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Hynes J, Dawson L, Seal M, Green J, Woods M, Etchegary H. "There should be one spot that you can go:" BRCA mutation carriers' perspectives on cancer risk management and a hereditary cancer registry. J Community Genet 2024; 15:49-58. [PMID: 37864742 PMCID: PMC10858006 DOI: 10.1007/s12687-023-00685-5] [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: 07/24/2023] [Accepted: 10/11/2023] [Indexed: 10/23/2023] Open
Abstract
Individuals who carry BRCA1 or BRCA2 pathogenic variants are recommended to have extensive cancer prevention screening and risk-reducing surgeries. Uptake of these recommendations is variable, and there remains room for improvement in the risk management of BRCA carriers. This paper explores female BRCA carriers' experiences with the current model of care and their perspectives on (and interest in) an inherited cancer registry. Findings can inform the development of a dedicated high-risk screening and management program for these patients. Quantitative and qualitative data were gathered through a provincial descriptive survey and semi-structured qualitative interviews to assess BRCA carriers' opinions toward risk management services in the province of Newfoundland and Labrador (NL), Canada. Survey (n = 69) and interview data (n = 15) revealed continuity and coordination challenges with the current system of care of high-risk individuals. Respondents suggested an inherited cancer registry would help identify high-risk individuals and provide a centralized system of risk management for identified carriers. Respondents identified concerns about the privacy of their registry data, including who could access it. Findings suggest BRCA carriers see great value in an inherited cancer registry. Specifically, participants noted it could provide a centralized system to help improve the coordination of burdensome, life-long risk management. Important patient concerns about protecting their privacy and their health data confidentiality must be addressed in patient and public information and informed consent documents about a registry.
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Affiliation(s)
- J Hynes
- Faculty of Medicine, Memorial University, Craig L. Dobbin Centre for Genetics, Rm 4M210, St. John's, NL, A1B 3V6, Canada
| | - L Dawson
- Department Obstetrics and Gynecology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - M Seal
- Cancer Care Program, Eastern Regional Health Authority, St. John's, NL, Canada
| | - J Green
- Faculty of Medicine, Memorial University, Craig L. Dobbin Centre for Genetics, Rm 4M210, St. John's, NL, A1B 3V6, Canada
| | - M Woods
- Faculty of Medicine, Memorial University, Craig L. Dobbin Centre for Genetics, Rm 4M210, St. John's, NL, A1B 3V6, Canada
| | - H Etchegary
- Faculty of Medicine, Memorial University, Craig L. Dobbin Centre for Genetics, Rm 4M210, St. John's, NL, A1B 3V6, Canada.
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Green J, Lindqvist Bagge AS, Laporte N, Andiné P, Wallinius M, Hildebrand Karlén M. A latent class analysis of mental disorders, substance use, and aggressive antisocial behavior among Swedish forensic psychiatric patients. Compr Psychiatry 2023; 127:152428. [PMID: 37778180 DOI: 10.1016/j.comppsych.2023.152428] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Patients in the forensic mental health services (FMHS) with a mental disorder, a co-occurring substance use disorder (SUD), and high risk of aggressive antisocial behavior (AAB) are sometimes referred to as the 'triply troubled'. They suffer poor treatment outcomes, high rates of criminal recidivism, and increased risk of drug related mortality. To improve treatment for this heterogeneous patient group, more insight is needed concerning their co-occurring mental disorders, types of substances used, and the consequent risk of AAB. METHODS A three-step latent class analysis (LCA) was used to identify clinically relevant subgroups in a sample of patients (n = 98) from a high-security FMHS clinic in Sweden based on patterns in their history of mental disorders, SUD, types of substances used, and AAB. RESULTS A four-class model best fit our data: class 1 (42%) had a high probability of SUD, psychosis, and having used all substances; class 2 (26%) had a high probability of psychosis and cannabis use; class 3 (22%) had a high probability of autism and no substance use; and class 4 (10%) had a high probability of personality disorders and having used all substances. Both polysubstance classes (1 and 4) had a significantly more extensive history of AAB compared to classes 2 and 3. Class 3 and class 4 had extensive histories of self-directed aggression. CONCLUSIONS The present study helps disentangle the heterogeneity of the 'triply troubled' patient group in FMHS. The results provide an illustration of a more person-oriented perspective on patient comorbidity and types of substances used which could benefit clinical assessment, treatment planning, and risk-management among patients in forensic psychiatric care.
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Affiliation(s)
- J Green
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
| | - A S Lindqvist Bagge
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - N Laporte
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden
| | - P Andiné
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Forensic Psychiatry, National Board of Forensic Medicine, Gothenburg, Sweden; Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - M Wallinius
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden
| | - M Hildebrand Karlén
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Psychology, University of Gothenburg, Gothenburg, Sweden; Department of Forensic Psychiatry, National Board of Forensic Medicine, Gothenburg, Sweden
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Hayano W, Kerscher M, Day D, Ogilvie A, Pavicic T, Lim T, Lorenc PZ, Hernandez C, Frank K, Moellhoff N, Prinz V, Mia C, Pooth R, Green J. Novel, Validated, 5-Point Photonumeric Scales for Assessment of the Perioral Region. Aesthet Surg J 2023; 43:1347-1356. [PMID: 37052953 DOI: 10.1093/asj/sjad103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/02/2023] [Accepted: 03/17/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND The use of validated scales is still considered the gold standard for evaluating the severity of an aesthetic facial condition. OBJECTIVES The aim of this investigation was to create and validate 5-point photonumeric scales for the assessment of perioral lines and marionette lines. METHODS A medical team created 2 different novel 5-point photonumeric scales for the assessment of perioral lines and marionette lines. Eleven international raters were involved in the digital validation, and 4 raters performed a live validation. RESULTS For the Croma Static Perioral Lines-Assessment Scale, the digital interrater intraclass correlation coefficients (ICCs) were 0.88 (95% CI, 0.85-0.91) in the first rating and 0.87 (95% CI, 0.83-0.90) in the second rating. The digital intrarater ICCs were 0.90 (95% CI, 0.87-0.92). In the live rating, the interrater ICCs were 0.89 (95% CI, 0.85-0.93) in the first rating and 0.91 (95% CI, 0.87-0.93) in the second rating with an intrarater ICC of 0.91 (95% CI, 0.88-0.95). For the Croma Marionette Lines-Assessment Scale, the digital rating interrater ICCs were 0.85 (95% CI, 0.81-0.89) in the first rating and 0.87 (95% CI, 0.84-0.90) in the second rating with an intrarater ICC of 0.89 (95% CI, 0.88-0.91). In the live rating, the interrater ICCs were 0.73 (95% CI, 0.54-0.83) in the first rating and 0.79 (95% CI, 0.65-0.87) in the second rating with an intrarater ICC of 0.88 (95% CI, 0.83-0.94). CONCLUSIONS The Croma Static Perioral Lines-Assessment Scale and the Croma Marionette Lines-Assessment Scale have exceptional inter- and intrarater agreements that justify their use in clinical and study settings for all ethnic groups. LEVEL OF EVIDENCE: 5
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Aalbers J, Akerib DS, Akerlof CW, Al Musalhi AK, Alder F, Alqahtani A, Alsum SK, Amarasinghe CS, Ames A, Anderson TJ, Angelides N, Araújo HM, Armstrong JE, Arthurs M, Azadi S, Bailey AJ, Baker A, Balajthy J, Balashov S, Bang J, Bargemann JW, Barry MJ, Barthel J, Bauer D, Baxter A, Beattie K, Belle J, Beltrame P, Bensinger J, Benson T, Bernard EP, Bhatti A, Biekert A, Biesiadzinski TP, Birch HJ, Birrittella B, Blockinger GM, Boast KE, Boxer B, Bramante R, Brew CAJ, Brás P, Buckley JH, Bugaev VV, Burdin S, Busenitz JK, Buuck M, Cabrita R, Carels C, Carlsmith DL, Carlson B, Carmona-Benitez MC, Cascella M, Chan C, Chawla A, Chen H, Cherwinka JJ, Chott NI, Cole A, Coleman J, Converse MV, Cottle A, Cox G, Craddock WW, Creaner O, Curran D, Currie A, Cutter JE, Dahl CE, David A, Davis J, Davison TJR, Delgaudio J, Dey S, de Viveiros L, Dobi A, Dobson JEY, Druszkiewicz E, Dushkin A, Edberg TK, Edwards WR, Elnimr MM, Emmet WT, Eriksen SR, Faham CH, Fan A, Fayer S, Fearon NM, Fiorucci S, Flaecher H, Ford P, Francis VB, Fraser ED, Fruth T, Gaitskell RJ, Gantos NJ, Garcia D, Geffre A, Gehman VM, Genovesi J, Ghag C, Gibbons R, Gibson E, Gilchriese MGD, Gokhale S, Gomber B, Green J, Greenall A, Greenwood S, van der Grinten MGD, Gwilliam CB, Hall CR, Hans S, Hanzel K, Harrison A, Hartigan-O'Connor E, Haselschwardt SJ, Hernandez MA, Hertel SA, Heuermann G, Hjemfelt C, Hoff MD, Holtom E, Hor JYK, Horn M, Huang DQ, Hunt D, Ignarra CM, Jacobsen RG, Jahangir O, James RS, Jeffery SN, Ji W, Johnson J, Kaboth AC, Kamaha AC, Kamdin K, Kasey V, Kazkaz K, Keefner J, Khaitan D, Khaleeq M, Khazov A, Khurana I, Kim YD, Kocher CD, Kodroff D, Korley L, Korolkova EV, Kras J, Kraus H, Kravitz S, Krebs HJ, Kreczko L, Krikler B, Kudryavtsev VA, Kyre S, Landerud B, Leason EA, Lee C, Lee J, Leonard DS, Leonard R, Lesko KT, Levy C, Li J, Liao FT, Liao J, Lin J, Lindote A, Linehan R, Lippincott WH, Liu R, Liu X, Liu Y, Loniewski C, Lopes MI, Lopez Asamar E, López Paredes B, Lorenzon W, Lucero D, Luitz S, Lyle JM, Majewski PA, Makkinje J, Malling DC, Manalaysay A, Manenti L, Mannino RL, Marangou N, Marzioni MF, Maupin C, McCarthy ME, McConnell CT, McKinsey DN, McLaughlin J, Meng Y, Migneault J, Miller EH, Mizrachi E, Mock JA, Monte A, Monzani ME, Morad JA, Morales Mendoza JD, Morrison E, Mount BJ, Murdy M, Murphy ASJ, Naim D, Naylor A, Nedlik C, Nehrkorn C, Neves F, Nguyen A, Nikoleyczik JA, Nilima A, O'Dell J, O'Neill FG, O'Sullivan K, Olcina I, Olevitch MA, Oliver-Mallory KC, Orpwood J, Pagenkopf D, Pal S, Palladino KJ, Palmer J, Pangilinan M, Parveen N, Patton SJ, Pease EK, Penning B, Pereira C, Pereira G, Perry E, Pershing T, Peterson IB, Piepke A, Podczerwinski J, Porzio D, Powell S, Preece RM, Pushkin K, Qie Y, Ratcliff BN, Reichenbacher J, Reichhart L, Rhyne CA, Richards A, Riffard Q, Rischbieter GRC, Rodrigues JP, Rodriguez A, Rose HJ, Rosero R, Rossiter P, Rushton T, Rutherford G, Rynders D, Saba JS, Santone D, Sazzad ABMR, Schnee RW, Scovell PR, Seymour D, Shaw S, Shutt T, Silk JJ, Silva C, Sinev G, Skarpaas K, Skulski W, Smith R, Solmaz M, Solovov VN, Sorensen P, Soria J, Stancu I, Stark MR, Stevens A, Stiegler TM, Stifter K, Studley R, Suerfu B, Sumner TJ, Sutcliffe P, Swanson N, Szydagis M, Tan M, Taylor DJ, Taylor R, Taylor WC, Temples DJ, Tennyson BP, Terman PA, Thomas KJ, Tiedt DR, Timalsina M, To WH, Tomás A, Tong Z, Tovey DR, Tranter J, Trask M, Tripathi M, Tronstad DR, Tull CE, Turner W, Tvrznikova L, Utku U, Va'vra J, Vacheret A, Vaitkus AC, Verbus JR, Voirin E, Waldron WL, Wang A, Wang B, Wang JJ, Wang W, Wang Y, Watson JR, Webb RC, White A, White DT, White JT, White RG, Whitis TJ, Williams M, Wisniewski WJ, Witherell MS, Wolfs FLH, Wolfs JD, Woodford S, Woodward D, Worm SD, Wright CJ, Xia Q, Xiang X, Xiao Q, Xu J, Yeh M, Yin J, Young I, Zarzhitsky P, Zuckerman A, Zweig EA. First Dark Matter Search Results from the LUX-ZEPLIN (LZ) Experiment. Phys Rev Lett 2023; 131:041002. [PMID: 37566836 DOI: 10.1103/physrevlett.131.041002] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 03/06/2023] [Accepted: 06/07/2023] [Indexed: 08/13/2023]
Abstract
The LUX-ZEPLIN experiment is a dark matter detector centered on a dual-phase xenon time projection chamber operating at the Sanford Underground Research Facility in Lead, South Dakota, USA. This Letter reports results from LUX-ZEPLIN's first search for weakly interacting massive particles (WIMPs) with an exposure of 60 live days using a fiducial mass of 5.5 t. A profile-likelihood ratio analysis shows the data to be consistent with a background-only hypothesis, setting new limits on spin-independent WIMP-nucleon, spin-dependent WIMP-neutron, and spin-dependent WIMP-proton cross sections for WIMP masses above 9 GeV/c^{2}. The most stringent limit is set for spin-independent scattering at 36 GeV/c^{2}, rejecting cross sections above 9.2×10^{-48} cm at the 90% confidence level.
