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Shrimpton AJ, Quayle AC, Sleep DL, Brown JM, Cook TM. Quantification of aerosol generation during positive pressure ventilation via a supraglottic airway with an intentional leak. Anaesthesia 2024; 79:318-320. [PMID: 38217363 DOI: 10.1111/anae.16197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 01/15/2024]
Affiliation(s)
| | - A C Quayle
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - D L Sleep
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - J M Brown
- North Bristol NHS Trust, Bristol, UK
| | - T M Cook
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
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2
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Brown JM, Steffensen A, Trump B. Clinical features and overall survival of osteosarcoma of the mandible. Int J Oral Maxillofac Surg 2023; 52:524-530. [PMID: 36243646 DOI: 10.1016/j.ijom.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 09/08/2022] [Accepted: 10/06/2022] [Indexed: 04/09/2023]
Abstract
Osteosarcoma is the most common bone sarcoma and is typically found in the distal femur, proximal tibia, and proximal humerus. While several factors are known to influence survival, less is known regarding the influence of primary tumor location. This study describes the clinical features and prognosis of mandibular osteosarcoma. The SEER database was utilized to identify cases of mandibular osteosarcoma diagnosed between 2004 and 2015. Sex, age, grade, histological subtype, tumor size, tumor extension, presence of metastasis at diagnosis, and therapeutic intervention were determined. Osteosarcomas originating from other sites were assessed for comparison. There were 164 cases of mandibular osteosarcoma identified, representing 5.5% of all surveyed osteosarcomas. The 2-, 5-, and 10-year overall survival rates were 79.9%, 65.6% and 58.5%, respectively. Survival was worse for patients with older age, larger tumor size, metastatic disease, and absence of surgical resection. Compared to other sites, mandibular osteosarcomas were significantly smaller tumors and were far less likely to metastasize. Mandibular osteosarcoma manifested at an older age than the more common extremity osteosarcomas and presented with smaller tumors. Rates of metastasis of jaw osteosarcoma were much lower than osteosarcoma found in the extremities, while mortality rates were comparable.
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Affiliation(s)
- J M Brown
- Department of Orthopaedics, Huntsman Cancer Institute, Salt Lake City, Utah, USA.
| | - A Steffensen
- University of Utah School of Dentistry, Salt Lake City, Utah, USA
| | - B Trump
- University of Utah School of Dentistry, Salt Lake City, Utah, USA
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Shrimpton AJ, O'Farrell G, Howes HM, Craven R, Duffen AR, Cook TM, Reid JP, Brown JM, Pickering AE. A quantitative evaluation of aerosol generation during awake tracheal intubation. Anaesthesia 2023; 78:587-597. [PMID: 36710390 DOI: 10.1111/anae.15968] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 01/31/2023]
Abstract
Aerosol-generating procedures are medical interventions considered high risk for transmission of airborne pathogens. Tracheal intubation of anaesthetised patients is not high risk for aerosol generation; however, patients often perform respiratory manoeuvres during awake tracheal intubation which may generate aerosol. To assess the risk, we undertook aerosol monitoring during a series of awake tracheal intubations and nasendoscopies in healthy participants. Sampling was undertaken within an ultraclean operating theatre. Procedures were performed and received by 12 anaesthetic trainees. The upper airway was topically anaesthetised with lidocaine and participants were not sedated. An optical particle sizer continuously sampled aerosol. Passage of the bronchoscope through the vocal cords generated similar peak median (IQR [range]) aerosol concentrations to coughing, 1020 (645-1245 [120-48,948]) vs. 1460 (390-2506 [40-12,280]) particles.l-1 respectively, p = 0.266. Coughs evoked when lidocaine was sprayed on the vocal cords generated 91,700 (41,907-166,774 [390-557,817]) particles.l-1 which was significantly greater than volitional coughs (p < 0.001). For 38 nasendoscopies in 12 participants, the aerosol concentrations were relatively low, 180 (120-525 [0-9552]) particles.l-1 , however, five nasendoscopies generated peak aerosol concentrations greater than a volitional cough. Awake tracheal intubation and nasendoscopy can generate high concentrations of respiratory aerosol. Specific risks are associated with lidocaine spray of the larynx, instrumentation of the vocal cords, procedural coughing and deep breaths. Given the proximity of practitioners to patient-generated aerosol, airborne infection control precautions are appropriate when undertaking awake upper airway endoscopy (including awake tracheal intubation, nasendoscopy and bronchoscopy) if respirable pathogens cannot be confidently excluded.
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Affiliation(s)
- A J Shrimpton
- Anaesthesia, Pain and Critical Care Sciences, School of Physiology, Pharmacology and Neuroscience, University of Bristol, UK
| | - G O'Farrell
- Department of Anaesthesia, University Hospitals Bristol and Weston Foundation Trust, Bristol, UK
| | - H M Howes
- Department of Anaesthesia, University Hospitals Bristol and Weston Foundation Trust, Bristol, UK
| | - R Craven
- Department of Anaesthesia, University Hospitals Bristol and Weston Foundation Trust, Bristol, UK
| | - A R Duffen
- Department of Anaesthesia, University Hospitals Bristol and Weston Foundation Trust, Bristol, UK
| | - T M Cook
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital NHS Trust, Bath, UK
| | - J P Reid
- School of Chemistry, University of Bristol, UK
| | - J M Brown
- Department of Anaesthesia and Intensive Care Medicine, North Bristol NHS Trust, Bristol, UK
| | - A E Pickering
- Anaesthesia, Pain and Critical Care Sciences, School of Physiology, Pharmacology and Neuroscience, University of Bristol, UK.,Department of Anaesthesia, University Hospitals Bristol and Weston Foundation Trust, Bristol, UK
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Shrimpton AJ, Brown JM, Cook TM, Penfold CM, Reid JP, Pickering AE. Quantitative evaluation of aerosol generation from upper airway suctioning assessed during tracheal intubation and extubation sequences in anaesthetized patients. J Hosp Infect 2022; 124:13-21. [PMID: 35276282 PMCID: PMC9172909 DOI: 10.1016/j.jhin.2022.02.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/17/2022] [Accepted: 02/28/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Open respiratory suctioning is defined as an aerosol generating procedure (AGP). Laryngopharyngeal suctioning, used to clear secretions during anaesthesia, is widely managed as an AGP. However, it is uncertain whether upper airway suctioning should be designated as an AGP due to the lack of both aerosol and epidemiological evidence. AIM To assess the relative risk of aerosol generation by upper airway suctioning during tracheal intubation and extubation in anaesthetized patients. METHODS This prospective environmental monitoring study was undertaken in an ultraclean operating theatre setting to assay aerosol concentrations during intubation and extubation sequences, including upper airway suctioning, for patients undergoing surgery (N=19). An optical particle sizer (particle size 0.3-10 μm) sampled aerosol 20 cm above the patient's mouth. Baseline recordings (background, tidal breathing and volitional coughs) were followed by intravenous induction of anaesthesia with neuromuscular blockade. Four periods of laryngopharyngeal suctioning were performed with a Yankauer sucker: pre-laryngoscopy, post-intubation, pre-extubation and post-extubation. FINDINGS Aerosol was reliably detected {median 65 [interquartile range (IQR) 39-259] particles/L} above background [median 4.8 (IQR 1-7) particles/L, P<0.0001] when sampling in close proximity to the patient's mouth during tidal breathing. Upper airway suctioning was associated with a much lower average aerosol concentration than breathing [median 6.0 (IQR 0-12) particles/L, P=0.0007], and was indistinguishable from background (P>0.99). Peak aerosol concentrations recorded during suctioning [median 45 (IQR 30-75) particles/L] were much lower than during volitional coughs [median 1520 (IQR 600-4363) particles/L, P<0.0001] and tidal breathing [median 540 (IQR 300-1826) particles/L, P<0.0001]. CONCLUSION Upper airway suctioning during airway management was not associated with a higher aerosol concentration compared with background, and was associated with a much lower aerosol concentration compared with breathing and coughing. Upper airway suctioning should not be designated as a high-risk AGP.
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Affiliation(s)
- A J Shrimpton
- Anaesthesia, Pain and Critical Care, School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK.
| | - J M Brown
- Department of Anaesthesia and Intensive Care Medicine, North Bristol NHS Trust, Bristol, UK
| | - T M Cook
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital NHS Trust, Bath, UK
| | - C M Penfold
- Bristol Biomedical Research Centre, University of Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - J P Reid
- School of Chemistry, University of Bristol, Bristol, UK
| | - A E Pickering
- Anaesthesia, Pain and Critical Care, School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
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Shrimpton AJ, Gregson FKA, Brown JM, Cook TM, Bzdek BR, Hamilton F, Reid JP, Pickering AE. A quantitative evaluation of aerosol generation during supraglottic airway insertion and removal. Anaesthesia 2021; 76:1577-1584. [PMID: 34287820 DOI: 10.1111/anae.15542] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2021] [Indexed: 12/30/2022]
Abstract
Many guidelines consider supraglottic airway use to be an aerosol-generating procedure. This status requires increased levels of personal protective equipment, fallow time between cases and results in reduced operating theatre efficiency. Aerosol generation has never been quantitated during supraglottic airway use. To address this evidence gap, we conducted real-time aerosol monitoring (0.3-10-µm diameter) in ultraclean operating theatres during supraglottic airway insertion and removal. This showed very low background particle concentrations (median (IQR [range]) 1.6 (0-3.1 [0-4.0]) particles.l-1 ) against which the patient's tidal breathing produced a higher concentration of aerosol (4.0 (1.3-11.0 [0-44]) particles.l-1 , p = 0.048). The average aerosol concentration detected during supraglottic airway insertion (1.3 (1.0-4.2 [0-6.2]) particles.l-1 , n = 11), and removal (2.1 (0-17.5 [0-26.2]) particles.l-1 , n = 12) was no different to tidal breathing (p = 0.31 and p = 0.84, respectively). Comparison of supraglottic airway insertion and removal with a volitional cough (104 (66-169 [33-326]), n = 27), demonstrated that supraglottic airway insertion/removal sequences produced <4% of the aerosol compared with a single cough (p < 0.001). A transient aerosol increase was recorded during one complicated supraglottic airway insertion (which initially failed to provide a patent airway). Detailed analysis of this event showed an atypical particle size distribution and we subsequently identified multiple sources of non-respiratory aerosols that may be produced during airway management and can be considered as artefacts. These findings demonstrate supraglottic airway insertion/removal generates no more bio-aerosol than breathing and far less than a cough. This should inform the design of infection prevention strategies for anaesthetists and operating theatre staff caring for patients managed with supraglottic airways.
