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Hayes D, Olsson A, Begum S, Bertotti M, Jarvis-Beesley P, Stapley E. Barriers and facilitators to social prescribing in child and youth mental health: perspectives from the frontline. Eur Child Adolesc Psychiatry 2024; 33:1465-1479. [PMID: 37405485 DOI: 10.1007/s00787-023-02257-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 06/27/2023] [Indexed: 07/06/2023]
Abstract
There is growing interest in the role of Social Prescribing (SP) to help promote mental well-being and support individuals with mental health difficulties. Yet, implementation of SP to children and young people (CYP) has proved slow and underdeveloped compared with adult populations. Understanding the barriers and facilitators will help key stakeholders to better embed SP for CYP into practice. Using the Theoretical Domains Framework (TDF), a comprehensive, theoretical-led framework, underpinned by 33 behaviour change theories and 128 constructs, perceived barriers and facilitators to SP were investigated. The sample comprised of 11 Link Workers and 9 individuals involved in facilitating SP with CYP, who took part in semi-structured interviews. Transcripts were analysed using a deductive thematic analysis, and themes were coded under each theoretical domain. Overall, 33 barriers and facilitators for SP were identified across 12 domains of the TDF. Under capability, barriers and facilitators were found for knowledge, skills, memory/attention/decision making processes, and behavioural regulation. For opportunity, barriers and facilitators were found for social/professional influences, as well as environmental context and resources. Finally, for motivation, domains covered included: beliefs about consequences, beliefs about capabilities, optimism, motivations/goals, reinforcement, and emotions. Findings suggest that a wide range of barriers and facilitators affect the implementation of CYP SP to improve mental health and well-being. Interventions which target different domains related to capability, opportunity and motivation should be developed to better facilitate CYP SP.
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Affiliation(s)
- D Hayes
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England.
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, England.
| | - A Olsson
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England
- The Healthcare Improvement Studies (THIS) Institute, University of Cambridge, Cambridge, England
| | - S Begum
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England
| | - M Bertotti
- Institute for Connected Communities, University of East London, London, England
| | - P Jarvis-Beesley
- Social Prescribing Youth Network (SPYN), Streetgames, Manchester, England
| | - E Stapley
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England
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Casetta C, Santosh P, Bayley R, Bisson J, Byford S, Dixon C, Drake RJ, Elvins R, Emsley R, Fung N, Hayes D, Howes O, James A, James K, Jones R, Killaspy H, Lennox B, Marchant L, McGuire P, Oloyede E, Rogdaki M, Upthegrove R, Walters J, Egerton A, MacCabe JH. CLEAR - clozapine in early psychosis: study protocol for a multi-centre, randomised controlled trial of clozapine vs other antipsychotics for young people with treatment resistant schizophrenia in real world settings. BMC Psychiatry 2024; 24:122. [PMID: 38355533 PMCID: PMC10865566 DOI: 10.1186/s12888-023-05397-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/22/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Clozapine is an antipsychotic drug with unique efficacy, and it is the only recommended treatment for treatment-resistant schizophrenia (TRS: failure to respond to at least two different antipsychotics). However, clozapine is also associated with a range of adverse effects which restrict its use, including blood dyscrasias, for which haematological monitoring is required. As treatment resistance is recognised earlier in the illness, the question of whether clozapine should be prescribed in children and young people is increasingly important. However, most research to date has been in older, chronic patients, and evidence regarding the efficacy and safety of clozapine in people under age 25 is lacking. The CLEAR (CLozapine in EARly psychosis) trial will assess whether clozapine is more effective than treatment as usual (TAU), at the level of clinical symptoms, patient rated outcomes, quality of life and cost-effectiveness in people below 25 years of age. Additionally, a nested biomarker study will investigate the mechanisms of action of clozapine compared to TAU. METHODS AND DESIGN This is the protocol of a multi-centre, open label, blind-rated, randomised controlled effectiveness trial of clozapine vs TAU (any other oral antipsychotic monotherapy licenced in the British National Formulary) for 12 weeks in 260 children and young people with TRS (12-24 years old). AIM AND OBJECTIVES The primary outcome is the change in blind-rated Positive and Negative Syndrome Scale scores at 12 weeks from baseline. Secondary outcomes include blind-rated Clinical Global Impression, patient-rated outcomes, quality of life, adverse effects, and treatment adherence. Patients will be followed up for 12 months and will be invited to give consent for longer term follow-up using clinical records and potential re-contact for further research. For mechanism of action, change in brain magnetic resonance imaging (MRI) biomarkers and peripheral inflammatory markers will be measured over 12 weeks. DISCUSSION The CLEAR trial will contribute knowledge on clozapine effectiveness, safety and cost-effectiveness compared to standard antipsychotics in young people with TRS, and the results may guide future clinical treatment recommendation for early psychosis. TRIAL REGISTRATION ISRCTN Number: 37176025, IRAS Number: 1004947. TRIAL STATUS In set-up. Protocol version 4.0 01/08/23. Current up to date protocol available here: https://fundingawards.nihr.ac.uk/award/NIHR131175# /.
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Affiliation(s)
- C Casetta
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- South London and Maudsley NHS Foundation Trust, London, UK.
| | - P Santosh
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - R Bayley
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - J Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - S Byford
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - C Dixon
- Wonford House Hospital, Devon Partnership NHS Trust, Exeter, UK
| | - R J Drake
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - R Elvins
- Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - R Emsley
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - N Fung
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - D Hayes
- South London and Maudsley NHS Foundation Trust, London, UK
| | - O Howes
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - A James
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - K James
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - R Jones
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - H Killaspy
- Division of Psychiatry, University College London, London, UK
| | - B Lennox
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - L Marchant
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - P McGuire
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - E Oloyede
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - M Rogdaki
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - R Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, UK
- Birmingham Early Intervention Service, Birmingham Womens and Childrens NHS Foundation Trust, Birmingham, UK
| | - J Walters
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - A Egerton
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - J H MacCabe
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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Hayes D, Fancourt D, Burton A. The experiences and impact of the COVID-19 pandemic on young carers: practice implications and planning for future health emergencies. Child Adolesc Psychiatry Ment Health 2024; 18:2. [PMID: 38172971 PMCID: PMC10765662 DOI: 10.1186/s13034-023-00697-6] [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: 10/26/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Young carers are children or young people aged up to 25 years old who undertake unpaid caring responsibilities for a friend or family member. Young carers faced significant challenges brought on by the COVID-19 pandemic. We explored the impact of the pandemic and associated restrictions on mental health, wellbeing and access to support in young carers in the United Kingdom (UK) to understand how to improve services, as well as support this population in future health emergencies. METHOD We conducted 22 qualitative semi-structured interviews from May to November 2021 with 14 young carers and eight staff working in organisations that supported them. Interviews took place remotely over video or telephone call and explored participant experiences of the pandemic and its impact on their health, wellbeing and caring responsibilities. We used reflexive thematic analysis to analyse interview transcripts. RESULTS We identified four overarching themes pertaining to the impact of the pandemic and associated restrictions on mental health, wellbeing and access to support in young carers in the UK: (1) challenges in protecting loved ones from the virus, (2) changes to and loss of routine, (3) reduced access to pre-pandemic informal and formal support structures and (4) better understanding of inner resilience and goals. Many participants struggled with their mental health and wellbeing as a result of pandemic related restrictions which impacted on support structures for themselves and the individual they cared for. However, positive impacts pertained to additional support provided by local authority and third sector organisations. CONCLUSIONS Our findings highlight some of the changes that affected young carers during the COVID-19 pandemic. The impact of changes to routine and a reduction in pre-pandemic support were the greatest concerns reported by participants in this study. The additional support provided by local authority and third sector organisations during social restrictions suggests such organisations could play a greater role in supporting this population going forward and that schools and Governments may wish to put in additional strategies and provisions to protect young carers in the future.