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Affiliation(s)
- J Aalbers
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - D S Akerib
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - C W Akerlof
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - A K Al Musalhi
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - F Alder
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - A Alqahtani
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - S K Alsum
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - C S Amarasinghe
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - A Ames
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - T J Anderson
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - N Angelides
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - H M Araújo
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - J E Armstrong
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - M Arthurs
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - S Azadi
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - A J Bailey
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A Baker
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - J Balajthy
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - S Balashov
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - J Bang
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - J W Bargemann
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - M J Barry
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Barthel
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - D Bauer
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A Baxter
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - K Beattie
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Belle
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - P Beltrame
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - J Bensinger
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - T Benson
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - E P Bernard
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - A Bhatti
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - A Biekert
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - T P Biesiadzinski
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - H J Birch
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - B Birrittella
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - G M Blockinger
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - K E Boast
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - B Boxer
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - R Bramante
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - C A J Brew
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - P Brás
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - J H Buckley
- Washington University in St. Louis, Department of Physics, St. Louis, Missouri 63130-4862, USA
| | - V V Bugaev
- Washington University in St. Louis, Department of Physics, St. Louis, Missouri 63130-4862, USA
| | - S Burdin
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - J K Busenitz
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - M Buuck
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - R Cabrita
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - C Carels
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - D L Carlsmith
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - B Carlson
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - M C Carmona-Benitez
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - M Cascella
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - C Chan
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Chawla
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - H Chen
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J J Cherwinka
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - N I Chott
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - A Cole
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Coleman
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - M V Converse
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - A Cottle
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - G Cox
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - W W Craddock
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - O Creaner
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D Curran
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - A Currie
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - J E Cutter
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - C E Dahl
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
- Northwestern University, Department of Physics & Astronomy, Evanston, Illinois 60208-3112, USA
| | - A David
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - J Davis
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - T J R Davison
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - J Delgaudio
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - S Dey
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - L de Viveiros
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - A Dobi
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J E Y Dobson
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - E Druszkiewicz
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - A Dushkin
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - T K Edberg
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - W R Edwards
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - M M Elnimr
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - W T Emmet
- Yale University, Department of Physics, New Haven, Connecticut 06511-8499, USA
| | - S R Eriksen
- University of Bristol, H.H. Wills Physics Laboratory, Bristol, BS8 1TL, United Kingdom
| | - C H Faham
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - A Fan
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - S Fayer
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - N M Fearon
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - S Fiorucci
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - H Flaecher
- University of Bristol, H.H. Wills Physics Laboratory, Bristol, BS8 1TL, United Kingdom
| | - P Ford
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - V B Francis
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - E D Fraser
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - T Fruth
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R J Gaitskell
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - N J Gantos
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D Garcia
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Geffre
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - V M Gehman
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Genovesi
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - C Ghag
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R Gibbons
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - E Gibson
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - M G D Gilchriese
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - S Gokhale
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - B Gomber
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - J Green
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - A Greenall
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - S Greenwood
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | | | - C B Gwilliam
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - C R Hall
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - S Hans
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - K Hanzel
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - A Harrison
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - E Hartigan-O'Connor
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - S J Haselschwardt
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - M A Hernandez
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - S A Hertel
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
| | - G Heuermann
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - C Hjemfelt
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - M D Hoff
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - E Holtom
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - J Y-K Hor
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - M Horn
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - D Q Huang
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D Hunt
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - C M Ignarra
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - R G Jacobsen
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - O Jahangir
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R S James
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - S N Jeffery
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - W Ji
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - J Johnson
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - A C Kaboth
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - A C Kamaha
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
- University of Califonia, Los Angeles, Department of Physics and Astronomy, Los Angeles, California 90095-1547
| | - K Kamdin
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - V Kasey
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - K Kazkaz
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - J Keefner
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - D Khaitan
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - M Khaleeq
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A Khazov
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - I Khurana
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - Y D Kim
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - C D Kocher
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D Kodroff
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - L Korley
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - E V Korolkova
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - J Kras
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - H Kraus
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - S Kravitz
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - H J Krebs
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - L Kreczko
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - B Krikler
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - V A Kudryavtsev
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - S Kyre
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - B Landerud
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - E A Leason
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - C Lee
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - J Lee
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - D S Leonard
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - R Leonard
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - K T Lesko
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - C Levy
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - J Li
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - F-T Liao
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - J Liao
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - J Lin
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - A Lindote
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - R Linehan
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - W H Lippincott
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - R Liu
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - X Liu
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - Y Liu
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - C Loniewski
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - M I Lopes
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - E Lopez Asamar
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - B López Paredes
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - W Lorenzon
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - D Lucero
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - S Luitz
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - J M Lyle
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - P A Majewski
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - J Makkinje
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D C Malling
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Manalaysay
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - L Manenti
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R L Mannino
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - N Marangou
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - M F Marzioni
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - C Maupin
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - M E McCarthy
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - C T McConnell
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D N McKinsey
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - J McLaughlin
- Northwestern University, Department of Physics & Astronomy, Evanston, Illinois 60208-3112, USA
| | - Y Meng
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - J Migneault
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - E H Miller
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - E Mizrachi
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - J A Mock
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - A Monte
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - M E Monzani
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
- Vatican Observatory, Castel Gandolfo, V-00120, Vatican City State
| | - J A Morad
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - J D Morales Mendoza
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - E Morrison
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - B J Mount
- Black Hills State University, School of Natural Sciences, Spearfish, South Dakota 57799-0002, USA
| | - M Murdy
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
| | - A St J Murphy
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - D Naim
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - A Naylor
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - C Nedlik
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
| | - C Nehrkorn
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - F Neves
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - A Nguyen
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - J A Nikoleyczik
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - A Nilima
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - J O'Dell
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - F G O'Neill
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - K O'Sullivan
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - I Olcina
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - M A Olevitch
- Washington University in St. Louis, Department of Physics, St. Louis, Missouri 63130-4862, USA
| | - K C Oliver-Mallory
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - J Orpwood
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - D Pagenkopf
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - S Pal
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - K J Palladino
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - J Palmer
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - M Pangilinan
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - N Parveen
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - S J Patton
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - E K Pease
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - B Penning
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - C Pereira
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - G Pereira
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - E Perry
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - T Pershing
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - I B Peterson
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - A Piepke
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - J Podczerwinski
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - D Porzio
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - S Powell
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - R M Preece
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - K Pushkin
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - Y Qie
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - B N Ratcliff
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - J Reichenbacher
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - L Reichhart
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - C A Rhyne
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Richards
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - Q Riffard
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - G R C Rischbieter
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - J P Rodrigues
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - A Rodriguez
- Black Hills State University, School of Natural Sciences, Spearfish, South Dakota 57799-0002, USA
| | - H J Rose
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - R Rosero
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - P Rossiter
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - T Rushton
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - G Rutherford
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D Rynders
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - J S Saba
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D Santone
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - A B M R Sazzad
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - R W Schnee
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - P R Scovell
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - D Seymour
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - S Shaw
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - T Shutt
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - J J Silk
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - C Silva
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - G Sinev
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - K Skarpaas
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - W Skulski
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - R Smith
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - M Solmaz
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - V N Solovov
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - P Sorensen
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Soria
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - I Stancu
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - M R Stark
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - A Stevens
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - T M Stiegler
- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
| | - K Stifter
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - R Studley
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - B Suerfu
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - T J Sumner
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - P Sutcliffe
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - N Swanson
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - M Szydagis
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - M Tan
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - D J Taylor
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - R Taylor
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - W C Taylor
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D J Temples
- Northwestern University, Department of Physics & Astronomy, Evanston, Illinois 60208-3112, USA
| | - B P Tennyson
- Yale University, Department of Physics, New Haven, Connecticut 06511-8499, USA
| | - P A Terman
- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
| | - K J Thomas
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D R Tiedt
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - M Timalsina
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - W H To
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - A Tomás
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - Z Tong
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - D R Tovey
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - J Tranter
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - M Trask
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - M Tripathi
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - D R Tronstad
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - C E Tull
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - W Turner
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - L Tvrznikova
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
- Yale University, Department of Physics, New Haven, Connecticut 06511-8499, USA
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - U Utku
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - J Va'vra
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - A Vacheret
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A C Vaitkus
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - J R Verbus
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - E Voirin
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - W L Waldron
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - A Wang
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - B Wang
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - J J Wang
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - W Wang
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
| | - Y Wang
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - J R Watson
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - R C Webb
- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
| | - A White
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D T White
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - J T White
- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
| | - R G White
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - T J Whitis
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - M Williams
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - W J Wisniewski
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - M S Witherell
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - F L H Wolfs
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - J D Wolfs
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - S Woodford
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - D Woodward
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - S D Worm
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - C J Wright
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - Q Xia
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - X Xiang
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - Q Xiao
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - J Xu
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - M Yeh
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - J Yin
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - I Young
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - P Zarzhitsky
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - A Zuckerman
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - E A Zweig
- University of Califonia, Los Angeles, Department of Physics and Astronomy, Los Angeles, California 90095-1547
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Kerscher M, Green J, Day D, Ogilvie A, Pavicic T, Lim T, Hayano W, Lorenc ZP, Hernandez C, Frank K, Moellhoff N, Prinz V, Cajkovsky M, Pooth R. Novel, Validated Five-Point Photonumeric Scales for Assessment of the Neck and Décolleté. Aesthet Surg J 2023:7058062. [PMID: 36840504 DOI: 10.1093/asj/sjad041] [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] [Received: 01/08/2023] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND A scarcity of scales which assess platysmal bands, wrinkles in the décolleté, and horizontal necklines in the digital and live setting exist. OBJECTIVES The objective of this investigation was to create and validate 5-point photo numeric scales which assess horizontal necklines, platysmal bands and wrinkles in the décolleté. METHODS A medical team created 3 different novel 5-point photonumeric scale for the assessment of horizontal necklines, platysmal bands and décolleté wrinkling. Eleven international raters were involved in the digital validation, while 4 raters performed a live validation. RESULTS The Croma Horizontal Neck Line - Assessment Scale showed substantial inter-rater agreement and almost perfect intra-rater agreement in the digital and live validations. The Croma Platysmal Bands-Assessment Scale showed substantial intra-rater agreement in both, digital and live validations. For the décolleté, a static and a dynamic scale was created and validated. The Croma Static Décolleté Wrinkling-Assessment Scale showed substantial and almost perfect inter-rater agreement in the digital validation and live-validation, respectively, while the intra-rater agreement was in both almost perfect. The Croma Dynamic Décolleté Wrinkling-Assessment Scale showed almost perfect agreement in both validation settings for both, inter-and intra-rater agreement. CONCLUSIONS The Croma Horizontal Neck Line - Assessment Scale, the Croma Static and Dynamic Décolleté Wrinkling-Assessment Scales have sufficient inter and intrarater agreements to be justifiably used in the clinical and study setting.
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Affiliation(s)
- Martina Kerscher
- Division of Cosmetic Science, Department of Chemistry, University of Hamburg, Hamburg, Germany
| | - Jeremy Green
- Physician in private practice in Coral Gables, Florida, USA
| | - Doris Day
- NYU Langone Health, New York, New York, USA
| | | | | | - Tingsong Lim
- Physician in private practice in Kuala Lumpur, Malaysia
| | - Windie Hayano
- Physician in private practice in Manila, the Philippines
| | - Z Paul Lorenc
- Department of Plastic Surgery, Lenox Hill Hospital, New York, NY, USA
| | | | | | - Nicholas Moellhoff
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Germany
| | - Valentina Prinz
- Clinical project manager at a private aesthetic clinic in Vienna, Austria
| | - Mia Cajkovsky
- Clinical project manager at a private aesthetic clinic in Vienna, Austria
| | - Rainer Pooth
- ICA Aesthetic Navigation GmbH, Frankfurt, Germany
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Kirby K, Lazaroo M, Green J, Hall H, Pilbery R, Whitley G, Voss S, Benger J. The reality of advanced airway management during out of hospital cardiac arrest; why did paramedics deviate from their allocated airway management strategy during the AIRWAYS-2 randomised trial? Resusc Plus 2023; 13:100365. [PMID: 36860989 PMCID: PMC9969270 DOI: 10.1016/j.resplu.2023.100365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/18/2023] [Accepted: 02/04/2023] [Indexed: 02/22/2023] Open
Abstract
Background AIRWAYS-2 was a large multi-centre cluster randomised controlled trial investigating the effect on functional outcome of a supraglottic airway device (i-gel) versus tracheal intubation (TI) as the initial advanced airway during out-of-hospital cardiac arrest. We aimed to understand why paramedics deviated from their allocated airway management algorithm during AIRWAYS-2. Methods This study employed a pragmatic sequential explanatory design utilising retrospective study data collected during the AIRWAYS-2 trial. Airway algorithm deviation data were analysed to categorise and quantify the reasons why paramedics did not follow their allocated strategy of airway management during AIRWAYS-2. Recorded free text entries provided additional context to the paramedic decision-making related to each category identified. Results In 680 (11.7%) of 5800 patients the study paramedic did not follow their allocated airway management algorithm. There was a higher percentage of deviations in the TI group (399/2707; 14.7%) compared to the i-gel group (281/3088; 9.1%). The predominant reason for a paramedic not following their allocated airway management strategy was airway obstruction, occurring more commonly in the i-gel group (109/281; 38.7%) versus (50/399; 12.5%) in the TI group. Conclusion There was a higher proportion of deviations from the allocated airway management algorithm in the TI group (399; 14.7%) compared to the i-gel group (281; 9.1%). The most frequent reason for deviating from the allocated airway management algorithm in AIRWAYS-2 was obstruction of the patient's airway by fluid. This occurred in both groups of the AIRWAYS-2 trial, but was more frequent in the i-gel group.
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Affiliation(s)
- K. Kirby
- University of the West of England, Bristol, United Kingdom,South Western Ambulance Service NHS Foundation Trust, Exeter, United Kingdom,Corresponding author.
| | - M. Lazaroo
- University of Bristol, Bristol, United Kingdom
| | - J. Green
- University of Plymouth, Plymouth, United Kingdom
| | - H. Hall
- James Paget University Hospital NHS Foundation Trust, Yarmouth, United Kingdom
| | - R. Pilbery
- Yorkshire Ambulance Service NHS Trust, Wakefield, United Kingdom
| | | | - S. Voss
- University of the West of England, Bristol, United Kingdom
| | - J. Benger
- University of the West of England, Bristol, United Kingdom
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Green J, Bagge ASL, Olausson S, Andiné P, Wallinius M, Karlén MH. Implementing clinical guidelines for co-occurring substance use and major mental disorders in Swedish forensic psychiatry: An exploratory, qualitative interview study with mental health care staff. J Subst Abuse Treat 2023; 144:108899. [PMID: 36270196 DOI: 10.1016/j.jsat.2022.108899] [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: 03/04/2022] [Revised: 07/04/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Patients with substance use disorders (SUD) and co-occurring mental disorders (COD) within forensic psychiatric care often suffer poor treatment outcomes and high rates of criminal recidivism, substance use, and psychiatric problems. This study aimed to describe the conditions for, and mental health care staff's experiences with, implementing integrated SUD-focused clinical guidelines, including assessment and treatment for patients with COD at a high-security forensic mental health services (FMHS) facility in Sweden. METHODS Study staff conducted nineteen semi-structured interviews with health care staff experienced in administering the new SUD assessment and treatment. The study conducted a thematic analysis to describe the health care staff's experiences with these guidelines and suggestions for improvement. RESULTS Most participants reported appreciation for the implementation of clinical guidelines with an SUD focus, an area they considered to have previously been neglected, but also noted the need for more practical guidance in the administration of the assessments. Participants reported the dual roles of caregiver and warden as difficult to reconcile and a similar, hindering division was also present in the health care staff's attitudes toward SUD. Participants' reports also described an imbalance prior to the implementation, whereby SUD was rarely assessed but treatment was still initiated. One year after the implementation, an imbalance still existed, but in reverse: SUD was more frequently assessed, but treatment was difficult to initiate. CONCLUSIONS Despite indications of some ambivalence among staff regarding the necessity of the assessment and treatment guidelines, many participants considered it helpful to have a structured way to assess and treat SUD in this patient group. The imbalance between frequent assessment and infrequent treatment may have been due to difficulties transitioning patients across the "gap" between assessment and treatment. To bridge this gap, mental health services should make efforts to increase patients' insight concerning their SUD, flexibility in the administration of treatment, and the motivational skills of the health care staff working with this patient group. Participants considered important for enhancing treatment quality a shared knowledge base regarding SUD, and increased collaboration between different professions and between in- and outpatient services.