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Affiliation(s)
- A J Shrimpton
- Pain and Critical Care Sciences and School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
| | - F K A Gregson
- School of Chemistry, University of Bristol, Bristol, UK
| | - J M Brown
- Department of Anaesthesia and Intensive Care Medicine, North Bristol NHS Trust, Bristol, UK
| | - T M Cook
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital NHS Trust, Bath, UK
| | - B R Bzdek
- School of Chemistry, University of Bristol, Bristol, UK
| | - F Hamilton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - J P Reid
- School of Chemistry, University of Bristol, Bristol, UK
| | - A E Pickering
- Pain and Critical Care Sciences and School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
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Kovacs TZ, Ramsden JA, Thomas IP, Brown JM. Synthesis, analysis and study of sulfide-linked high functionality resin beads. ARKIVOC 2021. [DOI: 10.24820/ark.5550190.p011.623] [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: 11/23/2022] Open
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7
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Shrimpton AJ, Brown JM, Cook TM, Pickering AE. A quantitative evaluation of aerosol generation during supraglottic airway insertion and removal. Anaesthesia 2021; 77:230-231. [PMID: 34432884 DOI: 10.1111/anae.15572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 11/30/2022]
Affiliation(s)
| | - J M Brown
- North Bristol NHS Trust, Bristol, UK
| | - T M Cook
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
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Brown JM, Yelland MJ, Pullen T, Silva E, Martin A, Gold I, Whittle L, Wisse P. Novel use of social media to assess and improve coastal flood forecasts and hazard alerts. Sci Rep 2021; 11:13727. [PMID: 34215770 PMCID: PMC8253846 DOI: 10.1038/s41598-021-93077-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/18/2021] [Indexed: 11/30/2022] Open
Abstract
Coastal communities and infrastructure need protection from flooding and wave overtopping events. Assessment of hazard prediction methods, used in sea defence design, defence performance inspections and forecasting services, requires observations at the land-sea interface but these are rarely collected. Here we show how a database of hindcast overtopping events, and the conditions that cause them, can be built using qualitative overtopping information obtained from social media. We develop a database for a case study site at Crosby in the Northwest of England, use it to test the standard methods applied in operational flood forecasting services and new defence design, and suggest improvements to these methods. This novel approach will become increasingly important to deliver long-term, cost-effective coastal management solutions as sea-levels rise and coastal populations grow. At sites with limited, or no, monitoring or forecasting services, this approach, especially if combined with citizen science initiatives, could underpin the development of simplified early warning systems.
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Affiliation(s)
- J M Brown
- National Oceanography Centre, 6 Brownlow Street, Liverpool, L3 5AD, UK.
| | - M J Yelland
- National Oceanography Centre, European Way, Southampton, SO14 3ZH, UK
| | - T Pullen
- HR Wallingford, Howbery Park, Wallingford, Oxfordshire, OX10 8BA, UK
| | - E Silva
- HR Wallingford, Howbery Park, Wallingford, Oxfordshire, OX10 8BA, UK
| | - A Martin
- Sefton Council, Trinity Road, Bootle, Liverpool, L20 3NJ, UK
| | - I Gold
- Environment Agency, Richard Fairclough House, Knutsford Road, Warrington, WA4 1HT, UK
| | - L Whittle
- Sefton Council, Trinity Road, Bootle, Liverpool, L20 3NJ, UK
| | - P Wisse
- Sefton Council, Trinity Road, Bootle, Liverpool, L20 3NJ, UK
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Huang TY, Linden MA, Fuller SE, Goldsmith FR, Simon J, Batdorf HM, Scott MC, Essajee NM, Brown JM, Noland RC. Combined effects of a ketogenic diet and exercise training alter mitochondrial and peroxisomal substrate oxidative capacity in skeletal muscle. Am J Physiol Endocrinol Metab 2021; 320:E1053-E1067. [PMID: 33843280 PMCID: PMC8285595 DOI: 10.1152/ajpendo.00410.2020] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Ketogenic diets (KDs) are reported to improve body weight, fat mass, and exercise performance in humans. Unfortunately, most rodent studies have used a low-protein KD, which does not recapitulate diets used by humans. Since skeletal muscle plays a critical role in responding to macronutrient perturbations induced by diet and exercise, the purpose of this study was to test if a normal-protein KD (NPKD) impacts shifts in skeletal muscle substrate oxidative capacity in response to exercise training (ExTr). A high fat, carbohydrate-deficient NPKD (16.1% protein, 83.9% fat, 0% carbohydrate) was given to C57BL/6J male mice for 6 wk, whereas controls (Con) received a low-fat diet with similar protein (15.9% protein, 11.9% fat, 72.2% carbohydrate). After 3 wk on the diet, mice began treadmill training 5 days/wk, 60 min/day for 3 wks. The NPKD increased body weight and fat mass, whereas ExTr negated a continued rise in adiposity. ExTr increased intramuscular glycogen, whereas the NPKD increased intramuscular triglycerides. Neither the NPKD nor ExTr alone altered mitochondrial content; however, in combination, the NPKD-ExTr group showed increases in PGC-1α and markers of mitochondrial fission/fusion. Pyruvate oxidative capacity was unchanged by either intervention, whereas ExTr increased leucine oxidation in NPKD-fed mice. Lipid metabolism pathways had the most notable changes as the NPKD and ExTr interventions both enhanced mitochondrial and peroxisomal lipid oxidation and many adaptations were additive or synergistic. Overall, these results suggest that a combination of a NPKD and ExTr induces additive and/or synergistic adaptations in skeletal muscle oxidative capacity.NEW & NOTEWORTHY A ketogenic diet with normal protein content (NPKD) increases body weight and fat mass, increases intramuscular triglyceride storage, and upregulates pathways related to protein metabolism. In combination with exercise training, a NPKD induces additive and/or synergistic activation of AMPK, PGC-1α, mitochondrial fission/fusion genes, mitochondrial fatty acid oxidation, and peroxisomal adaptations in skeletal muscle. Collectively, results from this study provide mechanistic insight into adaptations in skeletal muscle relevant to keto-adaptation.
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Affiliation(s)
- Tai-Yu Huang
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Melissa A Linden
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Scott E Fuller
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Felicia R Goldsmith
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Jacob Simon
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Heidi M Batdorf
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Matthew C Scott
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Nabil M Essajee
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - John M Brown
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Robert C Noland
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana
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Mattison A, Brown JM, Carmichael D, Alcock NW. Are stable atropisomers possible for meta-meta’ linked biphenols. Tetrahedron 2021. [DOI: 10.1016/j.tet.2021.132114] [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: 12/01/2022]
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Slade AL, Retzer A, Ahmed K, Kyte D, Keeley T, Armes J, Brown JM, Calman L, Gavin A, Glaser AW, Greenfield DM, Lanceley A, Taylor RM, Velikova G, Turner G, Calvert MJ. Systematic review of the use of translated patient-reported outcome measures in cancer trials. Trials 2021; 22:306. [PMID: 33902699 PMCID: PMC8074490 DOI: 10.1186/s13063-021-05255-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 04/08/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Patient-reported outcomes (PROs) are used in clinical trials to assess the effectiveness and tolerability of interventions. Inclusion of participants from different ethnic backgrounds is essential for generalisability of cancer trial results. PRO data collection should include appropriately translated patient-reported outcome measures (PROMs) to minimise missing data and sample attrition. METHODS Protocols and/or publications from cancer clinical trials using a PRO endpoint and registered on the National Institute for Health Research Portfolio were systematically reviewed for information on recruitment, inclusion of ethnicity data, and use of appropriately translated PROMs. Semi-structured interviews were conducted with key stakeholders to explore barriers and facilitators for optimal PRO trial design, diverse recruitment and reporting, and use of appropriately translated PROMs. RESULTS Eighty-four trials met the inclusion criteria, only 14 (17%) (n = 4754) reported ethnic group data, and ethnic group recruitment was low, 611 (13%). Although 8 (57%) studies were multi-centred and multi-national, none reported using translated PROMs, although available for 7 (88%) of the studies. Interviews with 44 international stakeholders identified a number of perceived barriers to ethnically diverse recruitment including diverse participant engagement, relevance of ethnicity to research question, prominence of PROs, and need to minimise investigator burden. Stakeholders had differing opinions on the use of translated PROMs, the impact of trial designs, and recruitment strategies on diverse recruitment. Facilitators of inclusive research were described and examples of good practice identified. CONCLUSIONS Greater transparency is required when PROs are used as primary or secondary outcomes in clinical trials. Protocols and publications should demonstrate that recruitment was accessible to diverse populations and facilitated by trial design, recruitment strategies, and appropriate PROM usage. The use of translated PROMs should be made explicit when used in cancer clinical trials.
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Affiliation(s)
- A L Slade
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. .,National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK. .,National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, West Midlands, UK.
| | - A Retzer
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - K Ahmed
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - D Kyte
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK.,National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK
| | - T Keeley
- Patient Centred Outcomes, GlaxoSmithKline, Brentford, UK
| | - J Armes
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,School of Health Sciences, University of Surrey, Guildford, UK.,NIHR Applied Research Collaboration Kent Surrey & Sussex University of Surrey, Guildford, UK
| | - J M Brown
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - L Calman
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Macmillan Survivorship Research Group, Health Sciences, University of Southampton, Highfield Campus, Southampton, UK
| | - A Gavin
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Northern Ireland Cancer Registry, Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - A W Glaser
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - D M Greenfield
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | - A Lanceley
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - R M Taylor
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Cancer Clinical Trials Unit, University College London Hospitals NHS Foundation Trust, London, UK
| | - G Velikova
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - G Turner
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - M J Calvert
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK.,National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, West Midlands, UK.,National Institute for Health Research Applied Research Collaboration, University of Birmingham, Birmingham, West Midlands, UK.,Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, West Midlands, UK
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Downey CL, Croft J, Ainsworth G, Buckley H, Shinkins B, Randell R, Brown JM, Jayne DG. Trial of remote continuous versus intermittent NEWS monitoring after major surgery (TRaCINg): a feasibility randomised controlled trial. Pilot Feasibility Stud 2020; 6:183. [PMID: 33292669 PMCID: PMC7684886 DOI: 10.1186/s40814-020-00709-8] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/16/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Despite medical advances, major surgery remains high risk with up to 44% of patients experiencing postoperative complications. Early recognition of postoperative complications is crucial in reducing morbidity and preventing long-term disability. The current standard of care is intermittent manual vital signs monitoring, but new wearable remote monitors offer the benefits of continuous vital signs monitoring without limiting the patient's mobility. The aim of this study was to evaluate the feasibility, acceptability and clinical outcomes of continuous remote monitoring after major surgery. METHODS The study was a randomised, controlled, unblinded, parallel group, feasibility trial. Adult patients undergoing elective major surgery were randomly assigned to receive continuous remote monitoring and normal National Early Warning Score (NEWS) monitoring (intervention group) or normal NEWS monitoring alone (control group). Continuous remote monitoring was achieved using the SensiumVitals® wireless patch which is worn on the patient's chest and monitors heart rate, respiratory rate and temperature continuously, and alerts the nurse when there is deviation from pre-set physiological norms. Feasibility was assessed by evaluating recruitment rate, adherence to protocol and randomisation and the amount of missing data. Clinical outcomes included time to antibiotics in cases of sepsis, length of hospital stay, number of critical care admissions and rate of hospital readmission within 30 days of discharge. RESULTS One hundred and thirty-six patients were randomised between October 2018 and April 2019: 67 to the control group and 69 to the intervention group. Recruitment was completed prior to the 12 month target with a high rate of eligibility and consent. Missing data was limited only to questionnaire responses; no participants were lost to follow-up and only one participant was withdrawn due to loss of capacity. The number of patients classed as 'drop-out' due to design (8.1%) were less than anticipated, and there were no participants who crossed over into the alternative trial allocation group. Seventeen participants in the intervention group (28%) did not adhere to the monitoring protocol. No formal comparisons between arms was undertaken; however, participants had fewer unplanned critical care admissions (1 versus 5) and had a shorter average length of hospital stay (11.6 days (95% confidence interval 9.5-13.7 days) versus 16.2 days (95% confidence interval 11.3-21.2 days)) in the continuous vital signs monitoring group. The time taken to receive antibiotics in cases of sepsis was similar in both arms. A cost-utility analysis indicated that the remote monitoring system was cost-saving when compared to standard NEWS monitoring alone. CONCLUSIONS It is feasible to perform a large-scale randomised controlled trial of continuous remote monitoring after major surgery. Progression to a definitive multicentre randomised controlled trial would be appropriate, taking consideration of factors, such as patient adherence, that might mask the potential benefit of additional monitoring. TRIAL REGISTRATION ISRCTN registry with study ID ISRCTN16601772 . Registered 30 August 2017.
