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McCurdy H, Nobbe A, Scott D, Patton H, Morgan TR, Bajaj JS, Yakovchenko V, Merante M, Gibson S, Lamorte C, Baffy G, Ioannou GN, Taddei TH, Rozenberg-Ben-Dror K, Anwar J, Dominitz JA, Rogal SS. Organizational and Implementation Factors Associated with Cirrhosis Care in the Veterans Health Administration. Dig Dis Sci 2024:10.1007/s10620-024-08409-6. [PMID: 38616215 DOI: 10.1007/s10620-024-08409-6] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 03/25/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND The Veterans Health Administration provides care to more than 100,000 Veterans with cirrhosis. AIMS This implementation evaluation aimed to understand organizational resources and barriers associated with cirrhosis care. METHODS Clinicians across 145 Department of Veterans Affairs (VA) medical centers (VAMCs) were surveyed in 2022 about implementing guideline-concordant cirrhosis care. VA Corporate Data Warehouse data were used to assess VAMC performance on two national cirrhosis quality measures: HCC surveillance and esophageal variceal surveillance or treatment (EVST). Organizational factors associated with higher performance were identified using linear regression models. RESULTS Responding VAMCs (n = 124, 86%) ranged in resource availability, perceived barriers, and care processes. In multivariable models, factors independently associated with HCC surveillance included on-site interventional radiology and identifying patients overdue for surveillance using a national cirrhosis population management tool ("dashboard"). EVST was significantly associated with dashboard use and on-site gastroenterology services. For larger VAMCs, the average HCC surveillance rate was similar between VAMCs using vs. not using the dashboard (47% vs. 41%), while for smaller and less resourced VAMCs, dashboard use resulted in a 13% rate difference (46% vs. 33%). Likewise, higher EVST rates were more strongly associated with dashboard use in smaller (55% vs. 50%) compared to larger (57% vs. 55%) VAMCs. CONCLUSIONS Resources, barriers, and care processes varied across diverse VAMCs. Smaller VAMCs without specialty care achieved HCC and EVST surveillance rates nearly as high as more complex and resourced VAMCs if they used a population management tool to identify the patients due for cirrhosis care.
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Affiliation(s)
- Heather McCurdy
- Gastroenterology Section, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Anna Nobbe
- Digestive Diseases Section, Cincinnati VA Medical Center, Cincinnati, OH, USA
| | - Dawn Scott
- VA Central Texas Healthcare System, Temple, TX, USA
| | - Heather Patton
- VA San Diego Healthcare System, San Diego, CA, USA
- University of California San Diego, La Jolla, CA, USA
| | - Timothy R Morgan
- VA Long Beach Healthcare System, Long Beach, CA, USA
- Department of Medicine, University of California, Irvine, CA, USA
- National Gastroenterology and Hepatology Program, Department of Veterans Affairs, Veterans Health Administration, Washington, DC, USA
| | - Jasmohan S Bajaj
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, USA
- Division of Gastroenterology, Hepatology and Nutrition, Central Virginia VA Health Care System, Richmond, VA, USA
| | - Vera Yakovchenko
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Monica Merante
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Sandra Gibson
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carolyn Lamorte
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Gyorgy Baffy
- Section of Gastroenterology, Department of Medicine, VA Boston Healthcare System, Boston, MA, USA
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - George N Ioannou
- VA Puget Sound Health Care System, Seattle, WA, USA
- University of Washington, Seattle, WA, USA
| | - Tamar H Taddei
- VA Connecticut Healthcare System, West Haven, CT, USA
- Yale University, New Haven, CT, USA
| | | | - Jennifer Anwar
- VA Long Beach Healthcare System, Long Beach, CA, USA
- National Gastroenterology and Hepatology Program, Department of Veterans Affairs, Veterans Health Administration, Washington, DC, USA
| | - Jason A Dominitz
- National Gastroenterology and Hepatology Program, Department of Veterans Affairs, Veterans Health Administration, Washington, DC, USA
- VA Puget Sound Health Care System, Seattle, WA, USA
- University of Washington, Seattle, WA, USA
| | - Shari S Rogal
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Building 30 Room 2A113, University Drive (151C), Pittsburgh, PA, 15240, USA.
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Scott D, Bruinvels G, Norris D, Lovell R. The Dose-Response in Elite Soccer: Preliminary Insights From Menstrual-Cycle Tracking During the FIFA Women's World Cup 2019. Int J Sports Physiol Perform 2024; 19:331-339. [PMID: 38198788 DOI: 10.1123/ijspp.2022-0282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/27/2023] [Accepted: 11/26/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE This preliminary study examined the influence of estimated menstrual-cycle (MC) phase on responses to soccer matches and training sessions in preparation for and during the FIFA (Fédération internationale de football association) Women's World Cup 2019. METHODS Twenty outfield players representing a national team were tracked over a 45-day period. External (10-Hz global positioning system; total and distance covered at high-metabolic power [≥20 W·kg-1]) and internal load measures (minutes ≥80% heart-rate maximum, sessional ratings of perceived exertion) were collected during all training and matches, with single-item wellness measures (fatigue, soreness, sleep quality, and sleep duration) collected each morning prior to activity. MC phase was estimated individually via an algorithm, informed from pretournament survey responses and ongoing symptom reporting (FitrWoman). Model comparison statistics were used to determine the impact of estimated MC phase in nonhormonal contraceptive users (n = 16). RESULTS Sessional rating of perceived exertion responses to total distances ≥5 km were higher during the luteal phase (+0.6-1.0 au; P ≤ .0178) versus menstruation (phase 1), but no other observable dose-response trends were observed. Sleep, fatigue, and soreness ratings were not typically associated with MC phase, with the exception of exacerbated fatigue ratings in luteal versus follicular phase 48 hours postmatch (-0.73 au, P = .0275). CONCLUSIONS Preliminary findings suggest that estimated MC phase may contribute to the understanding of the dose-response to soccer training and matches.
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Affiliation(s)
- Dawn Scott
- Performance, Medical & Innovation Department, Washington Spirit Soccer Club, Washington, DC, USA
- School of Health Sciences, Western Sydney University, Penrith, Australia
| | - Georgie Bruinvels
- Orreco Ltd, Galway, Ireland
- University College London, London, United Kingdom
- St Mary's University, London, United Kingdom
| | - Dean Norris
- School of Health Sciences, Western Sydney University, Penrith, Australia
| | - Ric Lovell
- School of Health Sciences, Western Sydney University, Penrith, Australia
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia
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Oester C, Norris D, Scott D, Pedlar C, Bruinvels G, Lovell R. Inconsistencies in the perceived impact of the menstrual cycle on sport performance and in the prevalence of menstrual cycle symptoms: A scoping review of the literature. J Sci Med Sport 2024:S1440-2440(24)00077-X. [PMID: 38508888 DOI: 10.1016/j.jsams.2024.02.012] [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: 11/26/2023] [Revised: 02/16/2024] [Accepted: 02/29/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVES This scoping review aimed to summarize the findings of studies regarding the perceived impact of the menstrual cycle on athletic performance, as well as the prevalence of negative menstrual cycle symptoms. DESIGN Scoping review. METHODS Three databases were searched and the Preferred Reporting Items for Systematic reviews and Meta Analyses extension for Scoping Reviews (PRISMA-ScR) was used as guidance. RESULTS A total of 39 studies were included in the final analysis. Between 2.8 and 100 % of athletes reported their performance being negatively impacted by their menstrual cycle, and the main reason was the occurrence of menstrual cycle symptoms. Additionally, a large variability in the prevalence of menstrual cycle symptoms was reported in the different studies mainly due to methodological differences and recall biases. CONCLUSIONS Similarly, as to what has been reported in reviews summarizing performance outcomes during different menstrual cycle phases, this review highlights the high degree of variability between how athletes perceive to be impacted by their menstrual/hormonal contraceptive cycle. REGISTRATION The protocol of this scoping review was registered at the Open Science Framework on 14 September 2023 (osf.io/efu9x).
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Affiliation(s)
- Chelsea Oester
- Western Sydney University, School of Health Sciences, Australia.
| | - Dean Norris
- Western Sydney University, School of Health Sciences, Australia. https://twitter.com/DNorrisSC
| | - Dawn Scott
- Washington Spirit, USA. https://twitter.com/DawnScott06
| | - Charles Pedlar
- St Mary's University, Faculty of Sport, Health and Applied Science, United Kingdom; National University of Ireland, Orreco Business Innovation Unit, Ireland; University College of London, Institute of Sport, Exercise and Health, United Kingdom. https://twitter.com/PedlarCR
| | - Georgie Bruinvels
- St Mary's University, Faculty of Sport, Health and Applied Science, United Kingdom; National University of Ireland, Orreco Business Innovation Unit, Ireland; University College of London, Institute of Sport, Exercise and Health, United Kingdom. https://twitter.com/GBruinvels
| | - Ric Lovell
- Western Sydney University, School of Health Sciences, Australia; University of Wollongong, Faculty of Science, Medicine and Health, Australia. https://twitter.com/Ric_Lovell
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Yakovchenko V, Rogal SS, Goodrich DE, Lamorte C, Neely B, Merante M, Gibson S, Scott D, McCurdy H, Nobbe A, Morgan TR, Chinman MJ. Getting to implementation: Adaptation of an implementation playbook. Front Public Health 2023; 10:980958. [PMID: 36684876 PMCID: PMC9853037 DOI: 10.3389/fpubh.2022.980958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 12/12/2022] [Indexed: 01/09/2023] Open
Abstract
Introduction Implementation strategies supporting the translation of evidence into practice need to be tailored and adapted for maximum effectiveness, yet the field of adapting implementation strategies remains nascent. We aimed to adapt "Getting To Outcomes"® (GTO), a 10-step implementation playbook designed to help community-based organizations plan and evaluate behavioral health programs, into "Getting To Implementation" (GTI) to support the selection, tailoring, and use of implementation strategies in health care settings. Methods Our embedded evaluation team partnered with operations, external facilitators, and site implementers to employ participatory methods to co-design and adapt GTO for Veterans Health Administration (VA) outpatient cirrhosis care improvement. The Framework for Reporting Adaptations and Modifications to Evidenced-based Implementation Strategies (FRAME-IS) guided documentation and analysis of changes made pre- and post-implementation of GTI at 12 VA medical centers. Data from multiple sources (interviews, observation, content analysis, and fidelity tracking) were triangulated and analyzed using rapid techniques over a 3-year period. Results Adaptations during pre-implementation were planned, proactive, and focused on context and content to improve acceptability, appropriateness, and feasibility of the GTI playbook. Modifications during and after implementation were unplanned and reactive, concentrating on adoption, fidelity, and sustainability. All changes were collaboratively developed, fidelity consistent at the level of the facilitator and/or implementer. Conclusion GTO was initially adapted to GTI to support health care teams' selection and use of implementation strategies for improving guideline-concordant medical care. GTI required ongoing modification, particularly in steps regarding team building, context assessment, strategy selection, and sustainability due to difficulties with step clarity and progression. This work also highlights the challenges in pragmatic approaches to collecting and synthesizing implementation, fidelity, and adaptation data. Trial registration This study was registered on ClinicalTrials.gov (Identifier: NCT04178096).
