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Hartup SM, Morgan JL, Cheng VWT, Barry PA, Copson E, Cutress RI, Dave R, Elsberger B, Fairbrother P, Hogan B, Horgan K, Kirwan CC, McIntosh SA, O’Connell RL, Patani N, Potter S, Rattay T, Sheehan L, Wyld L, Kim B. The MARECA (national study of management of breast cancer locoregional recurrence and oncological outcomes) study: protocol for a prospective, multicentre cohort study. Int J Surg Protoc 2024; 28:20-26. [PMID: 38433867 PMCID: PMC10905491 DOI: 10.1097/sp9.0000000000000018] [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: 10/19/2023] [Accepted: 12/11/2023] [Indexed: 03/05/2024] Open
Abstract
Background Despite a UK 5-year breast cancer survival rate of 86.6%, patients may develop breast cancer recurrence within the same breast after breast conserving surgery, as well as in the remaining skin or chest wall after mastectomy or in the ipsilateral lymph glands. These recurrences, collectively termed locoregional recurrence (LRR), occur in around 8% of patients within 10 years of their original diagnosis. Currently, there is a lack of robust information on the presentation and prevalence of LRR with no UK-specific clinical guidelines available for the optimal management of this patient group. Additionally, there is a need to identify patterns of LRR presentation and their progression, which will enable prognostic factors to be determined. This will subsequently enable the tailoring of treatment and improve patient outcome. Methods The MARECA study is a prospective, multicentre cohort study recruiting patients diagnosed with breast cancer LRR +/- associated distant metastases. Over 50 UK breast units are participating in the study with the aim of recruiting at least 500 patients over a recruitment period of 24 months. The data collected will detail the tumour pathology, imaging results, surgical treatment, radiotherapy and systemic therapy of the primary and recurrent breast cancer. Study follow-up will be for up to 5 years following LRR diagnosis to determine subsequent oncological outcomes and evaluate potential prognostic factors. Discussion This study will address the current knowledge gap and identify subgroups of patients who have less successful treatment outcomes. The results will determine the current management of LRR and the prognosis of patients diagnosed with breast cancer LRR +/- distant metastases in the UK, with the aim of establishing best practice and informing future national guidelines. The results will direct future research and inform the design of additional interventional trials and translational studies.
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Affiliation(s)
- Sue M. Hartup
- The Breast Unit at the Leeds Cancer Centre, St James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds
| | - Jenna L. Morgan
- Division of Clinical Medicine, University of Sheffield School of Medicine and Population Health, Beech Hill Road, Sheffield
| | - Vinton WT Cheng
- The Breast Unit at the Leeds Cancer Centre, St James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds
| | - Peter A. Barry
- Department of Breast Surgery, The Royal Marsden NHS Foundation Trust, Sutton, Surrey
- The Institute of Cancer Research
| | - Ellen Copson
- Somers Cancer Research Building, University of Southampton and University Hospital Southampton, Southampton
| | - Ramsey I. Cutress
- Somers Cancer Research Building, University of Southampton and University Hospital Southampton, Southampton
| | - Rajiv Dave
- The Nightingale Breast Cancer Centre, Wythenshawe Hospital
| | - Beatrix Elsberger
- Aberdeen Breast Unit, Aberdeen Royal Infirmary, Foresterhill, Aberdeen
| | | | - Brian Hogan
- The Breast Unit at the Leeds Cancer Centre, St James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds
| | - Kieran Horgan
- The Breast Unit at the Leeds Cancer Centre, St James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds
| | - Cliona C. Kirwan
- The Nightingale Breast Cancer Centre, Wythenshawe Hospital
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oglesby Cancer Research Building, Manchester Cancer Research Centre, Manchester
| | - Stuart A. McIntosh
- Patrick G Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast
| | - Rachel L. O’Connell
- Department of Breast Surgery, The Royal Marsden NHS Foundation Trust, Sutton, Surrey
- The Institute of Cancer Research
| | - Neill Patani
- Department of Breast Surgery, University College London Hospitals NHS Foundation Trust
| | - Shelley Potter
- Translational Health Sciences, Bristol Medical School, Learning and Research Building, Southmead Hospital
- Bristol Breast Care Centre, North Bristol NHS Trust, Bristol
| | - Tim Rattay
- Leicester Cancer Research Centre, Clinical Sciences Building, University of Leicester, Leicester Royal Infirmary
- Department of Breast Surgery, University Hospitals of Leicester NHS Trust, Leicester
| | - Lisa Sheehan
- Wessex Deanery, Southern House, Otterbourne, Winchester, UK
| | - Lynda Wyld
- Division of Clinical Medicine, University of Sheffield School of Medicine and Population Health, Beech Hill Road, Sheffield
| | - Baek Kim
- The Breast Unit at the Leeds Cancer Centre, St James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds
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Tavabie OD, Abbott J, Abeysekera KWM, Balachandrakumar VK, Bennett K, Brennan P, Buchanan R, Dhaliwal A, Galanakis V, Hardy T, Harris R, Kronsten VT, Leighton J, Li W, Yin JL, Macken L, Marjot T, Maurice JB, McDowell H, Navaratnam J, Pohl K, Nayagam JS, Saunsbury E, Scott J, Sheth A, Sinharay R, Sheiybani G, Subhani M, Tavabie OD, Turner L, White H, Zakeri N, Balachandrakumar VK, Cook C, Hardy T, Harris R, Navaratnam J, Saunsbury E, Tavabie OD, Abbas N, Abbasi A, Abdul R, Abdulaziz M, Abduljabbar D, Abeysekera KWM, Adamson R, Adebayo D, Adhikarla AK, Adler M, Ahmad S, Ahmed S, Afifi M, Akram A, Al Radhi B, Al-Talib I, Alele J, Ali AM, Almusai S, Appleby V, Asmat H, Astbury S, Atkinson A, Badrulhisham F, Balachandrakumar VK, Ball A, Banfa M, Barn J, Begum S, Belfield K, Bendall O, Bhandari R, Bhatti P, Bradley M, Brennan P, Brown E, Bryce K, Burke L, Campbell R, Cargill T, Carroll G, Cartledge J, Chatterjee D, Chaundry R, Choudhry Z, Clare K, Cobbold J, Coburn R, Corvan F, Cox R, Craig D, Creamer J, Curran C, De Silva S, Dean L, Dillon J, Dunn R, Eckersley R, Eike G, Elagib A, Elkholi A, Elshaarawy O, Faloon S, Fan F, Fazili M, Fernandes D, Fox J, Foxton M, Gaba W, Gaikwad G, Gairola A, Galanakis V, Gallaher C, Gautam N, Germain L, Giles B, Gill C, Glover B, Glover J, Gomez D, Gomez M, Gordon V, Gormley S, Goulder J, Goyal S, Greenham O, Guthrie S, Hackett R, Haddadin Y, Hadjinicolaou A, Hall J, Haque T, Hardy T, Harris R, Hart C, Hasnain Nadir SM, Hassall J, Hasan S, Hawker-Bond G, Hawkyard J, Healey S, Hornby C, Hamza M, Humayun M, Hutchison J, Iftikhar Z, Ismail A, James J, Jopson L, Juthani D, Kaina P, Karim A, Karim SM, Kashyap V, Kassab M, Katarey D, Kenny L, Kerry G, Khan A, Khan A, Khan A, Khan MT, Khan T, Khatib A, Khattak MF, King JJ, Korani M, Kotha S, Kooner E, Lam WL, Lateef M, Leith D, Li W, Liaros A, Lourenco F, Lyles A, Mahenthiran M, Magee C, Maggs D, Mahalingam A, Mahmood R, Mandour MO, Manocha N, Mansour D, Marks D, Marjot T, Martin C, Martin H, Martin I, Martin K, Maruthan S, Masin R, Mason D, Matthews C, Mavrou A, Maxan E, Maxfield D, McAvoy E, McColl K, McCaughan H, McCorry R, McGoran J, McDonald S, McDowell H, McIlwane S, Meakin O, Mebarek L, Merrill H, Michail S, Modarres P, Mohamedali A, Mohammed Y, Mohammed Z, Mohan J, Monnier C, Moran E, Morrison G, Moroni F, Msaddi A, Mutar S, Navaratnam J, Neto-Pereira L, Nahed I, Ng J, Nwoguh C, O’Kane R, Omar S, Ososanya A, Parambil JV, Patel J, Pericleous M, Pervais Z, Phoolchund A, Pietrzycki J, Pillay L, Prabhu K, Putri YRF, Qazi U, Rafique KK, Raman K, Ranade V, Rastelli F, Ratcliffe E, Rattehalli D, Raza T, Razak A, Raghuraman A, Read G, Robins A, Rushbrook S, Salama M, St. Aimee L, Saravan R, Sarkar S, Saunsbury E, Serna S, Shahzad H, Shamsaldeen M, Sharip M, Shearer J, Sheikh A, Sheiybani G, Sheth A, Sherwin M, Shintre N, Singhal S, Sinha R, Sinharay R, Smith G, Smith R, Spicer J, Spoor J, Sreenivasan S, Srinivasa A, Srivastava A, Stagg G, Stanley J, Stevenson J, Stokes D, Stroud R, Subhani M, Suliman H, Sultana M, Summers N, Sutherland C, Swann R, Sykes L, Taha M, Tan KE, Tariq Z, Ming Tay JJ, Taylor A, Thakor A, Tsang J, Tyler Z, Unitt E, Volcek E, Wischhusen J, Watson I, Watters C, Wells G, Widlak M, Williams M, Woodland H, Wren L, Xyda S, Yeh J, Young A, Jie Yuan JS, Abbott J, Abeysekera KWM, Galanakis V, Li W, Sheth A, Sinharay R, Sheiybani G, Tavabie OD, Abbott J, Abeysekera KWM, Galanakis V, Li W, Sheth A, Sinharay R, Sheiybani G, Tavabie OD, Abeysekera KWM, Brennan P, Li W, Marjot T, Tavabie OD, Aithal G, Bernal W, Dillon J, Hogan B, McPherson S, Jones R, Rowe I, Snowdon V. Defining characteristics and outcomes for patients with non-alcoholic fatty liver disease admitted to hospital with decompensated cirrhosis. J Hepatol 2023; 79:e165-e167. [PMID: 37315808 DOI: 10.1016/j.jhep.2023.05.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 06/16/2023]