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Affiliation(s)
- C L Downey
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, LS9 7TF, UK.
- St James's University Hospital, Level 7, Clinical Sciences Building, Leeds, LS9 7TF, UK.
| | - J Croft
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9NL, UK
| | - G Ainsworth
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9NL, UK
| | - H Buckley
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9NL, UK
| | - B Shinkins
- Academic Unit of Health Economics, University of Leeds, Leeds, LS2 9NL, UK
| | - R Randell
- School of Healthcare, Baines Wing, University of Leeds, Leeds, LS2 9JT, UK
| | - J M Brown
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9NL, UK
| | - D G Jayne
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, LS9 7TF, UK
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Ibba F, Pupo G, Thompson AL, Brown JM, Claridge TDW, Gouverneur V. Impact of Multiple Hydrogen Bonds with Fluoride on Catalysis: Insight from NMR Spectroscopy. J Am Chem Soc 2020; 142:19731-19744. [PMID: 33166450 PMCID: PMC7677927 DOI: 10.1021/jacs.0c09832] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
![]()
Hydrogen-bonding
interactions have been explored in catalysis,
enabling complex chemical reactions. Recently, enantioselective nucleophilic
fluorination with metal alkali fluoride has been accomplished with
BINAM-derived bisurea catalysts, presenting up to four NH hydrogen-bond
donors (HBDs) for fluoride. These catalysts bring insoluble CsF and
KF into solution, control fluoride nucleophilicity, and provide a
chiral microenvironment for enantioselective fluoride delivery to
the electrophile. These attributes encouraged a 1H/19F NMR study to gain information on hydrogen-bonding networks
with fluoride in solution, as well as how these arrangements impact
the efficiency of catalytic nucleophilic fluorination. Herein, NMR
experiments enabled the determination of the number and magnitude
of HB contacts to fluoride for thirteen bisurea catalysts. These data
supplemented by diagnostic coupling constants 1hJNH···F– give
insight into how multiple H bonds to fluoride influence reaction performance.
In dichloromethane (DCM-d2), nonalkylated
BINAM-derived bisurea catalyst engages two of its four NH groups in
hydrogen bonding with fluoride, an arrangement that allows effective
phase-transfer capability but low control over enantioselectivity
for fluoride delivery. The more efficient N-alkylated BINAM-derived
bisurea catalysts undergo urea isomerization upon fluoride binding
and form dynamically rigid trifurcated hydrogen-bonded fluoride complexes
that are structurally similar to their conformation in the solid state.
Insight into how the countercation influences fluoride complexation
is provided based on NMR data characterizing the species formed in
DCM-d2 when reacting a bisurea catalyst
with tetra-n-butylammonium fluoride (TBAF) or CsF.
Structure–activity analysis reveals that the three hydrogen-bond
contacts with fluoride are not equal in terms of their contribution
to catalyst efficacy, suggesting that tuning individual electronic
environment is a viable approach to control phase-transfer ability
and enantioselectivity.
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Affiliation(s)
- Francesco Ibba
- Chemistry Research Laboratory, University of Oxford, 12 Mansfield Road, Oxford OX1 3TA, United Kingdom
| | - Gabriele Pupo
- Chemistry Research Laboratory, University of Oxford, 12 Mansfield Road, Oxford OX1 3TA, United Kingdom
| | - Amber L Thompson
- Chemistry Research Laboratory, University of Oxford, 12 Mansfield Road, Oxford OX1 3TA, United Kingdom
| | - John M Brown
- Chemistry Research Laboratory, University of Oxford, 12 Mansfield Road, Oxford OX1 3TA, United Kingdom
| | - Timothy D W Claridge
- Chemistry Research Laboratory, University of Oxford, 12 Mansfield Road, Oxford OX1 3TA, United Kingdom
| | - Véronique Gouverneur
- Chemistry Research Laboratory, University of Oxford, 12 Mansfield Road, Oxford OX1 3TA, United Kingdom
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Emmerson J, Brown JM. Understanding Survival Analysis in Clinical Trials. Clin Oncol (R Coll Radiol) 2020; 33:12-14. [PMID: 32788065 DOI: 10.1016/j.clon.2020.07.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 06/30/2020] [Accepted: 07/15/2020] [Indexed: 11/26/2022]
Affiliation(s)
- J Emmerson
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.
| | - J M Brown
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
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15
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Papadimitriou-Olivgeri I, Brown JM, Kilpatrick AFR, Gill HS, Athanasou NA. Correction to: Solochrome cyanine: A histological stain for cobalt-chromium wear particles in metal-on-metal periprosthetic tissues. J Mater Sci Mater Med 2019; 30:110. [PMID: 31555914 PMCID: PMC6828412 DOI: 10.1007/s10856-019-6312-0] [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] [Indexed: 06/10/2023]
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Affiliation(s)
- I Papadimitriou-Olivgeri
- Department of Histopathology, NDORMS, University of Oxford, Nuffield Orthopaedic Centre, Oxford, OX3 7HE, UK
| | - J M Brown
- Department of Histopathology, NDORMS, University of Oxford, Nuffield Orthopaedic Centre, Oxford, OX3 7HE, UK
| | - A F R Kilpatrick
- Chemistry Research Laboratory, Mansfield Road, Oxford, OX1 3TA, UK
| | - H S Gill
- Department of Mechanical Engineering, University of Bath, Bath, BA2 7AY, UK
| | - N A Athanasou
- Department of Histopathology, NDORMS, University of Oxford, Nuffield Orthopaedic Centre, Oxford, OX3 7HE, UK.
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16
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Papadimitriou-Olivgeri I, Brown JM, Kilpatrick AFR, Gill HS, Athanasou NA. Solochrome cyanine: A histological stain for cobalt-chromium wear particles in metal-on-metal periprosthetic tissues. J Mater Sci Mater Med 2019; 30:103. [PMID: 31493091 PMCID: PMC6731196 DOI: 10.1007/s10856-019-6304-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 08/23/2019] [Indexed: 06/10/2023]
Abstract
Metal-on-metal (MoM) hip arthroplasties produce abundant implant-derived wear debris composed mainly of cobalt (Co) and chromium (Cr). Cobalt-chromium (Co-Cr) wear particles are difficult to identify histologically and need to be distinguished from other wear particle types and endogenous components (e.g., haemosiderin, fibrin) which may be present in MoM periprosthetic tissues. In this study we sought to determine whether histological stains that have an affinity for metals are useful in identifying Co-Cr wear debris in MoM periprosthetic tissues. Histological sections of periprosthetic tissue from 30 failed MoM hip arthroplasties were stained with haematoxylin-eosin (HE), Solochrome Cyanine (SC), Solochrome Azurine (SA) and Perls' Prussian Blue (PB). Sections of periprosthetic tissue from 10 cases of non-MoM arthroplasties using other implant biomaterials, including titanium, ceramic, polymethylmethacrylate (PMMA) and ultra-high molecular weight polyethylene (UHMWP) were similarly analysed. Sections of 10 cases of haemosiderin-containing knee tenosynovial giant cell tumour (TSGCT) were also stained with HE, SC, SA and PB. In MoM periprosthetic tissues, SC stained metal debris in phagocytic macrophages and in the superficial necrotic zone which exhibited little or no trichrome staining for fibrin. In non-MoM periprosthetic tissues, UHMWP, PMMA, ceramic and titanium particles were not stained by SC. Prussian Blue, but not SC or SA, stained haemosiderin deposits in MoM periprosthetic tissues and TSGT. Our findings show that SC staining (most likely Cr-associated) is useful in distinguishing Co-Cr wear particles from other metal/non-metal wear particles types in histological preparations of periprosthetic tissue and that SC reliably distinguishes haemosiderin from Co-Cr wear debris.
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Affiliation(s)
- I Papadimitriou-Olivgeri
- Department of Histopathology, NDORMS, University of Oxford, Nuffield Orthopaedic Centre, Oxford, OX3 7HE, UK
| | - J M Brown
- Department of Histopathology, NDORMS, University of Oxford, Nuffield Orthopaedic Centre, Oxford, OX3 7HE, UK
| | - A F R Kilpatrick
- Chemistry Research Laboratory, Mansfield Road, Oxford, OX1 3TA, UK
| | - H S Gill
- Department of Mechanical Engineering, University of Bath, Bath, BA2 7AY, UK
| | - N A Athanasou
- Department of Histopathology, NDORMS, University of Oxford, Nuffield Orthopaedic Centre, Oxford, OX3 7HE, UK.