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Affiliation(s)
- Vera Yakovchenko
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, United States
| | - Shari S. Rogal
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, United States
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - David E. Goodrich
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, United States
| | - Carolyn Lamorte
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, United States
| | - Brittney Neely
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, United States
| | - Monica Merante
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, United States
| | - Sandra Gibson
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, United States
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Dawn Scott
- Department of Medicine, Central Texas Veterans Healthcare System, Temple, TX, United States
| | - Heather McCurdy
- VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - Anna Nobbe
- Digestive Disease Section, Cincinnati VA Medical Center, Cincinnati, OH, United States
| | - Timothy R. Morgan
- Gastroenterology Section, VA Long Beach Healthcare System, Long Beach, CA, United States
- Division of Gastroenterology, Department of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Matthew J. Chinman
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, United States
- RAND Corporation, Pittsburgh, PA, United States
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Yakovchenko V, Morgan TR, Miech EJ, Neely B, Lamorte C, Gibson S, Beste LA, McCurdy H, Scott D, Gonzalez R, Park A, Powell BJ, Bajaj JS, Dominitz JA, Chartier M, Ross D, Chinman MJ, Rogal SS. Core implementation strategies for improving cirrhosis care in the Veterans Health Administration. Hepatology 2022; 76:404-417. [PMID: 35124820 PMCID: PMC9288973 DOI: 10.1002/hep.32395] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIMS The Veterans Health Administration (VHA) provides care for more than 80,000 veterans with cirrhosis. This longitudinal, multimethod evaluation of a cirrhosis care quality improvement program aimed to (1) identify implementation strategies associated with evidence-based, guideline-concordant cirrhosis care over time, and (2) use qualitative interviews to operationalize strategies for a manualized intervention. APPROACH AND RESULTS VHA providers were surveyed annually about the use of 73 implementation strategies to improve cirrhosis care in fiscal years 2018 (FY18) and 2019 (FY19). Implementation strategies linked to guideline-concordant cirrhosis care were identified using bivariate statistics and comparative configurational methods. Semistructured interviews were conducted with 12 facilities in the highest quartile of cirrhosis care to specify the successful implementation strategies and their mechanisms of change. A total of 106 VHA facilities (82%) responded at least once over the 2-year period (FY18, n = 63; FY19, n = 100). Facilities reported using a median of 12 (interquartile range [IQR] 20) implementation strategies in FY18 and 10 (IQR 19) in FY19. Of the 73 strategies, 35 (48%) were positively correlated with provision of evidence-based cirrhosis care. Configurational analysis identified multiple strategy pathways directly linked to more guideline-concordant cirrhosis care. Across both methods, a subset of eight strategies was determined to be core to cirrhosis care improvement and specified using qualitative interviews. CONCLUSIONS In a national cirrhosis care improvement initiative, a multimethod approach identified a core subset of successful implementation strategy combinations. This process of empirically identifying and specifying implementation strategies may be applicable to other implementation challenges in hepatology.
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Affiliation(s)
- Vera Yakovchenko
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA
| | - Timothy R. Morgan
- Gastroenterology Section, VA Long Beach Healthcare System, Long Beach, CA,Division of Gastroenterology, Department of Medicine, University of California, Irvine, CA
| | - Edward J. Miech
- Department of Veterans Affairs, Roudebush VA Medical Center, HSR&D Center for Health Information & Communication, VA PRIS-M QUERI, Indianapolis, IN,Regenstrief Institute, Indianapolis, IN
| | - Brittney Neely
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA
| | - Carolyn Lamorte
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA
| | - Sandra Gibson
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA,Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Lauren A. Beste
- Division of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA,General Medicine Service, VA Puget Sound Health Care System, Seattle, WA
| | | | - Dawn Scott
- Department of Medicine, Central Texas Veterans Healthcare System, Temple, TX
| | - Rachel Gonzalez
- Department of Veterans Affairs, Sierra Pacific Veterans Integrated Service Network, Pharmacy Benefits Management, Mather, CA
| | - Angela Park
- Office of Healthcare Transformation, Department of Veterans Affairs, Washington, DC
| | - Byron J. Powell
- Brown School, Washington University in St. Louis, St. Louis, MO
| | - Jasmohan S. Bajaj
- Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University, Richmond, VA,Division of Gastroenterology, Central Virginia Veterans Affairs Healthcare System, Richmond, VA
| | - Jason A. Dominitz
- Gastroenterology Section, Veterans Affairs Puget Sound Health Care System, Seattle, WA,Division of Gastroenterology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Maggie Chartier
- HIV, Hepatitis, and Related Conditions Programs, Office of Specialty Care Services, Veterans Health Administration, Washington, DC
| | - David Ross
- HIV, Hepatitis, and Related Conditions Programs, Office of Specialty Care Services, Veterans Health Administration, Washington, DC
| | - Matthew J. Chinman
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA,RAND Corporation, Pittsburgh, PA
| | - Shari S. Rogal
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA,Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA,Department of Surgery, University of Pittsburgh, Pittsburgh, PA
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Pan F, Tian J, Cervo M, Scott D, Cicuttini F, Jones G. POS1116 DIETARY INFLAMMATORY INDEX AND KNEE STRUCTURES ON MRI AND PAIN: A PROSPECTIVE COHORT STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1920] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundWhile some individual dietary nutrients/components have been shown to be associated with knee osteoarthritis (OA) progression, the associations of the dietary inflammatory index (DII), which reflects the overall inflammatory potential of a diet, with MRI-detected structural changes and pain have not been investigated.ObjectivesThis longitudinal study aimed to determine whether DII scores are associated with knee structural changes and pain over a 10.7-year follow-up in community-dwelling older adults.MethodsThis study utilised the data from a prospective population-based cohort study (mean age 63 years, 51% women) in which 1,099, 875, 768 and 563 participants completed assessments at baseline, 2.6, 5.1 and 10.7 years, respectively. T1-weighted or T2-weighted MRI of the right knee was performed to measure cartilage volume (CV) and bone marrow lesions (BMLs) at baseline and 10.7 years. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain questionnaire was used to measure knee pain at all assessments. Baseline energy-adjusted DII (E-DII) scores were calculated using a validated Food Frequency Questionnaire. X-ray was performed to assess radiographic knee osteoarthritis (ROA). Linear, log-binomial regression and linear mixed-effects modelling with adjustments for covariates were used to examine the associations of E-DII with CV loss, BML size increase and knee pain, respectively. Pain trajectories (i.e., ‘Minimal Pain’, ‘Mild Pain’, and ‘Moderate Pain’) were previously identified in this cohort using group-based trajectory modelling [1]. Multi-nominal logistic regression was used to examine the association between E-DII and pain trajectory groups.ResultsThe mean E-DII at baseline was -0.48±1.39. In multivariable analyses, E-DII score was not associated with tibial CV loss and BML size increase [CV loss: β=0.03% per annum, 95%CI -0.01–0.06; BML size increase: relative risk (RR)=0.94, 95%CI 0.84–1.05;]. Higher E-DII was associated with greater pain score over 10.7 years (β=0.21, 95%CI 0.004-0.43) and an increased risk of belonging to ‘Moderate pain’ as compared to ‘Minimal Pain’ trajectory group [relative risk ratio (RRR): 1.19, 95%CI 1.02-1.39] after adjustment for age, body mass index, physical activity, education level, employment, emotional problems, comorbidities, and ROA.ConclusionHigher DII was associated with greater pain score and higher risk of more severe pain trajectory, but not structural changes, suggesting discordance between effects of diet on structural damage and pain, and that targeting pro-inflammatory diets may be beneficial to reduce pain.References[1]Pan F, Tian J, Aitken D, Cicuttini F, Jones G. Predictors of pain severity trajectory in older adults: a 10.7-year follow-up study. Osteoarthritis Cartilage. 2018;26(12):1619-26.Disclosure of InterestsNone declared
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Jafri L, Naureen G, Brennan-Olsen S, Scott D, Habib A. M298 Vitamin D deficiency a possible precursor to sarcopenia in young adult females: A cross sectional study from Karachi, Pakistan. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.382] [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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Diego-Palazuelos P, Eskilt JR, Minami Y, Tristram M, Sullivan RM, Banday AJ, Barreiro RB, Eriksen HK, Górski KM, Keskitalo R, Komatsu E, Martínez-González E, Scott D, Vielva P, Wehus IK. Cosmic Birefringence from the Planck Data Release 4. Phys Rev Lett 2022; 128:091302. [PMID: 35302802 DOI: 10.1103/physrevlett.128.091302] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/27/2021] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
We search for the signature of parity-violating physics in the cosmic microwave background, called cosmic birefringence, using the Planck data release 4. We initially find a birefringence angle of β=0.30°±0.11° (68% C.L.) for nearly full-sky data. The values of β decrease as we enlarge the Galactic mask, which can be interpreted as the effect of polarized foreground emission. Two independent ways to model this effect are used to mitigate the systematic impact on β for different sky fractions. We choose not to assign cosmological significance to the measured value of β until we improve our knowledge of the foreground polarization.
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Affiliation(s)
- P Diego-Palazuelos
- Instituto de Física de Cantabria (CSIC-Universidad de Cantabria), Avenida de los Castros s/n, E-39005 Santander, Spain
- Departamento de Física Moderna, Universidad de Cantabria, Avenida de los Castros s/n, E-39005 Santander, Spain
| | - J R Eskilt
- Institute of Theoretical Astrophysics, University of Oslo, Blindern, N-0315 Oslo, Norway
| | - Y Minami
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - M Tristram
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - R M Sullivan
- Department of Physics & Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, British Columbia, Canada
| | - A J Banday
- Université de Toulouse, UPS-OMP, IRAP, F-31028 Toulouse cedex 4, France
- CNRS, IRAP, 9 Avenue colonel Roche, BP 44346, F-31028 Toulouse cedex 4, France
| | - R B Barreiro
- Instituto de Física de Cantabria (CSIC-Universidad de Cantabria), Avenida de los Castros s/n, E-39005 Santander, Spain
| | - H K Eriksen
- Institute of Theoretical Astrophysics, University of Oslo, Blindern, N-0315 Oslo, Norway
| | - K M Górski
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
- Warsaw University Observatory, Aleje Ujazdowskie 4, 00-478 Warszawa, Poland
| | - R Keskitalo
- Computational Cosmology Center, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Space Sciences Laboratory, University of California, Berkeley, California 94720, USA
| | - E Komatsu
- Max Planck Institute for Astrophysics, Karl-Schwarzschild-Strasse 1, D-85748 Garching, Germany
- Kavli Institute for the Physics and Mathematics of the Universe (Kavli IPMU, WPI), Todai Institutes for Advanced Study, The University of Tokyo, Kashiwa 277-8583, Japan
| | - E Martínez-González
- Instituto de Física de Cantabria (CSIC-Universidad de Cantabria), Avenida de los Castros s/n, E-39005 Santander, Spain
| | - D Scott
- Department of Physics & Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, British Columbia, Canada
| | - P Vielva
- Instituto de Física de Cantabria (CSIC-Universidad de Cantabria), Avenida de los Castros s/n, E-39005 Santander, Spain
| | - I K Wehus
- Institute of Theoretical Astrophysics, University of Oslo, Blindern, N-0315 Oslo, Norway
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Daly RM, Iuliano S, Fyfe JJ, Scott D, Kirk B, Thompson MQ, Dent E, Fetterplace K, Wright ORL, Lynch GS, Zanker J, Yu S, Kurrle S, Visvanathan R, Maier AB. Screening, Diagnosis and Management of Sarcopenia and Frailty in Hospitalized Older Adults: Recommendations from the Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) Expert Working Group. J Nutr Health Aging 2022; 26:637-651. [PMID: 35718874 DOI: 10.1007/s12603-022-1801-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Sarcopenia and frailty are highly prevalent conditions in older hospitalized patients, which are associated with a myriad of adverse clinical outcomes. This paper, prepared by a multidisciplinary expert working group from the Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR), provides an up-to-date overview of current evidence and recommendations based on a narrative review of the literature for the screening, diagnosis, and management of sarcopenia and frailty in older patients within the hospital setting. It also includes suggestions on potential pathways to implement change to encourage widespread adoption of these evidence-informed recommendations within hospital settings. The expert working group concluded there was insufficient evidence to support any specific screening tool for sarcopenia and recommends an assessment of probable sarcopenia/sarcopenia using established criteria for all older (≥65 years) hospitalized patients or in younger patients with conditions (e.g., comorbidities) that may increase their risk of sarcopenia. Diagnosis of probable sarcopenia should be based on an assessment of low muscle strength (grip strength or five times sit-to-stand) with sarcopenia diagnosis including low muscle mass quantified from dual energy X-ray absorptiometry, bioelectrical impedance analysis or in the absence of diagnostic devices, calf circumference as a proxy measure. Severe sarcopenia is represented by the addition of impaired physical performance (slow gait speed). All patients with probable sarcopenia or sarcopenia should be investigated for causes (e.g., chronic/acute disease or malnutrition), and treated accordingly. For frailty, it is recommended that all hospitalized patients aged 70 years and older be screened using a validated tool [Clinical Frailty Scale (CFS), Hospital Frailty Risk Score, the FRAIL scale or the Frailty Index]. Patients screened as positive for frailty should undergo further clinical assessment using the Frailty Phenotype, Frailty Index or information collected from a Comprehensive Geriatric Assessment (CGA). All patients identified as frail should receive follow up by a health practitioner(s) for an individualized care plan. To treat older hospitalized patients with probable sarcopenia, sarcopenia, or frailty, it is recommended that a structured and supervised multi-component exercise program incorporating elements of resistance (muscle strengthening), challenging balance, and functional mobility training be prescribed as early as possible combined with nutritional support to optimize energy and protein intake and correct any deficiencies. There is insufficient evidence to recommend pharmacological agents for the treatment of sarcopenia or frailty. Finally, to facilitate integration of these recommendations into hospital settings organization-wide approaches are needed, with the Spread and Sustain framework recommended to facilitate organizational culture change, with the help of 'champions' to drive these changes. A multidisciplinary team approach incorporating awareness and education initiatives for healthcare professionals is recommended to ensure that screening, diagnosis and management approaches for sarcopenia and frailty are embedded and sustained within hospital settings. Finally, patients and caregivers' education should be integrated into the care pathway to facilitate adherence to prescribed management approaches for sarcopenia and frailty.
