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Rhodes A, Moulton S, Loibl C, Haurin D, Joseph J. Mortgage Borrowing and Chronic Disease Outcomes in Older Age: Evidence from Biomarker Data in the Health and Retirement Study. J Gerontol B Psychol Sci Soc Sci 2024:gbae066. [PMID: 38630574 DOI: 10.1093/geronb/gbae066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE The medical diagnosis of a disease is common in older age and can carry significant financial costs. For many older adults, equity in a home is their primary component of wealth; however, housing wealth is illiquid. We analyze the relationship between the liquidation of housing wealth through mortgage borrowing on older homeowners' ability to successfully control a disease. METHODS We use data on homeowners age 65 and older from the 1998-2016 waves of the Health and Retirement Study (N=3,457). We use biomarkers and physical health indicators to measure disease control following a medical diagnosis of diabetes, heart condition, high blood pressure, lung disease, or cancer. Random effects linear probability and instrumental variable regressions estimate the associations of housing wealth, new mortgage borrowing, and disease control. RESULTS Descriptively, 28% of older homeowners who borrow against home equity are not controlled on their disease, compared to 33% of non-borrowers. Panel data instrumental variable regressions show that each $10,000 borrowed from home equity after diagnosis is associated with a 17 percentage-point reduction in the probability of the disease not being controlled. DISCUSSION Many older adults are not able or willing to liquidate housing wealth, and the ability to borrow also depends on changes in home values. Thus, housing wealth is not a uniform social determinant of health but is shaped by older adults' participation in financial markets.
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Affiliation(s)
- Alec Rhodes
- Institute for Research on Poverty, University of Wisconsin-Madison, Madison, WI, USA
| | - Stephanie Moulton
- John Glenn College of Public Affairs, The Ohio State University, Columbus, OH, USA
| | - Cäzilia Loibl
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Donald Haurin
- Department of Economics, The Ohio State University, Columbus, OH, USA
| | - Joshua Joseph
- College of Medicine, The Ohio State University, Columbus, OH, USA
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Parker CC, Petersen PM, Cook AD, Clarke NW, Catton C, Cross WR, Kynaston H, Parulekar WR, Persad RA, Saad F, Bower L, Durkan GC, Logue J, Maniatis C, Noor D, Payne H, Anderson J, Bahl AK, Bashir F, Bottomley DM, Brasso K, Capaldi L, Cooke PW, Chung C, Donohue J, Eddy B, Heath CM, Henderson A, Henry A, Jaganathan R, Jakobsen H, James ND, Joseph J, Lees K, Lester J, Lindberg H, Makar A, Morris SL, Oommen N, Ostler P, Owen L, Patel P, Pope A, Popert R, Raman R, Ramani V, Røder A, Sayers I, Simms M, Srinivasan V, Sundaram S, Tarver KL, Tran A, Wells P, Wilson J, Zarkar AM, Parmar MKM, Sydes MR. Timing of Radiotherapy (RT) After Radical Prostatectomy (RP): Long-term outcomes in the RADICALS-RT trial [NCT00541047]. Ann Oncol 2024:S0923-7534(24)00105-4. [PMID: 38583574 DOI: 10.1016/j.annonc.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND The optimal timing of radiotherapy (RT) after radical prostatectomy for prostate cancer has been uncertain. RADICALS-RT compared efficacy and safety of adjuvant RT versus an observation policy with salvage RT for PSA failure. METHODS RADICALS-RT was a randomised controlled trial enrolling patients with ≥1 risk factor (pT3/4, Gleason 7-10, positive margins, pre-op PSA≥10ng/ml) for recurrence after radical prostatectomy. Patients were randomised 1:1 to adjuvant RT ("Adjuvant-RT") or an observation policy with salvage RT for PSA failure ("Salvage-RT") defined as PSA≥0.1ng/ml or 3 consecutive rises. Stratification factors were Gleason score, margin status, planned RT schedule (52.5Gy/20 fractions or 66Gy/33 fractions) and treatment centre. The primary outcome measure was freedom-from-distant metastasis, designed with 80% power to detect an improvement from 90% with Salvage-RT (control) to 95% at 10yr with Adjuvant-RT. Secondary outcome measures were bPFS, freedom-from-non-protocol hormone therapy, safety and patient-reported outcomes. Standard survival analysis methods were used; HR<1 favours Adjuvant-RT. FINDINGS Between Oct-2007 and Dec-2016, 1396 participants from UK, Denmark, Canada and Ireland were randomised: 699 Salvage-RT, 697 Adjuvant-RT. Allocated groups were balanced with median age 65yr. 93% (649/697) Adjuvant-RT reported RT within 6m after randomisation; 39% (270/699) Salvage-RT reported RT during follow-up. Median follow-up was 7.8 years. With 80 distant metastasis events, 10yr FFDM was 93% for Adjuvant-RT and 90% for Salvage-RT: HR=0.68 (95%CI 0·43-1·07, p=0·095). Of 109 deaths, 17 were due to prostate cancer. Overall survival was not improved (HR=0.980, 95%CI 0.667-1.440, p=0.917). Adjuvant-RT reported worse urinary and faecal incontinence one year after randomisation (p=0.001); faecal incontinence remained significant after ten years (p=0.017). INTERPRETATION Long-term results from RADICALS-RT confirm adjuvant RT after radical prostatectomy increases the risk of urinary and bowel morbidity, but does not meaningfully improve disease control. An observation policy with salvage RT for PSA failure should be the current standard after radical prostatectomy.
