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Robey RC, Logue C, Caird CA, Hansel J, Hellyer TP, Simpson J, Dark P, Mathioudakis AG, Felton T. Immunomodulatory drugs in sepsis: a systematic review and meta-analysis. Anaesthesia 2024. [PMID: 38523060 DOI: 10.1111/anae.16263] [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] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 03/26/2024]
Abstract
Dysregulation of the host immune response has a central role in the pathophysiology of sepsis. There has been much interest in immunomodulatory drugs as potential therapeutic adjuncts in sepsis. We conducted a systematic review and meta-analysis of randomised controlled trials evaluating the safety and clinical effectiveness of immunomodulatory drugs as adjuncts to standard care in the treatment of adults with sepsis. Our primary outcomes were serious adverse events and all-cause mortality. Fifty-six unique, eligible randomised controlled trials were identified, assessing a range of interventions including cytokine inhibitors; anti-inflammatories; immune cell stimulators; platelet pathway inhibitors; and complement inhibitors. At 1-month follow-up, the use of cytokine inhibitors was associated with a decreased risk of serious adverse events, based on 11 studies involving 7138 patients (RR (95%CI) 0.95 (0.90-1.00), I2 = 0%). The only immunomodulatory drugs associated with an increased risk of serious adverse events were toll-like receptor 4 antagonists (RR (95%CI) 1.18 (1.04-1.34), I2 = 0% (two trials, 567 patients)). Based on 18 randomised controlled trials, involving 11,075 patients, cytokine inhibitors reduced 1-month mortality (RR (95%CI) 0.88 (0.78-0.98), I2 = 57%). Mortality reduction was also shown in the subgroup of 13 randomised controlled trials that evaluated anti-tumour necrosis factor α interventions (RR (95%CI) 0.93 (0.87-0.99), I2 = 0%). Anti-inflammatory drugs had the largest apparent effect on mortality at 2 months at any dose (two trials, 228 patients, RR (95%CI) 0.64 (0.51-0.80), I2 = 0%) and at 3 months at any dose (three trials involving 277 patients, RR (95%CI) 0.67 (0.55-0.81), I2 = 0%). These data indicate that, except for toll-like receptor 4 antagonists, there is no evidence of safety concerns for the use of immunomodulatory drugs in sepsis, and they may show some short-term mortality benefit for selected drugs.
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Affiliation(s)
- R C Robey
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - C Logue
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - C A Caird
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - J Hansel
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - T P Hellyer
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - J Simpson
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - P Dark
- University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Critical Care Unit, Northern Care Alliance NHS Foundation Trust, Salford Care Organisation, Salford, UK
| | - A G Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - T Felton
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
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Stopic V, Rizos A, Simpson J, Eccles FJR, Dembek TA, Barbe MT, Sauerbier A. [Intercultural adaptation of the PUKSoPC in German language : A scale for perceived control in patients with Parkinson's disease]. Nervenarzt 2024; 95:141-145. [PMID: 37982818 PMCID: PMC10850266 DOI: 10.1007/s00115-023-01569-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND The level of perceived control in people with Parkinson's disease plays a significant role in affecting their quality of life. Simpson et al. developed a scale of perceived control specific to Parkinson's disease called the Parkinson's UK Scale of Perceived Control (PUKSoPC). In this work, we present a cross-culturally adapted German translation of the original English version. METHODS After receiving approval by the original authors, an internationally established procedure was used for cross-cultural adaptation. Firstly, the original English version was translated into German independently by two bilingual neuroscientists, who then agreed on a consensus version. This was tested on 10 people with Parkinson's disease and independently back translated into English by two different neuroscientists. After forming a consensus version, this English version was compared with the original version by all four translators. Differences between the versions resulted in modifications to the German translation so that the back translation matched the original as closely as possible. The final version was approved by two of the original authors and clinically tested on 50 people with Parkinson's disease. RESULTS During the translation process, the four translators agreed on a culturally adapted German version of the PUKSoPC. Testing of the final version on 50 people with Parkinson's disease did not reveal any linguistic or content-related problems. CONCLUSION The linguistically validated German version of the PUKSoPC presented in this paper is now freely available for measuring the levels of perceived control in people with Parkinson's disease to advance both research and clinical practice.
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Affiliation(s)
- V Stopic
- Klinik und Poliklinik für Neurologie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - A Rizos
- Department of Neurology, King's College Hospital NHS Foundation Trust, London, Großbritannien
| | - J Simpson
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, Großbritannien
| | - F J R Eccles
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, Großbritannien
| | - T A Dembek
- Klinik und Poliklinik für Neurologie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - M T Barbe
- Klinik und Poliklinik für Neurologie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - A Sauerbier
- Klinik und Poliklinik für Neurologie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, Großbritannien.
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Li R, Jobson BT, Wen M, Li AL, Huangfu Y, Zhang W, Hardy R, O'Keeffe P, Simpson J, Fauci M, Paden N. Anthropogenic, biogenic, and photochemical influences on surface formaldehyde and its significant decadal (2006-2017) decrease in the Lewiston-Clarkston valley of the northwestern United States. Chemosphere 2024; 349:140962. [PMID: 38104739 DOI: 10.1016/j.chemosphere.2023.140962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/06/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023]
Abstract
Formaldehyde (HCHO) is a key carcinogen and plays an important role in atmospheric chemistry. Both field measurements and Positive Matrix Factorization (PMF) modeling have been employed to investigate the concentrations and sources of HCHO in the Lewiston-Clarkston (LC) valley of the mountainous northwestern U.S. Different instruments were deployed to measure surface formaldehyde and other related compounds in July of 2016 and 2017. The measurements reveal that the average HCHO concentrations have significantly decreased to 2-5 ppb in the LC valley in comparison to its levels (10-20 ppb) observed in July 2006. This discovery with surface measurements deserves attention given that satellite retrievals showed an increasing long-term trend from 2005 to 2014 in total vertical column density of HCHO in the region, suggesting that satellite instruments may not adequately resolve small valleys in the mountainous region. Our PMF modeling identified four major sources of HCHO in the valley: (1) emissions from a local paper mill, (2) secondary formation and background, (3) biogenic sources, and (4) traffic. This study reveals that the emissions from the paper mill cause high HCHO spikes (6-19 ppb) in the early morning. It is found that biogenic volatile organic compounds (VOCs) in the area are influenced by national forests surrounding the region (e.g., Nez Perce-Clearwater, Umatilla, Wallowa-Whitman, and Idaho Panhandle National Forests). The results provide useful information for developing strategies to control HCHO levels and have implications for future HCHO studies in atmospheric chemistry, which affects secondary aerosols and ozone formation.
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Affiliation(s)
- R Li
- Idaho Department of Environmental Quality, Boise, ID, USA.
| | - B T Jobson
- Laboratory for Atmospheric Research, Department of Civil & Environmental Engineering, Washington State University, Pullman, WA, USA
| | - M Wen
- Laboratory for Atmospheric Research, Department of Civil & Environmental Engineering, Washington State University, Pullman, WA, USA
| | - A L Li
- Boise High School, Boise, ID, USA
| | - Y Huangfu
- Laboratory for Atmospheric Research, Department of Civil & Environmental Engineering, Washington State University, Pullman, WA, USA
| | - W Zhang
- Idaho Department of Environmental Quality, Boise, ID, USA
| | - R Hardy
- Idaho Department of Environmental Quality, Boise, ID, USA
| | - P O'Keeffe
- Laboratory for Atmospheric Research, Department of Civil & Environmental Engineering, Washington State University, Pullman, WA, USA
| | - J Simpson
- Air Quality Program, Nez Perce Tribe, Lapwai, ID, USA
| | - M Fauci
- Air Quality Program, Nez Perce Tribe, Lapwai, ID, USA
| | - N Paden
- Idaho Department of Environmental Quality, Boise, ID, USA
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Simpson J, Keding A, Spencer S, Brealey S, Rangan A. Factor structure of the Oxford Shoulder Score: secondary analyses of the UK FROST and PROFHER trial populations. J Orthop Surg Res 2023; 18:846. [PMID: 37940977 PMCID: PMC10631035 DOI: 10.1186/s13018-023-04319-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: 06/02/2023] [Accepted: 10/25/2023] [Indexed: 11/10/2023] Open
Abstract
AIMS Frozen shoulder and proximal humeral fracture can cause pain, stiffness and loss of function. The impact of these symptoms on patients can be measured using the comprehensively validated, 12-item Oxford Shoulder Score (OSS). Evidence suggests that pain and function may have a differential impact on patients' experience of shoulder conditions, and this may be important for clinical management. We therefore explored the factor structure of the OSS within the UK FROST and PROFHER trial populations. METHODS We performed exploratory factor analysis (EFA), followed by confirmatory factor analysis (CFA), on baseline UK FROST data from 490 of the 503 trial participants. Data at 6 months post-randomisation were used for 228 of the 250 participants for the PROFHER trial. RESULTS UK FROST factor extraction results, using Velicer's Minimum Average Partial and Horn's Parallel Analysis tests, suggested a unifactorial solution, but two factors were weakly indicated by the less reliable 'Kaiser's eigenvalue > 1' and scree tests. We explored this further using EFA. Eight items (2 to 7, 9 and 10) loaded onto a 'Function' factor, three on a 'Pain' factor (1, 8 and 12) and item 11 cross-loaded. However, one- and two-factor models were rejected in CFA. Factor extraction of PROFHER data at 6 months demonstrated a single first-order factor solution, which was also subsequently rejected in CFA. CONCLUSION Insufficient evidence was found, within the constraints of the data available, to support the use of 'Pain' and 'Function' sub-scales of the OSS in either patient population.
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Affiliation(s)
- J Simpson
- York Trials Unit, Department of Health Sciences, University of York, York, UK.
- Hull York Medical School, University of York, York, UK.
| | - A Keding
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - S Spencer
- Health Research Institute, Edge Hill University, Ormskirk, UK
| | - S Brealey
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - A Rangan
- York Trials Unit, Department of Health Sciences, University of York, York, UK
- Hull York Medical School, University of York, York, UK
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Raman B, McCracken C, Cassar MP, Moss AJ, Finnigan L, Samat AHA, Ogbole G, Tunnicliffe EM, Alfaro-Almagro F, Menke R, Xie C, Gleeson F, Lukaschuk E, Lamlum H, McGlynn K, Popescu IA, Sanders ZB, Saunders LC, Piechnik SK, Ferreira VM, Nikolaidou C, Rahman NM, Ho LP, Harris VC, Shikotra A, Singapuri A, Pfeffer P, Manisty C, Kon OM, Beggs M, O'Regan DP, Fuld J, Weir-McCall JR, Parekh D, Steeds R, Poinasamy K, Cuthbertson DJ, Kemp GJ, Semple MG, Horsley A, Miller CA, O'Brien C, Shah AM, Chiribiri A, Leavy OC, Richardson M, Elneima O, McAuley HJC, Sereno M, Saunders RM, Houchen-Wolloff L, Greening NJ, Bolton CE, Brown JS, Choudhury G, Diar Bakerly N, Easom N, Echevarria C, Marks M, Hurst JR, Jones MG, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Howard LS, Jacob J, Man WDC, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Singh SJ, Thomas DC, Toshner M, Lewis KE, Heaney LG, Harrison EM, Kerr S, Docherty AB, Lone NI, Quint J, Sheikh A, Zheng B, Jenkins RG, Cox E, Francis S, Halling-Brown M, Chalmers JD, Greenwood JP, Plein S, Hughes PJC, Thompson AAR, Rowland-Jones SL, Wild JM, Kelly M, Treibel TA, Bandula S, Aul R, Miller K, Jezzard P, Smith S, Nichols TE, McCann GP, Evans RA, Wain LV, Brightling CE, Neubauer S, Baillie JK, Shaw A, Hairsine B, Kurasz C, Henson H, Armstrong L, Shenton L, Dobson H, Dell A, Lucey A, Price A, Storrie A, Pennington C, Price C, Mallison G, Willis G, Nassa H, Haworth J, Hoare M, Hawkings N, Fairbairn S, Young S, Walker S, Jarrold I, Sanderson A, David C, Chong-James K, Zongo O, James WY, Martineau A, King B, Armour C, McAulay D, Major E, McGinness J, McGarvey L, Magee N, Stone R, Drain S, Craig T, Bolger A, Haggar A, Lloyd A, Subbe C, Menzies D, Southern D, McIvor E, Roberts K, Manley R, Whitehead V, Saxon W, Bularga A, Mills NL, El-Taweel H, Dawson J, Robinson L, Saralaya D, Regan K, Storton K, Brear L, Amoils S, Bermperi A, Elmer A, Ribeiro C, Cruz I, Taylor J, Worsley J, Dempsey K, Watson L, Jose S, Marciniak S, Parkes M, McQueen A, Oliver C, Williams J, Paradowski K, Broad L, Knibbs L, Haynes M, Sabit R, Milligan L, Sampson C, Hancock A, Evenden C, Lynch C, Hancock K, Roche L, Rees M, Stroud N, Thomas-Woods T, Heller S, Robertson E, Young B, Wassall H, Babores M, Holland M, Keenan N, Shashaa S, Price C, Beranova E, Ramos H, Weston H, Deery J, Austin L, Solly R, Turney S, Cosier T, Hazelton T, Ralser M, Wilson A, Pearce L, Pugmire S, Stoker W, McCormick W, Dewar A, Arbane G, Kaltsakas G, Kerslake H, Rossdale J, Bisnauthsing K, Aguilar Jimenez LA, Martinez LM, Ostermann M, Magtoto MM, Hart N, Marino P, Betts S, Solano TS, Arias AM, Prabhu A, Reed A, Wrey Brown C, Griffin D, Bevan E, Martin J, Owen J, Alvarez Corral M, Williams N, Payne S, Storrar W, Layton A, Lawson C, Mills C, Featherstone J, Stephenson L, Burdett T, Ellis Y, Richards A, Wright C, Sykes DL, Brindle K, Drury K, Holdsworth L, Crooks MG, Atkin P, Flockton R, Thackray-Nocera S, Mohamed A, Taylor A, Perkins E, Ross G, McGuinness H, Tench H, Phipps J, Loosley R, Wolf-Roberts R, Coetzee S, Omar Z, Ross A, Card B, Carr C, King C, Wood C, Copeland D, Calvelo E, Chilvers ER, Russell E, Gordon H, Nunag JL, Schronce J, March K, Samuel K, Burden L, Evison L, McLeavey L, Orriss-Dib L, Tarusan L, Mariveles M, Roy M, Mohamed N, Simpson N, Yasmin N, Cullinan P, Daly P, Haq S, Moriera S, Fayzan T, Munawar U, Nwanguma U, Lingford-Hughes A, Altmann D, Johnston D, Mitchell J, Valabhji J, Price L, Molyneaux PL, Thwaites RS, Walsh S, Frankel A, Lightstone L, Wilkins M, Willicombe M, McAdoo S, Touyz R, Guerdette AM, Warwick K, Hewitt M, Reddy R, White S, McMahon A, Hoare A, Knighton A, Ramos A, Te A, Jolley CJ, Speranza F, Assefa-Kebede H, Peralta I, Breeze J, Shevket K, Powell N, Adeyemi O, Dulawan P, Adrego R, Byrne S, Patale S, Hayday A, Malim M, Pariante C, Sharpe C, Whitney