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Affiliation(s)
- J Green
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
| | - A S Lindqvist Bagge
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - S Olausson
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - P Andiné
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Forensic Psychiatry, National Board of Forensic Medicine, Gothenburg, Sweden; Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - M Wallinius
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden
| | - M Hildebrand Karlén
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Psychology, University of Gothenburg, Gothenburg, Sweden; Department of Forensic Psychiatry, National Board of Forensic Medicine, Gothenburg, Sweden
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8
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Saggu G, Stroopinsky D, Dudek A, Olszanski A, Juric D, Dowlati A, Vaishampayan U, Assad H, Rodón J, Gibbs J, Green J, Du Z, Rudicell R, Kannan K, Gharavi R, Gomez-Pinillos A, Fram R, Berger A, Sachsenmeier K, Kasar S. Subasumstat, a first-in-class inhibitor of SUMO-activating enzyme, demonstrates dose-dependent target engagement and SUMOylation inhibition, leading to rapid activation of innate and adaptive immune responses in the dose escalation portion of a phase 1/2 clinical study. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01134-0] [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: 11/12/2022]
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Coleman E, Radix AE, Bouman WP, Brown GR, de Vries ALC, Deutsch MB, Ettner R, Fraser L, Goodman M, Green J, Hancock AB, Johnson TW, Karasic DH, Knudson GA, Leibowitz SF, Meyer-Bahlburg HFL, Monstrey SJ, Motmans J, Nahata L, Nieder TO, Reisner SL, Richards C, Schechter LS, Tangpricha V, Tishelman AC, Van Trotsenburg MAA, Winter S, Ducheny K, Adams NJ, Adrián TM, Allen LR, Azul D, Bagga H, Başar K, Bathory DS, Belinky JJ, Berg DR, Berli JU, Bluebond-Langner RO, Bouman MB, Bowers ML, Brassard PJ, Byrne J, Capitán L, Cargill CJ, Carswell JM, Chang SC, Chelvakumar G, Corneil T, Dalke KB, De Cuypere G, de Vries E, Den Heijer M, Devor AH, Dhejne C, D'Marco A, Edmiston EK, Edwards-Leeper L, Ehrbar R, Ehrensaft D, Eisfeld J, Elaut E, Erickson-Schroth L, Feldman JL, Fisher AD, Garcia MM, Gijs L, Green SE, Hall BP, Hardy TLD, Irwig MS, Jacobs LA, Janssen AC, Johnson K, Klink DT, Kreukels BPC, Kuper LE, Kvach EJ, Malouf MA, Massey R, Mazur T, McLachlan C, Morrison SD, Mosser SW, Neira PM, Nygren U, Oates JM, Obedin-Maliver J, Pagkalos G, Patton J, Phanuphak N, Rachlin K, Reed T, Rider GN, Ristori J, Robbins-Cherry S, Roberts SA, Rodriguez-Wallberg KA, Rosenthal SM, Sabir K, Safer JD, Scheim AI, Seal LJ, Sehoole TJ, Spencer K, St Amand C, Steensma TD, Strang JF, Taylor GB, Tilleman K, T'Sjoen GG, Vala LN, Van Mello NM, Veale JF, Vencill JA, Vincent B, Wesp LM, West MA, Arcelus J. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. Int J Transgend Health 2022; 23:S1-S259. [PMID: 36238954 PMCID: PMC9553112 DOI: 10.1080/26895269.2022.2100644] [Citation(s) in RCA: 455] [Impact Index Per Article: 227.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.
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Affiliation(s)
- E Coleman
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A E Radix
- Callen-Lorde Community Health Center, New York, NY, USA
- Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - W P Bouman
- Nottingham Centre for Transgender Health, Nottingham, UK
- School of Medicine, University of Nottingham, Nottingham, UK
| | - G R Brown
- James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
- James H. Quillen VAMC, Johnson City, TN, USA
| | - A L C de Vries
- Department of Child and Adolescent Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M B Deutsch
- Department of Family & Community Medicine, University of California-San Francisco, San Francisco, CA, USA
- UCSF Gender Affirming Health Program, San Francisco, CA, USA
| | - R Ettner
- New Health Foundation Worldwide, Evanston, IL, USA
- Weiss Memorial Hospital, Chicago, IL, USA
| | - L Fraser
- Independent Practice, San Francisco, CA, USA
| | - M Goodman
- Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - J Green
- Independent Scholar, Vancouver, WA, USA
| | - A B Hancock
- The George Washington University, Washington, DC, USA
| | - T W Johnson
- Department of Anthropology, California State University, Chico, CA, USA
| | - D H Karasic
- University of California San Francisco, San Francisco, CA, USA
- Independent Practice at dankarasic.com
| | - G A Knudson
- University of British Columbia, Vancouver, Canada
- Vancouver Coastal Health, Vancouver, Canada
| | - S F Leibowitz
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - H F L Meyer-Bahlburg
- New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | | | - J Motmans
- Transgender Infopunt, Ghent University Hospital, Gent, Belgium
- Centre for Research on Culture and Gender, Ghent University, Gent, Belgium
| | - L Nahata
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Endocrinology and Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - T O Nieder
- University Medical Center Hamburg-Eppendorf, Interdisciplinary Transgender Health Care Center Hamburg, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Hamburg, Germany
| | - S L Reisner
- Harvard Medical School, Boston, MA, USA
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - C Richards
- Regents University London, UK
- Tavistock and Portman NHS Foundation Trust, London, UK
| | | | - V Tangpricha
- Division of Endocrinology, Metabolism & Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Atlanta VA Medical Center, Decatur, GA, USA
| | - A C Tishelman
- Boston College, Department of Psychology and Neuroscience, Chestnut Hill, MA, USA
| | - M A A Van Trotsenburg
- Bureau GenderPRO, Vienna, Austria
- University Hospital Lilienfeld-St. Pölten, St. Pölten, Austria
| | - S Winter
- School of Population Health, Curtin University, Perth, WA, Australia
| | - K Ducheny
- Howard Brown Health, Chicago, IL, USA
| | - N J Adams
- University of Toronto, Ontario Institute for Studies in Education, Toronto, Canada
- Transgender Professional Association for Transgender Health (TPATH)
| | - T M Adrián
- Asamblea Nacional de Venezuela, Caracas, Venezuela
- Diverlex Diversidad e Igualdad a Través de la Ley, Caracas, Venezuela
| | - L R Allen
- University of Nevada, Las Vegas, NV, USA
| | - D Azul
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - H Bagga
- Monash Health Gender Clinic, Melbourne, Victoria, Australia
- Monash University, Melbourne, Victoria, Australia
| | - K Başar
- Department of Psychiatry, Hacettepe University, Ankara, Turkey
| | - D S Bathory
- Independent Practice at Bathory International PLLC, Winston-Salem, NC, USA
| | - J J Belinky
- Durand Hospital, Guemes Clinic and Urological Center, Buenos Aires, Argentina
| | - D R Berg
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J U Berli
- Oregon Health & Science University, Portland, OR, USA
| | - R O Bluebond-Langner
- NYU Langone Health, New York, NY, USA
- Hansjörg Wyss Department of Plastic Surgery, New York, NY, USA
| | - M-B Bouman
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Plastic Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - M L Bowers
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mills-Peninsula Medical Center, Burlingame, CA, USA
| | - P J Brassard
- GrS Montreal, Complexe CMC, Montreal, Quebec, Canada
- Université de Montreal, Quebec, Canada
| | - J Byrne
- University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
| | - L Capitán
- The Facialteam Group, Marbella International Hospital, Marbella, Spain
| | | | - J M Carswell
- Harvard Medical School, Boston, MA, USA
- Boston's Children's Hospital, Boston, MA, USA
| | - S C Chang
- Independent Practice, Oakland, CA, USA
| | - G Chelvakumar
- Nationwide Children's Hospital, Columbus, OH, USA
- The Ohio State University, College of Medicine, Columbus, OH, USA
| | - T Corneil
- School of Population & Public Health, University of British Columbia, Vancouver, BC, Canada
| | - K B Dalke
- Penn State Health, PA, USA
- Penn State College of Medicine, Hershey, PA, USA
| | - G De Cuypere
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
| | - E de Vries
- Nelson Mandela University, Gqeberha, South Africa
- University of Cape Town, Cape Town, South Africa
| | - M Den Heijer
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Endocrinology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - A H Devor
- University of Victoria, Victoria, BC, Canada
| | - C Dhejne
- ANOVA, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - A D'Marco
- UCTRANS-United Caribbean Trans Network, Nassau, The Bahamas
- D M A R C O Organization, Nassau, The Bahamas
| | - E K Edmiston
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - L Edwards-Leeper
- Pacific University, Hillsboro, OR, USA
- Independent Practice, Beaverton, OR, USA
| | - R Ehrbar
- Whitman Walker Health, Washington, DC, USA
- Independent Practice, Maryland, USA
| | - D Ehrensaft
- University of California San Francisco, San Francisco, CA, USA
| | - J Eisfeld
- Transvisie, Utrecht, The Netherlands
| | - E Elaut
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
- Department of Clinical Experimental and Health Psychology, Ghent University, Gent, Belgium
| | - L Erickson-Schroth
- The Jed Foundation, New York, NY, USA
- Hetrick-Martin Institute, New York, NY, USA
| | - J L Feldman
- Institute for Sexual and Gender Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A D Fisher
- Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
| | - M M Garcia
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Departments of Urology and Anatomy, University of California San Francisco, San Francisco, CA, USA
| | - L Gijs
- Institute of Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | | | - B P Hall
- Duke University Medical Center, Durham, NC, USA
- Duke Adult Gender Medicine Clinic, Durham, NC, USA
| | - T L D Hardy
- Alberta Health Services, Edmonton, Alberta, Canada
- MacEwan University, Edmonton, Alberta, Canada
| | - M S Irwig
- Harvard Medical School, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - A C Janssen
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - K Johnson
- RMIT University, Melbourne, Australia
- University of Brighton, Brighton, UK
| | - D T Klink
- Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Gent, Belgium
- Division of Pediatric Endocrinology and Diabetes, ZNA Queen Paola Children's Hospital, Antwerp, Belgium
| | - B P C Kreukels
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - L E Kuper
- Department of Psychiatry, Southwestern Medical Center, University of Texas, Dallas, TX, USA
- Department of Endocrinology, Children's Health, Dallas, TX, USA
| | - E J Kvach
- Denver Health, Denver, CO, USA
- University of Colorado School of Medicine, Aurora, CO, USA
| | - M A Malouf
- Malouf Counseling and Consulting, Baltimore, MD, USA
| | - R Massey
- WPATH Global Education Institute
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - T Mazur
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- John R. Oishei Children's Hospital, Buffalo, NY, USA
| | - C McLachlan
- Professional Association for Transgender Health, South Africa
- Gender DynamiX, Cape Town, South Africa
| | - S D Morrison
- Division of Plastic Surgery, Seattle Children's Hospital, Seattle, WA, USA
- Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA
| | - S W Mosser
- Gender Confirmation Center, San Francisco, CA, USA
- Saint Francis Memorial Hospital, San Francisco, CA, USA
| | - P M Neira
- Johns Hopkins Center for Transgender Health, Baltimore, MD, USA
- Johns Hopkins Medicine Office of Diversity, Inclusion and Health Equity, Baltimore, MD, USA
| | - U Nygren
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden
| | - J M Oates
- La Trobe University, Melbourne, Australia
- Melbourne Voice Analysis Centre, East Melbourne, Australia
| | - J Obedin-Maliver
- Stanford University School of Medicine, Department of Obstetrics and Gynecology, Palo Alto, CA, USA
- Department of Epidemiology and Population Health, Stanford, CA, USA
| | - G Pagkalos
- Independent PracticeThessaloniki, Greece
- Military Community Mental Health Center, 424 General Military Training Hospital, Thessaloniki, Greece
| | - J Patton
- Talkspace, New York, NY, USA
- CytiPsychological LLC, San Diego, CA, USA
| | - N Phanuphak
- Institute of HIV Research and Innovation, Bangkok, Thailand
| | - K Rachlin
- Independent Practice, New York, NY, USA
| | - T Reed
- Gender Identity Research and Education Society, Leatherhead, UK
| | - G N Rider
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J Ristori
- Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
| | | | - S A Roberts
- Harvard Medical School, Boston, MA, USA
- Division of Endocrinology, Boston's Children's Hospital, Boston, MA, USA
| | - K A Rodriguez-Wallberg
- Department of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | - S M Rosenthal
- Division of Pediatric Endocrinology, UCSF, San Francisco, CA, USA
- UCSF Child and Adolescent Gender Center
| | - K Sabir
- FtM Phoenix Group, Krasnodar Krai, Russia
| | - J D Safer
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mount Sinai Center for Transgender Medicine and Surgery, New York, NY, USA
| | - A I Scheim
- Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | - L J Seal
- Tavistock and Portman NHS Foundation Trust, London, UK
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | - K Spencer
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - C St Amand
- University of Houston, Houston, TX, USA
- Mayo Clinic, Rochester, MN, USA
| | - T D Steensma
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - J F Strang
- Children's National Hospital, Washington, DC, USA
- George Washington University School of Medicine, Washington, DC, USA
| | - G B Taylor
- Atrium Health Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Charlotte, NC, USA
| | - K Tilleman
- Department for Reproductive Medicine, Ghent University Hospital, Gent, Belgium
| | - G G T'Sjoen
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
- Department of Endocrinology, Ghent University Hospital, Gent, Belgium
| | - L N Vala
- Independent Practice, Campbell, CA, USA
| | - N M Van Mello
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Obstetrics and Gynaecology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - J F Veale
- School of Psychology, University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
| | - J A Vencill
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - B Vincent
- Trans Learning Partnership at https://spectra-london.org.uk/trans-learning-partnership, UK
| | - L M Wesp
- College of Nursing, University of Wisconsin MilwaukeeMilwaukee, WI, USA
- Health Connections Inc., Glendale, WI, USA
| | - M A West
- North Memorial Health Hospital, Robbinsdale, MN, USA
- University of Minnesota, Minneapolis, MN, USA
| | - J Arcelus
- School of Medicine, University of Nottingham, Nottingham, UK
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
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Powles T, Sridhar S, Bellmunt J, Sternberg C, Grivas P, Hunter E, Dezfouli M, Salter M, Powell R, Dring A, Green J, Akoulitchev A, Amezquita R, Ching K, Pu J, Deng S, di Pietro A, Davis C. LBA74 Genomic biomarkers in peripheral blood (PB) from patients (pts) enrolled in the JAVELIN Bladder 100 trial of avelumab first-line (1L) maintenance in advanced urothelial carcinoma (aUC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.08.080] [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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Green J, Jakins C, Asfaw E, Parker A, de Waal L, D'Cruze N. Welfare concerns associated with captive lions ( Panthera leo) and the implications for commercial lion farms in South Africa. Anim Welf 2022. [DOI: 10.7120/09627286.31.2.005] [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: 11/05/2022]
Abstract
Breeding and housing wild animals in captive environments can pose challenges for their welfare. In South Africa, thousands of lions (Panthera leo) are bred and raised at commercial captive breeding facilities, so called 'lion farms', for use in tourism, trophy hunting and traditional
medicine. To gain a better understanding of the potential welfare challenges faced by lions on farms we reviewed 91 peer-reviewed articles relating to lion welfare, identified via a systematic review of the scientific literature. Across these studies, we identified 170 different terms relating
to negative behaviours and physical health afflictions. The majority of these terms were associated with disease and injury (124; 73%), followed by negative behaviours (19; 11%), negative mental experiences (15; 9%), nutritional concerns (7; 4%), and environmental challenges or discomfort
arising from the animal's surroundings (5; 3%). Of the 91 articles, 32 (35%) focused on data concerning captive lions. Only two studies focused specifically on data obtained from lion farms in South Africa, whilst the remainder reported on data collected from zoos, wildlife parks, sanctuaries,
game reserves and private ownership. Our preliminary review of the scientific literature draws attention to some of the challenges associated with caring for lions in captivity, and outlines the potential significance of these welfare challenges for commercial lion farms. Our data highlight
the apparent lack of scientific research involving captive lion welfare generally, particularly data collected at commercial breeding facilities in South Africa and the consequences this could have for the welfare of thousands of lions within the industry.