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Affiliation(s)
- C C Parker
- Institute of Cancer Research, Royal Marsden NHS Foundation Trust, Sutton, UK
| | - P M Petersen
- Dept of Oncology, Copenhagen Prostate Cancer Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - A D Cook
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK
| | - N W Clarke
- Dept of Urology, The Christie and Salford Royal Hospitals, Manchester, UK; The University of Manchester, Manchester, UK
| | - C Catton
- Dept of Radiation Oncology, Princess Margaret Hospital, University Health Network, Toronto, ON, Canada
| | - W R Cross
- Dept of Urology, St James's University Hospital, Leeds, UK
| | - H Kynaston
- Division of Cancer and Genetics, Cardiff University, Cardiff, UK
| | - W R Parulekar
- Canadian Cancer Trials Group, Queen's University, Kingston, ON, Canada
| | - R A Persad
- Dept of Urology, Bristol Urological Institute, Bristol, UK
| | - F Saad
- Dept of Urology, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
| | - L Bower
- Guy's and St Thomas' NHS Foundation Trust, London, UK; Institute of Cancer Research, Royal Marsden NHS Foundation Trust, London, UK
| | - G C Durkan
- Dept of Urology, University Hospital Galway, Galway, Ireland
| | - J Logue
- Dept of Oncology, The Christie Hospital NHS FT, Wilmslow Road, Manchester, UK
| | - C Maniatis
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK
| | - D Noor
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK
| | - H Payne
- The Prostate Centre, London, UK
| | - J Anderson
- St James's Institute of Oncology, Leeds, UK
| | - A K Bahl
- Bristol Haematology and Oncology Centre, University Hospitals Bristol & Weston NHS Trust, Bristol, UK
| | - F Bashir
- Queen's Centre for Oncology, Castle Hill Hospital, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | | | - K Brasso
- Dept of Urology, Copenhagen Prostate Cancer Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Dept of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - L Capaldi
- Worcester Oncology Centre, Worcestershire Acute NHS Hospitals Trust, Worcester, UK
| | - P W Cooke
- Dept of Urology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - C Chung
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK
| | - J Donohue
- Dept of Urology, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
| | - B Eddy
- East Kent University Hospitals Foundation Trust, Kent, UK
| | - C M Heath
- Dept of Clinical Oncology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - A Henderson
- Dept of Urology, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
| | - A Henry
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - R Jaganathan
- Dept of Urology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - H Jakobsen
- Dept of Urology, Herlev University Hospital, Herlev, Denmark
| | - N D James
- Institute of Cancer Research, Royal Marsden NHS Foundation Trust, London, UK
| | - J Joseph
- Leeds Teaching Hospitals, UK; York and Scarborough Teaching Hospitals, UK
| | - K Lees
- Dept of Oncology, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
| | - J Lester
- South West Wales Cancer Centre, Singleton Hospital, Swansea, UK
| | - H Lindberg
- Dept of Oncology, Herlev University Hospital, Herlev, Denmark
| | - A Makar
- Dept of Urology, Worcestershire Acute Hospitals Trust, Worcester, UK
| | - S L Morris
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - N Oommen
- Wrexham Maelor Hospital, Wrexham, UK
| | - P Ostler
- Mount Vernon Cancer Centre, Northwood, UK
| | - L Owen
- Bradford Royal Infirmary, Bradford, UK; Leeds Cancer Centre, Leeds, UK
| | - P Patel
- Dept of Urology, University College London Hospitals, London, UK
| | - A Pope
- Mount Vernon Cancer Centre, Northwood, UK
| | - R Popert
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - R Raman
- Kent Oncology Centre, Kent & Canterbury Hospital, Canterbury, UK
| | - V Ramani
- Dept of Urology, The Christie and Salford Royal Hospitals, Manchester, UK
| | - A Røder
- Dept of Urology, Copenhagen Prostate Cancer Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - I Sayers
- Deanesly Centre, New Cross Hospital, Wolverhampton, UK
| | - M Simms
- Dept of Urology, Hull University Hospitals NHS Trust, UK
| | - V Srinivasan
- Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Rhyl, UK
| | - S Sundaram
- Dept of Urology, Mid Yorkshire Teaching Hospital, Pontefract, UK
| | - K L Tarver
- Dept of Oncology, Queen's Hospital, Romford, UK
| | - A Tran
- Dept of Oncology, The Christie Hospital NHS FT, Wilmslow Road, Manchester, UK
| | - P Wells
- St Bartholomews Hospital, London UK
| | - J Wilson
- Royal Gwent Hospital, Newport, UK
| | - A M Zarkar
- Dept of Oncology, University Hospitals Birmingham, Birmingham, UK
| | - M K M Parmar
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK
| | - M R Sydes
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK.
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Mason J, Hanson C, Fox EJ, Burns H, Joseph J, Horwitz H, Classen S. Perceptions of Autonomous Shuttles for Adults With Spinal Cord Injuries. OTJR (Thorofare N J) 2024; 44:47-56. [PMID: 37381903 DOI: 10.1177/15394492231182058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Individuals with a spinal cord injury (SCI) have challenges using transportation. Autonomous shuttles (ASs), if accessible, may support their transportation needs. This study quantified the perceptions of AS for adults with and without SCI, before and after riding in the AS. We hypothesized that the perceptions of AS for individuals with SCI would improve, by the greatest magnitude, after riding in the AS. This mixed-method quasi-experimental design included 16 adults with SCI and 16 age-matched controls. While there were no differences between the groups, both groups reported having fewer perceived barriers to using AS after riding in the AS (p = .025). After riding in the AS, both groups stated that the AS must be available, accessible, and affordable if they are to use AS. In conclusion, adults with SCI should experience AS if they are to accept and adopt this mode of transportation.
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Affiliation(s)
- Justin Mason
- University of Florida, Gainesville, USA
- University of Iowa, Coralville, USA
| | - C Hanson
- University of Florida, Gainesville, USA
| | - E J Fox
- University of Iowa, Coralville, USA
- Brooks Rehabilitation, Jacksonville, FL, USA
| | - H Burns
- University of Florida, Gainesville, USA
| | - J Joseph
- University of Florida, Gainesville, USA
| | - H Horwitz
- University of Florida, Gainesville, USA
| | - S Classen
- University of Florida, Gainesville, USA
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Venkatesh KK, Huang X, Cameron NA, Petito LC, Joseph J, Landon MB, Grobman WA, Khan SS. Rural-urban disparities in pregestational and gestational diabetes in pregnancy: Serial, cross-sectional analysis of over 12 million pregnancies. BJOG 2024; 131:26-35. [PMID: 37366023 PMCID: PMC10751384 DOI: 10.1111/1471-0528.17587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/24/2023] [Accepted: 06/10/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVE To compare trends in pregestational (DM) and gestational diabetes (GDM) in pregnancy in rural and urban areas in the USA, because pregnant women living in rural areas face unique challenges that contribute to rural-urban disparities in adverse pregnancy outcomes. DESIGN Serial, cross-sectional analysis. SETTING US National Center for Health Statistics (NCHS) Natality Files from 2011 to 2019. POPULATION A total of 12 401 888 singleton live births to nulliparous women aged 15-44 years. METHODS We calculated the frequency (95% confidence interval [CI]) per 1000 live births, the mean annual percentage change (APC), and unadjusted and age-adjusted rate ratios (aRR) of DM and GDM in rural compared with urban maternal residence (reference) per the NCHS Urban-Rural Classification Scheme overall, and by delivery year, reported race and ethnicity, and US region (effect measure modification). MAIN OUTCOME MEASURES The outcomes (modelled separately) were diagnoses of DM and GDM. RESULTS From 2011 to 2019, there were increases in both the frequency (per 1000 live births; mean APC, 95% CI per year) of DM and GDM in rural areas (DM: 7.6 to 10.4 per 1000 live births; APC 2.8%, 95% CI 2.2%-3.4%; and GDM: 41.4 to 58.7 per 1000 live births; APC 3.1%, 95% CI 2.6%-3.6%) and urban areas (DM: 6.1 to 8.4 per 1000 live births; APC 3.3%, 95% CI 2.2%-4.4%; and GDM: 40.8 to 61.2 per 1000 live births; APC 3.9%, 95% CI 3.3%-4.6%). Individuals living in rural areas were at higher risk of DM (aRR 1.48, 95% CI 1.45%-1.51%) and GDM versus those in urban areas (aRR 1.17, 95% CI 1.16%-1.18%). The increased risk was similar each year for DM (interaction p = 0.8), but widened over time for GDM (interaction p < 0.01). The rural-urban disparity for DM was wider for individuals who identified as Hispanic race/ethnicity and in the South and West (interaction p < 0.01 for all); and for GDM the rural-urban disparity was generally wider for similar factors (i.e. Hispanic race/ethnicity, and in the South; interaction p < 0.05 for all). CONCLUSIONS The frequency of DM and GDM increased in both rural and urban areas of the USA from 2011 to 2019 among nulliparous pregnant women. Significant rural-urban disparities existed for DM and GDM, and increased over time for GDM. These rural-urban disparities were generally worse among those of Hispanic race/ethnicity and in women who lived in the South. These findings have implications for delivering equitable diabetes care in pregnancy in rural US communities.