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Mullane KM, Morrison VA, Camacho LH, Arvin A, McNeil SA, Durrand J, Campbell B, Su SC, Chan ISF, Parrino J, Kaplan SS, Popmihajlov Z, Annunziato PW, Cerana S, Dictar MO, Bonvehi P, Tregnaghi JP, Fein L, Ashley D, Singh M, Hayes T, Playford G, Morrissey O, Thaler J, Kuehr T, Greil R, Pecherstorfer M, Duck L, Van Eygen K, Aoun M, De Prijck B, Franke FA, Barrios CHE, Mendes AVA, Serrano SV, Garcia RF, Moore F, Camargo JFC, Pires LA, Alves RS, Radinov A, Oreshkov K, Minchev V, Hubenova AI, Koynova T, Ivanov I, Rabotilova B, Minchev V, Petrov PA, Chilingirov P, Karanikolov S, Raynov J, Grimard D, McNeil S, Kumar D, Larratt LM, Weiss K, Delage R, Diaz-Mitoma FJ, Cano PO, Couture F, Carvajal P, Yepes A, Torres Ulloa R, Fardella P, Caglevic C, Rojas C, Orellana E, Gonzalez P, Acevedo A, Galvez KM, Gonzalez ME, Franco S, Restrepo JG, Rojas CA, Bonilla C, Florez LE, Ospina AV, Manneh R, Zorica R, Vrdoljak DV, Samarzija M, Petruzelka L, Vydra J, Mayer J, Cibula D, Prausova J, Paulson G, Ontaneda M, Palk K, Vahlberg A, Rooneem R, Galtier F, Postil D, Lucht F, Laine F, Launay O, Laurichesse H, Duval X, Cornely OA, Camerer B, Panse J, Zaiss M, Derigs HG, Menzel H, Verbeek M, Georgoulias V, Mavroudis D, Anagnostopoulos A, Terpos E, Cortes D, Umanzor J, Bejarano S, Galeano RW, Wong RSM, Hui P, Pedrazzoli P, Ruggeri L, Aversa F, Bosi A, Gentile G, Rambaldi A, Contu A, Marei L, Abbadi A, Hayajneh W, Kattan J, Farhat F, Chahine G, Rutkauskiene J, Marfil Rivera LJ, Lopez Chuken YA, Franco Villarreal H, Lopez Hernandez J, Blacklock H, Lopez RI, Alvarez R, Gomez AM, Quintana TS, Moreno Larrea MDC, Zorrilla SJ, Alarcon E, Samanez FCA, Caguioa PB, Tiangco BJ, Mora EM, Betancourt-Garcia RD, Hallman-Navarro D, Feliciano-Lopez LJ, Velez-Cortes HA, Cabanillas F, Ganea DE, Ciuleanu TE, Ghizdavescu DG, Miron L, Cebotaru CL, Cainap CI, Anghel R, Dvorkin MV, Gladkov OA, Fadeeva NV, Kuzmin AA, Lipatov ON, Zbarskaya II, Akhmetzyanov FS, Litvinov IV, Afanasyev BV, Cherenkova M, Lioznov D, Lisukov IA, Smirnova YA, Kolomietz S, Halawani H, Goh YT, Drgona L, Chudej J, Matejkova M, Reckova M, Rapoport BL, Szpak WM, Malan DR, Jonas N, Jung CW, Lee DG, Yoon SS, Lopez Jimenez J, Duran Martinez I, Rodriguez Moreno JF, Solano Vercet C, de la Camara R, Batlle Massana M, Yeh SP, Chen CY, Chou HH, Tsai CM, Chiu CH, Siritanaratkul N, Norasetthada L, Sriuranpong V, Seetalarom K, Akan H, Dane F, Ozcan MA, Ozsan GH, Kalayoglu Besisik SF, Cagatay A, Yalcin S, Peniket A, Mullan SR, Dakhil KM, Sivarajan K, Suh JJG, Sehgal A, Marquez F, Gomez EG, Mullane MR, Skinner WL, Behrens RJ, Trevarthe DR, Mazurczak MA, Lambiase EA, Vidal CA, Anac SY, Rodrigues GA, Baltz B, Boccia R, Wertheim MS, Holladay CS, Zenk D, Fusselman W, Wade III JL, Jaslowsk AJ, Keegan J, Robinson MO, Go RS, Farnen J, Amin B, Jurgens D, Risi GF, Beatty PG, Naqvi T, Parshad S, Hansen VL, Ahmed M, Steen PD, Badarinath S, Dekker A, Scouros MA, Young DE, Graydon Harker W, Kendall SD, Citron ML, Chedid S, Posada JG, Gupta MK, Rafiyath S, Buechler-Price J, Sreenivasappa S, Chay CH, Burke JM, Young SE, Mahmood A, Kugler JW, Gerstner G, Fuloria J, Belman ND, Geller R, Nieva J, Whittenberger BP, Wong BMY, Cescon TP, Abesada-Terk G, Guarino MJ, Zweibach A, Ibrahim EN, Takahashi G, Garrison MA, Mowat RB, Choi BS, Oliff IA, Singh J, Guter KA, Ayrons K, Rowland KM, Noga SJ, Rao SB, Columbie A, Nualart MT, Cecchi GR, Campos LT, Mohebtash M, Flores MR, Rothstein-Rubin R, O'Connor BM, Soori G, Knapp M, Miranda FG, Goodgame BW, Kassem M, Belani R, Sharma S, Ortiz T, Sonneborn HL, Markowitz AB, Wilbur D, Meiri E, Koo VS, Jhangiani HS, Wong L, Sanani S, Lawrence SJ, Jones CM, Murray C, Papageorgiou C, Gurtler JS, Ascensao JL, Seetalarom K, Venigalla ML, D'Andrea M, De Las Casas C, Haile DJ, Qazi FU, Santander JL, Thomas MR, Rao VP, Craig M, Garg RJ, Robles R, Lyons RM, Stegemoller RK, Goel S, Garg S, Lowry P, Lynch C, Lash B, Repka T, Baker J, Goueli BS, Campbell TC, Van Echo DA, Lee YJ, Reyes EA, Senecal FM, Donnelly G, Byeff P, Weiss R, Reid T, Roeland E, Goel A, Prow DM, Brandt DS, Kaplan HG, Payne JE, Boeckh MG, Rosen PJ, Mena RR, Khan R, Betts RF, Sharp SA, Morrison VA, Fitz-Patrick D, Congdon J, Erickson N, Abbasi R, Henderson S, Mehdi A, Wos EJ, Rehmus E, Beltzer L, Tamayo RA, Mahmood T, Reboli AC, Moore A, Brown JM, Cruz J, Quick DP, Potz JL, Kotz KW, Hutchins M, Chowhan NM, Devabhaktuni YD, Braly P, Berenguer RA, Shambaugh SC, O'Rourke TJ, Conkright WA, Winkler CF, Addo FEK, Duic JP, High KP, Kutner ME, Collins R, Carrizosa DR, Perry DJ, Kailath E, Rosen N, Sotolongo R, Shoham S, Chen T. Safety and efficacy of inactivated varicella zoster virus vaccine in immunocompromised patients with malignancies: a two-arm, randomised, double-blind, phase 3 trial. The Lancet Infectious Diseases 2019; 19:1001-1012. [DOI: 10.1016/s1473-3099(19)30310-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/02/2019] [Accepted: 05/03/2019] [Indexed: 12/25/2022]
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Fuller SE, Huang TY, Simon J, Batdorf HM, Essajee NM, Scott MC, Waskom CM, Brown JM, Burke SJ, Collier JJ, Noland RC. Low-intensity exercise induces acute shifts in liver and skeletal muscle substrate metabolism but not chronic adaptations in tissue oxidative capacity. J Appl Physiol (1985) 2019; 127:143-156. [PMID: 31095457 PMCID: PMC6692746 DOI: 10.1152/japplphysiol.00820.2018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 04/23/2019] [Accepted: 05/08/2019] [Indexed: 02/08/2023] Open
Abstract
Adaptations in hepatic and skeletal muscle substrate metabolism following acute and chronic (6 wk; 5 days/wk; 1 h/day) low-intensity treadmill exercise were tested in healthy male C57BL/6J mice. Low-intensity exercise maximizes lipid utilization; therefore, we hypothesized pathways involved in lipid metabolism would be most robustly affected. Acute exercise nearly depleted liver glycogen immediately postexercise (0 h), whereas hepatic triglyceride (TAG) stores increased in the early stages after exercise (0-3 h). Also, hepatic peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) gene expression and fat oxidation (mitochondrial and peroxisomal) increased immediately postexercise (0 h), whereas carbohydrate and amino acid oxidation in liver peaked 24-48 h later. Alternatively, skeletal muscle exhibited a less robust response to acute exercise as stored substrates (glycogen and TAG) remained unchanged, induction of PGC-1α gene expression was delayed (up at 3 h), and mitochondrial substrate oxidation pathways (carbohydrate, amino acid, and lipid) were largely unaltered. Peroxisomal lipid oxidation exhibited the most dynamic changes in skeletal muscle substrate metabolism after acute exercise; however, this response was also delayed (peaked 3-24 h postexercise), and expression of peroxisomal genes remained unaffected. Interestingly, 6 wk of training at a similar intensity limited weight gain, increased muscle glycogen, and reduced TAG accrual in liver and muscle; however, substrate oxidation pathways remained unaltered in both tissues. Collectively, these results suggest changes in substrate metabolism induced by an acute low-intensity exercise bout in healthy mice are more rapid and robust in liver than in skeletal muscle; however, training at a similar intensity for 6 wk is insufficient to induce remodeling of substrate metabolism pathways in either tissue. NEW & NOTEWORTHY Effects of low-intensity exercise on substrate metabolism pathways were tested in liver and skeletal muscle of healthy mice. This is the first study to describe exercise-induced adaptations in peroxisomal lipid metabolism and also reports comprehensive adaptations in mitochondrial substrate metabolism pathways (carbohydrate, lipid, and amino acid). Acute low-intensity exercise induced shifts in mitochondrial and peroxisomal metabolism in both tissues, but training at this intensity did not induce adaptive remodeling of metabolic pathways in healthy mice.
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Affiliation(s)
- Scott E Fuller
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center , Baton Rouge, Louisiana
- School of Kinesiology, University of Louisiana at Lafayette , Lafayette, Louisiana
| | - Tai-Yu Huang
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center , Baton Rouge, Louisiana
| | - Jacob Simon
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center , Baton Rouge, Louisiana
| | - Heidi M Batdorf
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center , Baton Rouge, Louisiana
- Laboratory of Immunogenetics, Pennington Biomedical Research Center , Baton Rouge, Louisiana
- Laboratory of Islet Biology and Inflammation, Pennington Biomedical Research Center , Baton Rouge, Louisiana
| | - Nabil M Essajee
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center , Baton Rouge, Louisiana
| | - Matthew C Scott
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center , Baton Rouge, Louisiana
| | - Callie M Waskom
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center , Baton Rouge, Louisiana
| | - John M Brown
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center , Baton Rouge, Louisiana
| | - Susan J Burke
- Laboratory of Immunogenetics, Pennington Biomedical Research Center , Baton Rouge, Louisiana
| | - J Jason Collier
- Laboratory of Islet Biology and Inflammation, Pennington Biomedical Research Center , Baton Rouge, Louisiana
| | - Robert C Noland
- Skeletal Muscle Metabolism Laboratory, Pennington Biomedical Research Center , Baton Rouge, Louisiana
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Kotecha T, Martinez-Naharro A, Lambe T, Francis RD, Chacko LIZA, Brown JM, Knight DS, Hawkins PN, Moon JM, Kellman PN, Bulluck H, Hausenloy DS, Rakhit RD, Fontana M. 48Quantification of myocardial infarct size and microvascular obstruction using dark-blood late gadolinium enhancement. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez112.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- T Kotecha
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - A Martinez-Naharro
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - T Lambe
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - R D Francis
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - L I Z A Chacko
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - J M Brown
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - D S Knight
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - P N Hawkins
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - J M Moon
- Barts Health NHS Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - P N Kellman
- National Institutes of Health, Bethesda, United States of America
| | - H Bulluck
- Norfolk and Norwich University Hospital, Norwich, United Kingdom of Great Britain & Northern Ireland
| | - D S Hausenloy
- National Heart Centre Singapore, Singapore, Singapore
| | - R D Rakhit
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - M Fontana
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
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Kotecha T, Martinez-Naharro A, Little C, Chacko LIZA, Manmathan G, Brown JM, Knight DS, Hawkins PN, Moon JM, Xue H, Lockie T, Rakhit RD, Kellman PN, Patel N, Fontana M. 303Quantitative CMR perfusion mapping to detect microvascular dysfunction in patients without obstructive coronary disease. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez119.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Kotecha
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - A Martinez-Naharro
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - C Little
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - L I Z A Chacko
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - G Manmathan
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - J M Brown
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - D S Knight
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - P N Hawkins
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - J M Moon
- Barts Health NHS Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - H Xue
- National Institutes of Health, Bethesda, United States of America
| | - T Lockie
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - R D Rakhit
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - P N Kellman
- National Institutes of Health, Bethesda, United States of America
| | - N Patel
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - M Fontana
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
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Kotecha T, Monteagudo JM, Martinez-Naharro A, Little C, Chacko LIZA, Brown JM, Knight D, Hawkins PN, Moon JM, Xue H, Kellman PN, Patel N, Lockie T, Rakhit RD, Fontana M. 302Redefining assessment of adenosine stress response using CMR perfusion mapping: An alternative to splenic switch off. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Kotecha
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - J M Monteagudo
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - A Martinez-Naharro
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - C Little
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - L I Z A Chacko
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - J M Brown
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - D Knight
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - P N Hawkins
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - J M Moon
- Barts Health NHS Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - H Xue
- National Institutes of Health, Bethesda, United States of America
| | - P N Kellman
- National Institutes of Health, Bethesda, United States of America
| | - N Patel
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - T Lockie
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - R D Rakhit
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - M Fontana
- Royal Free Hospital , Cardiology, London, United Kingdom of Great Britain & Northern Ireland
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22
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Abstract
Abstract
Over the past 100 years, the collaborative effort of the international science community, including government weather services and the media, along with the associated proliferation of environmental observations, improved scientific understanding, and growth of technology, has radically transformed weather forecasting into an effective global and regional environmental prediction capability. This chapter traces the evolution of forecasting, starting in 1919 [when the American Meteorological Society (AMS) was founded], over four eras separated by breakpoints at 1939, 1956, and 1985. The current state of forecasting could not have been achieved without essential collaboration within and among countries in pursuing the common weather and Earth-system prediction challenge. AMS itself has had a strong role in enabling this international collaboration.