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Affiliation(s)
- D Hayes
- The Social Biobehavioural Research Group, Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London (UCL), 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - D Fancourt
- The Social Biobehavioural Research Group, Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London (UCL), 1-19 Torrington Place, London, WC1E 7HB, UK
| | - A Burton
- The Social Biobehavioural Research Group, Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London (UCL), 1-19 Torrington Place, London, WC1E 7HB, UK
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Koh W, Benscoter A, Chlebowski M, Cooper D, Lehenbauer D, Winlaw D, Morales D, Hayes D. Innovative Clinical Model in Managing Children with Refractory Lung Failure. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Guzman-Gomez A, Ahmed H, Lehenbauer D, Morales D, Critser P, Hirsch R, Zafar F, Hayes D. Lung Transplant Outcomes in Young Adults with Pulmonary Hypertension Bridged with ECMO. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Guzman-Gomez A, Skala E, Dani A, Sharma N, Ziady A, Hayes D. Sex and Sex Hormones Matter in Lung Transplant Outcomes. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Guzman-Gomez A, Ahmed H, Lehenbauer D, Morales D, Critser P, Hirsch R, Zafar F, Hayes D. Outcomes of ECMO as Bridge to Lung Transplant in Children with Pulmonary Hypertension. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Affiliation(s)
- Aaron E Carroll
- Indiana University, Bloomington.,Center for Pediatric and Adolescent Comparative Effectiveness Research, Indiana University School of Medicine, Indianapolis.,Web and Social Media Editor, JAMA Pediatrics
| | - Denise Hayes
- Denise Hayes & Associates Counseling and Consulting, LLC, Indianapolis, Indiana.,Indiana University School of Public Health, Bloomington
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Skala E, Hayes D, Ziady A. 174 Identification of physiological characteristics at baseline and 1 and 6 months that segregate lung function response to ivacaftor using proteomic analysis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00864-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Dani A, Zafar F, Guzman-Gomez A, Morales D, Ziady A, Hayes D. High Volume Centers Have Lower Incidence of Acute Cellular Rejection in Pediatric Lung Transplant Recipients and Better Survival After Treatment. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Woodley F, Gecili E, Szczesniak R, Shrestha C, Nemastil C, Kopp B, Hayes D. 167: Sweat metabolomics profiling of cystic fibrosis pulmonary exacerbations. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01592-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Dani A, Zafar F, Thangappan K, Tiao G, Miethke A, Hayes D, Morales D. Lung-Liver Transplantation Has a Protective Effect on Long-Term Survival in Cystic Fibrosis and Interstitial Pulmonary Fibrosis. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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13
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Thangappan K, Guzman-Gomez A, Zafar F, Hirsch R, Shahanavaz S, Schecter M, Hayes D, Morales D. To Cath or Not to Cath: Pediatric Lung Transplant Candidates without a Diagnosis of Pulmonary Hypertension. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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14
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Dani A, Hayes D, Woods J, Morales D, Hirsch R, Zafar F, Hysinger E. Lung Transplantation for Bronchopulmonary Dysplasia: An Analysis of the UNOS Registry. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.494] [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: 11/30/2022] Open
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15
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Thangappan K, Morales D, Winlaw D, Hayes D, Towe C, Schecter M, Zafar F. Risk Factors for Bronchiolitis Obliterans Syndrome in Pediatric Lung Transplant Recipients. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.993] [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] Open
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Heidel J, Dani A, Hayes D, Towe C, Schecter M, Zhang Y, Hossain M, Zafar F, Morales D. Severely Low BMI Percentile is Associated with Higher Mortality Rate in Children Listed for Lung Transplant. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Hayes D, Stack D, Bjork B, Potter AC, Baldwin CH, Stutz RP. Eliminating Leakage Errors in Hyperfine Qubits. Phys Rev Lett 2020; 124:170501. [PMID: 32412273 DOI: 10.1103/physrevlett.124.170501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 04/13/2020] [Indexed: 06/11/2023]
Abstract
Population leakage outside the qubit subspace presents a particularly harmful source of error that cannot be handled by standard error correction methods. Using a trapped ^{171}Yb^{+} ion, we demonstrate an optical pumping scheme to suppress leakage errors in atomic hyperfine qubits. The selection rules and narrow linewidth of a quadrupole transition are used to selectively pump population out of leakage states and back into the qubit subspace. Each pumping cycle reduces the leakage population by a factor of ∼3, allowing for an exponential suppression in the number of cycles. We use interleaved randomized benchmarking on the qubit subspace to show that this pumping procedure has negligible side effects on the qubit subspace, bounding the induced qubit memory error by ≤2.0(8)×10^{-5} per cycle, and qubit population decay to ≤1.4(3)×10^{-7} per cycle. These results clear a major obstacle for implementations of quantum error correction and error mitigation protocols.
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Affiliation(s)
- D Hayes
- Honeywell Quantum Solutions, 303 S. Technology Ct. 80021 Broomfield, Colorado, USA
| | - D Stack
- Honeywell Quantum Solutions, 303 S. Technology Ct. 80021 Broomfield, Colorado, USA
| | - B Bjork
- Honeywell Quantum Solutions, 303 S. Technology Ct. 80021 Broomfield, Colorado, USA
| | - A C Potter
- Honeywell Quantum Solutions, 303 S. Technology Ct. 80021 Broomfield, Colorado, USA
| | - C H Baldwin
- Honeywell Quantum Solutions, 303 S. Technology Ct. 80021 Broomfield, Colorado, USA
| | - R P Stutz
- Honeywell Quantum Solutions, 303 S. Technology Ct. 80021 Broomfield, Colorado, USA
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Harhay M, Cherikh W, Toll A, Christie J, Stehlik J, Hayes D, Cantu E. Epidemiology, Risk Factors, and Outcomes of Lung Retransplantation: An Analysis of the International Society for Heart and Lung Transplantation (ISHLT) Registry. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Lepak M, Maul T, Hayes D, Hurtado C, Wearden P, Nelson J. Impact of Induction Immunosuppression on Early Outcomes in Pediatric Lung Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Lipp M, Brodmann P, Pietsch K, Pauwels J, Anklam E, Börchers T, Braunschweiger G, Busch U, Eklund E, Eriksen FD, Fagan J, Fellinger A, Gaugitsch H, Hayes D, Hertel C, Hörtner H, Joudrier P, Kruse L, Meyer R, Miraglia M, Müller W, Philipp P, Pöpping B, Rentsch R, Sawyer J, Schulze M, van Duijn G, Vollenhofer S, Wurtz A. IUPAC Collaborative Trial Study of a Method To Detect Genetically Modified Soy Beans and Maize in Dried Powder. J AOAC Int 2020. [DOI: 10.1093/jaoac/82.4.923] [Citation(s) in RCA: 167] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
This paper presents results of a collaborative trial study (IUPAC project No. 650/93/97) involving 29 laboratories in 13 countries applying a method for detecting genetically modified organisms (GMOs) in food. The method is based on using the polymerase chain reaction to determine the 35S promoter and the NOS terminator for detection of GMOs. Reference materials were produced that were derived from genetically modified soy beans and maize. Correct identification of samples containing 2% GMOs is achievable for both soy beans and maize. For samples containing 0.5% genetically modified soy beans, analysis of the 35S promoter resulted also in a 100% correct classification. However, 3 false-negative results (out of 105 samples analyzed) were reported for analysis of the NOS terminator, which is due to the lower sensitivity of this method. Because of the bigger genomic DNA of maize, the probability of encountering false-negative results for samples containing 0.5% GMOs is greater for maize than for soy beans. For blank samples (0% GMO), only 2 false-positive results for soy beans and one for maize were reported. These results appeared as very weak signals and were most probably due to contamination of laboratory equipment.