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Affiliation(s)
- J Green
- World Animal Protection, 222 Grayâ–™s Inn Rd, London WC1X 8HB, UK
| | - C Jakins
- Blood Lions NPC, PO Box 1154, Hermanus 7200, South Africa
| | - E Asfaw
- World Animal Protection, 222 Grayâ–™s Inn Rd, London WC1X 8HB, UK
| | - A Parker
- World Animal Protection, 222 Grayâ–™s Inn Rd, London WC1X 8HB, UK
| | - L de Waal
- Blood Lions NPC, PO Box 1154, Hermanus 7200, South Africa
| | - N D'Cruze
- Wildlife Conservation Research Unit, Department of Zoology, University of Oxford, Recanati-Kaplan Centre, Tubney House, Abingdon Road, Tubney, Abingdon OX13 5QL, UK
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Ware J, Boughton CK, Allen JM, Wilinska ME, Tauschmann M, Denvir L, Thankamony A, Campbell FM, Wadwa RP, Buckingham BA, Davis N, DiMeglio LA, Mauras N, Besser REJ, Ghatak A, Weinzimer SA, Hood KK, Fox DS, Kanapka L, Kollman C, Sibayan J, Beck RW, Hovorka R, Hovorka R, Acerini CL, Thankamony A, Allen JM, Boughton CK, Dovc K, Dunger DB, Ware J, Musolino G, Tauschmann M, Wilinska ME, Hayes JF, Hartnell S, Slegtenhorst S, Ruan Y, Haydock M, Mangat J, Denvir L, Kanthagnany SK, Law J, Randell T, Sachdev P, Saxton M, Coupe A, Stafford S, Ball A, Keeton R, Cresswell R, Crate L, Cripps H, Fazackerley H, Looby L, Navarra H, Saddington C, Smith V, Verhoeven V, Bratt S, Khan N, Moyes L, Sandhu K, West C, Wadwa RP, Alonso G, Forlenza G, Slover R, Towers L, Berget C, Coakley A, Escobar E, Jost E, Lange S, Messer L, Thivener K, Campbell FM, Yong J, Metcalfe E, Allen M, Ambler S, Waheed S, Exall J, Tulip J, Buckingham BA, Ekhlaspour L, Maahs D, Norlander L, Jacobson T, Twon M, Weir C, Leverenz B, Keller J, Davis N, Kumaran A, Trevelyan N, Dewar H, Price G, Crouch G, Ensom R, Haskell L, Lueddeke LM, Mauras N, Benson M, Bird K, Englert K, Permuy J, Ponthieux K, Marrero-Hernandez J, DiMeglio LA, Ismail H, Jolivette H, Sanchez J, Woerner S, Kirchner M, Mullen M, Tebbe M, Besser REJ, Basu S, London R, Makaya T, Ryan F, Megson C, Bowen-Morris J, Haest J, Law R, Stamford I, Ghatak A, Deakin M, Phelan K, Thornborough K, Shakeshaft J, Weinzimer SA, Cengiz E, Sherr JL, Van Name M, Weyman K, Carria L, Steffen A, Zgorski M, Sibayan J, Beck RW, Borgman S, Davis J, Rusnak J, Hellman A, Cheng P, Kanapka L, Kollman C, McCarthy C, Chalasani S, Hood KK, Hanes S, Viana J, Lanning M, Fox DS, Arreaza-Rubin G, Eggerman T, Green N, Janicek R, Gabrielson D, Belle SH, Castle J, Green J, Legault L, Willi SM, Wysham C. Cambridge hybrid closed-loop algorithm in children and adolescents with type 1 diabetes: a multicentre 6-month randomised controlled trial. Lancet Digit Health 2022; 4:e245-e255. [PMID: 35272971 DOI: 10.1016/s2589-7500(22)00020-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 12/10/2021] [Accepted: 01/25/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Closed-loop insulin delivery systems have the potential to address suboptimal glucose control in children and adolescents with type 1 diabetes. We compared safety and efficacy of the Cambridge hybrid closed-loop algorithm with usual care over 6 months in this population. METHODS In a multicentre, multinational, parallel randomised controlled trial, participants aged 6-18 years using insulin pump therapy were recruited at seven UK and five US paediatric diabetes centres. Key inclusion criteria were diagnosis of type 1 diabetes for at least 12 months, insulin pump therapy for at least 3 months, and screening HbA1c levels between 53 and 86 mmol/mol (7·0-10·0%). Using block randomisation and central randomisation software, we randomly assigned participants to either closed-loop insulin delivery (closed-loop group) or to usual care with insulin pump therapy (control group) for 6 months. Randomisation was stratified at each centre by local baseline HbA1c. The Cambridge closed-loop algorithm running on a smartphone was used with either (1) a modified Medtronic 640G pump, Medtronic Guardian 3 sensor, and Medtronic prototype phone enclosure (FlorenceM configuration), or (2) a Sooil Dana RS pump and Dexcom G6 sensor (CamAPS FX configuration). The primary endpoint was change in HbA1c at 6 months combining data from both configurations. The primary analysis was done in all randomised patients (intention to treat). Trial registration ClinicalTrials.gov, NCT02925299. FINDINGS Of 147 people initially screened, 133 participants (mean age 13·0 years [SD 2·8]; 57% female, 43% male) were randomly assigned to either the closed-loop group (n=65) or the control group (n=68). Mean baseline HbA1c was 8·2% (SD 0·7) in the closed-loop group and 8·3% (0·7) in the control group. At 6 months, HbA1c was lower in the closed-loop group than in the control group (between-group difference -3·5 mmol/mol (95% CI -6·5 to -0·5 [-0·32 percentage points, -0·59 to -0·04]; p=0·023). Closed-loop usage was low with FlorenceM due to failing phone enclosures (median 40% [IQR 26-53]), but consistently high with CamAPS FX (93% [88-96]), impacting efficacy. A total of 155 adverse events occurred after randomisation (67 in the closed-loop group, 88 in the control group), including seven severe hypoglycaemia events (four in the closed-loop group, three in the control group), two diabetic ketoacidosis events (both in the closed-loop group), and two non-treatment-related serious adverse events. There were 23 reportable hyperglycaemia events (11 in the closed-loop group, 12 in the control group), which did not meet criteria for diabetic ketoacidosis. INTERPRETATION The Cambridge hybrid closed-loop algorithm had an acceptable safety profile, and improved glycaemic control in children and adolescents with type 1 diabetes. To ensure optimal efficacy of the closed-loop system, usage needs to be consistently high, as demonstrated with CamAPS FX. FUNDING National Institute of Diabetes and Digestive and Kidney Diseases.
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Odlozilik B, Chaudhary P, Mcmurray A, Ahmed H, Doria D, Mcilvenny A, Milluzzo G, Botchway S, Green J, Greenwood B, Kar S, Martin P, Mccallum S, Petringa G, Catalano R, Borghesi M, Cirrone G. EFFECTIVENESS OF ULTRA-HIGH DOSE RATE PROTON CELL KILLING IN 2D AND 3D GLIOBLASTOMA. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01596-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Milluzzo G, Chaudhary P, Ahmed H, Romagnani L, Doria D, Green J, Greenwood B, Mcilvenny A, Kar S, Maiorino C, Mccallum S, Mcmurray A, Odlozilik B, Katzir Y, Pattahil R, Polin K, Prise K, Borghesi M. FLASH Modalities Track (Oral Presentations) DOSIMETRY AND BEAM DELIVERY ARRANGEMENTS FOR SINGLE-SHOT, ULTRA-HIGH DOSE-RATE RADIOBIOLOGY EXPERIMENTS EMPLOYING LASER-ACCELERATED IONS. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01541-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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McGuinness AJ, Davis JA, Dawson SL, Loughman A, Collier F, O’Hely M, Simpson CA, Green J, Marx W, Hair C, Guest G, Mohebbi M, Berk M, Stupart D, Watters D, Jacka FN. A systematic review of gut microbiota composition in observational studies of major depressive disorder, bipolar disorder and schizophrenia. Mol Psychiatry 2022; 27:1920-1935. [PMID: 35194166 PMCID: PMC9126816 DOI: 10.1038/s41380-022-01456-3] [Citation(s) in RCA: 146] [Impact Index Per Article: 73.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 12/22/2021] [Accepted: 01/18/2022] [Indexed: 02/07/2023]
Abstract
The emerging understanding of gut microbiota as 'metabolic machinery' influencing many aspects of physiology has gained substantial attention in the field of psychiatry. This is largely due to the many overlapping pathophysiological mechanisms associated with both the potential functionality of the gut microbiota and the biological mechanisms thought to be underpinning mental disorders. In this systematic review, we synthesised the current literature investigating differences in gut microbiota composition in people with the major psychiatric disorders, major depressive disorder (MDD), bipolar disorder (BD) and schizophrenia (SZ), compared to 'healthy' controls. We also explored gut microbiota composition across disorders in an attempt to elucidate potential commonalities in the microbial signatures associated with these mental disorders. Following the PRISMA guidelines, databases were searched from inception through to December 2021. We identified 44 studies (including a total of 2510 psychiatric cases and 2407 controls) that met inclusion criteria, of which 24 investigated gut microbiota composition in MDD, seven investigated gut microbiota composition in BD, and 15 investigated gut microbiota composition in SZ. Our syntheses provide no strong evidence for a difference in the number or distribution (α-diversity) of bacteria in those with a mental disorder compared to controls. However, studies were relatively consistent in reporting differences in overall community composition (β-diversity) in people with and without mental disorders. Our syntheses also identified specific bacterial taxa commonly associated with mental disorders, including lower levels of bacterial genera that produce short-chain fatty acids (e.g. butyrate), higher levels of lactic acid-producing bacteria, and higher levels of bacteria associated with glutamate and GABA metabolism. We also observed substantial heterogeneity across studies with regards to methodologies and reporting. Further prospective and experimental research using new tools and robust guidelines hold promise for improving our understanding of the role of the gut microbiota in mental and brain health and the development of interventions based on modification of gut microbiota.
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Affiliation(s)
- A. J. McGuinness
- grid.1021.20000 0001 0526 7079The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine and Barwon Health, Deakin University, Geelong, VIC Australia
| | - J. A. Davis
- grid.1021.20000 0001 0526 7079The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine and Barwon Health, Deakin University, Geelong, VIC Australia
| | - S. L. Dawson
- grid.1021.20000 0001 0526 7079The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine and Barwon Health, Deakin University, Geelong, VIC Australia ,grid.1058.c0000 0000 9442 535XMurdoch Children’s Research Institute, Parkville, VIC Australia
| | - A. Loughman
- grid.1021.20000 0001 0526 7079The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine and Barwon Health, Deakin University, Geelong, VIC Australia
| | - F. Collier
- grid.1021.20000 0001 0526 7079The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine and Barwon Health, Deakin University, Geelong, VIC Australia
| | - M. O’Hely
- grid.1021.20000 0001 0526 7079The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine and Barwon Health, Deakin University, Geelong, VIC Australia ,grid.1058.c0000 0000 9442 535XMurdoch Children’s Research Institute, Parkville, VIC Australia
| | - C. A. Simpson
- grid.1008.90000 0001 2179 088XMelbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC Australia ,grid.1008.90000 0001 2179 088XMelbourne Neuropsychiatry Centre, Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne and Melbourne Health, Melbourne, VIC Australia
| | - J. Green
- grid.1021.20000 0001 0526 7079The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine and Barwon Health, Deakin University, Geelong, VIC Australia ,grid.1002.30000 0004 1936 7857Monash Alfred Psychiatry Research Centre (MAPcr), Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Parkville, VIC Australia ,grid.466993.70000 0004 0436 2893Department of Psychiatry, Peninsula Health, Frankston, VIC Australia
| | - W. Marx
- grid.1021.20000 0001 0526 7079The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine and Barwon Health, Deakin University, Geelong, VIC Australia
| | - C. Hair
- grid.1021.20000 0001 0526 7079Deakin University, School of Medicine, Geelong, VIC Australia ,grid.414257.10000 0004 0540 0062Department of Gastroenterology, Barwon Health, Geelong, VIC Australia
| | - G. Guest
- grid.1021.20000 0001 0526 7079Deakin University, School of Medicine, Geelong, VIC Australia ,grid.415335.50000 0000 8560 4604Department of Surgery, University Hospital Geelong, Barwon Health, Geelong, VIC Australia
| | - M. Mohebbi
- grid.1021.20000 0001 0526 7079Biostatistics Unit, Faculty of Health, Deakin University, Melbourne, VIC Australia
| | - M. Berk
- grid.1021.20000 0001 0526 7079The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine and Barwon Health, Deakin University, Geelong, VIC Australia ,grid.1021.20000 0001 0526 7079Deakin University, School of Medicine, Geelong, VIC Australia ,grid.1008.90000 0001 2179 088XOrygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - D. Stupart
- grid.1021.20000 0001 0526 7079Deakin University, School of Medicine, Geelong, VIC Australia ,grid.415335.50000 0000 8560 4604Department of Surgery, University Hospital Geelong, Barwon Health, Geelong, VIC Australia
| | - D. Watters
- grid.1021.20000 0001 0526 7079Deakin University, School of Medicine, Geelong, VIC Australia ,grid.415335.50000 0000 8560 4604Department of Surgery, University Hospital Geelong, Barwon Health, Geelong, VIC Australia
| | - F. N. Jacka
- grid.1021.20000 0001 0526 7079The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine and Barwon Health, Deakin University, Geelong, VIC Australia ,grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, VIC Australia ,grid.418393.40000 0001 0640 7766Black Dog Institute, Sydney, NSW Australia ,grid.1011.10000 0004 0474 1797College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, QLD Australia
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Moradi A, Green J, Cohen J, Joseph J, Dakovic R, Odena G, Verma A, Scher R. Effectiveness and Safety of Calcium Hydroxylapatite With Lidocaine for Improving Jawline Contour. J Drugs Dermatol 2021; 20:1231-1238. [PMID: 34784131 DOI: 10.36849/jdd.6442] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND One of the early signs of aging is loss of jawline contour. Not all cases require surgical intervention and soft-tissue augmentation with injectable fillers may restore the profile and youthful appearance of the jawline. OBJECTIVE To demonstrate the effectiveness and safety of calcium hydroxylapatite with lidocaine [CaHA (+); Radiesse® (+)] to improve the contour of jawline after deep (subdermal and/or supraperiosteal) injection. METHODS Healthy eligible patients with moderate or severe ratings on the Merz Jawline Assessment Scale (MJAS) were randomized 2:1 to treatment with CaHA (+) or to control. Patients in the control group remained untreated until week 12, then received delayed treatment. Touch-ups were allowed in both groups, and re-treatment was allowed in the treatment group only. Effectiveness was evaluated on the MJAS, patient and investigator Global Aesthetic Improvement Scales, and FACE-Q™ questionnaires. Adverse events were recorded over a 60-week period. RESULTS Treatment response rate (≥1-point MJAS improvement) was 93/123 (75.6%) for the treatment group and 5/57 (8.8%) for the control/delayed-treatment group at week 12. The difference between response rates was statistically significant (P<0.0001), showing superiority of treatment over control. Satisfaction with aesthetic improvement was reported by patients and treating investigators throughout the study. A total of 76/113 (67.3%) patients who responded to treatment 12 weeks after initial injection also demonstrated persistent improvement 48 weeks after initial treatment. The study demonstrated a favorable safety profile, with no reported unexpected adverse events. CONCLUSIONS CaHA (+) is a safe and effective treatment for improving the contour of the jawline. J Drugs Dermatol. 2021;20(11): 1231-1238. doi:10.36849/JDD.6442.
