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Burry E, Collins J, Devey-Burry R. E-learning course for burn care: A proposal. Nursing 2024; 54:18-20. [PMID: 38386445 DOI: 10.1097/01.nurse.0001008484.30360.8d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Affiliation(s)
- Elizabeth Burry
- Elizabeth Burry is an RN on the Medical Surgical Intensive Care Unit at Health Sciences Centre in St. John's, Newfoundland and Labrador, Canada, and both Jennifer Collins and Robin Devey-Burry are assistant professors at Memorial University in Newfoundland and Labrador, Canada
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Porter WT, Gade L, Montfort P, Mihaljevic JR, Bowers JR, Willman A, Klimowski BA, LaFleur BJ, Sunenshine RH, Collins J, Adame G, Brady S, Komatsu KK, Williams S, Toda M, Chiller T, Litvintseva AP, Engelthaler DM. Understanding the exposure risk of aerosolized Coccidioides in a Valley fever endemic metropolis. Sci Rep 2024; 14:1311. [PMID: 38225347 PMCID: PMC10789871 DOI: 10.1038/s41598-024-51407-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] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/04/2024] [Indexed: 01/17/2024] Open
Abstract
Coccidioides is the fungal causative agent of Valley fever, a primarily pulmonary disease caused by inhalation of fungal arthroconidia, or spores. Although Coccidioides has been an established pathogen for 120 years and is responsible for hundreds of thousands of infections per year, little is known about when and where infectious Coccidioides arthroconidia are present within the ambient air in endemic regions. Long-term air sampling programs provide a means to investigate these characteristics across space and time. Here we present data from > 18 months of collections from 11 air sampling sites across the Phoenix, Arizona, metropolitan area. Overall, prevalence was highly variable across space and time with no obvious spatial or temporal correlations. Several high prevalence periods were identified at select sites, with no obvious spatial or temporal associations. Comparing these data with weather and environmental factor data, wind gusts and temperature were positively associated with Coccidioides detection, while soil moisture was negatively associated with Coccidioides detection. These results provide critical insights into the frequency and distribution of airborne arthroconidia and the associated risk of inhalation and potential disease that is present across space and time in a highly endemic locale.
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Affiliation(s)
- W Tanner Porter
- Pathogen & Microbiome Division, Translational Genomics Research Institute, Flagstaff, AZ, USA.
| | - Lalitha Gade
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Parker Montfort
- Pathogen & Microbiome Division, Translational Genomics Research Institute, Flagstaff, AZ, USA
| | - Joseph R Mihaljevic
- School of Informatics, Computing, and Cyber Systems, Northern Arizona University, Flagstaff, AZ, USA
| | - Jolene R Bowers
- Pathogen & Microbiome Division, Translational Genomics Research Institute, Flagstaff, AZ, USA
| | | | | | - Bonnie J LaFleur
- College of Pharmacy, The University of Arizona, Phoenix, AZ, USA
| | | | | | | | - Shane Brady
- Arizona Department of Health Services, Phoenix, AZ, USA
| | | | - Samantha Williams
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mitsuru Toda
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tom Chiller
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - David M Engelthaler
- Pathogen & Microbiome Division, Translational Genomics Research Institute, Flagstaff, AZ, USA
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Kelly LA, Miller BA, Graber A, Tran A, Collins J. The Gratitude Campaign: A Multihospital Evidence-Based Practice Project. J Nurs Adm 2023; 53:567-573. [PMID: 37824454 DOI: 10.1097/nna.0000000000001347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Nurse well-being and optimism were tested in the midst of COVID-19 patient surges and staffing challenges. Using the American Nurses Foundation Gratitude Toolkit, a health system implemented monthly gratitude practices at 4 hospitals. Validated survey measures indicated that nurses' scores of self-perceived gratitude, flourishing behaviors, and mindfulness were maintained during this challenging time but did not statistically increase. Although statistical significance increases were not demonstrated, the gratitude campaign offered clinical significance through positive feedback and was sustained through the distribution of a toolkit disseminated across the health system.
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Affiliation(s)
- Lesly A Kelly
- Author Affiliations: Nurse Scientist (Dr Kelly), CommonSpirit Health, Phoenix, Arizona; System Director High Reliability and Patient Safety (Miller), CommonSpirit Health, Bakersfield, California; Nursing Practice Coordinator (Graber), CHI Health Mercy Council Bluffs, Council Bluffs, Iowa; Professional Practice and Magnet Coordinator (Tran), CHI Health St Elizabeth, Lincoln, Nebraska; Chief Nursing Office (Collins), Bay Area Hospital, Coos Bay, Oregon
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Collins J, Babenko-Mould Y, Jackson KT, Smith-Carrier T. Understanding the Health and Well-being of Women With Multiple Sclerosis. J Neurosci Nurs 2023:01376517-990000000-00050. [PMID: 37381153 DOI: 10.1097/jnn.0000000000000714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
ABSTRACT BACKGROUND: Multiple sclerosis (MS) is an immune-mediated disease that affects the central nervous system, and is potentially disabling. Women experience MS more frequently than men at a 3:1 ratio. Current literature suggests that women may experience health, social determinants of health, and disability differentially, and there is a gap in the research examining how gender intersects with MS. METHODS: Interviews were conducted with 23 women with MS. van Manen's hermeneutic phenomenology was used to inform and analyze the data to understand the nature and meaning of health and well-being for participants. RESULTS: A key theme of "enhancing wholeness for women with MS" emerged from the data, which suggests that women with MS view themselves as healthy and "whole" despite living with MS. Supporting factors for physical, mental, and social well-being include the ability to enact human agency within social structures such as with employment or seeking care with MS clinics. The findings informed the development of a figure that depicts the supporting factors of health and well-being for women living with MS. CONCLUSION: The health and well-being of women with MS may be optimally supported by nurses and interdisciplinary healthcare teams through careful consideration as to how agency is enacted within social structures, for example, MS clinics, employment, and social support systems, as well as considerations for social determinants of health.
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Kretschmer M, Collins J, Dale AP, Garrett B, Koski L, Zabel K, Staab RN, Turnbow K, Nativio J, Andrews K, Smith WE, Townsend J, Busser N, Will J, Burr K, Jones FK, Santiago GA, Fitzpatrick KA, Ruberto I, Fitzpatrick K, White JR, Adams L, Sunenshine RH. Notes From the Field: First Evidence of Locally Acquired Dengue Virus Infection - Maricopa County, Arizona, November 2022. MMWR Morb Mortal Wkly Rep 2023; 72:290-291. [PMID: 36928186 PMCID: PMC10027408 DOI: 10.15585/mmwr.mm7211a5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
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Collins J, Benomar A, Iancu D, Farzin B, Darsaut TE, Raymond J. Research participants may not recall their participation but have a better understanding of alternative management options than patients in routine care. Neurochirurgie 2023; 69:101392. [PMID: 36669431 DOI: 10.1016/j.neuchi.2022.101392] [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: 09/14/2022] [Accepted: 09/23/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND Patient understanding of care interventions, of the clinical uncertainty, and of their participation in clinical research is often poor. We hypothesized that compared to routine care, patients would better understand the prevailing uncertainty when they participated in research. METHODS A questionnaire was administered to patients at the time they attended a follow-up neurovascular clinic 4 to 52 weeks after a care episode where they did or did not participate in a clinical trial. Patients were not reminded whether they had previously participated in a clinical trial. Questions concerned their understanding of the risks/benefits of interventions, the availability of alternative options, whether their personal opinion was taken into consideration, the reason for the final decision, their confidence at having received the best management, and whether they had been research participants. RESULTS Between June 2019 and June 2020, 167 patients were recruited; 71 had truly been research participants, while 96 had not. A greater proportion of research patients were aware of the existence of management alternatives (65% versus 44%; P=0.008). Patients of both groups believed their personal opinion counted in the final decision (76% versus 70%), and patients were equally confident that they had received the best management (94%). Research patients believed they had participated in research 46% of the time, compared to 12% of routine care patients (P=0.003). CONCLUSION Many patients do not recall that they participated in a clinical trial, but they have a better understanding of the clinical uncertainty and of the availability of alternative management options.
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Affiliation(s)
- J Collins
- Interventional Neuroradiology Research laboratory, CHUM Research Centre, Montreal, Quebec, Canada
| | - A Benomar
- Interventional Neuroradiology Research laboratory, CHUM Research Centre, Montreal, Quebec, Canada; Department of Radiology, service of Neuroradiology, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada
| | - D Iancu
- Interventional Neuroradiology Research laboratory, CHUM Research Centre, Montreal, Quebec, Canada; Department of Radiology, service of Neuroradiology, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada
| | - B Farzin
- Interventional Neuroradiology Research laboratory, CHUM Research Centre, Montreal, Quebec, Canada
| | - T E Darsaut
- Division of Neurosurgery, Department of Surgery, University of Alberta Hospital, Mackenzie Health Sciences Centre, Edmonton, Alberta, Canada
| | - J Raymond
- Interventional Neuroradiology Research laboratory, CHUM Research Centre, Montreal, Quebec, Canada; Department of Radiology, service of Neuroradiology, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada.
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Amos D, Collins J, Walker DT. Monkeypox presenting as supraglottitis in an immunocompromised patient. BMJ Case Rep 2023; 16:16/2/e252213. [PMID: 36737067 PMCID: PMC9899981 DOI: 10.1136/bcr-2022-252213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
We describe a young man with AIDS who presented to the ear, nose and throat team with a severe sore throat mimicking supraglottitis. He had a 3-day history of sore throat, hoarse voice, fevers and myalgia. On examination, he had cervical lymphadenopathy and profuse pus overlying his right tonsil. On flexible nasoendoscopy, this pus was seen to track down to the supraglottis, with associated mucosal ulceration. The patient was treated for supraglottitis and he improved. 24 hours postadmission, a pustule suspicious for monkeypox developed on the patient's hand. The diagnosis was confirmed by PCR testing. The patient was isolated and treated supportively and recovered fully. This case highlights that monkeypox may present with a severe sore throat without cutaneous lesions. Monkeypox is a growing public health concern . Its early symptoms are non-specific and healthcare professionals should be alert to it.