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Affiliation(s)
- Markus Lipp
- The National Physical Laboratory of Israel (INPL), Danciger A Bldg., Givat Ram, Jerusalem 91904, Israel, Tel: +972-2-6536534, Fax: +972-2-6520797
| | - Peter Brodmann
- Kantonales Labor Basel, Postfach, CH-4012 Basel, Switzerland
| | - Klaus Pietsch
- Chemische Landesuntersuchungsanstalt Freiburg, Bissierstrasse 5, D-79114 Freiburg, Germany
| | - Jean Pauwels
- European Commission, DG Joint Research Center, Institute for Reference Materials and Measurements, Retieseweg, B-2440 Geel, Belgium
| | - Elke Anklam
- European Commission, DG Joint Research Center, Institute for Health and Consumer Protection, Food Products Unit, 1-21020 Ispra(Va), Italy
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Fukushima M, Goda J, Oizumi A, Bounds J, Cutler T, Grove T, Hayes D, Hutchinson J, McKenzie G, McSpaden A, Sanchez R, Walker J, Tsujimoto K. Systematic Measurements and Analyses for Lead Void Reactivity Worth in a Plutonium Core and Two Uranium Cores with Different Enrichments. NUCL SCI ENG 2019. [DOI: 10.1080/00295639.2019.1663089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- M. Fukushima
- Japan Atomic Energy Agency, Nuclear Science and Engineering Center, 2-4 Shirane, Shirakata, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
| | - J. Goda
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - A. Oizumi
- Japan Atomic Energy Agency, Nuclear Science and Engineering Center, 2-4 Shirane, Shirakata, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
| | - J. Bounds
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - T. Cutler
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - T. Grove
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - D. Hayes
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - J. Hutchinson
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - G. McKenzie
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - A. McSpaden
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - R. Sanchez
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - J. Walker
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - K. Tsujimoto
- Japan Atomic Energy Agency, Nuclear Science and Engineering Center, 2-4 Shirane, Shirakata, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
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Kearney K, Bart N, Khush K, Hayes D, Keogh A. P4698Survival outcomes in patients with Eisenmenger syndrome after heart-lung or bilateral sequential lung transplantation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Eisenmenger syndrome (ES) is defined as pulmonary hypertension secondary to a right to left intracardiac shunt, commonly an atrial septal defect (ASD) or ventricular septal defect (VSD). Heart-lung (HLTx) or bilateral sequential lung transplantation (BSLT) are both treatment options for some candidates. The choice between these two procedures has varied historically and according to transplant centre preference and donor availability. We completed a retrospective study to determine if BSLT with cardiac repair was associated with better outcomes compared to HLTx.
Aim
This study compared post-transplant survival in patients with ES undergoing HLTx or BSLT.
Method
Using the International Society Heart and Lung Transplantation Registry data, we identified all patients with ES between October 1, 1987 and March 31, 2018.
Results
A total of 177 patients underwent HLTx for ES ASD and 101 who underwent BSLT with cardiac repair. Median follow up was 890 days (range 0–9888 days) for the entire post-transplant cohort. 126 HLTx and 66 BSLT patients died in the follow up period.
A total of 173 ES VSD patients underwent HLTx in the database, and 52 underwent BSLT with cardiac repair. Median follow up was 460 days (range 0–8406 days) for the entire post-transplant cohort. 116 HLTx and 36 BSLT patients died during the follow up period.
Figure 1 demonstratres the comparative Kaplan-Meier survival curves following BSLT or HLTx for Eisenmenger's ASD and VSD patients. No statistically significant difference in Eisenmenger survival between combined heart-lung transplantation or bilateral sequential lung transplantation group (ASD log rank test p value = 0.99, VSD log rank test p value = 0.1 performed for the first 6 year).
Figure 1
Conclusions
Our analysis determined that patients with ES and either VSD or ASD had similar long-term survival comparing HLTx with BSLT and cardiac repair.
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Affiliation(s)
- K Kearney
- St Vincents Hospital, Sydney, Australia
| | - N Bart
- St Vincents Hospital, Sydney, Australia
| | - K Khush
- Stanford University, Palo Alto, United States of America
| | - D Hayes
- Nationwide Children's Hospital, Columbus, United States of America
| | - A Keogh
- St Vincents Hospital, Sydney, Australia
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23
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Kearney K, Bart N, Khush K, Hayes D, Keogh A. 4974Waitlist outcomes for Eisenmengers patients listed for bilateral sequential lung transplant or heart-lung transplant. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Eisenmenger's syndrome (ES) is the end-stage of a longstanding intracardiac shunt, commonly an atrial septal defect (ASD) or ventricular septal defect (VSD). Transplantation is the final option to address the pulmonary hypertension and right heart failure that results. Both combined heart-lung (HLTx) and bilateral sequential lung transplantation (BSLT) have been performed for ES. Overall, BSLT are performed more commonly than HLTx because of donor organ availability. We postulated that ES patients would have higher waitlist mortality and longer time to transplant compared to patients listed for other indications, and BSLT patients would have reduced waitlist mortality and reduced time to transplant compared to HLTx based on availability.
Aim
This study compared waitlist outcomes between ES ASD, ES VSD and all patients listed for BSLT or HLTx.
Methods
We analysed the Organ Procurement and Transplant Network (OPTN) database for all patients listed for BSLT or HLTx between October 1, 1987 and March 31, 2018. Mood's median test was used for all tests of significance.
Results
Table 1 summarises the results of the analysis. A total of 56,698 patients were on the waitlist for BSLT for all aetiologies, which included 176 ES ASD patients and 156 ES VSD patients. A total of 3231 patients were on the waitlist for HLTx for all aetiologies, which included 89 ES ASD and 176 ES VSD patients. Median time to transplant was significantly longer for all ES patients on the waitlist for BSLT or HLTx compare to patients listed for other indications. Comparing time to transplant for BSLT to HLTx for either ES ASD or VSD did not reach statistical significance. Waitlist mortality was substantially higher for all ES patients regardless whether they were listed for BSLT or HLTx compared to patients listed for other indications.
Table 1 ES ASD ES VSD All patients BSLT HLTx BSLT HLTx BSLT HLTx Total number of patients listed 176 89 156 176 56698 3231 Transplanted 58 (33.0%) 38 (42.7%) 41 (25.8%) 78 (44.3%) 36441 (64.3%) 1229 (38.0%) Median time to transplant in days 330 (24 to 2723)* 431 (11 to 4527)$ 517 (10 to 2345)# 292 (16 to 2399)& 99 (0 to 6592) 174 (0 to 3606) p=0.54 p=0.08 *p≤0.001, #p=≤0.0001 $p=0.000, &p=0.003 Wait list mortality 27 (15.3%) 25 (28.1%) 23 (14.5%) 46 (26.1%) 2366 (4.2%) 371 (11.5%)
Conclusion
Our analysis identified longer waitlist time and higher mortality for all ES patients listed for BSLT or HLTx in the United States. These findings indicate current listing methods and prognostication place the ES population at disadvantage for thoracic transplantation.
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Affiliation(s)
- K Kearney
- St Vincents Hospital, Sydney, Australia
| | - N Bart
- St Vincents Hospital, Sydney, Australia
| | - K Khush
- Stanford University, Palo Alto, United States of America
| | - D Hayes
- Nationwide Children's Hospital, Columbus, United States of America
| | - A Keogh
- St Vincents Hospital, Sydney, Australia
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Helsen C, Hayes D, Hammill J, Aarts C, Bader A, Bramson J. Development of a CD19-TAC therapy in preparation of human trials. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.336] [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: 10/26/2022]
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25
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Hayes D, Edbrooke-Childs J, Town R, Wolpert M, Midgley N. Barriers and facilitators to shared decision making in child and youth mental health: clinician perspectives using the Theoretical Domains Framework. Eur Child Adolesc Psychiatry 2019; 28:655-666. [PMID: 30229306 PMCID: PMC6514112 DOI: 10.1007/s00787-018-1230-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 09/15/2018] [Indexed: 12/01/2022]
Abstract
Shared decision making (SDM) is increasingly being suggested as an integral part of mental health provision. Yet, there is little research on what clinicians believe the barriers and facilitators around practice to be. At the same time, there is also increasing recognition of a theory-practice gap within the field, with calls for more pragmatic uses of theory to inform and improve clinical practice. Using the Theoretical Domains Framework (TDF), a comprehensive, theoretical-led framework, underpinned by 33 behaviour change theories and 128 constructs, clinician perceived barriers and facilitators to SDM are investigated. The sample comprised of 15 clinicians across two sites in England, who took part in qualitative semi-structured interviews and focus groups. Transcripts were analysed using a deductive thematic analysis, and themes were coded under each theoretical domain. Overall, 21 barriers and facilitators for SDM in child and youth mental health were identified across ten domains of the TDF. Under capability, barriers and facilitators were found for knowledge, skills, memory/attention/decision making processes, and behavioural regulation. For opportunity, barriers and facilitators were found for social influences, as well as environmental context and resources. Finally, for motivation, domains covered included: beliefs about consequences, beliefs about capabilities, emotions, and professional role and identity. Findings suggest that a range of barriers and facilitators affect clinicians' abilities to engage in SDM with young people and parents. Interventions which target different domains related to capability, opportunity and motivation should be developed to better facilitate young people and their families in care and treatment decisions.