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Margariti C, Gannon K, Thompson R, Walsh J, Green J. Experiences of UK African-Caribbean prostate cancer survivors of discharge to primary care. Ethn Health 2021; 26:1115-1129. [PMID: 30987446 DOI: 10.1080/13557858.2019.1606162] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 02/22/2018] [Accepted: 04/02/2019] [Indexed: 06/09/2023]
Abstract
Objective: Black men are three times more likely to develop prostate cancer (PCa), to do so at a younger age and to experience a more aggressive form than White men. This study aims to understand the experiences of African-Caribbean men with respect to their discharge to primary care following successful PCa treatment and the challenges associated with survivorship.Design: Eight African-Caribbean men, who had been successfully treated for PCa, were recruited through the charity BME Cancer Communities. They participated in a focus group, which took place on the premises of the charity and was audio-recorded. The recording was transcribed and the data were analysed employing thematic analysis.Results: Three overarching themes were developed: Discharge - misconceptions and uncertainties; Survivorship - challenges and ways of coping; Black men and PCa: real and potential discrimination. Participants expressed concerns regarding the lack of information and clarity about what discharge meant, the quality of follow-up care, especially the levels of specialist knowledge among GPs, and the impact of side-effects, particularly erectile dysfunction (ED). Participants linked ED with stereotypes of Black male sexuality, particularly in relation to difficulties of expressing their emotions and psychological distress. African-Caribbean men face particular challenges in dealing with the side-effects of treatment for PCa, which are linked to socially-constructed ideas of masculinity.Conclusion: There needs to be a greater focus in primary care on understanding these issues and providing individualised culturally-sensitive care. In particular, GPs should be aware of sensitivities concerning help-seeking related to culturally-mediated understandings of masculinity.
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Affiliation(s)
- C Margariti
- School of Psychology, University of East London, London, UK
| | - K Gannon
- School of Psychology, University of East London, London, UK
| | - R Thompson
- Director of Black and Minority Ethnic (BME) Cancer Communities, Nottingham, UK
| | - J Walsh
- School of Psychology, University of East London, London, UK
| | - J Green
- Clinical Lecturer in Oncological Surgery, Institute of Oncology, Queen Mary & Westfield College, London, UK
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Hudson J, Green J, Clancy J, Roman C. 322: Communities of color provide insights about engagement barriers. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01746-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: 10/20/2022]
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19
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Odedra A, Allchorne P, Parker M, Lee J, Moyo-Gnahui S, Green J. 564 Freedom from Urethral Catherisation – Using QI Methodology to Improve Patient Outcome and Experiences. Br J Surg 2021. [DOI: 10.1093/bjs/znab258.047] [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
Aim
To reduce catheter burden on patients who could instead be free of urethral catheter and taught intermittent self-catheterisation (ISC).
Method
2 PDSA (Plan, Do, Study, Act) cycles were performed over a 21-month period from February 2018 to November 2020. Using multiple nurse-led TWOC clinics, data was extracted using nurse-completed proformas and electronic patient records to determine: TWOC rate; urethral catheter-free rate; and ISC rate. Following baseline measurement, interventions were made, such as centralisation of TWOC services, emphasis on ISC teaching and the introduction of industry-nurse led clinics.
Results
At baseline, TWOC rate, urethral catheter-free rate and ISC rate were 55.7%, 68% and 28.2%, respectively. Following centralisation of TWOC services and emphasis on ISC teaching in Cycle 1, urethral catheter-free rate rose to 77.8% whilst ISC rate fell to 25%. Cycle 2 followed the introduction of industry-nurse led clinics. Following this, urethral catheter-free rate rose further to 81.6%, with ISC rate rising dramatically to 56.3%
Conclusions
To those capable, ISC frees patients of catheter burden and its sequalae. Evidently, a greater onus on ISC training will increase the number of patients left catheter-free.
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Affiliation(s)
- A Odedra
- Whipps Cross University Hospital, Barts Health NHS Trust, London, United Kingdom
| | - P Allchorne
- Whipps Cross University Hospital, Barts Health NHS Trust, London, United Kingdom
| | - M Parker
- Whipps Cross University Hospital, Barts Health NHS Trust, London, United Kingdom
| | - J Lee
- Whipps Cross University Hospital, Barts Health NHS Trust, London, United Kingdom
| | - S Moyo-Gnahui
- Whipps Cross University Hospital, Barts Health NHS Trust, London, United Kingdom
| | - J Green
- Whipps Cross University Hospital, Barts Health NHS Trust, London, United Kingdom
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20
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Winters D, Mehmi A, Menzies-Wilson R, Folkard S, Ryan K, Sevdalis N, Green J. 123 Supporting A Learning System in Paediatric Emergency Pathways; Using Organisational Comparisons, Serious Incidents and Near Miss Events To Improve The Diagnosis And Treatment Of Testicular Torsion. Br J Surg 2021. [DOI: 10.1093/bjs/znab258.014] [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
Scrotal pain is a common presentation to the emergency department requiring prompt investigation and management to identify testicular torsion. Using national data we aim to identify key suboptimal areas in the acute diagnosis and management of testicular torsion with a view to improving outcomes.
Method
A freedom of information request was made to all Trusts in England that manage testicular torsion. Serious Incidents (SI's) were analysed to see if those with Paediatric Emergency Departments fared better than those without. In addition, a qualitative thematic analysis of the NHS England Strategic Executive Information System database from 2007-2019 was undertaken, identifying common themes associated with orchidectomies and ‘near miss’ events in children.
Results
304 serious incidents were returned with 62 Orchidectomies and 242 Near Miss Events. Misdiagnosis of symptomatic testicle was not significant when comparing ED to specialists (OR = 1.46, p = 0.3842). Atypical presentation resulting in orchidectomy was significant when comparing ED to specialists (OR = 6, p = 0.0355). Near miss events are due to a variety of factors. There was no statistical significance in incidents when comparing ED's caring for all ages with Paediatric EDs U = 807.5, z = -1.124, p = 0.261.
Conclusions
There's a need for education in ED about atypical presentation of testicular torsion and examination of scrotum in cases of lower abdominal pain. It's also vital that specialist teams are cognisant of the standard operating procedures relevant to scrotal pain. Finally, there should be a drive for annual audit in Urology and ED units with regards to testicular torsion as SI's may be under-reported.
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Affiliation(s)
- D Winters
- Whipps Cross Hospital, London, United Kingdom
| | - A Mehmi
- Whipps Cross Hospital, London, United Kingdom
| | | | - S Folkard
- Maidstone Hospital, Kent, United Kingdom
| | - K Ryan
- Royal London Hospital, London, United Kingdom
| | - N Sevdalis
- King College London, London, United Kingdom
| | - J Green
- Whipps Cross Hospital, London, United Kingdom
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21
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Bae J, Kapse S, Singh G, Gattu R, Ali S, Shah N, Marshall C, Pierce J, Phatak T, Gupta A, Green J, Madan N, Prasanna P. Predicting Clinical Outcomes in COVID-19 using Radiomics and Deep Learning on Chest Radiographs: A Multi-Institutional Study. ArXiv 2021:arXiv:2007.08028v2. [PMID: 32699815 PMCID: PMC7373136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Revised: 07/01/2021] [Indexed: 06/11/2023]
Abstract
We predict mechanical ventilation requirement and mortality using computational modeling of chest radiographs (CXRs) for coronavirus disease 2019 (COVID-19) patients. This two-center, retrospective study analyzed 530 deidentified CXRs from 515 COVID-19 patients treated at Stony Brook University Hospital and Newark Beth Israel Medical Center between March and August 2020. DL and machine learning classifiers to predict mechanical ventilation requirement and mortality were trained and evaluated using patient CXRs. A novel radiomic embedding framework was also explored for outcome prediction. All results are compared against radiologist grading of CXRs (zone-wise expert severity scores). Radiomic and DL classification models had mAUCs of 0.78+/-0.02 and 0.81+/-0.04, compared with expert scores mAUCs of 0.75+/-0.02 and 0.79+/-0.05 for mechanical ventilation requirement and mortality prediction, respectively. Combined classifiers using both radiomics and expert severity scores resulted in mAUCs of 0.79+/-0.04 and 0.83+/-0.04 for each prediction task, demonstrating improvement over either artificial intelligence or radiologist interpretation alone. Our results also suggest instances where inclusion of radiomic features in DL improves model predictions, something that might be explored in other pathologies. The models proposed in this study and the prognostic information they provide might aid physician decision making and resource allocation during the COVID-19 pandemic.
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22
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Menzies-Wilson R, Folkard S, Winters D, Sevdalis N, Green J. Testicular torsion serious incidents: Lessons from England to improve outcomes. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01451-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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23
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Larkin L, Moses A, Gallagher S, Fraser A, Esbensen BA, Green J, Glynn L, Kennedy N. AB0872-HPR IMPACT OF COVID-19 ON A PHYSICAL ACTIVITY FEASIBILITY PILOT STUDY: THE PIPPRA EXPERIENCE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The PIPPRA (Physiotherapist-led Intervention to Promote Physical Activity in Rheumatoid Arthritis) project is a feasibility project examining the impact of a physical activity behaviour change intervention in people who have rheumatoid arthritis (RA). The PIPPRA study recruitment commenced in October 2019, with participant assessment and intervention commencing in November 2019. In the Republic of Ireland people who have RA are categorised as high risk category for Covid-19, due to immunosuppression [1], although this categorisation contrasts with EULAR’s provisional recommendations [2].Objectives:To examine the impact of the Covid-19 pandemic and public health restrictions on a pilot randomised controlled feasibility study in 2020.Methods:Participants (aged 18 years+, diagnosis of RA, independently mobile and low levels of physical activity [3]) were recruited from a rheumatology clinic at an urban hospital. Target recruitment was four participants per month for one year (N=48). Assessments were planned at baseline, eight and twenty-four weeks (N=144). Participants were randomised to intervention group or control group. The intervention group received four 1:1 sixty minute sessions with a physiotherapist (N=96). The intervention was delivered over eight weeks. Intervention and control groups received a physical activity information leaflet.Results:The Covid-19 pandemic and associated public health restrictions forced the study to be formally paused in April 2020 and the study formally resumed in August 2020. N=48 participants were recruited between October 2019 and March 2020 (six months). N=20 participants have commenced in the study, N=16 are awaiting baseline assessment, N=6 withdrew and N=6 were lost to follow-up prior to baseline. Trial protocol planned for the delivery of N=55 assessments and N=36 intervention sessions for participants who had commenced in the study. N=22 assessments and N=26 intervention sessions were delivered between November 2019 and March 2020. N=5 assessments and N=6 intervention sessions were conducted between August and October 2020. No assessment or intervention delivery occurred in November-December 2020 due to participant hesitancy in attending for assessment and/or intervention with increased public health restrictions. The impact of Covid-19 restrictions resulted in N=33 (60%) deviations from assessment protocol and N=10 (27%) deviations from intervention delivery protocol (Figure 1).Figure 1.Deviations from assessment and intervention protocol in the PIPPRA studyConclusion:The Covid-19 pandemic has had a significant impact on the delivery of the PIPPRA study. Feasibility study outcomes, including participant retention rate, and study delivery as per protocol, have been affected due to the Covid-19 pandemic. Participant reluctance to attend face-to-face sessions demonstrates the need to consider alternative methods of delivery, e.g. virtual delivery of interventions, where attending in person is not acceptable to participants [4], in future studies.References:[1]Health Service Executive. (2019). People at higher risk from COVID-19.Accessed 5th Jan 2020 https://www2.hse.ie/conditions/coronavirus/people-at-higher-risk.html.[2]Landewé RB et al (2020). EULAR provisional recommendations for the management of rheumatic and musculoskeletal diseases in the context of SARS-CoV-2. Annals of the Rheumatic Diseases 79:851-858.[3]Godin, G. (2011). The Godin-Shephard leisure-time physical activity questionnaire. The Health & Fitness Journal of Canada, 4(1):18-22.[4]Inan, OT et al. (2020). Digitizing clinical trials. npj Digit. Med. 3:10.Disclosure of Interests:None declared
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24
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Lin Z, Kim E, Ahmed M, Han G, Simmons C, Redhead Y, Bartlett J, Pena Altamira LE, Callaghan I, White MA, Singh N, Sawiak S, Spires-Jones T, Vernon AC, Coleman MP, Green J, Henstridge C, Davies JS, Cash D, Sreedharan J. MRI-guided histology of TDP-43 knock-in mice implicates parvalbumin interneuron loss, impaired neurogenesis and aberrant neurodevelopment in amyotrophic lateral sclerosis-frontotemporal dementia. Brain Commun 2021; 3:fcab114. [PMID: 34136812 PMCID: PMC8204366 DOI: 10.1093/braincomms/fcab114] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 02/23/2021] [Revised: 04/13/2021] [Accepted: 04/17/2021] [Indexed: 01/01/2023] Open
Abstract
Amyotrophic lateral sclerosis and frontotemporal dementia are overlapping diseases in which MRI reveals brain structural changes in advance of symptom onset. Recapitulating these changes in preclinical models would help to improve our understanding of the molecular causes underlying regionally selective brain atrophy in early disease. We therefore investigated the translational potential of the TDP-43Q331K knock-in mouse model of amyotrophic lateral sclerosis-frontotemporal dementia using MRI. We performed in vivo MRI of TDP-43Q331K knock-in mice. Regions of significant volume change were chosen for post-mortem brain tissue analyses. Ex vivo computed tomography was performed to investigate skull shape. Parvalbumin neuron density was quantified in post-mortem amyotrophic lateral sclerosis frontal cortex. Adult mutants demonstrated parenchymal volume reductions affecting the frontal lobe and entorhinal cortex in a manner reminiscent of amyotrophic lateral sclerosis-frontotemporal dementia. Subcortical, cerebellar and brain stem regions were also affected in line with observations in pre-symptomatic carriers of mutations in C9orf72, the commonest genetic cause of both amyotrophic lateral sclerosis and frontotemporal dementia. Volume loss was also observed in the dentate gyrus of the hippocampus, along with ventricular enlargement. Immunohistochemistry revealed reduced parvalbumin interneurons as a potential cellular correlate of MRI changes in mutant mice. By contrast, microglia was in a disease activated state even in the absence of brain volume loss. A reduction in immature neurons was found in the dentate gyrus, indicative of impaired adult neurogenesis, while a paucity of parvalbumin interneurons in P14 mutant mice suggests that TDP-43Q331K disrupts neurodevelopment. Computerized tomography imaging showed altered skull morphology in mutants, further suggesting a role for TDP-43Q331K in development. Finally, analysis of human post-mortem brains confirmed a paucity of parvalbumin interneurons in the prefrontal cortex in sporadic amyotrophic lateral sclerosis and amyotrophic lateral sclerosis linked to C9orf72 mutations. Regional brain MRI changes seen in human amyotrophic lateral sclerosis-frontotemporal dementia are recapitulated in TDP-43Q331K knock-in mice. By marrying in vivo imaging with targeted histology, we can unravel cellular and molecular processes underlying selective brain vulnerability in human disease. As well as helping to understand the earliest causes of disease, our MRI and histological markers will be valuable in assessing the efficacy of putative therapeutics in TDP-43Q331K knock-in mice.
