveness of Atezolizumab for Adjuvant Treatment of Patients with Stage II-IIIA PD-L1+ Non-small Cell Lung Cancer. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Oezkan F, Hilz S, Grindheim J, Wallace A, Seweryn M, Reuben A, Zhang J, Owen D, Nicholas A, Yadav M, Nagarkar D, de Almeida P, Ebert P, Osborne E, Johnson A, Lee J, Bunn P, Johnson B, Chaft J, Kris M, Rusch V, Schulze K, Kwiatkowski D, Wistuba I, Carbone D. OA14.06 T-Cell Dynamics in Response to Neoadjuvant Atezolizumab in Early NSCLC by Antigen Response and T-Cell Receptor Sequencing. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.071] [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: 10/14/2022]
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Atkinson MA, Jelin EB, Baschat A, Blumenfeld Y, Chmait R, O’Hare E, Moldenhauer J, Zaretsky M, Miller R, Ruano R, Gonzalez J, Johnson A, Mould A, Davis J, Hanley D, Keiser A, Rosner M, Miller JL. Design and Protocol of the Renal Anhydramnios Fetal Therapy (RAFT) Trial. Clin Ther 2022; 44:1161-1171. [PMID: 35918190 PMCID: PMC9847373 DOI: 10.1016/j.clinthera.2022.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 04/15/2022] [Revised: 06/08/2022] [Accepted: 07/05/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE Anhydramnios secondary to anuria before 22 weeks of gestational age and congenital bilateral renal agenesis before 26 weeks of gestational age are collectively referred to as early-pregnancy renal anhydramnios. Early-pregnancy renal anhydramnios occurs in at least 1 in 2000 pregnancies and is considered universally fatal when left untreated because of severe pulmonary hypoplasia precluding ex utero survival The Renal Anhydramnios Fetal Therapy (RAFT) trial is a nonrandomized, nonblinded, multicenter clinical trial designed to assess the efficacy, safety, and feasibility of amnioinfusions for patients with pregnancies complicated by early-pregnancy renal anhydramnios. The primary objective of this study is to determine the proportion of neonates surviving to successful dialysis, defined as use of a dialysis catheter for ≥14 days. METHODS A consortium of 9 North American Fetal Therapy Network (NAFTNet) centers was formed, and the RAFT protocol was refined in collaboration with the NAFTNet Scientific Committee. Enrollment in the trial began in April 2020. Participants may elect to receive amnioinfusions or to join the nonintervention observational expectant management group. Eligible pregnant women must be at least 18 years of age with a fetal diagnosis of isolated early-pregnancy renal anhydramnios. FINDINGS In addition to the primary study objective stated above, secondary objectives include (1) to assess maternal safety and feasibility of the serial amnioinfusion intervention (2) to perform an exploratory study of the natural history of untreated early pregnancy renal anhydramnios (3) to examine correlations between prenatal imaging and lung specific factors in amniotic fluid as predictive of the efficacy of serial percutaneous amnioinfusions and (4) to determine short- and long-term outcomes and quality of life in surviving neonates and families enrolled in RAFT IMPLICATIONS: The RAFT trial is the first clinical trial to investigate the efficacy, safety, and feasibility of amnioinfusions to treat the survival-limiting pulmonary hypoplasia associated with anhydramnios. Although the intervention offers an opportunity to treat a condition known to be almost universally fatal in affected neonates, the potential burdens associated with end-stage kidney disease from birth must be acknowledged. CLINICALTRIALS gov identifier: NCT03101891.
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Affiliation(s)
- Meredith A. Atkinson
- Department of Pediatrics, Division of Nephrology, Johns Hopkins University, Baltimore, MD
| | - Eric B. Jelin
- Department of Surgery, Division of Pediatric Surgery, Johns Hopkins University, Baltimore, MD
| | - Ahmet Baschat
- Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD
| | - Yair Blumenfeld
- Department of Obstetrics and Gynecology, Stanford University, Palo Alto, CA
| | - Ramen Chmait
- Department of Fetal Surgery, Children’s Hospital Los Angeles-USC Fetal-Maternal Center, Los Angeles, CA
| | - Elizabeth O’Hare
- Department of Surgery, Division of Pediatric Surgery, Johns Hopkins University, Baltimore, MD
| | - Julie Moldenhauer
- Center for Fetal Diagnosis and Treatment, Children’s Hospital of Philadelphia, Philadelphia, PA
| | | | - Russell Miller
- Department of Obstetrics and Gynecology, Columbia University, New York, NY
| | - Rodrigo Ruano
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Miami Medical School, Miami, FL
| | - Juan Gonzalez
- Department of Obstetrics and Gynecology, University of California San Francisco, San Francisco, CA
| | - Anthony Johnson
- Department of Obstetrics and Gynecology, University of Texas Health Center, Houston, TX
| | - Andrew Mould
- Department of Neurology, Division of Brain Injury Outcomes, Johns Hopkins University, Baltimore, MD
| | - Jonathan Davis
- Department of Pediatrics, Tufts Children’s Hospital, Boston, MA
| | - Daniel Hanley
- Department of Neurology, Division of Brain Injury Outcomes, Johns Hopkins University, Baltimore, MD
| | - Amaris Keiser
- Department of Pediatrics, Division of Neonatology, Johns Hopkins University, Baltimore, MD
| | - Mara Rosner
- Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD
| | - Jena L. Miller
- Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD
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