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Affiliation(s)
- Kartik K. Venkatesh
- The Ohio State University College of Medicine, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine (Columbus, OH)
| | - Xiaoning Huang
- Northwestern University Feinberg School of Medicine, Department of Preventive Medicine (Chicago, IL)
| | - Natalie A. Cameron
- Northwestern University Feinberg School of Medicine, Department of Medicine, Division of General Internal Medicine and Geriatrics (Chicago, IL)
| | - Lucia C. Petito
- Northwestern University Feinberg School of Medicine, Department of Preventive Medicine (Chicago, IL)
| | - Joshua Joseph
- The Ohio State University College of Medicine, Department of Medicine (Columbus, OH)
| | - Mark B. Landon
- The Ohio State University College of Medicine, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine (Columbus, OH)
| | - William A. Grobman
- The Ohio State University College of Medicine, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine (Columbus, OH)
| | - Sadiya S. Khan
- Northwestern University Feinberg School of Medicine, Department of Preventive Medicine (Chicago, IL)
- Northwestern University Feinberg School of Medicine, Department of Medicine, Division of Cardiology (Chicago, IL)
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Beardmore S, Adeley J, Brookes A, Robinson C, Davendralingam N, Joseph J, McManoman B, Morgan B. Impact of changing from autopsy to post-mortem CT in an entire HM Coroner region due to a shortage of available pathologists. Clin Radiol 2023; 78:797-803. [PMID: 37827590 DOI: 10.1016/j.crad.2023.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 05/31/2023] [Accepted: 08/13/2023] [Indexed: 10/14/2023]
Abstract
A significant problem facing routine medicolegal coroner-referred autopsies is a shortfall of pathologists prepared to perform them. This was particularly acute in Lancashire, where the coroner decided to initiate a service that relied on post-mortem computed tomography (PMCT). This involved training anatomical pathology technologists (APTs) to perform external examinations, radiographers to perform scans, and radiologists to interpret them. The service started in 2018 and now examines over 1,500 cases per year. This study outlines the PMCT process using NHS staff, with CT equipment and logistics managed by the commercial sector. It compares the demographics and outcomes of PM investigations for two 6-month periods: the autopsy service prior to 2018, and then the PMCT service. These data were then compared with previous UK PMCT data. Referrals for adult non-suspicious deaths were made in 913 cases of which 793 (87%) had PMCT between 01/10/2018 and 31/03/2019. Fifty-six cases had autopsy after PMCT, so 81% of cases potentially avoided autopsy. The PMCT service did not delay release of bodies to the next-of-kin. Comparing the cause of death given shows no difference in the proportions of natural and unnatural deaths. There was an increase in diagnosis of coronary artery disease for PMCT, with less respiratory diagnoses, a feature not previously demonstrated. These data suggest PMCT is a practical solution for potentially failing autopsy services. By necessity, this involves changes in diagnoses, as PMCT and autopsy have different strengths and weakness, but the ability to pick up unnatural death appears unaffected.
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Affiliation(s)
- S Beardmore
- Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Sharoe Green Lane North, Fulwood, Preston, Lancashire, PR2 9HT, UK
| | - J Adeley
- HM Senior Coroner Lancashire and Blackburn with Darwen, Coroner's Court, 2 Faraday Court, Faraday Drive, Preston, Lancashire, PR2 9NB, UK
| | - A Brookes
- Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Sharoe Green Lane North, Fulwood, Preston, Lancashire, PR2 9HT, UK
| | - C Robinson
- Imaging Department, University Hospitals of Leicester, Leicester Royal Infirmary, Leicester, LE2 7LX, UK
| | - N Davendralingam
- Imaging Department, King's College Hospital, Denmark Hill, SE5 9RS, UK
| | - J Joseph
- Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Sharoe Green Lane North, Fulwood, Preston, Lancashire, PR2 9HT, UK
| | - B McManoman
- Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Sharoe Green Lane North, Fulwood, Preston, Lancashire, PR2 9HT, UK
| | - B Morgan
- Department of Life Sciences, University of Leicester, Radiology Department, Leicester Royal Infirmary, Infirmary Square, Leicester, LE2 7LX, UK.
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Yalamanchili A, Liu Y, Fisher P, Joseph J, Thomas TO. Cost Analysis of MR-Guided vs. CT-Guided Radiation Therapy for Locally Advanced Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e635. [PMID: 37785895 DOI: 10.1016/j.ijrobp.2023.06.2037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Stereotactic magnetic resonance guided on-table adaptive radiotherapy (SMART) is an increasingly utilized radiotherapy (RT) treatment for locally advanced pancreatic cancer (LAPC), providing improved local control and overall survival with reduced toxicity. Computed tomography (CT) guided RT options include stereotactic body radiotherapy (SBRT) and hypofractionated RT with volumetric modulated arc therapy (VMAT). Currently there are no financial comparisons for MR vs CT-guided RT for LAPC. We completed a cost analysis comparing the physician and hospital charges associated with RT options for LAPC. MATERIALS/METHODS To compare RT costs, we identified Current Procedural Terminology (CPT) codes utilized for 5-fraction SMART with adaptation (50 Gy, biological effective dose (BED) 100 Gy), 5-fraction CT-guided SBRT (33 Gy, BED 55 Gy), and 15-fraction CT-guided hypofractionated VMAT (67.5 Gy, BED 98 Gy) in a hospital-based practice setting. Physician and hospital Medicare prices associated with these codes together summarize the overall cost. We determined physician fees using the Centers for Medicare and Medicaid Services (CMS) Physician Fee Schedule Search to search the Healthcare Common Procedure Coding System (HCPCS) for "professional" costs included within "facility" costs. We determined hospital fees using the Outpatient Prospective Payment System addendum. To standardize costs, we searched for national payment amounts for the 2022 calendar year. RESULTS Total cost of SMART with adaptation was 136% higher than the cost of CT-SBRT and 149% higher than the cost of hypofractionated RT. Physician fees for SMART were 173% higher and 157% higher than the fees for CT-SBRT and hypofractionated RT, respectively. Hospital fees for SMART were 129% higher and 147% higher than the fees for CT-SBRT and hypofractionated RT, respectively. The total cost of CT-SBRT was only 5% higher than cost of hypofractionated RT. The physician fees for hypofractionated RT were 6% higher than those for CT-SBRT, while the outpatient fees for CT SBRT were 7% higher than those for hypofractionated RT. CONCLUSION With recent data demonstrating favorable efficacy and toxicity rates for SMART, practices may increasingly consider investing in this treatment modality. This is the first cost analysis comparing SMART to CT-guided SBRT and hypofractionated RT in LAPC. We demonstrate higher costs of SMART compared to CT-guided RT, attributable primarily to higher number of dosimetry calculations for this modality and for adapted fractions. We also demonstrate comparable costs of lower BED CT-guided SBRT and higher BED hypofractionated RT. Further investigation is needed to assess whether the survival benefit of SMART translates to favorable cost per quality adjusted life year.