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Affiliation(s)
- Ziqiang Lin
- Department of Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London SE5 9RT, UK
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Eugene Kim
- BRAIN Centre (Biomarker Research And Imaging for Neuroscience), Department of Neuroimaging, IoPPN, King’s College London, London SE5 9NU, UK
| | - Mohi Ahmed
- Centre for Craniofacial and Regenerative Biology, Floor 27 Tower Wing, Guy’s Hospital, King’s College London, London SE1 9RT, UK
| | - Gang Han
- Molecular Neurobiology Group, Institute of Life Sciences, School of Medicine, Swansea University, Swansea SA2 8PP, UK
| | - Camilla Simmons
- BRAIN Centre (Biomarker Research And Imaging for Neuroscience), Department of Neuroimaging, IoPPN, King’s College London, London SE5 9NU, UK
| | - Yushi Redhead
- Centre for Craniofacial and Regenerative Biology, Floor 27 Tower Wing, Guy’s Hospital, King’s College London, London SE1 9RT, UK
| | - Jack Bartlett
- Molecular Neurobiology Group, Institute of Life Sciences, School of Medicine, Swansea University, Swansea SA2 8PP, UK
| | - Luis Emiliano Pena Altamira
- Department of Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London SE5 9RT, UK
| | - Isobel Callaghan
- Department of Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London SE5 9RT, UK
| | - Matthew A White
- Department of Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London SE5 9RT, UK
| | - Nisha Singh
- BRAIN Centre (Biomarker Research And Imaging for Neuroscience), Department of Neuroimaging, IoPPN, King’s College London, London SE5 9NU, UK
- School of Biomedical Engineering & Imaging Sciences, St Thomas' Hospital, King's College London, 4th floor Lambeth Wing, London SE1 7EH, UK
| | - Stephen Sawiak
- Department of Clinical Neurosciences, Cambridge University, Cambridge CB2 0QQ, UK
| | - Tara Spires-Jones
- Centre for Discovery Brain Sciences, University of Edinburgh, Edinburgh EH8 9XD, UK
| | - Anthony C Vernon
- Department of Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London SE5 9RT, UK
| | | | - Jeremy Green
- Centre for Craniofacial and Regenerative Biology, Floor 27 Tower Wing, Guy’s Hospital, King’s College London, London SE1 9RT, UK
| | - Christopher Henstridge
- Centre for Discovery Brain Sciences, University of Edinburgh, Edinburgh EH8 9XD, UK
- Division of Systems Medicine, School of Medicine, University of Dundee, Dundee DD1 9SY, UK
| | - Jeffrey S Davies
- Molecular Neurobiology Group, Institute of Life Sciences, School of Medicine, Swansea University, Swansea SA2 8PP, UK
| | - Diana Cash
- BRAIN Centre (Biomarker Research And Imaging for Neuroscience), Department of Neuroimaging, IoPPN, King’s College London, London SE5 9NU, UK
| | - Jemeen Sreedharan
- Department of Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London SE5 9RT, UK
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Khadhouri S, Gallagher K, MacKenzie K, Shah T, Gao C, Moore S, Zimmermann E, Edison E, Jefferies M, Nambiar A, Mannas M, Lee T, Marra G, Gomez Rivas J, Marcq G, Assmus M, Ucar T, Claps F, Boltri M, Montagna GL, Burnhope T, Nkwam N, Austin T, Boxall N, Downey A, Sukhu T, Anton-Juanilla M, Rai S, Chin YF, Moore M, Drake T, Green J, Nielsen M, Takwoingi Y, McGrath J, Kasivisvanathan V. 92 Reshaping the Diagnostic Pathways for Investigation of Haematuria During and After The COVID-19 Pandemic: Diagnostic Accuracy of Strategies for Detection of Bladder Cancer from The IDENTIFY Cohort Study. Br J Surg 2021. [PMCID: PMC8135806 DOI: 10.1093/bjs/znab135.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Diagnostic haematuria services have been reduced due to the COVID-19 pandemic, compromising patient care, and necessitating a more pragmatic pathway.
Method
The IDENTIFY study was an international, prospective, multicentre cohort study of over 11,000 patients referred to secondary care for investigation of haematuria. Using this data, we developed strategies using combinations of imaging and cytology as triage tests to maximise cancer detection within a pragmatic pathway.
Results
8112 patients (74·4%) received an ultrasound or a CT urogram, with or without cytology. 5737 (70·7%) patients had visible haematuria (VH) and 2375 (29·3%) had non-visible haematuria (NVH). Diagnostic test performance was used to determine optimal age cut-offs for four proposed strategies. We recommended proceeding directly to transurethral resection of bladder tumour for patients of any age with positive triage tests for cancer. Patients with negative triage tests under 35-years-old with VH, or under 50-years-old with NVH can safely be discharged without undergoing flexible cystoscopy. The remaining patients may undergo flexible cystoscopy, with a greater priority for older patients to capture high risk bladder cancer.
Conclusions
We suggest diagnostic strategies in patients with haematuria, which focus on detection of bladder cancer, whilst reducing the burden to healthcare services in a resource-limited setting.
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Affiliation(s)
- S Khadhouri
- University of Aberdeen, Aberdeen, United Kingdom
- BURST, London, United Kingdom
| | - K Gallagher
- Western General Hospital, Edinburgh, United Kingdom
- BURST, London, United Kingdom
| | - K MacKenzie
- Freeman Hospital, Newcastle, United Kingdom
- BURST, London, United Kingdom
| | - T Shah
- Charing Cross Hospital, London, United Kingdom
- BURST, London, United Kingdom
| | - C Gao
- Addenbrookes Hospital, Cambridge, United Kingdom
- BURST, London, United Kingdom
| | - S Moore
- Wrexham Maelor Hospital, Wrexham, United Kingdom
- BURST, London, United Kingdom
| | - E Zimmermann
- Torbay and South Devon NHS Foundation Trust, Torbay, United Kingdom
- BURST, London, United Kingdom
| | - E Edison
- Whipps Cross Hospital, London, United Kingdom
- BURST, London, United Kingdom
| | - M Jefferies
- Morriston Hospital, Swansea, United Kingdom
- BURST, London, United Kingdom
| | - A Nambiar
- Freeman Hospital, Newcastle, United Kingdom
- BURST, London, United Kingdom
| | - M Mannas
- University of British Columbia, Vancouver, Canada
| | - T Lee
- University of British Columbia, Vancouver, Canada
| | - G Marra
- University of Turin, Turin, Italy
| | | | - G Marcq
- University of Lille, Lille, France
| | - M Assmus
- University of Alberta, Edmonton, Canada
| | - T Ucar
- Istanbul Medeniyet University, Istanbul, Turkey
| | - F Claps
- University of Trieste, Trieste, Italy
| | - M Boltri
- University of Trieste, Trieste, Italy
| | | | - T Burnhope
- University of Derby and Burton NHS Foundation Trust, Derby, United Kingdom
| | - N Nkwam
- University of Derby and Burton NHS Foundation Trust, Derby, United Kingdom
| | - T Austin
- Queen Alexandra Hospital, Portsmouth, United Kingdom
| | - N Boxall
- Salford Royal NHS Foundation Trust, Salford, United Kingdom
| | - A Downey
- Doncaster Royal Infirmary, Doncaster, United Kingdom
| | - T Sukhu
- University of North Carolina Hospitals, Chapel Hill, USA
| | | | - S Rai
- St James University Hospital, Leeds, United Kingdom
| | - Y F Chin
- Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - M Moore
- University of Derby and Burton NHS Foundation Trust, Derby, United Kingdom
| | - T Drake
- The Royal Bournemouth Hospital, Bournemouth, United Kingdom
| | - J Green
- Whipps Cross Hospital, London, United Kingdom
| | - M Nielsen
- University of North Carolina Hospitals, Chapel Hill, USA
| | - Y Takwoingi
- University of Birmingham, Birmingham, United Kingdom
| | - J McGrath
- University of Exeter Medical School, Exeter, United Kingdom
| | - V Kasivisvanathan
- University College London, London, United Kingdom
- BURST, London, United Kingdom
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26
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McGoldrick DM, Sarai R, Green J. Tongue and floor of mouth swelling: a potential rare manifestation of COVID-19. Br J Oral Maxillofac Surg 2021; 59:500-501. [PMID: 33752919 PMCID: PMC7942149 DOI: 10.1016/j.bjoms.2021.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 03/04/2021] [Indexed: 01/03/2023]
Affiliation(s)
- D M McGoldrick
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham, United Kingdom.
| | - R Sarai
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham, United Kingdom
| | - J Green
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham, United Kingdom
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27
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Weininger G, Green J, Mori M, Geirsson A. Cavitron ultrasonic surgical aspirator for mitral annular decalcification. Multimed Man Cardiothorac Surg 2021; 2021. [PMID: 33691046 DOI: 10.1510/mmcts.2021.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Mitral valve surgery can be especially difficult in patients with mitral annular calcification. Not only is it associated with higher morbidity and mortality, but there is no consensus strategy for the treatment of mitral annular calcification, which may render some patients inoperable. We describe a case of severe mitral annular calcification successfully treated with the cavitron ultrasonic surgical aspirator. We demonstrate the proper technique for and the efficacy of using this instrument for decalcification of the mitral annulus. The video tutorial includes the patient presentation, preoperative and postoperative imaging, and the proper surgical technique for cavitron ultrasonic surgical aspirator-assisted mitral annular decalcification. With the proper technique, the cavitron ultrasonic surgical aspirator may mitigate the risk of surgical complications associated with severe calcification of the mitral annulus.
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Affiliation(s)
- Gabe Weininger
- Section of Cardiac Surgery, Yale University School of Medicine
| | - Jeremy Green
- Frank H. Netter School of Medicine at Quinnipiac University
| | - Makoto Mori
- Section of Cardiac Surgery, Yale University School of Medicine
| | - Arnar Geirsson
- Section of Cardiac Surgery, Yale University School of Medicine
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28
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Arulkumaran N, Green J, Khan A, Bonnici T, Longobardo A, Singer M. Influence of respiratory and inflammatory parameters preceding intubation on survival of patients with COVID-19 ARDS- A single centre retrospective analysis. J Crit Care 2021; 62:289-291. [PMID: 33513551 PMCID: PMC7835523 DOI: 10.1016/j.jcrc.2021.01.001] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/02/2021] [Indexed: 11/18/2022]
Abstract
It remains unclear if intubation and ventilation earlier in the disease course confers a survival advantage in acute respiratory distress syndrome. Our objective was to determine whether patients with COVID-19 who died following mechanical ventilation were more advanced in their disease compared to survivors. Forty-seven patients admitted directly to our centre received ventilation, of who 26 (57%) patients died. The rate of fall in SpO2:FiO2 ratio (p = 0.478) and increasing respiratory rate (p = 0.948) prior to IMV were similar between survivors and non-survivors. Our data support a trial of continuous positive airway pressure prior to IMV in patients with moderate-to-severe COVID-19 ARDS.
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Affiliation(s)
- N Arulkumaran
- Bloomsbury Institute of Intensive Care Medicine, University College London, UK.
| | - J Green
- Bloomsbury Institute of Intensive Care Medicine, University College London, UK
| | - A Khan
- Bloomsbury Institute of Intensive Care Medicine, University College London, UK
| | - T Bonnici
- Bloomsbury Institute of Intensive Care Medicine, University College London, UK
| | - A Longobardo
- Bloomsbury Institute of Intensive Care Medicine, University College London, UK
| | - M Singer
- Bloomsbury Institute of Intensive Care Medicine, University College London, UK
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Anakwe A, Green J, BeLue R. Perceptions of Cultural Competence and Utilization of Advanced Practice Providers. J Allied Health 2021; 50:54-60. [PMID: 33646250] [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] [Received: 02/18/2020] [Accepted: 05/25/2020] [Indexed: 06/12/2023]
Abstract
Advanced practice providers (APPs) provide preventive services, continuity of care, and bridge health management gaps. Associations between perceptions of shared culture and utilization of APPs are not yet documented in the research literature. Nationally representative data from the 2017 National Health Interview Survey were analyzed using age-adjusted logistic regressions to compare associations between perceptions of cultural competence and utilization of APPs. A total of 11,954 males (mean age 50.0, SD 18.3) and 14,453 females (mean age 51.8, SD 18.8) from the US adult population were included in this study. Perceiving a shared culture with health care providers was significantly associated with utilization of APPs. Among males, perceived respect from providers was associated with an 11.4 percent¬age point increase in the probability of APP utilization (95% CI: 2.7, 27.1). Among females, visiting providers with a shared culture was associated with a 9.4 percentage point increase in the probability of APP utilization (95% CI: 4.4, 14.5). APP utilization decreased among those with less than college education and Hispanic race if providers asked opinions and beliefs about care. This study underscores the need to explore perceptual differences on cultural competence, influences on healthcare utilization, and patient-provider cultural congruence.
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Affiliation(s)
- Adaobi Anakwe
- Saint Louis University, 3545 Lafayette Avenue, Rm 403, St. Louis, MO 63104, USA. Tel 573-219-8330.