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Affiliation(s)
- R M Daly
- Professor Robin M. Daly, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Melbourne, Victoria, Australia 3125, Phone: +61 3 9244 6040, , ORCID ID: 0000-0002-9897-1598
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10
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Jansons P, Dalla Via J, Daly RM, Fyfe JJ, Gvozdenko E, Scott D. Delivery of Home-Based Exercise Interventions in Older Adults Facilitated by Amazon Alexa: A 12-week Feasibility Trial. J Nutr Health Aging 2022; 26:96-102. [PMID: 35067710 DOI: 10.1007/s12603-021-1717-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To evaluate the feasibility of using voice-controlled intelligent personal assistants (VIPAs) to remotely deliver and monitor an individually-tailored, home-based exercise program to older adults living independently and alone. DESIGN 12-week, prospective single-arm feasibility study. SETTING Community residences. PARTICIPANTS 15 adults aged 60 to 89 years living alone. INTERVENTION All participants were prescribed home-based muscle strengthening, weight-bearing impact and balance exercises, increasing from two to four 10-minute sessions per day over 12 weeks. Sessions were delivered using VIPAs (Amazon Alexa Echo Show 5; "Alexa") and a novel software program ("Buddy Link"). The program was individualized by an exercise physiologist based on participant voice responses to Alexa questions. MEASUREMENTS Study outcomes were feasibility (rate of retention, adherence, and adverse events), usability (System Usability Scale) and changes to quality of life (European Quality of Life Scale), and lower-extremity function (30 second sit-to-stand test). RESULTS All 15 participants (mean age, 70.3 years) completed the study (retention 100%). Mean adherence to the exercise program was 115% (i.e., collectively all participants were prescribed 8640 exercises but completed 9944 exercises) with no adverse events reported to be related to the intervention and usability scored as above average (75/100). Other outcomes did not significantly change across the 12-week follow-up (all P>0.05). CONCLUSIONS In this feasibility study of community-dwelling older adults living alone, a home-based exercise program delivered and monitored remotely by an exercise physiologist using VIPAs was safe and feasible.
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Affiliation(s)
- P Jansons
- Dr Paul Jansons, PhD, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia, Tel: + 61 402283624, E-mail:
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11
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Urban R, Chow R, Pickles T, Chan M, Livergant J, Gerrie A, Freeman C, Sehn L, Scott D, Villa D, Savage K, Slack G, Lo A. The Impact of Surveillance Imaging After Curative Intent Radiotherapy for Limited Stage Follicular Lymphoma. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Ellison C, Moreno T, Catchpole O, Fenton T, Lagutin K, MacKenzie A, Mitchell K, Scott D. Extraction of hemp seed using near-critical CO2, propane and dimethyl ether. J Supercrit Fluids 2021. [DOI: 10.1016/j.supflu.2021.105218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Seshadri MR, Fontán L, Scott D, Hatcher J, Sreevatsan P, Du G, Qiao Q, Wu H, Us I, Xia M, Gray N, Melnick A. MALT1 DEGRADATION FOR THE TREATMENT OF ACTIVATED B‐CELL TYPE DIFFUSE LARGE B‐CELL LYMPHOMA. Hematol Oncol 2021. [DOI: 10.1002/hon.12_2879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- M. R Seshadri
- Weill Cornell Medicine Department of Medicine Division of Hematology and Oncology New York New York USA
| | - L Fontán
- Weill Cornell Medicine Department of Medicine Division of Hematology and Oncology New York New York USA
| | - D Scott
- Dana Farber Cancer Institute Harvard Medical School Department of Biological Chemistry and Molecular Pharmacology Boston Massachusetts USA
| | - J Hatcher
- Dana Farber Cancer Institute Harvard Medical School Department of Biological Chemistry and Molecular Pharmacology Boston Massachusetts USA
| | - P Sreevatsan
- Dana Farber Cancer Institute Harvard Medical School Department of Biological Chemistry and Molecular Pharmacology Boston Massachusetts USA
| | - G Du
- Dana Farber Cancer Institute Harvard Medical School Department of Biological Chemistry and Molecular Pharmacology Boston Massachusetts USA
| | - Q Qiao
- Boston Children's Hospital Harvard Medical School Program in Cellular and Molecular Medicine Boston Massachusetts USA
| | - H Wu
- Boston Children's Hospital Harvard Medical School Program in Cellular and Molecular Medicine Boston Massachusetts USA
| | - I Us
- Weill Cornell Medicine Department of Medicine Division of Hematology and Oncology New York New York USA
| | - M Xia
- Weill Cornell Medicine Department of Medicine Division of Hematology and Oncology New York New York USA
| | - N Gray
- Stanford University Department of Chemical and Systems Biology Stanford California USA
| | - A Melnick
- Weill Cornell Medicine Department of Medicine Division of Hematology and Oncology New York New York USA
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Chahal M, Jiang A, Hayden A, Savage K, Villa D, Scott D, Gerrie A, Lo A, Chan M, Pickles T, Connors J, Sehn L, Freeman C. OUTCOMES AFTER INITIAL REFUSAL OF CURATIVE TREATMENT IN PATIENTS WITH HODGKIN LYMPHOMA IN BRITISH COLUMBIA. Hematol Oncol 2021. [DOI: 10.1002/hon.112_2880] [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: 11/06/2022]
Affiliation(s)
- M. Chahal
- BC Cancer, Medical Oncology Vancouver Canada
| | - A. Jiang
- British Columbia Cancer Research Centre Biostatistics Vancouver Canada
| | - A. Hayden
- BC Cancer Medical Oncology Surrey Canada
| | - K. Savage
- BC Cancer Centre for Lymphoid Cancer and Division of Medical Oncology Vancouver Canada
| | - D. Villa
- BC Cancer Centre for Lymphoid Cancer and Division of Medical Oncology Vancouver Canada
| | - D. Scott
- BC Cancer Centre for Lymphoid Cancer and Division of Medical Oncology Vancouver Canada
| | - A. Gerrie
- BC Cancer Centre for Lymphoid Cancer and Division of Medical Oncology Vancouver Canada
| | - A. Lo
- BC Cancer Division of Radiation Oncology Vancouver Canada
| | - M. Chan
- BC Cancer Division of Radiation Oncology Vancouver Canada
| | - T. Pickles
- BC Cancer Division of Radiation Oncology Vancouver Canada
| | - J. Connors
- BC Cancer Centre for Lymphoid Cancer and Division of Medical Oncology Vancouver Canada
| | - L. Sehn
- BC Cancer Centre for Lymphoid Cancer and Division of Medical Oncology Vancouver Canada
| | - C. Freeman
- BC Cancer Centre for Lymphoid Cancer and Division of Medical Oncology Vancouver Canada
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Rogal SS, Yakovchenko V, Gonzalez R, Park A, Beste LA, Rozenberg-Ben-Dror K, Bajaj JS, Scott D, McCurdy H, Comstock E, Sidorovic M, Gibson S, Lamorte C, Nobbe A, Chartier M, Ross D, Dominitz JA, Morgan TR. The Hepatic Innovation Team Collaborative: A Successful Population-Based Approach to Hepatocellular Carcinoma Surveillance. Cancers (Basel) 2021; 13:cancers13092251. [PMID: 34067177 PMCID: PMC8125814 DOI: 10.3390/cancers13092251] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/24/2021] [Accepted: 04/26/2021] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Liver cancer is a growing problem that largely impacts people with cirrhosis. This article describes the Veterans Health Administration’s national cirrhosis quality improvement program and its focus on early detection of liver cancer. Abstract After implementing a successful hepatitis C elimination program, the Veterans Health Administration’s (VHA) Hepatic Innovation Team (HIT) Collaborative pivoted to focus on improving cirrhosis care. This national program developed teams of providers across the country and engaged them in using systems redesign methods and population health approaches to improve care. The HIT Collaborative developed an Advanced Liver Disease (ALD) Dashboard to identify Veterans with cirrhosis who were due for surveillance for hepatocellular carcinoma (HCC) and other liver care, promoted the use of an HCC Clinical Reminder in the electronic health record, and provided training and networking opportunities. This evaluation aimed to describe the VHA’s approach to improving cirrhosis care and identify the facility factors and HIT activities associated with HCC surveillance rates, using a quasi-experimental design. Across all VHA facilities, as the HIT focused on cirrhosis between 2018–2019, HCC surveillance rates increased from 46% (IQR 37–53%) to 51% (IQR 42–60%, p < 0.001). The median HCC surveillance rate was 57% in facilities with high ALD Dashboard utilization compared with 45% in facilities with lower utilization (p < 0.001) and 58% in facilities using the HCC Clinical Reminder compared with 47% in facilities not using this tool (p < 0.001) in FY19. Increased use of the ALD Dashboard and adoption of the HCC Clinical Reminder were independently, significantly associated with HCC surveillance rates in multivariate models, controlling for other facility characteristics. In conclusion, the VHA’s HIT Collaborative is a national healthcare initiative associated with significant improvement in HCC surveillance rates.
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Affiliation(s)
- Shari S. Rogal
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, University Drive (151C), Pittsburgh, PA 15240, USA; (S.G.); (C.L.)
- Departments of Medicine and Surgery, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA 15240, USA
- Correspondence: ; Tel.: +1-412-360-6177
| | - Vera Yakovchenko
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, 200 Springs Road (152), Building 70, Bedford, MA 01730, USA;
| | - Rachel Gonzalez
- Department of Veterans Affairs, Sierra Pacific Veterans Integrated Service Network, Pharmacy Benefits Management, Mather, CA 94523, USA;
| | - Angela Park
- Office of Healthcare Transformation, Department of Veterans Affairs, 810 Vermont Avenue, Washington, DC 20420, USA;
| | - Lauren A. Beste
- Division of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195, USA;
- General Medicine Service, VA Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA 98108, USA
| | - Karine Rozenberg-Ben-Dror
- Veteran Affairs Great Lakes Health Care System, VISN 12 PBM, 11301 W Cermak Road, Ste 810, Westchester, IL 60154, USA;
| | - Jasmohan S. Bajaj
- Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 14th Floor, Box 980341, Richmond, VA 23298, USA;
- Division of Gastroenterology, Central Virginia Veterans Affairs Healthcare System, 1201 Broad Rock Blvd, Richmond, VA 23249, USA
| | - Dawn Scott
- Department of Medicine, Central Texas Veterans Healthcare System, 1901 Veterans Memorial Drive, Temple, TX 76504, USA;
| | - Heather McCurdy
- VA Ann Arbor Healthcare System, 2215 Fuller Rd, Ann Arbor, MI 48105, USA;
| | - Emily Comstock
- Department of Infectious Diseases, Baltimore VA Medical Center, 10 N Greene Street, Baltimore, MD 21201, USA;
| | - Michael Sidorovic
- Salisbury VA Medical Center, 1601 Brenner Avenue, Salisbury, NC 28144, USA;
| | - Sandra Gibson
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, University Drive (151C), Pittsburgh, PA 15240, USA; (S.G.); (C.L.)
| | - Carolyn Lamorte
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, University Drive (151C), Pittsburgh, PA 15240, USA; (S.G.); (C.L.)
| | - Anna Nobbe
- Digestive Disease Section, Cincinnati VA Medical Center, 3200 Vine Street, Cincinnati, OH 45220, USA;
| | - Maggie Chartier
- HIV, Hepatitis, and Related Conditions, Office of Specialty Care Services (10P11I), Department of Veterans Affairs, 810 Vermont Avenue, Washington, DC 20420, USA; (M.C.); (D.R.)
| | - David Ross
- HIV, Hepatitis, and Related Conditions, Office of Specialty Care Services (10P11I), Department of Veterans Affairs, 810 Vermont Avenue, Washington, DC 20420, USA; (M.C.); (D.R.)