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Affiliation(s)
- D. Hayes
- Evidence Based Practice Unit, University College London and Anna Freud Centre, 21 Maresfield Gardens, London, NW3 5SD UK
| | - J. Edbrooke-Childs
- Evidence Based Practice Unit, University College London and Anna Freud Centre, 21 Maresfield Gardens, London, NW3 5SD UK
| | - R. Town
- Evidence Based Practice Unit, University College London and Anna Freud Centre, 21 Maresfield Gardens, London, NW3 5SD UK
| | - M. Wolpert
- Evidence Based Practice Unit, University College London and Anna Freud Centre, 21 Maresfield Gardens, London, NW3 5SD UK
| | - N. Midgley
- Anna Freud National Centre for Children and Families, 21 Maresfield Gardens, London, NW3 5SD UK
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26
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Desai K, Rabinowitz EJ, Mitchell E, Hayes D, Tugertimur A, Kwon E, Dhanantwari P, Misra N, Rubin L. 643. Coronary Artery Aneurysms Are Found on Blindly Read Echocardiograms From Febrile Patients with and Without Kawasaki Disease. Open Forum Infect Dis 2018. [PMCID: PMC6253784 DOI: 10.1093/ofid/ofy210.650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background In 2017, the American Heart Association published new Kawasaki disease (KD) guidelines including echocardiographic (echo) criteria for diagnosis of incomplete KD (iKD). Echo is positive if 1 or more coronary arteries (CA) show aneurysmal dilation (Z score of ≥ 2.5), or if a CA has milder dilation (Z score of 2–2.49) plus ≥2 of the following: decreased left ventricular function, mitral regurgitation, and pericardial effusion. While CA dilation is seen commonly in KD and iKD, specificity of this finding is unclear because patients with systemic febrile illnesses may have CA dilation. To assess specificity of the American Heart Association criteria, blinded readers measured CA dimension in patients with KD and iKD and in febrile and healthy patient controls. Methods This is a single-center retrospective study. De-identified echo clips of CA from patients age 0–10 years were interpreted blindly and independently by six pediatric cardiologists. KD and iKD diagnoses were based on clinical data and IVIG treatment. Control groups were healthy patients evaluated for a benign murmur and febrile patients with fever ≥72 hours without a KD diagnosis or IVIG treatment. Detection of left ventricular dysfunction, mitral regurgitation and effusion was recorded. An echo was considered positive if the reading from at least one reader met AHA criteria for iKD. Results Echos from 29 KD, 30 iKD, 28 febrile, and 27 healthy patients were reviewed. The initial echo of 41% of KD and 43% of iKD groups met echo criteria for diagnosis of iKD and 55% and 57%, respectively, had CA dilation or aneurysm. Among febrile patients, 7 (25%) had an abnormal CA size of which 4 (14%) met echo criteria for iKD. In the healthy patients, four (15%) had abnormal CA of which two (7.4%) met echo criteria for iKD. Among patients with a positive echo read, the median number of readers who read a CA as dilated was similar for each group. Furthermore, of all patients meeting echo criteria for iKD, 90% had aneurysmal CA dilatation. Conclusion Although CA abnormalities diagnostic of KD were commonly present at time of diagnosis in patients with KD or iKD, these findings were also present in some healthy and some febrile patients. Diagnosis of iKD in febrile children using echo criteria may result in an over-diagnosis of KD. Disclosures All authors: No reported disclosures.
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Affiliation(s)
- Kinjal Desai
- Pediatrics, Cohen Children’s Medical Center, New Hyde Park, New York
| | - Edon J Rabinowitz
- Pediatric Cardiology, Cohen Children’s Medical Center, New Hyde Park, New York
| | - Elizabeth Mitchell
- Pediatric Cardiology, Cohen Children’s Medical Center, New Hyde Park, New York
| | - Denise Hayes
- Pediatric Cardiology, Cohen Children’s Medical Center, New Hyde Park, New York
| | - Aykut Tugertimur
- Pediatric Cardiology, Cohen Children’s Medical Center, New Hyde Park, New York
| | - Elena Kwon
- Pediatric Cardiology, Cohen Children’s Medical Center, New Hyde Park, New York
| | - Preeta Dhanantwari
- Pediatric Cardiology, Cohen Children’s Medical Center, New Hyde Park, New York
| | - Nilanjana Misra
- Pediatric Cardiology, Cohen Children’s Medical Center, New Hyde Park, New York
| | - Lorry Rubin
- Cohen Children’s Medical Center of New York, Northwell Health, New Hyde Park, New York
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27
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Kravariti E, Reeve-Mates C, Da Gama Pires R, Tsakanikos E, Hayes D, Renshaw S, McAllister S, Bhavsar V, Patterson P, Daley E, Stewart J, Pritchard M, Shetty H, Ramsay R, Perez-Iglesias R, McGuire P. Effectiveness of automated appointment reminders in Psychosis Community Services: A randomised controlled trial - CORRIGENDUM. BJPsych Open 2018; 4:419. [PMID: 30295223 PMCID: PMC6235977 DOI: 10.1192/bjo.2018.62] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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28
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Ryan S, Hayes D, Creedon B. Use of “Months of the Year Backwards” (MOTYB) as a Screening Tool for Delirium in Palliative Care Patients in the Acute Hospital Setting. Ir Med J 2018; 111:801. [PMID: 30547518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Introduction Delirium is common in palliative care. It effects up to 88% of patients with advanced cancer at end of life and has a point prevalence of 20% in the acute hospital setting across all diagnoses. It is under diagnosed and not optimally treated. “Months of the Year Backwards” (MOTYB) is an ideal screening tool for delirium with a sensitivity of 83.8%. It is brief to perform and carries low burden for patients. The aim of this study is to investigate the use of MOTYB as a screening tool for delirium in palliative care patients in the acute hospital setting. Methods All patients who were referred to the hospital palliative care team in September 2016 were screened. Results Forty five patients were screened using MOTYB. Fifteen patients (33%) screened positive for delirium. Conclusion MOTYB is a simple screening tool that was easily integrated into practice in a hospital service. It has the potential to identify missed cases of delirium and therefore improve management and ultimately patient outcomes.