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Khullar R, Shah S, Singh G, Bae J, Gattu R, Jain S, Green J, Anandarangam T, Cohen M, Madan N, Prasanna P. Effects of Prone Ventilation on Oxygenation, Inflammation, and Lung Infiltrates in COVID-19 Related Acute Respiratory Distress Syndrome: A Retrospective Cohort Study. J Clin Med 2020; 9:E4129. [PMID: 33371426 PMCID: PMC7767429 DOI: 10.3390/jcm9124129] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 11/09/2020] [Revised: 12/13/2020] [Accepted: 12/15/2020] [Indexed: 12/22/2022] Open
Abstract
Patients receiving mechanical ventilation for coronavirus disease 2019 (COVID-19) related, moderate-to-severe acute respiratory distress syndrome (CARDS) have mortality rates between 76-98%. The objective of this retrospective cohort study was to identify differences in prone ventilation effects on oxygenation, pulmonary infiltrates (as observed on chest X-ray (CXR)), and systemic inflammation in CARDS patients by survivorship and to identify baseline characteristics associated with survival after prone ventilation. The study cohort included 23 patients with moderate-to-severe CARDS who received prone ventilation for ≥16 h/day and was segmented by living status: living (n = 6) and deceased (n = 17). Immediately after prone ventilation, PaO2/FiO2 improved by 108% (p < 0.03) for the living and 150% (p < 3 × 10-4) for the deceased. However, the 48 h change in lung infiltrate severity in gravity-dependent lung zones was significantly better for the living than for the deceased (p < 0.02). In CXRs of the lower lungs before prone ventilation, we observed 5 patients with confluent infiltrates bilaterally, 12 patients with ground-glass opacities (GGOs) bilaterally, and 6 patients with mixed infiltrate patterns; 80% of patients with confluent infiltrates were alive vs. 8% of patients with GGOs. In conclusion, our small study indicates that CXRs may offer clinical utility in selecting patients with moderate-to-severe CARDS who will benefit from prone ventilation. Additionally, our study suggests that lung infiltrate severity may be a better indicator of patient disposition after prone ventilation than PaO2/FiO2.
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Affiliation(s)
- Rohit Khullar
- Renaissance School of Medicine and Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY 11794, USA;
| | - Shrey Shah
- Division of Pulmonary Critical Care, Department of Internal Medicine, Newark Beth Israel Medical Center, Newark, NJ 07112, USA; (S.S.); (T.A.); (N.M.)
| | - Gagandeep Singh
- Department of Radiology, Newark Beth Israel Medical Center, Newark, NJ 07112, USA; (G.S.); (R.G.); (J.G.)
| | - Joseph Bae
- Renaissance School of Medicine and Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY 11794, USA;
| | - Rishabh Gattu
- Department of Radiology, Newark Beth Israel Medical Center, Newark, NJ 07112, USA; (G.S.); (R.G.); (J.G.)
| | - Shubham Jain
- Department of Computer Science, Stony Brook University, Stony Brook, NY 11794, USA;
| | - Jeremy Green
- Department of Radiology, Newark Beth Israel Medical Center, Newark, NJ 07112, USA; (G.S.); (R.G.); (J.G.)
| | - Thiruvengadam Anandarangam
- Division of Pulmonary Critical Care, Department of Internal Medicine, Newark Beth Israel Medical Center, Newark, NJ 07112, USA; (S.S.); (T.A.); (N.M.)
| | - Marc Cohen
- Division of Cardiology, Department of Internal Medicine, Newark Beth Israel Medical Center, Newark, NJ 07112, USA;
| | - Nikhil Madan
- Division of Pulmonary Critical Care, Department of Internal Medicine, Newark Beth Israel Medical Center, Newark, NJ 07112, USA; (S.S.); (T.A.); (N.M.)
| | - Prateek Prasanna
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY 11794, USA
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Wharton-Smith A, Bacchus L, Loh E, Chai See L, Green J. The role of the clinical diagnosis of dengue during an outbreak: A qualitative study of how dengue is triaged and managed at a Malaysian hospital. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.11.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Velarde A, Najera K, Gay H, Powderly W, Mutic S, Green J, Michalski J, Henke L, De Falla V, Laugeman E, Catu M, Hugo G, Cai B, van Rheenen J. Transitioning from Old Cobalt-60 Teletherapy to Modern Linac Radiotherapy in a Lower-Middle Income Country Guatemala. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Peedell C, Aynsley E, Wood A, Kumar G, Masinghe S, Reynolds J, Huntley C, Blower A, Green J, Bradley J, Veeratterapillay J, Hassani A, Anderson M, Greenhalgh A, Daniel J, Swingler A, Turnbull M, Burke K. PO-0988: Is there a learning curve for SABR that affects overall survival outcomes in early stage NSCLC? Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01005-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bartsch R, Casabona G, Sitzwohl C, Kimberger O, Green J, Stanger J, Frank K, Onishi E, Cotofana S. The Influence of Different Treatment Combinations on Skin Laxity and Dimpling. J Drugs Dermatol 2020; 19:1030-1038. [DOI: 10.36849/jdd.2020.5117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Elledge R, Williams R, Fowell C, Green J. Maxillofacial education in the time of COVID-19: the West Midlands experience. Br J Oral Maxillofac Surg 2020; 60:52-57. [PMID: 32807595 PMCID: PMC7392048 DOI: 10.1016/j.bjoms.2020.07.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 07/21/2020] [Indexed: 12/11/2022]
Abstract
COVID-19 has accelerated a reliance on virtual technology for the delivery of postgraduate surgical education. We sought to develop a regional teaching programme with robust quality assurance. Webinars were delivered on a weekly basis by subspecialty experts using Zoom™ augmented with interactive polling software. Trainee feedback comprised Likert item rating on content and delivery, free text comments and self-assessed confidence levels using visual analogue scale (VAS) scores. A focus group was also convened and transcripts assessed with grounded theory analysis. Likert items revealed 442 (93.2%) positive responses regarding content and 642 (96.7%) positive responses regarding trainer delivery. There were statistically significant improvements in VAS scores across all programme content. Key themes from the focus group analysis were the pragmatics of delivering online education, issues surrounding trainer interactivity in the virtual world, the identification of the FRCS as a driving factor and a desire for case-based content and pre-learning of information (the ‘flipped classroom’). We are continuing to be reactive to trainee feedback in developing our online learning programme which will also include a regional Moodle-based virtual learning environment (VLE), the subject of future educational research in our region.
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Affiliation(s)
- R Elledge
- University Hospitals Birmingham NHS Foundation Trust, University of Birmingham; College of Medical and Dental Sciences, University of Birmingham.
| | - R Williams
- University Hospitals Birmingham NHS Foundation Trust, University of Birmingham.
| | - C Fowell
- Cambridge University Hospitals NHS Foundation Trust.
| | - J Green
- University Hospitals Birmingham NHS Foundation Trust, University of Birmingham.
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Tien T, Green J. The burden of muscle invasive bladder cancer 12 months before death: How do we improve the care of this multimorbid group of patients? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33696-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: 11/17/2022] Open
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Davidson RL, Oborn B, Robertson EF, Noel S, Earle GD, Green J, Kramer J. The gridded retarding ion drift sensor for the petitSat cubeSat mission. Rev Sci Instrum 2020; 91:064502. [PMID: 32611012 DOI: 10.1063/1.5140470] [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] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/20/2020] [Indexed: 06/11/2023]
Abstract
The Gridded Retarding Ion Drift Sensor (GRIDS) is a small sensor that will fly on the 6 U petitSat CubeSat. It is designed to measure the three-dimensional plasma drift velocity vector in the Earth's ionosphere. The GRIDS also supplies information about the ion temperature, ion density, and the ratio of light to heavy ions present in the ionospheric plasma. It utilizes well-proven techniques that have been successfully validated by similar instruments on larger satellite missions while meeting CubeSat-compatible requirements for low mass, size, and power consumption. GRIDS performs the functions of a Retarding Potential Analyzer (RPA) and an Ion Drift Meter (IDM) by combining the features of both types of instruments in a single package. The sensor alternates RPA and IDM measurements to produce the full set of measurement parameters listed above. On the petitSat mission, GRIDS will help identify and characterize a phenomenon known as plasma blobs (or enhancements).
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Affiliation(s)
- R L Davidson
- Electrical and Computer Engineering, Utah State University, Logan, Utah 84322, USA
| | - B Oborn
- Electrical and Computer Engineering, Utah State University, Logan, Utah 84322, USA
| | - E F Robertson
- Electrical and Computer Engineering, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - S Noel
- Electrical and Computer Engineering, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - G D Earle
- Electrical and Computer Engineering, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - J Green
- Electrical and Computer Engineering, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - J Kramer
- Electrical and Computer Engineering, Virginia Tech, Blacksburg, Virginia 24061, USA
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Green J, Korza G, Granados MR, Zenick B, Schlievert PM, Mok WMK, Setlow P. Lack of efficient killing of purified dormant spores of Bacillales and Clostridiales species by glycerol monolaurate in a non-aqueous gel. Lett Appl Microbiol 2020; 70:407-412. [PMID: 32133659 DOI: 10.1111/lam.13290] [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] [Received: 12/31/2019] [Revised: 02/29/2020] [Accepted: 03/02/2020] [Indexed: 11/29/2022]
Abstract
Inactivation of Bacillales and Clostridiales spores is of interest, since some cause food spoilage and human diseases. A recent publication (mSphere 3: e00597-1, 2018) reported that glycerol monolaurate (GML) in a non-aqueous gel (GMLg) effectively killed spores of Bacillus subtilis, Bacillus cereus and Clostridioides difficile, and Bacillus anthracis spores to a lesser extent. We now show that (i) the B. subtilis spores prepared as in the prior work were impure; (ii) if spore viability was measured by diluting spores 1/10 in GMLg, serially diluting incubations 10-fold and spotting aliquots on recovery plates, there was no colony formation from the 1/10 to 1/1000 dilutions due to GMLg carryover, although thorough ethanol washes of incubated spores eliminated this problem and (iii) GMLg did not kill highly purified spores of B. subtilis, B. cereus, Bacillus megaterium and C. difficile in 3-20 h in the conditions used in the recent publication. GMLg also gave no killing of crude B. subtilis spores prepared as in the recent publication in 5 h but gave ~1·5 log killing at 24 h. Thus, GMLg does not appear to be an effective sporicide, although the gel likely inhibits spore germination and could kill spores somewhat upon long incubations. SIGNIFICANCE AND IMPACT OF THE STUDY: Given potential deleterious effects of spores of Bacillales and Clostridiales, there is an ongoing interest in new ways of spore killing. A recent paper (mSphere 3: e00597-1, 2018) reported that glycerol monolaurate (GML) in a non-aqueous gel (GMLg) effectively killed spores of many species. We now find that (i) the Bacillus subtilis spores prepared as in the previous report were impure and (ii) GMLg gave no killing of purified spores of Bacillales and Clostridiales species in ≤5 h under the published conditions. Thus, GMLg is not an effective sporicide, though may prevent spore germination or kill germinated spores.
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Affiliation(s)
- J Green
- Department of Molecular Biology and Biophysics, UConn Health, Farmington, CT, USA
| | - G Korza
- Department of Molecular Biology and Biophysics, UConn Health, Farmington, CT, USA
| | - M R Granados
- Department of Molecular Biology and Biophysics, UConn Health, Farmington, CT, USA
| | - B Zenick
- Department of Molecular Biology and Biophysics, UConn Health, Farmington, CT, USA
| | - P M Schlievert
- Department of Microbiology and Immunology, University of Iowa, Iowa City, IA, USA
| | - W M K Mok
- Department of Molecular Biology and Biophysics, UConn Health, Farmington, CT, USA
| | - P Setlow
- Department of Molecular Biology and Biophysics, UConn Health, Farmington, CT, USA
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Farnell DJJ, Staffurth J, Sivell S, Ahmedzai S, Andreyev J, Green J, Sanders DS, Ferguson CJ, Pickett S, Muls A, O'Shea R, Campbell SH, Taylor SE, Nelson A. The ALERT-B questionnaire: A screening tool for the detection of gastroenterological late effects after radiotherapy for prostate cancer. Clin Transl Radiat Oncol 2020; 21:98-103. [PMID: 32072031 PMCID: PMC7016329 DOI: 10.1016/j.ctro.2020.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 02/02/2020] [Indexed: 01/03/2023] Open
Abstract
ALERT-B provides an effective screening tool for gastroenterological late effects. 84.4% and 95.7% of patients demonstrated complications at 6 and 12 months post-treatment. ROC curves at baseline indicated an AUC of 0.867 compared to the GSRS diarrhoea subscale. ROC curves at baseline indicated an AUC of 0.765 compared to the EPIC bowel subscale.
There is an increasing need to measure treatment-related side effects in normal tissues following cancer therapy. The ALERT-B (Assessment of Late Effects of RadioTherapy - Bowel) questionnaire is a screening tool that is composed of four items related specifically to bowel symptoms. Those patients that respond with a “yes” to any of these items are referred on to gastroenterologist in order to improve the long-term consequences of these side effects of radiological treatment. Here we wish to test the ability of this questionnaire to identify these subsequent gastroenterological complications by tracking prostate cancer patients that were positive with respect to ALERT-B. We also carry out receiver-operator curve (ROC) analysis for baseline data for an overall ALERT-B questionnaire score with respect to subscale data for the Gastrointestinal Symptom Rating Scale (GSRS) and the Expanded Prostate Cancer Index Composite (EPIC-26) questionnaire. 84.4% and 95.7% of patients identified by the ALERT-B questionnaire demonstrated complications diagnosed at 6 and 12 months post-treatment, respectively. ROC curve analysis of baseline data showed that ALERT-B detected clinically relevant levels of side effects established at baseline by the GSRS diarrhoea subscale (AUC = 0.867, 95% CI = 0.795 to 0.926) and at the minimally important level of side effects for the EPIC bowel subscale (AUC = 0.765, 95% CI = 0.617 to 0.913). These results show that ALERT-B provides a simple and effective screening tool for identifying gastroenterological complications after treatment for prostate cancer.