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Affiliation(s)
- A Yalamanchili
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Y Liu
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - P Fisher
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - J Joseph
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - T O Thomas
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
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Wang YF, Elliston C, Munbodh R, Savacool M, Tam J, Joseph J, Spina CS, Horowitz DP, Kachnic LA, Price M. Creation and Implementation of an Interdisciplinary Workflow for CBCT-Based Online Adaptive Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e736. [PMID: 37786139 DOI: 10.1016/j.ijrobp.2023.06.2262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) CBCT-based online adaptive radiotherapy (OART) is an emerging treatment strategy to replan based on the anatomy of the day while the patient remains on the couch. OART is not just an add-on to the current workflow; it necessitates a new approach across the patient's path of care, from CT simulation to treatment delivery. OART requires the addition of duties to clinical personnel, strategies to create auto-plan templates, and monitoring the "black box" adaptation process. Studies have shown that OART implementation is limited by its resource-intensive nature and the risks associated with the treatment approach. We hypothesized that the implementation of an interdisciplinary, streamlined workflow and checklists would enhance the OART treatment efficiency, prevent medical errors from the adaptation, and minimize the burden on clinicians. MATERIALS/METHODS An interdisciplinary OART working group comprising radiation oncologists, medical physicists, dosimetrists, and therapists was created to enable weekly knowledge sharing, workflow design, implementation, and continuous process improvement. 213 adaptive sessions from 5 treatment sites (pancreas, bladder, prostate, rectum, anus) were treated on a CBCT-based OART platform in a single institutional study. An evaluation of the treatment safety and workflow time was performed for each adaptive session. RESULTS The OART workflow was divided into four sub-workflows: 1) pre-treatment site-specific template preparation, 2) pre-treatment initial planning and verification, 3) on-treatment procedure, and 4) post-treatment evaluation. The sub-processes involved 4, 8, 13, and 4 separate, sequentially tasks, respectively, and a total of 11 task checklists. The template preparation is a new process developed for site-specific, standardized physician template directives, automated planning template development, and testing for its accuracy and robustness. The planning templates generated high-quality initial plans automatically within minutes once structures were segmented on the planning CT. This process was replicated during treatment using the CBCT. The median (interquartile range) online procedure time, defined as the time from initial CBCT to plan approval, of the five treatment sites (pancreas, bladder, prostate, rectum, anus) was 22.1 (19.2-24.8) min, 16.5 (15.3-17.5) min, 14.7 (13.9-17.4) min, 17 (15.3-19.7) min, and 24 (21.4-25.8) min, respectively. Safety assessment determined that no treatment deviations were observed. CONCLUSION Creating an interdisciplinary, standardized workflow and checklists allowed the safe delivery of OART with clinically feasible online procedure time and significantly reduced initial planning time compared with traditional EBRT. The unique workflow is essential to minimize the burden on the care team, increase patient safety, and access to OART.
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Affiliation(s)
- Y F Wang
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - C Elliston
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - R Munbodh
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - M Savacool
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - J Tam
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - J Joseph
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - C S Spina
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - D P Horowitz
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - L A Kachnic
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - M Price
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
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Sayan M, Eren AA, Alali B, Mohammadipour S, Vahedi F, Daneshmand B, Abbas W, Hawsawi Y, Nader T, Joseph J, Wahby R, Ozgenc I, Mula-Hussain L, Moningi S, Orio PF, Eren MF. Prostate Cancer Awareness in the Middle East. Int J Radiat Oncol Biol Phys 2023; 117:e433-e434. [PMID: 37785413 DOI: 10.1016/j.ijrobp.2023.06.1602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) A better understanding of cancer awareness is crucial to allow the appropriate implementation of interventions to improve screening and diagnosis. While the incidence of prostate cancer has been reported to increase over the last decade in the Middle East, data on prostate cancer awareness in this region remains limited. Therefore, an assessment of prostate cancer awareness is critically needed. The current study addresses this urgent need by investigating the level of awareness of prostate cancer among the general public in the Middle East. MATERIALS/METHODS A cross-sectional survey of men residing in 13 Middle Eastern countries was conducted in 2022. A validated prostate cancer awareness questionnaire was used to assess participants' knowledge on several domains of prostate cancer. Men younger than 40 years of age or history of prostate cancer were excluded from the study. RESULTS A total of 4,431 men completed the survey. The median age was 49 (range, 40-81) and the majority of participants (81%) had a formal education. Most participants (90%) were married and only 30% had a family history of cancer. Most participants (84%) reported hearing about prostate cancer in the past but only 31% of the participants recognized that prostate cancer is the most common malignancy in men and 22% thought that prostate cancer affects both men and women. Awareness of risk factors for prostate cancer was low: 29% of the participants recognized family history as a risk factor and 30% associated increasing age with prostate cancer. Most participants were not aware of screening, specifically only 19% of the participants knew that PSA test is used for PC screening. In terms of prognosis, participants thought that the majority of prostate cancer patients (mean, 75%) die due to their disease as opposed to old age or another cause of death. CONCLUSION Although the Middle Eastern men are familiar with the existence of prostate cancer, they are uninformed about the disease outcomes, risk factors, and screening. Overall, these results indicate critically low levels of awareness of prostate cancer in the Middle East. Thus, there is a vital need to target this population for practical interventions to increase awareness, in addition to screening and earlier diagnosis.