J, Bramham K, Ismail K, Wessely S, Nicholson T, Ashworth A, Humphries A, Tan AL, Whittam B, Coupland C, Favager C, Peckham D, Wade E, Saalmink G, Clarke J, Glossop J, Murira J, Rangeley J, Woods J, Hall L, Dalton M, Window N, Beirne P, Hardy T, Coakley G, Turtle L, Berridge A, Cross A, Key AL, Rowe A, Allt AM, Mears C, Malein F, Madzamba G, Hardwick HE, Earley J, Hawkes J, Pratt J, Wyles J, Tripp KA, Hainey K, Allerton L, Lavelle-Langham L, Melling L, Wajero LO, Poll L, Noonan MJ, French N, Lewis-Burke N, Williams-Howard SA, Cooper S, Kaprowska S, Dobson SL, Marsh S, Highett V, Shaw V, Beadsworth M, Defres S, Watson E, Tiongson GF, Papineni P, Gurram S, Diwanji SN, Quaid S, Briggs A, Hastie C, Rogers N, Stensel D, Bishop L, McIvor K, Rivera-Ortega P, Al-Sheklly B, Avram C, Faluyi D, Blaikely J, Piper Hanley K, Radhakrishnan K, Buch M, Hanley NA, Odell N, Osbourne R, Stockdale S, Felton T, Gorsuch T, Hussell T, Kausar Z, Kabir T, McAllister-Williams H, Paddick S, Burn D, Ayoub A, Greenhalgh A, Sayer A, Young A, Price D, Burns G, MacGowan G, Fisher H, Tedd H, Simpson J, Jiwa K, Witham M, Hogarth P, West S, Wright S, McMahon MJ, Neill P, Dougherty A, Morrow A, Anderson D, Grieve D, Bayes H, Fallon K, Mangion K, Gilmour L, Basu N, Sykes R, Berry C, McInnes IB, Donaldson A, Sage EK, Barrett F, Welsh B, Bell M, Quigley J, Leitch K, Macliver L, Patel M, Hamil R, Deans A, Furniss J, Clohisey S, Elliott A, Solstice AR, Deas C, Tee C, Connell D, Sutherland D, George J, Mohammed S, Bunker J, Holmes K, Dipper A, Morley A, Arnold D, Adamali H, Welch H, Morrison L, Stadon L, Maskell N, Barratt S, Dunn S, Waterson S, Jayaraman B, Light T, Selby N, Hosseini A, Shaw K, Almeida P, Needham R, Thomas AK, Matthews L, Gupta A, Nikolaidis A, Dupont C, Bonnington J, Chrystal M, Greenhaff PL, Linford S, Prosper S, Jang W, Alamoudi A, Bloss A, Megson C, Nicoll D, Fraser E, Pacpaco E, Conneh F, Ogg G, McShane H, Koychev I, Chen J, Pimm J, Ainsworth M, Pavlides M, Sharpe M, Havinden-Williams M, Petousi N, Talbot N, Carter P, Kurupati P, Dong T, Peng Y, Burns A, Kanellakis N, Korszun A, Connolly B, Busby J, Peto T, Patel B, Nolan CM, Cristiano D, Walsh JA, Liyanage K, Gummadi M, Dormand N, Polgar O, George P, Barker RE, Patel S, Price L, Gibbons M, Matila D, Jarvis H, Lim L, Olaosebikan O, Ahmad S, Brill S, Mandal S, Laing C, Michael A, Reddy A, Johnson C, Baxendale H, Parfrey H, Mackie J, Newman J, Pack J, Parmar J, Paques K, Garner L, Harvey A, Summersgill C, Holgate D, Hardy E, Oxton J, Pendlebury J, McMorrow L, Mairs N, Majeed N, Dark P, Ugwuoke R, Knight S, Whittaker S, Strong-Sheldrake S, Matimba-Mupaya W, Chowienczyk P, Pattenadk D, Hurditch E, Chan F, Carborn H, Foot H, Bagshaw J, Hockridge J, Sidebottom J, Lee JH, Birchall K, Turner K, Haslam L, Holt L, Milner L, Begum M, Marshall M, Steele N, Tinker N, Ravencroft P, Butcher R, Misra S, Walker S, Coburn Z, Fairman A, Ford A, Holbourn A, Howell A, Lawrie A, Lye A, Mbuyisa A, Zawia A, Holroyd-Hind B, Thamu B, Clark C, Jarman C, Norman C, Roddis C, Foote D, Lee E, Ilyas F, Stephens G, Newell H, Turton H, Macharia I, Wilson I, Cole J, McNeill J, Meiring J, Rodger J, Watson J, Chapman K, Harrington K, Chetham L, Hesselden L, Nwafor L, Dixon M, Plowright M, Wade P, Gregory R, Lenagh R, Stimpson R, Megson S, Newman T, Cheng Y, Goodwin C, Heeley C, Sissons D, Sowter D, Gregory H, Wynter I, Hutchinson J, Kirk J, Bennett K, Slack K, Allsop L, Holloway L, Flynn M, Gill M, Greatorex M, Holmes M, Buckley P, Shelton S, Turner S, Sewell TA, Whitworth V, Lovegrove W, Tomlinson J, Warburton L, Painter S, Vickers C, Redwood D, Tilley J, Palmer S, Wainwright T, Breen G, Hotopf M, Dunleavy A, Teixeira J, Ali M, Mencias M, Msimanga N, Siddique S, Samakomva T, Tavoukjian V, Forton D, Ahmed R, Cook A, Thaivalappil F, Connor L, Rees T, McNarry M, Williams N, McCormick J, McIntosh J, Vere J, Coulding M, Kilroy S, Turner V, Butt AT, Savill H, Fraile E, Ugoji J, Landers G, Lota H, Portukhay S, Nasseri M, Daniels A, Hormis A, Ingham J, Zeidan L, Osborne L, Chablani M, Banerjee A, David A, Pakzad A, Rangelov B, Williams B, Denneny E, Willoughby J, Xu M, Mehta P, Batterham R, Bell R, Aslani S, Lilaonitkul W, Checkley A, Bang D, Basire D, Lomas D, Wall E, Plant H, Roy K, Heightman M, Lipman M, Merida Morillas M, Ahwireng N, Chambers RC, Jastrub R, Logan S, Hillman T, Botkai A, Casey A, Neal A, Newton-Cox A, Cooper B, Atkin C, McGee C, Welch C, Wilson D, Sapey E, Qureshi H, Hazeldine J, Lord JM, Nyaboko J, Short J, Stockley J, Dasgin J, Draxlbauer K, Isaacs K, Mcgee K, Yip KP, Ratcliffe L, Bates M, Ventura M, Ahmad Haider N, Gautam N, Baggott R, Holden S, Madathil S, Walder S, Yasmin S, Hiwot T, Jackson T, Soulsby T, Kamwa V, Peterkin Z, Suleiman Z, Chaudhuri N, Wheeler H, Djukanovic R, Samuel R, Sass T, Wallis T, Marshall B, Childs C, Marouzet E, Harvey M, Fletcher S, Dickens C, Beckett P, Nanda U, Daynes E, Charalambou A, Yousuf AJ, Lea A, Prickett A, Gooptu B, Hargadon B, Bourne C, Christie C, Edwardson C, Lee D, Baldry E, Stringer E, Woodhead F, Mills G, Arnold H, Aung H, Qureshi IN, Finch J, Skeemer J, Hadley K, Khunti K, Carr L, Ingram L, Aljaroof M, Bakali M, Bakau M, Baldwin M, Bourne M, Pareek M, Soares M, Tobin M, Armstrong N, Brunskill N, Goodman N, Cairns P, Haldar P, McCourt P, Dowling R, Russell R, Diver S, Edwards S, Glover S, Parker S, Siddiqui S, Ward TJC, Mcnally T, Thornton T, Yates T, Ibrahim W, Monteiro W, Thickett D, Wilkinson D, Broome M, McArdle P, Upthegrove R, Wraith D, Langenberg C, Summers C, Bullmore E, Heeney JL, Schwaeble W, Sudlow CL, Adeloye D, Newby DE, Rudan I, Shankar-Hari M, Thorpe M, Pius R, Walmsley S, McGovern A, Ballard C, Allan L, Dennis J, Cavanagh J, Petrie J, O'Donnell K, Spears M, Sattar N, MacDonald S, Guthrie E, Henderson M, Guillen Guio B, Zhao B, Lawson C, Overton C, Taylor C, Tong C, Mukaetova-Ladinska E, Turner E, Pearl JE, Sargant J, Wormleighton J, Bingham M, Sharma M, Steiner M, Samani N, Novotny P, Free R, Allen RJ, Finney S, Terry S, Brugha T, Plekhanova T, McArdle A, Vinson B, Spencer LG, Reynolds W, Ashworth M, Deakin B, Chinoy H, Abel K, Harvie M, Stanel S, Rostron A, Coleman C, Baguley D, Hufton E, Khan F, Hall I, Stewart I, Fabbri L, Wright L, Kitterick P, Morriss R, Johnson S, Bates A, Antoniades C, Clark D, Bhui K, Channon KM, Motohashi K, Sigfrid L, Husain M, Webster M, Fu X, Li X, Kingham L, Klenerman P, Miiler K, Carson G, Simons G, Huneke N, Calder PC, Baldwin D, Bain S, Lasserson D, Daines L, Bright E, Stern M, Crisp P, Dharmagunawardena R, Reddington A, Wight A, Bailey L, Ashish A, Robinson E, Cooper J, Broadley A, Turnbull A, Brookes C, Sarginson C, Ionita D, Redfearn H, Elliott K, Barman L, Griffiths L, Guy Z, Gill R, Nathu R, Harris E, Moss P, Finnigan J, Saunders K, Saunders P, Kon S, Kon SS, O'Brien L, Shah K, Shah P, Richardson E, Brown V, Brown M, Brown J, Brown J, Brown A, Brown A, Brown M, Choudhury N, Jones S, Jones H, Jones L, Jones I, Jones G, Jones H, Jones D, Davies F, Davies E, Davies K, Davies G, Davies GA, Howard K, Porter J, Rowland J, Rowland A, Scott K, Singh S, Singh C, Thomas S, Thomas C, Lewis V, Lewis J, Lewis D, Harrison P, Francis C, Francis R, Hughes RA, Hughes J, Hughes AD, Thompson T, Kelly S, Smith D, Smith N, Smith A, Smith J, Smith L, Smith S, Evans T, Evans RI, Evans D, Evans R, Evans H, Evans J. Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study. Lancet Respir Med 2023; 11:1003-1019. [PMID: 37748493 PMCID: PMC7615263 DOI: 10.1016/s2213-2600(23)00262-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/16/2023] [Accepted: 06/30/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. METHODS In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. FINDINGS Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2-6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5-5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4-10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32-4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23-11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. INTERPRETATION After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification. FUNDING UK Research and Innovation and National Institute for Health Research.
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Wong JYC, Liu B, Dandapani SV, Li YR, Glaser SM, Liu J, Chen Q, Qing K, Chen HK, Simpson J, Da Silva A, Leung D, Feghali K, Dorff TB, Liu A, Williams TM. Pilot Study of a Novel Ring Gantry-Based PET/CT Linear Accelerator in Patients with Prostate Cancer Receiving [18F]-DCFPyL for PSMA PET Imaging. Int J Radiat Oncol Biol Phys 2023; 117:e451. [PMID: 37785452 DOI: 10.1016/j.ijrobp.2023.06.1636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The RefleXion X1® system is a hybrid PET imaging-radiotherapy system that uses real-time positron emissions from a PET tracer to deliver biologically guided radiotherapy (BgRT). This study (NCT05470699) evaluated the hypothesis that the X1 PET imaging subsystem would be able to detect [18F]-DCFPyL PSMA PET signal sufficient to generate a deliverable BgRT plan in patients with prostate cancer. MATERIALS/METHODS Patients with prostate cancer scheduled for a diagnostic [18F]-DCFPyL PSMA PET scan as part of standard of care were eligible. Upon completion of the diagnostic PSMA PET scan, images were transferred to the radiotherapy planning system for target identification and contouring. If at least one PET avid tumor lesion was identified, the patient was then scanned on the X1 unit. BgRT planning was performed on each X1 scanned patient. The target lesion volume, activity concentration (AC) and normalized target signal (NTS) were acquired. Successful and deliverable BgRT plans required that the target AC was ≥ 5 kBq/ml and NTS ≥ 2.7. RESULTS Twenty-six patients underwent [18F]-DCFPyL PET scans (13 with rising PSA after surgery or radiotherapy, 6 with known metastases and 7 with newly diagnosed high-risk prostate cancer). Median (range) PSA was 3.40 (0.04-122). In 16 patients a PET avid tumor was identified and contoured for planning (4 lymph nodes, 5 bone, 6 prostate gland, and 1 prostate bed). In 13 patients the target lesion was visualized on the X1 PET scan, while in 3 patients the target lesion was too close to the bladder to be clearly visualized. BgRT planning was feasible and met standard of care published SBRT organ dose constraints in 8 patients (3 prostate gland, 3 bone, 2 lymph nodes). BgRT planning was not feasible in 8 patients due to insufficient AC, low NTS or proximity of the target lesion to the PET avid bladder. The accompanying table compares median (range) target volume, AC and NTS for feasible versus not feasible plans. CONCLUSION This is the first study to investigate the feasibility of using [18F]-DCFPyL PET imaging for BgRT plan generation on the X1 system in patients with prostate cancer. Lesions that are relevant to radiotherapy of prostate cancer can be visualized including lymph node and bone metastases. A dedicated BgRT workflow with PSMA PET imaging on the X1 at 60 minutes post injection will result in higher target AC and will optimize BgRT planning. PET avid lesions < 1 cm or close to the bladder may make BgRT planning challenging. [18F]-DCFPyL-guided BgRT is technically feasible using the RefleXion X1. BgRT using targeted PET radiopharmaceuticals to biologically guide external beam radiotherapy represents a promising new dimension in radiation oncology and warrants further investigation.
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Affiliation(s)
- J Y C Wong
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - B Liu
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - S V Dandapani
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - Y R Li
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - S M Glaser
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - J Liu
- Clinical Trials Office, City of Hope National Medical Center, Duarte, CA
| | - Q Chen
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - K Qing
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - H K Chen
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - J Simpson
- Clinical Trials Office, City of Hope National Medical Center, Duarte, CA
| | | | - D Leung
- RefleXion Medical, Inc., Hayward, CA
| | - K Feghali
- RefleXion Medical, Inc., Hayward, CA
| | - T B Dorff
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, Duarte, CA
| | - A Liu
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - T M Williams
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
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Liu B, Chen Q, Qing K, Dandapani SV, Li YR, Glaser SM, Chen HK, Da Silva A, Leung D, Feghali KAA, Simpson J, Liu J, Dorff TB, Liu A, Williams TM, Wong JYC. Dosimetric Plan Evaluation of Biology Guided Radiotherapy Using [18F]-DCFPyL PSMA Radiotracer in Patients with Prostate Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e688. [PMID: 37786022 DOI: 10.1016/j.ijrobp.2023.06.2158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The X1 system represents a cutting-edge solution in radiotherapy delivery, with its capability to perform Biology Guided Radiotherapy (BgRT). The system utilizes real-time positron emission tomography (PET) signal as biological fiducials to provide tracked dose delivery and is initially available for use with [18F]-Fluorodeoxyglucose (FDG). The aim of this research study is to assess the quality of BgRT treatment plans for prostate cancer using patients' PSMA PET images obtained on the X1 system. MATERIALS/METHODS Sixteen patients with at least one PET-avid tumor identified on their whole-body diagnostic PSMA PET scan were selected. These patients were scanned on X1 following their diagnostic scan without additional radiotracer administration. Based on the X1 PET images, a BgRT plan was created for each patient, with the prescription dose determined by the location of treatment sites. The planning objectives of organs-at-risk (OARs) were established in accordance with the 2018 Timmerman guidelines. Target coverage objective was the dose covering 95% (D95%) of the planning target volume (PTV) to be higher than 100%. The following parameters were analyzed: PTV D95%, the minimal dose (Dmin) of gross tumor volume (GTV), plan maximum dose (Dmax), conformity index (CI), gradient index (GI), and maximum point dose (D0.03cc) to the nearest OARs. The X1 BgRT planning system also generated dose volume histogram (DVH) bounds, which model variations in BgRT delivery. The low boundary of GTV Dmin, representing the minimum GTV dose in the worst-case scenario, was recorded. RESULTS BgRT plans were created for all patients, except for one where the target signal was indistinguishable from the bladder. The prescription dose was 2700 cGy or 3000 cGy in 3 fractions for lymph node lesions, 2400 cGy to 3000 cGy in 3 fractions for bone metastasis, and 4500 cGy in 5 fractions for lesions in prostate. All plans met the dose constraints for OARs as per the Timmerman guidelines. The Dmax of all plans was 129.9% ± 6.9% (mean ± standard deviation). The PTV D95% and GTV Dmin were 101.7% ± 1.0% and 111.0% ± 7.6%, respectively. The low boundary of GTV Dmin was 95.9% ± 5.8%. The CI and GI were 1.22 ± 0.11 and 9.40 ± 2.12, respectively. The D0.03cc to nearest OARs was 84.6% ± 25.4%. The estimated treatment time was 699 ± 228 seconds. CONCLUSION This study is a pioneering effort to evaluate the quality of BgRT plans for prostate cancer patients using the [18F]-DCFPyL PSMA radiotracer. Our results showed that all BgRT plans met the planning objectives defined in the Timmerman protocol. BgRT with [18F]-DCFPyL represents a promising treatment modality for patients with prostate cancer. Further research is needed to validate this approach, including a comprehensive assessment of the dosimetric and tracking accuracy through physical measurements.