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Affiliation(s)
- Dora Amos
- Otolaryngology, Royal Surrey County Hospital, Guildford, UK
| | | | - David T Walker
- Otolaryngology Department, Royal Surrey NHS Foundation Trust, Guildford, UK.,ENT Deparment, Basingstoke and North Hampshire Hospital, Basingstoke, UK
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Valenti T, Kabler K, Dreier D, Henry K, Jones A, McCoole M, Cafarella M, Collins J, Bradley M, Samel A, Basu M. Evaluating the Functional Equivalency of Test Organism Performance in Negative and Solvent Controls During Chronic Sediment Ecotoxicity Studies Based on US Environmental Protection Agency Guidance. Environ Toxicol Chem 2023. [PMID: 36718725 DOI: 10.1002/etc.5576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/07/2022] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
The US Environmental Protection Agency (USEPA) considers sediment toxicity tests as conditional registration requirements for pesticides with soil Kd ≥50 L/kg-solid, Koc ≥1000 L/kg-organic carbon, or log Kow ≥3. The hydrophobicity of these compounds often necessitates use of solvents to ensure accurate and homogeneous dosing of spiked-sediment studies. For sediment tests, a volatile solvent (e.g., acetone) is generally used as a transient carrier. Due to low water solubility, test material is dissolved in a volatile solvent to create stock solutions. A measured aliquot of stock solution is then mixed with sand substrate, after which the solvent is evaporated. This spiking process results in negligible solvent exposure to organisms. In 2016, USEPA released final ecotoxicity test guidelines for subchronic freshwater (850.1735) and marine (850.1740) sediment test. These methods provide an option for conducting experiments with only a solvent control and no negative control. To adopt this testing strategy, functional equivalency between the negative and solvent control must be demonstrated. These test guidelines describe specific factors that should be considered for evaluating functional equivalency, including (a) the concentration of solvent in the test sediment after evaporation, (b) the levels of solvent that are known to affect organism health, (c) the known impurities in the solvent and their potential impact on organism health, and (d) the historical organism performance of solvent versus negative controls. Our analysis considers these factors and overall supports the elimination of the negative control requirement because this change is unlikely to impact the robustness or interpretability of spiked-sediment toxicity tests. Environ Toxicol Chem 2023;00:1-7. © 2023 CropLife America. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.
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Affiliation(s)
| | | | | | | | | | | | - Mark Cafarella
- Three Points Ecotox Consulting, Marion, Massachusetts, USA
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Truong JM, Meyer LG, Karirirwe G, Cory C, Dennehy TJ, Williams R, Jackman J, Clement W, Collins J, Gettel A, Holguin G, Kulaga J, Ledesma D, Levy S, Maroofi H, Perez V, Prete K, Schlum K, Tompkins C, Vital R, Zamora S, Jehn M. Developing an Equitable COVID-19 Pandemic Response: Lessons Learned From a Multisectoral Public Health Partnership in Guadalupe, Arizona. Journal of Humanistic Psychology 2023. [DOI: 10.1177/00221678221144954] [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: 01/31/2023]
Abstract
The COVID-19 pandemic has disproportionately impacted communities that are medically underserved across the United States, including the 6,700 Hispanic and Pascua Yaqui residents of Guadalupe, Arizona. In May 2020, Guadalupe experienced new COVID-19 cases at a rate 13.9 times as high as its surrounding county, urging town leadership to establish the Guadalupe Community Response Team (GCRT), a multisectoral network of community, academic, and public health partners. The objectives of the GCRT were to: (a) increase access to health and support services; (b) develop novel and intensive outreach efforts; and (c) build partnerships to strengthen public health capacity. From June 2020 to December 2021, the GCRT provided door-to-door case investigation and resource provision, coordinated testing and vaccination events, created public health communications, and developed COVID-19 guidance for cultural gatherings. These interventions were implemented in an effort to reduce community transmission of SARS-CoV-2 and increase equitable access to testing, vaccination, and social support resources. Cultural leaders, such as promotores de salud and Yaqui Cultural Specialists, were integral in building trust among community members. The GCRT provides valuable lessons learned on the importance of implementing a culturally grounded approach to COVID-19 mitigation to increase equitable access to health services during a public health emergency.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Aaron Gettel
- Maricopa County Department of Public Health, Phoenix, AZ, USA
| | | | | | | | | | | | | | | | - Kip Schlum
- Maricopa County Department of Public Health, Phoenix, AZ, USA
| | | | - Ricky Vital
- Pascua Yaqui Tribe, Guadalupe, AZ, USA
- Town of Guadalupe, Guadalupe, AZ, USA
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Darsaut TE, Collins J, Raymond J. Patients may be right: Clinical research should be designed in their best medical interest. Neurochirurgie 2023; 69:101391. [PMID: 36608449 DOI: 10.1016/j.neuchi.2022.101391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/23/2022] [Indexed: 01/05/2023]
Affiliation(s)
- T E Darsaut
- University of Alberta Hospital, Mackenzie Health Sciences Centre, Department of Surgery, Division of Neurosurgery, 112 Street, 8440 Edmonton, Alberta, Canada
| | - J Collins
- Centre hospitalier de l'université de Montréal - CHUM, Department of Radiology, Service of Interventional Neuroradiology, 1000, St-Denis street room, D03-5462B Montreal, Canada
| | - J Raymond
- Centre hospitalier de l'université de Montréal - CHUM, Department of Radiology, Service of Interventional Neuroradiology, 1000, St-Denis street room, D03-5462B Montreal, Canada.
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Collins J, Bonner P, Cafferkey A. Preventing unrecognised oesophageal intubation: addressing hierarchies and the importance of critical language. Anaesthesia 2023; 78:130-131. [PMID: 36256690 DOI: 10.1111/anae.15891] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2022] [Indexed: 12/13/2022]
Affiliation(s)
- J Collins
- St. James's Hospital, Dublin, Ireland
| | - P Bonner
- Irish Air Corps, Dublin, Ireland
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Raymond J, Collins J, Darsaut TE. Understanding the research-care demarcation and why it must be revised. Neurochirurgie 2023; 69:101393. [PMID: 36566695 DOI: 10.1016/j.neuchi.2022.101393] [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: 09/14/2022] [Accepted: 09/23/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND A clean-cut separation between research and care was artificially created at the time of the Belmont report more than 40 years ago. The demarcation was initially controversial but eventually was implemented for political reasons. We examine why it must be revised. METHODS We review historical research scandals as well as the theoretical basis for the Belmont demarcation. We then discuss consequences on medical practice and propose an alternative. DISCUSSION Most research scandals involved abusing human beings supposedly for the sake of science. Belmont commissioners were aware the research/care problem was double-headed. While research subjects should be protected from abuse in the research context, patients need to be protected from unvalidated medical and surgical interventions in the care context. For political reasons the Commission recommended the regulation of research but to leave medical practice untouched. Thus the Commission had to distinguish research from care. The notion of 'generalizable knowledge' was introduced to define and regulate research, but the inadvertent result was that by trying to protect research subjects, the regulation has not only failed to protect all other patients, but also encouraged the widespread practice of unvalidated interventions within the care context. The notion of validated care should be re-introduced into a proper analysis of the care-research demarcation, for care research is an integral ingredient of a good medical practice. CONCLUSION The research-care demarcation should be revised to leave room for the validated/unvalidated care distinction. Care research, essential to guide medical practice, should be facilitated at all levels.
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Affiliation(s)
- J Raymond
- Centre Hospitalier de l'Université de Montréal-CHUM, Department of Radiology, Service of Interventional Neuroradiology, 1000 St-Denis, Montreal H2X 0C1, Canada.
| | - J Collins
- Centre Hospitalier de l'Université de Montréal-CHUM, Department of Radiology, Service of Interventional Neuroradiology, 1000 St-Denis, Montreal H2X 0C1, Canada.
| | - T E Darsaut
- University of Alberta Hospital, Mackenzie Health Sciences Centre, Department of Surgery, Division of Neurosurgery, 8440 - 112 Street, Edmonton T6G 2B7, Alberta, Canada.
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Collins J, O'Sullivan E. Rapid sequence induction and intubation. BJA Educ 2022; 22:484-490. [PMID: 36406036 PMCID: PMC9669739 DOI: 10.1016/j.bjae.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 08/16/2022] [Accepted: 09/01/2022] [Indexed: 11/07/2022] Open
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Mann B, Rose A, Hughes J, Skandarajah A, Murugasu A, Spillane A, Chua B, Zdenkowski N, Badger H, Braggett H, Gebski V, Eggins R, Park A, Collins J. Primary results of ANZ 1002 : Post-operative Radiotherapy Omission in Selected Patients with Early breast Cancer Trial (PROSPECT) following pre-operative breast MRI. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01476-9] [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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Dale AP, Almendares O, Howard B, Burnett E, Prasai S, Arons M, Collins J, Duffy N, Pandit U, Brady S, White J, Garrett B, Kirking HL, Sunenshine R, Tate JE, Scott SE. Investigation of a Severe Acute Respiratory Syndrome Coronavirus 2 Delta (B.1.617.2) Variant Outbreak Among Residents of a Skilled Nursing Facility and Vaccine Effectiveness Analysis: Maricopa County, Arizona, June-July 2021. Clin Infect Dis 2022; 75:e20-e26. [PMID: 35413107 PMCID: PMC9047249 DOI: 10.1093/cid/ciac240] [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] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Short-term rehabilitation units present unique infection control challenges because of high turnover and medically complex residents. In June 2021, the Maricopa County Department of Public Health was notified of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta outbreak in a skilled nursing facility short-term rehabilitation unit. We describe the outbreak and assess vaccine effectiveness (VE). METHODS Facility electronic medical records were reviewed for residents who spent > 1 night on the affected unit between June 10 and July 23, 2021, to collect demographics, SARS-CoV-2 test results, underlying medical conditions, vaccination status, and clinical outcomes. Coronavirus disease 2019 VE estimates using Cox proportional hazards models were calculated. RESULTS Forty (37%) of 109 short-stay rehabilitation unit residents who met inclusion criteria tested positive for SARS-CoV-2. SARS-CoV-2-positive case-patients were mostly male (58%) and White (78%) with a median age of 65 (range, 27-92) years; 11 (27%) were immunocompromised. Of residents, 39% (10 cases, 32 noncases) received 2 doses and 9% (4 cases, 6 noncases) received 1 dose of messenger RNA (mRNA) vaccine. Among nonimmunocompromised residents, adjusted 2-dose primary-series mRNA VE against symptomatic infection was 80% (95% confidence interval, 15-95). More cases were hospitalized (33%) or died (38%) than noncases (10% hospitalized; 16% died). CONCLUSIONS In this large SARS-CoV-2 Delta outbreak in a high-turnover short-term rehabilitation unit, a low vaccination rate and medically complex resident population were noted alongside severe outcomes. VE of 2-dose primary-series mRNA vaccine against symptomatic infection was the highest in nonimmunocompromised residents. Health departments can use vaccine coverage data to prioritize facilities for assistance in preventing outbreaks.