| | - Jason A. Dominitz
- Gastroenterology Section, Veterans Affairs Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA 98108, USA;
- Division of Gastroenterology, Department of Medicine, RR-512, Health Sciences Building, University of Washington School of Medicine, Box 356420, 1959 NE Pacific Street, Seattle, WA 98195, USA
| | - Timothy R. Morgan
- Gastroenterology Section, VA Long Beach Healthcare System, 5901 E 7th Street, Long Beach, CA 90822, USA;
- Division of Gastroenterology, Department of Medicine, University of California, 333 City Blvd. West, Suite 400, Orange, CA 92868, USA
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Ng CA, McMillan LB, Humbert L, Ebeling PR, Scott D. Feasibility, safety and effectiveness of a pilot 16-week home-based, impact exercise intervention in postmenopausal women with low bone mineral density. Osteoporos Int 2021; 32:893-905. [PMID: 33159533 DOI: 10.1007/s00198-020-05723-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/29/2020] [Indexed: 12/01/2022]
Abstract
UNLABELLED The feasibility and efficacy of home-based, impact exercise are unclear. This pilot impact exercise intervention was feasible and safe, and improved bone health and physical function in postmenopausal women with low bone density. Appropriately designed randomised controlled trials are now required to determine whether such interventions can reduce fracture risk. INTRODUCTION The feasibility and efficacy of impact exercise in postmenopausal women with low bone mineral density (BMD) are unclear. We aimed to determine adherence, safety and changes in BMD, bone microarchitecture and physical function following a pilot home-based, impact exercise intervention in postmenopausal women with low BMD. METHODS Fifty community-dwelling postmenopausal women with BMD T-scores < - 1.0 participated in 16 weeks of home-based impact exercise progressively increasing to 50 multi-directional unilateral hops on each leg daily. Bone density and structure were assessed by lumbar spine and hip dual-energy X-ray absorptiometry (DXA), 3D modelling (3D-SHAPER) of hip DXA scans and distal tibial high-resolution peripheral quantitative computed tomography scans. Physical performance was assessed by repeated chair stand time and stair climb time. RESULTS Forty-four women (mean ± SD age 64.5 ± 7.5 years) completed the intervention, with adherence of 85.3 ± 17.3%. Reasons for withdrawal were related soreness (n = 2), unrelated injury (n = 1) and loss of interest (n = 3). Femoral neck areal BMD increased by 1.13 ± 3.76% (p = 0.048). Trabecular volumetric BMD (vBMD) increased at the total hip (2.27 ± 7.03%; p = 0.038) and femoral neck increased (3.20 ± 5.39%; p < 0.001). Distal tibia total vBMD increased by 0.32 ± 0.88% (p = 0.032) and cortical cross-sectional area increased by 0.55 ± 1.54% (p = 0.034). Chair stand and stair climb time improved by 2.34 ± 1.88 s (p < 0.001) and 0.27 ± 0.49 s (p < 0.001), respectively. CONCLUSION A 16-week home-based, impact exercise was feasible and may be effective in improving femoral neck areal BMD, total hip and distal tibial vBMD and physical function in postmenopausal women. Appropriately designed randomised controlled trials are now required to determine whether such interventions can reduce fracture risk in older populations.
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Affiliation(s)
- C-A Ng
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
| | - L B McMillan
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - L Humbert
- Musculoskeletal Unit, Galgo Medical, Barcelona, Spain
| | - P R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - D Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- Department of Medicine at Western Health, The University of Melbourne, Sunshine, Victoria, Australia
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Ueno HM, MacKenzie A, Scott D, Higurashi S, Toba Y, Kobayashi T. Milk Phospholipid Profiling Among Japanese Women with Differing Docosahexaenoic Acid Levels. JPGN Rep 2021; 2:e058. [PMID: 37207066 PMCID: PMC10191534 DOI: 10.1097/pg9.0000000000000058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 01/27/2021] [Indexed: 05/21/2023]
Abstract
To characterize the milk phospholipids (PLs) profile using phosphorus-31 nuclear magnetic resonance (31P-NMR) and to investigate the effect of elevated milk docosahexaenoic acid (DHA) levels on PLs profiles in Japanese mothers. Methods Milk samples from eligible patients with high and low DHA from a former cross-sectional study (n = 20; n = 10 for each group) were included. Fifteen milk PLs were analyzed using 31P-NMR, and the profiles were compared group-wise using Mann-Whitney U-test. The P value of <0.05 was considered statistically significant. Results The median DHA content in milk was 1.13% and 0.29% for the high and low milk DHA groups, respectively. Twelve PLs, excluding lysophosphatidylserine, cardiolipin, and phosphatidylglycerol, were detected in all participants with 100% positive results. The median concentrations and proportions of total PLs, sphingophospholipids, and glycerophospholipids were comparable between groups. The proportions of choline-containing glycerophospholipid were significantly higher in the high milk DHA group than that in the low milk DHA group (24.09% [median, interquartile range: 23.08%-26.38%] and 21.41% [20.74%-22.84%], P = 0.019). Although the proportions of phosphatidylinositol were significantly lower in the high milk DHA group than that in the low milk DHA group (6.62% [5.75%-6.72%] versus 7.63% [7.11%-8.16%], P = 0.002), while that of phosphatidylcholine (21.90% [18.51%-23.22%] versus 19.78% [18.17%-20.26%], P = 0.059) and alkyl-acyl phosphatidylcholine (0.60% [0.40%-0.74%] versus 0.33% [0.14%-0.51%], P = 0.059) were higher in the former than that in the latter. Conclusions Our results were comparable to that of the previous literature. Large variations in the milk DHA might affect the composition of choline-containing glycerophospholipids in Japanese mothers. However, possible confounders were not excluded in the study populations.
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Affiliation(s)
- Hiroshi M. Ueno
- From the Research and Development Department, Bean Stalk Snow Co., Ltd., Kawagoe, Japan
| | | | - Dawn Scott
- Callaghan Innovation, Wellington, New Zealand
| | - Satoshi Higurashi
- From the Research and Development Department, Bean Stalk Snow Co., Ltd., Kawagoe, Japan
| | - Yasuhiro Toba
- From the Research and Development Department, Bean Stalk Snow Co., Ltd., Kawagoe, Japan
| | - Toshiya Kobayashi
- From the Research and Development Department, Bean Stalk Snow Co., Ltd., Kawagoe, Japan
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Yu DD, Rutty M, Scott D, Li S. A comparison of the holiday climate index:beach and the tourism climate index across coastal destinations in China. Int J Biometeorol 2021; 65:741-748. [PMID: 32761265 PMCID: PMC7406217 DOI: 10.1007/s00484-020-01979-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 06/11/2023]
Abstract
Climatic resources are vitally important for tourism, driving major intra- and inter-regional travel flows for sun-sand-surf (3S) tourism around the world. The development of climate indices to measure the suitability of climate for major tourism market segments has evolved over three decades. This study provides the first application of the holiday climate index (HCI):Beach specification in the Asia-Pacific tourism region. The HCI is designed from international tourist climate preference studies and is compared with the tourism climate index (TCI), which is widely applied, but not based on tourist climate preferences. The index inter-comparison is conducted at 14 of the most popular beach resort destinations in China, which include four geographic regions of China with four different Köppen classifications. The results show key differences between the two indices in rating the climatic suitability of the selected beach destinations in China, with the TCI rating beach destinations in the north and south higher during the spring and fall seasons, which is not consistent with beach tourism visits. During the summer months, southern destinations have much higher HCI:Beach rating, reflecting the 3S tourists' desire for higher temperatures. The findings reinforce those from other tourism regions that indicate the TCI is not appropriate for assessing 3S tourism potential and that additional cross-cultural studies of tourist climate indices are needed to better inform market segment climate service development and to understand the potential impacts of future climate change.
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Affiliation(s)
- D D Yu
- School of Geographic Sciences, East China Normal University, Shanghai, China.
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, Canada.
| | - M Rutty
- Faculty of Environment, University of Waterloo, Waterloo, Canada.
| | - D Scott
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, Canada.
| | - S Li
- School of Geographic Sciences, East China Normal University, Shanghai, China
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Hillerton JE, Bryan MA, Beattie BH, Scott D, Millar A, French N. Use of antimicrobials for food animals in New Zealand: updated estimates to identify a baseline to measure targeted reductions. N Z Vet J 2021; 69:180-185. [PMID: 33720815 DOI: 10.1080/00480169.2021.1890648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AIM To describe the use of antimicrobial drugs for food animals in New Zealand, based on sales data reported to government for 2005-2018, to provide a baseline to determine the success of measures to reduce antimicrobial use for food animals and to compare usage to selected European countries. METHODS Data were sourced from official government and industry reports to update previous estimates of use (as amount sold) of antimicrobial products applied to animals in New Zealand. The data included antimicrobial sales and animal populations, weighted where appropriate by breed and age class. Antimicrobial use was estimated based on the amount of active ingredient sold, per kg of animal biomass standardised to the probable weight at time of treatment or lifetime average but not slaughter weight (population correction unit; PCU). New Zealand data for 2017 and 2018 were adjusted to account only for antimicrobials used for farm animals by discounting horticulture use, companion animal use and export. RESULTS Between 2014 and 2018 the estimated usage of antimicrobials in animals flattened to a 5-year rolling average of 10.40 mg/PCU. New data on use for companion animals and on exports of zinc bacitracin and tylosin, included previously in the gross New Zealand values, allow a more refined estimate of use of antimicrobials in food animals of 10.21 mg/PCU in 2018, the third lowest rate of use for countries reporting by the same methodology. The intensive industries of pigs and poultry combined use more than 500 mg/PCU whereas the extensive red meat and dairy industries use an estimated 6.25 mg/PCU. New Zealand uses proportionally more cephalosporins and macrolides, two of the critically important antimicrobial groups, when compared with European countries, but less quinolones. The most obvious difference is the extensive use of zinc bacitracin and tylosin fed to pigs and poultry in New Zealand but not in the European Union. CONCLUSIONS Use of antimicrobials in food animals has stabilised to a rate of approximately 10.2 mg/PCU. This baseline should be used by the animal health industry to measure future success in its efforts to reduce and make more refined use of antimicrobial drugs as New Zealand works to deliver the government's Antimicrobial Resistance Action Plan. High rates of use of zinc bacitracin and some critically important macrolides represent clear targets in attempts to reduce usage.
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Affiliation(s)
| | | | - B H Beattie
- New Zealand Veterinary Association, Wellington, New Zealand
| | - D Scott
- Ethical Agents, Manukau City, Manukau, New Zealand
| | - A Millar
- Fonterra Co-operative Group Limited, Russley, Christchurch, New Zealand
| | - N French
- School of Veterinary Sciences, Massey University, Palmerston North, New Zealand
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Bruinvels G, Lewis NA, Blagrove RC, Scott D, Simpson RJ, Baggish AL, Rogers JP, Ackerman KE, Pedlar CR. COVID-19-Considerations for the Female Athlete. Front Sports Act Living 2021; 3:606799. [PMID: 33665612 PMCID: PMC7921484 DOI: 10.3389/fspor.2021.606799] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 09/18/2020] [Accepted: 01/22/2021] [Indexed: 01/10/2023] Open
Abstract
The SARS CoV-2 virus (COVID-19) caused the whole sporting calendar to be paused. As we embark on the challenge of navigating through the return to play (RTP) process, there is a necessity to consider the needs of all athletes. This commentary specifically considers recommendations and requirements for the female athlete with a physiological emphasis during and following the COVID-19 pandemic, however, it will be relevant for any similar future scenarios that may present. It is important to acknowledge that there remain many unknowns surrounding COVID-19 and the female athlete both in the short- and long-term.