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Affiliation(s)
- B Liu
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - Q Chen
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - K Qing
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - S V Dandapani
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - Y R Li
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - S M Glaser
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - H K Chen
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | | | - D Leung
- RefleXion Medical, Inc., Hayward, CA
| | | | - J Simpson
- Clinical Trials Office, City of Hope National Medical Center, Duarte, CA
| | - J Liu
- Clinical Trials Office, City of Hope National Medical Center, Duarte, CA
| | - T B Dorff
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, Duarte, CA
| | - A Liu
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - T M Williams
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - J Y C Wong
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
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Morgan G, Casalino S, Chowdhary S, Frangione E, Fung CYJ, Haller S, Lapadula E, Scott M, Wolday D, Young J, Arnoldo S, Aujla N, Bearss E, Binnie A, Bombard Y, Borgundvaag B, Briollais L, Dagher M, Devine L, Faghfoury H, Friedman SM, Gingras AC, Goneau LW, Khan Z, Mazzulli T, McLeod SL, Nomigolzar R, Noor A, Pugh TJ, Richardson D, Satnam Singh HK, Simpson J, Stern S, Strug L, Taher A, Lerner-Ellis J, Taher J. Characterizing Risk Factors for Hospitalization and Clinical Characteristics in a Cohort of COVID-19 Patients Enrolled in the GENCOV Study. Viruses 2023; 15:1764. [PMID: 37632107 PMCID: PMC10457914 DOI: 10.3390/v15081764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/02/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
The GENCOV study aims to identify patient factors which affect COVID-19 severity and outcomes. Here, we aimed to evaluate patient characteristics, acute symptoms and their persistence, and associations with hospitalization. Participants were recruited at hospital sites across the Greater Toronto Area in Ontario, Canada. Patient-reported demographics, medical history, and COVID-19 symptoms and complications were collected through an intake survey. Regression analyses were performed to identify associations with outcomes including hospitalization and COVID-19 symptoms. In total, 966 responses were obtained from 1106 eligible participants (87% response rate) between November 2020 and May 2022. Increasing continuous age (aOR: 1.05 [95%CI: 1.01-1.08]) and BMI (aOR: 1.17 [95%CI: 1.10-1.24]), non-White/European ethnicity (aOR: 2.72 [95%CI: 1.22-6.05]), hypertension (aOR: 2.78 [95%CI: 1.22-6.34]), and infection by viral variants (aOR: 5.43 [95%CI: 1.45-20.34]) were identified as risk factors for hospitalization. Several symptoms including shortness of breath and fever were found to be more common among inpatients and tended to persist for longer durations following acute illness. Sex, age, ethnicity, BMI, vaccination status, viral strain, and underlying health conditions were associated with developing and having persistent symptoms. By improving our understanding of risk factors for severe COVID-19, our findings may guide COVID-19 patient management strategies by enabling more efficient clinical decision making.
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Affiliation(s)
- Gregory Morgan
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Selina Casalino
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Sunakshi Chowdhary
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Erika Frangione
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Chun Yiu Jordan Fung
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Simona Haller
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Elisa Lapadula
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Mackenzie Scott
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Dawit Wolday
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Juliet Young
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Saranya Arnoldo
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
- William Osler Health System, Brampton, ON L6R 3J7, Canada
| | - Navneet Aujla
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Erin Bearss
- Mount Sinai Academic Family Health Team, Mount Sinai Hospital, Toronto, ON M5T 3L9, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
| | - Alexandra Binnie
- Department of Critical Care, William Osler Health System, Etobicoke, ON M9V 1R8, Canada
| | - Yvonne Bombard
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5B 1A6, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
| | - Bjug Borgundvaag
- Schwartz/Reisman Emergency Medicine Institute, Sinai Health System, Toronto, ON M5G 2A2, Canada
| | | | - Marc Dagher
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
- Women’s College Hospital, Toronto, ON M5S 1B2, Canada
| | - Luke Devine
- Division of General Internal Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Hanna Faghfoury
- Fred A Litwin Family Centre in Genetic Medicine, University Health Network & Mount Sinai Hospital, Toronto, ON M5T 3H7, Canada
| | - Steven M. Friedman
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
- Emergency Medicine, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Lee W. Goneau
- Dynacare Medical Laboratories, Brampton, ON L6T 5V1, Canada
| | - Zeeshan Khan
- Mackenzie Health, Richmond Hill, ON L4C 4Z3, Canada
| | - Tony Mazzulli
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Microbiology, Mount Sinai Hospital, Sinai Health, Toronto, ON M5G 1X5, Canada
| | - Shelley L. McLeod
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
- Schwartz/Reisman Emergency Medicine Institute, Sinai Health System, Toronto, ON M5G 2A2, Canada
| | | | - Abdul Noor
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Trevor J. Pugh
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada
- Ontario Institute for Cancer Research, Toronto, ON M5G 0A3, Canada
| | | | - Harpreet Kaur Satnam Singh
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Jared Simpson
- Ontario Institute for Cancer Research, Toronto, ON M5G 0A3, Canada
- Department of Computer Science, University of Toronto, Toronto, ON M5S 2E4, Canada
| | - Seth Stern
- Mackenzie Health, Richmond Hill, ON L4C 4Z3, Canada
| | - Lisa Strug
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Department of Statistical Sciences, University of Toronto, Toronto, ON M5G 1Z5, Canada
| | - Ahmed Taher
- Mackenzie Health, Richmond Hill, ON L4C 4Z3, Canada
- Division of Emergency Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada
| | - Jordan Lerner-Ellis
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Jennifer Taher
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
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Temple S, Rowbottom C, Simpson J. Patient views on the implementation of artificial intelligence in radiotherapy. Radiography (Lond) 2023; 29 Suppl 1:S112-S116. [PMID: 36964044 DOI: 10.1016/j.radi.2023.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 03/26/2023]
Abstract
PURPOSE/OBJECTIVE To date there has been limited research looking at patient views on the implementation of artificial intelligence (AI) in radiotherapy. The aim of this study is to adapt and utilise a validated patient questionnaire to develop an understanding of current patient views on the use of AI in radiotherapy. MATERIALS/METHODS An existing questionnaire, developed to assess understanding of patients' views on the implementation of AI in radiology, was adapted to the field of radiotherapy. The questionnaire was distributed to cancer patients receiving radiotherapy treatment between November 2021 and March 2022. Completed questionnaires were analysed to assess patient levels of positivity or negativity towards AI. Results were grouped into five factors, representing underlying patient perspectives, and correlation of factors with demographic variables was assessed. RESULTS In total, 95 patients participated. Overall, there was a moderately negative patient view towards the use of AI in radiotherapy. Certain factors drew a more negative response than others, for example patients desire significant personal interaction with healthcare professionals during the course of their treatment. No significant correlation was found between the demographics of age and gender and the strength of views towards the use of AI in radiotherapy. CONCLUSION This study has found that there are clear patient concerns around the use of AI in radiotherapy. As the use of AI in this field increases in future years, it will therefore be extremely important to educate and involve patients in the future direction of this technology.
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Affiliation(s)
- S Temple
- The Clatterbridge Cancer Centre NHS Foundation Trust, 65 Pembroke Place, Liverpool L7 8YA, UK.
| | - C Rowbottom
- The Clatterbridge Cancer Centre NHS Foundation Trust, 65 Pembroke Place, Liverpool L7 8YA, UK
| | - J Simpson
- The Clatterbridge Cancer Centre NHS Foundation Trust, 65 Pembroke Place, Liverpool L7 8YA, UK
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Simpson J, Moulton D, Giroud C, Groth M, Horvath L, Casson F, Kochl F, Frassinetti L, Corrigan G, Saarelma D, Garzotti L, Gahle S, Chankin A. Investigation of the dependence of pe,ped on ne,sep in JET H-Mode plasmas using integrated JETTO-MISHKA-FRANTIC simulations. Nuclear Materials and Energy 2023. [DOI: 10.1016/j.nme.2023.101365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Hillege L, Waelen J, Ziemons J, Aarnoutse R, De Vos-Geelen J, De Boer M, Van Riet Y, Vincent J, Venema K, Rensen S, Simpson J, Redinbo M, Penders J, Smidt M. Bacterial β-glucuronidase activity in postmenopausal breast cancer patients: a pilot study. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01578-7] [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: 11/19/2022]
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McDowell K, Simpson J, Jhund PS, Abraham WT, Claggett B, Cunningham J, Desai AS, Kober L, Prescott M, Rouleau JL, Swedberg K, Zile MR, Solomon SD, Packer M, McMurray JJV. A comprehensive study of the incremental prognostic value of novel biomarkers in PARADIGM-HF (Bio-PREDICT-HF). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.914] [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
Although multiple novel biomarkers have individually been shown to predict outcomes in patients with HFrEF, the value of these over and above conventional clinical and laboratory variables, plus natriuretic peptides, is uncertain.
Purpose
To test the incremental predictive value of 11 novel biomarkers added to a recent prognostic model 1 (PREDICT-HF) derived in PARADIGM-HF and validated in ATMOSPHERE and the Swedish heart failure registry. The PREDICT-HF model includes clinical variables, standard laboratory variables, and BNP or NT-proBNP.
Methods
1559 participants enrolled in PARADIGM-HF had all 11 biomarkers of interest measured. These reflected different pathophysiological pathways: (i) myocyte injury (high sensitivity cardiac troponin T), (ii) cardiac remodelling and inflammation (growth stimulation expressed gene 2, growth differentiation factor-15 and galectin-3), (iii) extracellular matrix remodelling (matrix metalloproteinase-2, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1), (iv) neurohormonal pathways (aldosterone) and (v) renal dysfunction and injury (cystatin C, kidney injury molecule-1 and urinary albumin to creatinine ratio). The incremental prognostic value of these biomarkers was evaluated using Harrell's C statistic.
Results
The mean age of participants studied was 67.3 (SD 9.9) years, 1254 (80%) were men and 1103 (71%) were in NYHA class II. During a median follow-up of 31 months, 197 patients died and 300 experienced the primary composite outcome (cardiovascular death or heart failure hospitalization).
When each candidate biomarker (log unit) was added individually to the PREDICT-HF base model, GDF-15, ST2, TIMP1, cystatin C, hsTnT and UACR were independent predictors of all-cause mortality (Table 1). GDF-15, TIMP1, hs-TnT and cystatin C consistently increased the risk of both all-cause mortality and the primary outcome. Individuals who had all 4 biomarkers elevated (compared to none elevated) had the highest risk: HR for all-cause mortality 3.65 (2.01–6.64), p<0.0001. Adding these 4 biomarkers to the baseline PREDICT HF model improved the C statistic for all-cause mortality from 0.726 to 0.745.
Conclusion
Several novel biomarkers provide meaningful additional prognostic information in patients with HFrEF. A multimarker approach incorporating biomarkers reflecting different pathophysiological pathways added most information. This approach may be useful in refining risk and targeting treatment.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): The PARADIGM-HF trial was funded by Novartis.J.J.V.M is supported by a British Heart Foundation Centre of Excellence Grant
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Affiliation(s)
- K McDowell
- University of Glasgow, BHF Cardiovascular Research Centre , Glasgow , United Kingdom
| | - J Simpson
- University of Glasgow, BHF Cardiovascular Research Centre , Glasgow , United Kingdom
| | - P S Jhund
- University of Glasgow, BHF Cardiovascular Research Centre , Glasgow , United Kingdom
| | - W T Abraham
- Ohio State University, Davis Heart and Lung Research Institiute, Division of Cardiovascular Medicine , Ohio , United States of America
| | - B Claggett
- Brigham and Women's Hospital, Cardiovascular medicine , Boston , United States of America
| | - J Cunningham
- Brigham and Women's Hospital, Cardiovascular medicine , Boston , United States of America
| | - A S Desai
- Brigham and Women's Hospital, Cardiovascular medicine , Boston , United States of America
| | - L Kober
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - M Prescott
- Novartis , East Hanover , United States of America
| | - J L Rouleau
- Montreal Heart Institute, Institute of Cardiology , Montreal , Canada
| | - K Swedberg
- University of Gothenburg, Department of Molecular and Clinical Medicine , Gothenburg , Sweden
| | - M R Zile
- Medical University of South Carolina , Charleston , United States of America
| | - S D Solomon
- Brigham and Women's Hospital, Cardiovascular medicine , Boston , United States of America
| | - M Packer
- Baylor University Medical Centre, Baylor Heart and Vascular Institiute , Dallas , United States of America
| | - J J V McMurray
- University of Glasgow, BHF Cardiovascular Research Centre , Glasgow , United Kingdom
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Frangione E, Chung M, Casalino S, MacDonald G, Chowdhary S, Mighton C, Faghfoury H, Bombard Y, Strug L, Pugh T, Simpson J, Hao L, Lebo M, Lane WJ, Taher J, Lerner‐Ellis J. Genome Reporting for Healthy Populations-Pipeline for Genomic Screening from the GENCOV COVID-19 Study. Curr Protoc 2022; 2:e534. [PMID: 36205462 PMCID: PMC9874607 DOI: 10.1002/cpz1.534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Genome sequencing holds the promise for great public health benefits. It is currently being used in the context of rare disease diagnosis and novel gene identification, but also has the potential to identify genetic disease risk factors in healthy individuals. Genome sequencing technologies are currently being used to identify genetic factors that may influence variability in symptom severity and immune response among patients infected by SARS-CoV-2. The GENCOV study aims to look at the relationship between genetic, serological, and biochemical factors and variability of SARS-CoV-2 symptom severity, and to evaluate the utility of returning genome screening results to study participants. Study participants select which results they wish to receive with a decision aid. Medically actionable information for diagnosis, disease risk estimation, disease prevention, and patient management are provided in a comprehensive genome report. Using a combination of bioinformatics software and custom tools, this article describes a pipeline for the analysis and reporting of genetic results to individuals with COVID-19, including HLA genotyping, large-scale continental ancestry estimation, and pharmacogenomic analysis to determine metabolizer status and drug response. In addition, this pipeline includes reporting of medically actionable conditions from comprehensive gene panels for Cardiology, Neurology, Metabolism, Hereditary Cancer, and Hereditary Kidney, and carrier screening for reproductive planning. Incorporated into the genome report are polygenic risk scores for six diseases-coronary artery disease; atrial fibrillation; type-2 diabetes; and breast, prostate, and colon cancer-as well as blood group genotyping analysis for ABO and Rh blood types and genotyping for other antigens of clinical relevance. The genome report summarizes the findings of these analyses in a way that extensively communicates clinically relevant results to patients and their physicians. © 2022 Wiley Periodicals LLC. Basic Protocol 1: HLA genotyping and disease association Basic Protocol 2: Large-scale continental ancestry estimation Basic Protocol 3: Dosage recommendations for pharmacogenomic gene variants associated with drug response Support Protocol: System setup.