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Affiliation(s)
- Stanley G. Benjamin
- NOAA/Office of Oceanic and Atmospheric Research/Earth System Research Laboratory Global Systems Division, Boulder, Colorado
| | - John M. Brown
- NOAA/Office of Oceanic and Atmospheric Research/Earth System Research Laboratory Global Systems Division, Boulder, Colorado
| | - Gilbert Brunet
- Environment and Climate Change Canada, Montreal, Quebec, Canada
| | | | - Kazuo Saito
- Atmosphere and Ocean Research Institute, University of Tokyo, Tokyo, Japan
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23
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Pupo G, Vicini AC, Ascough DMH, Ibba F, Christensen KE, Thompson AL, Brown JM, Paton RS, Gouverneur V. Hydrogen Bonding Phase-Transfer Catalysis with Potassium Fluoride: Enantioselective Synthesis of β-Fluoroamines. J Am Chem Soc 2019; 141:2878-2883. [DOI: 10.1021/jacs.8b12568] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Gabriele Pupo
- Chemistry Research
Laboratory, University of Oxford, 12 Mansfield Road, Oxford OX1 3TA, United Kingdom
| | - Anna Chiara Vicini
- Chemistry Research
Laboratory, University of Oxford, 12 Mansfield Road, Oxford OX1 3TA, United Kingdom
| | - David M. H. Ascough
- Chemistry Research
Laboratory, University of Oxford, 12 Mansfield Road, Oxford OX1 3TA, United Kingdom
| | - Francesco Ibba
- Chemistry Research
Laboratory, University of Oxford, 12 Mansfield Road, Oxford OX1 3TA, United Kingdom
| | - Kirsten E. Christensen
- Chemistry Research
Laboratory, University of Oxford, 12 Mansfield Road, Oxford OX1 3TA, United Kingdom
| | - Amber L. Thompson
- Chemistry Research
Laboratory, University of Oxford, 12 Mansfield Road, Oxford OX1 3TA, United Kingdom
| | - John M. Brown
- Chemistry Research
Laboratory, University of Oxford, 12 Mansfield Road, Oxford OX1 3TA, United Kingdom
| | - Robert S. Paton
- Chemistry Research
Laboratory, University of Oxford, 12 Mansfield Road, Oxford OX1 3TA, United Kingdom
- Department of Chemistry, Colorado State University, Fort Collins, Colorado 80523, United States
| | - Véronique Gouverneur
- Chemistry Research
Laboratory, University of Oxford, 12 Mansfield Road, Oxford OX1 3TA, United Kingdom
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24
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Bolton WS, Aruparayil N, Quyn A, Scott J, Wood A, Bundu I, Gnanaraj J, Brown JM, Jayne DG. Disseminating technology in global surgery. Br J Surg 2019; 106:e34-e43. [DOI: 10.1002/bjs.11036] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 10/02/2018] [Indexed: 12/12/2022]
Abstract
Abstract
Background
Effective dissemination of technology in global surgery is vital to realize universal health coverage by 2030. Challenges include a lack of human resource, infrastructure and finance. Understanding these challenges, and exploring opportunities and solutions to overcome them, are essential to improve global surgical care.
Methods
This review focuses on technologies and medical devices aimed at improving surgical care and training in low- and middle-income countries. The key considerations in the development of new technologies are described, along with strategies for evaluation and wider dissemination. Notable examples of where the dissemination of a new surgical technology has achieved impact are included.
Results
Employing the principles of frugal and responsible innovation, and aligning evaluation and development to high scientific standards help overcome some of the challenges in disseminating technology in global surgery. Exemplars of effective dissemination include low-cost laparoscopes, gasless laparoscopic techniques and innovative training programmes for laparoscopic surgery; low-cost and versatile external fixation devices for fractures; the LifeBox pulse oximeter project; and the use of immersive technologies in simulation, training and surgical care delivery.
Conclusion
Core strategies to facilitate technology dissemination in global surgery include leveraging international funding, interdisciplinary collaboration involving all key stakeholders, and frugal scientific design, development and evaluation.
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Affiliation(s)
- W S Bolton
- Section of Translational Anaesthesia and Surgery, Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK
| | - N Aruparayil
- Section of Translational Anaesthesia and Surgery, Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK
| | - A Quyn
- Section of Translational Anaesthesia and Surgery, Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK
| | - J Scott
- Leeds Vascular Institute, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A Wood
- Department of Orthopaedic Surgery, Leeds General Infirmary, Leeds, UK
| | - I Bundu
- Department of Surgery, Connaught Hospital, Freetown, Sierra Leone
| | - J Gnanaraj
- Karunya Institute of Technology and Science, Karunya Nagar, Coimbatore, India
| | - J M Brown
- Leeds Institute for Clinical Trials Research, University of Leeds, Leeds, UK
| | - D G Jayne
- Section of Translational Anaesthesia and Surgery, Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK
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25
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Pupo G, Ibba F, Ascough DMH, Vicini AC, Ricci P, Christensen KE, Pfeifer L, Morphy JR, Brown JM, Paton RS, Gouverneur V. Asymmetric nucleophilic fluorination under hydrogen bonding phase-transfer catalysis. Science 2018; 360:638-642. [PMID: 29748281 DOI: 10.1126/science.aar7941] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/21/2018] [Indexed: 12/24/2022]
Abstract
Common anionic nucleophiles such as those derived from inorganic salts have not been used for enantioselective catalysis because of their insolubility. Here, we report that merging hydrogen bonding and phase-transfer catalysis provides an effective mode of activation for nucleophiles that are insoluble in organic solvents. This catalytic manifold relies on hydrogen bonding complexation to render nucleophiles soluble and reactive, while simultaneously inducing asymmetry in the ensuing transformation. We demonstrate the concept using a chiral bis-urea catalyst to form a tridentate hydrogen bonding complex with fluoride from its cesium salt, thereby enabling highly efficient enantioselective ring opening of episulfonium ion. This fluorination method is synthetically valuable considering the scarcity of alternative protocols and points the way to wider application of the catalytic approach with diverse anionic nucleophiles.
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Affiliation(s)
- Gabriele Pupo
- University of Oxford, Chemistry Research Laboratory, 12 Mansfield Road, Oxford OX1 3TA, UK
| | - Francesco Ibba
- University of Oxford, Chemistry Research Laboratory, 12 Mansfield Road, Oxford OX1 3TA, UK
| | - David M H Ascough
- University of Oxford, Chemistry Research Laboratory, 12 Mansfield Road, Oxford OX1 3TA, UK
| | - Anna Chiara Vicini
- University of Oxford, Chemistry Research Laboratory, 12 Mansfield Road, Oxford OX1 3TA, UK
| | - Paolo Ricci
- University of Oxford, Chemistry Research Laboratory, 12 Mansfield Road, Oxford OX1 3TA, UK
| | - Kirsten E Christensen
- University of Oxford, Chemistry Research Laboratory, 12 Mansfield Road, Oxford OX1 3TA, UK
| | - Lukas Pfeifer
- University of Oxford, Chemistry Research Laboratory, 12 Mansfield Road, Oxford OX1 3TA, UK
| | - John Richard Morphy
- Medicinal Chemistry, Eli Lilly and Company Limited, Erl Wood Manor, Sunninghill Road, Windlesham GU20 6PH, UK
| | - John M Brown
- University of Oxford, Chemistry Research Laboratory, 12 Mansfield Road, Oxford OX1 3TA, UK
| | - Robert S Paton
- University of Oxford, Chemistry Research Laboratory, 12 Mansfield Road, Oxford OX1 3TA, UK
| | - Véronique Gouverneur
- University of Oxford, Chemistry Research Laboratory, 12 Mansfield Road, Oxford OX1 3TA, UK.
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Downey CL, Croft J, Buckley H, Randell R, Brown JM, Jayne DG. Trial of Remote Continuous versus Intermittent NEWS monitoring after major surgery (TRaCINg): protocol for a feasibility randomised controlled trial. Pilot Feasibility Stud 2018; 4:112. [PMID: 29992041 PMCID: PMC5994656 DOI: 10.1186/s40814-018-0299-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 05/21/2018] [Indexed: 01/21/2023] Open
Abstract
Background Despite medical advances, major surgery remains high risk. Up to 44% of patients experience postoperative complications, which can have huge impacts for patients and the healthcare system. Early recognition of postoperative complications is crucial in reducing morbidity and preventing long-term disability. The current standard of care is intermittent manual vital signs monitoring, but new wearable remote monitors offer the benefits of continuous vital signs monitoring without limiting the patient's mobility. The aim of this study is to evaluate the feasibility, acceptability and clinical impacts of continuous remote monitoring after major surgery. Methods The study is a randomised, controlled, unblinded, parallel group, feasibility trial. Adult patients undergoing elective major surgery will be invited to participate if they have the capacity to provided informed, written consent and do not have a cardiac pacemaker or an allergy to adhesives. Participants will be randomly assigned to receive continuous remote monitoring and normal National Early Warning Score (NEWS) monitoring (intervention group) or normal NEWS monitoring alone (control group). Continuous remote monitoring will be achieved using the SensiumVitals® wireless patch which is worn on the patient's chest and monitors heart rate, respiratory rate and temperature continuously and alerts the nurse when there is deviation from pre-set physiological norms. Participants will be followed up throughout their hospital admission and for 30 days after discharge. Feasibility will be assessed by evaluating recruitment rate, adherence to protocol and randomisation, and the amount of missing data. The acceptability of the patch to nursing staff and patients will be assessed using questionnaires and interviews. Clinical outcomes will include time to antibiotics in cases of sepsis, length of hospital stay, number of critical care admissions and rate of readmission within 30 days of discharge. Discussion Early detection and treatment of complications minimises the need for critical care, improves patient outcomes, and produces significant cost savings for the healthcare system. Remote continuous monitoring systems have the potential to allow earlier detection of complications, but evidence from the literature is mixed. Demonstrating significant benefit over intermittent monitoring to offset the practical and economic implications of continuous monitoring requires well-controlled studies in high-risk populations to demonstrate significant differences in clinical outcomes; this feasibility trial seeks to provide evidence of how best to conduct such a confirmatory trial. Trial registration This study is listed on the ISRCTN registry with study ID ISRCTN16601772.