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Affiliation(s)
- M Sayan
- Dana Farber Cancer Institute, Boston, MA
| | - A Ay Eren
- Kartal Dr. Lütfi Kırdar Education and Research Hospital, Istanbul, Turkey
| | - B Alali
- Jaber Al Ahmad Hospital, Kuwait, Kuwait
| | | | - F Vahedi
- University of Tehran, Tehran, Iran (Islamic Republic of Iran)
| | | | - W Abbas
- Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of Iran)
| | - Y Hawsawi
- Al-Faisal University, Jeddah, Saudi Arabia
| | - T Nader
- Faculty of Medicine of Damascus University, Damascus, Syrian Arab Republic
| | - J Joseph
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - R Wahby
- Galala University, Suez, Egypt
| | - I Ozgenc
- University of Nicosia Medical School, Egkomi, Cyprus
| | | | - S Moningi
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA
| | - P F Orio
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - M F Eren
- Marmara Universitesi Hastanesi, Istanbul, Turkey
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9
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Stryker K, Farghaly S, Alsunaid S, Joseph J, BORGI J, Forest S, Mansour A. Weight It Out: Use of Semaglutide for Weight Loss in Patients Undergoing Lung Transplant Evaluation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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10
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Farghaly S, Alsunaid S, Stryker K, Joseph J, Forest S, Borgi J, Mansour A. Successful Use of Glecapravir/pibrentasvir in the Setting of Extracorporeal Membrane Oxygenation in a Lung Transplant Recipient: A Case Report. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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11
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Farghaly S, Yun S, Mansour A, Stryker K, Joseph J, Forest S, Borgi J, Alsunaid S. Outcomes and Immunosuppression of Combined Liver-Lung Transplantation: A Single Center Experience. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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12
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Sagar H, George J, Joseph V, Joseph J, Abdullakutty J, Mathew R. Optical Coherence Tomography (OCT) evaluation of culprit lesions in patients with Non-ST Elevation Acute Coronary Syndromes (NSTE-ACS). Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
OCT is an excellent tool to determine plaque morphology in Acute Coronary Syndromes. While plaque rupture has been determined to be the dominant morphology in ST Elevation Myocardial Infarction, there is paucity of literature in NSTE-ACS, which includes Non–ST Segment Elevation Myocardial Infarction (NSTEMI) and Unstable angina (UA).
Purpose
To characterize culprit lesion morphology by OCT in NSTE-ACS and to evaluate the frequency of each type of lesion in patients presenting with NSTEMI and UA.
Methods
In this single-centre observational study, OCT imaging of culprit lesion was acquired during coronary angioplasty of culprit lesions of 50 patients presenting with NSTE-ACS between August 2020 to July 2021. A comparison of the frequency of each type of lesion between NSTEMI and UA was performed.
Results
OCT of culprit vessel in the entire cohort of NSTE-ACS showed plaque erosion in 32% (n=16), plaque rupture in 32% (n=16), tight stenosis in 26% (n=13) and calcific nodule in 10% (n= 5) patients. Lipid plaque was seen in a higher number of patients with plaque erosion and plaque rupture (93.8% and 87.5% respectively). Comparison of the frequency of these lesions in NSTEMI and UA, revealed that among NSTEMI patients (n=25), 48% had plaque erosion, 36% had plaque rupture, 12% had tight stenosis and 4% had calcific nodule whereas, among UA patients (n=25), 16% had plaque erosion, 28% had plaque rupture, 40% had tight stenosis and 16% had calcific nodule. There was a statistically significant increase in plaque erosion in NSTEMI compared to UA (p=0.015) while tight stenosis was significantly more common in UA (p=0.024). Similarly, red thrombus and spotty calcium (p=0.002 and 0.008 respectively) were higher in NSTEMI compared to UA. There was no significant difference in frequency of thin cap fibroatheroma, macrophages, cholesterol crystals, white thrombus, and neovascularization among the two groups.
Conclusions
OCT provides unique insights into the mechanisms of NSTE-ACS. In our study plaque erosion and plaque rupture were both equally seen in patients presenting with NSTE- ACS. However, NSTEMI patients had a higher frequency of plaque erosion, red thrombus, and spotty calcium when compared to UA. While UA patients had a higher incidence of tight stenosis.
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Affiliation(s)
- H Sagar
- LISIE HOSPITAL , Kochi , India
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Field CP, Denning-Johnson Lynch C, Fareed N, Joseph J, Wu J, Thung S, Gabbe S, Landon MB, Grobman WA, Venkatesh KK. Association of community walkability and glycemic control among pregnant individuals with pregestational diabetes. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Vuillier L, Joseph J, Greville-Harris M, May L, Somerville MP, Harrison A, Moseley RL. What about males? Exploring sex differences in the relationship between emotion difficulties and eating disorders. J Eat Disord 2022; 10:193. [PMID: 36514166 PMCID: PMC9749243 DOI: 10.1186/s40337-022-00715-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE While eating disorders (EDs) are more commonly diagnosed in females, there is growing awareness that men also experience EDs and may do so in a different way. Difficulties with emotion processing and emotion regulation are believed to be important in EDs, but as studies have involved predominantly female samples, it is unclear whether this is also true for males. METHODS In a sample of 1604 participants (n = 631 males), we assessed emotion processing and emotion regulation in males with EDs (n = 109) and compared results to both females with EDs (n = 220) and males from the general population (n = 522). We also looked at whether emotion processing and emotion regulation difficulties predicted various aspects of eating psychopathology and whether this was moderated by sex. We assessed emotion processing with the Toronto Alexithymia Scale, emotion regulation with the Difficulties in Emotion Regulation Scale and the Emotion Regulation Questionnaire, and eating psychopathology with the Eating Disorder Examination Questionnaire. RESULTS We found that males with ED, like their female counterparts, suffered from emotion processing and emotion regulation deficits. We did find some sex differences, in that males with EDs tended to report more difficulties with their emotions as well as a more externally oriented thinking style compared to females with EDs. Difficulties with emotion processing and emotion regulation were strongly predictive of various aspects of eating psychopathology in both sexes. Importantly, we found that sex moderated the relationship between cognitive reappraisal and eating restraint. As such, low use of reappraisal was found to be associated with higher levels of restraint in females but not in males. DISCUSSION Difficulties with emotion processing and emotion regulation are associated with eating psychopathology in both males and females. Reappraisal was not found to be associated with reduced eating psychopathology in males, suggesting a cautious approach to interventions targeting this strategy. Research around explanatory mechanisms and interventions must adopt a broader viewpoint including those that are traditionally overlooked in EDs.
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Affiliation(s)
- L Vuillier
- Department of Psychology, Bournemouth University, Poole, UK.
| | - J Joseph
- Department of Psychology, Bournemouth University, Poole, UK
| | | | - L May
- Dorset Healthcare University NHS Foundation Trust, Poole, UK
| | - M P Somerville
- UCL Institute of Education, University College London, London, UK
| | - A Harrison
- UCL Institute of Education, University College London, London, UK
| | - R L Moseley
- Department of Psychology, Bournemouth University, Poole, UK
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Abeyakoon O, Woitek R, Wallis M, Moyle P, Morscher S, Dahlhaus N, Ford S, Burton N, Manavaki R, Mendichovszky I, Joseph J, Quiros-Gonzalez I, Bohndiek S, Gilbert F. An optoacoustic imaging feature set to characterise blood vessels surrounding benign and malignant breast lesions. Photoacoustics 2022; 27:100383. [PMID: 36068806 PMCID: PMC9441264 DOI: 10.1016/j.pacs.2022.100383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/21/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
Combining optoacoustic (OA) imaging with ultrasound (US) enables visualisation of functional blood vasculature in breast lesions by OA to be overlaid with the morphological information of US. Here, we develop a simple OA feature set to differentiate benign and malignant breast lesions. 94 female patients with benign, indeterminate or suspicious lesions were recruited and underwent OA-US. An OA-US imaging feature set was developed using images from the first 38 patients, which contained 14 malignant and 8 benign solid lesions. Two independent radiologists blindly scored the OA-US images of a further 56 patients, which included 31 malignant and 13 benign solid lesions, with a sensitivity of 96.8% and specificity of 84.6%. Our findings indicate that OA-US can reveal vascular patterns of breast lesions that indicate malignancy using a simple feature set based on single wavelength OA data, which is therefore amenable to application in low resource settings for breast cancer management.