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Affiliation(s)
- Erika Frangione
- Mount Sinai HospitalSinai HealthTorontoOntarioCanada,Lunenfeld‐Tanenbaum Research InstituteSinai HealthTorontoOntarioCanada
| | - Monica Chung
- Mount Sinai HospitalSinai HealthTorontoOntarioCanada,Lunenfeld‐Tanenbaum Research InstituteSinai HealthTorontoOntarioCanada
| | - Selina Casalino
- Mount Sinai HospitalSinai HealthTorontoOntarioCanada,Lunenfeld‐Tanenbaum Research InstituteSinai HealthTorontoOntarioCanada
| | - Georgia MacDonald
- Mount Sinai HospitalSinai HealthTorontoOntarioCanada,Lunenfeld‐Tanenbaum Research InstituteSinai HealthTorontoOntarioCanada
| | - Sunakshi Chowdhary
- Mount Sinai HospitalSinai HealthTorontoOntarioCanada,Lunenfeld‐Tanenbaum Research InstituteSinai HealthTorontoOntarioCanada
| | - Chloe Mighton
- Mount Sinai HospitalSinai HealthTorontoOntarioCanada,Lunenfeld‐Tanenbaum Research InstituteSinai HealthTorontoOntarioCanada,University of TorontoTorontoOntarioCanada,Unity Health TorontoTorontoOntarioCanada
| | | | - Yvonne Bombard
- University of TorontoTorontoOntarioCanada,Unity Health TorontoTorontoOntarioCanada
| | - Lisa Strug
- The Hospital for Sick ChildrenTorontoOntarioCanada
| | - Trevor Pugh
- University Health NetworkTorontoOntarioCanada,Ontario Institute for Cancer ResearchTorontoOntarioCanada
| | - Jared Simpson
- Ontario Institute for Cancer ResearchTorontoOntarioCanada
| | - Limin Hao
- Laboratory of Molecular MedicinePartners Personalized MedicineBostonMassachusetts
| | - Matthew Lebo
- Laboratory of Molecular MedicinePartners Personalized MedicineBostonMassachusetts,Harvard Medical School & Brigham and Women's HospitalBostonMassachusetts
| | - William J. Lane
- Harvard Medical School & Brigham and Women's HospitalBostonMassachusetts
| | - Jennifer Taher
- Mount Sinai HospitalSinai HealthTorontoOntarioCanada,University of TorontoTorontoOntarioCanada
| | - Jordan Lerner‐Ellis
- Mount Sinai HospitalSinai HealthTorontoOntarioCanada,Lunenfeld‐Tanenbaum Research InstituteSinai HealthTorontoOntarioCanada,University of TorontoTorontoOntarioCanada
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14
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Torkington J, Harries R, O'Connell S, Knight L, Islam S, Bashir N, Watkins A, Fegan G, Cornish J, Rees B, Cole H, Jarvis H, Jones S, Russell I, Bosanquet D, Cleves A, Sewell B, Farr A, Zbrzyzna N, Fiera N, Ellis-Owen R, Hilton Z, Parry C, Bradbury A, Wall P, Hill J, Winter D, Cocks K, Harris D, Hilton J, Vakis S, Hanratty D, Rajagopal R, Akbar F, Ben-Sassi A, Francis N, Jones L, Williamson M, Lindsey I, West R, Smart C, Ziprin P, Agarwal T, Faulkner G, Pinkney T, Vimalachandran D, Lawes D, Faiz O, Nisar P, Smart N, Wilson T, Myers A, Lund J, Smolarek S, Acheson A, Horwood J, Ansell J, Phillips S, Davies M, Davies L, Bird S, Palmer N, Williams M, Galanopoulos G, Rao PD, Jones D, Barnett R, Tate S, Wheat J, Patel N, Rahmani S, Toynton E, Smith L, Reeves N, Kealaher E, Williams G, Sekaran C, Evans M, Beynon J, Egan R, Qasem E, Khot U, Ather S, Mummigati P, Taylor G, Williamson J, Lim J, Powell A, Nageswaran H, Williams A, Padmanabhan J, Phillips K, Ford T, Edwards J, Varney N, Hicks L, Greenway C, Chesters K, Jones H, Blake P, Brown C, Roche L, Jones D, Feeney M, Shah P, Rutter C, McGrath C, Curtis N, Pippard L, Perry J, Allison J, Ockrim J, Dalton R, Allison A, Rendell J, Howard L, Beesley K, Dennison G, Burton J, Bowen G, Duberley S, Richards L, Giles J, Katebe J, Dalton S, Wood J, Courtney E, Hompes R, Poole A, Ward S, Wilkinson L, Hardstaff L, Bogden M, Al-Rashedy M, Fensom C, Lunt N, McCurrie M, Peacock R, Malik K, Burns H, Townley B, Hill P, Sadat M, Khan U, Wignall C, Murati D, Dhanaratne M, Quaid S, Gurram S, Smith D, Harris P, Pollard J, DiBenedetto G, Chadwick J, Hull R, Bach S, Morton D, Hollier K, Hardy V, Ghods M, Tyrrell D, Ashraf S, Glasbey J, Ashraf M, Garner S, Whitehouse A, Yeung D, Mohamed SN, Wilkin R, Suggett N, Lee C, Bagul A, McNeill C, Eardley N, Mahapatra R, Gabriel C, Datt P, Mahmud S, Daniels I, McDermott F, Nodolsk M, Park L, Scott H, Trickett J, Bearn P, Trivedi P, Frost V, Gray C, Croft M, Beral D, Osborne J, Pugh R, Herdman G, George R, Howell AM, Al-Shahaby S, Narendrakumar B, Mohsen Y, Ijaz S, Nasseri M, Herrod P, Brear T, Reilly JJ, Sohal A, Otieno C, Lai W, Coleman M, Platt E, Patrick A, Pitman C, Balasubramanya S, Dickson E, Warman R, Newton C, Tani S, Simpson J, Banerjee A, Siddika A, Campion D, Humes D, Randhawa N, Saunders J, Bharathan B, Hay O. Incisional hernia following colorectal cancer surgery according to suture technique: Hughes Abdominal Repair Randomized Trial (HART). Br J Surg 2022; 109:943-950. [PMID: 35979802 PMCID: PMC10364691 DOI: 10.1093/bjs/znac198] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/09/2022] [Accepted: 05/13/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Incisional hernias cause morbidity and may require further surgery. HART (Hughes Abdominal Repair Trial) assessed the effect of an alternative suture method on the incidence of incisional hernia following colorectal cancer surgery. METHODS A pragmatic multicentre single-blind RCT allocated patients undergoing midline incision for colorectal cancer to either Hughes closure (double far-near-near-far sutures of 1 nylon suture at 2-cm intervals along the fascia combined with conventional mass closure) or the surgeon's standard closure. The primary outcome was the incidence of incisional hernia at 1 year assessed by clinical examination. An intention-to-treat analysis was performed. RESULTS Between August 2014 and February 2018, 802 patients were randomized to either Hughes closure (401) or the standard mass closure group (401). At 1 year after surgery, 672 patients (83.7 per cent) were included in the primary outcome analysis; 50 of 339 patients (14.8 per cent) in the Hughes group and 57 of 333 (17.1 per cent) in the standard closure group had incisional hernia (OR 0.84, 95 per cent c.i. 0.55 to 1.27; P = 0.402). At 2 years, 78 patients (28.7 per cent) in the Hughes repair group and 84 (31.8 per cent) in the standard closure group had incisional hernia (OR 0.86, 0.59 to 1.25; P = 0.429). Adverse events were similar in the two groups, apart from the rate of surgical-site infection, which was higher in the Hughes group (13.2 versus 7.7 per cent; OR 1.82, 1.14 to 2.91; P = 0.011). CONCLUSION The incidence of incisional hernia after colorectal cancer surgery is high. There was no statistical difference in incidence between Hughes closure and mass closure at 1 or 2 years. REGISTRATION NUMBER ISRCTN25616490 (http://www.controlled-trials.com).
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15
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Pérez-Vidal RM, Gadea A, Domingo-Pardo C, Gargano A, Valiente-Dobón JJ, Clément E, Lemasson A, Coraggio L, Siciliano M, Szilner S, Bast M, Braunroth T, Collado J, Corina A, Dewald A, Doncel M, Dudouet J, de France G, Fransen C, González V, Hüyük T, Jacquot B, John PR, Jungclaus A, Kim YH, Korichi A, Labiche M, Lenzi S, Li H, Ljungvall J, López-Martens A, Mengoni D, Michelagnoli C, Müller-Gatermann C, Napoli DR, Navin A, Quintana B, Ramos D, Rejmund M, Sanchis E, Simpson J, Stezowski O, Wilmsen D, Zielińska M, Boston AJ, Barrientos D, Bednarczyk P, Benzoni G, Birkenbach B, Boston HC, Bracco A, Cederwall B, Cullen DM, Didierjean F, Eberth J, Gottardo A, Goupil J, Harkness-Brennan LJ, Hess H, Judson DS, Kaşkaş A, Korten W, Leoni S, Menegazzo R, Million B, Nyberg J, Podolyak Z, Pullia A, Ralet D, Recchia F, Reiter P, Rezynkina K, Salsac MD, Şenyiğit M, Sohler D, Theisen C, Verney D. Evidence of Partial Seniority Conservation in the πg_{9/2} Shell for the N=50 Isotones. Phys Rev Lett 2022; 129:112501. [PMID: 36154392 DOI: 10.1103/physrevlett.129.112501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 02/08/2022] [Accepted: 07/29/2022] [Indexed: 06/16/2023]
Abstract
The reduced transition probabilities for the 4_{1}^{+}→2_{1}^{+} and 2_{1}^{+}→0_{1}^{+} transitions in ^{92}Mo and ^{94}Ru and for the 4_{1}^{+}→2_{1}^{+} and 6_{1}^{+}→4_{1}^{+} transitions in ^{90}Zr have been determined in this experiment making use of a multinucleon transfer reaction. These results have been interpreted on the basis of realistic shell-model calculations in the f_{5/2}, p_{3/2}, p_{1/2}, and g_{9/2} proton valence space. Only the combination of extensive lifetime information and large scale shell-model calculations allowed the extent of the seniority conservation in the N=50 g_{9/2} orbital to be understood. The conclusion is that seniority is largely conserved in the first πg_{9/2} orbital.
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Affiliation(s)
- R M Pérez-Vidal
- Instituto de Física Corpuscular, CSIC-Universidad de Valencia, Valencia E-46980, Spain
- INFN Laboratori Nazionali di Legnaro, I-35020 Legnaro, Italy
| | - A Gadea
- Instituto de Física Corpuscular, CSIC-Universidad de Valencia, Valencia E-46980, Spain
| | - C Domingo-Pardo
- Instituto de Física Corpuscular, CSIC-Universidad de Valencia, Valencia E-46980, Spain
| | - A Gargano
- INFN Complesso Universitario di Monte S. Angelo, Via Cintia, I-80126 Napoli, Italy
| | | | - E Clément
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - A Lemasson
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - L Coraggio
- INFN Complesso Universitario di Monte S. Angelo, Via Cintia, I-80126 Napoli, Italy
- Dipartimento di Matematica e Fisica, Università degli Studi della Campania "Luigi Vanvitelli", viale Abramo Lincoln 5, I-81100 Caserta, Italy
| | - M Siciliano
- Physics Division, Argonne National Laboratory, Lemont, 60439 Illinois, USA
| | - S Szilner
- Ruder Bošković Institute, 10000 Zagreb, Croatia
| | - M Bast
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - T Braunroth
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - J Collado
- Departamento de Ingeniería Electrónica, Universitat de Valencia, Burjassot, E-46100 Valencia, Spain
| | - A Corina
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia BC V5A 1S6, Canada
| | - A Dewald
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - M Doncel
- Department of Physics, Stockholm University, SE-106 91 Stockholm, Sweden
| | - J Dudouet
- Université Lyon, Université Claude Bernard Lyon 1, CNRS/IN2P3, IP2I Lyon, F-69622 Villeurbanne, France
| | - G de France
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - C Fransen
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - V González
- Departamento de Ingeniería Electrónica, Universitat de Valencia, Burjassot, E-46100 Valencia, Spain
| | - T Hüyük
- Instituto de Física Corpuscular, CSIC-Universidad de Valencia, Valencia E-46980, Spain
- Instituto de Estructura de la Materia, CSIC, Madrid, E-28006 Madrid, Spain
| | - B Jacquot
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - P R John
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - A Jungclaus
- Instituto de Estructura de la Materia, CSIC, Madrid, E-28006 Madrid, Spain
| | - Y H Kim
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
- Institut Laue-Langevin, 71 Avenue des Martyrs, 38042 Grenoble, France
| | - A Korichi
- IJCLab Orsay, IN2P3-CNRS, Université Paris-Saclay and Université Paris-Sud, 91405 Orsay, France
| | - M Labiche
- STFC Daresbury Laboratory, Daresbury, Warrington WA4 4AD, United Kingdom
| | - S Lenzi
- Dipartimento di Fisica e Astronomia dell'Università di Padova, I-35131 Padova, Italy
- INFN Sezione di Padova, I-35131 Padova, Italy
| | - H Li
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - J Ljungvall
- IJCLab Orsay, IN2P3-CNRS, Université Paris-Saclay and Université Paris-Sud, 91405 Orsay, France
| | - A López-Martens
- IJCLab Orsay, IN2P3-CNRS, Université Paris-Saclay and Université Paris-Sud, 91405 Orsay, France
| | - D Mengoni
- Dipartimento di Fisica e Astronomia dell'Università di Padova, I-35131 Padova, Italy
- INFN Sezione di Padova, I-35131 Padova, Italy
| | - C Michelagnoli
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
- Institut Laue-Langevin, 71 Avenue des Martyrs, 38042 Grenoble, France
| | - C Müller-Gatermann
- Physics Division, Argonne National Laboratory, Lemont, 60439 Illinois, USA
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - D R Napoli
- INFN Laboratori Nazionali di Legnaro, I-35020 Legnaro, Italy
| | - A Navin
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - B Quintana
- Laboratorio de Radiaciones Ionizantes, Universidad de Salamanca, E-37008 Salamanca, Spain
| | - D Ramos
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - M Rejmund
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - E Sanchis
- Departamento de Ingeniería Electrónica, Universitat de Valencia, Burjassot, E-46100 Valencia, Spain
| | - J Simpson
- STFC Daresbury Laboratory, Daresbury, Warrington WA4 4AD, United Kingdom
| | - O Stezowski
- Université Lyon, Université Claude Bernard Lyon 1, CNRS/IN2P3, IP2I Lyon, F-69622 Villeurbanne, France
| | - D Wilmsen
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - M Zielińska
- Irfu, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A J Boston
- Oliver Lodge Laboratory, The University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | | | - P Bednarczyk
- The Henryk Niewodniczański Institute of Nuclear Physics, Polish Academy of Sciences, ul. Radzikowskiego 152, 31-342 Kraków, Poland
| | - G Benzoni
- INFN Sezione di Milano, I-20133 Milano, Italy
| | - B Birkenbach
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - H C Boston
- Oliver Lodge Laboratory, The University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - A Bracco
- INFN Sezione di Milano, I-20133 Milano, Italy
- Dipartimento di Fisica, Università di Milano, I-20133 Milano, Italy
| | - B Cederwall
- Department of Physics, KTH Royal Institute of Technology, SE-10691 Stockholm, Sweden
| | - D M Cullen
- Nuclear Physics Group, Schuster Laboratory, University of Manchester, Manchester M13 9PL, United Kingdom
| | - F Didierjean
- Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France
| | - J Eberth
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - A Gottardo
- INFN Laboratori Nazionali di Legnaro, I-35020 Legnaro, Italy
| | - J Goupil
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - L J Harkness-Brennan
- Oliver Lodge Laboratory, The University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - H Hess
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - D S Judson
- Oliver Lodge Laboratory, The University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - A Kaşkaş
- Department of Physics, Ankara University, 06100 Besevler-Ankara, Turkey
| | - W Korten
- Irfu, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - S Leoni
- INFN Sezione di Milano, I-20133 Milano, Italy
- Dipartimento di Fisica, Università di Milano, I-20133 Milano, Italy
| | - R Menegazzo
- INFN Sezione di Padova, I-35131 Padova, Italy
| | - B Million
- INFN Sezione di Milano, I-20133 Milano, Italy
| | - J Nyberg
- Department of Physics and Astronomy, Uppsala University, SE-75120 Uppsala, Sweden
| | - Zs Podolyak
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - A Pullia
- INFN Sezione di Milano, I-20133 Milano, Italy
- Dipartimento di Fisica, Università di Milano, I-20133 Milano, Italy
| | - D Ralet
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - F Recchia
- Dipartimento di Fisica e Astronomia dell'Università di Padova, I-35131 Padova, Italy
- INFN Sezione di Padova, I-35131 Padova, Italy
| | - P Reiter
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - K Rezynkina
- INFN Sezione di Padova, I-35131 Padova, Italy
- Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France
| | - M D Salsac
- Irfu, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Şenyiğit
- Department of Physics, Ankara University, 06100 Besevler-Ankara, Turkey
| | - D Sohler
- Institute for Nuclear Research, Atomki, 4001 Debrecen, P.O. Box 51, Hungary
| | - Ch Theisen
- Irfu, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - D Verney
- IJCLab Orsay, IN2P3-CNRS, Université Paris-Saclay and Université Paris-Sud, 91405 Orsay, France
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Casalino S, Mighton C, Clausen M, Frangione E, Chowdhary S, Chung M, Jordan Fung CY, Morgan G, MacDonald G, Lapadula E, Faghfoury H, Arnoldo S, Bearss E, Binnie A, Borgundvaag B, Chertkow H, Devine L, Friedmen SM, Gingras AC, Khan Z, Mazzulli T, McGeer A, McLeod S, Pugh T, Richardson D, Simpson J, Stern S, Strug L, Taher A, Wong I, Zarei N, Kaushik D, Goneau L, Dagher M, Noor A, Greenfeld E, Bombard Y, Taher J, Lerner-Ellis J. eP294: Return of genome sequencing results in ostensibly healthy COVID-19 positive individuals: GENCOV Study Canada. Genet Med 2022. [PMCID: PMC8935071 DOI: 10.1016/j.gim.2022.01.330] [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: 11/13/2022] Open
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Frangione E, Chung M, Mighton C, Casalino S, Chowdhary S, Satnam Singh HK, Xu L, Di Iorio D, Jain A, Kidwai A, Wong Q, Aujla N, Li JM, Quraishi M, Morgan G, Clausen M, Jordan Fung CY, MacDonald G, Lapadula E, Arnoldo S, Bearss E, Binnie A, Borgundvaag B, Chertkow H, Devine L, Friedmen SM, Gingras AC, Khan Z, Mazzulli T, McGeer A, McLeod S, Pugh T, Richardson D, Simpson J, Stern S, Strug L, Taher A, Wong I, Zarei N, Kaushik D, Goneau L, Dagher M, Greenfeld E, Faghfoury H, Bombard Y, Noor A, Taher J, Lerner-Ellis J. eP325: Medically actionable DNA variation from the GENCOV COVID-19 Genome Sequencing Study. Genet Med 2022. [PMCID: PMC8935062 DOI: 10.1016/j.gim.2022.01.360] [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: 11/30/2022] Open
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Stegeman R, Feldmann M, Claessens NHP, Jansen NJG, Breur JMPJ, de Vries LS, Logeswaran T, Reich B, Knirsch W, Kottke R, Hagmann C, Latal B, Simpson J, Pushparajah K, Bonthrone AF, Kelly CJ, Arulkumaran S, Rutherford MA, Counsell SJ, Benders MJNL. A Uniform Description of Perioperative Brain MRI Findings in Infants with Severe Congenital Heart Disease: Results of a European Collaboration. AJNR Am J Neuroradiol 2021; 42:2034-2039. [PMID: 34674999 PMCID: PMC8583253 DOI: 10.3174/ajnr.a7328] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/19/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND PURPOSE A uniform description of brain MR imaging findings in infants with severe congenital heart disease to assess risk factors, predict outcome, and compare centers is lacking. Our objective was to uniformly describe the spectrum of perioperative brain MR imaging findings in infants with congenital heart disease. MATERIALS AND METHODS Prospective observational studies were performed at 3 European centers between 2009 and 2019. Brain MR imaging was performed preoperatively and/or postoperatively in infants with transposition of the great arteries, single-ventricle physiology, or left ventricular outflow tract obstruction undergoing cardiac surgery within the first 6 weeks of life. Brain injury was assessed on T1, T2, DWI, SWI, and MRV. A subsample of images was assessed jointly to reach a consensus. RESULTS A total of 348 MR imaging scans (180 preoperatively, 168 postoperatively, 146 pre- and postoperatively) were obtained in 202 infants. Preoperative, new postoperative, and cumulative postoperative white matter injury was identified in 25%, 30%, and 36%; arterial ischemic stroke, in 6%, 10%, and 14%; hypoxic-ischemic watershed injury in 2%, 1%, and 1%; intraparenchymal cerebral hemorrhage, in 0%, 4%, and 5%; cerebellar hemorrhage, in 6%, 2%, and 6%; intraventricular hemorrhage, in 14%, 6%, and 13%; subdural hemorrhage, in 29%, 17%, and 29%; and cerebral sinovenous thrombosis, in 0%, 10%, and 10%, respectively. CONCLUSIONS A broad spectrum of perioperative brain MR imaging findings was found in infants with severe congenital heart disease. We propose an MR imaging protocol including T1-, T2-, diffusion-, and susceptibility-weighted imaging, and MRV to identify ischemic, hemorrhagic, and thrombotic lesions observed in this patient group.