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Affiliation(s)
- Ariella P Dale
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
- Maricopa County Department of Public Health, Phoenix, AZ, United States
- Arizona Department of Health Services, Phoenix, AZ, United States
| | | | - Brandon Howard
- Maricopa County Department of Public Health, Phoenix, AZ, United States
| | | | - Siru Prasai
- Maricopa County Department of Public Health, Phoenix, AZ, United States
| | - Melissa Arons
- CDC COVID-19 Response, Atlanta, Georgia, United States
| | - Jennifer Collins
- Maricopa County Department of Public Health, Phoenix, AZ, United States
| | | | - Urvashi Pandit
- Maricopa County Department of Public Health, Phoenix, AZ, United States
| | - Shane Brady
- Arizona Department of Health Services, Phoenix, AZ, United States
| | - Jessica White
- Maricopa County Department of Public Health, Phoenix, AZ, United States
| | - Brenna Garrett
- Arizona Department of Health Services, Phoenix, AZ, United States
| | | | - Rebecca Sunenshine
- Maricopa County Department of Public Health, Phoenix, AZ, United States
- CDC COVID-19 Response, Atlanta, Georgia, United States
| | | | - Sarah E Scott
- Maricopa County Department of Public Health, Phoenix, AZ, United States
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Collins J, Takhar A, Niziol R, Fry A, Oakley R, Hopkins C, Surda P. Single-stage endoscopic-assisted eye sparing resection with primary orbital reconstruction for sinonasal malignancy. Rhinology 2022; 60:397-400. [PMID: 35818924 DOI: 10.4193/rhin22.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- J Collins
- Department of Otolaryngology and Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - A Takhar
- Department of Otolaryngology and Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - R Niziol
- Department of Otolaryngology and Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - A Fry
- Department of Otolaryngology and Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - R Oakley
- Department of Otolaryngology and Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - C Hopkins
- Department of Otolaryngology and Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - P Surda
- Department of Otolaryngology and Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
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Scott SE, Mrukowicz C, Collins J, Jehn M, Charifson M, Hobbs KC, Zabel K, Chronister S, Howard BJ, White JR. Using Automation, Prioritization, and Collaboration to Manage a COVID-19 Case Surge in Maricopa County, Arizona, 2020. Public Health Rep 2022; 137:29S-34S. [PMID: 35786066 PMCID: PMC9357819 DOI: 10.1177/00333549221100798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
During summer 2020, the Maricopa County Department of Public Health (MCDPH) responded to a surge in COVID-19 cases. We used internet-based platforms to automate case notifications, prioritized investigation of cases more likely to have onward transmission or severe COVID-19 based on available preinvestigation information, and partnered with Arizona State University (ASU) to scale investigation capacity. We assessed the speed of automated case notifications and accuracy of our investigation prioritization criteria. Timeliness of case notification-the median time between receipt of a case report at MCDPH and first case contact-improved from 11 days to <1 day after implementation of automated case notification. We calculated the sensitivity and positive predictive value (PPV) of the investigation prioritization system by applying our high-risk prioritization criteria separately to data available pre- and postinvestigation to determine whether a case met these criteria preinvestigation, postinvestigation, or both. We calculated the sensitivity as the percentage of cases classified postinvestigation as high risk that had also been classified as high risk preinvestigation. We calculated PPV as the percentage of all cases deemed high risk preinvestigation that remained so postinvestigation. During June 30 to July 31, 2020, a total of 55 056 COVID-19 cases with an associated telephone number (94% of 58 570 total cases) were reported. Preinvestigation, 8799 (16%) cases met high-risk criteria. Postinvestigation, 17 037 (31%) cases met high-risk criteria. Sensitivity was 52% and PPV was 98%. Automating case notifications, prioritizing investigations, and collaborating with ASU improved the timeliness of case contact, focused public health resources toward high-priority cases, and increased investigation capacity. Establishing partnerships between health departments and academia might be a helpful strategy for future surge capacity planning.
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Affiliation(s)
- Sarah E. Scott
- Office of Epidemiology and Data Services, Maricopa County Department of Public Health, Phoenix, AZ, USA
| | - Christina Mrukowicz
- Office of Epidemiology and Data Services, Maricopa County Department of Public Health, Phoenix, AZ, USA
| | - Jennifer Collins
- Office of Epidemiology and Data Services, Maricopa County Department of Public Health, Phoenix, AZ, USA
| | - Megan Jehn
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
| | - Mia Charifson
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
| | - Katherine C. Hobbs
- Office of Epidemiology and Data Services, Maricopa County Department of Public Health, Phoenix, AZ, USA
| | - Karen Zabel
- Office of Epidemiology and Data Services, Maricopa County Department of Public Health, Phoenix, AZ, USA
| | - Sara Chronister
- Office of Epidemiology and Data Services, Maricopa County Department of Public Health, Phoenix, AZ, USA
| | - Brandon J. Howard
- Office of Epidemiology and Data Services, Maricopa County Department of Public Health, Phoenix, AZ, USA
| | - Jessica R. White
- Office of Epidemiology and Data Services, Maricopa County Department of Public Health, Phoenix, AZ, USA
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Fowle N, Garrett B, Floyd OL, Collins J, Krasnow AD, Islas M, Holland SC, Smith MF, Lim ES, Jarrett NM, Scott SE. University-Associated SARS-CoV-2 Omicron BA.2 Infections, Maricopa County, Arizona, USA, 2022. Emerg Infect Dis 2022; 28:1520-1522. [PMID: 35654405 PMCID: PMC9239890 DOI: 10.3201/eid2807.220470] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
We investigated a university-affiliated cohort of SARS-CoV-2 Omicron BA.2 infections in Arizona, USA. Of 44 cases, 43 were among students; 26 persons were symptomatic, 8 sought medical care, but none were hospitalized. Most (55%) persons had completed a primary vaccine series; 8 received booster vaccines. BA.2 infection was mild in this young cohort.
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19
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Collins J, Langdon PE, Barnoux M. The Adapted Firesetting Assessment Scale: reliability and validity. J Intellect Disabil Res 2022; 66:642-654. [PMID: 35621252 PMCID: PMC9323425 DOI: 10.1111/jir.12950] [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: 01/07/2022] [Revised: 04/04/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The Adapted Firesetting Assessment Scale was developed for use with adults with developmental disabilities targeting fire-related factors thought to be associated with deliberate firesetting behaviour (i.e. attitudes towards fire, fire interest, fire normalisation, identification with fire and fire safety awareness). However, the psychometric properties of the scale are yet to be evaluated. METHOD The reliability, validity, comprehensibility, relevance and comprehensiveness of the Adapted Firesetting Assessment Scale were evaluated. Fifty-nine adults with developmental disabilities, some of whom had a history of firesetting, completed the Adapted Firesetting Assessment Scale on two occasions. Feedback about the questionnaire was sought from both participants and professionals. RESULTS The AFAS has acceptable internal consistency and excellent test-retest reliability. The attitudes towards fire, fire normalisation, poor fire safety subscales and total scores discriminated firesetters from non-firesetters. Content analysis of feedback indicated items of the AFAS were understood, relevant, accessible and comprehensible. CONCLUSION A larger study is needed to examine the factor structure of the AFAS.
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Affiliation(s)
- J. Collins
- Tizard CentreUniversity of KentCanterburyUK
| | - P. E. Langdon
- Centre for Educational Development, Appraisal and Research (CEDAR)The University of WarwickCoventryUK
- Coventry and Warwickshire Partnership NHS TrustCoventryUK
| | - M. Barnoux
- Tizard CentreUniversity of KentCanterburyUK
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20
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Collins J, Horton K, Gale-St Ives E, Murphy G, Barnoux M. A Systematic Review of Autistic People and the Criminal Justice System: An Update of King and Murphy (2014). J Autism Dev Disord 2022:10.1007/s10803-022-05590-3. [PMID: 35637365 DOI: 10.1007/s10803-022-05590-3] [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] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
The purpose of this paper was to determine whether recommendations made by King & Murphy (Journal of Autism and Developmental Disorders 44:2717-2733, 2014) in their review of the evidence on autistic people in contact with the criminal justice system (CJS) have been addressed. Research published since 2013 was systematically examined and synthesised. The quality of 47 papers was assessed using the Mixed Methods Appraisal Tool. Findings suggest a limited amount of good quality research has been conducted that has focused on improving our understanding of autistic people in contact with the CJS since 2013. Methodological limitations make direct comparisons between autistic and non-autistic offenders difficult. Autistic people commit a range of crimes and appear to have unique characteristics that warrant further exploration (i.e., vulnerabilities, motivations for offending).