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Tavabie OD, Abeysekera KWM, Brennan PN, Marjot T, Kronsten VT, Li W, Nayagam JS, Dhaliwal A, Hardy T, Maurice JB, Zakeri N, Abbas N, Abbasi A, Abbott J, Abdul R, Abdulaziz M, Abduljabbar D, Adamson R, Adebayo D, Adhikarla AK, Adler M, Afifi M, Ahmad S, Ahmed S, Aithal G, Akram A, Al Radhi B, Al-Talib I, Alele J, Ali AM, Almusai S, Appleby V, Asmat H, Astbury S, Atkinson A, Badrulhisham F, Balachandrakumar VK, Ball A, Banfa M, Barn J, Begum S, Belfield K, Bendall O, Bennett K, Bernal W, Bhandari R, Bhatti P, Bradley M, Brown E, Bryce K, Buchanan R, Burke L, Campbell R, Cargill T, Carroll G, Cartledge J, Chatterjee D, Chaundry R, Choudhry Z, Clare K, Cobbold J, Coburn R, Cook C, Corvan F, Cox R, Craig D, Creamer J, Curran C, De Silva S, Dean L, Dillon J, Dillon J, Dunn R, Eckersley R, Eike G, Elagib A, Elkholi A, Elshaarawy O, Faloon S, Fan F, Fazili M, Fernandes D, Fox J, Foxton M, Gaba W, Gaikwad G, Gairola A, Galanakis V, Gallaher C, Gautam N, Germain L, Giles B, Gill C, Glover B, Glover J, Gomez D, Gomez M, Gordon V, Gormley S, Goulder J, Goyal S, Greenham O, Guthrie S, Hackett R, Haddadin Y, Hadjinicolaou A, Hall J, Hamza M, Haque T, Harris R, Hart C, Hasan S, Hasnain Nadir SM, Hassall J, Hawker-Bond G, Hawkyard J, Healey S, Hogan B, Hornby C, Humayun MD, Hutchison J, Iftikhar Z, Ismail A, James J, Jones R, Jopson L, Juthani D, Kaina P, Karim A, Karim SM, Kashyap V, Kassab M, Katarey D, Kenny L, Kerry G, Khan A, Khan A, Khan A, Khan MT, Khan T, Khatib A, Khattak MF, King JJ, Kooner E, Korani M, Kotha S, Lam WL, Lateef M, Leighton J, Leith D, Liaros A, Liu Yin J, Lourenco F, Lyles A, Macken L, Magee C, Maggs D, Mahalingam A, Mahenthiran M, Mahmood R, Mandour MO, Manocha N, Mansour D, Marks D, Martin C, Martin H, Martin I, Martin K, Maruthan S, Masin R, Mason D, Matthews C, Mavrou A, Maxan E, Maxfield D, McAvoy E, McCaughan H, McColl K, McCorry R, McDonald S, McDowell H, McGoran J, McIlwane S, McPherson S, Meakin O, Mebarek L, Merrill H, Michail S, Modarres P, Mohamedali A, Mohammed Y, Mohammed Z, Mohan J, Monnier C, Moran E, Moroni F, Morrison G, Msaddi A, Mutar S, Nahed I, Navaratnam J, Neto-Pereira L, Ng J, Nwoguh C, O'Kane R, Omar S, Ososanya A, Parambil JV, Patel J, Pericleous M, Pervais Z, Phoolchund A, Pietrzycki J, Pillay L, Pohl K, Prabhu K, Putri YRF, Qazi U, Rafique KK, Raghuraman A, Raman K, Ranade V, Rastelli F, Ratcliffe E, Rattehalli D, Raza T, Razak A, Read G, Robins A, Rowe I, Rushbrook S, Salama M, Saravan R, Sarkar S, Saunsbury E, Scott J, Serna S, Shahzad H, Shamsaldeen M, Sharip M, Shearer J, Sheikh A, Sheiybani G, Sherwin M, Sheth A, Shintre N, Singhal S, Sinha R, Sinharay R, Smith G, Smith R, Snowdon V, Spicer J, Spoor J, Sreenivasan S, Srinivasa A, Srivastava A, St. Aimee L, Stagg G, Stanley J, Stevenson J, Stokes D, Stroud R, Subhani M, Suliman H, Sultana M, Summers N, Sutherland C, Swann R, Sykes L, Taha M, Tan KE, Tariq Z, Tay JJM, Taylor A, Thakor A, Tsang J, Turner L, Tyler Z, Unitt E, Volcek E, Watson I, Watters C, Wells G, White H, Widlak M, Williams M, Wischhusen J, Woodland H, Wren L, Xyda S, Yeh J, Young A, Yuan JSJ. Regional variation in characteristics of patients with decompensated cirrhosis admitted to hospitals in the UK. Lancet Gastroenterol Hepatol 2023; 8:604-606. [PMID: 37148900 DOI: 10.1016/s2468-1253(23)00114-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 05/08/2023]
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Pollok JM, Tinguely P, Berenguer M, Niemann CU, Raptis DA, Spiro M, Dominguez B, Muller E, Rando K, Enoch MA, Tamir N, Healy P, Manser T, Briggs T, Chaudhary A, Humar A, Jafarian A, Soin AS, Eghtesad B, Miller C, Cherqui D, Samuel D, Broering D, Pomfret E, Villamil F, Durand F, Berlakovich G, McCaughan G, Auzinger G, Testa G, Klintmalm G, Belghiti J, Findlay J, Lai J, Fung J, Klinck J, Roberts J, Liu L, Cattral M, Ghobrial M, Selzner M, Ramsay M, Rela M, Ascher N, Man NK, Selzner N, Burra P, Friend P, Busuttil R, Hwang S, McCluskey S, Mas V, Vohra V, Vij V, Merritt W, Tokat Y, Kang Y, Chan A, Mazzola A, Hessheimer A, Rammohan A, Hogan B, Vinaixa C, Nasralla D, Victor D, De Martin E, Alconchel F, Roll G, Kabacam G, Sapisochin G, Campos-Varela I, Liu J, Patel MS, Izzy M, Kalisvaart M, Adams M, Goldaracena N, Tinguely P, Hernandez-Alejandro R, Chadha R, Shaker TM, Klair TS, Pan T, Tanaka T, Yoon U, Kirchner V, Hannon V, Cheah YL, Frola C, Morkane C, Milliken D, Lurje G, Potts J, Fernandez T, Badenoch A, Mukhtar A, Zanetto A, Montano-Loza A, Chieh AKW, Shetty A, DeWolf A, Olmos A, Mrzljak A, Blasi A, Berzigotti A, Malik A, Rajakumar A, Davidson B, O'Farrell B, Kotton C, Imber C, Kwon CHD, Wray C, Ahn CS, Morkane C, Krenn C, Quintini C, Maluf D, Mina DS, Sellers D, Balci D, Patel D, Rudow DL, Monbaliu D, Bezinover D, Krzanicki D, Milliken D, Kim DS, Brombosz E, Blumberg E, Weiss E, Wey E, Kaldas F, Saliba F, Pittau G, Wagener G, Song GW, Biancofiore G, Testa G, Crespo G, Rodríguez G, Palli GM, McKenna G, Petrowsky H, Egawa H, Montasser I, Pirenne J, Eason J, Guarrera J, Pomposelli J, Lerut J, Emond J, Boehly J, Towey J, Hillingsø JG, de Jonge J, Potts J, Caicedo J, Heimbach J, Emamaullee JA, Bartoszko J, Ma KW, Kronish K, Forkin KT, Chok KSH, Olthoff K, Reyntjens K, Lee KW, Suh KS, Denehy L, van der Laan LJ, McCormack L, Gorvin L, Ruffolo L, Bhat M, Ramírez MAM, Londoño MC, Gitman M, Levstik M, Selzner M, de Santibañes M, Lindsay M, Parotto M, Armstrong M, Kasahara M, Schofield N, Rizkalla N, Akamatsu N, Scatton O, Keskin O, Imventarza O, Andacoglu O, Muiesan P, Giorgio P, Northup P, Matins P, Abt P, Newsome PN, Dutkowski P, Bhangui P, Bhangui P, Tandon P, Brustia R, Planinsic R, Brown R, Porte R, Barth R, Ciria R, Florman S, Dharancy S, Pai SL, Yagi S, Nadalin S, Chinnakotla S, Forbes SJ, Rahman S, Hong SK, Liying S, Orloff S, Rubman S, Eguchi S, Ikegami T, Reichman T, Settmacher U, Aluvihare V, Xia V, Yoon YI, Soejima Y, Genyk Y, Jalal A, Borakati A, Gustar A, Mohamed A, Ramirez A, Rothnie A, Scott A, Sharma A, Munro A, Mahay A, Liew B, Hidalgo C, Crouch C, Yan CT, Tschuor C, Shaw C, Schizas D, Fritche D, Huda FF, Wells G, Farrer G, Kwok HT, Kostakis I, Mestre-Costa J, Fan KH, Fan KS, Fraser K, Jeilani L, Pang L, Lenti L, Kathirvel M, Zachiotis M, Vailas M, Milan MM, Elnagar M, Alradhawi M, Dimitrokallis N, Machairas N, Morare N, Yeung O, Khanal P, Satish P, Ghani SA, Makhdoom S, Arulrajan S, Bogan S, Pericleous S, Blakemore T, Otti V, Lam W, Jackson W, Abdi Z. Enhanced recovery for liver transplantation: recommendations from the 2022 International Liver Transplantation Society consensus conference. Lancet Gastroenterol Hepatol 2023; 8:81-94. [PMID: 36495912 DOI: 10.1016/s2468-1253(22)00268-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 12/12/2022]
Abstract
There is much controversy regarding enhanced recovery for recipients of liver transplants from deceased and living donors. The objectives of this Review were to summarise current knowledge on individual enhanced recovery elements on short-term outcomes, identify key components for comprehensive pathways, and create internationally accepted guidelines on enhanced recovery for liver-transplant recipients. The ERAS4OLT.org collaborative partnered by the International Liver Transplantation Society performed systematic literature reviews on the effect of 32 relevant enhanced perioperative recovery elements on short-term outcomes, and global specialists prepared expert statements on deceased and living donor liver transplantation. The Grading Recommendations, Assessment, Development and Evaluations approach was used for rating of quality of evidence and grading of recommendations. A virtual international consensus conference was held in January, 2022, in which results were presented, voted on by the audience, and discussed by an independent international jury of eight members, applying the Danish model of consensus. 273 liver transplantation specialists from 30 countries prepared expert statements on elements of enhanced recovery for liver transplantation based on the systematic literature reviews. The consensus conference yielded 80 final recommendations, covering aspects of enhanced recovery for preoperative assessment and optimisation, intraoperative surgical and anaesthetic conduct, and postoperative management for the recipients of liver transplants from both deceased and living donors, and for the living donor. The recommendations represent a comprehensive overview of the relevant elements and areas of enhanced recovery for liver transplantation. These internationally established guidelines could direct the development of enhanced recovery programmes worldwide, allowing adjustments according to local resources and practices.
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Affiliation(s)
- Joerg M Pollok
- Clinical Service of HPB Surgery and Liver Transplantation, Royal Free Hospital, NHS Foundation Trust, London, UK; Division of Surgery and Interventional Science, University College London, London, UK
| | - Pascale Tinguely
- Clinical Service of HPB Surgery and Liver Transplantation, Royal Free Hospital, NHS Foundation Trust, London, UK
| | - Marina Berenguer
- Liver Unit, CIBERehd, Instituto de Investigación Sanitaria La Fe, Hospital Universitario y Politécnico La Fe-Universidad de Valencia, Valencia, Spain
| | - Claus U Niemann
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA; Department of Surgery, Division of Transplantation, University of California San Francisco, San Francisco, CA, USA
| | - Dimitri A Raptis
- Clinical Service of HPB Surgery and Liver Transplantation, Royal Free Hospital, NHS Foundation Trust, London, UK; Division of Surgery and Interventional Science, University College London, London, UK
| | - Michael Spiro
- Department of Anaesthesia and Intensive Care Medicine, Royal Free Hospital, NHS Foundation Trust, London, UK; The Royal Free Perioperative Research Group, Royal Free Hospital, NHS Foundation Trust, London, UK; Division of Surgery and Interventional Science, University College London, London, UK.