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Affiliation(s)
- R Stegeman
- From the Departments of Neonatology (R.S., N.H.P.C., L.S.d.V., M.J.N.L.B.)
- Pediatric Intensive Care (R.S., N.H.P.C., N.J.G.J.)
- Pediatric Cardiology (R.S., N.H.P.C., J.M.P.J.B.), Wilhelmina Children's Hospital, UMC Utrecht, Utrecht, the Netherlands
- Utrecht Brain Center (R.S., L.S.d.V., M.J.N.L.B.), UMC Utrecht, Utrecht University, Utrecht, the Netherlands
| | | | - N H P Claessens
- From the Departments of Neonatology (R.S., N.H.P.C., L.S.d.V., M.J.N.L.B.)
- Pediatric Intensive Care (R.S., N.H.P.C., N.J.G.J.)
- Pediatric Cardiology (R.S., N.H.P.C., J.M.P.J.B.), Wilhelmina Children's Hospital, UMC Utrecht, Utrecht, the Netherlands
| | - N J G Jansen
- Pediatric Intensive Care (R.S., N.H.P.C., N.J.G.J.)
- Department of Pediatrics (N.J.G.J.), Beatrix Children's Hospital, UMC Groningen, Groningen, the Netherlands
| | - J M P J Breur
- Pediatric Cardiology (R.S., N.H.P.C., J.M.P.J.B.), Wilhelmina Children's Hospital, UMC Utrecht, Utrecht, the Netherlands
| | - L S de Vries
- From the Departments of Neonatology (R.S., N.H.P.C., L.S.d.V., M.J.N.L.B.)
- Utrecht Brain Center (R.S., L.S.d.V., M.J.N.L.B.), UMC Utrecht, Utrecht University, Utrecht, the Netherlands
| | - T Logeswaran
- Pediatric Heart Center (T.L., B.R.), University Hospital Giessen, Justus-Liebig-University Giessen, Giessen, Germany
| | - B Reich
- Pediatric Heart Center (T.L., B.R.), University Hospital Giessen, Justus-Liebig-University Giessen, Giessen, Germany
| | - W Knirsch
- Division of Pediatric Cardiology (W.K.), Pediatric Heart Center
| | - R Kottke
- Department of Diagnostic Imaging (R.K.)
| | - C Hagmann
- Department of Neonatology and Pediatric Intensive Care (C.H.), University Children's Hospital Zurich, Zurich, Switzerland
| | - B Latal
- Child Development Center (M.F., B.L.)
| | - J Simpson
- Department of Pediatric Cardiology (J.S., K.P.), Evelina Children's Hospital London, London, UK
| | - K Pushparajah
- Department of Pediatric Cardiology (J.S., K.P.), Evelina Children's Hospital London, London, UK
- Centre for the Developing Brain (K.P., A.F.B., C.J.K., S.A., M.A.R., S.J.C.), School of Biomedical Engineering and Imaging Sciences, King.s College London, London, UK
| | - A F Bonthrone
- Centre for the Developing Brain (K.P., A.F.B., C.J.K., S.A., M.A.R., S.J.C.), School of Biomedical Engineering and Imaging Sciences, King.s College London, London, UK
| | - C J Kelly
- Centre for the Developing Brain (K.P., A.F.B., C.J.K., S.A., M.A.R., S.J.C.), School of Biomedical Engineering and Imaging Sciences, King.s College London, London, UK
| | - S Arulkumaran
- Centre for the Developing Brain (K.P., A.F.B., C.J.K., S.A., M.A.R., S.J.C.), School of Biomedical Engineering and Imaging Sciences, King.s College London, London, UK
| | - M A Rutherford
- Centre for the Developing Brain (K.P., A.F.B., C.J.K., S.A., M.A.R., S.J.C.), School of Biomedical Engineering and Imaging Sciences, King.s College London, London, UK
| | - S J Counsell
- Centre for the Developing Brain (K.P., A.F.B., C.J.K., S.A., M.A.R., S.J.C.), School of Biomedical Engineering and Imaging Sciences, King.s College London, London, UK
| | - M J N L Benders
- From the Departments of Neonatology (R.S., N.H.P.C., L.S.d.V., M.J.N.L.B.)
- Utrecht Brain Center (R.S., L.S.d.V., M.J.N.L.B.), UMC Utrecht, Utrecht University, Utrecht, the Netherlands
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Savelli CJ, Simpson J, Mateus C. Exploring the Experiences of Members of the International Food Safety Authorities Network: An Interpretative Phenomenological Analysis. J Food Prot 2021; 84:1683-1697. [PMID: 34086917 DOI: 10.4315/jfp-21-171] [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: 04/20/2021] [Accepted: 06/01/2021] [Indexed: 11/11/2022]
Abstract
ABSTRACT The International Food Safety Authorities Network (INFOSAN) is a global network of national food safety authorities from 190 countries, managed jointly by the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) that aims to facilitate the rapid exchange of information during food safety incidents. A three-phase study of INFOSAN was launched in 2019 to characterize and examine the network as a functional community of practice and determine its value systematically and rigorously from its members' perspectives. The first two phases of the study involved analyzing the INFOSAN Community Website and surveying of all of its members. The main objective of this third and final phase of the study was to understand the experiences of a small group of INFOSAN members as they relate to various dimensions of membership. A qualitative methodology was used to provide a deeper understanding of members' experiences and supplement the results from the first two quantitative study phases. Interviews were conducted with 10 INFOSAN members from 10 geographic regions, transcribed verbatim, and analyzed using interpretative phenomenological analysis. The results offer an understanding of INFOSAN members' experiences in the context of what participation in this global network means to them and relate to five themes concerning trust, learning, health protection, sense of community, and future potential. The findings suggest that focusing on outreach to sustain personal interest, training to improve technical capacity, and advocacy to obtain political buy-in are ways in which the INFOSAN Secretariat could enable participation and create value at the individual, organizational, and national level, respectively. Such engagement could translate into more effective international communication during urgent food safety incidents and fewer cases of foodborne illness worldwide. HIGHLIGHTS
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Affiliation(s)
- Carmen Joseph Savelli
- World Health Organization, Nutrition and Food Safety, Avenue Appia 20, 1211, Geneva, Switzerland.,Faculty of Health and Medicine, Division of Health Research, Lancaster University, Bailrigg, Lancaster LA1 4YW, UK
| | - J Simpson
- Faculty of Health and Medicine, Division of Health Research, Lancaster University, Bailrigg, Lancaster LA1 4YW, UK
| | - C Mateus
- Faculty of Health and Medicine, Division of Health Research, Lancaster University, Bailrigg, Lancaster LA1 4YW, UK
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21
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Taher J, Mighton C, Chowdhary S, Casalino S, Frangione E, Arnoldo S, Bearss E, Binnie A, Bombard Y, Borgundvaag B, Chertkow H, Clausen M, Devine L, Faghfoury H, Friedman SM, Gingras AC, Khan Z, Mazzulli T, McGeer A, McLeod SL, Pugh TJ, Richardson D, Simpson J, Stern S, Strug L, Taher A, Lerner-Ellis J. Implementation of serological and molecular tools to inform COVID-19 patient management: protocol for the GENCOV prospective cohort study. BMJ Open 2021; 11:e052842. [PMID: 34593505 PMCID: PMC8487020 DOI: 10.1136/bmjopen-2021-052842] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION There is considerable variability in symptoms and severity of COVID-19 among patients infected by the SARS-CoV-2 virus. Linking host and virus genome sequence information to antibody response and biological information may identify patient or viral characteristics associated with poor and favourable outcomes. This study aims to (1) identify characteristics of the antibody response that result in maintained immune response and better outcomes, (2) determine the impact of genetic differences on infection severity and immune response, (3) determine the impact of viral lineage on antibody response and patient outcomes and (4) evaluate patient-reported outcomes of receiving host genome, antibody and viral lineage results. METHODS AND ANALYSIS A prospective, observational cohort study is being conducted among adult patients with COVID-19 in the Greater Toronto Area. Blood samples are collected at baseline (during infection) and 1, 6 and 12 months after diagnosis. Serial antibody titres, isotype, antigen target and viral neutralisation will be assessed. Clinical data will be collected from chart reviews and patient surveys. Host genomes and T-cell and B-cell receptors will be sequenced. Viral genomes will be sequenced to identify viral lineage. Regression models will be used to test associations between antibody response, physiological response, genetic markers and patient outcomes. Pathogenic genomic variants related to disease severity, or negative outcomes will be identified and genome wide association will be conducted. Immune repertoire diversity during infection will be correlated with severity of COVID-19 symptoms and human leucocyte antigen-type associated with SARS-CoV-2 infection. Participants can learn their genome sequencing, antibody and viral sequencing results; patient-reported outcomes of receiving this information will be assessed through surveys and qualitative interviews. ETHICS AND DISSEMINATION This study was approved by Clinical Trials Ontario Streamlined Ethics Review System (CTO Project ID: 3302) and the research ethics boards at participating hospitals. Study findings will be disseminated through peer-reviewed publications, conference presentations and end-users.
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Affiliation(s)
- Jennifer Taher
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Chloe Mighton
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Sunakshi Chowdhary
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Ontario, Canada
| | - Selina Casalino
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Ontario, Canada
| | - Erika Frangione
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Ontario, Canada
| | - Saranya Arnoldo
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- William Osler Health System, Brampton, Ontario, Canada
| | - Erin Bearss
- Mount Sinai Academic Family Health Team, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Yvonne Bombard
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Bjug Borgundvaag
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Emergency Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | | | - Marc Clausen
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Luke Devine
- Division of General Internal Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Hanna Faghfoury
- Fred A Litwin and Family Centre in Genetic Medicine, University Health Network & Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Steven Marc Friedman
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Emergency Medicine, University Health Network, Toronto, Ontario, Canada
| | - Anne-Claude Gingras
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Zeeshan Khan
- Mackenzie Health, Richmond Hill, Ontario, Canada
| | - Tony Mazzulli
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Department of Microbiology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Allison McGeer
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Microbiology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Shelley L McLeod
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Schwartz/Reisman Emergency Medicine Institute, Sinai Health System, Toronto, Ontario, Canada
| | - Trevor J Pugh
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | | | - Jared Simpson
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- Department of Computer Science, University of Toronto, Toronto, Ontario, Canada
| | - Seth Stern
- Mackenzie Health, Richmond Hill, Ontario, Canada
| | - Lisa Strug
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Statistical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Ahmed Taher
- Emergency Medicine, University Health Network, Toronto, Ontario, Canada
- Mackenzie Health, Richmond Hill, Ontario, Canada
- Division of Emergency Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jordan Lerner-Ellis
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Ontario, Canada
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Simpson J, Moulton D, Giroud C, Casson F, Groth M, Chankin A, Horvath L, Gahle D, Garzotti L, Corrigan G, Kochl F. An examination of the Neutral Penetration Model 1/ne,ped scaling for its validity of spatially varying neutral sources. Nuclear Materials and Energy 2021. [DOI: 10.1016/j.nme.2021.101037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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23
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Simpson J, Raith A, Fauzi F, Lin K, Macann A, Rouse P, Ehrgott M. OC-0311 Integrating data envelopment analysis into radiotherapy treatment planning for head and neck cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06858-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Huang X, Malek N, Simpson J, Kalladka D, Dunn FG, Leach JP. Winning hearts and minds: ECG reporting in the first seizure clinic. BMC Cardiovasc Disord 2021; 21:364. [PMID: 34332536 PMCID: PMC8325235 DOI: 10.1186/s12872-021-02174-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 07/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND AIMS An electrocardiogram (ECG) is a mandatory test for anyone presenting with loss of consciousness. Many referrals to the first seizure clinic (FSC) are caused by syncope. We assessed the sensitivity of neurologists' ECG reporting in detecting rhythm abnormalities including some potentially life-threatening cardiac conditions. METHODS We audited patients referred to a FSC in Glasgow over 4 years. All ECGs were interpreted by the attending neurologist as standard practice. Subsequently, two cardiologists reviewed the ECGs independently. RESULTS Of 160 consecutive patients, 92 patients (58%) were diagnosed as having seizures, 43 (27%) as syncope, and 25 (16%) were unclassified. Twenty eight ECGs thought to be normal by the neurologist were considered abnormal by the cardiologist, including three with long corrected QT interval. The proportion of abnormal ECGs and disparity in reporting between neurologists and cardiologists persisted independent of the underlying diagnosis. CONCLUSION Reporting of ECGs by non-cardiologists may not be adequately sensitive in picking up potentially life threatening cardiac conditions. Cardiologist input into FSCs is recommended to enhance the diagnostic yield.