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Affiliation(s)
- J Collins
- Tizard Centre, University of Kent, Canterbury, CT2 7NF, UK.
| | - K Horton
- Tizard Centre, University of Kent, Canterbury, CT2 7NF, UK
| | - E Gale-St Ives
- Tizard Centre, University of Kent, Canterbury, CT2 7NF, UK
| | - G Murphy
- Tizard Centre, University of Kent, Canterbury, CT2 7NF, UK
| | - M Barnoux
- Tizard Centre, University of Kent, Canterbury, CT2 7NF, UK
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21
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Collins J, Varghese D, Miranda M, Nordstrom B, Murphy B, Harland D. 186P A real-world study on prevalence of and outcomes related to brain metastases among patients with HER2-positive metastatic breast cancer (mBC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.205] [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: 11/01/2022] Open
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22
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Iancu D, Collins J, Farzin B, Darsaut TE, Eneling J, Boisseau W, Olijnyk L, Boulouis G, Chaalala C, Bojanowski MW, Weill A, Roy D, Raymond J. Recruitment in a pragmatic randomized trial on the management of unruptured intracranial aneurysms. World Neurosurg 2022; 163:e413-e419. [PMID: 35395427 DOI: 10.1016/j.wneu.2022.03.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The Comprehensive Aneurysm Management (CAM) study is a pragmatic trial designed to manage UIA patients within a care research framework. METHOD CAM is an all-inclusive study. Management options are allocated according to an algorithm combining pre-randomization and clinical judgment. Eligible patients are offered 1:1 randomized allocation of intervention versus conservative management and 1:1 randomization allocation of surgical versus endovascular treatment. Ineligible patients are registered. The primary outcome is survival without dependency (mRS<3) at 10 years. All UIA patients at one center are reported. RESULTS Between February 2020 and July 2021, 403 UIA patients were recruited: 179 (44%) in one of the RCTs and 224 (56%) in one of the registries. Conservative management was recommended for 205/403 patients (51%); of 198 (49%) patients considered for curative treatment, 159 (80%) were randomly allocated conservative (n=81) or curative treatment (n=78). These patients were younger and had larger aneurysms than those in the observation registry (P = .004). In 39/198 patients (20%), conservative management was not considered reasonable (17 patients were recommended endovascular, 2 surgery, and 20 the RCT comparing endovascular with surgical treatment). In total, 70 patients were recruited in the RCT comparing surgery and endovascular treatment. After informed discussion at time of consent, 141/159 patients (89%) agreed with the randomly allocated management plan, while 11% crossed-over to the alternative management option. CONCLUSION CAM was successfully integrated into routine practice. Meaningful conclusions can be obtained if multiple centers actively participate in the trial.
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Affiliation(s)
- Daniela Iancu
- Department of Radiology, Service of Interventional Neuroradiology, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada and CHUM Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Jennifer Collins
- Department of Radiology, Service of Interventional Neuroradiology, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada and CHUM Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Behzad Farzin
- Department of Radiology, Service of Interventional Neuroradiology, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada and CHUM Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Tim E Darsaut
- University of Alberta Hospital, Mackenzie Health Sciences Centre, Department of Surgery, Division of Neurosurgery, Edmonton, Alberta, Canada
| | - Johanna Eneling
- Department of Radiology, Service of Interventional Neuroradiology, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada and CHUM Research Center (CRCHUM), Montreal, Quebec, Canada
| | - William Boisseau
- Department of Radiology, Service of Interventional Neuroradiology, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada and CHUM Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Leonardo Olijnyk
- Department of Radiology, Service of Interventional Neuroradiology, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada and CHUM Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Grégoire Boulouis
- Neuroradiology Department, Université Paris Descartes, INSERM S894, Centre Hospitalier Sainte-Anne, France
| | - Chiraz Chaalala
- Department of Surgery, Service of Neurosurgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada
| | - Michel W Bojanowski
- Department of Surgery, Service of Neurosurgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada
| | - Alain Weill
- Department of Radiology, Service of Interventional Neuroradiology, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada and CHUM Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Daniel Roy
- Department of Radiology, Service of Interventional Neuroradiology, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada and CHUM Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Jean Raymond
- Department of Radiology, Service of Interventional Neuroradiology, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada and CHUM Research Center (CRCHUM), Montreal, Quebec, Canada.
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23
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Collins J, Shabbir Z, Mortel M, Kosuri S. Association of Tacrolimus Levels and Time from Transplant with Graft-Versus-Host Disease in Allogeneic Hematopoietic Stem Cell Transplant Patients. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00542-5] [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: 10/18/2022]
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Jacklin C, Rodrigues J, Collins J, Cook J, Harrison C. 183 A Systematic Review of Sample Size Calculations in High-Profile Surgical Trials That Use Patient-Reported Outcome Measures. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.110] [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: 11/13/2022]
Abstract
Abstract
Background
Patient reported outcome measures (PROMs) are increasingly recognised as a measure of treatment efficacy in randomised controlled trials (RCTs). It can be difficult to determine meaningful target differences in PROM scores for sample size calculations and this can risk over-recruitment and/or erroneous trial conclusions. The Difference ELicitation in TriAls (DELTA2) statement sets recommendations for sample size calculations in RCTs including target difference determination. We aimed to evaluate sample size calculations from high-profile surgical RCTs that used PROMs as their primary outcome, against DELTA2 standards, with a focus on target differences.
Method
Pubmed was systematically searched for surgical RCTs published in the five highest ranking journals, by Thomson Reuters impact factor, for medicine and surgery. Studies were included if surgery was the intervention and/or comparator arm, and a PROM was the primary outcome. Surgery was defined as using instrumentation to change macro-anatomy with the aim of improving health. Data were extracted with a piloted data collection sheet that included the DELTA2 reporting recommendations.
Results
Most target differences used in sample size calculations were determined with suboptimal techniques and target difference justification was overall poor. In this sample, £28 million of UK public research spending supported trials with poor target difference justification.
Conclusions
In this sample of trials, sample size calculations were generally not reported to DELTA2 standards. There was frequent use of sub-optimal methods to determine the target difference. This risks over-recruitment and/or erroneous trial conclusions. Clinicians should be aware of these potential pitfalls when interpreting published trials.
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Affiliation(s)
- C. Jacklin
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford, United Kingdom
| | - J. Rodrigues
- Warwick Clinical Trials Unit, Warwick, United Kingdom
| | - J. Collins
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford, United Kingdom
| | - J. Cook
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford, United Kingdom
| | - C. Harrison
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford, United Kingdom
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25
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Asif A, Nathan A, Patel S, Georgi M, Hang M, Mullins W, Fricker M, Ng A, Ghosh A, Francis N, Collins J, Sridhar A. Virtual classroom proficiency-based progression for robotic surgery training (VROBOT): A prospective, cross-over, effectiveness study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00116-6] [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: 11/04/2022]
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26
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Collins J, Troville J, Williams K, Rudin S, Bednarek DR. Real-time Detection of Patient Head Position and Cephalometric Landmarks from Neuro-Interventional Procedure Images Using Machine Learning for Patient Eye-Lens Dose Prediction. Proc SPIE Int Soc Opt Eng 2022; 12031:120314A. [PMID: 35982766 PMCID: PMC9385175 DOI: 10.1117/12.2611184] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A deep learning (DL) model has been developed to estimate patient-lens dose in real-time for given exposure and geometric conditions during fluoroscopically-guided neuro-interventional procedures. Parameters input into the DL model for dose prediction include the patient head shift from isocenter and cephalometric landmark locations as a surrogate for head size. Machine learning (ML) models were investigated to automatically detect these parameters from the in-procedure fluoroscopic image. Fluoroscopic images of a Kyoto Kagaku anthropomorphic head phantom were taken at various known X (transverse) and Y (longitudinal) shifts, as well as different magnification modes, to create an image database. For each image, anatomical landmark coordinate locations were obtained manually using ImageJ and are used as ground-truth labels for training. This database was then used to train the two separate ML models. One ML model predicts the patient head shift in both the X and Y directions and the other model predicts the coordinates of the anatomical landmarks. From the coordinates, the distance between these anatomical landmarks is calculated, and input into the DL dose-prediction model. Model performance was evaluated using mean absolute error (MAE) and mean absolute percentage error (MAPE) for the head-shift and landmark-coordinate models, respectively. The goal is to implement these two separate models into the Dose Tracking System (DTS) developed by our group. This would allow the DTS to automatically detect the patient head size and position for eye-lens dose prediction and eliminate the need for manual input by the clinical staff.
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Affiliation(s)
- J Collins
- The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Canon Stroke and Vascular Research Center, 875 Ellicott St., Buffalo, NY 14203
| | - J Troville
- The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Canon Stroke and Vascular Research Center, 875 Ellicott St., Buffalo, NY 14203
| | - K Williams
- The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Canon Stroke and Vascular Research Center, 875 Ellicott St., Buffalo, NY 14203
| | - S Rudin
- The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Canon Stroke and Vascular Research Center, 875 Ellicott St., Buffalo, NY 14203
| | - D R Bednarek
- The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Canon Stroke and Vascular Research Center, 875 Ellicott St., Buffalo, NY 14203
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Ledesma D, Maroofi H, Sabin S, Dennehy TJ, Truong JM, Meyer LG, Salik M, Scott S, White JR, Collins J, Mrukowicz C, Charifson M, Shafer MS, Jehn M. Design and Implementation of a COVID-19 Case Investigation Program: An Academic-Public Health Partnership, Arizona, 2020. Public Health Rep 2022; 137:213-219. [PMID: 35060793 DOI: 10.1177/00333549211068495] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
From May through July 2020, Arizona was a global hotspot for new COVID-19 cases. In response to the surge of cases, local public health departments looked for innovative ways to form external partnerships to address their staffing needs. In collaboration with the Maricopa County Department of Public Health, the Arizona State University Student Outbreak Response Team (SORT) created and implemented a virtual call center to conduct public health case investigations for COVID-19. SORT officially launched a dedicated COVID-19 case investigation program after 3 weeks of program design and training. From June 29 through November 8, 2020, SORT recruited and trained 218 case investigators, completed 5000 case patient interviews, and closed 10 000 cases. Our team also developed process improvements to address disparities in case investigation timeliness. A strong infrastructure designed to accommodate remote case investigations, paired with a large workforce, enabled SORT to provide additional surge capacity for the county's high volume of cases. University-driven multidisciplinary case investigator teams working in partnership with state, tribal, and local public health staff members can be an effective tool for supporting a diverse and growing public health workforce. We discuss the essential design factors involved in building a university program to complement local COVID-19 response efforts, including workflows for case management, volunteer case investigator recruitment and training, secure technology platforms for conducting case investigations remotely, and robust data-tracking procedures for maintaining quality control and timely case reporting.