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Affiliation(s)
- Georgie Bruinvels
- Faculty of Sport, Health and Applied Science, St Mary's University, Twickenham, United Kingdom.,Orreco Ltd., Unit 103, Business Innovation Centre, NUI Galway, Galway, Ireland
| | - Nathan A Lewis
- Faculty of Sport, Health and Applied Science, St Mary's University, Twickenham, United Kingdom.,Orreco Ltd., Unit 103, Business Innovation Centre, NUI Galway, Galway, Ireland
| | - Richard C Blagrove
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Dawn Scott
- School of Science and Health, University of Western Sydney, Penrith, NSW, Australia
| | - Richard J Simpson
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, United States.,Department of Pediatrics, University of Arizona, Tucson, AZ, United States.,Department of Immunobiology, University of Arizona, Tucson, AZ, United States
| | - Aaron L Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston, MA, United States
| | - John P Rogers
- Department of Sports Medicine, Manchester Institute of High Performance, Manchester, United Kingdom.,Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Kathryn E Ackerman
- Boston Children's Hospital and Harvard Medical School, Boston, MA, United States
| | - Charles R Pedlar
- Faculty of Sport, Health and Applied Science, St Mary's University, Twickenham, United Kingdom.,Orreco Ltd., Unit 103, Business Innovation Centre, NUI Galway, Galway, Ireland
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21
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McMurray AJ, Muenjohn N, Scott D. Measuring workplace innovation: Scale development. Journal of Small Business Management 2021. [DOI: 10.1080/00472778.2020.1844490] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- A. J. McMurray
- School of Management, College of Business and Law, RMIT University, Australia
| | - N. Muenjohn
- School of Management, College of Business and Law, RMIT University, Australia
| | - D. Scott
- School of Commerce and Management, Southern Cross University, Australia
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22
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Scott D, Hirani V, Waite LM, Blyth F, Le Couteur DG, Cumming R, Jones G. Letter to the Editor: 'Giant' Claims Require Strong Evidence: A Comment on 'Osteosarcopenia: A Geriatric Giant of the XXI Century'. J Nutr Health Aging 2021; 25:946-947. [PMID: 34409977 DOI: 10.1007/s12603-021-1659-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- D Scott
- Associate Professor David Scott, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia 3125, , Telephone: +61 3 9246 8438
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Naureen G, Sanders KM, Busija L, Scott D, Lim K, Talevski J, Connaughton C, Brennan-Olsen SL. Prediction models and questionnaires developed to predict vitamin D status in adults: a systematic review. Osteoporos Int 2020; 31:2287-2302. [PMID: 32662035 DOI: 10.1007/s00198-020-05539-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/07/2020] [Indexed: 12/18/2022]
Abstract
A systematic review of prediction models/questionnaires developed to identify people with deficient/insufficient vitamin D status shows the potential of self-reported information to estimate vitamin D status. The objective is to identify and compare existing screening tools, developed to identify vitamin D deficiency or insufficiency in adults. A systematic search of literature was conducted using MEDLINE, Scopus, Web of Science and CINAHL databases. Risk of bias and applicability concerns were assessed by quality assessment of diagnostic accuracy studies (QUADAS-2). Data were extracted on socio-demographic, anthropometric, risk factors, serum 25 hydroxyvitamin D [25(OH)D] levels, statistical methods and predictive ability. A total of 12 studies were considered for inclusion for this systematic review after screening of 4851 abstracts and 15 full-text articles. Ten of twelve studies developed prediction models and 2 studies developed questionnaires. The majority of studies had low risk of bias and applicability as assessed by QUADAS-2. All studies included only self-reported predictors of vitamin D status in their final models and development of scores. Sunlight exposure and related factors were important significant contributors to the predictive ability of the models and/or questionnaires. Sensitivity and specificity of the prediction models or questionnaires ranged from 55 to 91% and 35 to 84%, respectively. Six out of twelve studies converted final models to scores associated with vitamin D status. There was no evidence that any of these existing tools have been translated into clinical practice. The prediction models or questionnaires identified in this systematic review were moderately sensitive and specific for identifying people with vitamin D deficiency or insufficiency. The substantial contribution of sunlight exposure to the prediction of vitamin D status highlights the importance of including this information when developing vitamin D screening tools.
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Affiliation(s)
- G Naureen
- Level 3, Department of Medicine-Western Health, The University of Melbourne, 176 Furlong Road, St Albans, VIC, 3021, Australia.
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC, Australia.
| | - K M Sanders
- Level 3, Department of Medicine-Western Health, The University of Melbourne, 176 Furlong Road, St Albans, VIC, 3021, Australia
| | - L Busija
- School of Public Health and Preventive Medicine, Monash University, St Kilda, VIC, Australia
| | - D Scott
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC, Australia
- School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
| | - K Lim
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - J Talevski
- Level 3, Department of Medicine-Western Health, The University of Melbourne, 176 Furlong Road, St Albans, VIC, 3021, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC, Australia
| | - C Connaughton
- Level 3, Department of Medicine-Western Health, The University of Melbourne, 176 Furlong Road, St Albans, VIC, 3021, Australia
- Academic Centre for Health, Royal Women's Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - S L Brennan-Olsen
- Level 3, Department of Medicine-Western Health, The University of Melbourne, 176 Furlong Road, St Albans, VIC, 3021, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC, Australia
- School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
- Institute for Health Transformation, Deakin University, Melbourne, VIC, Australia
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Ludbrook G, Lloyd C, Story D, Maddern G, Riedel B, Richardson I, Scott D, Louise J, Edwards S. The effect of advanced recovery room care on postoperative outcomes in moderate-risk surgical patients: a multicentre feasibility study. Anaesthesia 2020; 76:480-488. [PMID: 33027534 DOI: 10.1111/anae.15260] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2020] [Indexed: 01/03/2023]
Abstract
Postoperative complications are common and may be under-recognised. It has been suggested that enhanced postoperative care in the recovery room may reduce in-hospital complications in moderate- and high-risk surgical patients. We investigated the feasibility of providing advanced recovery room care for 12-18 h postoperatively in the post-anaesthesia care unit. The primary hypothesis was that a clinical trial of advanced recovery room care was feasible. The secondary hypothesis was that this model may have a sustained impact on postoperative in-hospital and post-discharge events. This was a multicentre, prospective, feasibility before-and-after trial of moderate-risk patients (predicted 30-day mortality of 1-4%) undergoing non-cardiac surgery and who were scheduled for postoperative ward care. Patients were managed using defined assessment checklists and goals of care in an advanced recovery room care setting in the immediate postoperative period. This utilised existing post-anaesthesia care unit infrastructure and staffing, but extended care until the morning of the first postoperative day. The advanced recovery room care trial was deemed feasible, as defined by the recruitment and per protocol management of > 120 patients. However, in a specialised cancer centre, recruitment was slow due to low rates of eligibility according to narrow inclusion criteria. At a rural site, advanced recovery room care could not be commenced due to logistical issues in establishing a new model of care. A definitive randomised controlled trial of advanced recovery room care appears feasible and, based on the indicative data on outcomes, we believe this is warranted.
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Affiliation(s)
- G Ludbrook
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - C Lloyd
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - D Story
- Centre for Integrated Critical Care, University of Melbourne, Melbourne, Australia
| | - G Maddern
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - B Riedel
- Department of Anaesthetics, Peri-operative and Pain Medicine, the Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
| | - I Richardson
- Department of Anaesthetics, Peri-operative and Pain Medicine, the Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
| | - D Scott
- School of Medicine, Western Sydney University, Sydney, Australia
| | - J Louise
- Adelaide Health Technology Assessment, University of Adelaide, Adelaide, Australia
| | - S Edwards
- Adelaide Health Technology Assessment, University of Adelaide, Adelaide, Australia
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Scott D, Norris D, Lovell R. Dose-Response Relationship Between External Load and Wellness in Elite Women's Soccer Matches: Do Customized Velocity Thresholds Add Value? Int J Sports Physiol Perform 2020; 15:1245-1251. [PMID: 32887847 DOI: 10.1123/ijspp.2019-0660] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/11/2019] [Accepted: 12/16/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE To examine the dose-response relationship between match-play high-speed running (HSR), very high-speed running (VHSR), and sprint (SPR) distances versus subsequent ratings of fatigue and soreness. METHODS Thirty-six outfield players competing in the professional National Women's Soccer League (NWSL, United States) with a minimum of five 90-minute match observations were monitored during the 2016 and 2017 seasons (408 match observations, 11 [6]/player). HSR (≥3.47 m·s-1), VHSR (≥5.28 m·s-1), and SPR (≥6.25 m·s-1) were determined generically (GEN) in players using a 10-Hz global positioning system. HSR, VHSR, and SPR speed thresholds were also reconfigured according to player peak speed per se and in combination with the final velocity achieved in the 30:15 Intermittent Fitness Test (locomotor approach to establishing individual speed zones). On the morning following matches (match day [MD + 1]), players recorded subjective wellness ratings of fatigue and soreness using 7-point Likert scales. RESULTS Fatigue (-2.32; 95% CI, -2.60 to -2.03 au; P < .0001) and soreness (-2.05; 95% CI, -2.29 to -1.81; P < .0001) ratings worsened on MD + 1. Standardized unit changes in HSRGEN (fatigue: -0.05; 95% CI, -0.11 to 0.02 and soreness: -0.02, 95% CI, -0.07 to 0.04) and VHSRGEN (fatigue: -0.06; 95% CI, -0.12 to 0.00 and soreness: -0.04; 95% CI, -0.10 to 0.02) had no influence on wellness ratings at MD + 1. Individualized speed thresholds did not improve the model fit. CONCLUSIONS Subjective ratings of fatigue and wellness are not sensitive to substantial within-player changes in match physical performance. HSR, VHSR, and SPR thresholds customized for individual players' athletic qualities did not improve the dose-response relationship between external load and wellness ratings.
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Scott D, Litton K, Kendall A. Review of the Pathway for Breast Cancer Patients Receiving Neoadjuvant Chemotherapy in a District General Hospital. Clin Oncol (R Coll Radiol) 2020. [DOI: 10.1016/j.clon.2020.02.024] [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: 10/23/2022]
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Scott D, Hogan T, John J. Rubber dam evidence. Br Dent J 2020; 229:150. [PMID: 32811914 PMCID: PMC7431737 DOI: 10.1038/s41415-020-2011-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ford PR, Hodges NJ, Broadbent D, O'Connor D, Scott D, Datson N, Andersson HA, Williams AM. The developmental and professional activities of female international soccer players from five high-performing nations. J Sports Sci 2020; 38:1432-1440. [PMID: 32627682 DOI: 10.1080/02640414.2020.1789384] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
We study the developmental and professional activities engaged in by 86 female adult soccer players from the senior national teams of Australia, Canada, England, Sweden, and the United States of America. Players completed the Participation History Questionnaire (PHQ) to elicit the amount and type of activities engaged in across their developmental and professional years, including milestones, soccer-specific activity and engagement in other sport activity. Greater specialisation than diversification characterised their childhood developmental activities, including all players starting in soccer in childhood and accumulating more hours in soccer activity than other sports during this period. However, interindividual variation further characterised these childhood activities, with a proportion of players diversifying into other sports and/or soccer play to a greater or lesser degree during childhood when compared to the other players. The amount of coach-led soccer practice increased for all players across their development culminating in an average of 15-16 h/wk across a 40-week season in early adulthood. In contrast, the amount of engagement in other sports and soccer peer-led play varied between players but generally decreased across adolescence to negligible amounts in late adolescence. Findings are commensurate with the deliberate practice framework and early engagement.