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Reveendran D, Tait C, Hogan B. O052 A retrospective analysis of a single-centre experience with administration of neoadjuvant chemotherapy prior to surgical removal of breast tumour. Br J Surg 2022. [DOI: 10.1093/bjs/znac242.052] [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: 11/07/2022]
Abstract
Abstract
Introduction
Neoadjuvant chemotherapy (NACT) is increasingly used to aid breast preservation surgery for patients with non-conservable disease at presentation. NICE guidelines recommend offering primary systemic therapy to patients with ER- disease and/or HER2+ disease and for those with ER+ disease to reduce tumour size. This retrospective study aimed to analyse the incidence of local and systemic recurrence post NACT.
Methods
A retrospective analysis of NACT usage was conducted from January 2011 to December 2020 at the breast surgery unit. Clinical data of patients who received NACT were collected using the local Breast Unit database, Electronic Patient Record (EPR) and Systm1. Data included patient demographics, type of breast and axillary surgical procedure, histopathology of breast tumour, pathological response to NACT and time to local and/or systemic recurrence.
Results
202 patients received NACT for breast cancer between January 2011 to December 2020. Analysis showed an increasing use of NACT ranging from 2.19% of all cancers in 2013 to 14.5% in 2020. 89/202 patients underwent breast preservation surgery. 1 patient developed local recurrence at median follow up of 26 months. 42 patients developed systemic recurrence, and 40 of them had residual disease found at surgery post NACT at median follow up of 24 months.
Conclusion
Our unit has been increasingly using NACT over the last 8 years in line with guidance. Breast conserving surgery post NACT is associated with a low risk of local recurrence. The risk of systemic disease progression post NACT is very low for patients who have complete pathological response.
Take-home message
Breast conserving surgery post NACT is associated with a low risk of local recurrence. The risk of systemic disease progression post NACT is very low for patients who have complete pathological response.
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Affiliation(s)
| | - C Tait
- Bradford Teaching Hospitals NHS Trust
| | - B Hogan
- Leeds Teaching Hospitals NHS Trust
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Morgan JL, Cheng V, Barry PA, Copson E, Cutress RI, Dave R, Elsberger B, Fairbrother P, Hartup S, Hogan B, Horgan K, Kirwan CC, McIntosh SA, O'Connell RL, Patani N, Potter S, Rattay T, Sheehan L, Wyld L, Kim B. The MARECA (national study of management of breast cancer locoregional recurrence and oncological outcomes) study: National practice questionnaire of United Kingdom multi-disciplinary decision making. Eur J Surg Oncol 2022; 48:1510-1519. [PMID: 35410760 DOI: 10.1016/j.ejso.2022.03.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 02/07/2022] [Revised: 03/05/2022] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Evidence based guidelines for the optimal management of breast cancer locoregional recurrence (LRR) are limited, with potential for variation in clinical practice. This national practice questionnaire (NPQ) was designed to establish the current practice of UK breast multidisciplinary teams (MDTs) regarding LRR management. METHODS UK breast units were invited to take part in the MARECA study MDT NPQ. Scenario-based questions were used to elicit preference in pre-operative staging investigations, surgical management, and adjuvant therapy. RESULTS 822 MDT members across 42 breast units (out of 144; 29%) participated in the NPQ (February-August 2021). Most units (95%) routinely performed staging CT scan, but bone scan was selectively performed (31%). For patients previously treated with breast conserving surgery (BCS) and radiotherapy, few units (7%) always/usually offered repeat BCS. However, in the absence of radiotherapy, most units (90%) always/usually offered repeat BCS. For patients presenting with isolated local recurrence following previous BCS and SLNB (sentinel lymph node biopsy), most units (95%) advocated repeat SLNB. Where SLNs could not be identified, 86% proceeded to a four-node axillary sampling procedure. For ER positive, HER2 negative, node negative local recurrence, 10% of units always/usually offered chemotherapy. For ER positive, HER2 negative, node positive local recurrence, this recommendation increased to 64%. For triple negative breast cancer local recurrence, 90% of units always/usually offered chemotherapy. CONCLUSION This survey has highlighted where consistencies and variations exist in the multidisciplinary management of breast cancer LRR. However, further research is required to determine how these management patterns influence patient outcomes, which will further refine optimal treatment pathways.
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Affiliation(s)
- Jenna L Morgan
- Department of Oncology and Metabolism, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.
| | - Vinton Cheng
- The Breast Unit at the Leeds Cancer Centre, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, UK
| | - Peter A Barry
- Department of Breast Surgery, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - Ellen Copson
- Cancer Sciences Academic Unit, University of Southampton and University Hospital Southampton, Tremona Road, Southampton, SO16 6YD, UK
| | - Ramsey I Cutress
- Cancer Sciences Academic Unit, University of Southampton and University Hospital Southampton, Tremona Road, Southampton, SO16 6YD, UK
| | - Rajiv Dave
- The Nightingale Breast Cancer Centre, Wythenshawe Hospital, Manchester, M23 9LT, UK
| | - Beatrix Elsberger
- Aberdeen Breast Unit, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, AB25 2ZN, UK
| | | | - Sue Hartup
- The Breast Unit at the Leeds Cancer Centre, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, UK
| | - Brian Hogan
- The Breast Unit at the Leeds Cancer Centre, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, UK
| | - Kieran Horgan
- The Breast Unit at the Leeds Cancer Centre, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, UK
| | - Cliona C Kirwan
- The Nightingale Breast Cancer Centre, Wythenshawe Hospital, Manchester, M23 9LT, UK; Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oglesby Cancer Research Building, Manchester Cancer Research Centre, Wilmslow Road, Manchester, M20 4BX, UK
| | - Stuart A McIntosh
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK
| | - Rachel L O'Connell
- Department of Breast Surgery, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - Neill Patani
- Department of Breast Surgery, University College London Hospitals NHS Foundation Trust, London, NW1 2BU, UK
| | - Shelley Potter
- Translational Health Sciences, Bristol Medical School, Canynge Hall, Whatley Road, Bristol, BS8 2PS, UK
| | - Tim Rattay
- Leicester Cancer Research Centre, Clinical Sciences Building, University of Leicester, Leicester Royal Infirmary, Leicester, LE2 2LX, UK
| | - Lisa Sheehan
- Wessex Deanery, Southern House, Otterbourne, Winchester, SO21 2RU, UK
| | - Lynda Wyld
- Department of Oncology and Metabolism, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK
| | - Baek Kim
- The Breast Unit at the Leeds Cancer Centre, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, UK
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Jeyanesan D, Balachandrakumar VK, Hogan B. Guideline review: transjugular intrahepatic portosystemic stent-shunt in the management of portal hypertension-a BSG guideline. Frontline Gastroenterol 2022; 13:531-534. [PMID: 36250168 PMCID: PMC9555133 DOI: 10.1136/flgastro-2022-102151] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/03/2022] [Indexed: 02/04/2023] Open
Abstract
The decision-making around transjugular intrahepatic portosystemic shunt (TIPSS) placement in the management of patients with chronic liver disease and portal hypertension (PH) is a regular challenge for hepatologists. In the UK, access has improved, with more than 35 hospitals now offering this service. However, its role in acute variceal bleeding, refractory ascites and other complications of PH continues to be redefined and expanded. In particular, the role of pre-emptive TIPSS has become more established and requires re-evaluation of pathways to enable equitable access for patients. Here, we summarise the key recommendations from the recently published British Society of Gastroenterology guidelines and expand on the challenges posed.
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Affiliation(s)
- Dhaarica Jeyanesan
- Institute of Liver Studies, King's College Hospital Liver Unit, London, UK
| | | | - Brian Hogan
- Institute of Liver Studies, King's College Hospital Liver Unit, London, UK
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8
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Morgan J, Cheng V, Barry P, Copson E, Cutress R, Dave R, Elsberger B, Fairbrother P, Hartup S, Hogan B, Horgan K, Kirwan C, McIntosh S, O'Connell R, Patani N, Potter S, Rattay T, Sheehan L, Wyld L, Kim B. The MARECA (national study of management of breast cancer locoregional recurrence and oncological outcomes) study: National practice questionnaire of United Kingdom multi-disciplinary decision making. European Journal of Surgical Oncology 2022. [DOI: 10.1016/j.ejso.2022.03.218] [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: 11/27/2022]
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9
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Reveendran D, Tait C, Hogan B. A retrospective analysis of a single-centre experience with administration of neoadjuvant chemotherapy prior to surgical removal of breast tumour. European Journal of Surgical Oncology 2022. [DOI: 10.1016/j.ejso.2022.03.157] [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: 11/27/2022]
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10
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Sunthareswaran J, Hogan B, Sharma N. Artificial intelligence improves efficiency in the one stop symptomatic breast clinic. European Journal of Surgical Oncology 2022. [DOI: 10.1016/j.ejso.2022.03.118] [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: 12/01/2022]
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11
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Rampal R, Hirst N, Jones S, Young C, Hartup S, Mckenzie S, Achuthan R, Hogan B, Macinnes E, Savage J, Turton P, Kim B. 3 months analysis of the PROM-Q study: Comparison of patient reported outcome measures using the BREAST-Q questionnaire in pre- versus sub-pectoral implant based immediate breast reconstruction. European Journal of Surgical Oncology 2022. [DOI: 10.1016/j.ejso.2022.03.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Cococcia S, Dutta P, Moghim M, Hogan B, Tanwar S, Marshall A, Macdonald D, Yu D, O'Beirne J, Rosenberg WM, Trembling PM. The fate of indeterminate liver lesions: What proportion are precursors of hepatocellular carcinoma? BMC Gastroenterol 2022; 22:118. [PMID: 35272611 PMCID: PMC8908619 DOI: 10.1186/s12876-022-02135-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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background The natural history and incidence of hepatocellular carcinoma (HCC) arising from indeterminate liver lesions are not well described. We aimed to define the incidence of HCC in a cohort of patients undergoing surveillance by magnetic resonance imaging (MRI) and estimate any associations with incident HCC. Methods We performed a retrospective follow-up study, identifying MRI scans in which indeterminate lesions had been reported between January 2006 and January 2017. Subsequent MRI scan reports were reviewed for incident HCC arising from indeterminate lesions, data were extracted from electronic patient records and survival analysis performed to estimate associations with baseline factors. Results One hundred and nine patients with indeterminate lesions on MRI were identified. HCC developed in 19 (17%) patients over mean follow up of 4.6 years. Univariate Cox proportional hazards analysis found incident HCC to be significantly associated with baseline low platelet count (hazard ratio (HR) = 7.3 (95% confidence intervals (CI) 2.1–24.9), high serum alpha-fetoprotein level (HR = 2.7 (95% CI 1.0–7.1)) and alcohol consumption above fourteen units weekly (HR = 3.1 (95% CI 1.1–8.7)). Multivariate analysis, however, found that only low platelet count was independently associated with HCC (HR = 5.5 (95% CI 0.6–5.1)). Conclusions HCC arises in approximately one fifth of indeterminate liver lesions over 4.6 years and is associated with a low platelet count at the time of first diagnosis of an indeterminate lesion. Incidence of HCC was more common in people with viral hepatitis and in those consuming > 14 units of alcohol per week. Our data may be used to support a strategy of enhanced surveillance in patients with indeterminate lesions. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-022-02135-x.