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Affiliation(s)
- S Ryan
- University Hospital Waterford
| | - D Hayes
- University Hospital Waterford
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29
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Shelby ML, Hayes D, Lestrange P, Fransted K, Lemke H, Zhu D, Li X, Chen LX. Ultrafast reaction pathways in a metalloprotein revealed by optical polarization selected X-ray transient absorption spectroscopy and quantum mechanical calculations. Acta Crystallogr A Found Adv 2018. [DOI: 10.1107/s0108767318095508] [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: 11/10/2022] Open
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30
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Helsen C, Hammill J, Mwawasi K, Lau V, Hayes D, Afsahi A, Bezverbnaya K, Newhook L, Aarts C, Denisova G, Bramson J. T cells engineered with T-cell antigen coupler (TAC) receptors display robust efficacy against solid and liquid tumor xenografts in the absence of any toxicity. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.010] [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: 11/25/2022]
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31
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Koutsokera A, Benden C, Cantu E, Chambers D, Cypel M, Edelman J, Emtiazjoo A, Fisher A, Greenland J, Hayes D, Hwang D, Keller B, Lease E, Perch M, Sato M, Todd J, Verleden S, von der Thüsen J, Weight S, Keshavjee S, Martinu T. Bronchoalveolar Lavage Practices in Lung Transplantation: Results of a Large-scale International Survey. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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32
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McKee C, Tumin D, Alevriadou BR, Nicol KK, Yates AR, Hayes D, Tobias JD. Age-Dependent Association Between Pre-transplant Blood Transfusion and Outcomes of Pediatric Heart Transplantation. Pediatr Cardiol 2018; 39:743-748. [PMID: 29340730 DOI: 10.1007/s00246-018-1814-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 10/20/2017] [Accepted: 01/04/2018] [Indexed: 02/07/2023]
Abstract
Avoidance of red blood cell (RBC) transfusions in patients awaiting heart transplantation (HTx) has been suggested to minimize the risk of allosensitization. Although recent studies have suggested that an immature immune system in younger HTx recipients may reduce risks associated with RBC transfusion, the role of age in moderating the influence of transfusion on HTx outcomes remains unclear. We used available data from a national transplant registry to explore whether the association between pre-transplant transfusions and outcomes of pediatric HTx varies by patient age. De-identified data were obtained from the United Network for Organ Sharing registry, including first-time recipients of isolated HTx performed at age 0-17 years in 1995-2015. The primary exposure was receiving blood transfusions within 2 weeks prior to HTx. Patient survival after HTx was evaluated using multivariable Cox proportional hazards, where age at transplant was interacted with exposure to pre-transplant transfusion. Age-specific hazard ratios (HRs) of pre-transplant transfusion were plotted across ages at transplant. There were 4883 patients meeting inclusion criteria, of whom 1258 died during follow-up (mean follow-up duration 6 ± 5 years). Patients receiving pre-transplant transfusions were distinguished by younger age, higher prevalence of prior cardiac surgery, greater likelihood of being in the intensive care unit, and greater use of left ventricular assist device bridge to transplant. In multivariable analysis, pre-transplant transfusions were associated with increased mortality hazard among infants < 1 year of age (HR = 1.46; 95% CI 1.23, 1.74; p < 0.001). For each additional year of age, the excess hazard associated with pre-transplant transfusions decreased by 3% (interaction HR = 0.97; 95% CI 0.98, 0.99; p = 0.003). By age 8, the association between pre-transplant transfusions and post-transplant mortality was no longer statistically significant (HR = 1.15; 95% CI 0.99, 1.32; p = 0.060). Pre-transplant transfusions were associated with increased mortality hazard only among younger children (age < 8 years) undergoing HTx. These data support the current practices of transfusion avoidance prior to HTx, particularly in younger patients.
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Affiliation(s)
- C McKee
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA. .,Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA.
| | - D Tumin
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA
| | - B R Alevriadou
- Departments of Biomedical Engineering and Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - K K Nicol
- Department of Pathology, Nationwide Children's Hospital, Columbus, OH, USA
| | - A R Yates
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - D Hayes
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - J D Tobias
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
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Abstract
Aims and MethodThe use of the term ‘client’ has become increasingly popular among non-medical staff in psychiatric practice. We sought to describe the preferences and attitudes of people attending a psychiatric clinic to the terms patient and client. A questionnaire and case note review was employed.Results147 people completed the questionnaire, of these 77% preferred the term patient. There was no subgroup that preferred the term client. Attitudes towards the two terms were significantly different, with a greater antipathy demonstrated towards the term client.Clinical ImplicationsThe majority of people attending a psychiatric clinic prefer the use of the term patient; the term client is disliked.
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34
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Huntzinger DN, Michalak AM, Schwalm C, Ciais P, King AW, Fang Y, Schaefer K, Wei Y, Cook RB, Fisher JB, Hayes D, Huang M, Ito A, Jain AK, Lei H, Lu C, Maignan F, Mao J, Parazoo N, Peng S, Poulter B, Ricciuto D, Shi X, Tian H, Wang W, Zeng N, Zhao F. Uncertainty in the response of terrestrial carbon sink to environmental drivers undermines carbon-climate feedback predictions. Sci Rep 2017; 7:4765. [PMID: 28684755 PMCID: PMC5500546 DOI: 10.1038/s41598-017-03818-2] [Citation(s) in RCA: 118] [Impact Index Per Article: 16.9] [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: 10/11/2016] [Accepted: 05/05/2017] [Indexed: 11/17/2022] Open
Abstract
Terrestrial ecosystems play a vital role in regulating the accumulation of carbon (C) in the atmosphere. Understanding the factors controlling land C uptake is critical for reducing uncertainties in projections of future climate. The relative importance of changing climate, rising atmospheric CO2, and other factors, however, remains unclear despite decades of research. Here, we use an ensemble of land models to show that models disagree on the primary driver of cumulative C uptake for 85% of vegetated land area. Disagreement is largest in model sensitivity to rising atmospheric CO2 which shows almost twice the variability in cumulative land uptake since 1901 (1 s.d. of 212.8 PgC vs. 138.5 PgC, respectively). We find that variability in CO2 and temperature sensitivity is attributable, in part, to their compensatory effects on C uptake, whereby comparable estimates of C uptake can arise by invoking different sensitivities to key environmental conditions. Conversely, divergent estimates of C uptake can occur despite being based on the same environmental sensitivities. Together, these findings imply an important limitation to the predictability of C cycling and climate under unprecedented environmental conditions. We suggest that the carbon modeling community prioritize a probabilistic multi-model approach to generate more robust C cycle projections.
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Affiliation(s)
- D N Huntzinger
- School of Earth Sciences and Environmental Sustainability, Northern Arizona University, P.O. Box 5694, Flagstaff, Arizona, 86011-5694, USA.
| | - A M Michalak
- Department of Global Ecology, Carnegie Institution for Science, Stanford, California, USA
| | - C Schwalm
- School of Earth Sciences and Environmental Sustainability, Northern Arizona University, P.O. Box 5694, Flagstaff, Arizona, 86011-5694, USA
- Woods Hole Research Center, Falmouth, MA, 02540, USA
| | - P Ciais
- Laboratoire des Sciences du Climat et de l'Environnement, IPSL-LSCE CEA CNRS UVSQ, 91191, Gif sur, Yvette, France
| | - A W King
- Environmental Sciences Division and Climate Change Science Institute, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
| | - Y Fang
- Department of Global Ecology, Carnegie Institution for Science, Stanford, California, USA
| | - K Schaefer
- National Snow and Ice Data Center, Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, Colorado, USA
| | - Y Wei
- Environmental Sciences Division and Climate Change Science Institute, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
| | - R B Cook
- Environmental Sciences Division and Climate Change Science Institute, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
| | - J B Fisher
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - D Hayes
- School of Forest Resources, University of Maine, Orno, ME, USA
| | - M Huang
- Atmospheric and Global Change Division, Pacific Northwest National Laboratory, Richland, WA, USA
| | - A Ito
- National Institute for Environmental Studies, Tsukuba, Japan
| | - A K Jain
- Department of Atmospheric Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - H Lei
- Atmospheric Sciences and Global Change Division, Pacific Northwest National Laboratory, Richland, Washington, USA
- State Key Laboratory of Hydroscience and Engineering, Department of Hydraulic Engineering, Tsinghua University, Beijing, China
| | - C Lu
- Department of Ecology, Evolution and Organismal Biology, Iowa State University, Ames, IA, USA
| | - F Maignan
- Laboratoire des Sciences du Climat et de l'Environnement, IPSL-LSCE CEA CNRS UVSQ, 91191, Gif sur, Yvette, France
| | - J Mao
- Environmental Sciences Division and Climate Change Science Institute, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
| | - N Parazoo
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - S Peng
- Laboratoire des Sciences du Climat et de l'Environnement, IPSL-LSCE CEA CNRS UVSQ, 91191, Gif sur, Yvette, France
| | - B Poulter
- Department of Ecology, Montana State University, Bozeman, MT, USA
| | - D Ricciuto
- Environmental Sciences Division and Climate Change Science Institute, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
| | - X Shi
- Environmental Sciences Division and Climate Change Science Institute, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
| | - H Tian
- International Center for Climate and Global Change Research and School of Forestry and Wildlife Sciences, Auburn University, Auburn, Alabama, USA
| | - W Wang
- Ames Research Center, National Aeronautics and Space Administration, Moffett Field, California, USA
| | - N Zeng
- Department of Atmospheric and Oceanic Science, University of Maryland, College Park, Maryland, USA
| | - F Zhao
- Department of Atmospheric and Oceanic Science, University of Maryland, College Park, Maryland, USA
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35
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Grossman RL, Abel B, Angiuoli S, Barrett JC, Bassett D, Bramlett K, Blumenthal GM, Carlsson A, Cortese R, DiGiovanna J, Davis-Dusenbery B, Dittamore R, Eberhard DA, Febbo P, Fitzsimons M, Flamig Z, Godsey J, Goswami J, Gruen A, Ortuño F, Han J, Hayes D, Hicks J, Holloway D, Hovelson D, Johnson J, Juhl H, Kalamegham R, Kamal R, Kang Q, Kelloff GJ, Klozenbuecher M, Kolatkar A, Kuhn P, Langone K, Leary R, Loverso P, Manmathan H, Martin AM, Martini J, Miller D, Mitchell M, Morgan T, Mulpuri R, Nguyen T, Otto G, Pathak A, Peters E, Philip R, Posadas E, Reese D, Reese MG, Robinson D, Dei Rossi A, Sakul H, Schageman J, Singh S, Scher HI, Schmitt K, Silvestro A, Simmons J, Simmons T, Sislow J, Talasaz A, Tang P, Tewari M, Tomlins S, Toukhy H, Tseng HR, Tuck M, Tzou A, Vinson J, Wang Y, Wells W, Welsh A, Wilbanks J, Wolf J, Young L, Lee J, Leiman LC. Collaborating to Compete: Blood Profiling Atlas in Cancer (BloodPAC) Consortium. Clin Pharmacol Ther 2017; 101:589-592. [PMID: 28187516 PMCID: PMC5525192 DOI: 10.1002/cpt.666] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 02/08/2017] [Accepted: 02/08/2017] [Indexed: 01/02/2023]
Abstract
The cancer community understands the value of blood profiling measurements in assessing and monitoring cancer. We describe an effort among academic, government, biotechnology, diagnostic, and pharmaceutical companies called the Blood Profiling Atlas in Cancer (BloodPAC) Project. BloodPAC will aggregate, make freely available, and harmonize for further analyses, raw datasets, relevant associated clinical data (e.g., clinical diagnosis, treatment history, and outcomes), and sample preparation and handling protocols to accelerate the development of blood profiling assays.