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Affiliation(s)
- Paul R Ford
- School of Sport and Service Management, University of Brighton , Brighton, UK
| | - Nicola J Hodges
- School of Kinesiology, University of British Columbia , Vancouver, Canada
| | - David Broadbent
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University , London, UK
| | - Donna O'Connor
- Sydney School of Education and Social Work, The University of Sydney , Sydney, Australia
| | - Dawn Scott
- The Football Association , Burton upon Trent, UK
| | - Naomi Datson
- Institute of Sport, University of Chichester , Chichester, UK
| | - Helena A Andersson
- The Swedish School of Sport and Health Sciences, GIH , Stockholm, Sweden
| | - A Mark Williams
- Department of Health, Kinesiology, and Recreation, College of Health, University of Utah , UT, USA
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Kilbride C, Scott D, Butcher T, Warland A, Ryan J, Norris M, Baker K, Anoyke N, Buxarrais GS, Athanasiou D, Nowicky A. Rehabilitation via home based gaming exercise for the upper-limb post stroke (RHOMBUS): results of an intervention feasibility trial. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.036] [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]
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Scott D, Haigh J, Lovell R. Physical characteristics and match performances in women’s international versus domestic-level football players: a 2-year, league-wide study. SCI MED FOOTBALL 2020. [DOI: 10.1080/24733938.2020.1745265] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Dawn Scott
- US Soccer Federation, Chicago, IL, USA
- Western Sydney University, Penrith, Australia
| | | | - Ric Lovell
- Western Sydney University, Penrith, Australia
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Ng CA, McMillan LB, Beck B, Humbert L, Ebeling PR, Scott D. Associations between physical activity and bone structure in older adults: does the use of self-reported versus objective assessments of physical activity influence the relationship? Osteoporos Int 2020; 31:493-503. [PMID: 31720706 DOI: 10.1007/s00198-019-05208-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 10/23/2019] [Indexed: 12/22/2022]
Abstract
UNLABELLED Associations of current and previous physical activity (PA) with bone health are unclear. In postmenopausal women with low bone mineral density (BMD), current PA was positively associated with femoral neck BMD and microarchitecture. Past PA was positively associated with tibial microarchitecture. PA appears beneficial for bone health throughout the lifespan. INTRODUCTION To compare associations of current and past self-reported bone-specific physical activity, and current accelerometer-determined physical activity (PA), with bone structure (bone mineral density [BMD] and microarchitecture) in postmenopausal women with osteopenia or osteoporosis. METHODS Fifty community-dwelling postmenopausal women (mean age 64.4 ± 7.7) with hip or spine BMD T-score < - 1.0 SD were recruited for an exercise intervention. At baseline, current, past and total Bone-specific Physical Questionnaire (BPAQ) scores were self-reported, and percentages of sedentary, light and moderate to vigorous PA (MVPA) were objectively determined by accelerometer measurements. Bone structure was assessed by lumbar spine and hip dual-energy X-ray absorptiometry (DXA), 3D modelling algorithms (3D-SHAPER) of hip DXA scans and distal tibial high-resolution peripheral quantitative computed tomography (HR-pQCT) scans. RESULTS Current BPAQ scores and MVPA were significantly positively associated with femoral neck areal BMD (β = 0.315, p = 0.031 and β = 0.311, p = 0.042, respectively) following multivariable adjustments. MVPA was also positively associated with femoral cortical surface BMD (β = 0.333, p = 0.028) and mean cortical thickness (β = 0.374, p = 0.013). Past and total BPAQ scores demonstrated positive associations with tibial trabecular number (β = 0.391, p = 0.008 and β = 0.381, p = 0.010, respectively), and negative associations with trabecular separation (β = - 0.396, p = 0.006 and β = - 0.380, p = 0.009, respectively) and distribution (β = - 0.411, p = 0.004 and β = - 0.396, p = 0.006, respectively). Current BPAQ score was positively associated with tibial cortical periosteal perimeter (β = 0.278, p = 0.014). CONCLUSION BPAQ scores were most consistently associated with tibial bone parameters in older women, with past PA having lasting benefits for trabecular microarchitecture, and current PA positively associated with cortical bone.
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Affiliation(s)
- C-A Ng
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, 3168, Australia.
| | - L B McMillan
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, 3168, Australia
| | - B Beck
- Menzies Health Institute Queensland, School of Allied Health Sciences, Griffith University, Gold Coast, Australia
- The Bone Clinic, Brisbane, Australia
| | - L Humbert
- Musculoskeletal Unit, Galgo Medical, Barcelona, Spain
| | - P R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, 3168, Australia
| | - D Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, 3168, Australia
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Kinlaw S, Dailey M, Scott D, Hanchey S, Tumin D, Higginson A. Improved Physical Exam Documentation in a Pediatric After-Hours Clinic. Am J Med Qual 2019; 35:506. [PMID: 31833380 DOI: 10.1177/1062860619893454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jones AR, Tovée MJ, Cutler LR, Parkinson KN, Ells LJ, Araujo-Soares V, Pearce MS, Mann KD, Scott D, Harris JM, Adamson AJ. Development of the MapMe intervention body image scales of known weight status for 4-5 and 10-11 year old children. J Public Health (Oxf) 2019; 40:582-590. [PMID: 29190364 PMCID: PMC6266708 DOI: 10.1093/pubmed/fdx129] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 09/18/2017] [Indexed: 11/12/2022] Open
Abstract
Background Parents tend to visually assess children to determine their weight status and typically underestimate child body size. A visual tool may aid parents to more accurately assess child weight status and so support strategies to reduce childhood overweight. Body image scales (BIS) are visual images of people ranging from underweight to overweight but none exist for children based on UK criteria. Our aim was to develop sex- and age-specific BIS for children, based on British growth reference (UK90) criteria. Methods BIS were developed using 3D surface body scans of children, their associated weight status using UK90 criteria from height and weight measurements, and qualitative work with parents and health professionals. Results Height, weight and 3D body scans were collected (211: 4–5 years; 177: 10–11 years). Overall, 12 qualitative sessions were held with 37 participants. Four BIS (4–5-year-old girls and boys, 10–11-year-old girls and boys) were developed. Conclusions This study has created the first sex- and age-specific BIS, based on UK90 criteria. The BIS have potential for use in child overweight prevention and management strategies, and in future research. This study also provides a protocol for the development of further BIS appropriate to other age groups and ethnicities.
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Affiliation(s)
- A R Jones
- Institute of Health & Society, Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - M J Tovée
- School of Psychology, University of Lincoln, Lincoln, UK.,Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - L R Cutler
- Institute of Health & Society, Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - K N Parkinson
- Institute of Health & Society, Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - L J Ells
- School of Health and Social Care, Health and Social Care Institute, Teesside University, Middlesbrough, UK
| | - V Araujo-Soares
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - M S Pearce
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - K D Mann
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - D Scott
- Department of Public Health and Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - J M Harris
- School of Psychology and Neuroscience. University of St Andrews, Fife, UK
| | - A J Adamson
- Institute of Health & Society, Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
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Scott D, Shore-Lorenti C, Ebeling PR. Multiple vertebral compression fractures after sleeve gastrectomy and a subsequent pregnancy: a case report. Osteoporos Int 2019; 30:2151-2154. [PMID: 31273389 DOI: 10.1007/s00198-019-05073-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 06/25/2019] [Indexed: 11/29/2022]
Abstract
We report that a 33-year-old woman developed multiple compression fractures several years after a sleeve gastrectomy followed by pregnancy. Despite normal areal BMD values assessed by dual-energy X-ray absorptiometry and no family history of osteoporosis, the patient demonstrated low lumbar spine trabecular bone score, as well as low peripheral trabecular volumetric BMD and deterioration of trabecular microarchitecture assessed by high-resolution peripheral quantitative computed tomography. Women of reproductive age should be provided with lifestyle management targeting bone health following bariatric surgery.
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Affiliation(s)
- D Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, 3168, Australia.
- Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School-Western Campus, The University of Melbourne, St Albans, Victoria, Australia.
| | - C Shore-Lorenti
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, 3168, Australia
| | - P R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, 3168, Australia
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Abstract
Maintaining mobility is an important aspect of health and well-being in older men. This literature review describes several modifiable and nonmodifiable risk factors impacting bone, muscle, and joint health. Exercise and nutritional interventions may help to prevent the progressive deterioration in bones, muscles, and joints impacting mobility in later life. Limitations in mobility are increasingly recognized as a major public health problem due to an aging population and growing number of older individuals affected by disabling comorbidities. Despite increasing numbers and debilitating consequences, there are no guidelines providing recommendations on strategies to maintain mobility for healthy aging among older men. This narrative review aims to fill this literature gap. PubMed, Scopus, and Google Scholar databases were searched using predefined search terms. Primary studies, exploratory analyses, cross-sectional surveys, meta-analyses, evidence-based clinical reviews, and guidelines from nationally recognized societies focusing on mobility in older men and key elements including bone, muscle and joint health, and balance were selected. Several modifiable and nonmodifiable risk factors have been reported in the literature that impact bone, muscle, and joint health and predispose older men to falls and fractures. The most common conditions impacting bones, muscles, and joints are osteoporosis, sarcopenia, and osteoarthritis, respectively. In addition to being key contributors to disability in the elderly, these conditions are all associated with a higher mortality risk. Although more studies are required, current evidence supports the use of various nonpharmacological (mainly exercise and nutrition) and/or pharmacological treatment modalities to help prevent and/or reverse these conditions. Incorporating lifestyle interventions involving exercise and nutrition at a younger age can help prevent the age-related, progressive deterioration in bones, muscles, and joints that can reduce mobility in later life. Established barriers to physical activities (e.g., poor health, social isolation) in men are important to consider for optimizing outcomes.
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Affiliation(s)
- P R Ebeling
- School of Clinical Sciences at Monash Health, Monash Medical Centre, Monash University, Level 5 / Block E, 246 Clayton Road, Clayton, VIC, 3168, Australia.
| | - F Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
| | - D Scott
- Australian Institute for Musculoskeletal Science, The University of Melbourne, Melbourne, Australia
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
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Weinbren M, Scott D, Bower W, Milanova D. Observation study of water outlet design from a cross-infection/user perspective: time for a radical re-think? J Hosp Infect 2019; 103:e68-e72. [DOI: 10.1016/j.jhin.2018.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 11/08/2018] [Indexed: 10/27/2022]
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Foster A, Scott D, Layfield R, Rea S. An FTLD-associated SQSTM1 variant impacts Nrf2 and NF-κB signalling and is associated with reduced phosphorylation of p62. Mol Cell Neurosci 2019; 98:32-45. [DOI: 10.1016/j.mcn.2019.04.001] [Citation(s) in RCA: 10] [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: 11/14/2018] [Revised: 03/28/2019] [Accepted: 04/02/2019] [Indexed: 12/12/2022] Open
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Affiliation(s)
- Ric Lovell
- School of Science and Health, Western Sydney University, Australia
| | | | - Laurence Park
- School of Computing, Engineering and Mathematics, Western Sydney University
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Dubey JP, Cerqueira-Cézar CK, Murata FHA, Mowery JD, Scott D, Dohlen ARV, Lindsay DS. Confirmation of Sarcocystis jamaicensis Sarcocysts in IFN-c Gene Knockout Mice Orally Inoculated with Sporocysts from a Red-Tailed Hawk (Buteo jamaicensis). J Parasitol 2019. [DOI: 10.1645/18-148] [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: 11/10/2022] Open
Affiliation(s)
- J. P. Dubey
- United States Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Center, Animal Parasitic Diseases Laboratory, Building 1001, Beltsville, Maryland 20705-2350
| | - Camila K. Cerqueira-Cézar
- United States Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Center, Animal Parasitic Diseases Laboratory, Building 1001, Beltsville, Maryland 20705-2350
| | - Fernando H. A. Murata
- United States Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Center, Animal Parasitic Diseases Laboratory, Building 1001, Beltsville, Maryland 20705-2350
| | - J. D. Mowery
- United States Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Center, Electron and Confocal Microscopy Unit, Building 12, Beltsville, Maryland 20705
| | - D. Scott
- Carolina Raptor Center, 6000 Sample Road, Huntersville, North Carolina 28078
| | - A. Rosypal von Dohlen
- Department of Natural Sciences and Mathematics, Johnson C. Smith University, Charlotte, North Carolina 28216
| | - David S. Lindsay
- Department of Biomedical Sciences and Pathobiology, College of Veterinary Medicine, Faculty of Health Sciences, Virginia Tech, Blacksburg, Virginia 24061
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Myles PS, Smith JA, Kasza J, Silbert B, Jayarajah M, Painter T, Cooper DJ, Marasco S, McNeil J, Bussières JS, McGuinness S, Byrne K, Chan MT, Landoni G, Wallace S, Forbes A, Myles P, Smith J, Cooper DJ, Silbert B, McNeil J, Marasco S, Esmore D, Krum H, Tonkin A, Buxton B, Heritier S, Merry A, Liew D, McNeil J, Forbes A, Cooper D, Wallace S, Meehan A, Myles P, Wallace S, Galagher W, Farrington C, Ditoro A, Wutzlhofer L, Story D, Peyton P, Baulch S, Sidiropoulos S, Potgieter D, Baker R, Pesudovs B, O'Loughlin J Wells E, Coutts P, Bolsin S, Osborne C, Ives K, Smith J, Hulley A, Christie-Taylor G, Painter T, Lang S, Mackay H, Cokis C, March S, Bannon P, Wong C, Turner L, Scott D, Silbert B, Said S, Corcoran P, Painter T, de Prinse L, Bussières J, Gagné N, Lamy A, Semelhago L, Chan M, Underwood M, Choi G, Fung B, Landoni G, Lembo R, Monaco F, Simeone F, Marianello D, Alvaro G, De Vuono G, van Dijk D, Dieleman J, Numan S, McGuinness S, Parke R, Raudkivi P, Gilder E, Byrne K, Dunning J, Termaat J, Mans G, Jayarajah M, Alderton J, Waugh D, Platt M, Pai A, Sevillano A, Lal A, Sinclair C, Kunst G, Knighton A, Cubas G, Saravanan P, Millner R, Vasudevan V, Patteril M, Lopez E, Basu R, Lu J. Tranexamic acid in coronary artery surgery: One-year results of the Aspirin and Tranexamic Acid for Coronary Artery Surgery (ATACAS) trial. J Thorac Cardiovasc Surg 2019; 157:644-652.e9. [DOI: 10.1016/j.jtcvs.2018.09.113] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 09/13/2018] [Accepted: 09/27/2018] [Indexed: 11/30/2022]
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Dubey JP, Cerqueira-Cézar CK, Murata FHA, Mowery JD, Scott D, von Dohlen AR, Lindsay DS. Confirmation of Sarcocystis jamaicensis Sarcocysts in IFN-γ Gene Knockout Mice Orally Inoculated with Sporocysts from a Red-Tailed Hawk ( Buteo jamaicensis). J Parasitol 2019; 105:143-145. [PMID: 30807718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
Here, we report confirmation of sarcocysts of Sarcocystis jamaicensis in an experimental intermediate host, IFN-γ gene knockout (KO) mice orally inoculated sporocysts from its natural definitive host, a red-tailed hawk ( Buteo jamaicensis) (RTH). A RTH submitted to the Carolina Raptor Center, Huntersville, North Carolina, was euthanized because it could not be rehabilitated and released. Fully sporulated sporocysts from intestinal scrapings of the RTH were orally fed to 2 laboratory-reared outbred Swiss Webster mice (SW; Mus musculus) and to 2 KO mice. The sporocysts were infective for KO mice but not to SW mice. Both SW mice remained asymptomatic, and neither schizonts nor sarcocysts were found in their tissues when euthanized on day 54 post-inoculation (PI). The KO mice developed neurological signs and were necropsied 38-54 days PI. Schizonts/merozoites were found in both KO mice euthanized and they were confined to the brain. The predominant lesion was meningoencephalitis. Microscopic sarcocysts were found in muscles of both KO mice. When viewed with light microscopy, the sarcocyst wall appeared thin (<1 μm thick) and smooth. Ultrastructural details of sarcocysts are described.