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Affiliation(s)
- Sara Cococcia
- Sheila Sherlock Liver Centre, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK.,Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK.,First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Priti Dutta
- Department of Radiology, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK
| | - Melika Moghim
- Sheila Sherlock Liver Centre, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK
| | - Brian Hogan
- Sheila Sherlock Liver Centre, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK.,Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK
| | - Sudeep Tanwar
- Sheila Sherlock Liver Centre, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK.,Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK
| | - Aileen Marshall
- Sheila Sherlock Liver Centre, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK.,Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK
| | - Douglas Macdonald
- Sheila Sherlock Liver Centre, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK.,Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK
| | - Dominic Yu
- Department of Radiology, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK
| | - James O'Beirne
- Sheila Sherlock Liver Centre, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK.,Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK.,Department of Hepatology, Sunshine Coast University Hospital, Birtinya, QLD, Australia
| | - William M Rosenberg
- Sheila Sherlock Liver Centre, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK.,Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK
| | - Paul M Trembling
- Sheila Sherlock Liver Centre, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK. .,Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK.
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13
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Gilbert-Kawai N, Hogan B, Milan Z. Perioperative management of patients with liver disease. BJA Educ 2022; 22:111-117. [PMID: 35211328 PMCID: PMC8847800 DOI: 10.1016/j.bjae.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2021] [Indexed: 11/16/2022] Open
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14
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Ottewill C, Mulpeter R, Lee J, Shrestha G, O’Sullivan D, Subramaniam A, Hogan B, Varghese C. Therapeutic anti-coagulation in COVID-19 and the potential enhanced risk of retroperitoneal hematoma. QJM 2021; 114:508-510. [PMID: 33742677 PMCID: PMC8083784 DOI: 10.1093/qjmed/hcab059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 02/17/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Ottewill
- Department of Respiratory Medicine, Tallaght University Hospital, Tallaght, Dublin 24, Ireland
- Address correspondence to Dr C. Ottewill, Department of Respiratory Medicine, Tallaght University Hospital, Tallaght, Dublin 24, Ireland.
| | - R Mulpeter
- Department of Respiratory Medicine, Tallaght University Hospital, Tallaght, Dublin 24, Ireland
| | - J Lee
- Department of Radiology, Tallaght University Hospital, Tallaght, Dublin 24, Ireland
| | - G Shrestha
- Department of Respiratory Medicine, Tallaght University Hospital, Tallaght, Dublin 24, Ireland
| | - D O’Sullivan
- Department of Respiratory Medicine, Tallaght University Hospital, Tallaght, Dublin 24, Ireland
| | - A Subramaniam
- Department of Respiratory Medicine, Tallaght University Hospital, Tallaght, Dublin 24, Ireland
| | - B Hogan
- Department of Radiology, Tallaght University Hospital, Tallaght, Dublin 24, Ireland
| | - C Varghese
- Department of Respiratory Medicine, Tallaght University Hospital, Tallaght, Dublin 24, Ireland
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15
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Ow TW, Fatourou E, Rabinowich L, van den Boom BP, Nair S, Patel VC, Hogan B, McPhail M, Roberts LN, Bernal W. Prevalence of bleeding and thrombosis in critically ill patients with chronic liver disease. Thromb Haemost 2021; 122:1006-1016. [PMID: 34638152 DOI: 10.1055/a-1667-7293] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Haemorrhage and venous thromboembolism (VTE) are recognised complications of chronic liver disease (CLD), but their prevalence and risk factors in critically ill patients is uncertain. PATIENTS AND METHODS We studied a retrospective cohort of patients with CLD non-electively admitted to a specialist intensive care unit determining the prevalence and timing of major bleeding and VTE (early, present on admission/diagnosed within 48h; later diagnosed >48h post ICU admission). Associations with baseline clinical and laboratory characteristics, multi-organ failure (MOF), blood product administration and mortality were explored. Odds ratios (OR) and 95% CIs were calculated using logistic regression. RESULTS Of 623 patients with median age 52, bleeding (>48 hours after admission) occurred in 87 (14%) patients. Bleeding was associated with greater illness severity and increased mortality. Gastrointestinal bleeding accounted for 72% of events, secondary to portal hypertension in >90%. Procedure-related bleeding was uncommon. VTE occurred in 125 (20%) patients: Early VTE in 80 (13%) and involving the portal vein (PVT) in 85%. Later VTE affected 45 (7.2%) patients. Hepatocellular Carcinoma (HCC) and non-alcoholic liver disease were independently associated with early VTE (OR 2.79, (95% CI 1.5 -5.2) and 2.32, (1.4 -3.9) respectively), and HCC, sepsis and cryoprecipitate use with late VTE (OR 2.45, (1.11-5.43), 2.26 (1.2-4.3) and 2.60 (1.3-5.1). CONCLUSION VTE was prevalent on admission to critical care and less commonly developed later. Bleeding was associated with MOF and increased mortality. Severe MOF was not associated with an increased rate of VTE which was linked with HCC, and specific etiologies of CLD.
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Affiliation(s)
- Tsai-Wing Ow
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Evangelia Fatourou
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Liane Rabinowich
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Bente Pernille van den Boom
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland.,2. Surgical Research Laboratory and Section of Hepatobiliary Surgery and Liver Transplantation, University Medical Centre Groningen, Groningen, Netherlands
| | - Shirjit Nair
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Vishal C Patel
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland.,School of Immunology and Microbial Sciences, King's College London Faculty of Life Sciences and Medicine, London, United Kingdom of Great Britain and Northern Ireland.,Institute of Hepatology, Foundation for Liver Research, London, United Kingdom of Great Britain and Northern Ireland
| | - Brian Hogan
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Mark McPhail
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland.,School of Immunology and Microbial Sciences, King's College London Faculty of Life Sciences and Medicine, London, United Kingdom of Great Britain and Northern Ireland
| | - Lara N Roberts
- King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - William Bernal
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland.,School of Immunology and Microbial Sciences, King's College London Faculty of Life Sciences and Medicine, London, United Kingdom of Great Britain and Northern Ireland
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16
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Birkett M, Melville J, Janulis P, Phillips G, Contractor N, Hogan B. Network Canvas: Key decisions in the design of an interviewer assisted network data collection software suite. Soc Networks 2021; 66:114-124. [PMID: 34054204 PMCID: PMC8153363 DOI: 10.1016/j.socnet.2021.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Self-reported social network analysis studies are often complex and burdensome, both during the interview process itself, and when conducting data management following the interview. Through funding obtained from the National Institute on Drug Abuse (NIDA/NIH), our team developed the Network Canvas suite of software - a set of complementary tools that are designed to simplify the collection and storage of complex social network data, with an emphasis on usability and accessibility across platforms and devices, and guided by the practical needs of researchers. The suite consists of three applications: Architect: an application for researchers to design and export interview protocols; Interviewer: a touch-optimized application for loading and administering interview protocols to study participants; and Server: an application for researchers to manage the interview deployment process and export their data for analysis. Together, they enable researchers with minimal technological expertise to access a complete research workflow, by building their own network interview protocols, deploying these protocols widely within a variety of contexts, and immediately attaining the resulting data from a secure central location. In this paper, we outline the critical decisions taken in developing this suite of tools for the network research community. We also describe the work which guides our decision-making, including prior experiences and key discovery events. We focus on key design choices, taken for theoretical, philosophical, and pragmatic reasons, and outline their strengths and limitations.
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Affiliation(s)
- M Birkett
- Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, Chicago, IL
| | - J Melville
- Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, Chicago, IL
| | - P Janulis
- Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, Chicago, IL
| | - G Phillips
- Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, Chicago, IL
| | - N Contractor
- Northwestern University Kellogg School of Management, Department of Management and Organizations, Evanston, IL
| | - B Hogan
- University of Oxford, Oxford Internet Institute, Oxford, UK
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17
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Connoley D, Patel PJ, Hogan B, Tanwar S, Rhodes F, Parkes J, Burt A, Watkins J, Sievert W, Rosenberg W. The Enhanced Liver Fibrosis test maintains its diagnostic and prognostic performance in alcohol-related liver disease: a cohort study. BMC Gastroenterol 2021; 21:268. [PMID: 34182924 PMCID: PMC8240375 DOI: 10.1186/s12876-021-01795-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/20/2021] [Indexed: 01/06/2023] Open
Abstract
Background Alcohol is the main cause of chronic liver disease. The Enhanced Liver Fibrosis (ELF) test is a serological biomarker for fibrosis staging in chronic liver disease, however its utility in alcohol-related liver disease warrants further validation. We assessed the diagnostic and prognostic performance of ELF in alcohol-related liver disease.
Methods Observational cohort study assessing paired ELF and histology from 786 tertiary care patients with chronic liver disease due to alcohol (n = 81) and non-alcohol aetiologies (n = 705). Prognostic data were available for 64 alcohol patients for a median of 6.4 years. Multiple ELF cut-offs were assessed to determine diagnostic utility in moderate fibrosis and cirrhosis. Survival data were assessed to determine the ability of ELF to predict liver related events and all-cause mortality. Results ELF identified cirrhosis and moderate fibrosis in alcohol-related liver disease independently of aminotransferase levels with areas under receiver operating characteristic curves of 0.895 (95% CI 0.823–0.968) and 0.923 (95% CI 0.866–0.981) respectively, which were non-inferior to non-alcohol aetiologies. The overall performance of ELF was assessed using the Obuchowski method: in alcohol = 0.934 (95% CI 0.908–0.960); non-alcohol = 0.907 (95% CI 0.895–0.919). Using ELF < 9.8 to exclude and ≧ 10.5 to diagnose cirrhosis, 87.7% of alcohol cases could have avoided biopsy, with sensitivity of 91% and specificity of 85%. A one-unit increase in ELF was associated with a 2.6 (95% CI 1.55–4.31, p < 0.001) fold greater odds of cirrhosis at baseline and 2.0-fold greater risk of a liver related event within 6 years (95% CI 1.39–2.99, p < 0.001). Conclusions ELF accurately stages liver fibrosis independently of transaminase elevations as a marker of inflammation and has superior prognostic performance to biopsy in alcohol-related liver disease. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-021-01795-5.
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Affiliation(s)
- Declan Connoley
- Monash University, Melbourne, Australia.,Monash Health, Melbourne, Australia.,Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Campus, Rowland Hill Street, Hampstead, London, NW3 2PF, UK.,The Royal Free London NHS Foundation Trust, London, UK
| | - Preya Janubhai Patel
- Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Campus, Rowland Hill Street, Hampstead, London, NW3 2PF, UK.,The Royal Free London NHS Foundation Trust, London, UK
| | - Brian Hogan
- Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Campus, Rowland Hill Street, Hampstead, London, NW3 2PF, UK
| | - Sudeep Tanwar
- Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Campus, Rowland Hill Street, Hampstead, London, NW3 2PF, UK
| | - Freya Rhodes
- Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Campus, Rowland Hill Street, Hampstead, London, NW3 2PF, UK.,The Royal Free London NHS Foundation Trust, London, UK
| | - Julie Parkes
- Primary Care, Public Health and Medical Statistics, University of Southampton, Southampton, UK
| | - Alastair Burt
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Jennifer Watkins
- Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Campus, Rowland Hill Street, Hampstead, London, NW3 2PF, UK
| | - William Sievert
- Monash University, Melbourne, Australia.,Monash Health, Melbourne, Australia
| | - William Rosenberg
- Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Campus, Rowland Hill Street, Hampstead, London, NW3 2PF, UK. .,The Royal Free London NHS Foundation Trust, London, UK.