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Affiliation(s)
- D J J Farnell
- School of Dentistry, Cardiff University, Cardiff, United Kingdom
| | - J Staffurth
- Velindre Cancer Centre, Cardiff, United Kingdom.,Cardiff University, Cardiff, United Kingdom
| | - S Sivell
- Marie Curie Palliative Care Research Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - S Ahmedzai
- National Institute for Health Research, Clinical Research Network - Cancer Cluster Office, University of Leeds, Leeds, United Kingdom
| | - J Andreyev
- Department of Gastroenterology, Lincoln County Hospital, Lincoln, United Kingdom
| | - J Green
- Institute of Medical Education, School of Medicine, Cardiff University and Department of Gastroenterology, University Hospital Llandough, Cardiff and Vale UHB, Vale of Glamorgan, Cardiff, United Kingdom
| | - D S Sanders
- University of Sheffield Medical School, Sheffield, United Kingdom
| | - C J Ferguson
- University of Sheffield Medical School, Sheffield, United Kingdom
| | - S Pickett
- Swansea Centre for Health Economics, Swansea University, Swansea, United Kingdom
| | - A Muls
- Royal Marsden Hospital, Fulham Road, London, United Kingdom
| | - R O'Shea
- Marie Curie Palliative Care Research Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - S H Campbell
- Marie Curie Palliative Care Research Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - S E Taylor
- Macmillan Cancer Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - A Nelson
- Marie Curie Palliative Care Research Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
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Mori M, Bin Mahmood SU, Zhuo H, Yousef S, Green J, Mangi AA, Zhang Y, Geirsson A. Persistence of risk of death after hospital discharge to locations other than home after cardiac surgery. J Thorac Cardiovasc Surg 2020; 159:528-535.e1. [DOI: 10.1016/j.jtcvs.2019.02.079] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 02/11/2019] [Accepted: 02/18/2019] [Indexed: 10/27/2022]
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Cottrell D, Wright-Hughes A, Eisler I, Fortune S, Green J, House A, Kerfoot M, Owens D, Simic M, McLellan V, Tubeuf S, Farrin A. Longer-term effectiveness of systemic family therapy compared with treatment as usual for young people after self-harm: An extended follow up of pragmatic randomised controlled trial. EClinicalMedicine 2020; 18:100246. [PMID: 31956857 PMCID: PMC6956753 DOI: 10.1016/j.eclinm.2019.100246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/22/2019] [Accepted: 12/12/2019] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Self-harm in adolescents is common and repetition frequent. Evidence for effective interventions to reduce self-harm is limited. Long term follow-up of existing studies is rare. METHODS Extended follow up, from 18 to at least 36-months, of the SHIFT trial: a pragmatic, multi-centre, individually-randomised, controlled trial involving young people (11-17) who had self-harmed at least twice and presented to Child & Adolescent Mental Health Services (CAMHS). SHIFT evaluated manualised family therapy (FT) versus treatment as usual (TAU) in reducing repetition of self-harm leading to hospital attendance 18 months post-randomisation.We obtained ONS mortality data, adult mental health data, and further details of hospital attendance from routine Hospital Episode Statistics (HES) data plus researcher follow-up. We assessed longer-term differences in outcome using multivariable Cox Proportional Hazards regression analysis, and assessed all-cause mortality and morbidity relating to hospital attendances for reasons other than self-harm. STUDY REGISTRATION ISRCTN 59793150. OUTCOMES The original sample of 832 were randomised between April 2010 and December 2013. Extended follow-up continued until February 2017 for a median 55·4 months (range 0-82·5 months), providing post 18-month data for 804 (96·6%) participants, of whom 785 (94·4%) had a minimum of 36-months follow-up.There was no evidence of a between-group difference in the primary outcome during the extended follow-up period (Hazard Ratio (HR) 1·03; 95% CI: 0·83, 1·28; p-value=0·78), consistent with our findings in the original trial with 18 months follow-up (HR 1·14, 95% CI 0·87, 1·49; p-value 0·33). There was a reduced rate of self-harm in older participants aged 15-17 (HR 0·7, 95% CI 0·56, 0·88), as compared with those aged 11-14; and significantly increased rates of self-harm in participants whose index episode combined self-injury and poisoning (HR 1·8, 95% CI 1·2, 2·7). Two deaths were reported during the extended follow up period. INTERPRETATION For adolescents referred to CAMHS after self-harm, having self-harmed at least once before, trial FT confers no benefits over TAU in reducing subsequent hospitalisation for self-harm over 18 months or 36 months. FUNDING NIHR HTA Reference: 07/33/01.
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Affiliation(s)
- D.J. Cottrell
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
- Corresponding author.
| | | | - I. Eisler
- Institute of Psychiatry, Psychology and Neurological Science Kings College London, London, UK
| | - S. Fortune
- Department of Psychological Medicine, University of Otago, New Zealand
| | - J. Green
- Division of Neuroscience & Experimental Psychology, School of Biological Science, University of Manchester, Manchester, UK
- Royal Manchester Children's Hospital, Manchester, UK
| | - A.O. House
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - M. Kerfoot
- University of Manchester, Manchester, UK
| | - D.W. Owens
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - M. Simic
- South London and Maudsley NHS Foundation Trust, London, UK
| | - V. McLellan
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - S. Tubeuf
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Louvain-La-Neuve, Belgium
| | - A.J. Farrin
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
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Hewish M, Messenger J, Aldik G, Saikia S, Nimako K, Macintyre J, Powell H, Tate P, Adams N, Nakos A, McKinna F, Callin J, Green J, Harris J, Sevdalis N, Mendis J, Taylor C. A multi-component intervention to improve lung cancer multi-disciplinary team meeting (MDTM) effectiveness. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30242-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cotofana S, Hexsel D, E.T. Avelar L, Munia C, Muniz M, Casabona G, Schenck T, Green J, Lachman N, Frank K. Calculating the Thickness of the Superficial Fatty Layer of the Body Using Age, Gender, and Body Mass Index. J Drugs Dermatol 2019; 19:36-44. [DOI: 10.36849/jdd.2020.4619] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Elledge R, Mercuri L, Attard A, Green J, Speculand B. Review of emerging temporomandibular joint total joint replacement systems. Br J Oral Maxillofac Surg 2019; 57:722-728. [DOI: 10.1016/j.bjoms.2019.08.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 08/14/2019] [Indexed: 10/26/2022]
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Green J, Bin Mahmood SU, Mori M, Yousef S, Mangi AA, Geirsson A. Stability across time of the neutrophil-lymphocyte and lymphocyte-neutrophil ratios and associations with outcomes in cardiac surgery patients. J Cardiothorac Surg 2019; 14:164. [PMID: 31511078 PMCID: PMC6737616 DOI: 10.1186/s13019-019-0988-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 09/02/2019] [Indexed: 12/18/2022] Open
Abstract
Background Elevated white blood cell counts and leukocyte ratios are recognized markers of systemic inflammation associated with poor surgical outcomes. We analyzed the temporal stability and prognostic value of the preoperative Neutrophil-to-Lymphocyte ratio (NLR) and Lymphocyte-to-Neutrophil ratio (LNR) in patients undergoing coronary artery bypass grafts and/or valve surgery. Methods We retrospectively reviewed 558 patients who underwent elective cardiac surgery between July 2014 and December 2016, excluding patients with immunosuppressed status. The stability of NLR and LNR was evaluated using interclass correlation coefficients. The patients were dichotomized into two groups, high NLR and low NLR, based on the median value of preoperative NLR in our cohort. A logistic regression model compared preoperative NLR and LNR values to clinical outcomes, including a composite of perioperative events and mid-term mortality. Results We identified that NLR reliability over time was good (ICC = .592; R-squared = .351), and LNR reliability over time was excellent (ICC = .761; R-squared = .601). Furthermore, an increased duration between collection dates was not significantly correlated with increased variability in NLR (Pearson Correlation Coefficient: −.111, p = .117). On multivariate model, neither high NLR (OR = .879, p = .168) nor low LNR (OR = 3.30, p = .214) was significantly associated with a composite of perioperative events, but increased LNR was associated with lower mid-term mortality (HR .001, p = .026). Conclusions Both NLR and LNR were stable over time, up to 100 days, but LNR values were more consistent compared to NLR. High LNR was significantly associated with decreased risk of mid-term mortality, and LNR showed a stronger relationship with mid-term mortality than its NLR counterpart. Both of these findings indicate that LNR may be a more useful and valuable clinical marker.
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Affiliation(s)
- Jeremy Green
- Frank H. Netter School of Medicine at Quinnipiac University, North Haven, USA
| | | | - Makoto Mori
- Section of Cardiac Surgery, Yale University School of Medicine, New Haven, USA
| | - Sameh Yousef
- Section of Cardiac Surgery, Yale University School of Medicine, New Haven, USA
| | - Abeel A Mangi
- Section of Cardiac Surgery, Yale University School of Medicine, New Haven, USA
| | - Arnar Geirsson
- Section of Cardiac Surgery, Yale University School of Medicine, New Haven, USA
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Milluzzo G, Scuderi V, Alejo A, Amico AG, Booth N, Borghesi M, Cirrone GAP, Cuttone G, Doria D, Green J, Kar S, Korn G, Larosa G, Leanza R, Margarone D, Martin P, McKenna P, Petringa G, Pipek J, Romagnani L, Romano F, Russo A, Schillaci F. A new energy spectrum reconstruction method for time-of-flight diagnostics of high-energy laser-driven protons. Rev Sci Instrum 2019; 90:083303. [PMID: 31472608 DOI: 10.1063/1.5082746] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 07/16/2019] [Indexed: 06/10/2023]
Abstract
The Time-of-Flight (TOF) technique coupled with semiconductorlike detectors, as silicon carbide and diamond, is one of the most promising diagnostic methods for high-energy, high repetition rate, laser-accelerated ions allowing a full on-line beam spectral characterization. A new analysis method for reconstructing the energy spectrum of high-energy laser-driven ion beams from TOF signals is hereby presented and discussed. The proposed method takes into account the detector's working principle, through the accurate calculation of the energy loss in the detector active layer, using Monte Carlo simulations. The analysis method was validated against well-established diagnostics, such as the Thomson parabola spectrometer, during an experimental campaign carried out at the Rutherford Appleton Laboratory (UK) with the high-energy laser-driven protons accelerated by the VULCAN Petawatt laser.
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Affiliation(s)
- G Milluzzo
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - V Scuderi
- INFN-Laboratori Nazionali del Sud (LNS-INFN), Via S Sofia 62, Catania 95123, Italy
| | - A Alejo
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - A G Amico
- INFN-Laboratori Nazionali del Sud (LNS-INFN), Via S Sofia 62, Catania 95123, Italy
| | - N Booth
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Didcot OX11 0QX, United Kingdom
| | - M Borghesi
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - G A P Cirrone
- INFN-Laboratori Nazionali del Sud (LNS-INFN), Via S Sofia 62, Catania 95123, Italy
| | - G Cuttone
- INFN-Laboratori Nazionali del Sud (LNS-INFN), Via S Sofia 62, Catania 95123, Italy
| | - D Doria
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - J Green
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Didcot OX11 0QX, United Kingdom
| | - S Kar
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - G Korn
- Institute of Physics ASCR, v.v.i. (FZU), ELI-Beamlines Project, 18221 Prague, Czech Republic
| | - G Larosa
- INFN-Laboratori Nazionali del Sud (LNS-INFN), Via S Sofia 62, Catania 95123, Italy
| | - R Leanza
- INFN-Laboratori Nazionali del Sud (LNS-INFN), Via S Sofia 62, Catania 95123, Italy
| | - D Margarone
- Institute of Physics ASCR, v.v.i. (FZU), ELI-Beamlines Project, 18221 Prague, Czech Republic
| | - P Martin
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - P McKenna
- Department of Physics, SUPA, University of Strathclyde, Glasgow G4 0NG, United Kingdom
| | - G Petringa
- INFN-Laboratori Nazionali del Sud (LNS-INFN), Via S Sofia 62, Catania 95123, Italy
| | - J Pipek
- INFN-Laboratori Nazionali del Sud (LNS-INFN), Via S Sofia 62, Catania 95123, Italy
| | - L Romagnani
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - F Romano
- INFN-Laboratori Nazionali del Sud (LNS-INFN), Via S Sofia 62, Catania 95123, Italy
| | - A Russo
- INFN-Laboratori Nazionali del Sud (LNS-INFN), Via S Sofia 62, Catania 95123, Italy
| | - F Schillaci
- Physics and Astronomy Department, University of Catania, Via S Sofia 64, Catania 95123, Italy
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47
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Rajoo Y, Wong J, Cooper G, Raj IS, Castle DJ, Chong AH, Green J, Kennedy GA. The relationship between physical activity levels and symptoms of depression, anxiety and stress in individuals with alopecia Areata. BMC Psychol 2019; 7:48. [PMID: 31337438 PMCID: PMC6651906 DOI: 10.1186/s40359-019-0324-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 07/17/2019] [Indexed: 01/28/2023] Open
Abstract
Background Alopecia Areata (AA) is an autoimmune condition that is characterised by non-scarring hair loss. Its aesthetic repercussions can lead to profound changes in psychological well-being. Although physical activity (PA) has been associated with better mental health outcomes in diverse populations, the association in individuals with AA has not been established. The aim of this study was to examine the associations between PA and mental health outcomes in individuals with AA to inform intervention strategies for this specific population. Methods A cross-sectional study was conducted among individuals who were diagnosed with AA. A total of 83 respondents aged (40.95 ± 13.24 years) completed a self-report questionnaire consisting of International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Depression and Anxiety Stress Scale (DASS-21). Three-way contingency Chi-square analyses were used to determine the associations between PA, mental health outcomes and participants with hair loss of more than 50% on the scalp. Results 81.9% of the participants did not meet PA guidelines. Participants with hair loss of more than 50% on the scalp, and who did not meet PA guidelines, were significantly more likely to experience symptoms of severe depression (p = .003), moderate anxiety (p = .04) and mild stress (p = .003) than those who met guidelines Conclusion Findings suggest that increased PA participation in AA individuals with severe hair loss is associated with improved mental health status. Intervention efforts for this specific population should consider barriers and enablers to PA participation as they face challenges that differ from the general population.
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Affiliation(s)
- Y Rajoo
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.
| | - J Wong
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.,School of Education, RMIT University, Melbourne, Australia
| | - G Cooper
- School of Education, RMIT University, Melbourne, Australia
| | - I S Raj
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - D J Castle
- Department of Psychological Sciences and Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.,Department of Psychiatry, St. Vincent's Mental Health, Melbourne, Victoria, Australia
| | - A H Chong
- Department of Medicine (Dermatology), St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - J Green
- Western Dermatology, Melbourne, Victoria, Australia
| | - G A Kennedy
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.,Institute for Breathing and Sleep, Austin Hospital, Melbourne, Victoria, Australia
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Hasan N, Green J, Meinel S, Engelhardt M, Krieg S, Negele J, Pochinsky A, Syritsyn S. Nucleon axial, scalar, and tensor charges using lattice QCD at the physical pion mass. Int J Clin Exp Med 2019. [DOI: 10.1103/physrevd.99.114505] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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49
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Dong W, Green J, Korza G, Setlow P. Killing of spores ofBacillusspecies by cetyltrimethylammonium bromide. J Appl Microbiol 2019; 126:1391-1401. [DOI: 10.1111/jam.14242] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 02/19/2019] [Accepted: 02/27/2019] [Indexed: 12/23/2022]
Affiliation(s)
- W. Dong
- School of Resource and Environmental Engineering Jiangxi University of Science and Technology Ganzhou China
- Department of Molecular Biology and Biophysics UConn Health Farmington CT USA
| | - J. Green
- Department of Molecular Biology and Biophysics UConn Health Farmington CT USA
| | - G. Korza
- Department of Molecular Biology and Biophysics UConn Health Farmington CT USA
| | - P. Setlow
- Department of Molecular Biology and Biophysics UConn Health Farmington CT USA
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50
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Dooley AC, Scott E, Green J, Springer KB, Dooley BS, Smith GJ. Mammut pacificus sp. nov., a newly recognized species of mastodon from the Pleistocene of western North America. PeerJ 2019; 7:e6614. [PMID: 30944777 PMCID: PMC6441323 DOI: 10.7717/peerj.6614] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 02/12/2019] [Indexed: 11/26/2022] Open
Abstract
A new species of mastodon from the Pleistocene of western North America, Mammut pacificus sp. nov. is herein recognized, with specimens identified throughout California and from two localities in southern Idaho. This new taxon differs from the contemporaneous M. americanum in having narrower teeth, most prominently in M3/m3, as well as six sacral vertebrae, femur with a proportionally greater mid-shaft diameter, and no mandibular tusks at any growth stage. All known Pleistocene Mammut remains from California are consistent with our diagnosis of M. pacificus, which indicates that M. americanum was not present in California.
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Affiliation(s)
| | - Eric Scott
- Cogstone Resource Management, Inc., Orange, CA, USA.,Department of Biology, California State University, San Bernardino, San Bernardino, CA, USA
| | - Jeremy Green
- Kent State University at Tuscarawas, New Philadelphia, OH, USA
| | | | | | - Gregory James Smith
- Department of Earth and Environmental Sciences, Vanderbilt University, Nashville, TN, USA
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