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Affiliation(s)
- R L Grossman
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - B Abel
- Genomic Health, Redwood City, California, USA
| | - S Angiuoli
- Personal Genome Diagnostics, Baltimore, Maryland, USA
| | | | | | - K Bramlett
- Thermo Fisher Scientific, Austin, Texas, USA
| | - G M Blumenthal
- Center for Drug Evaluation and Research, Food and Drug Administration, Silver Springs, Maryland, USA
| | - A Carlsson
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, University of California, Los Angeles, California, USA
| | - R Cortese
- Seven Bridges, Cambridge, Massachusetts, USA
| | | | | | - R Dittamore
- Epic Research and Diagnostics, San Diego, California, USA
| | | | - P Febbo
- Genomic Health, Redwood City, California, USA
| | - M Fitzsimons
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - Z Flamig
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - J Godsey
- Thermo Fisher Scientific, Waltham, Massachusetts, USA
| | - J Goswami
- Thermo Fisher Scientific, Carlsbad, California, USA
| | - A Gruen
- Seven Bridges, Cambridge, Massachusetts, USA
| | - F Ortuño
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - J Han
- Genomic Health, Redwood City, California, USA
| | - D Hayes
- University of Michigan, Ann Arbor, Michigan, USA
| | - J Hicks
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, University of California, Los Angeles, California, USA
| | - D Holloway
- Seven Bridges, Cambridge, Massachusetts, USA
| | - D Hovelson
- University of Michigan, Ann Arbor, Michigan, USA
| | - J Johnson
- AstraZeneca, Waltham, Massachusetts, USA
| | - H Juhl
- Indivumed GmbH, Hamburg, Germany
| | - R Kalamegham
- Genentech, Washington, District of Columbia, USA
| | - R Kamal
- Omicia, Oakland, California, USA
| | - Q Kang
- University of Michigan, Ann Arbor, Michigan, USA
| | - G J Kelloff
- Office of the Director, National Cancer Institute, Bethesda, Maryland, USA
| | | | - A Kolatkar
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, University of California, Los Angeles, California, USA
| | - P Kuhn
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, University of California, Los Angeles, California, USA
| | - K Langone
- Genomic Health, Redwood City, California, USA
| | - R Leary
- Novartis Institute for Biomedical Research, Cambridge, Massachusetts, USA
| | - P Loverso
- Personal Genome Diagnostics, Baltimore, Maryland, USA
| | - H Manmathan
- Seven Bridges, Cambridge, Massachusetts, USA
| | - A-M Martin
- Novartis Pharmaceuticals, East Hanover, New Jersey, USA
| | | | - D Miller
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - M Mitchell
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - T Morgan
- University of Michigan, Ann Arbor, Michigan, USA
| | - R Mulpuri
- Provista Diagnostics Inc., New York, New York, USA
| | - T Nguyen
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - G Otto
- Foundation Medicine, Cambridge, Massachusetts, USA
| | - A Pathak
- Center for Device and Radiological Health, Food and Drug Administration, Silver Springs, Maryland, USA
| | - E Peters
- Genentech, South San Francisco, California, USA
| | - R Philip
- Center for Device and Radiological Health, Food and Drug Administration, Silver Springs, Maryland, USA
| | - E Posadas
- CytoLumina, Inc., Los Angeles, California, USA.,Cedar-Sinai Medical Center, Los Angeles, California, USA
| | - D Reese
- Provista Diagnostics Inc., New York, New York, USA
| | | | - D Robinson
- Novartis Institute for Biomedical Research, Cambridge, Massachusetts, USA
| | - A Dei Rossi
- Genomic Health, Redwood City, California, USA
| | - H Sakul
- Pfizer, San Diego, California, USA
| | - J Schageman
- Thermo Fisher Scientific, Austin, Texas, USA
| | - S Singh
- Foundation Medicine, Cambridge, Massachusetts, USA
| | - H I Scher
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - K Schmitt
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - A Silvestro
- Novartis Institute for Biomedical Research, Cambridge, Massachusetts, USA
| | - J Simmons
- Personal Genome Diagnostics, Baltimore, Maryland, USA
| | - T Simmons
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - J Sislow
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - A Talasaz
- Guardant Health, Inc., Redwood City, California, USA
| | - P Tang
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - M Tewari
- University of Michigan, Ann Arbor, Michigan, USA
| | - S Tomlins
- University of Michigan, Ann Arbor, Michigan, USA
| | - H Toukhy
- Guardant Health, Inc., Redwood City, California, USA
| | - H R Tseng
- CytoLumina, Inc., Los Angeles, California, USA.,Crump Institute for Molecular Imaging, University of California, Los Angeles, California, USA
| | - M Tuck
- University of Michigan, Ann Arbor, Michigan, USA
| | - A Tzou
- Center for Device and Radiological Health, Food and Drug Administration, Silver Springs, Maryland, USA
| | - J Vinson
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Y Wang
- Epic Research and Diagnostics, San Diego, California, USA
| | - W Wells
- Open Commons Consortium, Chicago, Illinois, USA
| | - A Welsh
- Foundation Medicine, Cambridge, Massachusetts, USA
| | - J Wilbanks
- Sage Bionetworks, Seattle, Washington, USA
| | - J Wolf
- Provista Diagnostics Inc., New York, New York, USA
| | - L Young
- Foundation Medicine, Cambridge, Massachusetts, USA
| | - Jsh Lee
- Office of the Director, National Cancer Institute, Bethesda, Maryland, USA
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Morrison A, Tumin D, Hayes D, Phelps C, Tobias J, Gajarski R, Nandi D. Pediatric Marginal Donor Hearts: National Use and Center-Specific Variability. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Ammerman E, Danziger-Isakov L, Storch G, Fenchel M, Conrad C, Hayes D, Faro A, Goldfarb S, Kesler K, Melicoff-Portillo E, Schecter M, Visner G, Williams N, Sweet S. Risk and Outcomes of Pulmonary Fungal Infection in Pediatric Lung Transplant. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Sweet S, Buller R, Chin H, Conrad C, Faro A, Goldfarb S, Hayes D, Heeger P, Ikle D, Kesler K, Melicoff-Portillo E, Mohanakumar T, Schecter M, Storch G, Visner G, Williams N, Danziger-Isakov L. Respiratory Viral Infections in Pediatric Lung Transplant Recipients Are Not Associated with BOS, Retransplant or Death. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Hayes D, Hartwig MG, Tobias JD, Tumin D. Lung Transplant Center Volume Ameliorates Adverse Influence of Prolonged Ischemic Time on Mortality. Am J Transplant 2017; 17:218-226. [PMID: 27278264 PMCID: PMC5148712 DOI: 10.1111/ajt.13916] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 05/24/2016] [Accepted: 06/03/2016] [Indexed: 01/25/2023]
Abstract
The influence of prolonged ischemic time on outcomes after lung transplant is controversial, but no research has investigated ischemic time in the context of center volume. We used data from the United Network for Organ Sharing to estimate the influence of ischemic time on patient survival conditional on center volume in the post-lung allocation score era (2005-2015). The analytic sample included 14 877 adult lung transplant recipients, of whom 12 447 were included in multivariable survival analysis. Patient survival was improved in high-volume centers compared with low-volume centers (log-rank test p = 0.001), although mean ischemic times were longer at high-volume centers (5.16 ± 1.70 h vs. 4.83 ± 1.63 h, p < 0.001). Multivariable Cox proportional hazards regression stratified by transplant center found an adverse influence of longer ischemic time at low-volume centers but not at high-volume centers. At centers performing 50 transplants in the period 2005-2015, for example, 8 versus 6 h of ischemia were associated with an 18.9% (95% confidence interval 6.5-32.7%; p < 0.001) greater mortality hazard, whereas at centers performing 350 transplants in this period, no differences in survival by ischemic time were predicted. Despite longer mean ischemic time at high-volume transplant centers, these centers had favorable patient outcomes and no adverse survival implications of prolonged ischemia.