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Affiliation(s)
- Daniela Ledesma
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA.,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Hanna Maroofi
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA.,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Susanna Sabin
- Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA
| | - Timothy J Dennehy
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
| | - Jasmine M Truong
- Health and Clinical Partnerships, Arizona State University, Tempe, AZ, USA
| | - Laura G Meyer
- School of Social Work, Arizona State University, Tempe, AZ, USA
| | - McMillan Salik
- School of Social Work, Arizona State University, Tempe, AZ, USA
| | - Sarah Scott
- Maricopa County Department of Public Health, Phoenix, AZ, USA
| | - Jessica R White
- Maricopa County Department of Public Health, Phoenix, AZ, USA
| | | | | | - Mia Charifson
- Vilcek Institute of Biomedical Graduate Studies, New York University School of Medicine, New York, NY, USA
| | | | - Megan Jehn
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
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Mercer JS, Erickson-Owens DA, Deoni SC, Dean DC, Tucker R, Parker AB, Joelson S, Mercer EN, Collins J, Padbury JF. The Effects of Delayed Cord Clamping on 12-Month Brain Myelin Content and Neurodevelopment: A Randomized Controlled Trial. Am J Perinatol 2022; 39:37-44. [PMID: 32702760 PMCID: PMC9800052 DOI: 10.1055/s-0040-1714258] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This study aimed to determine if delayed cord clamping (DCC) affected brain myelin water volume fraction (VFm) and neurodevelopment in term infants. STUDY DESIGN This was a single-blinded randomized controlled trial of healthy pregnant women with term singleton fetuses randomized at birth to either immediate cord clamping (ICC) (≤ 20 seconds) or DCC (≥ 5 minutes). Follow-up at 12 months of age consisted of blood work for serum iron indices and lead levels, a nonsedated magnetic resonance imaging (MRI), followed within the week by neurodevelopmental testing. RESULTS At birth, 73 women were randomized into one of two groups: ICC (the usual practice) or DCC (the intervention). At 12 months, among 58 active participants, 41 (80%) had usable MRIs. There were no differences between the two groups on maternal or infant demographic variables. At 12 months, infants who had DCC had increased white matter brain growth in regions localized within the right and left internal capsules, the right parietal, occipital, and prefrontal cortex. Gender exerted no difference on any variables. Developmental testing (Mullen Scales of Early Learning, nonverbal, and verbal composite scores) was not significantly different between the two groups. CONCLUSION At 12 months of age, infants who received DCC had greater myelin content in important brain regions involved in motor function, visual/spatial, and sensory processing. A placental transfusion at birth appeared to increase myelin content in the early developing brain. KEY POINTS · DCC resulted in higher hematocrits in newborn period.. · DCC appears to increase myelin at 12 months.. · Gender did not influence study outcomes..
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Affiliation(s)
- Judith S. Mercer
- College of Nursing, University of Rhode Island, Kingston, Rhode Island,Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, Rhode Island,Pediatrics, Alpert School of Medicine, Brown University, Providence, Rhode Island
| | - Debra A. Erickson-Owens
- College of Nursing, University of Rhode Island, Kingston, Rhode Island,Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, Rhode Island
| | - Sean C.L. Deoni
- Advanced Baby Imaging Lab, Memorial Hospital of Rhode Island, Pawtucket, Rhode Island,Maternal, Neonatal, and Child Health, Discovery and Tools, Bill and Melinda Gates Foundation, Munirka, New Delhi, India
| | - Douglas C. Dean
- Department of Pediatrics, University of Wisconsin, Madison, Wisconsin,Department of Medical Physics, University of Wisconsin, Madison, Wisconsin,Waisman Laboratory for Brain Imaging and Behavior, Waisman Center, University of Wisconsin, Madison, Wisconsin
| | - Richard Tucker
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, Rhode Island
| | - Ashley B. Parker
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, Rhode Island
| | - Sarah Joelson
- Advanced Baby Imaging Lab, Memorial Hospital of Rhode Island, Pawtucket, Rhode Island
| | - Emily N. Mercer
- Advanced Baby Imaging Lab, Memorial Hospital of Rhode Island, Pawtucket, Rhode Island
| | - Jennifer Collins
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, Rhode Island
| | - James F. Padbury
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, Rhode Island,Pediatrics, Alpert School of Medicine, Brown University, Providence, Rhode Island
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Geile K, DiMola M, Langley P, Price B, Reid P, Spinale A, Collins J. Apheresis Nursing & Allied Health in North America. Transfus Apher Sci 2021; 60:103307. [PMID: 34838442 DOI: 10.1016/j.transci.2021.103307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kira Geile
- St. Louis Children's Hospital, St. Louis, MO, USA
| | - Maria DiMola
- SickKids- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Pam Langley
- Children's Healthcare of Atlanta, Atlanta, GA, USA
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Ng A, Nathan A, Patel S, Georgi M, Hang K, Mullins W, Asif A, Fricker M, Francis N, Collins J, Sridhar A. Can virtual classroom training improve the acquisition of robotic training skills? A prospective, cross-over, effectiveness study (V-ROBOT). EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)02268-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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31
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Nathan A, Hanna N, Rashid A, Patel S, Phuah Y, Flora K, Fricker M, Cleaveland P, Kasivisvanathan V, Williams N, Miah S, Shah N, Hines J, Collins J, Sridhar A, Kelkar A, Briggs T, Kelly J, Shaw G, Sooriakumaran P, Rajan P, Lamb B, Nathan S. 141 New Guidelines to Reduce Unnecessary Blood Tests, Delayed Discharge and Costs Following Robot Assisted Radical Prostatectomy. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1070] [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]
Abstract
Abstract
Objectives
Routine postoperative blood tests (POBT) following robot assisted radical prostatectomy (RARP) are used to evaluate the impact of surgery on pre-existing co-morbidities and to detect early complications. This practice dates back to an era of open surgery, when blood loss and complication rates were higher. We propose new guidelines to improve the specificity of POBT.
Method
The cases of 1040 consecutive patients who underwent a primary or salvage RARP at two large tertiary urology centres in the United Kingdom were retrospectively reviewed to form new guidelines. The new guidelines were prospectively validated in a sample of 300 patients.
Results
Derivation Dataset: 3% and 5% had intra- and post-operative Clavien-Dindo complications, respectively. 15% had clinical concerns postoperatively. 0.9% required perioperative transfusion. 78% had routine blood tests without clinical concerns, none of whom developed a complication. 98% of complications were suspected by clinical judgement. 6% of patients had a discharge delay of ≥ 1 day due to delayed or incomplete blood tests. Validation Dataset: No significant difference existed in complication, clinical concern or transfusion rates between the derivation and validation datasets. Number of POBT requested reduced by 73% (p < 0.001). The new guidelines improved POBT sensitivity for complications from 98% to 100% and specificity from 0% to 74%. Discharge delays reduced from 6% to 0% (p = 0.008). Cost savings were £178 per patient.
Conclusions
Postoperative complications and transfusion following RARP are rare. Routine POBT without clinical indication are unnecessary and inefficient. A guideline-based approach to POBT can reduce costs and optimise discharge without compromising patient safety or care.
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Affiliation(s)
- A Nathan
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
- University College London, London, United Kingdom
| | - N Hanna
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- University of Cambridge, Cambridge, United Kingdom
| | - A Rashid
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- University of Cambridge, Cambridge, United Kingdom
| | - S Patel
- University College London, London, United Kingdom
| | - Y Phuah
- University College London, London, United Kingdom
| | - K Flora
- University College London, London, United Kingdom
| | - M Fricker
- Newcastle University, Newcastle, United Kingdom
| | - P Cleaveland
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - V Kasivisvanathan
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - N Williams
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - S Miah
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - N Shah
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - J Hines
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - J Collins
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - A Sridhar
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - A Kelkar
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - T Briggs
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - J Kelly
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - G Shaw
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - P Sooriakumaran
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - P Rajan
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
- Barts Cancer Institute, CR-UK Barts Centre, Queen Mary University of London, London, United Kingdom
| | - B Lamb
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - S Nathan
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
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Nathan A, Patel S, Georgi M, Hang K, Mullins W, Asif A, Fricker M, Ng A, Sridhar A, Collins J. 1420 ViRtual prOficiency Based prOgression for Robotic Training (VROBOT): A Prospective Cohort Study Protocol. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.797] [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]
Abstract
Abstract
Introduction
Robotic surgery is an evolving field that requires specialist training. Historically, robotic surgery training has lacked standardisation. Recently, training centres have introduced proficiency-based modules and curriculums to certify and progress the skills of novice robotic surgeons. However, training tends to be self-directed and non-interactive. Limited interactive teaching does exist but can be inaccessible and expensive. We aim to validate the effectiveness of the current Fundamentals of Robotic Surgery (FRS) training curriculum with the addition of interactive virtual classroom teaching.
Method
16 novice surgical trainees will be assigned to two training groups. The interventions will be implemented following a one-week robotic skills induction. Both groups will receive access to the FRS curriculum for one week. The intervention group will additionally receive virtual classroom robotic skills training. The primary outcome will be the objective performance scores after training using a synthetic model based on task errors, time taken and contact pressure. In week 3, each group will receive the alternate intervention and objective performance scores will be measured to determine the trajectory of scores.
Results
Significant objective performance improvement following the intervention will be indicative of intervention quality.
Conclusions
This will be the first feasibility study evaluating the efficacy of interactive virtual robotic surgery training. It will determine the effect size of virtual classroom training on the development of basic robotic surgical skills in addition to the proficiency-based FRS curriculum. The findings will assist the development and implementation of further resource-efficient virtual robotic surgical skills training programs.
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Affiliation(s)
- A Nathan
- University College London, London, United Kingdom
| | - S Patel
- University College London, London, United Kingdom
| | - M Georgi
- University College London, London, United Kingdom
| | - K Hang
- University College London, London, United Kingdom
| | - W Mullins
- University of Cambridge, Cambridge, United Kingdom
| | - A Asif
- University of Leicester, Leicester, United Kingdom
| | - M Fricker
- Newcastle University, Newcastle, United Kingdom
| | - A Ng
- University College London, London, United Kingdom
| | - A Sridhar
- University College London, London, United Kingdom
| | - J Collins
- University College London, London, United Kingdom
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Cohen R, Borzutzky C, Wilkinson TA, Thompson M, Collins J. POSTER ABSTRACTS. Contraception 2021. [DOI: 10.1016/j.contraception.2021.07.096] [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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Abstract
BACKGROUND Intranasal corticosteroids are widely used for management of many upper airway diseases because of their ability to effectively deliver local relief of inflammation. CASE REPORT This paper presents the case of a 51-year-old man with human immunodeficiency virus treated with ritonavir who was started on fluticasone intranasal spray for presumed chronic rhinosinusitis. Months after starting this therapy, he developed symptoms of Cushing's syndrome and avascular necrosis of the shoulder due to the pharmacological interactions between fluticasone and ritonavir. CONCLUSION Although intranasal corticosteroids are deemed a low-risk route of drug administration, clinicians need to be vigilant in appropriately prescribing corticosteroids in the setting of drug potentiators, particularly in these high-risk patients. Alternative corticosteroids such as beclomethasone dipropionate should be considered in such cases.