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18
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Borg E, Turton P, Hogan B. P163. Assessment of service provision in patients investigated for breast-implant associated seromas at leeds teaching hospitals - Should more be done for seromas which are not suspicious for BIA-ALCL? Eur J Surg Oncol 2021. [DOI: 10.1016/j.ejso.2021.03.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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19
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Jones S, Hogan B, Patel K, Ooi S, Turton P, Achuthan R, Kim B. Identification of factors that influence the decision to take chemoprevention in patients with a significant family history of breast cancer: results from a patient questionnaire survey. Breast Cancer Res Treat 2021; 187:207-213. [PMID: 33389407 DOI: 10.1007/s10549-020-06046-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/02/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Chemoprevention reduces the risk of developing breast cancer in women with increased family history (FH) risk of breast cancer. However, chemoprevention uptake remains low and the reasons for this remain unclear. METHODS Patients with moderate- or high-risk FH of breast cancer were counselled about chemoprevention (n = 1620; September 2015 to July 2018) in breast clinics. A postal questionnaire survey was subsequently sent to these patients in order to explore the potential factors influencing their decision on chemoprevention uptake. RESULTS 518 patients (32%) completed the questionnaire survey; 75% were pre-menopausal and the majority had moderate as opposed to high-risk FH (87.5% vs. 12.5%). Breast cancer chemoprevention uptake rate was 10.8% (56/518). The identified incentives were more commonly stated for patients who took chemoprevention when compared to those who refused chemoprevention. The commonest incentives were breast cancer prevention (89.3% vs. 61.7%; p = 0.001), belief in the effectiveness of chemoprevention (76.8% vs. 63.4%; p = 0.048), and personal perception of breast cancer risk (67.9% vs. 45.5%; p = 0.002). Similarly, the identified barriers were more commonly stated for patients who refused chemoprevention when compared to those who took chemoprevention. The commonest barriers were side effects (79.4% vs. 55.4%; p = 0.001) and lack of information (53% vs. 28.6%; p = 0.001). CONCLUSION Despite its proven efficacy, chemoprevention uptake in patients with a significant FH of breast cancer remains low. We have identified important factors which influence the patient's decision making. Future clinic consultations should focus on exploring these factors to aid patient decision making.
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Affiliation(s)
- Stacey Jones
- Department of Oncoplastic Breast and Reconstructive Surgery, St. James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK.
| | - Brian Hogan
- Department of Oncoplastic Breast and Reconstructive Surgery, St. James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK
| | - Kirtida Patel
- Department of Oncoplastic Breast and Reconstructive Surgery, St. James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK
| | - Shiwei Ooi
- Department of Oncoplastic Breast and Reconstructive Surgery, St. James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK
| | - Philip Turton
- Department of Oncoplastic Breast and Reconstructive Surgery, St. James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK
| | - Rajgopal Achuthan
- Department of Oncoplastic Breast and Reconstructive Surgery, St. James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK
| | - Baek Kim
- Department of Oncoplastic Breast and Reconstructive Surgery, St. James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK
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20
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MacInnes EG, Piper J, Tait C, Waterworth A, Achuthan R, Hogan B, McKenzie S, Turton P, Kim B, Horgan K. Breast Cancer Surgery During the COVID-19 Pandemic Peak in the UK: Operative Outcomes. Cureus 2020; 12:e9280. [PMID: 32821623 PMCID: PMC7431302 DOI: 10.7759/cureus.9280] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Introduction The COVID-19 pandemic caused widespread changes in delivery of breast cancer care, aiming to protect vulnerable patients whilst minimising compromise to oncological outcomes. This multicentre observational study aimed to establish early surgical outcomes from breast cancer surgery performed during the peak of the COVID-19 pandemic. Materials and methods Data were collected on consecutive patients that underwent breast surgery in four units between 16 March and 24 April 2020. Outcome data at 30 days post-operation were collected, including documented COVID-19 cases in patients and reported cases in healthcare workers directly involved in their care. Recommended modifications to practice to reduce COVID-19 transmission risk, both to patients and healthcare workers in each centre, are described. Results A total of 202 patients underwent surgery in four hospitals delivering breast services in the West Yorkshire region over the six-week period at the peak of the pandemic. The age ranged from 28 to 91 years (median 57, interquartile range, 48-65) with 22% having co-morbidities linked to COVID-19, e.g. diabetes or respiratory disease. No patients presented post-operatively with COVID-19 symptoms and at 30 days there had not been any identified COVID-19 cases. There were no unexpected critical care admissions or deaths. One healthcare worker involved in the delivery of breast surgery was diagnosed with COVID-19 during this time and made an uneventful recovery. Conclusion Breast cancer surgery, in selected groups and with meticulous adherence to measures designed to reduce COVID-19 transmission, does not appear to be associated with elevated risk to patients or healthcare workers.
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Affiliation(s)
- Emma G MacInnes
- Breast Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, GBR
| | - Jenny Piper
- Breast Surgery, York Teaching Hospitals NHS Foundation Trust, York, GBR
| | - Catherine Tait
- Breast Surgery, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, GBR
| | - Alison Waterworth
- Breast Surgery, Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, GBR
| | - Raj Achuthan
- Breast Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, GBR
| | - Brian Hogan
- Breast Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, GBR
| | | | - Philip Turton
- Breast Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, GBR
| | - Baek Kim
- Breast Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, GBR
| | - Kieran Horgan
- Breast Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, GBR
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Rajgopal A, Tait C, Waterworth A, Kim B, Sharma N, Achuthan R, Hogan B. P056: Post-biopsy cases of breast cancer where localisation is not possible - A clinical dilemma. Eur J Surg Oncol 2020. [DOI: 10.1016/j.ejso.2020.03.095] [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: 10/24/2022] Open
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22
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Jones S, Achuthan R, Fenn C, Hogan B, Mckenzie S, Turton P, Kim B. P117: Comparison of pattern and outcome of immediate breast reconstruction and subsequent surgery for cancer versus risk reduction. Eur J Surg Oncol 2020. [DOI: 10.1016/j.ejso.2020.03.156] [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: 11/24/2022] Open
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Abstract
Blood-stained nipple discharge in a man would usually be proved to be male breast cancer. We present a case where this unusual presentation was associated with benign intraductal papillomas, managed with simple duct excision, preserving the patient’s nipple whilst adequately investigating and managing the condition.
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Affiliation(s)
| | - Isobel Haigh
- Breast Radiology, Leeds Teaching Hospitals Trust, Leeds, GBR
| | - Anju Nijhawan
- Pathology, Leeds Teaching Hospitals Trust, Leeds, GBR
| | - Brian Hogan
- Breast Surgery, Leeds Teaching Hospitals Trust, Leeds, GBR
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24
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Schaeffer ML, May B, Cimino-Mathews A, Orellana M, McCullough M, Hogan B, Armstrong D, Visvanathan K. Abstract P4-10-06: Factors impacting the accuracy of self-reported breast procedures among women with and without breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-10-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Clinical/epidemiologic observational studies frequently rely on participants' recall for information about breast procedures. However, there is limited data on the accuracy of self-reported breast procedures. To address this knowledge gap and inform future study design and collection and interpretation of similar data, we investigated the impact of type, diagnosis, age, time, and other patient characteristics on the accuracy of self-report in a prospective cohort.
Methods: All benign breast biopsies, lumpectomies, and mastectomies for breast cancer treatment among women enrolled in the BOSS Cohort, a prospective study of women and men with a familial risk of breast/ovarian cancer, were identified. Study staff obtained pathology reports for 93% of women from self-reported breast procedure locations. For this analysis, we focused on 577 women who had at least one ascertained pathology report, and who self-reported at least one breast procedure at baseline. We estimated the percentage of self-reports (95% confidence interval (CI)) with matching pathology report within 6 months (+/- 6 months), and agreement between self-reported procedures and pathology-confirmed diagnoses (normal/benign vs. atypical hyperplasia vs. LCIS, and DCIS vs. invasive cancer) with the Kappa statistic. We also examined predictors of an accurate biopsy self-report, including age at baseline, personal and family history of breast cancer, educational attainment, and time between biopsy and baseline, using logistic regression models.
Results: At baseline, 158 women reported having at least one benign biopsy, 193 women reported having a lumpectomy for cancer treatment, and 174 women reported having a mastectomy for cancer treatment. The median time between biopsy, lumpectomy, mastectomy, and baseline was 9 years, 2 years, and 2 years, respectively. Fifty-seven percent (95% CI: 49-64.5%) of benign biopsy self-reports, 90.7% (95% CI: 85.6-94.1%) of lumpectomy self-reports, and 85.1% (95% CI: 78.9-89.7%) of mastectomy self-reports had a matching pathology report within 6 months. Further diagnostic agreement was moderate for biopsies, lumpectomies, and mastectomies with Kappa statistics of 0.65, 0.66, 0.65, respectively. Age at baseline (p-interaction =0.01) and time (p-interaction = 0.03) were independent and joint predictors of accurate biopsy self-reports. Women less than 49 years old had the largest reduction in odds of having an accurate self-report (26%) for every additional year between biopsy and baseline [adjusted odds ratio = 0.74 (95% CI: 0.63-0.88)]. Similarly, women with a biopsy within 4 years prior to baseline had a 10% reduction in the odds of having an accurate self-report with increasing age [adjusted odds ratio = 0.9 (95% CI: 0.84-0.97)].
Conclusions: In this highly-educated cohort, the overall accuracy of self-report of benign biopsies was only modest, and the accuracy of self-report of lumpectomies and mastectomies was lower than expected. This study suggests that age at baseline and time between procedure and baseline are important predictors of accuracy of self-report and should be considered when utilizing self-reported information. Furthermore, where possible, prospective collection of breast procedure data should be prioritized.
Citation Format: Schaeffer ML, May B, Cimino-Mathews A, Orellana M, McCullough M, Hogan B, Armstrong D, Visvanathan K. Factors impacting the accuracy of self-reported breast procedures among women with and without breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-10-06.
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Affiliation(s)
- ML Schaeffer
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Johns Hopkins School of Medicine, Baltimore, MD; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
| | - B May
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Johns Hopkins School of Medicine, Baltimore, MD; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
| | - A Cimino-Mathews
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Johns Hopkins School of Medicine, Baltimore, MD; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
| | - M Orellana
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Johns Hopkins School of Medicine, Baltimore, MD; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
| | - M McCullough
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Johns Hopkins School of Medicine, Baltimore, MD; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
| | - B Hogan
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Johns Hopkins School of Medicine, Baltimore, MD; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
| | - D Armstrong
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Johns Hopkins School of Medicine, Baltimore, MD; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
| | - K Visvanathan
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Johns Hopkins School of Medicine, Baltimore, MD; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
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25
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Hogan B, Lewis L, McAuliffe M, Hegarty SP. Mid-infrared optical sensing using sub-wavelength gratings. Opt Express 2019; 27:3169-3179. [PMID: 30732342 DOI: 10.1364/oe.27.003169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 12/18/2018] [Indexed: 06/09/2023]
Abstract
Optical sensing has shown great potential for both quantitative and qualitative analysis of compounds. In particular sensors which are capable of detecting changes in refractive index at a surface as well as in bulk material have received much attention. Much of the recent research has focused on developing technologies that enable such sensors to be deployed in an integrated photonic device. In this work we demonstrate experimentally, using a sub-wavelength grating the detection of ethanol in aqueous solution by interrogating its large absorption band at 9.54 μm. Theoretical investigation of the operating principle of our grating sensor shows that in general, as the total field interacting with the analyte is increased, the corresponding absorption is also increased. We also theoretically demonstrate how sub-wavelength gratings can detect changes in the real part of the refractive index, similar to conventional refractive index (RI) sensors.