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Affiliation(s)
- D. Hayes
- Department of Pediatrics, The Ohio State University, Columbus, OH,Department of Internal Medicine, The Ohio State University, Columbus, OH,Department of Surgery, The Ohio State University, Columbus, OH,Center for Epidemiology of Organ Failure and Transplantation, Nationwide Children’s Hospital, Columbus, OH,Section of Pulmonary Medicine, Nationwide Children’s Hospital, Columbus, OH,Corresponding author: Don Hayes, Jr.,
| | | | - J. D. Tobias
- Center for Epidemiology of Organ Failure and Transplantation, Nationwide Children’s Hospital, Columbus, OH,Department of Anesthesiology, The Ohio State University, Columbus, OH,Department of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital, Columbus, OH
| | - D. Tumin
- Department of Pediatrics, The Ohio State University, Columbus, OH,Center for Epidemiology of Organ Failure and Transplantation, Nationwide Children’s Hospital, Columbus, OH,Department of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital, Columbus, OH
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Liblik T, Karstensen J, Testor P, Alenius P, Hayes D, Ruiz S, Heywood K, Pouliquen S, Mortier L, Mauri E. Potential for an underwater glider component as part of the Global Ocean Observing System. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.mio.2016.05.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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41
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Olefeldt D, Goswami S, Grosse G, Hayes D, Hugelius G, Kuhry P, McGuire AD, Romanovsky VE, Sannel A, Schuur E, Turetsky MR. Circumpolar distribution and carbon storage of thermokarst landscapes. Nat Commun 2016; 7:13043. [PMID: 27725633 PMCID: PMC5062615 DOI: 10.1038/ncomms13043] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [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: 11/03/2015] [Accepted: 08/26/2016] [Indexed: 11/24/2022] Open
Abstract
Thermokarst is the process whereby the thawing of ice-rich permafrost ground causes land subsidence, resulting in development of distinctive landforms. Accelerated thermokarst due to climate change will damage infrastructure, but also impact hydrology, ecology and biogeochemistry. Here, we present a circumpolar assessment of the distribution of thermokarst landscapes, defined as landscapes comprised of current thermokarst landforms and areas susceptible to future thermokarst development. At 3.6 × 106 km2, thermokarst landscapes are estimated to cover ∼20% of the northern permafrost region, with approximately equal contributions from three landscape types where characteristic wetland, lake and hillslope thermokarst landforms occur. We estimate that approximately half of the below-ground organic carbon within the study region is stored in thermokarst landscapes. Our results highlight the importance of explicitly considering thermokarst when assessing impacts of climate change, including future landscape greenhouse gas emissions, and provide a means for assessing such impacts at the circumpolar scale.
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Affiliation(s)
- D. Olefeldt
- Department of Renewable Resources, University of Alberta, Edmonton, Alberta, Canada T6G 2H1
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada N1G 2W1
| | - S. Goswami
- Environmental Sciences Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- National Remote Sensing Centre, Indian Space Research Organization, Balanagar, Hyderabad 500037, India
| | - G. Grosse
- Alfred Wegener Institute, Helmholtz Centre for Polar and Marine Research, Telegrafenberg A45, Potsdam 14473, Germany
| | - D. Hayes
- School of Forest Resources, University of Maine, Orono, Maine 04473, USA
| | - G. Hugelius
- Department of Physical Geography, Stockholm University, Stockholm 106 91, Sweden
| | - P. Kuhry
- Department of Physical Geography, Stockholm University, Stockholm 106 91, Sweden
| | - A. D. McGuire
- U.S. Geological Survey, Alaska Cooperative Fish and Wildlife Research Unit, University of Alaska Fairbanks, Fairbanks, Alaska 99775, USA
| | - V. E. Romanovsky
- Geophysical Institute, University of Alaska Fairbanks, Fairbanks, Alaska 99775, USA
- Tyumen State Oil and Gas University, Tyumen, Tyument. Oblast 625000, Russia
| | - A.B.K. Sannel
- Department of Physical Geography, Stockholm University, Stockholm 106 91, Sweden
| | - E.A.G. Schuur
- Center for Ecosystem Science and Society, Northern Arizona University, Flagstaff, Arizona 86011, USA
| | - M. R. Turetsky
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada N1G 2W1
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Loh R, Bergfeld J, Hayes D, O'hara A, Pyecroft S, Raidal S, Sharpe R. The Pathology of Devil Facial Tumor Disease (DFTD) in Tasmanian Devils (Sarcophilus harrisii). Vet Pathol 2016; 43:890-5. [PMID: 17099145 DOI: 10.1354/vp.43-6-890] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A disfiguring and debilitating neoplastic condition known as devil facial tumor disease (DFTD) has been discovered in wild Tasmanian Devils ( Sarcophilus harrisii) across 51% of its natural range, with population declines of up to 80% in some areas (C. Hawkins, personal communication). Between 2001 and 2004, 91 cases were examined. The tumors presented as large, solid, soft tissue masses usually with flattened, centrally ulcerated, and exudative surfaces. They were typically multicentric, appearing first in the oral, face, or neck regions. Histologically, the tumors were composed of circumscribed to infiltrative nodular aggregates of round to spindle-shaped cells, often within a pseudocapsule and divided into lobules by delicate fibrous septae. They were locally aggressive and metastasized in 65% of cases. There was minimal cytologic differentiation among the tumor cell population under light and electron microscopic examination. The results indicate DFTD to be an undifferentiated soft tissue neoplasm.
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Affiliation(s)
- R Loh
- Animal Health Laboratory, PO Box 46, Kings Meadows 7249, Tasmania, Australia.