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Affiliation(s)
- O. Abeyakoon
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK
| | - R. Woitek
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK
| | - M.G. Wallis
- Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - P.L. Moyle
- Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - S. Morscher
- iThera Medical GmbH, Zielstattstrasse 13, Munich 81379, Germany
| | - N. Dahlhaus
- iThera Medical GmbH, Zielstattstrasse 13, Munich 81379, Germany
| | - S.J. Ford
- iThera Medical GmbH, Zielstattstrasse 13, Munich 81379, Germany
| | - N.C. Burton
- iThera Medical GmbH, Zielstattstrasse 13, Munich 81379, Germany
| | - R. Manavaki
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK
| | - I.A. Mendichovszky
- Department of Nuclear Medicine, Cambridge University Hospitals Foundation Trust, Cambridge CB2 0QQ, UK
| | - J. Joseph
- Department of Physics, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge CB2 0RE, UK
| | - I. Quiros-Gonzalez
- Department of Physics, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge CB2 0RE, UK
| | - S.E. Bohndiek
- Department of Physics, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge CB2 0RE, UK
| | - F.J. Gilbert
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK
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Kiefer MK, Finneran MM, Ware CA, Fareed N, Joseph J, Thung SF, Costantine MM, Landon MB, Gabbe SG, Venkatesh KK. Association of change in haemoglobin A1c with adverse perinatal outcomes in women with pregestational diabetes. Diabet Med 2022; 39:e14822. [PMID: 35261060 DOI: 10.1111/dme.14822] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/26/2022] [Indexed: 01/28/2023]
Abstract
AIMS To determine whether a net decline in glycosylated haemoglobin (HbA1c ) from early to late pregnancy is associated with lower risk of adverse perinatal outcomes at delivery among women with pregestational diabetes. METHODS A retrospective analysis from 2012 to 2016 at a tertiary care centre. The exposure was the net change in HbA1c from early (<20 weeks gestation) to late pregnancy (≥20 weeks gestation). Primary outcomes were large for gestational age (LGA) and neonatal hypoglycaemia. The association between outcomes per 6 mmol/mol (0.5%) absolute decrease in HbA1c was evaluated using modified Poisson regression, and adjusted for age, body mass index, White Class, early HbA1c and haemoglobin and gestational age at HbA1c measurement and delivery. RESULTS Among 347 women with pregestational diabetes, HbA1c was assessed in early (9 weeks [IQR 7,13]) and late pregnancy (31 weeks [IQR 29,34]). Mean HbA1c decreased from early (59 mmol/mol [7.5%]) to late (47 mmol/mol [6.5%]) pregnancy. Each 6 mmol/mol (0.5%) absolute decrease in HbA1c was associated with a 12% reduced risk of LGA infant (30%, aRR:0.88; 95% CI:0.81,0.95), and a 7% reduced risk of neonatal hypoglycaemia (35%, aRR:0.93; 95% CI:0.87,0.99). Preterm birth (36%, aRR:0.93; 95% CI:0.89,0.98) and neonatal intensive care unit admission (55%, aRR:0.95; 95% CI:0.91,0.98) decreased with a net decline in HbA1c , but not caesarean delivery, pre-eclampsia, shoulder dystocia and respiratory distress syndrome. CONCLUSIONS Women with pregestational diabetes with a reduction in HbA1c may have fewer infants born LGA or with neonatal hypoglycaemia. Repeated assessment of HbA1c may provide an additional measure of glycaemic control.
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Affiliation(s)
- Miranda K Kiefer
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, USA
| | - Matthew M Finneran
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Courtney A Ware
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, USA
| | - Naleef Fareed
- Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio, USA
| | - Joshua Joseph
- Division of Endocrinology, Department of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Stephen F Thung
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, USA
| | - Maged M Costantine
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, USA
| | - Mark B Landon
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, USA
| | - Steven G Gabbe
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, USA
| | - Kartik K Venkatesh
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, USA
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Gladis EHE, Nagashri K, Anisha M, Joseph J. Synthesis, characterisation, DNA binding, acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activities and molecular docking studies of metal(II) complexes with 1,10-phenanthroline scaffold. J Biomol Struct Dyn 2022:1-19. [PMID: 35699274 DOI: 10.1080/07391102.2022.2078412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
A series of metal complexes containing Phenanthroline scaffold [ML] (L-1,10-Phenanthroline derivative comprises conjugated aromatic core and selenol group); M = Cu(II), Zn(II), Co(II) and Zn(II) ions were designed and synthesised to obtain effective anti-cholinesterase efficiencies of metal chelates. Analytical and spectroscopic studies were used to determine the structural features. An octahedral structure with moderate distortion was attributed to the above metal chelates based on spectroscopic data. The distorted octahedral geometry of copper(II) complex to DNA (Kb = 4.05 × 105 M-1) is stronger than that of ethidium bromide (EB) to DNA (Kb = 3.2 × 105 M-1), other metal complexes, respectively. The synthesised 1,10-Phenanthroline derivative had the best inhibitory effects against acetylcholinesterase (AChE) and butyrylcholinesterase, with IC50 values of 0.45 and 3.6 M, respectively, which were lower than the reference molecules. As a result, nitrogen-containing heterocyclic compounds (H2L) showed significant inhibitory profiles against the metabolic enzymes. Therefore, we believe that these experimental results may contribute to the development of new drug molecules particularly in the treatment of neurological disorders including glaucoma, Alzheimer's disease (AD) and diabetes. Docking, AChE and BuChE inhibition activities results revealed that ligand may be used for AD. The prepared 1,10-phenanthroline analogue, which has a high selectivity for AChE, may be studied further to find potential candidates for treating early-stage Alzheimer's symptoms.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- E H Edinsha Gladis
- Department of Chemistry, Manonmaniam Sundaranar University, Tirunelveli, India
| | - K Nagashri
- Department of Chemistry, Manonmaniam Sundaranar University, Tirunelveli, India
| | - M Anisha