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Affiliation(s)
- Xuya Huang
- Department of Neurology, Institute of Neurosciences, Queen Elizabeth University Hospital, Glasgow, G51 4TF, UK.
| | - N Malek
- Department of Neurology, Ipswich Hospital NHS Trust, Ipswich, UK
| | - J Simpson
- British Heart Foundation, Institute of Cardiovascular and Medical Sciences, University of Glasgow, University Avenue, Glasgow, UK
| | - D Kalladka
- Directorate of Stroke and Neurosciences, Imperial College Healthcare NHS Trust, Charing Cross Hospital, Fulham Palace Road, London, UK
| | - F G Dunn
- School of Medicine, University of Glasgow, Glasgow, UK
| | - J P Leach
- Department of Neurology, Institute of Neurosciences, Queen Elizabeth University Hospital, Glasgow, G51 4TF, UK.,School of Medicine, University of Glasgow, Glasgow, UK
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Lawson K, Groth M, Harting D, Menmuir S, Reiter D, Aggarwal K, Brezinsek S, Coffey I, Corrigan G, Keenan F, Maggi C, Meigs A, O'Mullane M, Simpson J, Wiesen S. Use of the Culham He model He II atomic data in JET EDGE2D-EIRENE simulations. Nuclear Materials and Energy 2021. [DOI: 10.1016/j.nme.2021.101010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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26
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Sayer K, Whiteaway K, Dawson JO, Simpson J, Chu W. 57 Physical Activity Improvement in Elderly Hospitalised Patients at the Royal London: Exercise as Part of A Multimodal Intervention. Age Ageing 2021. [DOI: 10.1093/ageing/afab030.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Approximately 65% of elderly patients admitted to hospital experience some level of deconditioning during their stay. This can lead to longer length of stays, premature admissions to care homes and loss of function whilst in hospital (British Geriatrics Society). There is evidence that exercise can be safe and effective in reversing functional decline in this population. However, there is limited evidence into the effectiveness and feasibility of running a multi modal exercise intervention (eg. Dance and Exercise) on a busy elderly care ward in the UK.
Method
An 8-week inpatient programme consisting of a 60-minute exercise classes once a week and/or 60-minute dance class once a week started on the Older Person’s Wards at the Royal London. Primary outcome measures included: 5 x Sit To Stands (5xSTS) and Falls Efficacy Scale International (FES-I). Secondary measures; Rockwood score, Barthel Index, Elderly Mobility Score (EMS), Mood, 4AT and handgrip strength. Patient satisfaction scores were also recorded.
Results
23 patients were included in the analysis, 3 patients attended the dance class, 14 attended the exercise class and 5 attended both. In total 37 sessions were completed. The average score for all outcome measures improved except one after 8 weeks. The 5xSTS times improved by an average of 7.7 seconds and the FES-I score dropped by 3.9. The Barthel score increased by 5 points. Handgrip strength increased by 2.3 kg and 57% improved on their EMS. Mood improved from 5.4/10 to 6.0/10 and 4AT from 2.7 to 1.7. Overall, 70% of participants reported enjoying the classes and 90% said they would re-attend.
Conclusion
A multifactorial intervention including seated dance and exercise sessions showed significant improvements in mobility, fear of falling, cognition and functional tasks. Further work will look into the impact on length of stay and readmissions inpatient to hospital.
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Affiliation(s)
- K Sayer
- The Royal London Hospital, Wards 14E and 14F
| | - K Whiteaway
- The Royal London Hospital, Wards 14E and 14F
| | - J O Dawson
- The Royal London Hospital, Wards 14E and 14F
| | - J Simpson
- The Royal London Hospital, Wards 14E and 14F
| | - W Chu
- The Royal London Hospital, Wards 14E and 14F
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27
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Novak AB, Pelletier MC, Colarusso P, Simpson J, Gutierrez MN, Arias-Ortiz A, Charpentier M, Masque P, Vella P. Factors Influencing Carbon Stocks and Accumulation Rates in Eelgrass Meadows Across New England, USA. Estuaries Coast 2020; 43:2076-2091. [PMID: 33364916 PMCID: PMC7751660] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Increasing the protection of coastal vegetated ecosystems has been suggested as one strategy to compensate for increasing carbon dioxide (CO2) in the atmosphere as the capacity of these habitats to sequester and store carbon exceeds that of terrestrial habitats. Seagrasses are a group of foundation species that grow in shallow coastal and estuarine systems and have an exceptional ability to sequester and store large quantities of carbon in biomass and, particularly, in sediments. However, carbon stocks (Corg stocks) and carbon accumulation rates (Corg accumulation) in seagrass meadows are highly variable both spatially and temporally, making it difficult to extrapolate this strategy to areas where information is lacking. In this study, Corg stocks and Corg accumulation were determined at 11 eelgrass meadows across New England, representing a range of eutrophication and exposure conditions. In addition, the environmental factors and structural characteristics of meadows related to variation in Corg stocks were identified. The objectives were accomplished by assessing stable isotopes of δ13C and δ15N as well as %C and %N in plant tissues and sediments, measuring grain size and 210Pb of sediment cores, and through assessing site exposure. Variability in Corg stocks in seagrass meadows is well predicted using commonly measured environmental variables such as grain size distribution. This study allows incorporation of data and insights for the northwest Atlantic, where few studies on carbon sequestration by seagrasses have been conducted.
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Affiliation(s)
- A. B. Novak
- Earth and Environment, Boston University, Boston, MA, USA
| | - M. C. Pelletier
- Atlantic Ecology Division, US EPA, ORD, NHEERL, Narragansett, RI, USA
| | | | | | - M. N. Gutierrez
- Atlantic Ecology Division, US EPA, ORD, NHEERL, Narragansett, RI, USA
| | - A. Arias-Ortiz
- Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain
- Ecosystem Science Division, Department of Environmental Science, Policy and Management, University of California, Berkeley, CA, USA
| | | | - P. Masque
- Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain
- School of Science and Centre for Marine Ecosystems Research, Edith Cowan University, Joondalup, Western Australia 6027, Australia
- Departament de Física, Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain
- International Atomic Energy, 4a Quai Antoine 1er, 98000 Principality of Monaco, Monaco
| | - P. Vella
- Massachusetts Coastal Zone Management, Boston, MA, USA
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Abstract
Abstract
Background
ESC guidelines recommend measurement of troponin T in patients with hypertrophic cardiomyopathy (HCM) because high concentrations are associated with cardiovascular events, heart failure and death. The cardiac Troponin I subunit is not expressed in skeletal muscle making it a cardio-specific isoform. The use of troponin biomarkers in management of patients HCM is limited because concentrations only weakly correlate with clinical parameters. Most studies are small, and few have examined their relation with genotype and mortality.
Purpose
To assess the relationship between high-sensitive troponin I (hsTnI) and characteristics of adults with HCM.
Methods
Patients included were adults with an established diagnosis of HCM referred to a single centre for genetic testing. Demographic, clinical and imaging data were recorded at baseline. Echocardiography and cardiac magnetic resonance (CMR) were performed according to EACVI standards. Quantification of late gadolinium enhancement (LGE) was performed using the 5 SD quantitative threshold. Genotype was evaluated using a 16 gene panel in an accredited UK laboratory. Pathogenic and likely pathogenic variants were considered as a positive genotype. Serum hsTnI was measured by a two-site electrochemiluminescence immunoassay on a Roche E170 analyser. Normal values for the assay 0–34 ng/L for males and 0–16 ng/L for females.
Results
313 patients (n=200, 64% male) median age 57 (IQR 47–68) years were included. hsTnI concentration was abnormal in 69 (22%) patients. An abnormal hsTnI was more common in females (n=36, 32%) compared to males (n=33, 17%, c2 9.9, p<0.05). A pathogenic variant in a sarcomere gene was identified in 95 (30%) individuals. An abnormal hsTnI concentration was associated with higher left ventricular (LV) wall thickness (20mm v 18mm, p<0.05) and LV outflow tract (LVOT) gradient (34 v 22 mmHg) on echocardiography (n=313). Of the patients (n=204) who had a CMR, an abnormal hsTnI concentration was associated with higher LV mass (183 v 156g, p<0.05) and greater % LGE (30 v 16%, p<0.01, n=129). There was no difference in hsTnI between those with a positive or negative genotype. During follow-up, 18 patients died. Of the 9 patients that died with a normal hsTnI, two died suddenly.
Conclusions
In HCM, patients with abnormal hsTnI concentration have higher LV mass and LVOT gradient and more fibrosis. Whilst mortality is higher in those with abnormal hsTnI, sudden cardiac death may occur with a normal hsTnI. It may not be appropriate to extrapolate hsTnI sex-specific thresholds used in the diagnosis of myocardial infarction to HCM.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- J Osmanska
- NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - A Connelly
- NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - S Nordin
- NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - A Vega
- NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - J Simpson
- NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - J Anusas
- NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - I Findlay
- NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - C Coats
- NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
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Affiliation(s)
| | | | | | - J. Slay
- Troy University, Troy, Alabama
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Hadley-Barrows T, Quicke J, Evans N, Duffy H, Chatwin L, Stevenson K, Jones S, Shipway C, Simpson J, Hurley M, Dziedzic K. Optimising resources for patient benefit: implementing ESCAPE-pain in collaboration with leisure and third sector community partners. A pilot study. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.176] [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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Khan A, Hughes M, Ting M, Riding G, Simpson J, Egun A, Banihani M. A 'hot clinic' for cold limbs: the benefit of urgent clinics for patients with critical limb ischaemia. Ann R Coll Surg Engl 2020; 102:412-417. [PMID: 32306742 DOI: 10.1308/rcsann.2020.0068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The national reconfiguration of vascular surgery means that arterial centres serve larger populations with increased demand on resources. Emergency general surgery ambulatory clinics facilitate timely review and intervention, avoiding admission; a critical limb ischaemia (CLI) 'hot clinic' (HC) was implemented to achieve similar for vascular patients. The aim of the study was to determine HC efficacy. METHODS This was a prospective cohort study comparing HC patients with emergency admission (EA) patients between 1 May and 1 December 2017. Age, sex, comorbidities, CLI severity and smoking status were noted. HC patients were provided with satisfaction surveys. Primary outcome measures were freedom from reintervention and major amputation. Secondary outcome measures included time to procedure, length of stay, returns to theatre and 30-day readmission. RESULTS A total of 147 patients (72 HC, 75 EA) were enrolled in the study. No statistical difference was found in age, sex, smoking status, severity of CLI or prevalence of comorbidities between the groups except that diabetes was more prevalent in EA patients (p=0.028). The median length of stay for the HC cohort was shorter (3 days vs 17 days, p<0.001), with no difference between time to procedure, return to theatre or 30-day readmission. HC patients were nearly 6 times more likely to experience freedom from reintervention (odds ratio: 5.824, p<0.001) and 2.5 times less likely to undergo amputation (odds ratio: 2.616, p=0.043). HC utilisation saved a total of 441 bed days. Over 90% of attendees responded with 100% positive feedback. CONCLUSIONS A vascular HC facilitates urgent review and revascularisation. It provides comparable in-hospital outcomes and better long-term outcomes, with greater efficiency than hospital admission, demonstrating its value in treating CLI.
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Affiliation(s)
- A Khan
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
| | - M Hughes
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
| | - M Ting
- University of Manchester, UK
| | - G Riding
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
| | - J Simpson
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
| | - A Egun
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
| | - M Banihani
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
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Cederwall B, Liu X, Aktas Ö, Ertoprak A, Zhang W, Qi C, Clément E, de France G, Ralet D, Gadea A, Goasduff A, Jaworski G, Kuti I, Nyakó BM, Nyberg J, Palacz M, Wadsworth R, Valiente-Dobón JJ, Al-Azri H, Ataç Nyberg A, Bäck T, de Angelis G, Doncel M, Dudouet J, Gottardo A, Jurado M, Ljungvall J, Mengoni D, Napoli DR, Petrache CM, Sohler D, Timár J, Barrientos D, Bednarczyk P, Benzoni G, Birkenbach B, Boston AJ, Boston HC, Burrows I, Charles L, Ciemala M, Crespi FCL, Cullen DM, Désesquelles P, Domingo-Pardo C, Eberth J, Erduran N, Ertürk S, González V, Goupil J, Hess H, Huyuk T, Jungclaus A, Korten W, Lemasson A, Leoni S, Maj A, Menegazzo R, Million B, Perez-Vidal RM, Podolyak Z, Pullia A, Recchia F, Reiter P, Saillant F, Salsac MD, Sanchis E, Simpson J, Stezowski O, Theisen C, Zielińska M. Isospin Properties of Nuclear Pair Correlations from the Level Structure of the Self-Conjugate Nucleus ^{88}Ru. Phys Rev Lett 2020; 124:062501. [PMID: 32109090 DOI: 10.1103/physrevlett.124.062501] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/27/2019] [Accepted: 12/18/2019] [Indexed: 06/10/2023]
Abstract
The low-lying energy spectrum of the extremely neutron-deficient self-conjugate (N=Z) nuclide _{44}^{88}Ru_{44} has been measured using the combination of the Advanced Gamma Tracking Array (AGATA) spectrometer, the NEDA and Neutron Wall neutron detector arrays, and the DIAMANT charged particle detector array. Excited states in ^{88}Ru were populated via the ^{54}Fe(^{36}Ar,2nγ)^{88}Ru^{*} fusion-evaporation reaction at the Grand Accélérateur National d'Ions Lourds (GANIL) accelerator complex. The observed γ-ray cascade is assigned to ^{88}Ru using clean prompt γ-γ-2-neutron coincidences in anticoincidence with the detection of charged particles, confirming and extending the previously assigned sequence of low-lying excited states. It is consistent with a moderately deformed rotating system exhibiting a band crossing at a rotational frequency that is significantly higher than standard theoretical predictions with isovector pairing, as well as observations in neighboring N>Z nuclides. The direct observation of such a "delayed" rotational alignment in a deformed N=Z nucleus is in agreement with theoretical predictions related to the presence of strong isoscalar neutron-proton pair correlations.