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Danziger-Isakov L, Buller R, Williams N, Mason S, Fenchel M, Astor T, Conrad C, Faro A, Goldfarb S, Hayes D, Melicoff-Portillo E, Schecter M, Visner G, Ikle D, Storch G, Sweet S. Respiratory Viral Infections Are Common in the First Year After Pediatric Lung Transplantation: A Multi-Center Prospective Study. J Heart Lung Transplant 2016. [PMCID: PMC7172067 DOI: 10.1016/j.healun.2016.01.094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Arya B, Kerstein D, Leu CS, Hayes D, Zuckerman WA, Krishnan U, Lai WW. Echocardiographic Assessment of Right Atrial Pressure in a Pediatric and Young Adult Population. Pediatr Cardiol 2016; 37:558-67. [PMID: 26667961 DOI: 10.1007/s00246-015-1315-1] [Citation(s) in RCA: 18] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 11/21/2015] [Indexed: 12/13/2022]
Abstract
Right atrial pressure (RAP) reflects right-sided cardiac hemodynamics and is useful in management of patients with cardiac and systemic disease. Studies in older adults demonstrated that inferior vena cava (IVC) diameter, IVC collapsibility index, hepatic vein systolic filling fraction (SFF), and right atrial volume (RAV) correlated with mean RAP at catheterization. This study aimed to assess the utility of echocardiographic parameters for assessment of RAP in children and young adults. Patients with pulmonary hypertension or heart transplantation undergoing right heart catheterization were recruited for this prospective observational pilot study. Transthoracic echocardiographic assessment of RAP was performed simultaneously with catheterization. For each parameter, three consecutive cardiac cycles were recorded. Long- and short-axis images of the IVC were obtained. RAV was assessed by area-length and biplane methods. IVC diameters and RAV were indexed to body surface area (BSA)(0.5) and (BSA)(1.4), respectively. Relationships between echocardiographic parameters and mean RAP were correlated using "Pearson's r." Fifty subjects aged 0.3-23 years (median 13, mean 12.3 ± 7 years) were enrolled. Mean RAP correlated modestly with RAV (r = 0.51, p < 0.001). Long-axis IVCmax (r = 0.30, p < 0.05) and tricuspid E wave velocity (r = 0.36, p < 0.01) also correlated with mean RAP. RV free wall tissue Doppler velocities, IVC collapsibility index, and hepatic vein SFF had no relation to mean RAP. In a pediatric and young adult population with pulmonary hypertension or heart transplantation, echocardiographic assessment of RAV and long-axis IVCmax provided a reasonable estimate of mean RAP. IVC collapsibility index and hepatic vein SFF demonstrated no association with mean RAP.
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Affiliation(s)
- Bhawna Arya
- Division of Pediatric Cardiology, Seattle Children's Hospital, University of Washington School of Medicine, 4800 Sand Point Way NE, M/S RC.2.820, PO Box 5371, Seattle, WA, 98105, USA.
| | - Diane Kerstein
- Division of Pediatric Cardiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Cheng-Shiun Leu
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Denise Hayes
- Division of Pediatric Cardiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Warren A Zuckerman
- Division of Pediatric Cardiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Usha Krishnan
- Division of Pediatric Cardiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Wyman W Lai
- Division of Pediatric Cardiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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Beal EW, Shilo K, Hayes D, Pope-Harman AL. 52-Year-Old Male With Upper Lobe Predominant Cystic Lung Disease Requiring Bilateral Lung Transplantation. Am J Transplant 2015; 15:3268-70. [PMID: 26587826 PMCID: PMC5461781 DOI: 10.1111/ajt.13501] [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: 01/25/2023]
Affiliation(s)
- E. W. Beal
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH,Corresponding author: Eliza W. Beal,
| | - K. Shilo
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - D. Hayes
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - A. L. Pope-Harman
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH,The Comprehensive Transplant Center, The Ohio State University Wexner Medical Center, Columbus, OH
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O'Shaughnessy J, Campone M, Brain E, Neven P, Hayes D, Bondarenko I, Griffin TW, Martin J, De Porre P, Kheoh T, Yu MK, Peng W, Johnston S. Abiraterone acetate, exemestane or the combination in postmenopausal patients with estrogen receptor-positive metastatic breast cancer. Ann Oncol 2015; 27:106-13. [PMID: 26504153 PMCID: PMC4684153 DOI: 10.1093/annonc/mdv487] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 09/30/2015] [Indexed: 11/28/2022] Open
Abstract
Resistance to nonsteroidal aromatase inhibitors is a major obstacle in the management of estrogen receptor-positive postmenopausal metastatic breast cancer. The addition of abiraterone acetate to exemestane did not improve clinical outcomes compared with exemestane alone in an androgen receptor-enriched population, potentially due to induced serum progesterone as a resistance mechanism. Background Androgen receptor (AR) signaling and incomplete inhibition of estrogen signaling may contribute to metastatic breast cancer (MBC) resistance to a nonsteroidal aromatase inhibitor (NSAI; letrozole or anastrozole). We assessed whether combined inhibition of androgen biosynthesis with abiraterone acetate plus prednisone and estradiol synthesis with exemestane (E) may be of clinical benefit to postmenopausal patients with NSAI-pretreated estrogen receptor-positive (ER+) MBC. Patients and methods Patients (N = 297) were stratified by the number of prior therapies for metastatic disease (0–1 versus 2) and by prior NSAI use (adjuvant versus metastatic), and randomized (1 : 1 : 1) to receive oral once daily 1000 mg abiraterone acetate plus 5 mg prednisone (AA) versus AA with 25 mg E (AAE) versus 25 mg E alone (E). Each treatment arm was well balanced with regard to the proportion of patients with AR-positive breast cancer. The primary end point was progression-free survival (PFS). Secondary end points included overall survival, clinical benefit rate, duration of response, and overall response rate. Results There was no significant difference in PFS with AA versus E (3.7 versus 3.7 months; hazard ratio [HR] = 1.1; 95% confidence interval [CI] 0.82–1.60; P = 0.437) or AAE versus E (4.5 versus 3.7 months; HR = 0.96; 95% CI 0.70–1.32; P = 0.794). Increased serum progesterone concentrations were observed in both arms receiving AA, but not with E. Grade 3 or 4 treatment-emergent adverse events associated with AA, including hypokalemia and hypertension, were less common in patients in the E (2.0% and 2.9%, respectively) and AA arms (3.4% and 1.1%, respectively) than in the AAE arm (5.8% for both). Conclusions Adding AA to E in NSAI-pretreated ER+ MBC patients did not improve PFS compared with treatment with E. An AA-induced progesterone increase may have contributed to this lack of clinical activity. ClinicalTrials.gov NCT01381874.
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Affiliation(s)
- J O'Shaughnessy
- Texas Oncology-Baylor Charles A. Sammons Cancer Center/US Oncology, Dallas, USA
| | - M Campone
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Nantes
| | - E Brain
- Departments of Clinical Research and Medical Oncology, Hôpital René Huguenin, Saint-Cloud, France
| | - P Neven
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - D Hayes
- Breast Oncology Program, The University of Michigan Comprehensive Cancer Center, Ann Arbor, USA
| | - I Bondarenko
- Oncology Department, Municipal Clinical Hospital #4, State Medical Academy, Dnepropetrovsk, Ukraine
| | - T W Griffin
- Janssen Research & Development, Los Angeles, USA
| | - J Martin
- Janssen Research & Development, High Wycombe, UK
| | - P De Porre
- Janssen Research & Development, Beerse, Belgium
| | - T Kheoh
- Janssen Research & Development, Los Angeles, USA
| | - M K Yu
- Janssen Research & Development, Los Angeles, USA
| | - W Peng
- Janssen Research & Development, Los Angeles, USA
| | - S Johnston
- Department of Medicine, The Royal Marsden Hospital and The Institute of Cancer Research, London, UK
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Sparano J, Gray R, Zujewski J, Makower D, Pritchard K, Albain K, Hayes D, Geyer C, Dees C, Perez E, Keane M, Vallejos C, Goggins T, Mayer I, Brufsky A, Toppmeyer D, Kaklamani V, Atkins J, Olson J, Sledge G. 5BA Prospective trial of endocrine therapy alone in patients with estrogen-receptor positive, HER2-negative, node-negative breast cancer: Results of the TAILORx low risk registry. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31935-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Nelson K, Black S, Eren E, Hayes D, Dumond C, Bennett S, Ghadiali S, Whitson B. Determination of Optimum Ventilation Strategy for Ex-Vivo Lung Perfusion: Comparing Negative and Positive Pressure Ventilation. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.754] [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] Open
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Whitson B, Pope-Harman A, Lee P, Kilic A, Sai-Sudhakar C, Kirkby S, Higgins R, Tobias J, Hayes D. Body Mass Index Impacts Short, Intermediate, and Long-Term Survival in Lung Transplantation. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.030] [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] Open
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50
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Whitson B, Ravi Y, Pope-Harman A, Kilic A, Tobias J, Sai-Sudhakar C, Higgins R, Hayes D. Elderly Lung Transplant Recipient Long-Term Survival Is Not Impacted By Donor Age. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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