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Affiliation(s)
- J P Dubey
- 1 United States Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Center, Animal Parasitic Diseases Laboratory, Building 1001, Beltsville, Maryland 20705-2350
| | - Camila K Cerqueira-Cézar
- 1 United States Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Center, Animal Parasitic Diseases Laboratory, Building 1001, Beltsville, Maryland 20705-2350
| | - Fernando H A Murata
- 1 United States Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Center, Animal Parasitic Diseases Laboratory, Building 1001, Beltsville, Maryland 20705-2350
| | - J D Mowery
- 2 United States Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Center, Electron and Confocal Microscopy Unit, Building 12, Beltsville, Maryland 20705
| | - D Scott
- 3 Carolina Raptor Center, 6000 Sample Road, Huntersville, North Carolina 28078
| | - A Rosypal von Dohlen
- 4 Department of Natural Sciences and Mathematics, Johnson C. Smith University, Charlotte, North Carolina 28216
| | - David S Lindsay
- 5 Department of Biomedical Sciences and Pathobiology, College of Veterinary Medicine, Faculty of Health Sciences, Virginia Tech, Blacksburg, Virginia 24061
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Sim M, Prince RL, Scott D, Daly RM, Duque G, Inderjeeth CA, Zhu K, Woodman RJ, Hodgson JM, Lewis JR. Utility of four sarcopenia criteria for the prediction of falls-related hospitalization in older Australian women. Osteoporos Int 2019; 30:167-176. [PMID: 30456572 DOI: 10.1007/s00198-018-4755-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 10/22/2018] [Indexed: 01/07/2023]
Abstract
UNLABELLED Numerous sarcopenia definitions are not associated with increased falls-related hospitalization risk over 5 years to 9.5 years in older community-dwelling Australian women. Measures of muscle strength and physical function, but not appendicular lean mass (measured by dual-energy X-ray absorptiometry) may help discriminate the risk of falls-related hospitalization. INTRODUCTION The aim of this prospective, population-based cohort study of 903 Caucasian-Australian women (mean age 79.9 ± 2.6 years) was to compare the clinical utility of four sarcopenia definitions for the prediction of falls-related hospitalization over 9.5 years. METHODS The four definitions were the United States Foundation for the National Institutes of Health (FNIH), the European Working Group on Sarcopenia in Older People (EWGSOP), and modified FNIH (AUS-POPF) and EWGSOP (AUS-POPE) definitions using Australian population-specific cut points (< 2 SD below the mean of young healthy Australian women). Components of sarcopenia including muscle strength, physical function, and appendicular lean mass (ALM) were quantified using hand grip strength, timed-up-and-go (TUG), and dual-energy X-ray absorptiometry (DXA), respectively. Incident 9.5-year falls-related hospitalization were captured by linked data. RESULTS Baseline prevalence of sarcopenia according to FNIH (9.4%), EWGSOP (24.1%), AUS-POPF (12.0%), and AUS-POPE (10.7%) differed substantially. Sarcopenia did not increase the relative hazard ratio (HR) for falls-related hospitalization before or after adjustment for age (aHR): FNIH aHR 1.00 95%CI (0.69-1.47), EWGSOP aHR 1.20 95%CI (0.93-1.54), AUS-POPF aHR 0.96 95%CI (0.68-1.35), and AUS-POPE aHR 1.33 95%CI (0.94-1.88). When examining individual components of sarcopenia, only muscle strength and physical function but not ALM (adjusted for height2 or BMI) were associated with falls-related hospitalization. CONCLUSION Current definitions of sarcopenia were not associated with falls-related hospitalization risk in this cohort of community-dwelling older Australian women. Finally, measures of muscle strength and physical function, but not ALM (measured by DXA) may help discriminate the risk of falls-related hospitalization.
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Affiliation(s)
- M Sim
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
- Medical School, The University Western Australia, Perth, Western Australia, Australia.
| | - R L Prince
- Medical School, The University Western Australia, Perth, Western Australia, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - D Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School - Western Campus, The University of Melbourne, St Albans, Victoria, Australia
| | - R M Daly
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - G Duque
- Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School - Western Campus, The University of Melbourne, St Albans, Victoria, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Victoria, Australia
| | - C A Inderjeeth
- Medical School, The University Western Australia, Perth, Western Australia, Australia
- North Metropolitan Health Service, Nedlands, Western Australia, Australia
| | - K Zhu
- Medical School, The University Western Australia, Perth, Western Australia, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - R J Woodman
- Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, South Australia, Australia
| | - J M Hodgson
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, The University Western Australia, Perth, Western Australia, Australia
| | - J R Lewis
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, The University Western Australia, Perth, Western Australia, Australia
- Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
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Zanker J, Scott D, Reijnierse EM, Brennan-Olsen SL, Daly RM, Girgis CM, Grossmann M, Hayes A, Henwood T, Hirani V, Inderjeeth CA, Iuliano S, Keogh JWL, Lewis JR, Maier AB, Pasco JA, Phu S, Sanders KM, Sim M, Visvanathan R, Waters DL, Yu SCY, Duque G. Establishing an Operational Definition of Sarcopenia in Australia and New Zealand: Delphi Method Based Consensus Statement. J Nutr Health Aging 2019; 23:105-110. [PMID: 30569078 DOI: 10.1007/s12603-018-1113-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Globally there are several operational definitions for sarcopenia, complicating clinical and research applications. OBJECTIVE The objective of the Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) Task Force on Diagnostic Criteria for Sarcopenia was to reach consensus on the operational definition of sarcopenia for regional use by clinicians and researchers. METHOD A four-Phase modified Delphi process was undertaken in which 24 individuals with expertise or a recognised interest in sarcopenia from different fields across Australia and New Zealand were invited to be Task Force members. An initial face-to-face meeting was held in Adelaide, South Australia, in November 2017, followed by two subsequent online Phases conducted by electronic surveys. A final Phase was used to approve the final statements. Responses were analysed using a pre-specified strategy. The level of agreement required for consensus was 80%. RESULTS In Phase 2, 94.1% of Task Force respondents voted in favour of adopting an existing operational definition of sarcopenia. In Phase 3, 94.4% of respondents voted in favour of adopting the European Working Group on Sarcopenia in Older People (EWGSOP) definition as the operational definition for sarcopenia in Australia and New Zealand. CONCLUSION With consensus achieved, the ANZSSFR will adopt, promote and validate the EWGSOP operational definition of sarcopenia for use by clinicians and researchers in Australia and New Zealand.
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Affiliation(s)
- J Zanker
- Prof. Gustavo Duque, MD, PhD, FRACP, FGSA, Australian Institute for Musculoskeletal Science (AIMSS), 176 Furlong Road, St. Albans, VIC, Australia 3021, e-mail: , phone: +61 8395 8121
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Archibald AT, Folberth G, Wade DC, Scott D. A world avoided: impacts of changes in anthropogenic emissions on the burden and effects of air pollutants in Europe and North America. Faraday Discuss 2018; 200:475-500. [PMID: 28580997 DOI: 10.1039/c7fd00004a] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Emissions from anthropogenic activity are known to have deleterious impacts on human and ecosystem health and as such a significant amount of time, effort and money has been spent developing legislation to minimise their effects. Here we use a state of the art coupled chemistry-climate model HadGEM2-ES, with extended tropospheric chemistry, to assess the impacts that changes in emissions from anthropogenic activity have had on the burden and impacts of air pollutants over the last three decades. We use HadGEM2-ES to assess an alternative trajectory in air pollutant emissions to that which we have seen, with a regional focus on the contiguous United States and areas of Western Europe. This alternative trajectory can be considered to reflect a world avoided. In this world avoided, the significant levels of air pollution legislation imposed over the last three decades are simulated to not have come into effect in the contiguous United States and Western Europe. Rather a business as usual emission scenario is followed from 1970 to the present day. By combining the results of simulations of the world avoided with a base case present day atmosphere our model runs demonstrate that as a result of air pollution legislation, over 500 000 early mortalities a year have been mitigated owing to extensive reduction in sulfate aerosol and up to 8000 early mortalities a year have been mitigated as a result of improvements in ozone and nitrogen dioxide pollution. These results highlight the important role of legislation in reducing air pollution related mortality in these areas of the globe and highlight a compelling case for developing regions to follow.
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Affiliation(s)
- A T Archibald
- Department of Chemistry, University of Cambridge, CB2 1EW, UK.
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Wray D, Coppin JD, Scott D, Jacob DA, Jinadatha C. Increased HCV Screening Yields Discordant Gains in Diagnoses Among Urban and Rural Veteran Populations in Texas: Results of a Statewide Quality Improvement Initiative. Jt Comm J Qual Patient Saf 2018; 45:112-122. [PMID: 30266248 DOI: 10.1016/j.jcjq.2018.06.005] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 06/21/2018] [Accepted: 06/28/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Chronic hepatitis C virus (HCV) infection is a significant health burden among military veterans. Our goals were to increase monthly HCV screenings, diagnoses, and sustained virologic responses (SVR) among 88,652 unscreened birth cohort Veterans in Texas. METHODS The interventions were enabled within six of the eight healthcare systems (HCSs) that compose Veteran's Integrated Service Network 17. The remaining two HCSs served as controls. The HCSs were separated into two groups: urban and rural; each composed of a control and three interventional HCSs. Decision support programming was embedded within the Computerized Patient Record System that prompted HCV screening among previously unscreened birth cohort patients. Clinical process design and educational efforts were enacted to enhance treatment capacity. RESULTS Monthly screenings increased 4.89 times (p < 0.001) and 2.97 times (p < 0.001) during the postinterventional period relative to control for urban and rural HCSs, respectively. For urban HCSs, diagnoses increased 1.58 (p < 0.001) times more than the control group during the postinterventional period, but there was no difference in number of diagnoses in the rural HCSs (p = 0.86). Monthly SVR increased 2.69 times more than the control group during the postinterventional period (p < 0.001). CONCLUSION Decision support improved HCV screening among birth cohort patients in both urban and rural HCSs. Increased screening boosted the monthly number of diagnoses in the urban HCSs, but not in the rural HCSs; which rebuts the utility of birth cohort screening among rurally residing veterans. These interventions significantly improved the rate of SVR achievement relative to control.