- Department of Biomedical Engineering, Kalasalingam Academy of Research and Education, Krishnankoil, India
| | - J Joseph
- Department of Chemistry, Noorul Islam Centre for Higher Education, Kumaracoil, India
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Venkatesh KK, Germann K, Joseph J, Kiefer M, Buschur E, Thung S, Costantine MM, Gabbe S, Grobman WA, Fareed N. Association Between Social Vulnerability and Achieving Glycemic Control Among Pregnant Individuals With Pregestational Diabetes. Obstet Gynecol 2022; 139:1051-1060. [PMID: 35675602 PMCID: PMC10953616 DOI: 10.1097/aog.0000000000004727] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/13/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the association between community-level social vulnerability and achieving glycemic control (defined as hemoglobin A1c [Hb A1c] less than 6.0% or less than 6.5%) among individuals with pregestational diabetes. METHODS We conducted a retrospective cohort of individuals with pregestational diabetes with singleton gestations from 2012 to 2016 at a tertiary care center. Addresses were geocoded using ArcGIS and then linked at the census tract to the Centers for Disease Control and Prevention's 2018 SVI (Social Vulnerability Index), which incorporates 15 Census variables to produce a composite score and four scores across thematic domains (socioeconomic status, household composition and disability, minority status and language, and housing type and transportation). Scores range from 0 to 1, with higher values indicating greater community-level social vulnerability. The primary outcome was Hb A1c less than 6.0%, and, secondarily, Hb A1c less than 6.5%, in the second or third trimesters. Multivariable Poisson regression with robust error variance was used to evaluate the association between SVI score as a continuous measure and target Hb A1c. RESULTS Among 418 assessed pregnant individuals (33.0% type 1; 67.0% type 2 diabetes), 41.4% (173/418) achieved Hb A1c less than 6.0%, and 56.7% (237/418) Hb A1c less than 6.5% at a mean gestational age of 29.5 weeks (SD 5.78). Pregnant individuals with a higher SVI score were less likely to achieve Hb A1c less than 6.0% compared with those with a lower SVI score. For each 0.1-unit increase in SVI score, the risk of achieving Hb A1c less than 6.0% decreased by nearly 50% (adjusted risk ratio [aRR] 0.53; 95% CI 0.36-0.77), and by more than 30% for Hb A1c less than 6.5% (adjusted odds ratio 0.67; 95% CI 0.51-0.88). With regard to specific SVI domains, those who scored higher on socioeconomic status (aRR 0.50; 95% CI 0.35-0.71) as well as on household composition and disability (aRR 0.55; 95% CI 0.38-0.79) were less likely to achieve Hb A1c less than 6.0%. CONCLUSION Pregnant individuals with pregestational diabetes living in an area with higher social vulnerability were less likely to achieve glycemic control, as measured by HgbA1c levels. Interventions are needed to assess whether addressing social determinants of health can improve glycemic control in pregnancy.
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Affiliation(s)
- Kartik K Venkatesh
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, the College of Medicine, the Division of Endocrinology, Department of Medicine, and the Department of Bioinformatics, The Ohio State University, Columbus, Ohio
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Prakasan A, Krishna J, Kumar A, Mathews S, Sambasivan S, Joseph J, James F. 22P A comparison of new ESGO-ESTRO-ESP endometrial risk classification with previous classification in predicting outcome. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Van Der Sluijs KM, Bakker EA, Schuijt TJ, Joseph J, Thijssen DHJ, Eijsvogels TMH. Long-term cardiovascular health and physical functioning of non-hospitalised ex-COVID-19 patients: a case-control study. Eur J Prev Cardiol 2022. [PMCID: PMC9384083 DOI: 10.1093/eurjpc/zwac056.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Dutch Heart Foundation (Nederlandse Hartstichting) Background/Introduction SARS-CoV-2 and the associated coronavirus disease 2019 (COVID-19) has substantial acute effects on cardiovascular health and physical functioning, but the long-term effects are less clear, especially in individuals that recover from COVID-19 at home, representing ~95% of all cases. Purpose We compared cardiovascular health and physical functioning of non-hospitalised ex-COVID-19 patients versus age- and sex-matched healthy peers. Methods We recruited non-hospitalised adults with PCR-proven COVID-19 and age- and sex-matched controls for this case-control study. Duration of COVID-19 illness and presence of residual complaints were inquired. Cardiovascular health status and physical functioning were assessed through a series of measurements: blood pressure, blood biomarkers (NT-proBNP, high-sensitive cardiac troponin I, C-reactive protein), carotid-femoral pulse wave velocity (ARTSENS), handgrip strength, 4-metre gait speed, habitual physical activity (days per week with at least 30 minutes of moderate physical activity) and quality of life based on the 12-item short form. Results We included 101 ex-COVID-19 patients (median age 59.0 [54.5-65.5], 59 (58.4%) male) at a median of 5.0 [4.0-7.0] months post-infection and 101 age- and sex-matched controls (median age 58.0 [54.0-64.5], 58 (57.4%) male). Median duration of COVID-19 illness was 8.0 days [6.0-14.0] and 32.3% of the cases reported residual complaints at the time of inclusion. We found no differences between ex-COVID-19 patients and controls in blood pressure (134-81 vs. 133-81 mmHg, p=0.40 and p=0.30 for systolic and diastolic pressures respectively), concentrations of NT-proBNP (8.50 vs. 7.00 pmol/L, p=0.22), high-sensitive cardiac troponin I (4.11 vs. 3.38 ng/L, p=0.06), C-reactive protein (4.00 vs. 4.00 mg/L, p=0.93) and carotid-femoral pulse wave velocity (6.63 vs. 7.01 m/s, p=0.30). Ex-COVID-19 patients showed higher handgrip strength compared to controls (43 kg vs. 38 kg, p=0.004), but 4-metre gait speed (2.62 vs. 2.56 s, p=0.33), habitual physical activity levels (6.0 vs. 6.0 days, p=0.16) and reported quality of life (86.4% vs. 88.6%, p=0.10) were not different between groups. Conclusion(s) Cardiovascular health and physical functioning parameters were not different between non-hospitalised ex-COVID-19 patients and age- and sex-matched controls at five months post-infection. This suggests that individuals who recovered from COVID-19 at home do not have an increased cardiovascular risk or impaired physical functioning in the long-term.