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Affiliation(s)
- J James
- City University of New York School of Medicine, USA
| | - L Caulley
- Department of Otolaryngology - Head and Neck Surgery, University of Ottawa, Ottawa Hospital, Canada
- Department of Clinical Epidemiology, Ottawa Hospital Research Institute, Canada
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - J Collins
- ENT Department, Guy's Hospital, London, UK
| | - C Hopkins
- ENT Department, Guy's Hospital, London, UK
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Say R, Collins J, Holmes K, Lucey J, Murphy S, Buckley S, Curran TI. A Study of GP Workload and Satisfaction. Ir Med J 2021; 114:404. [PMID: 34520522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Aims In this novel study in the Irish setting, we quantified the number items managed per General Practitioner (GP) consult, how each item is managed, and impact on a GP's job satisfaction. Methods Participating GPs at two surgeries completed a questionnaire - integrated into the practice management software - after each consultation that satisfied the inclusion criteria during a four-week period. Results Due to feasibility constraints, 500 of 857 (58.3%) completed questionnaires were randomly selected for our sample. GPs manage an average of 1.76 items per consultation. Older patients presented with more items. Greater number of presenting items led to less being managed on the day 71% (n=5) for 5 items vs. 95.2% (n= 246) for 1 item, longer consultation duration (mean = 14.63 minutes (4-45) and decreased GP satisfaction, mean 8/10 (2-10). Conclusion Increasing the number of items in a GP consultation has a statistically significant effect on duration of consultation, how each item is managed, and even GP satisfaction.
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Affiliation(s)
- R Say
- Ross Medical Practice, Killarney Primary Care Centre, Killarney, Co Kerry
| | - J Collins
- Brandon Medical Centre, Hoffmans Terrace, Basin Road, Tralee, Co. Kerry
| | - K Holmes
- Brandon Medical Centre, Hoffmans Terrace, Basin Road, Tralee, Co. Kerry
| | - J Lucey
- Dromcollogher Medical Centre, Newcastle West Road, Dromcollogher, Co. Limerick
| | - S Murphy
- Dromcollogher Medical Centre, Newcastle West Road, Dromcollogher, Co. Limerick
| | - S Buckley
- Dromcollogher Medical Centre, Newcastle West Road, Dromcollogher, Co. Limerick
| | - T I Curran
- Ross Medical Practice, Killarney Primary Care Centre, Killarney, Co Kerry
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Nathan A, Fricker M, Hanna N, Asif A, Patel S, Georgi M, Hang K, Sinha A, Mullins W, Shea J, Lamb B, Sridhar A, Kelly J, Collins J. O43 Virtual: virtual interactive surgical skills classroom: a randomized controlled trial (protocol). Br J Surg 2021. [DOI: 10.1093/bjs/znab282.048] [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]
Abstract
Abstract
Introduction
High costs and inaccessibility are significant barriers to face-to-face basic surgical skills (BSS) training. Virtual classrooms enable the combination of computer-based learning with interactive expert instruction. They may optimise resources and increase accessibility, facilitating larger-scale training with a similar educational benefit. We aim to evaluate the efficacy of virtual BSS classroom training compared to both non-interactive video and face-to-face teaching.
Method
72 medical students will be randomly assigned to three equal intervention groups based on surgical skills experience and confidence. Interventions will be implemented following an instructional video. Group A will practice independently, Group B will receive face-to-face training, and Group C will attend a virtual classroom. Participants will be recorded placing three interrupted sutures with hand tied knots pre- and post-intervention. Objective Structured Assessment of Technical Skills (OSATS) will be blind marked by two experts.
Result
Change in confidence, time to completion and a novel granular performance score will also be measured. Each intervention’s feasibility and accessibility will be assessed. Significant improvement in OSATS within groups will be indicative of intervention quality. Difference in improvement between groups will determine the relative performance of the interventions.
Conclusion
This will be the largest randomised control trial investigating virtual BSS classroom training. It will serve as a comprehensive appraisal of the suitability of virtual classrooms as an alternative to face-to-face training. The findings will assist the development and implementation of further resource-efficient training programs during the COVID-19 pandemic and beyond.
Take-home Message
This is the first RCT assessing virtual basic surgical skill classroom training and serves as a comprehensive appraisal of the suitability of virtual classrooms as an alternative to face-to-face training. The findings will assist the development and implementation of further resource-efficient training programs during the COVID-19 pandemic and in the future.
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Affiliation(s)
- A Nathan
- University College London, London, UK
| | | | - N Hanna
- University of Cambridge, Cambridge, UK
| | - A Asif
- University of Leicester, Leicester, UK
| | - S Patel
- University College London, London, UK
| | - M Georgi
- University College London, London, UK
| | - K Hang
- University College London, London, UK
| | - A Sinha
- University of Cambridge, Cambridge, UK
| | - W Mullins
- University of Cambridge, Cambridge, UK
| | - J Shea
- University of Cambridge, Cambridge, UK
| | - B Lamb
- Cambridge University Hospitals, Cambridge, UK
| | - A Sridhar
- University College London, London, UK
| | - J Kelly
- University College London, London, UK
| | - J Collins
- University College London, London, UK
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Fricker M, Nathan A, Hannah N, Rashid A, Patel S, Phuah Y, Flora K, Cleaveland P, Kasivisvanathan V, Williams N, Miah S, Shah N, Hines J, Collins J, Sridhar A, Kelkar A, Briggs T, Kelly J, Shaw G, Sooriakumaran P, Rajan P, Lamb B, Nathan S. O50 New guidelines to reduce unnecessary blood tests, delayed discharge and costs following robot assisted radical prostatectomy. Br J Surg 2021. [DOI: 10.1093/bjs/znab282.055] [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]
Abstract
Abstract
Introduction
Routine postoperative blood tests (POBT) are used to evaluate the impact of surgery on pre-existing co-morbidities and to detect early complications. This practice dates back to an era of open surgery, when blood loss and complication rates were higher. We propose new guidelines to improve the specificity of POBT.
Method
The cases of 1040 consecutive patients who underwent a primary or salvage RARP at two large tertiary urology centres in the United Kingdom were retrospectively reviewed, and new guidelines were designed. The guidelines were prospectively validated in a cohort of 300 patients.
Result
Derivation Dataset 3% and 5% had intra- and post-operative Clavien-Dindo complications, respectively. 15% had clinical concerns postoperatively. 0.9% required perioperative transfusion. 78% had routine blood tests without clinical concerns, none of whom developed a complication. 98% of complications were suspected by clinical judgement. 6% of patients had a discharge delay of ≥ 1 days due to delayed or incomplete blood tests.
Validation Dataset No significant difference existed in complication, clinical concern or transfusion rates between the derivation and validation datasets. New guidelines improved sensitivity for complications from 98% to 100% and specificity from 0% to 74%. The number of blood tests requested reduced by 73% (P < 0.001). Discharge delays reduced from 6% to 0% (P = 0.008). Cost savings were £178 per patient.
Conclusion
Postoperative complications and transfusion following RARP are rare. Routine POBT without clinical indication are unnecessary and inefficient. A guideline-based approach to POBT can reduce costs and optimise discharge without compromising patient safety or care.
Take-home Message
Routine postoperative blood tests following robot assisted radical prostatectomy are often unnecessary. A guideline-based approach can reduce costs and optimise patient care.
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Affiliation(s)
| | - A Nathan
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
- University College London
| | - N Hannah
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust
- University of Cambridge
| | - A Rashid
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust
- University of Cambridge
| | | | | | | | - P Cleaveland
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - V Kasivisvanathan
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - N Williams
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - S Miah
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust
| | - N Shah
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust
| | - J Hines
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - J Collins
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - A Sridhar
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - A Kelkar
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - T Briggs
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - J Kelly
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - G Shaw
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - P Sooriakumaran
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
- Nuffield Department of Surgical Sciences, University of Oxford
| | - P Rajan
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
- Barts Cancer Institute, CR-UK Barts Centre, Queen Mary University of London
| | - B Lamb
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust
| | - S Nathan
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
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Eenjes E, Buscop-van Kempen M, Boerema-de Munck A, Edel GG, Benthem F, de Kreij-de Bruin L, Schnater M, Tibboel D, Collins J, Rottier RJ. SOX21 modulates SOX2-initiated differentiation of epithelial cells in the extrapulmonary airways. eLife 2021; 10:57325. [PMID: 34286693 PMCID: PMC8331192 DOI: 10.7554/elife.57325] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 07/20/2021] [Indexed: 12/23/2022] Open
Abstract
SOX2 expression levels are crucial for the balance between maintenance and differentiation of airway progenitor cells during development and regeneration. Here, we describe patterning of the mouse proximal airway epithelium by SOX21, which coincides with high levels of SOX2 during development. Airway progenitor cells in this SOX2+/SOX21+ zone show differentiation to basal cells, specifying cells for the extrapulmonary airways. Loss of SOX21 showed an increased differentiation of SOX2+ progenitor cells to basal and ciliated cells during mouse lung development. We propose a mechanism where SOX21 inhibits differentiation of airway progenitors by antagonizing SOX2-induced expression of specific genes involved in airway differentiation. Additionally, in the adult tracheal epithelium, SOX21 inhibits basal to ciliated cell differentiation. This suppressing function of SOX21 on differentiation contrasts SOX2, which mainly drives differentiation of epithelial cells during development and regeneration after injury. Furthermore, using human fetal lung organoids and adult bronchial epithelial cells, we show that SOX2+/SOX21+ regionalization is conserved. Lastly, we show that the interplay between SOX2 and SOX21 is context and concentration dependent leading to regulation of differentiation of the airway epithelium.