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Affiliation(s)
- Laurence A. F. Park
- School of Computing, Engineering and Mathematics, Western Sydney University, Sydney, Australia
| | - Dawn Scott
- High Performance Department, US Soccer Federation, Chicago, IL, USA
| | - Ric Lovell
- School of Science and Health, Western Sydney University, Sydney, Australia
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McMillan LB, Aitken D, Ebeling P, Jones G, Scott D. The relationship between objectively assessed physical activity and bone health in older adults differs by sex and is mediated by lean mass. Osteoporos Int 2018. [PMID: 29532131 DOI: 10.1007/s00198-018-4446-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
UNLABELLED Relationships between objectively assessed free-living physical activity (PA) and changes in bone health over time are poorly understood in older adults. This study suggests these relationships are sex-specific and that body composition may influence the mechanical loading benefits of PA. INTRODUCTION To investigate associations of objectively assessed PA and bone health in community-dwelling older adults. METHODS This secondary analysis of a subset of the Tasmanian Older Adult Cohort study included participants with PA assessed utilising ActiGraph GT1M accelerometers over 7 days (N = 209 participants, 53% female; mean ± SD age 64.5 ± 7.2 years). Steps/day and PA intensity were estimated via established thresholds. Bone mineral content (BMC) was acquired at the total hip, lumbar spine, legs and whole body by DXA at baseline and approximately 2.2 years later. Relationships between PA and BMC were assessed by multivariable linear regression analyses adjusted for age, smoking status, height and total lean mass. RESULTS Men with above-median total hip BMC completed significantly less steps per day, but there was no significant difference in PA intensity compared with those with below-median BMC. There were no significant differences in PA in women stratified by median BMC. In women, steps/day were positively associated with leg BMC (B = 0.178; P = 0.017), and sedentary behaviour was negatively associated with leg BMC (- 0.165; 0.016) at baseline. After adjustment for confounders including lean mass and height, higher sedentary behaviour at baseline was associated with declines in femoral neck BMC (- 0.286; 0.011) but also with increases in pelvic BMC (0.246; 0.030) in men and increases in total hip BMC (0.215; 0.032) in women, over 2.2 years. No other significant longitudinal associations were observed after adjustment for body composition. CONCLUSIONS Associations of accelerometer-determined sedentary behaviour and PA with bone health in older adults differ by sex and anatomical site and are mediated by body composition.
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Affiliation(s)
- L B McMillan
- School of Clinical Sciences at Monash Health, Department of Medicine, Monash Medical Centre, Monash University, 246 Clayton Road, Clayton, VIC, 3168, Australia.
| | - D Aitken
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia
| | - P Ebeling
- School of Clinical Sciences at Monash Health, Department of Medicine, Monash Medical Centre, Monash University, 246 Clayton Road, Clayton, VIC, 3168, Australia
- Australian Institute of Musculoskeletal Science (AIMSS), Melbourne Medical School (Western Campus), Sunshine Hospital, The University of Melbourne, St Albans, Melbourne, VIC, 3021, Australia
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia
| | - D Scott
- School of Clinical Sciences at Monash Health, Department of Medicine, Monash Medical Centre, Monash University, 246 Clayton Road, Clayton, VIC, 3168, Australia
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia
- Australian Institute of Musculoskeletal Science (AIMSS), Melbourne Medical School (Western Campus), Sunshine Hospital, The University of Melbourne, St Albans, Melbourne, VIC, 3021, Australia
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Zaidat OO, Bozorgchami H, Ribó M, Saver JL, Mattle HP, Chapot R, Narata AP, Francois O, Jadhav AP, Grossberg JA, Riedel CH, Tomasello A, Clark WM, Nordmeyer H, Lin E, Nogueira RG, Yoo AJ, Jovin TG, Siddiqui AH, Bernard T, Claffey M, Andersson T, Ribo M, Hetts S, Hacke W, Mehta B, Hacein-Bey L, Kim A, Abou-Chebl A, Shabe P, Hetts S, Hacein-Bey L, Kim A, Abou-Chebl A, Dix J, Gurian J, Zink W, Dabus G, O’Leary, N, Reilly A, Lee K, Foley J, Dolan M, Hartley E, Clark T, Nadeau K, Shama J, Hull L, Brown B, Priest R, Nesbit G, Horikawa M, Hoak D, Petersen B, Beadell N, Herrick K, White C, Stacey M, Ford S, Liu J, Ribó M, Sanjuan, E, Sanchis M, Molina C, Rodríguez-Luna, D, Boned Riera S, Pagola J, Rubiera M, Juega J, Rodríguez N, Muller N, Stauder M, Stracke P, Heddier M, Charron V, Decock A, Herbreteau D, Bibi R, De Sloovere A, Doutreloigne I, Pieters D, Dewaele T, Bourgeois P, Vanhee F, Vanderdouckt P, Vancaster E, Baxendell L, Gilchrist V, Cannon Y, Graves C, Armbruster K, Jovin T, Jankowitz B, Ducruet A, Aghaebrahim A, Kenmuir C, Shoirah H, Molyneaux B, Tadi P, Walker G, Starr M, Doppelheuer S, Schindler K, Craft L, Schultz M, Perez H, Park J, Hall A, Mitchell A, Webb L, Haussen D, Frankel M, Bianchi N, Belagaje S, Mahdi N, Lahoti S, Katema A, Winningham M, Anderson A, Tilley D, Steinhauser T, Scott D, Thacker A, Calderon V, Lin E, Becke S, Krieter S, Jansen O, Wodarg F, Larsen N, Binder A, Wiesen C, Hartney M, Bookhagan L, Ross H, Gay J, Snyder K, Levy E, Davies J, Sonig A, Rangel-Castilla L, Mowla A, Shakir H, Fennell V, Atwal G, Natarajan S, Beecher J, Thornton J, Cullen A, Brennan P, O’Hare A, Asadi H, Budzik R, Taylor M, Jennings M, Laube F, Jackson J, Gatrell R, Reebel L, Albon A, Gerniak J, Groezinger K, Lauf M, Voraco N, Pema P, Davis T, Hicks W, Mejilla J, Teleb M, Sunenshine P, Russo E, Flynn R, Twyford J, Ver Hage A, Smith E, Apolinar L, Blythe S, Maxan J, Carter J, Taschner T, Bergmann U, Meckel S, Elsheik S, Urbach H, Maurer C, Egger K, Niesen W, Baxter B, Knox, A, Hazelwood B, Quarfordt S, Calvert J, Hawk H, Malek, R, Padidar A, Tolley U, Gutierrez A, Mordasini P, Seip T, Balasubramaniam R, Gralla J, Fischer U, Zibold F, Piechowiak E, DeLeacy R, Apruzzeses R, Alfonso C, Haslett J, Fifi J, Mocco J, Starkman S, Guzy, J, Grunberg N, Szeder V, Tateshima S, Duckwiler G, Nour M, Liebeskind D, Tang X, Hinman J, Tipirneni A, Yavagal D, Guada L, Bates K, Balladeras S, Bokka S, Suir S, Caplan J, Kandewall P, Peterson E, Starke R, Puri A, Hawk M, Brooks C, L’Heurex J, Ty K, Rex D, Massari F, Wakhloo A, Lozano D, Rodrigua K, Pierot L, Fabienne M, Sebastien S, Emmoinoli M. Primary Results of the Multicenter ARISE II Study (Analysis of Revascularization in Ischemic Stroke With EmboTrap). Stroke 2018; 49:1107-1115. [DOI: 10.1161/strokeaha.117.020125] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 02/05/2018] [Accepted: 02/26/2018] [Indexed: 02/04/2023]
Affiliation(s)
- Osama O. Zaidat
- From the Department of Neuroscience, Mercy St. Vincent Medical Center, Toledo, OH (O.O.Z., E.L.)
| | | | - Marc Ribó
- Department of Neuroradiology, Vall d’Hebron University Hospital, Barcelona, Spain (M.R., A.T.)
| | - Jeffrey L. Saver
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles (J.L.S.)
| | - Heinrich P. Mattle
- Department of Neurology, Inselspital, University of Bern, Switzerland (H.P.M.)
| | - René Chapot
- Department of Radiology and Neuroradiology, Alfried Krupp Krankenhaus, Essen, Germany (R.C., H.N.)
| | - Ana Paula Narata
- Centre Hospitalier Régional Universitaire, Hôpitaux de Tours, France (A.P.N.)
| | | | - Ashutosh P. Jadhav
- Department of Neurology, University of Pittsburgh Medical Center, PA (A.P.J., T.G.J.)
| | - Jonathan A. Grossberg
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA (J.A.G., R.G.N.)
| | | | - Alejandro Tomasello
- Department of Neuroradiology, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden (T.A.)
| | - Wayne M. Clark
- Oregon Health and Science University Hospital, Portland (H.B., W.M.C.)
| | - Hannes Nordmeyer
- Department of Radiology and Neuroradiology, Alfried Krupp Krankenhaus, Essen, Germany (R.C., H.N.)
| | - Eugene Lin
- From the Department of Neuroscience, Mercy St. Vincent Medical Center, Toledo, OH (O.O.Z., E.L.)
| | - Raul G. Nogueira
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA (J.A.G., R.G.N.)
| | - Albert J. Yoo
- Department of Interventional Radiology, Texas Stroke Institute, Dallas–Fort Worth (A.J.Y.)
| | - Tudor G. Jovin
- Department of Neurology, University of Pittsburgh Medical Center, PA (A.P.J., T.G.J.)
| | | | | | | | - Tommy Andersson
- Department of Neuroradiology, Vall d’Hebron University Hospital, Barcelona, Spain (M.R., A.T.)
- AZ Groeninge, Kortrijk, Belgium (O.F., T.A.)
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Abbott T, Fowler A, Pelosi P, Gama de Abreu M, Møller A, Canet J, Creagh-Brown B, Mythen M, Gin T, Lalu M, Futier E, Grocott M, Schultz M, Pearse R, Myles P, Gan T, Kurz A, Peyton P, Sessler D, Tramèr M, Cyna A, De Oliveira G, Wu C, Jensen M, Kehlet H, Botti M, Boney O, Haller G, Grocott M, Cook T, Fleisher L, Neuman M, Story D, Gruen R, Bampoe S, Evered L, Scott D, Silbert B, van Dijk D, Kalkman C, Chan M, Grocott H, Eckenhoff R, Rasmussen L, Eriksson L, Beattie S, Wijeysundera D, Landoni G, Leslie K, Biccard B, Howell S, Nagele P, Richards T, Lamy A, Gabreu M, Klein A, Corcoran T, Jamie Cooper D, Dieleman S, Diouf E, McIlroy D, Bellomo R, Shaw A, Prowle J, Karkouti K, Billings J, Mazer D, Jayarajah M, Murphy M, Bartoszko J, Sneyd R, Morris S, George R, Moonesinghe R, Shulman M, Lane-Fall M, Nilsson U, Stevenson N, van Klei W, Cabrini L, Miller T, Pace N, Jackson S, Buggy D, Short T, Riedel B, Gottumukkala V, Alkhaffaf B, Johnson M. A systematic review and consensus definitions for standardised end-points in perioperative medicine: pulmonary complications. Br J Anaesth 2018; 120:1066-1079. [DOI: 10.1016/j.bja.2018.02.007] [Citation(s) in RCA: 125] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 02/01/2018] [Accepted: 02/12/2018] [Indexed: 02/02/2023] Open
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Cowie B, Baker L, Shoghi B, Worner M, Scott D. Electrocardiogram failure in the operating room - bench testing to prevent bed-side disaster. Anaesthesia 2018. [PMID: 29520908 DOI: 10.1111/anae.14250] [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] [Indexed: 11/30/2022]
Abstract
Electrocardiogram (ECG) false alarms are common in electrically-hostile peri-operative environments. Newer integrated monitoring, with sophisticated hardware and software, has the potential to minimise artefacts. However, monitoring issues continue to occur, with the potential for critical incidents and unnecessary and harmful interventions. We describe the root cause analysis of a series of apparent ECG flatline asystolic events that appeared in the operating room shortly after the introduction of new intra-operative monitoring systems. Clinical events and biomedical laboratory testing revealed complete loss of ECG signal with increasing resistance. The new ECG systems had incorporated both software and hardware changes to improve the fidelity of signal acquisition and display, but had become much more sensitive to impedance changes. After we alerted the manufacturer, they added software and hardware updates that resulted in resolution of all incidents of ECG loss-of-signal.
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Affiliation(s)
- B Cowie
- Department of Anaesthesia and Acute Pain Medicine, St. Vincent's Hospital, Melbourne
| | - L Baker
- Department of Anaesthesia and Acute Pain Medicine, St. Vincent's Hospital, Melbourne
| | - B Shoghi
- Department of Anaesthesia and Acute Pain Medicine, St. Vincent's Hospital, Melbourne
| | - M Worner
- Department of Anaesthesia and Acute Pain Medicine, St. Vincent's Hospital, Melbourne
| | - D Scott
- Department of Anaesthesia and Acute Pain Medicine, St. Vincent's Hospital, Melbourne
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