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Affiliation(s)
- C L Downey
- Leeds Institute of Biomedical and Clinical Sciences, Clinical Sciences Building, St. James's University Hospital, University of Leeds, Level 7 Clinical Sciences Building, Leeds, LS9 7TF UK
| | - J Croft
- 2Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9NL UK
| | - H Buckley
- 2Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9NL UK
| | - R Randell
- 3School of Healthcare, Baines Wing, University of Leeds, Leeds, LS2 9JT UK
| | - J M Brown
- 2Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9NL UK
| | - D G Jayne
- Leeds Institute of Biomedical and Clinical Sciences, Clinical Sciences Building, St. James's University Hospital, University of Leeds, Level 7 Clinical Sciences Building, Leeds, LS9 7TF UK
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27
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Downey CL, Chapman S, Randell R, Brown JM, Jayne DG. The impact of continuous versus intermittent vital signs monitoring in hospitals: A systematic review and narrative synthesis. Int J Nurs Stud 2018; 84:19-27. [PMID: 29729558 DOI: 10.1016/j.ijnurstu.2018.04.013] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 04/17/2018] [Accepted: 04/17/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Continuous vital signs monitoring on general hospital wards may allow earlier detection of patient deterioration and improve patient outcomes. This systematic review will assess if continuous monitoring is practical outside of the critical care setting, and whether it confers any clinical benefit to patients. METHODS MEDLINE®, MEDLINE® In-Process, EMBASE, CINAHL and The Cochrane Library were searched for articles that evaluated the clinical or non-clinical outcomes of continuous vital signs monitoring in adults outside of the critical care setting. The protocol was registered with PROSPERO (CRD42017058098). FINDINGS Twenty-four studies met the inclusion criteria and reported outcomes on a total of 40,274 patients and 59 ward staff in nine countries. The majority of studies showed benefits in terms of critical care use and length of hospital stay. Larger studies were more likely to demonstrate clinical benefit, particularly critical care use and length of hospital stay. Three studies showed cost-effectiveness. Barriers to implementation included nursing and patient satisfaction and the burden of false alerts. CONCLUSIONS Continuous vital signs monitoring outside the critical care setting is feasible and may provide a benefit in terms of improved patient outcomes and cost efficiency. Large, well-controlled studies in high-risk populations are required to evaluate the clinical benefit of continuous monitoring systems.
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Affiliation(s)
- C L Downey
- Leeds Institute of Biomedical & Clinical Sciences, Clinical Sciences Building, St. James's University Hospital, University of Leeds, Leeds, LS9 7TF, United Kingdom.
| | - S Chapman
- Leeds Institute of Biomedical & Clinical Sciences, Clinical Sciences Building, St. James's University Hospital, University of Leeds, Leeds, LS9 7TF, United Kingdom
| | - R Randell
- School of Healthcare, Baines Wing, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - J M Brown
- Leeds Institute of Clinical Trials Research, Worsley Building, University of Leeds, Leeds, LS2 9NL, United Kingdom
| | - D G Jayne
- Leeds Institute of Biomedical & Clinical Sciences, Clinical Sciences Building, St. James's University Hospital, University of Leeds, Leeds, LS9 7TF, United Kingdom
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28
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Downey CL, Brown JM, Jayne DG, Randell R. Patient attitudes towards remote continuous vital signs monitoring on general surgery wards: An interview study. Int J Med Inform 2018; 114:52-56. [PMID: 29673603 DOI: 10.1016/j.ijmedinf.2018.03.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 12/07/2017] [Accepted: 03/23/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Vital signs monitoring is used to identify deteriorating patients in hospital. The most common tool for vital signs monitoring is an early warning score, although emerging technologies allow for remote, continuous patient monitoring. A number of reviews have examined the impact of continuous monitoring on patient outcomes, but little is known about the patient experience. This study aims to discover what patients think of monitoring in hospital, with a particular emphasis on intermittent early warning scores versus remote continuous monitoring, in order to inform future implementations of continuous monitoring technology. METHODS Semi-structured interviews were undertaken with 12 surgical inpatients as part of a study testing a remote continuous monitoring device. All patients were monitored with both an early warning score and the new device. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. FINDINGS Patients can see the value in remote, continuous monitoring, particularly overnight. However, patients appreciate the face-to-face aspect of early warning score monitoring as it allows for reassurance, social interaction, and gives them further opportunity to ask questions about their medical care. CONCLUSION Early warning score systems are widely used to facilitate detection of the deteriorating patient. Continuous monitoring technologies may provide added reassurance. However, patients value personal contact with their healthcare professionals and remote monitoring should not replace this. We suggest that remote monitoring is best introduced in a phased manner, and initially as an adjunct to usual care, with careful consideration of the patient experience throughout.
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Affiliation(s)
- C L Downey
- Leeds Institute of Biomedical & Clinical Sciences, Clinical Sciences Building, St. James's University Hospital, University of Leeds, Leeds, LS9 7TF, United Kingdom.
| | - J M Brown
- Leeds Institute of Clinical Trials Research, Worsley Building, University of Leeds, Leeds, LS2 9NL, United Kingdom
| | - D G Jayne
- Leeds Institute of Biomedical & Clinical Sciences, Clinical Sciences Building, St. James's University Hospital, University of Leeds, Leeds, LS9 7TF, United Kingdom
| | - R Randell
- School of Healthcare, Baines Wing, University of Leeds, Leeds, LS2 9JT, United Kingdom
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29
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Vidanapathirana AK, Thompson LC, Herco M, Odom J, Sumner SJ, Fennell TR, Brown JM, Wingard CJ. Acute intravenous exposure to silver nanoparticles during pregnancy induces particle size and vehicle dependent changes in vascular tissue contractility in Sprague Dawley rats. Reprod Toxicol 2018; 75:10-22. [PMID: 29154916 PMCID: PMC6241519 DOI: 10.1016/j.reprotox.2017.11.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 10/26/2017] [Accepted: 11/13/2017] [Indexed: 12/17/2022]
Abstract
The use of silver nanoparticles (AgNP) raises safety concerns during susceptible life stages such as pregnancy. We hypothesized that acute intravenous exposure to AgNP during late stages of pregnancy will increase vascular tissue contractility, potentially contributing to alterations in fetal growth. Sprague Dawley rats were exposed to a single dose of PVP or Citrate stabilized 20 or 110nm AgNP (700μg/kg). Differential vascular responses and EC50 values were observed in myographic studies in uterine, mesenteric arteries and thoracic aortic segments, 24h post-exposure. Reciprocal responses were observed in aortic and uterine vessels following PVP stabilized AgNP with an increased force of contraction in uterine artery and increased relaxation responses in aorta. Citrate stabilized AgNP exposure increased contractile force in both uterine and aortic vessels. Intravenous AgNP exposure during pregnancy displayed particle size and vehicle dependent moderate changes in vascular tissue contractility, potentially influencing fetal blood supply.
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Affiliation(s)
- A K Vidanapathirana
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC, 27834, USA
| | - L C Thompson
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC, 27834, USA
| | - M Herco
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC, 27834, USA
| | - J Odom
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC, 27834, USA
| | - S J Sumner
- Discovery Sciences, RTI International, Research Triangle Park, NC, 27709, USA; Department of Nutrition School of Public Health University of North Carolina at Chapel Hill, Kannapolis, NC, 28081, USA
| | - T R Fennell
- Discovery Sciences, RTI International, Research Triangle Park, NC, 27709, USA
| | - J M Brown
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, CO, 80045, USA
| | - C J Wingard
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC, 27834, USA; Department of Physical Therapy, Bellarmine University, Louisville, KY, 40205, USA.
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Abstract
Silyl-substituted aromatic compounds can participate as the electrophilic component in palladium-catalysed cross-couplings, and reactivity is enhanced by a neighbouring silyl-group. Products analogous to those obtained from C-H activation chemistry are accessible by this means with the additional benefit of regiochemistry defined by the site of silyl substitution. DFT studies described here show that the mechanism of C-Si cleavage is distinct from previously recognised mechanisms for C-H cleavage, with a cascade of silyl intermediates en route to a stable product. The amide directing-groups are involved only in the stabilisation of palladacyclic intermediates, and are never disposed to activate silicon directly. 5-Membered and 6-membered palladacycles are known to behave differently in coupling reactions and the calculations reveal underlying reasons in the cationic pathways studied here.
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Affiliation(s)
- Waqar Rauf
- Health Biotechnology Division, NIBGE, Faisalabad, Pakistan.
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Abstract
A solid phase in the mixed water-carbon dioxide system, previously identified as carbonic acid, was observed in the high-pressure diamond-anvil cell. The pressure-temperature paths of both its melting and peritectic curves were measured, beginning at 4.4 GPa and 165 °C (where it exists in a quadruple equilibrium, together with an aqueous fluid and the ices H2O(VII) and CO2(I)) and proceeding to higher pressures and temperatures. Single-crystal X-ray diffraction revealed a triclinic crystal with unit cell parameters (at 6.5 GPa and 20 °C) of a = 5.88 Å, b = 6.59 Å, c = 6.99 Å, α = 88.7°, β = 79.7°, and γ = 67.7°. Raman spectra exhibit a major line at ~1080 cm−1 and lattice modes below 300 cm−1.
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Affiliation(s)
- E H Abramson
- Department of Earth and Space Sciences, University of Washington, Seattle, WA, 98195-1310, USA.