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Affiliation(s)
- B Cederwall
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
| | - X Liu
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
| | - Ö Aktas
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
| | - A Ertoprak
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
- Department of Physics, Faculty of Science, Istanbul University, Vezneciler/Fatih, 34134 Istanbul, Turkey
| | - W Zhang
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
| | - C Qi
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
| | - E Clément
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DSM-CNRS/IN2P3, Bd Henri Becquerel, BP 55027, F-14076 Caen Cedex 5, France
| | - G de France
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DSM-CNRS/IN2P3, Bd Henri Becquerel, BP 55027, F-14076 Caen Cedex 5, France
| | - D Ralet
- Centre de Sciences Nucléaires et Sciences de la Matière, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay, France
| | - A Gadea
- Instituto de Física Corpuscular, CSIC-Universidad de Valencia, E-46980 Valencia, Spain
| | - A Goasduff
- Istituto Nazionale di Fisica Nucleare, Laboratori Nazionali di Legnaro, I-35020 Legnaro, Italy
| | - G Jaworski
- Istituto Nazionale di Fisica Nucleare, Laboratori Nazionali di Legnaro, I-35020 Legnaro, Italy
- Heavy Ion Laboratory, University of Warsaw, ul. Pasteura 5A,02-093 Warszawa, Poland
| | - I Kuti
- MTA Atomki, H-4001 Debrecen, Hungary
| | - B M Nyakó
- MTA Atomki, H-4001 Debrecen, Hungary
| | - J Nyberg
- Department of Physics and Astronomy, Uppsala University, SE-75121 Uppsala, Sweden
| | - M Palacz
- Heavy Ion Laboratory, University of Warsaw, ul. Pasteura 5A,02-093 Warszawa, Poland
| | - R Wadsworth
- Department of Physics, University of York, Heslington, York, YO10 5DD, United Kingdom
| | - J J Valiente-Dobón
- Istituto Nazionale di Fisica Nucleare, Laboratori Nazionali di Legnaro, I-35020 Legnaro, Italy
| | - H Al-Azri
- Rustaq College of Education, Department of Science, 329 Al-Rustaq, Sultanate of Oman
| | - A Ataç Nyberg
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
| | - T Bäck
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
| | - G de Angelis
- Istituto Nazionale di Fisica Nucleare, Laboratori Nazionali di Legnaro, I-35020 Legnaro, Italy
| | - M Doncel
- KTH Royal Institute of Technology, 10691 Stockholm, Sweden
- Department of Physics, Oliver Lodge Laboratory, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - J Dudouet
- Université Lyon, CNRS/IN2P3, IPN-Lyon, F-69622, Villeurbanne, France
| | - A Gottardo
- Centre de Sciences Nucléaires et Sciences de la Matière, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay, France
| | - M Jurado
- Instituto de Física Corpuscular, CSIC-Universidad de Valencia, E-46980 Valencia, Spain
| | - J Ljungvall
- Centre de Sciences Nucléaires et Sciences de la Matière, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay, France
| | - D Mengoni
- Istituto Nazionale di Fisica Nucleare, Laboratori Nazionali di Legnaro, I-35020 Legnaro, Italy
| | - D R Napoli
- Istituto Nazionale di Fisica Nucleare, Laboratori Nazionali di Legnaro, I-35020 Legnaro, Italy
| | - C M Petrache
- Centre de Sciences Nucléaires et Sciences de la Matière, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay, France
| | - D Sohler
- MTA Atomki, H-4001 Debrecen, Hungary
| | - J Timár
- MTA Atomki, H-4001 Debrecen, Hungary
| | | | - P Bednarczyk
- The Henryk Niewodniczański Institute of Nuclear Physics, Polish Academy of Sciences, ul. Radzikowskiego 152, 31-342 Kraków, Poland
| | - G Benzoni
- INFN Sezione di Milano, I-20133 Milano, Italy
| | - B Birkenbach
- Institut für Kernphysik, Universität zu Köln, Zülpicher Str. 77, D-50937 Köln, Germany
| | - A J Boston
- Oliver Lodge Laboratory, The University of Liverpool, Liverpool, L69 7ZE, United Kingdom
| | - H C Boston
- Oliver Lodge Laboratory, The University of Liverpool, Liverpool, L69 7ZE, United Kingdom
| | - I Burrows
- STFC Daresbury Laboratory, Daresbury, Warrington, WA4 4AD, United Kingdom
| | - L Charles
- IPHC, UNISTRA, CNRS, 23 rue du Loess, 67200 Strasbourg, France
| | - M Ciemala
- The Henryk Niewodniczański Institute of Nuclear Physics, Polish Academy of Sciences, ul. Radzikowskiego 152, 31-342 Kraków, Poland
| | - F C L Crespi
- University of Milano, Department of Physics, I-20133 Milano, Italy
- INFN Milano, I-20133 Milano, Italy
| | - D M Cullen
- Nuclear Physics Group, Schuster Laboratory, University of Manchester, Manchester, M13 9PL, United Kingdom
| | - P Désesquelles
- Centre de Sciences Nucléaires et Sciences de la Matière, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay, France
- CNRS-IN2P3, Universiteé Paris-Saclay, Bat 104, F-91405 Orsay Campus, France
| | - C Domingo-Pardo
- Instituto de Física Corpuscular, CSIC-Universidad de Valencia, E-46071 Valencia, Spain
| | - J Eberth
- Institut für Kernphysik, Universität zu Köln, Zülpicher Str. 77, D-50937 Köln, Germany
| | - N Erduran
- Faculty of Engineering and Natural Sciences, Istanbul Sabahattin Zaim University, 34303, Istanbul, Turkey
| | - S Ertürk
- Department of Physics, University of Nigde, 51240 Nigde, Turkey
| | - V González
- Departamento de Ingeniería Electrónica, Universitat de Valencia, 46100 Burjassot, Valencia, Spain
| | - J Goupil
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DSM-CNRS/IN2P3, Bd Henri Becquerel, BP 55027, F-14076 Caen Cedex 5, France
| | - H Hess
- Institut für Kernphysik, Universität zu Köln, Zülpicher Str. 77, D-50937 Köln, Germany
| | - T Huyuk
- Instituto de Física Corpuscular, CSIC-Universidad de Valencia, E-46980 Valencia, Spain
| | - A Jungclaus
- Instituto de Estructura de la Materia, CSIC, Madrid, E-28006 Madrid, Spain
| | - W Korten
- Irfu, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Lemasson
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DSM-CNRS/IN2P3, Bd Henri Becquerel, BP 55027, F-14076 Caen Cedex 5, France
| | - S Leoni
- University of Milano, Department of Physics, I-20133 Milano, Italy
- INFN Milano, I-20133 Milano, Italy
| | - A Maj
- The Henryk Niewodniczański Institute of Nuclear Physics, Polish Academy of Sciences, ul. Radzikowskiego 152, 31-342 Kraków, Poland
| | | | | | - R M Perez-Vidal
- Instituto de Física Corpuscular, CSIC-Universidad de Valencia, E-46071 Valencia, Spain
| | - Zs Podolyak
- Department of Physics, University of Surrey, Guildford, GU2 7XH, United Kingdom
| | - A Pullia
- University of Milano, Department of Physics, I-20133 Milano, Italy
- INFN Milano, I-20133 Milano, Italy
| | - F Recchia
- Dipartimento di Fisica e Astronomia dell'Università di Padova and INFN Padova, I-35131 Padova, Italy
| | - P Reiter
- Institut für Kernphysik, Universität zu Köln, Zülpicher Str. 77, D-50937 Köln, Germany
| | - F Saillant
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DSM-CNRS/IN2P3, Bd Henri Becquerel, BP 55027, F-14076 Caen Cedex 5, France
| | - M D Salsac
- Irfu, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - E Sanchis
- Departamento de Ingeniería Electrónica, Universitat de Valencia, 46100 Burjassot, Valencia, Spain
| | - J Simpson
- STFC Daresbury Laboratory, Daresbury, Warrington, WA4 4AD, United Kingdom
| | - O Stezowski
- Université Lyon 1, CNRS/IN2P3, IPN-Lyon, F-69622, Villeurbanne, France
| | - Ch Theisen
- Irfu, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Zielińska
- Irfu, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
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Jiang Z, Mathew A, Peck L, Rudra P, Simpson J. 9 The ‘Colchester Older Persons’ Evaluation for Surgery (COPES)’ Clinic: A Multidisciplinary Approach to Preoperative Management of Frail, Older Patients. Age Ageing 2020. [DOI: 10.1093/ageing/afz183.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
In 2014-15, 2.5 million patients over 75 years old underwent surgery compared to 1.5 million in 2006-7. The population is aging with increasing numbers of comorbidities, and associated frailty.1 The Royal College of Anaesthetists recommends that preoperative assessment for these complex older patients takes a “cross-specialty approach.”2 In Colchester the COPES clinic has been introduced in which selected high-risk patients are seen by a Consultant Anaesthetist and Consultant Geriatrician. This aims to medically optimise patients prior to surgery and to facilitate shared decision making.
Methods
The new clinic was introduced in October 2018. The following data was collected from COPES clinic letters from October to February 2018-19 (n=46):Patient/ surgery characteristics: age, comorbidities, frailty score and any cognitive impairmentInterventions: changes to medication, specialty referral, intravenous iron, diabetes optimisation, otherOutcomes of surgery following the COPES clinic
Patients were asked to complete feedback forms to evaluate the service.
Results
52% of patients had 4-6, and 28% had 7-9 comorbidities. The majority had Rockwood frailty scores of 4 or 5. 28% of patients had medications changed, 48% had specialty referrals, 17% received intravenous iron, 8.7% required diabetes optimisation and 28% of patients had investigations including echocardiograms, MRI and CT scans. 12/46 patients had surgery deemed unlikely to go ahead after shared decision making with patients in conjunction with the multidisciplinary team involved in their care. 2 patients died of their comorbidities after deciding not to proceed with surgery. 12/46 patients underwent surgery; 4 developed post-operative complications, none died and the mean length of stay was 3.38 days. The remaining 22/46 patients are awaiting surgery. Patient feedback questionnaires (n=10) were overwhelmingly positive. Everyone felt that they were treated with respect and that their fears were addressed and they were clear in the next steps in management.
Conclusions
The introduction of the ‘COPES’ clinic has helped address frailty and multiple comorbidities by optimising patients’ medical conditions and allowing alternatives to surgery to be considered. Patients were very satisfied with the COPES clinic and felt it has prepared them for upcoming surgery.
References
1. Lin H. Frailty and post-operative outcomes in older surgical patients: a systematic review. BMC Geriatrics, 2016.
2. RCoA. Guidelines for the Provision of Anaesthesia Services. www.pre-op.org/sites/default/files/GPAS%202016.pdf
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Wen PY, de Groot J, Battiste JD, Goldlust SA, Garner J, Simpson J, Olivero A, Cloughesy T. P05.06 Phase 2 study to evaluate the safety, pharmacokinetics and clinical activity of PI3K/mTOR inhibitor GDC-0084 given to glioblastoma (GBM) patients with unmethylated O6-methylguanine-methyltransferase (MGMT) promoter status. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
GDC-0084 is a potent, oral, selective small molecule inhibitor of class I phosphoinositide 3-kinase and mammalian target of rapamycin (PI3K/mTOR). The PI3K pathway is activated in ≥ 70% of tumors, making it a compelling target for the treatment of GBM. GDC-0084 crosses the blood-brain barrier and achieves a brain / plasma ratio of approximately 1.0. GDC-0084 was given as once daily oral dosing in a phase 1 study (Wen et al, J Clin Oncol 34, 2016(15) suppl.2012) in 47 patients with recurrent high-grade gliomas. The adverse events were generally consistent with the established PI3K/mTOR inhibitor class-effects. The MTD identified was 45 mg once daily.
MATERIAL AND METHODS
This study has a 2-part design consisting of an open-label, multicenter dose-escalation study with expansion to assess the safety, tolerability, RP2D, PK, and clinical activity of GDC-0084 at QD dosing in patients with newly-diagnosed GBM with unmethylated MGMT promotor status. In the escalation phase the first cohort is completed without DLT. At the identified MTD, 20 subjects will be recruited in an expansion cohort and patients will be randomized to take GDC-0084 in fed and fasted states. Subjects in the expansion cohort will also have serial fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging.
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Affiliation(s)
- P Y Wen
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, United States
| | - J de Groot
- Department of Neuro-Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - J D Battiste
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, United States
| | - S A Goldlust
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, United States
| | - J Garner
- Kazia Therapeutics Limited, Sydney, Australia
| | - J Simpson
- Kazia Therapeutics Limited, Sydney, Australia
| | - A Olivero
- Genentech Inc, South San Francisco, CA, United States
| | - T Cloughesy
- Department of Neurology, Ronald Reagan UCLA Medical Center University of California, Los Angeles, CA, United States
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Simpson J, Moulton D, Giroud C, Groth M, Corrigan G. Using EDGE2D-EIRENE to simulate the effect of impurity seeding and fueling on the upstream electron separatrix temperature. Nuclear Materials and Energy 2019. [DOI: 10.1016/j.nme.2019.02.002] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Simpson J, Millman B, Nagakumar P, Desai M, Butler L, Colley J, Fairbank J, Haw S. P351 Baby PEP or percussion. Is there a clear winner? J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30643-5] [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: 10/26/2022]
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Nordin S, Findlay I, Simpson J, Brockway C, Orchard V, Berry C, Coats C. P381Clinical utility of multiparametric CMR in the assessment of cardiac involvement in Becker muscular dystrophy with raised troponin levels. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez109.022] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- S Nordin
- Golden Jubilee National Hospital, Glasgow, United Kingdom of Great Britain & Northern Ireland
| | - I Findlay
- Queen Elizabeth University Hospital, Glasgow, United Kingdom of Great Britain & Northern Ireland
| | - J Simpson
- Golden Jubilee National Hospital, Glasgow, United Kingdom of Great Britain & Northern Ireland
| | - C Brockway
- Golden Jubilee National Hospital, Glasgow, United Kingdom of Great Britain & Northern Ireland
| | - V Orchard
- Golden Jubilee National Hospital, Glasgow, United Kingdom of Great Britain & Northern Ireland
| | - C Berry
- Golden Jubilee National Hospital, Glasgow, United Kingdom of Great Britain & Northern Ireland
| | - C Coats
- Queen Elizabeth University Hospital, Glasgow, United Kingdom of Great Britain & Northern Ireland
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Madjunkova S, Antes R, Abramov R, Yin Y, Chen S, Zuzarte P, Jorgensen L, Sundaravadanam Y, Simpson J, Librach C. The first report of comprehensive preimplantation genetic testing for chromosomal structural rearrangements (PGT-SR) using long read sequencing. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.1201] [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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Bailey MH, Wang LB, Liang WW, Foltz S, Dong G, Wendl MC, McLellan M, Hirbe AC, Simpson J, Gerstein M, Ding L. Abstract 419: Reproducibility assessment of mutations calls in exome- and whole-genome sequencing using consensus calling from TCGA and ICGC. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Two large cancer genomic consortia recently published the largest and highest-quality consensus mutations calls for both whole-exome sequencing (WES) and whole-genome sequencing (WGS) in cancer: The Cancer Genome Atlas (TCGA), and the International Cancer Genetics Consortia (ICGC), respectively. Together these datasets encompass more than 60M mutations from ~13,000 samples (~10,000 WES and ~3,000 WGS). An intersecting set of 742 samples, from 22 cancer types, was sequenced using both platforms and mutations were identified using a combined 13 variant calling tools (7 WES and 5 WGS). These samples represent an ideal dataset to compare and contrast WES with WGS performance, reliability, and reproducibility of mutation calling in exons, and provide the community with key regions flanking exons that play a role in carcinogenesis. MAF files were collected using strict filtering criteria for initial file release, including the elimination of germline contaminants, 8-oxo-guanine artifacts, depth filtering and repeat masking. Additional filtering included minimum coverage requirements and restriction of both WES and WGS to variants detected within targeted exons. Finally, we restricted our data to known cancer genes. This final step suggests that these 742 samples have anywhere between 11.5K to 12.3K mutations from covered exons in potential cancer driver genes—WES and WGS, respectively. Preliminary results found that ~70% of samples had had >80% congruent mutations between both platforms; ~25% of samples had had >80% congruent mutations calls in one or the other platform; and the remaining samples had poor performance in replicating identical mutations. We observed that a majority of the variants unique to a sequencing platform were primarily from mutations with low VAF. We also sought to explore regions of the genome that are captured by both technologies despite the knowledge that WES did not target these regions. This is made possible by obtaining access to the primary data resources, and relaxing filtering criteria to include other regions such as 3' and 5' UTR, exon flanking regions, and intronic regions. We identified many recurrent mutations from non-exonic regions that were corroborated using both platforms that have not been previously reported in pan-cancer efforts. At this historic junction in time, as preliminary results from whole-genome sequencing efforts emerge and large exome sequencing efforts taper, 742 samples spanning both efforts can provide insights into the lessons learned from exome sequencing, and provide a solid foundation stepping forward into whole-genome analysis. We will continue to glean insights into the etiology of human disease by using both technologies; however, these mutation calls highlight the challenges that still exist in somatic variant calling, and provide grounds for more critical evaluation of genomic findings in cancer.
Citation Format: Matthew H. Bailey, Liang-Bo Wang, Wen-Wei Liang, Steven Foltz, Guanlan Dong, Michael C. Wendl, Michael McLellan, Angela C. Hirbe, Jared Simpson, Mark Gerstein, Li Ding. Reproducibility assessment of mutations calls in exome- and whole-genome sequencing using consensus calling from TCGA and ICGC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 419.
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Affiliation(s)
| | | | | | - Steven Foltz
- 1Washington University in St. Louis, St. Louis, MO
| | - Guanlan Dong
- 1Washington University in St. Louis, St. Louis, MO
| | | | | | | | - Jared Simpson
- 2Ontario Institute of Cancer Research, Ontario, Ontario, Canada
| | | | - Li Ding
- 1Washington University in St. Louis, St. Louis, MO
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Miller TB, Chapman SC, Aravena M, Ashby MLN, Hayward CC, Vieira JD, Weiß A, Babul A, Béthermin M, Bradford CM, Brodwin M, Carlstrom JE, Chen CC, Cunningham DJM, De Breuck C, Gonzalez AH, Greve TR, Harnett J, Hezaveh Y, Lacaille K, Litke KC, Ma J, Malkan M, Marrone DP, Morningstar W, Murphy EJ, Narayanan D, Pass E, Perry R, Phadke KA, Rennehan D, Rotermund KM, Simpson J, Spilker JS, Sreevani J, Stark AA, Strandet ML, Strom AL. A massive core for a cluster of galaxies at a redshift of 4.3. Nature 2018; 556:469-472. [PMID: 29695849 DOI: 10.1038/s41586-018-0025-2] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 01/24/2018] [Indexed: 11/09/2022]
Abstract
Massive galaxy clusters have been found that date to times as early as three billion years after the Big Bang, containing stars that formed at even earlier epochs1-3. The high-redshift progenitors of these galaxy clusters-termed 'protoclusters'-can be identified in cosmological simulations that have the highest overdensities (greater-than-average densities) of dark matter4-6. Protoclusters are expected to contain extremely massive galaxies that can be observed as luminous starbursts 7 . However, recent detections of possible protoclusters hosting such starbursts8-11 do not support the kind of rapid cluster-core formation expected from simulations 12 : the structures observed contain only a handful of starbursting galaxies spread throughout a broad region, with poor evidence for eventual collapse into a protocluster. Here we report observations of carbon monoxide and ionized carbon emission from the source SPT2349-56. We find that this source consists of at least 14 gas-rich galaxies, all lying at redshifts of 4.31. We demonstrate that each of these galaxies is forming stars between 50 and 1,000 times more quickly than our own Milky Way, and that all are located within a projected region that is only around 130 kiloparsecs in diameter. This galaxy surface density is more than ten times the average blank-field value (integrated over all redshifts), and more than 1,000 times the average field volume density. The velocity dispersion (approximately 410 kilometres per second) of these galaxies and the enormous gas and star-formation densities suggest that this system represents the core of a cluster of galaxies that was already at an advanced stage of formation when the Universe was only 1.4 billion years old. A comparison with other known protoclusters at high redshifts shows that SPT2349-56 could be building one of the most massive structures in the Universe today.