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26
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Annoh R, Loo CY, Hogan B, Tan HL, Tang LS, Tatham AJ. Accuracy of detection of patients with narrow angles by community optometrists in Scotland. Ophthalmic Physiol Opt 2019; 39:104-112. [PMID: 30600544 DOI: 10.1111/opo.12601] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 11/27/2018] [Indexed: 11/29/2022]
Abstract
AIM To examine the accuracy of referrals by community optometrists for suspected primary angle closure, including primary angle closure suspects, primary angle closure and primary angle closure glaucoma. METHODS A retrospective review of 769 consecutive patients referred by community optometrists to the glaucoma clinic at a university hospital in Scotland. Ninety-five of 715 eligible subjects (13%) were referred due to suspected angle closure. All subjects had a comprehensive eye examination in the glaucoma clinic, including gonioscopy, with angle closure defined according to the International Society of Geographical and Epidemiological Ophthalmology classification as iridotrabecular contact over at least 270 degrees. RESULTS Fifty-nine of 95 subjects referred due to suspected angle closure were confirmed to have an occludable angle, while 36 of 95 (38%) had open angles (positive predictive value = 62%). Of 620 patients referred to the glaucoma clinic for reasons other than narrow angles, 601 (97%) had open angles on gonioscopy and 19 (3%) had narrow angles. Using the 620 patients referred with 'open angles' as a control group, sensitivity was estimated as 76% and specificity 94%. Eleven of 95 (12%) patients referred for possible angle closure were discharged at the first visit compared to 156 of 620 (25%) referred to the glaucoma clinic for other reasons (p = 0.003). In a multivariable model, suspect angle closure detected by the optometrist (OR = 56.0, 95% CI 35.2-89.2, p < 0.001) and female gender (OR = 1.9, 95% CI 1.2-3.1, p = 0.008) were associated with increased odds of angle closure on gonioscopy. CONCLUSION Community optometrists had good ability to detect eyes at risk of angle closure. There was also greater accuracy of referrals for suspected angle closure than for other glaucoma referrals.
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Affiliation(s)
- Roxanne Annoh
- Princess Alexandra Eye Pavilion and Department of Ophthalmology, University of Edinburgh, Edinburgh, UK
| | - Cheng Yi Loo
- Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Brian Hogan
- Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Huai Ling Tan
- Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Ling Shan Tang
- Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Andrew J Tatham
- Princess Alexandra Eye Pavilion and Department of Ophthalmology, University of Edinburgh, Edinburgh, UK
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27
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Hogan B, Lewis L, Romero-Vivas J, Ochalski TJ, Hegarty SP. Resonant gratings with an etch-stop layer and a fabrication-error tolerant design. Opt Express 2018; 26:13205-13213. [PMID: 29801347 DOI: 10.1364/oe.26.013205] [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: 01/05/2018] [Accepted: 03/11/2018] [Indexed: 06/08/2023]
Abstract
Sub-wavelength gratings (SWG) have shown much promise for applications such as lightweight high bandwidth reflectors, polarising filters and focusing lenses. Unfortunately, grating performance may be rapidly degraded through variability in grating dimensions. We demonstrate, in particular, how an error in depth of etch can be detrimental to the performance of zero contrast grating reflectors. We mitigate the impact of this fabrication error through the introduction of an etch stop layer and in so doing we experimentally realise a high bandwidth reflector based on this modified structure. Another common fabrication error is variation in the duty-cycle of fabricated gratings. This duty-cycle variation can weaken grating performance, however we demonstrate that grating designs that exhibit tolerance to duty-cycle fluctuation can be identified through simulation. Finally, we discuss the impact of lateral etching and the resulting sidewall concavity. We present our approach for numerically predicting the spectral response from such a grating and also for convenience we outline an approach for quickly approximating grating performance. Good agreement is observed between these numerical predictions and measurements made on a HCG with concave sidewalls.
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28
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Rutz H, Hogan B, Hook S, Hinckley A, Feldman K. Exploring an alternative approach to Lyme disease surveillance in Maryland. Zoonoses Public Health 2018; 65:254-259. [PMID: 29411541 PMCID: PMC10880063 DOI: 10.1111/zph.12446] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 08/09/2017] [Indexed: 11/28/2022]
Abstract
In Maryland, Lyme disease (LD) is a reportable disease and all laboratories and healthcare providers are required to report to the local health department. Given the volume of LD reports and effort required for investigation, surveillance for LD is burdensome and subject to underreporting. We explored the utility of International Classification of Diseases, 9th Revision, Clinical Modification (administrative) codes for use with LD surveillance. We aimed to collect the administrative codes for a 10% sample of 2009 LD reports (n = 474) from 292 facilities stratified by case classification (confirmed, probable, suspected and not a case). Sixty-three per cent (n = 184) of facilities responded to the survey, and 341 different administrative codes were obtained for 91% (n = 430) of sampled reports. The administrative code for Lyme disease (088.81) was the most commonly reported code (133/430 patients) among sampled reports; while it was used for 62 of 151 (41%) confirmed cases, it was also used for 48 of 192 (25%) not a case reports (sensitivity 41% and specificity 73%). A combination of nine codes was developed with sensitivity of 74% and specificity of 37% when compared to not a case reports. We conclude that the administrative code for LD alone has low ability to identify LD cases in Maryland. Grouping certain codes improved sensitivity, but our results indicate that administrative codes alone are not a viable surveillance alternative for a disease with complex manifestations such as LD.
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Affiliation(s)
- H Rutz
- Emerging Infections Program, Maryland Department of Health, Baltimore, MD, USA
| | - B Hogan
- Emerging Infections Program, Maryland Department of Health, Baltimore, MD, USA
| | - S Hook
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - A Hinckley
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - K Feldman
- Emerging Infections Program, Maryland Department of Health, Baltimore, MD, USA
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29
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Bühl H, Eibach D, Nagel M, Greub G, Borel N, Sarpong N, Rettig T, Pesch T, Aeby S, Klöckner A, Brunke M, Krannich S, Kreuels B, Owusu-Dabo E, Hogan B, May J, Henrichfreise B. Chlamydiae in febrile children with respiratory tract symptoms and age-matched controls, Ghana. New Microbes New Infect 2018; 22:44-48. [PMID: 29511568 PMCID: PMC5832669 DOI: 10.1016/j.nmni.2017.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 11/30/2017] [Accepted: 12/21/2017] [Indexed: 11/29/2022] Open
Abstract
Members of the Chlamydiales order are obligate intracellular pathogens causing acute and chronic infectious diseases. Chlamydiaceae are established agents of community- and zoonotically acquired respiratory tract infections, and emerging pathogens among the Chlamydia-related bacteria have been implicated in airway infections. The role of both in airway infections in Africa is underexplored. We performed a case -control study on the prevalence of Chlamydiaceae and Chlamydia-related emerging pathogens in children with febrile respiratory tract infections in West Africa, Ghana. Using a pan-Chlamydiales broad-range real-time PCR, we detected chlamydial DNA in 11 (1.9%) of 572 hospitalized febrile children with respiratory tract symptoms and in 24 (4.3%) of 560 asymptomatic age-matched controls (p 0.03). Chlamydiaceae were found to be common among both symptomatic and healthy Ghanaian children, with Chlamydia pneumoniae being the most prevalent species. Parachlamydiaceae were detected in two children without symptoms but not in the symptomatic group. We identified neither Chlamydia psittaci nor Simkania negevensis but a member of a new chlamydial family that shared 90.2% sequence identity with the 16S rRNA gene of the zoonotic pathogen Chlamydia pecorum. In addition, we found a new Chlamydia-related species that belonged to a novel family sharing 91.3% 16S rRNA sequence identity with Candidatus Syngnamydia venezia. The prevalence and spectrum of chlamydial species differed from previous results obtained from children of other geographic regions and our study indicates that both, Chlamydiaceae and Chlamydia-related bacteria, are not clearly linked to clinical symptoms in Ghanaian children.