| | - O Bollengier
- Department of Earth and Space Sciences, University of Washington, Seattle, WA, 98195-1310, USA
| | - J M Brown
- Department of Earth and Space Sciences, University of Washington, Seattle, WA, 98195-1310, USA
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Polomsky M, Koulogiannis KP, Kipperman RM, Cohen BM, Magovern CJ, Slater JP, Xydas S, Marcoff L, Brown JM. Mitral Valve Replacement With Sapien 3 Transcatheter Valve in Severe Mitral Annular Calcification. Ann Thorac Surg 2017; 103:e57-e59. [DOI: 10.1016/j.athoracsur.2016.06.105] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 06/02/2016] [Accepted: 06/22/2016] [Indexed: 11/29/2022]
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Pfeifer L, Engle KM, Pidgeon GW, Sparkes HA, Thompson AL, Brown JM, Gouverneur V. Hydrogen-Bonded Homoleptic Fluoride–Diarylurea Complexes: Structure, Reactivity, and Coordinating Power. J Am Chem Soc 2016; 138:13314-13325. [DOI: 10.1021/jacs.6b07501] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Lukas Pfeifer
- Chemistry
Research Laboratory, University of Oxford, 12 Mansfield Road, OX1 3TA Oxford, United Kingdom
| | - Keary M. Engle
- Chemistry
Research Laboratory, University of Oxford, 12 Mansfield Road, OX1 3TA Oxford, United Kingdom
| | - George W. Pidgeon
- Chemistry
Research Laboratory, University of Oxford, 12 Mansfield Road, OX1 3TA Oxford, United Kingdom
| | - Hazel A. Sparkes
- ISIS Facility,
STFC-Rutherford Appleton Laboratory, OX11
0QX Didcot, United Kingdom
| | - Amber L. Thompson
- Chemistry
Research Laboratory, University of Oxford, 12 Mansfield Road, OX1 3TA Oxford, United Kingdom
| | - John M. Brown
- Chemistry
Research Laboratory, University of Oxford, 12 Mansfield Road, OX1 3TA Oxford, United Kingdom
| | - Véronique Gouverneur
- Chemistry
Research Laboratory, University of Oxford, 12 Mansfield Road, OX1 3TA Oxford, United Kingdom
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34
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Arnold SV, Reynolds MR, Wang K, Magnuson EA, Baron SJ, Chinnakondepalli KM, Reardon MJ, Tadros PN, Zorn GL, Maini B, Mumtaz MA, Brown JM, Kipperman RM, Adams DH, Popma JJ, Cohen DJ. Health Status After Transcatheter or Surgical Aortic Valve Replacement in Patients With Severe Aortic Stenosis at Increased Surgical Risk: Results From the CoreValve US Pivotal Trial. JACC Cardiovasc Interv 2016; 8:1207-1217. [PMID: 26292584 DOI: 10.1016/j.jcin.2015.04.018] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 04/23/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study sought to compare the health status outcomes for patients treated with either self-expanding transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (AVR). BACKGROUND In patients at increased surgical risk, TAVR with a self-expanding bioprosthesis is associated with improved 1-year survival compared with AVR. However, elderly patients may be just as concerned with quality-of-life improvement as with prolonged survival as a goal of treatment. METHODS Between 2011 and 2012, 795 patients with severe aortic stenosis at increased surgical risk were randomized to TAVR or AVR in the CoreValve US Pivotal Trial. Health status was assessed at baseline, 1 month, 6 months, and 1 year using the Kansas City Cardiomyopathy Questionnaire, Medical Outcomes Study Short-Form 12 Questionnaire, and EuroQOL 5-dimension questionnaire; growth curve models were used to examine changes over time. RESULTS Over the 1-year follow-up period, disease-specific and generic health status improved substantially for both treatment groups. At 1 month, there was a significant interaction between the benefit of TAVR over AVR and access site. Among surviving patients eligible for iliofemoral (IF) access, there was a clinically relevant early benefit with TAVR across all disease-specific and generic health status measures. Among the non-IF cohort, however, most health status measures were similar for TAVR and AVR, although there was a trend toward early benefit with TAVR on the Short-Form 12 Questionnaire's physical health scale. There were no consistent differences in health status between TAVR and AVR at the later time points. CONCLUSIONS Health status improved substantially in surviving patients with increased surgical risk who were treated with either self-expanding TAVR or AVR. TAVR via the IF route was associated with better early health status compared with AVR, but there was no early health status benefit with non-IF TAVR compared with AVR. (Safety and Efficacy Study of the Medtronic CoreValve® System in the Treatment of Symptomatic Severe Aortic Stenosis in High Risk and Very High Risk Subjects Who Need Aortic Valve Replacement; NCT01240902).
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Affiliation(s)
- Suzanne V Arnold
- Saint Luke's Mid America Heart Institute, Kansas City, Missouri; University of Missouri-Kansas City, Kansas City, Missouri
| | | | - Kaijun Wang
- Saint Luke's Mid America Heart Institute, Kansas City, Missouri
| | - Elizabeth A Magnuson
- Saint Luke's Mid America Heart Institute, Kansas City, Missouri; University of Missouri-Kansas City, Kansas City, Missouri
| | - Suzanne J Baron
- Saint Luke's Mid America Heart Institute, Kansas City, Missouri; University of Missouri-Kansas City, Kansas City, Missouri
| | | | | | | | | | - Brij Maini
- Pinnacle Health, Harrisburg, Pennsylvania
| | | | - John M Brown
- Morristown Memorial Hospital, Morristown, New Jersey
| | | | | | | | - David J Cohen
- Saint Luke's Mid America Heart Institute, Kansas City, Missouri; University of Missouri-Kansas City, Kansas City, Missouri.
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Affiliation(s)
- J M Brown
- Aneurin Bevan University Health Board , UK
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Brown JM, Shanor C, Wright EM, Kolesik M. Carrier-wave shape effects in optical filamentation. Opt Lett 2016; 41:859-862. [PMID: 26974064 DOI: 10.1364/ol.41.000859] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Strong-field ionization in optical filaments created by ultrashort pulses with sub-cycle engineered waveforms is studied theoretically. To elucidate the physics of the recently demonstrated enhanced ionization yield and spatial control of the optical filament core in two color pulses, we employ two types of quantum models integrated into spatially resolved pulse-propagation simulations. We show that the dependence of the ionization on the shape of the excitation carrier is adiabatic in nature, and is driven by local temporal peaks of the electric field. Implications for the modeling of light-matter interactions in multicolor optical fields are also discussed.
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Rauf W, Brown JM. Palladium-catalysed directed C–H activation by anilides and ureas; water participation in a general base mechanism. Org Biomol Chem 2016; 14:5251-7. [DOI: 10.1039/c6ob00897f] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A general-base pathway for CH-activation in anilides and ureas en route to palladacycles was developed through DFT calculations and fits available evidence.
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Affiliation(s)
- Waqar Rauf
- Chemistry Research Laboratory
- Oxford University
- Oxford OX1 3QY
- UK
- Health Biotechnology Division
| | - John M. Brown
- Chemistry Research Laboratory
- Oxford University
- Oxford OX1 3QY
- UK
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Glazer DI, Davenport MS, Khalatbari S, Cohan RH, Ellis JH, Caoili EM, Stein EB, Childress JC, Masch WR, Brown JM, Mollard BJ, Montgomery JS, Palapattu GS, Francis IR. Mass-like peripheral zone enhancement on CT is predictive of higher-grade (Gleason 4 + 3 and higher) prostate cancer. ACTA ACUST UNITED AC 2015; 40:560-70. [PMID: 25193787 DOI: 10.1007/s00261-014-0233-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To determine whether focal peripheral zone enhancement on routine venous-phase CT is predictive of higher-grade (Gleason 4 + 3 and higher) prostate cancer. MATERIALS AND METHODS IRB approval was obtained and informed consent waived for this HIPAA-compliant retrospective study. Forty-three patients with higher-grade prostate cancer (≥Gleason 4 + 3) and 96 with histology-confirmed lower-grade (≤Gleason 3 + 4 [n = 47]) or absent (n = 49) prostate cancer imaged with venous-phase CT comprised the study population. CT images were reviewed by ten blinded radiologists (5 attendings, 5 residents) who scored peripheral zone enhancement on a scale of 1 (benign) to 5 (malignant). Mass-like peripheral zone enhancement was considered malignant. Likelihood ratios (LR) and specificities were calculated. Multivariate conditional logistic regression analyses were conducted. RESULTS Scores of "5" were strongly predictive of higher-grade prostate cancer (pooled LR+ 9.6 [95% CI 5.8-15.8]) with rare false positives (pooled specificity: 0.98 [942/960, 95% CI 0.98-0.99]; all 10 readers had specificity ≥95%). Attending scores of "5" were more predictive than resident scores of "5" (LR+: 14.7 [95% CI 5.8-37.2] vs. 7.6 [95% CI 4.2-13.7]) with similar specificity (0.99 [475/480, 95% CI 0.98-1.00] vs. 0.97 [467/480, 95% CI 0.96-0.99]). Significant predictors of an assigned score of "5" included presence of a peripheral zone mass (p < 0.0001), larger size (p < 0.0001), and less reader experience (p = 0.0008). Significant predictors of higher-grade prostate cancer included presence of a peripheral zone mass (p = 0.0002) and larger size (p < 0.0001). CONCLUSION Focal mass-like peripheral zone enhancement on routine venous-phase CT is specific and predictive of higher-grade (Gleason 4 + 3 and higher) prostate cancer.
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Affiliation(s)
- D I Glazer
- Department of Radiology, University of Michigan Health System, B2-A209P, Ann Arbor, MI, 48109, USA
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Pubill-Ulldemolins C, Fernánez E, Bo C, Brown JM. Origins of observed reactivity and specificity in the addition of B2Cl4 and analogues to unsaturated compounds. Org Biomol Chem 2015; 13:9619-28. [PMID: 26260922 DOI: 10.1039/c5ob01280e] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In 1954 Schlesinger and co-workers observed the direct reaction of diboron tetrachloride with simple organic compounds under mild conditions, the 1,2 addition product being formed with either ethylene or acetylene. In the following 25 years a series of addition reactions to simple alkenes, alkynes and dienes was demonstrated. B2F4 was shown to react in similar manner, albeit under more forcing conditions. Crucially, it was demonstrated that the addition to (E)- or (Z)-but-2-ene occurred with cis-stereospecificity. Only sporadic interest was shown in this field thereafter until catalysed addition reactions of diboron reagents were realized. Encouraged by this revival of interest through the discovery of transition-metal and nucleophilic catalysis of diboryl additions, DFT analysis of uncatalysed additions of B2X4 has been carried out and interpreted. This includes the relative reactivity of several B-B reagents with ethene, and that of B2Cl4vs. B2F4 additions, including benzene, naphthalene and C60 as reactants. This allows the analysis of relative reactivity vis-à-vis substitution on boron, and also direct comparison with hydroboration by HBCl2. [4 + 2] Addition of diboron reagents to dienes with B-B cleavage competes with direct [2 + 2] addition, favourably so for B2F4. The computational results demonstrate that the stereospecific addition to isomeric but-2-enes is a rare concerted [2σs + 2πs] process.
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Bahl A, Brown JM, Wright EM, Kolesik M. Assessment of the metastable electronic state approach as a microscopically self-consistent description for the nonlinear response of atoms. Opt Lett 2015; 40:4987-4990. [PMID: 26512500 DOI: 10.1364/ol.40.004987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This Letter presents the first quantitative assessment of the recently proposed metastable electronic state approach (MESA) for calculation of the nonlinear optical response of noble gas atoms. Based on the single active electron potentials for several atomic species, Stark resonant states are used to extract the nonlinear polarization and ionization rates free of any additional fitting parameters. It is shown that even the simplest version of the method provides a viable, first-principle-based, and self-consistent alternative to the standard model commonly used for simulations in the field of extreme nonlinear optics.
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Brown JM, Price SJ, Price RA. Predicting risk after aneurysm surgery. Anaesthesia 2015; 70:1320. [PMID: 26449294 DOI: 10.1111/anae.13241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - R A Price
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
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Holland NA, Becak DP, Shannahan JH, Brown JM, Carratt SA, Winkle L, Pinkerton KE, Wang CM, Munusamy P, Baer DR, Sumner SJ, Fennell TR, Lust RM, Wingard CJ. Cardiac Ischemia Reperfusion Injury Following Instillation of 20 nm Citrate-capped Nanosilver. ACTA ACUST UNITED AC 2015; 6. [PMID: 26966636 DOI: 10.4172/2157-7439.s6-006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Silver nanoparticles (AgNP) have garnered much interest due to their antimicrobial properties, becoming one of the most utilized nano-scale materials. However, any potential evocable cardiovascular injury associated with exposure has not been reported to date. We have previously demonstrated expansion of myocardial infarction after intratracheal (IT) instillation of carbon-based nanomaterials. We hypothesized pulmonary exposure to Ag core AgNP induces a measureable increase in circulating cytokines, expansion of cardiac ischemia-reperfusion (I/R) injury and is associated with depressed coronary constrictor and relaxation responses. Secondarily, we addressed the potential contribution of silver ion release on AgNP toxicity. METHODS Male Sprague-Dawley rats were exposed to 200 μl of 1 mg/ml of 20 nm citrate-capped Ag core AgNP, 0.01, 0.1, 1 mg/ml Silver Acetate (AgAc), or a citrate vehicle by intratracheal (IT) instillation. One and 7 days following IT instillation the lungs were evaluated for inflammation and the presence of silver; serum was analyzed for concentrations of selected cytokines; cardiac I/R injury and coronary artery reactivity were assessed. RESULTS AgNP instillation resulted in modest pulmonary inflammation with detection of silver in lung tissue and alveolar macrophages, elevation of serum cytokines: G-CSF, MIP-1α, IL-1β, IL-2, IL-6, IL-13, IL-10, IL-18, IL-17α, TNFα, and RANTES, expansion of I/R injury and depression of the coronary vessel reactivity at 1 day post IT compared to vehicle treated rats. Silver within lung tissue was persistent at 7 days post IT instillation and was associated with an elevation in cytokines: IL-2, IL-13, and TNFα and expansion of I/R injury. AgAc resulted in a concentration dependent infarct expansion and depressed vascular reactivity without marked pulmonary inflammation or serum cytokine response. CONCLUSIONS Based on these data, IT instillation of AgNP increases circulating levels of several key cytokines, which may contribute to persistent expansion of I/R injury possibly through an impaired vascular responsiveness.