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Affiliation(s)
- Evelien Eenjes
- Department of Pediatric Surgery, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, Netherlands
| | - Marjon Buscop-van Kempen
- Department of Pediatric Surgery, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, Netherlands
| | - Anne Boerema-de Munck
- Department of Pediatric Surgery, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, Netherlands
| | - Gabriela G Edel
- Department of Pediatric Surgery, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, Netherlands
| | - Floor Benthem
- Department of Pediatric Surgery, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, Netherlands
| | - Lisette de Kreij-de Bruin
- Department of Pediatric Surgery, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, Netherlands
| | - Marco Schnater
- Department of Pediatric Surgery, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, Netherlands
| | - Dick Tibboel
- Department of Pediatric Surgery, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, Netherlands
| | - Jennifer Collins
- Department of Pediatric Surgery, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, Netherlands
| | - Robbert J Rottier
- Department of Pediatric Surgery, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, Netherlands.,Department of Cell biology, Erasmus Medical Center, Rotterdam, Netherlands
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Wei Y, Shrestha R, Pal S, Gerken T, Feng S, McNelis J, Singh D, Thornton MM, Boyer AG, Shook MA, Chen G, Baier BC, Barkley ZR, Barrick JD, Bennett JR, Browell EV, Campbell JF, Campbell LJ, Choi Y, Collins J, Dobler J, Eckl M, Fiehn A, Fried A, Digangi JP, Barton‐Grimley R, Halliday H, Klausner T, Kooi S, Kostinek J, Lauvaux T, Lin B, McGill MJ, Meadows B, Miles NL, Nehrir AR, Nowak JB, Obland M, O’Dell C, Fao RMP, Richardson SJ, Richter D, Roiger A, Sweeney C, Walega J, Weibring P, Williams CA, Yang MM, Zhou Y, Davis KJ. Atmospheric Carbon and Transport - America (ACT-America) Data Sets: Description, Management, and Delivery. Earth Space Sci 2021; 8:e2020EA001634. [PMID: 34435081 PMCID: PMC8365738 DOI: 10.1029/2020ea001634] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/19/2021] [Accepted: 05/09/2021] [Indexed: 06/13/2023]
Abstract
The ACT-America project is a NASA Earth Venture Suborbital-2 mission designed to study the transport and fluxes of greenhouse gases. The open and freely available ACT-America data sets provide airborne in situ measurements of atmospheric carbon dioxide, methane, trace gases, aerosols, clouds, and meteorological properties, airborne remote sensing measurements of aerosol backscatter, atmospheric boundary layer height and columnar content of atmospheric carbon dioxide, tower-based measurements, and modeled atmospheric mole fractions and regional carbon fluxes of greenhouse gases over the Central and Eastern United States. We conducted 121 research flights during five campaigns in four seasons during 2016-2019 over three regions of the US (Mid-Atlantic, Midwest and South) using two NASA research aircraft (B-200 and C-130). We performed three flight patterns (fair weather, frontal crossings, and OCO-2 underflights) and collected more than 1,140 h of airborne measurements via level-leg flights in the atmospheric boundary layer, lower, and upper free troposphere and vertical profiles spanning these altitudes. We also merged various airborne in situ measurements onto a common standard sampling interval, which brings coherence to the data, creates geolocated data products, and makes it much easier for the users to perform holistic analysis of the ACT-America data products. Here, we report on detailed information of data sets collected, the workflow for data sets including storage and processing of the quality controlled and quality assured harmonized observations, and their archival and formatting for users. Finally, we provide some important information on the dissemination of data products including metadata and highlights of applications of ACT-America data sets.
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Nathan A, Fricker M, De Groote R, Arora A, Phuah Y, Flora K, Pavan N, Kasivisvanathan V, Collins J, Kelkar A, Sridhar A, Shaw G, Rajan P, Kelly J, Briggs T, Sooriakumaran P, Nathan S. Salvage versus primary robot-assisted radical prostatectomy: A propensity-matched comparative effectiveness study from a high-volume tertiary center. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01569-4] [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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Collins J, Ní Eochagáin A, O'Sullivan EP. A recurring case of 'no trace, right place' during emergency tracheal intubations in the critical care setting. Anaesthesia 2021; 76:1671. [PMID: 33872383 PMCID: PMC8250767 DOI: 10.1111/anae.15492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2021] [Indexed: 11/18/2022]
Affiliation(s)
- J Collins
- St. James' Hospital, Dublin, Ireland
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42
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Hanrath AT, Schim van der Loeff I, Lendrem DW, Baker KF, Price DA, McDowall P, McDowall K, Cook S, Towns P, Schwab U, Evans A, Dixon J, Collins J, Burton-Fanning S, Saunders D, Harwood J, Samuel J, Schmid ML, Pareja-Cebrian L, Hunter E, Murphy E, Taha Y, Payne BAI, Duncan CJA. SARS-CoV-2 Testing of 11,884 Healthcare Workers at an Acute NHS Hospital Trust in England: A Retrospective Analysis. Front Med (Lausanne) 2021; 8:636160. [PMID: 33777979 PMCID: PMC7994756 DOI: 10.3389/fmed.2021.636160] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/16/2021] [Indexed: 11/13/2022] Open
Abstract
Healthcare workers (HCWs) are known to be at increased risk of infection with SARS-CoV-2, although whether these risks are equal across all roles is uncertain. Here we report a retrospective analysis of a large real-world dataset obtained from 10 March to 6 July 2020 in an NHS Foundation Trust in England with 17,126 employees. 3,338 HCWs underwent symptomatic PCR testing (14.4% positive, 2.8% of all staff) and 11,103 HCWs underwent serological testing for SARS-CoV-2 IgG (8.4% positive, 5.5% of all staff). Seropositivity was lower than other hospital settings in England but higher than community estimates. Increased test positivity rates were observed in HCWs from BAME backgrounds and residents in areas of higher social deprivation. A multiple logistic regression model adjusting for ethnicity and social deprivation confirmed statistically significant increases in the odds of testing positive in certain occupational groups, most notably domestic services staff, nurses, and health-care assistants. PCR testing of symptomatic HCWs appeared to underestimate overall infection levels, probably due to asymptomatic seroconversion. Clinical outcomes were reassuring, with only a small minority of HCWs with COVID-19 requiring hospitalization (2.3%) or ICU management (0.7%) and with no deaths. Despite a relatively low level of HCW infection compared to other UK cohorts, there were nevertheless important differences in test positivity rates between occupational groups, robust to adjustment for demographic factors such as ethnic background and social deprivation. Quantitative and qualitative studies are needed to better understand the factors contributing to this risk. Robust informatics solutions for HCW exposure data are essential to inform occupational monitoring.
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Affiliation(s)
- Aidan T. Hanrath
- Immunity and Inflammation Theme, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Ina Schim van der Loeff
- Immunity and Inflammation Theme, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Dennis W. Lendrem
- Immunity and Inflammation Theme, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre, Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Kenneth F. Baker
- Immunity and Inflammation Theme, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre, Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - David A. Price
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Peter McDowall
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Kiera McDowall
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Susan Cook
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Peter Towns
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Ulrich Schwab
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Adam Evans
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Jill Dixon
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Jennifer Collins
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | | | - David Saunders
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Jayne Harwood
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Julie Samuel
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Matthias L. Schmid
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Lucia Pareja-Cebrian
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Ewan Hunter
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Elizabeth Murphy
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Yusri Taha
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Brendan A. I. Payne
- Immunity and Inflammation Theme, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Christopher J. A. Duncan
- Immunity and Inflammation Theme, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
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Barge L, Tran S, Kennedy G, Ritchie DS, Gottlieb D, Milliken S, Spencer A, Purtill D, Perera T, Doocey RT, Larsen S, Butler A, Bardy P, Greenwood M, Durrant S, Curley C, Stewart C, Tam CS, Collins J, Balendran S, Di Ciaccio PR, Patil S, Han MH, Hamad N. Improvement in Non-Relapse Mortality Following Allogeneic Transplantation for Chronic Lymphocytic Leukaemia in Australia and New Zealand: An Australasian Bone Marrow Transplant Recipient Registry Study. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00168-8] [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: 11/15/2022]
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Major A, Collins J, Craney C, Heitman AK, Bauer E, Zerante E, Stock W, Bishop MR, Jasielec J. Management of hemophagocytic lymphohistiocytosis (HLH) associated with chimeric antigen receptor T-cell (CAR-T) therapy using anti-cytokine therapy: an illustrative case and review of the literature. Leuk Lymphoma 2021; 62:1765-1769. [PMID: 33559517 DOI: 10.1080/10428194.2021.1881507] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Ajay Major
- Section of Hematology/Oncology at the University of Chicago, University of Chicago Comprehensive Cancer Center, Chicago, IL, USA
| | - Jennifer Collins
- Section of Hematology/Oncology at the University of Chicago, University of Chicago Comprehensive Cancer Center, Chicago, IL, USA
| | - Caroline Craney
- Section of Hematology/Oncology at the University of Chicago, University of Chicago Comprehensive Cancer Center, Chicago, IL, USA
| | - Alisa K Heitman
- Section of Hematology/Oncology at the University of Chicago, University of Chicago Comprehensive Cancer Center, Chicago, IL, USA
| | - Emily Bauer
- Section of Hematology/Oncology at the University of Chicago, University of Chicago Comprehensive Cancer Center, Chicago, IL, USA
| | - Elizabeth Zerante
- Section of Hematology/Oncology at the University of Chicago, University of Chicago Comprehensive Cancer Center, Chicago, IL, USA
| | - Wendy Stock
- The David and Etta Jonas Center for Cellular Therapy at the University of Chicago, Chicago, IL, USA
| | - Michael R Bishop
- The David and Etta Jonas Center for Cellular Therapy at the University of Chicago, Chicago, IL, USA
| | - Jagoda Jasielec
- The David and Etta Jonas Center for Cellular Therapy at the University of Chicago, Chicago, IL, USA
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Collins J, Sun S, Guo C, Podgorsak A, Rudin S, Bednarek DR. Estimation of Patient Eye-Lens Dose During Neuro-Interventional Procedures using a Dense Neural Network (DNN). Proc SPIE Int Soc Opt Eng 2021; 11595:1159543. [PMID: 34334873 PMCID: PMC8323862 DOI: 10.1117/12.2580723] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The patient's eye-lens dose changes for each projection view during fluoroscopically-guided neuro-interventional procedures. Monte-Carlo (MC) simulation can be done to estimate lens dose but MC cannot be done in real-time to give feedback to the interventionalist. Deep learning (DL) models were investigated to estimate patient-lens dose for given exposure conditions to give real-time updates. MC simulations were done using a Zubal computational phantom to create a dataset of eye-lens dose values for training the DL models. Six geometric parameters (entrance-field size, LAO gantry angulation, patient x, y, z head position relative to the beam isocenter, and whether patient's right or left eye) were varied for the simulations. The dose for each combination of parameters was expressed as lens dose per entrance air kerma (mGy/Gy). Geometric parameter combinations associated with high-dose values were sampled more finely to generate more high-dose values for training purposes. Additionally, dose at intermediate parameter values was calculated by MC in order to validate the interpolation capabilities of DL. Data was split into training, validation and testing sets. Stacked models and median algorithms were implemented to create more robust models. Model performance was evaluated using mean absolute percentage error (MAPE). The goal for this DL model is that it be implemented into the Dose Tracking System (DTS) developed by our group. This would allow the DTS to infer the patient's eye-lens dose for real-time feedback and eliminate the need for a large database of pre-calculated values with interpolation capabilities.