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Affiliation(s)
- H Bühl
- Institute for Pharmaceutical Microbiology, University Clinic, University of Bonn, Germany
| | - D Eibach
- Bernhard Nocht Institute for Tropical Medicine, University Medical Centre Hamburg Eppendorf, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck, Germany
| | - M Nagel
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - G Greub
- Institute of Microbiology, University Hospital Center and University of Lausanne, Switzerland
| | - N Borel
- Institute of Veterinary Pathology, University of Zurich, Vetsuisse Faculty, Zurich, Switzerland
| | - N Sarpong
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck, Germany.,Agogo Presbyterian Hospital, Department of Child Health, Agogo, Ghana
| | - T Rettig
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - T Pesch
- Institute of Veterinary Pathology, University of Zurich, Vetsuisse Faculty, Zurich, Switzerland
| | - S Aeby
- Institute of Microbiology, University Hospital Center and University of Lausanne, Switzerland
| | - A Klöckner
- Institute for Pharmaceutical Microbiology, University Clinic, University of Bonn, Germany.,German Center for Infection Research (DZIF), Bonn, Germany
| | - M Brunke
- Institute for Pharmaceutical Microbiology, University Clinic, University of Bonn, Germany
| | - S Krannich
- Institute for Pharmaceutical Microbiology, University Clinic, University of Bonn, Germany
| | - B Kreuels
- Division of Tropical Medicine, I. Department of Internal Medicine, University Medical Centre Hamburg Eppendorf, Hamburg, Germany
| | - E Owusu-Dabo
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana.,Department of Global Health, School of Public Health, College of Health Sciences, KNUST, Kumasi, Ghana
| | - B Hogan
- Bernhard Nocht Institute for Tropical Medicine, University Medical Centre Hamburg Eppendorf, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck, Germany
| | - J May
- Bernhard Nocht Institute for Tropical Medicine, University Medical Centre Hamburg Eppendorf, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck, Germany
| | - B Henrichfreise
- Institute for Pharmaceutical Microbiology, University Clinic, University of Bonn, Germany
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30
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Krumkamp R, Hogan B, Eibach D, Sarpong N, Kreuels B, Maiga-Ascofaré O, Adu-Sarkodie Y, Owusu-Dabo E, May J. Co-diagnoses in hospitalised children – revealing the cause of admission in a malaria endemic area. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- R Krumkamp
- Bernhard-Nocht-Institut für Tropenmedizin, Hamburg
- Deutsches Zentrum für Infektionsforschung, Hamburg
| | - B Hogan
- Bernhard-Nocht-Institut für Tropenmedizin, Hamburg
| | - D Eibach
- Bernhard-Nocht-Institut für Tropenmedizin, Hamburg
| | - N Sarpong
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi
| | - B Kreuels
- Bernhard-Nocht-Institut für Tropenmedizin, Hamburg
- Deutsches Zentrum für Infektionsforschung, Hamburg
- Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - O Maiga-Ascofaré
- Bernhard-Nocht-Institut für Tropenmedizin, Hamburg
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi
| | - Y Adu-Sarkodie
- Kwame Nkrumah University of Science and Technology, Kumasi
| | - E Owusu-Dabo
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi
| | - J May
- Bernhard-Nocht-Institut für Tropenmedizin, Hamburg
- Deutsches Zentrum für Infektionsforschung, Hamburg
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31
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Lyons M, Gill E, Hogan B, Hayes E, Feather K, Bain J, Paterson R. The balance of accuracy and reliability in estimating tidal volume from height. J Intensive Care Soc 2017; 18:257. [PMID: 29118843 DOI: 10.1177/1751143716681327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- M Lyons
- School of Medicine, University of Edinburgh, Edinburgh, UK
| | - E Gill
- School of Medicine, University of Edinburgh, Edinburgh, UK
| | - B Hogan
- School of Medicine, University of Edinburgh, Edinburgh, UK
| | - E Hayes
- School of Medicine, University of Edinburgh, Edinburgh, UK
| | - K Feather
- School of Medicine, University of Edinburgh, Edinburgh, UK
| | - J Bain
- Department of Critical Care, Western General Hospital, Edinburgh, UK
| | - R Paterson
- School of Medicine, University of Edinburgh, Edinburgh, UK.,Department of Critical Care, Western General Hospital, Edinburgh, UK
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Vergis N, Khamri W, Beale K, Sadiq F, Aletrari MO, Moore C, Atkinson SR, Bernsmeier C, Possamai LA, Petts G, Ryan JM, Abeles RD, James S, Foxton M, Hogan B, Foster GR, O'Brien AJ, Ma Y, Shawcross DL, Wendon JA, Antoniades CG, Thursz MR. Defective monocyte oxidative burst predicts infection in alcoholic hepatitis and is associated with reduced expression of NADPH oxidase. Gut 2017; 66:519-529. [PMID: 26860769 PMCID: PMC5534772 DOI: 10.1136/gutjnl-2015-310378] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 10/07/2015] [Accepted: 10/25/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE In order to explain the increased susceptibility to serious infection in alcoholic hepatitis, we evaluated monocyte phagocytosis, aberrations of associated signalling pathways and their reversibility, and whether phagocytic defects could predict subsequent infection. DESIGN Monocytes were identified from blood samples of 42 patients with severe alcoholic hepatitis using monoclonal antibody to CD14. Phagocytosis and monocyte oxidative burst (MOB) were measured ex vivo using flow cytometry, luminometry and bacterial killing assays. Defects were related to the subsequent development of infection. Intracellular signalling pathways were investigated using western blotting and PCR. Interferon-γ (IFN-γ) was evaluated for its therapeutic potential in reversing phagocytic defects. Paired longitudinal samples were used to evaluate the effect of in vivo prednisolone therapy. RESULTS MOB, production of superoxide and bacterial killing in response to Escherichia coli were markedly impaired in patients with alcoholic hepatitis. Pretreatment MOB predicted development of infection within two weeks with sensitivity and specificity that were superior to available clinical markers. Accordingly, defective MOB was associated with death at 28 and 90 days. Expression of the gp91 phox subunit of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase was reduced in patients with alcoholic hepatitis demonstrating defective MOB. Monocytes were refractory to IFN-γ stimulation and showed high levels of a negative regulator of cytokine signalling, suppressor of cytokine signalling-1. MOB was unaffected by 7 days in vivo prednisolone therapy. CONCLUSIONS Monocyte oxidative burst and bacterial killing is impaired in alcoholic hepatitis while bacterial uptake by phagocytosis is preserved. Defective MOB is associated with reduced expression of NADPH oxidase in these patients and predicts the development of infection and death.
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Affiliation(s)
- Nikhil Vergis
- Department of Hepatology and Gastroenterology, Imperial College, London, UK
| | - Wafa Khamri
- Department of Hepatology and Gastroenterology, Imperial College, London, UK
| | - Kylie Beale
- Department of Hepatology and Gastroenterology, Imperial College, London, UK
| | - Fouzia Sadiq
- Department of Hepatology and Gastroenterology, Imperial College, London, UK
| | - Mina O Aletrari
- Department of Hepatology and Gastroenterology, Imperial College, London, UK
| | - Celia Moore
- Department of Hepatology and Gastroenterology, Imperial College, London, UK
| | - Stephen R Atkinson
- Department of Hepatology and Gastroenterology, Imperial College, London, UK
| | - Christine Bernsmeier
- Department of Hepatology, King's College Hospital, Institute of Liver Studies, London, UK
| | - Lucia A Possamai
- Department of Hepatology and Gastroenterology, Imperial College, London, UK
| | - Gemma Petts
- Department of Hepatology and Gastroenterology, Imperial College, London, UK
| | - Jennifer M Ryan
- Department of Hepatology, King's College Hospital, Institute of Liver Studies, London, UK
| | - Robin D Abeles
- Department of Hepatology, King's College Hospital, Institute of Liver Studies, London, UK
| | - Sarah James
- Department of Hepatology, University College, London, UK
| | | | - Brian Hogan
- Department of Hepatology, Royal Free Hospital, London, UK
| | - Graham R Foster
- Department of Gastroenterology, Royal London Hospital, London, UK
| | | | - Yun Ma
- Department of Hepatology, King's College Hospital, Institute of Liver Studies, London, UK
| | - Debbie L Shawcross
- Department of Hepatology, King's College Hospital, Institute of Liver Studies, London, UK
| | - Julia A Wendon
- Department of Hepatology, King's College Hospital, Institute of Liver Studies, London, UK
| | | | - Mark R Thursz
- Department of Hepatology and Gastroenterology, Imperial College, London, UK
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Weir A, Robinson P, Hogan B, Franklyn-Miller A. MRI investigation for groin pain in athletes: is radiological terminology clarifying or confusing? Br J Sports Med 2017; 51:1185-1186. [DOI: 10.1136/bjsports-2016-096973] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2017] [Indexed: 11/04/2022]
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Vivien C, Pichol-Thievend C, Bower N, Hogan B, Hudson J, Francois M, Porrello E. Role of Lymphangiogenesis in Zebrafish Cardiac Regeneration. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Farrell G, McGrath F, Hogan B, Logan M, Denvir K, O’Connell B, Irwin E, Gissane C, Wilson F. 95% prevalence of abnormality on hip MRI in elite academy level rugby union: A clinical and imaging study of hip disorders. J Sci Med Sport 2016; 19:893-897. [DOI: 10.1016/j.jsams.2016.01.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 12/22/2015] [Accepted: 01/21/2016] [Indexed: 11/30/2022]
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Hogan B, Hegarty SP, Lewis L, Romero-Vivas J, Ochalski TJ, Huyet G. Realization of high-contrast gratings operating at 10 μm. Opt Lett 2016; 41:5130-5133. [PMID: 27805701 DOI: 10.1364/ol.41.005130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We present a new material pairing that can be used to realize high-contrast gratings at wavelengths of 10 μm and greater. Using only optical lithography, the material pair solves the absorption issue limiting the popular Si/SiO2 pairing from operation above 6 μm. We describe the obstacles that exist with the currently used grating materials for this wavelength range and outline why our chosen materials overcome this obstacle. We numerically demonstrate that gratings utilizing these materials are capable of wideband high reflectivity. We experimentally show that the spectral response of gratings that are fabricated using such a process show good agreement with theoretically predicted performance.
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Hogan B, Al-Huneidi R, Holmes W, Dodwell D, Horgan K, Sharma N. Selective use of breast MR in all pathological subtypes has a high diagnostic yield. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.02.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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38
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Rodríguez-Perálvarez M, García-Caparrós C, Tsochatzis E, Germani G, Hogan B, Poyato-González A, O'Beirne J, Senzolo M, Guerrero-Misas M, Montero-Álvarez JL, Patch D, Barrera P, Briceño J, Dhillon AP, Burra P, Burroughs AK, De la Mata M. Lack of agreement for defining 'clinical suspicion of rejection' in liver transplantation: a model to select candidates for liver biopsy. Transpl Int 2015; 28:455-64. [PMID: 25557691 DOI: 10.1111/tri.12514] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 10/17/2014] [Accepted: 12/30/2014] [Indexed: 12/14/2022]
Abstract
The gold standard to diagnose acute cellular rejection (ACR) after liver transplantation (LT) is histological evaluation, but there is no consensus to select patients for liver biopsy. We aimed to evaluate the agreement among clinicians to select candidates for liver biopsy early after LT. From a protocol biopsy population (n = 690), we randomly selected 100 LT patients in whom the biopsy was taken 7-10 days after LT. The clinical information between LT and protocol biopsy was given to nine clinicians from three transplant centres who decided whether a liver biopsy was needed. The agreement among clinicians to select candidates for liver biopsy was poor: κ = 0.06-0.62, being κ < 0.40 in 76% of comparisons. The concordance between indication for liver biopsy and moderate-severe ACR in the protocol biopsy was κ < 0.30 in all cases. A multivariate model based on the product age-by-MELD (OR = 0.81; P = 0.013), delta eosinophils (OR = 1.5; P = 0.002) and mean tacrolimus trough concentrations <6 ng/ml within the prior 4 days (OR = 11.4; P = 0.047) had an AUROC = 0.84 to diagnose moderate-severe histological ACR. In conclusion, the agreement among clinicians to select patients for liver biopsy is very poor. If further validated the proposed model would provide an objective method to select candidates for liver biopsy after LT.
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Affiliation(s)
- Manuel Rodríguez-Perálvarez
- Department of Hepatology and Liver Transplantation, Reina Sofía University Hospital, IMIBIC, CIBERehd, Córdoba, Spain
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Hogan B, Chan S, Salhab M, Linforth R, Tait C. 186. Reducing margin width following breast conserving surgery increases risk of residual disease in the breast. Eur J Surg Oncol 2014. [DOI: 10.1016/j.ejso.2014.08.181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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41
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Qiu C, Khalizov AF, Hogan B, Petersen EL, Zhang R. High sensitivity of diesel soot morphological and optical properties to combustion temperature in a shock tube. Environ Sci Technol 2014; 48:6444-6452. [PMID: 24803287 DOI: 10.1021/es405589d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Carbonaceous particles produced from combustion of fossil fuels have strong impacts on air quality and climate, yet quantitative relationships between particle characteristics and combustion conditions remain inadequately understood. We have used a shock tube to study the formation and properties of diesel combustion soot, including particle size distributions, effective density, elemental carbon (EC) mass fraction, mass-mobility scaling exponent, hygroscopicity, and light absorption and scattering. These properties are found to be strongly dependent on the combustion temperature and fuel equivalence ratio. Whereas combustion at higher temperatures (∼2000 K) yields fractal particles of a larger size and high EC content (90 wt %), at lower temperatures (∼1400 K) smaller particles of a higher organic content (up to 65 wt %) are produced. Single scattering albedo of soot particles depends largely on their organic content, increasing drastically from 0.3 to 0.8 when the particle EC mass fraction decreases from 0.9 to 0.3. The mass absorption cross-section of diesel soot increases with combustion temperature, being the highest for particles with a higher EC content. Our results reveal that combustion conditions, especially the temperature, may have significant impacts on the direct and indirect climate forcing of atmospheric soot aerosols.