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Affiliation(s)
- N A Holland
- Department of Physiology, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA
| | - D P Becak
- Department of Physiology, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA
| | - Jonathan H Shannahan
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, The University of Colorado Anschutz Medical Campus, Aurora, USA
| | - J M Brown
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, The University of Colorado Anschutz Medical Campus, Aurora, USA
| | - S A Carratt
- Department of Anatomy, Physiology and Cell Biology, School of Veterinary Medicine, University of California at Davis, Davis, California, USA
| | - Lsv Winkle
- Department of Anatomy, Physiology and Cell Biology, School of Veterinary Medicine, University of California at Davis, Davis, California, USA
| | - K E Pinkerton
- Department of Anatomy, Physiology and Cell Biology, School of Veterinary Medicine, University of California at Davis, Davis, California, USA
| | - C M Wang
- Pacific Northwest National Laboratory, EMSL, Richland, USA
| | - P Munusamy
- Pacific Northwest National Laboratory, EMSL, Richland, USA
| | - Don R Baer
- Pacific Northwest National Laboratory, EMSL, Richland, USA
| | - S J Sumner
- RTI International, Discovery Sciences, Research Triangle Park, USA
| | - T R Fennell
- RTI International, Discovery Sciences, Research Triangle Park, USA
| | - R M Lust
- Department of Physiology, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA
| | - C J Wingard
- Department of Physiology, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA
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Engle KM, Pfeifer L, Pidgeon GW, Giuffredi GT, Thompson AL, Paton RS, Brown JM, Gouverneur V. Coordination diversity in hydrogen-bonded homoleptic fluoride-alcohol complexes modulates reactivity. Chem Sci 2015; 6:5293-5302. [PMID: 29449931 PMCID: PMC5669313 DOI: 10.1039/c5sc01812a] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 06/22/2015] [Indexed: 11/21/2022] Open
Abstract
The nucleophilic reactivity of fluoride ion is altered in the presence of hydrogen-bond donors, including alcohols. Relatively little is known about the coordination involved; to rectify this, the X-ray structures of fourteen novel fluoride-alcohol complexes with tetrabutylammonium as the counterion have been determined. The coordination number varies from two to four depending on the steric bulk of the alcohol and is closely linked to trends in reactivity. This diversity in coordination stoichiometry is unprecedented but significant, as it implies differences in the ability of the fluoride-alcohol complexes to dissociate in solution with release of a more active and/or selective fluoride source.
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Affiliation(s)
- Keary M Engle
- Chemistry Research Laboratory , Department of Chemistry , Oxford University , OX1 3TA , UK .
| | - Lukas Pfeifer
- Chemistry Research Laboratory , Department of Chemistry , Oxford University , OX1 3TA , UK .
| | - George W Pidgeon
- Chemistry Research Laboratory , Department of Chemistry , Oxford University , OX1 3TA , UK .
| | - Guy T Giuffredi
- Chemistry Research Laboratory , Department of Chemistry , Oxford University , OX1 3TA , UK .
| | - Amber L Thompson
- Chemistry Research Laboratory , Department of Chemistry , Oxford University , OX1 3TA , UK .
| | - Robert S Paton
- Chemistry Research Laboratory , Department of Chemistry , Oxford University , OX1 3TA , UK .
| | - John M Brown
- Chemistry Research Laboratory , Department of Chemistry , Oxford University , OX1 3TA , UK .
| | - Véronique Gouverneur
- Chemistry Research Laboratory , Department of Chemistry , Oxford University , OX1 3TA , UK .
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Viale E, Martinez-Sañudo I, Brown JM, Simonato M, Girolami V, Squartini A, Bressan A, Faccoli M, Mazzon L. Pattern of association between endemic Hawaiian fruit flies (Diptera, Tephritidae) and their symbiotic bacteria: Evidence of cospeciation events and proposal of "Candidatus Stammerula trupaneae". Mol Phylogenet Evol 2015; 90:67-79. [PMID: 25959751 DOI: 10.1016/j.ympev.2015.04.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 04/18/2015] [Accepted: 04/28/2015] [Indexed: 11/18/2022]
Abstract
Several insect lineages have evolved mutualistic association with symbiotic bacteria. This is the case of some species of mealybugs, whiteflies, weevils, tsetse flies, cockroaches, termites, carpenter ants, aphids and fruit flies. Some species of Tephritinae, the most specialized subfamily of fruit flies (Diptera: Tephritidae), harbour co-evolved vertically transmitted, bacterial symbionts in their midgut, known as "Candidatus Stammerula spp.". The 25 described endemic species of Hawaiian tephritids, plus at least three undescribed species, are taxonomically distributed among three genera: the cosmopolitan genus Trupanea (21 described spp.), the endemic genus Phaeogramma (2 spp.) and the Nearctic genus Neotephritis (2 spp.). We examined the presence of symbiotic bacteria in the endemic tephritids of the Hawaiian Islands, which represent a spectacular example of adaptive radiation, and tested the concordant evolution between host and symbiont phylogenies. We detected through PCR assays the presence of specific symbiotic bacteria, designated as "Candidatus Stammerula trupaneae", from 35 individuals of 15 species. The phylogeny of the insect host was reconstructed based on two regions of the mitochondrial DNA (16S rDNA and COI-tRNALeu-COII), while the bacterial 16S rRNA was used for the symbiont analysis. Host and symbiont phylogenies were then compared and evaluated for patterns of cophylogeny and strict cospeciation. Topological congruence between Hawaiian Tephritinae and their symbiotic bacteria phylogenies suggests a limited, but significant degree of host-symbiont cospeciation. We also explored the character reconstruction of three host traits, as island location, host lineage, and host tissue attacked, based on the symbiont phylogenies under the hypothesis of cospeciation.
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Affiliation(s)
- E Viale
- Department of Agronomy, Food, Natural Resources, Animals and Environment (DAFNAE), University of Padova - Agripolis, Viale dell'Università, 16, 35020 Legnaro, Padova, Italy.
| | - I Martinez-Sañudo
- Department of Agronomy, Food, Natural Resources, Animals and Environment (DAFNAE), University of Padova - Agripolis, Viale dell'Università, 16, 35020 Legnaro, Padova, Italy.
| | - J M Brown
- Department of Biology, Grinnell College, Grinnell, IA 50012, USA.
| | - M Simonato
- Department of Agronomy, Food, Natural Resources, Animals and Environment (DAFNAE), University of Padova - Agripolis, Viale dell'Università, 16, 35020 Legnaro, Padova, Italy.
| | - V Girolami
- Department of Agronomy, Food, Natural Resources, Animals and Environment (DAFNAE), University of Padova - Agripolis, Viale dell'Università, 16, 35020 Legnaro, Padova, Italy
| | - A Squartini
- Department of Agronomy, Food, Natural Resources, Animals and Environment (DAFNAE), University of Padova - Agripolis, Viale dell'Università, 16, 35020 Legnaro, Padova, Italy.
| | - A Bressan
- Bayer Crop Science LP, R&D Trait Research, 3500 Paramount Parkway, Morrisville, NC 27560, USA.
| | - M Faccoli
- Department of Agronomy, Food, Natural Resources, Animals and Environment (DAFNAE), University of Padova - Agripolis, Viale dell'Università, 16, 35020 Legnaro, Padova, Italy.
| | - L Mazzon
- Department of Agronomy, Food, Natural Resources, Animals and Environment (DAFNAE), University of Padova - Agripolis, Viale dell'Università, 16, 35020 Legnaro, Padova, Italy.
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Brown JM. New Trends in Cross-Coupling - Theory and Applications. Herausgegeben von Thomas J. Colacot. Angew Chem Int Ed Engl 2015. [DOI: 10.1002/ange.201501713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Affiliation(s)
- John M. Brown
- Chemistry Research Laboratory, University of Oxford, 12 Mansfield Road, Oxford OX1 3TA, U.K
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Ordidge KL, Brown JM, Succony L, Navani N, Hardavella G, Lawrence DR, Fraioli F, Groves A, Janes SM. Massive pulmonary carcinoid tumor deemed inoperable until (68)Ga DOTATATE positron emission tomography/magnetic resonance imaging. Am J Respir Crit Care Med 2014; 190:e16-7. [PMID: 25171317 DOI: 10.1164/rccm.201309-1635im] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- K L Ordidge
- 1 Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, Rayne Building, University College London, London, United Kingdom
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Schneider CM, Repka CP, Brown JM, Lalonde TL, Dallow KT, Barlow CE, Hayward R. Demonstration of the need for cardiovascular and pulmonary normative data for cancer survivors. Int J Sports Med 2014; 35:1134-7. [PMID: 24995960 DOI: 10.1055/s-0034-1375691] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Despite evidence that cancer and its treatments severely reduce cardiorespiratory fitness (CRF), normative data for cancer survivors do not exist. The present study identifies age and gender-specific CRF distributions in a cancer population. The use of cancer-specific normative CRF data may help stratify initial fitness status and assess improvements in response to exercise interventions in cancer survivors. Data from 703 cancer survivors were analyzed for this study. Quintiles were compiled for peak oxygen consumption (VO2peak), forced vital capacity (FVC), and forced expiratory volume (FEV1) for males and females in 5 age groups (19-39, 40-49, 50-59, 60-69, and ≥70 years of age). VO2peak values for the cancer population were significantly lower than the general US population. The cancer population average in each age group fell within the "very poor" classification of VO2peak values for the general population. FVC values in the cancer population were similar to the general population. Cancer survivors had very low age group-specific VO2peak values compared to the apparently healthy general US population. Previously, CRF values of cancer survivors were compared to normative values for the apparently healthy general population, which yielded imprecise classifications of initial fitness and changes in fitness, resulting in patient discouragement.
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Affiliation(s)
- C M Schneider
- Rocky Mountain Cancer Rehabilitation Institute, University of Northern Colorado, Greeley, United States
| | - C P Repka
- Rocky Mountain Cancer Rehabilitation Institute, University of Northern Colorado, Greeley, United States
| | - J M Brown
- Rocky Mountain Cancer Rehabilitation Institute, University of Northern Colorado, Greeley, United States
| | - T L Lalonde
- Department of Applied Statistics and Research Methods, University of Northern Colorado, Greeley, United States
| | - K T Dallow
- Family Medicine, North Colorado Medical Center, Greeley, United States
| | - C E Barlow
- Research Department, The Cooper Institute, Dallas, United States
| | - R Hayward
- Rocky Mountain Cancer Rehabilitation Institute, University of Northern Colorado, Greeley, United States
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