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Affiliation(s)
- J Collins
- The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Canon Stroke and Vascular Research Center, 875 Ellicott St., Buffalo, NY 14203
| | - S Sun
- The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Canon Stroke and Vascular Research Center, 875 Ellicott St., Buffalo, NY 14203
| | - C Guo
- The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Canon Stroke and Vascular Research Center, 875 Ellicott St., Buffalo, NY 14203
| | - A Podgorsak
- The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Canon Stroke and Vascular Research Center, 875 Ellicott St., Buffalo, NY 14203
| | - S Rudin
- The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Canon Stroke and Vascular Research Center, 875 Ellicott St., Buffalo, NY 14203
| | - D R Bednarek
- The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Canon Stroke and Vascular Research Center, 875 Ellicott St., Buffalo, NY 14203
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Froidevaux JSP, Boughey KL, Hawkins CL, Jones G, Collins J. Evaluating survey methods for bat roost detection in ecological impact assessment. Anim Conserv 2020; 23:597-606. [PMID: 33288979 PMCID: PMC7687239 DOI: 10.1111/acv.12574] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/05/2020] [Indexed: 11/27/2022]
Abstract
The disturbance, damage and destruction of roosts are key drivers of bat population declines worldwide. In countries where bats are protected by law, bat roost surveys are often required to inform ecological impact assessments. Yet, evidence‐based information on survey methodology to detect bat roosts is crucially lacking, and failing to detect a roost can lead to serious errors during decision‐making processes. Here, we assess the efficacy of bat roost surveys in buildings as implemented in the UK. These consist of a daytime inspection of buildings, followed by a series of acoustic surveys at dusk/dawn if during the daytime inspection evidence of bats is found, or if the absence of bats cannot be verified. We reviewed 155 ecological consultants’ reports to (1) compare survey outcome between daytime inspection and acoustic surveys and (2) determine the minimum sampling effort required during acoustic surveys to be confident that no bats are roosting within a building. We focused on two genera of bats most frequently found in buildings in Europe – Pipistrellus (crevice roosting species with high‐intensity echolocation calls that can be easily detected by ultrasound detectors) and Plecotus (species that roost in open spaces and which emit faint echolocation calls that are difficult to detect). Daytime inspections were efficient in detecting open‐roosting species such as Plecotus species but were likely to miss the presence of crevice‐dwelling ones (here Pipistrellus species) which may lead to erroneous conclusions if no acoustic surveys are subsequently prescribed to confirm their absence. A minimum of three and four acoustic surveys are required to be 95% confident that a building does not host a roost of Pipistrellus species and Plecotus species, respectively, thus exceeding current recommendations. Overall, we demonstrated that reports submitted as part of an ecological impact assessment provide suitable data to test and improve survey methods.
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Affiliation(s)
- J S P Froidevaux
- School of Biological Sciences University of Bristol Bristol UK.,Université de Toulouse, INRAE, UMR DYNAFOR Castanet-Tolosan France
| | | | | | - G Jones
- School of Biological Sciences University of Bristol Bristol UK
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Gawedzki P, Collins J. Impact of the implementation of a pharmacist-driven immunosuppression drug monitoring protocol for hematopoietic stem cell transplant recipients. J Oncol Pharm Pract 2020; 27:1907-1913. [PMID: 33250016 DOI: 10.1177/1078155220975088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
For patients with serious hematologic malignancies, hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment option. Majority of HSCT recipients receive tacrolimus as part of their immunosuppressive regimen. The purpose of this study is to evaluate the clinical impact of a pharmacist driven immunosuppression drug monitoring protocol for HSCT recipients on tacrolimus.This was a single-center, pre-post interventional study conducted at the University of Chicago Medical Center. Data collected via chart review includes the immunosuppressive agent used, interacting medications, adverse events, dose adjustments, drug concentrations, time to engraftment, and diagnosis of GVHD.Following the incorporation of a therapeutic drug monitoring protocol, the percentage of therapeutic tacrolimus levels was similar to when there was no protocol in place; 68% versus 64%, respectively (p = 0.34). There were 18 total adverse events observed in the pre-protocol group versus 10 in the post-protocol group (p = 0.03). Nephrotoxicity was the most common adverse event occurring in 23% of patients in the pre-protocol group and 15% of patients in the post-protocol group (p = 0.18). In the post-protocol group, there were 20 patients with two or more interacting drugs versus two patients in the pre-protocol group (p < 0.05). Additionally, the post-protocol group had 12 instances of an empiric dose adjustment made whereas the pre-protocol group had three instances (p = 0.006).Although there was no significant difference in percentage of therapeutic tacrolimus levels, pharmacist involvement resulted in improved safety outcomes such as management of drug interactions and incidence of adverse events.
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Affiliation(s)
- Paula Gawedzki
- Department of Pharmacy Services, 2462University of Chicago Medicine, Chicago, IL, USA
| | - Jennifer Collins
- Department of Pharmacy Services, 2462University of Chicago Medicine, Chicago, IL, USA
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Nezafat Maldonado BM, Collins J, Blundell HJ, Singh L. Engaging the vulnerable: A rapid review of public health communication aimed at migrants during the COVID-19 pandemic in Europe. J Migr Health 2020; 1:100004. [PMID: 33447830 PMCID: PMC7661962 DOI: 10.1016/j.jmh.2020.100004] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The World Health Organization recommends national risk communications tools targeting migrant communities to contain the spread of COVID-19. Within Europe, migrants are often left behind in healthcare due to structural barriers driven by hostile environment measures. This study aimed to assess inclusion of migrants in COVID-19 prevention measures by evaluating if governmental risk communications are available in common migrant languages across Europe. METHODS A rapid review was performed in June 2020 to understand the availability of government produced risk communications across Council of Europe member states, namely: COVID-19 health communications, migrant-specific guidelines and COVID-19 helplines. RESULTS 96% (45/47) of countries sampled had online government COVID-19 advice. 30% (15/47) issued information in their official language(s), whilst 64% (30/47) of countries delivered information in additional languages. 48% (23/47) translated information into at least one migrant language. However, information on testing or healthcare entitlements in common migrant languages was only found in 6% (3/47). Half (53%; 25/47) of the countries with COVID-19 helpline offered information in at least one alternative language.No government produced risk communications on disease prevention targeting people in refugee camps or informal settlements. CONCLUSIONS There are clear gaps in the availability of translated COVID-19 risk communications across Europe, excluding migrants from the COVID-19 response. Governments must reflect on the inclusion of migrants within their COVID-19 response and seek to engage vulnerable communities. Governments should urgently partner with non-governmental organizations who already play a key role in addressing unmet health needs.
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Affiliation(s)
| | | | | | - Lucy Singh
- EGA Institute for Women's Health, University College London, London, UK
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Nathan A, Hanna N, Rashid A, Patel S, Phuah Y, Flora K, Cleaveland P, Kasivisvanathan V, Miah S, Collins J, Sridhar A, Kelkar A, Hines J, Kelly J, Shah N, Briggs T, Shaw G, Sooriakumaran P, Rajan P, Lamb B, Nathan S. Novel guidelines to avoid routine blood tests after Robot Assisted Radical Prostatectomy (RARP). EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35850-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: 10/23/2022] Open
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50
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Huang G, Murillo Solano C, Melendez J, Shaw J, Collins J, Banks R, Arshadi AK, Boonhok R, Min H, Miao J, Chakrabarti D, Yuan Y. Synthesis, Structure-Activity Relationship, and Antimalarial Efficacy of 6-Chloro-2-arylvinylquinolines. J Med Chem 2020; 63:11756-11785. [PMID: 32959656 DOI: 10.1021/acs.jmedchem.0c00858] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
There is an urgent need to develop new efficacious antimalarials to address the emerging drug-resistant clinical cases. Our previous phenotypic screening identified styrylquinoline UCF501 as a promising antimalarial compound. To optimize UCF501, we herein report a detailed structure-activity relationship study of 2-arylvinylquinolines, leading to the discovery of potent, low nanomolar antiplasmodial compounds against a Plasmodium falciparum CQ-resistant Dd2 strain, with excellent selectivity profiles (resistance index < 1 and selectivity index > 200). Several metabolically stable 2-arylvinylquinolines are identified as fast-acting agents that kill asexual blood-stage parasites at the trophozoite phase, and the most promising compound 24 also demonstrates transmission blocking potential. Additionally, the monophosphate salt of 24 exhibits excellent in vivo antimalarial efficacy in the murine model without noticeable toxicity. Thus, the 2-arylvinylquinolines represent a promising class of antimalarial drug leads.
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Affiliation(s)
- Guang Huang
- Department of Chemistry, University of Central Florida, Orlando, Florida 32816, United States
| | - Claribel Murillo Solano
- Division of Molecular Microbiology, Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida 32826, United States
| | - Joel Melendez
- Division of Molecular Microbiology, Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida 32826, United States
| | - Justin Shaw
- Division of Molecular Microbiology, Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida 32826, United States
| | - Jennifer Collins
- Division of Molecular Microbiology, Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida 32826, United States
| | - Robert Banks
- Research Program Services, University of Central Florida, Orlando, Florida 32816, United States
| | - Arash Keshavarzi Arshadi
- Division of Molecular Microbiology, Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida 32826, United States
| | - Rachasak Boonhok
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida 33612, United States.,Department of Medical Technology, School of Allied Health Science, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Hui Min
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida 33612, United States
| | - Jun Miao
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida 33612, United States
| | - Debopam Chakrabarti
- Division of Molecular Microbiology, Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida 32826, United States
| | - Yu Yuan
- Department of Chemistry, University of Central Florida, Orlando, Florida 32816, United States
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