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Affiliation(s)
- Chong Qiu
- Department of Chemistry & Industrial Hygiene, University of North Alabama , Florence, Alabama 35632-5049, United States
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Smith K, Paterson S, Capon S, De Angelis J, Grassini D, Lagendijk A, Bailey G, Simons C, Taft R, Hogan B. A large-scale phenotype-to-genotype screen identifies regulators of cardiac development and function. Heart Lung Circ 2014. [DOI: 10.1016/j.hlc.2014.07.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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de Torres A, Michahelles A, Hogan B, Güssow U, Eckert B, Michels P, Röther J. Reduktion der Door-to-Needle-Zeit durch Patientenübergabe am CT-Tisch - Von der Rettungsliege auf den CT-Tisch. Akt Neurol 2013. [DOI: 10.1055/s-0033-1355334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- A. de Torres
- Asklepios Klinik Altona, Abteilung für Neurologie, Hamburg
| | - A. Michahelles
- Asklepios Klinik Altona, Abteilung für Neurologie, Hamburg
| | - B. Hogan
- Asklepios Klinik Altona, Zentrale Notaufnahme, Hamburg
| | - U. Güssow
- Asklepios Klinik Altona, Zentrale Notaufnahme, Hamburg
| | - B. Eckert
- Asklepios Klinik Altona, Neuroradiologie, Hamburg
| | - P. Michels
- Asklepios Klinik Altona, Abteilung für Neurologie, Hamburg
| | - J. Röther
- Asklepios Klinik Altona, Abteilung für Neurologie, Hamburg
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Crawford MK, Smalley RJ, Cohen G, Hogan B, Wood B, Kumar SK, Melnichenko YB, He L, Guise W, Hammouda B. Chain conformation in polymer nanocomposites with uniformly dispersed nanoparticles. Phys Rev Lett 2013; 110:196001. [PMID: 23705720 DOI: 10.1103/physrevlett.110.196001] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Indexed: 05/28/2023]
Abstract
The effect of nanoparticles (NP) on chain dimensions in polymer melts has been the source of considerable theoretical and experimental controversy. We exploit our ability to ensure a spatially uniform dispersion of 13 nm silica NPs miscible in polystyrene melts, together with neutron scattering, x-ray scattering, and transmission electron microscopy, to show that there is no measurable change in the polymer size in miscible mixtures, regardless of the relative sizes of the chains and the nanoparticles, and for NP loadings as high as 32.7 vol%. Our results provide a firm basis from which to understand the properties of polymer nanocomposites.
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Affiliation(s)
- M K Crawford
- DuPont Central Research and Development, E400/5424, Wilmington, Delaware 19880-0400, USA
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Teudt I, Grundmann T, Pueschel K, Hogan B, Leventli B. [ENT emergency treatment and alcohol related head and neck injuries]. Laryngorhinootologie 2013; 92:536-40. [PMID: 23568584 DOI: 10.1055/s-0033-1337950] [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: 10/27/2022]
Abstract
The spectrum of ENT-diseases can differ widely among emergency departments (ED) of different geographic regions. Especially in terms of head and neck trauma a higher number of injuries can be expected in large cities due to alcohol related violence.The ED of a large hospital situated in the center of Hamburg Germany was analysed for ENT-emergency treatments in 2011 retrospectively. Beside usual patient statistics, the study focused on alcohol related injuries with an ENT-surgeon involved. All data were compared to reports by other EDs in Germany and alcohol related costs were approximated for initiation of prevention programs in the future.2 339 ENT-patients were admitted to the ED. 19% of all patients used an ambulance whereas 80% reached the ED by private transportation. The majority of patients were between 21 and 30 years of age. For 143 of all trauma cases alcohol involvement was documented. Subanalysis revealed male dominance and a high use of ambulance transportation.The high number of traumata differs considerably from other ENT studies. One reason is the hospital's close proximity to all time party districts like "Reeperbahn" and the "Port of Hamburg". In those areas high amounts of alcohol ingestion takes place leading to more injuries at the head- and neck region. Theoretically financial resources would be plenty after the initiation of those programs as the severe costs for alcohol related medical treatment would decline.
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Affiliation(s)
- I Teudt
- Asklepios Klinik Altona, HNO-Abteilung, Hamburg.
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46
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Greutélaers B, Wadl M, Nachtnebel M, Rieck T, Hogan B, Adlhoch C, Eckmanns T, Benzler J. [Hospital surveillance during major outbreaks of community-acquired diseases. Pandemic Influenza Hospital Surveillance (PIKS) 2009/2010 and Surveillance of Bloody Diarrhea (SBD) 2011]. Dtsch Med Wochenschr 2013; 138:632-7. [PMID: 23512362 DOI: 10.1055/s-0032-1332962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND OBJECTIVE During the influenza pandemic 2009/2010 and the outbreak of entero-haemorrhagic Escherichia coli (EHEC)/hemolytic-uremic syndrome (HUS) 2011, the statutory reporting system in Germany was complemented by additional event-related surveillance systems in hospitals. The Pandemic Influenza Hospital Surveillance (PIKS) and the Surveillance of Bloody Diarrhea (SBD) were evaluated, to make experiences available for similar future situations. METHODS The description and evaluation of our surveillance systems is based on the "Updated Guidelines for Evaluating Public Health Surveillance Systems" published by the U.S. Centers for Disease Control and Prevention in 2001. RESULTS PIKS and SBD could be implemented quickly and were able to capture resilient data in a timely manner both on the severity and course of the influenza pandemic 2009/2010 and the outbreak of EHEC and HUS 2011. Although lacking in representativeness, sensitive and useful data were generated. CONCLUSION In large outbreaks of severe diseases, the establishment of specific hospital surveillance should be considered as early as possible. In Germany, the participating hospitals were able to rapidly implement the required measures.
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Affiliation(s)
- B Greutélaers
- Abteilung für Infektionsepidemiologie, Robert Koch-Institut, Berlin, Germany.
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Oldenburg M, Hogan B, Jensen HJ. Systematic review of maritime field studies about stress and strain in seafaring. Int Arch Occup Environ Health 2012; 86:1-15. [PMID: 22915144 DOI: 10.1007/s00420-012-0801-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 07/15/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE The aim of this study was to summarize and evaluate the current scientific literature on stress and strain on seafarers on board as defined by maritime field surveys. METHODS Using a systematic review, 109 studies on the stress and strain experienced by seafarers were identified for the period January 1990 to January 2012. RESULTS Only 13 of the identified maritime studies were conducted as field studies, and in 10 of these studies, the focus was on the watch system and/or on fatigue. According to the study results, sleepiness tends to be stronger in the 2-watch system than in the 3-watch system (particularly between 4:00 and 6:00 a.m.). Occasional short sleep episodes appear to provide adequate recovery. Fatigue does not appear to depend on the seafarers' age and is often associated with poor sleep quality; noise and night shifts are also considered to contribute to fatigue. Stress among the seafarers was primarily recorded in sleep diaries (9 times) and with devices for measuring physical activity (4 times). As a rule, a questionnaire was used to assess the strain on the crew on board; 7 studies also additionally recorded biometrical parameters. Only in 6 cases were several groups with different ranks on board investigated. CONCLUSION The conducted literature review makes it clear that most maritime field studies have focused on fatigue and watch systems in the shipping industry--in each case as univariate parameters. Thus, scientific field studies with comprehensive multivariate stress and strain analyses on board are required.
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Affiliation(s)
- M Oldenburg
- Department of Maritime Medicine, Hamburg Port Health Centre, Institute for Occupational and Maritime Medicine, ZfAM, Hamburg State Department for Health and Consumer Protection, University of Hamburg, Seewartenstrasse 10, 20459 Hamburg, Germany.
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Cramer JP, Mac T, Hogan B, Stauga S, Eberhardt S, Wichmann O, Mertens T, Burchard GD. Influenza A(H1N1)pdm09 antibodies after pandemic and trivalent seasonal influenza vaccination as well as natural infection in November 2010 in Hamburg, Germany. Euro Surveill 2012. [DOI: 10.2807/ese.17.02.20052-en] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The 2009 influenza pandemic has introduced the new re-assorted influenza A(H1N1)pdm09 virus which recirculated during the 2010/11 influenza season. Before that season, it was possible to acquire protective immunity either by pandemic or seasonal influenza vaccination against influenza A(H1N1)pdm09 or by natural infection. To obtain data on vaccination coverage and antibody levels in a reference population and to calculate whether or not the herd immunity threshold (HIT, calculated as 33% given an R0 of 1.5) was reached at the beginning of the 2010/11 season we performed a seroprevalence study in November 2010 in Hamburg, Germany. Antibody titres were assessed applying a haemagglutination inhibition test. Vaccination coverage was very low: 14% for pandemic and 11% for seasonal 2010/11 vaccinations. Even in those with underlying risk factors, vaccination coverage was not much higher: 17% for both vaccines. Serological analysis revealed antibody titres of ≥1:10 in 135 of 352 (38%) and of ≥1:40 in 61 of 352 study participants (17%). Specific antibodies were measurable in 26% of those without history of vaccination or natural infection, indicating a high proportion of subclinical and mild influenza disease. Nevertheless, the HIT was not reached, leaving the majority of the population susceptible to influenza A(H1N1)pdm09 and its potential complications.
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Affiliation(s)
- J P Cramer
- Section Tropical Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Section Clinical Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - T Mac
- Section Tropical Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - B Hogan
- Section Clinical Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - S Stauga
- Section Tropical Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - S Eberhardt
- Section Tropical Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - O Wichmann
- Immunisation Unit, Robert Koch Institute, Berlin, Germany
| | - T Mertens
- Institute of Virology, University Medical Centre Ulm, Germany
| | - G D Burchard
- Section Clinical Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- Section Tropical Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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Cramer J, Mac T, Hogan B, Stauga S, Eberhardt S, Wichmann O, Mertens T, Burchard G. Influenza A(H1N1)pdm09 antibodies after pandemic and trivalent seasonal influenza vaccination as well as natural infection in November 2010 in Hamburg, Germany. Euro Surveill 2012; 17:20052. [PMID: 22264864] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
The 2009 influenza pandemic has introduced the new re-assorted influenza A(H1N1)pdm09 virus which recirculated during the 2010/11 influenza season. Before that season, it was possible to acquire protective immunity either by pandemic or seasonal influenza vaccination against influenza A(H1N1)pdm09 or by natural infection. To obtain data on vaccination coverage and antibody levels in a reference population and to calculate whether or not the herd immunity threshold (HIT, calculated as 33% given an R0 of 1.5) was reached at the beginning of the 2010/11 season we performed a seroprevalence study in November 2010 in Hamburg, Germany. Antibody titres were assessed applying a haemagglutination inhibition test. Vaccination coverage was very low: 14% for pandemic and 11% for seasonal 2010/11 vaccinations. Even in those with underlying risk factors, vaccination coverage was not much higher: 17% for both vaccines. Serological analysis revealed antibody titres of ≥1:10 in 135 of 352 (38%) and of ≥1:40 in 61 of 352 study participants (17%). Specific antibodies were measurable in 26% of those without history of vaccination or natural infection, indicating a high proportion of subclinical and mild influenza disease. Nevertheless, the HIT was not reached, leaving the majority of the population susceptible to influenza A(H1N1)pdm09 and its potential complications.
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Affiliation(s)
- Jp Cramer
- Section Tropical Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
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Griffiths B, Quinn G, Hogan B, Peter M, Dall B, Achuthan R. The role of ultrasound and Fine-Needle Aspiration Cytology in staging the axilla in breast cancer patients. Eur J Surg Oncol 2010. [DOI: 10.1016/j.ejso.2010.08.043] [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: 10/19/2022] Open
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