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Affiliation(s)
- T B Miller
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada. .,Department of Astronomy, Yale University, New Haven, CT, USA.
| | - S C Chapman
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada.,National Research Council, Herzberg Astronomy and Astrophysics, Victoria, British Columbia, Canada
| | - M Aravena
- Núcleo de Astronomía, Facultad de Ingeniería y Ciencias, Universidad Diego Portales, Santiago, Chile
| | - M L N Ashby
- Harvard-Smithsonian Center for Astrophysics, Cambridge, MA, USA
| | - C C Hayward
- Harvard-Smithsonian Center for Astrophysics, Cambridge, MA, USA.,Center for Computational Astrophysics, Flatiron Institute, New York, NY, USA
| | - J D Vieira
- Department of Astronomy, University of Illinois, Urbana, IL, USA
| | - A Weiß
- Max-Planck-Institut für Radioastronomie, Bonn, Germany
| | - A Babul
- Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia, Canada
| | - M Béthermin
- Aix-Marseille Université, CNRS, LAM, Laboratoire d'Astrophysique de Marseille, Marseille, France
| | - C M Bradford
- California Institute of Technology, Pasadena, CA, USA.,Jet Propulsion Laboratory, Pasadena, CA, USA
| | - M Brodwin
- Department of Physics and Astronomy, University of Missouri, Kansas City, MO, USA
| | - J E Carlstrom
- Kavli Institute for Cosmological Physics, University of Chicago, Chicago, IL, USA.,Department of Physics, University of Chicago, Chicago, IL, USA.,Enrico Fermi Institute, University of Chicago, Chicago, IL, USA.,Department of Astronomy and Astrophysics, University of Chicago, Chicago, IL, USA
| | | | - D J M Cunningham
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Astronomy and Physics, Saint Mary's University, Halifax, Nova Scotia, Canada
| | - C De Breuck
- European Southern Observatory, Garching, Germany
| | - A H Gonzalez
- Department of Astronomy, University of Florida, Gainesville, FL, USA
| | - T R Greve
- Department of Physics and Astronomy, University College London, London, UK
| | - J Harnett
- School of Physics, University of Sydney, Sydney, New South Wales, Australia
| | - Y Hezaveh
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA, USA
| | - K Lacaille
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Physics and Astronomy, McMaster University, Hamilton, Ontario, Canada
| | - K C Litke
- Steward Observatory, University of Arizona, Tucson, AZ, USA
| | - J Ma
- Department of Astronomy, University of Florida, Gainesville, FL, USA
| | - M Malkan
- Department of Physics and Astronomy, University of California, Los Angeles, CA, USA
| | - D P Marrone
- Steward Observatory, University of Arizona, Tucson, AZ, USA
| | - W Morningstar
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA, USA
| | - E J Murphy
- National Radio Astronomy Observatory, Charlottesville, VA, USA
| | - D Narayanan
- Department of Astronomy, University of Florida, Gainesville, FL, USA
| | - E Pass
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Physics and Astronomy, University of Waterloo, Waterloo, Ontario, Canada
| | - R Perry
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - K A Phadke
- Department of Astronomy, University of Illinois, Urbana, IL, USA
| | - D Rennehan
- Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia, Canada
| | - K M Rotermund
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - J Simpson
- Institute for Astronomy, Royal Observatory, University of Edinburgh, Edinburgh, UK.,Centre for Extragalactic Astronomy, Department of Physics, Durham University, Durham, UK
| | - J S Spilker
- Steward Observatory, University of Arizona, Tucson, AZ, USA
| | - J Sreevani
- Department of Astronomy, University of Illinois, Urbana, IL, USA
| | - A A Stark
- Harvard-Smithsonian Center for Astrophysics, Cambridge, MA, USA
| | - M L Strandet
- Max-Planck-Institut für Radioastronomie, Bonn, Germany.,International Max Planck Research School (IMPRS) for Astronomy and Astrophysics, Bonn, Germany
| | - A L Strom
- Observatories of The Carnegie Institution for Science, Pasadena, CA, USA
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Gamba E, Lalkovski S, Rudigier M, Bruce A, Bottoni S, Carpenter M, Zhu S, Ayangeakaa A, Anderson J, Berry T, Burrows I, Carroll R, Copp P, Carmona Gallardo M, Cullen D, Daniel T, Greene J, Gurgi L, Hartley D, Ilieva R, Ilieva S, Janssens R, Kondev F, Kröll T, Lane G, Lauritsen T, Lazarus I, Lotay G, Fernández Martínez G, Podolyák Z, Pucknell V, Reed M, Regan P, Rohrer J, Sethi J, Seweryniak D, Shand C, Simpson J, Smolen M, Stefanova E, Vedia V, Yordanov O. Fast-timing measurements in neutron-rich odd-mass zirconium isotopes using LaBr 3:Ce detectors coupled with Gammasphere. EPJ Web Conf 2018. [DOI: 10.1051/epjconf/201819305004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A fast-timing experiment was performed at the Argonne National Laboratory to measure the lifetimes of the lowest lying states of nuclei belonging to the deformed regions around mass number A≃110 and A≃150. These regions were populated via spontaneous fission of 252Cf and the gamma radiation following the decay of excited states in the fission fragments was measured using 51 Gammasphere detectors coupled with 25 LaBr3:Ce detectors. A brief description of the acquisition system and some preliminary results from the fast-timing analysis of the fission fragment 100Zr are presented. The lifetime value of τ = 840(65) ps was found for the 2+ state in 100Zr consistent within one standard deviation of the adopted value with 791 +26 -35ps. This is associated with a quadrupole deformation parameter of 0.36(2) which is within one standard deviation of the literature value of 0.3556+82 -57.
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Macann A, Fauzi F, Simpson J, Sasso G, Krawitz H, Fraser-Browne C, Manitz J, Raith A. Humidification mitigates acute mucosal toxicity during radiotherapy when factoring volumetric parameters. Trans Tasman Radiation Oncology Group (TROG) RadioHUM 07.03 substudy. Oral Oncol 2017; 75:75-80. [PMID: 29224827 DOI: 10.1016/j.oraloncology.2017.10.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 05/02/2017] [Revised: 10/11/2017] [Accepted: 10/23/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE/OBJECTIVE(S) To model in a subset of patients from TROG 07.03 managed at a single site the association between domiciliary based humidification use and mucositis symptom burden during radiotherapy (RT) for head and neck cancer (HNC) when factoring in volumetric radiotherapy parameters derived from tumour and normal tissue regions of interest. MATERIALS/METHODS From June 2008 through June 2011, 210 patients with HNC receiving RT were randomised to either a control arm or humidification using the Fisher & Paykel Healthcare MR880 humidifier. This subset analysis involves patients recruited from Auckland City Hospital treated with a prescribed dose of ≥70 Gy. Regression models included control variables for Planning Target Volume 70 GY (PTV70Gy); Equivalent Uniform Dose (EUD) MOIST and TSV (surrogates of total mucosal and total swallowing volumes respectively). RESULTS The analysis included 39 patients (humidification 20, control 19). There was a significant odds reduction in CTCAE v3.0 functional mucositis score of 0.29 associated with the use of humidification (p<.001). Within the parameters of the model therefore, the risk of a humidification patient being scored as experiencing a one-step increase in functional mucositis was 3.45 times lower (1/0.29) than for control patients. A control patient was 4.17 times more likely to receive an unfavourable nutritional mode score (p<.001). The risk of being admitted to hospital decreased by a factor of 11.11 for humidification patients (p=.013). CONCLUSION The results support the hypothesis that humidification can help mitigate mucositis symptom burden. Radiotherapy dosimetric parameters assist in the evaluation of toxicity interventions.
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Affiliation(s)
- A Macann
- Department of Radiation Oncology, Auckland City Hospital, Auckland, New Zealand.
| | - F Fauzi
- Faculty of Information Science and Technology, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - J Simpson
- Department of Medical Physics, Newcastle Mater Hospital, Newcastle, Australia
| | - G Sasso
- Department of Radiation Oncology, Auckland City Hospital, Auckland, New Zealand
| | - H Krawitz
- Department of Radiation Oncology, Auckland City Hospital, Auckland, New Zealand
| | - C Fraser-Browne
- Oncology Research Centre, Auckland City Hospital, Auckland, New Zealand
| | - J Manitz
- Centre for Statistics, University of Göttingen, Göttingen, Germany
| | - A Raith
- Department of Engineering Science, University of Auckland, Auckland, New Zealand
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Ravikumar R, Sabin C, Abu Hilal M, Al-Hilli A, Aroori S, Bond-Smith G, Bramhall S, Coldham C, Hammond J, Hutchins R, Imber C, Preziosi G, Saleh A, Silva M, Simpson J, Spoletini G, Stell D, Terrace J, White S, Wigmore S, Fusai G. Impact of portal vein infiltration and type of venous reconstruction in surgery for borderline resectable pancreatic cancer. Br J Surg 2017; 104:1539-1548. [PMID: 28833055 DOI: 10.1002/bjs.10580] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 12/29/2016] [Accepted: 04/04/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND The International Study Group of Pancreatic Surgery (ISGPS) recommends operative exploration and resection of pancreatic cancers in the presence of reconstructable mesentericoportal axis involvement. However, there is no consensus on the ideal method of vascular reconstruction. The effect of depth of tumour invasion of the vessel wall on outcome is also unknown. METHODS This was a retrospective cohort study of pancreaticoduodenectomy with vein resection for T3 adenocarcinoma of the head of the pancreas across nine centres. Outcome measures were overall survival based on the impact of the depth of tumour infiltration of the vessel wall, and morbidity, in-hospital mortality and overall survival between types of venous reconstruction: primary closure, end-to-end anastomosis and interposition graft. RESULTS A total of 229 patients underwent portal vein resection; 129 (56·3 per cent) underwent primary closure, 64 (27·9 per cent) had an end-to-end anastomosis and 36 (15·7 per cent) an interposition graft. There was no difference in overall morbidity (26 (20·2 per cent), 14 (22 per cent) and 9 (25 per cent) respectively; P = 0·817) or in-hospital mortality (6 (4·7 per cent), 2 (3 per cent) and 2 (6 per cent); P = 0·826) between the three groups. One hundred and six patients (47·5 per cent) had histological evidence of vein involvement; 59 (26·5 per cent) had superficial invasion (tunica adventitia) and 47 (21·1 per cent) had deep invasion (tunica media or intima). Median survival was 18·8 months for patients who had primary closure, 27·6 months for those with an end-to-end anastomosis and 13·0 months among patients with an interposition graft. There was no significant difference in median survival between patients with superficial, deep or no histological vein involvement (20·8, 21·3 and 13·3 months respectively; P = 0·111). Venous tumour infiltration was not associated with decreased overall survival on multivariable analysis. CONCLUSION In this study, there was no difference in morbidity between the three modes of venous reconstruction, and overall survival was similar regardless of tumour infiltration of the vein.
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Affiliation(s)
- R Ravikumar
- Department of Hepatopancreatobiliary (HPB) and Liver Transplant Surgery, Royal Free Hospital, London, UK
| | - C Sabin
- Research Department of Infection and Population Health, Royal Free Campus, University College London, London, UK
| | - M Abu Hilal
- Department of HPB Surgery, Southampton General Hospital, Southampton, UK
| | - A Al-Hilli
- Department of HPB Surgery, Southampton General Hospital, Southampton, UK
| | - S Aroori
- Department of HPB Surgery, Plymouth Hospitals, Plymouth, UK
| | - G Bond-Smith
- Department of HPB Surgery, Royal London Hospital, London, UK
| | - S Bramhall
- Liver Unit, University Hospital Birmingham, Birmingham, UK
| | - C Coldham
- Liver Unit, University Hospital Birmingham, Birmingham, UK
| | - J Hammond
- Department of HPB, Nottingham University Hospitals, Nottingham, UK
| | - R Hutchins
- Department of HPB Surgery, Royal London Hospital, London, UK
| | - C Imber
- Department of Hepatopancreatobiliary (HPB) and Liver Transplant Surgery, Royal Free Hospital, London, UK
| | - G Preziosi
- Department of Hepatopancreatobiliary (HPB) and Liver Transplant Surgery, Royal Free Hospital, London, UK
| | - A Saleh
- Department of HPB and Transplantation, Freeman Hospital, Newcastle upon Tyne, UK
| | - M Silva
- Department of HPB Surgery, Churchill Hospital, Oxford, UK
| | - J Simpson
- Department of HPB, Nottingham University Hospitals, Nottingham, UK
| | - G Spoletini
- Department of HPB Surgery, Churchill Hospital, Oxford, UK
| | - D Stell
- Department of HPB Surgery, Plymouth Hospitals, Plymouth, UK
| | - J Terrace
- Department of HPB and Liver Transplant Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - S White
- Department of HPB and Transplantation, Freeman Hospital, Newcastle upon Tyne, UK
| | - S Wigmore
- Department of HPB and Liver Transplant Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - G Fusai
- Department of Hepatopancreatobiliary (HPB) and Liver Transplant Surgery, Royal Free Hospital, London, UK
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Lawson K, Groth M, Harting D, Menmuir S, Reiter D, Brezinsek S, Corrigan G, Drewelow P, Maggi C, Meigs A, Simpson J, Stamp M, Wiesen S, Contributors. A study of the atomic and molecular power loss terms in EDGE2D-EIRENE simulations of JET ITER-like wall L-mode discharges. Nuclear Materials and Energy 2017. [DOI: 10.1016/j.nme.2017.04.015] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Uljanovs J, Groth M, Jaervinen A, Moulton D, Brix M, Corrigan G, Drewelow P, Guillemaut C, Harting D, Simpson J, Huber A, Jachmich S, Kruezi U, Lawson K, Meigs A, Sips A, Stamp M, Wiesen S. The isotope effect on divertor conditions and neutral pumping in horizontal divertor configurations in JET-ILW Ohmic plasmas. Nuclear Materials and Energy 2017. [DOI: 10.1016/j.nme.2017.03.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tabberner M, Nixon W, Patchell C, Simpson J, Desai M. 374 Successful establishment of nurse-led MDT cystic fibrosis baby clinic. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30704-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Simpson J, Tabberner M, Paskin L, Desai M. 265 Tolerance of dry powdered inhaled (DPI) antibiotics in a paediatric cystic fibrosis population. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30607-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Fuangrod T, Simpson J, Bhatia S, Lim S, Lovelock M, Greer P. PO-0868: Evaluation of Watchdog response to anatomical changes during head and neck IMRT treatment. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31305-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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De Visser R, Richters J, Yeung A, Rissel C, Simpson J. PS-01-006 Sexual difficulties: Prevalence, impact, and help-seeking in a population-representative sample. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.03.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Tolosa-Delgado A, Agramunt J, Ahn DS, Algora A, Baba H, Bae S, Brewer NT, Caballero Folch R, Calvino F, Coleman-Smith PJ, Cortes G, Davinson T, Dillmann I, Domingo-Pardo C, Estrade A, Fukuda N, Go S, Griffin CJ, Grzywacz R, Ha J, Hall O, Harkness-Brennan L, Isobe T, Kahl D, Kiss GG, Kogimtzis M, Kubono S, Labiche M, Lazarus I, Lee J, Liu J, Lorusso G, Matsui K, Miernik K, Montes F, Moon B, Morales A, Nepal N, Nishimura S, Page RD, Phong VH, Podolyak Z, Pucknell VFE, Rasco BC, Regan P, Riego A, Rubio B, Rykaczewski K, Saito Y, Sakurai H, Shimizu Y, Simpson J, Söderström PA, Stracener DW, Sumikama T, Suzuki H, Tain JL, Takechi M, Takeda H, Tarifeño-Saldivia A, Thomas SL, Woods P. Commissioning of the BRIKEN beta-delayed neutron detector for the study of exotic neutron-rich nuclei. EPJ Web Conf 2017. [DOI: 10.1051/epjconf/201716501051] [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: 11/14/2022] Open
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