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Affiliation(s)
- KM Van Der Sluijs
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, Netherlands (The)
| | - EA Bakker
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, Netherlands (The)
| | - TJ Schuijt
- Gelderse Vallei Hospital, Clinical Chemistry and Hematology Laboratory, Ede, Netherlands (The)
| | - J Joseph
- Indian Institute of Technology (IIT) Madras, Department of Electrical Engineering, Chennai, India
| | - DHJ Thijssen
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, Netherlands (The)
| | - TMH Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, Netherlands (The)
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21
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Sundaram V, Rao G, Bhattacharjee M, Joseph J, Balaji B, Patil D. PO-1544 The role of dose rate and gantry speed variations in PRO and PO algorithms for rapidarc delivery. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03508-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Mongraw-Chaffin M, Saldana S, Carnethon MR, Chen H, Effoe V, Golden SH, Joseph J, Kalyani RR, Bertoni AG. Determinants of metabolic syndrome and type 2 diabetes in the absence of obesity: The Jackson Heart Study. J Endocr Soc 2022; 6:bvac059. [PMID: 35528825 PMCID: PMC9071278 DOI: 10.1210/jendso/bvac059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Indexed: 11/19/2022] Open
Abstract
Context Multiple studies suggest that adults who were normal weight at diabetes diagnosis are at higher risk for all-cause mortality than those who had overweight or obesity at diagnosis. Objective While obesity is a known risk factor for cardiometabolic disease, differences in body fat distribution in those without obesity are understudied, especially in African Americans. Methods In 1005 participants of the Jackson Heart Study, without cardiovascular disease at baseline, we used logistic regression to investigate the longitudinal association of body fat distribution by CT scan with metabolic syndrome (MetS) or type 2 diabetes (T2D). We used the harmonized International Diabetes Federation criteria to define MetS. We included only normal weight or overweight participants (BMI: 18.5 to < 30.0 kg/m2). We created separate models for MetS and T2D adjusted for a standard set of covariates. We excluded participants with prevalent MetS or T2D, respectively in sensitivity. Results Higher visceral fat, subcutaneous fat, BMI, and insulin resistance (HOMA-IR) were significantly associated with MetS and T2D after adjustment. Visceral fat was strongly associated with both outcomes (MetS OR = 2.07 [1.66-2.68]; T2D OR = 1.51 [1.21-1.88]), and the association for MetS persisted in the normal weight only group. Estimates were robust to sensitivity analysis and were only modestly mediated by insulin resistance. Physical activity was not associated with MetS or T2D. Conclusion Visceral fat is strongly associated with developing MetS, even in normal weight individuals, suggesting that excess visceral fat plays a role in cardiometabolic risk beyond that of overall adiposity and obesity in African Americans.
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Affiliation(s)
| | - Santiago Saldana
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem NC
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Haiying Chen
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem NC
| | - Valery Effoe
- Division of Cardiology, Morehouse School of Medicine, Atlanta, GA
| | - Sherita Hill Golden
- Division of Endocrinology Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Joshua Joseph
- Division of Endocrinology Diabetes and Metabolism, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Rita R Kalyani
- Division of Endocrinology Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Alain G Bertoni
- Department of Epidemiology & Prevention, Wake Forest School of Medicine, Winston-Salem NC
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23
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Kopp R, Joseph J, Ni X, Roy N, Wardle BL. Deep Learning Unlocks X-ray Microtomography Segmentation of Multiclass Microdamage in Heterogeneous Materials. Adv Mater 2022; 34:e2107817. [PMID: 34800056 DOI: 10.1002/adma.202107817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/16/2021] [Indexed: 06/13/2023]
Abstract
Four-dimensional quantitative characterization of heterogeneous materials using in situ synchrotron radiation computed tomography can reveal 3D sub-micrometer features, particularly damage, evolving under load, leading to improved materials. However, dataset size and complexity increasingly require time-intensive and subjective semi-automatic segmentations. Here, the first deep learning (DL) convolutional neural network (CNN) segmentation of multiclass microscale damage in heterogeneous bulk materials is presented, teaching on advanced aerospace-grade composite damage using ≈65 000 (trained) human-segmented tomograms. The trained CNN machine segments complex and sparse (<<1% of volume) composite damage classes to ≈99.99% agreement, unlocking both objectivity and efficiency, with nearly 100% of the human time eliminated, which traditional rule-based algorithms do not approach. The trained machine is found to perform as well or better than the human due to "machine-discovered" human segmentation error, with machine improvements manifesting primarily as new damage discovery and segmentation augmentation/extension in artifact-rich tomograms. Interrogating a high-level network hyperparametric space on two material configurations, DL is found to be a disruptive approach to quantitative structure-property characterization, enabling high-throughput knowledge creation (accelerated by two orders of magnitude) via generalizable, ultrahigh-resolution feature segmentation.
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Affiliation(s)
- Reed Kopp
- Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, 02139, USA
| | - Joshua Joseph
- MIT Quest for Intelligence, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, 02139, USA
| | - Xinchen Ni
- Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, 02139, USA
| | - Nicholas Roy
- Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, 02139, USA
- MIT Quest for Intelligence, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, 02139, USA
| | - Brian L Wardle
- Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, 02139, USA
- Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, 02139, USA
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24
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Meenakshisundaram R, Joseph J, Perumal P, Areeb A, Pancheti P, Sampath D, Jared E, Ryan A. This Article Corrects: “A Chemist with a Strange Etiology of Rhabdomyolysis: A Case Report of a Rare Toxicological Emergency”. Clin Pract Cases Emerg Med 2022; 6:99. [PMID: 35226864 PMCID: PMC8885213 DOI: 10.5811/cpcem.2022.2.56452] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
| | - Joshua Joseph
- Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India
| | - Prabakaran Perumal
- Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India
| | - Akmal Areeb
- Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India
| | - Prathap Pancheti
- Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India
| | - Dinesh Sampath
- Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India
| | - Esther Jared
- Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India
| | - Allison Ryan
- Einstein Medical Center, Department of Emergency Medicine, Philadelphia, Pennsylvania
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25
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O'Brien J, Manning T, Kelly B, Chen K, Merrilees D, Joseph J, Sengupta S, Goad J, Bolton D, Lawrenstchuk N. Sealing the leak: A 10-year multicentre experience managing refractory post retroperitoneal lymph node dissection chylous ascites. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00647-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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26
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Vijila B, Gladis EHE, Keerthi N, Joseph J. Mesoporous aluminum impregnated rubber seed shell waste enriched with calcium as adsorbent material for the removal of microbial DNA in aqueous solution. Nucleosides Nucleotides Nucleic Acids 2022; 41:183-219. [PMID: 35019823 DOI: 10.1080/15257770.2022.2026382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 01/01/2022] [Accepted: 01/03/2022] [Indexed: 06/14/2023]
Abstract
Water contamination by pathogens and diseases induced by these pathogens is a major water quality issue all over the world. Poor public health has been linked to tap water polluted with DNA harboring antibiotic resistance genes sequence. According to HSAB concept, surface modification of rubber seed shell waste with alumina (AIRSS) as novel agro-waste adsorbent creates more active surface constituents for DNA adsorption. The proximate, ultimate and EDAX analysis provides the percentage levels of ash concentration, volatile, moisture and fixed carbon content, elemental composition present in the adsorbent. The structural features of AIRSS were determined using FT-IR, SEM and XRD. In order to improve reaction conditions, the effect of pH, temperature, adsorbent amount, and reaction time is also examined. The highest percent of DNA removal (92.5%) was achieved at the optimum conditions: 2 g/L at pH 4, contact time 120 minutes as compared to the conventional methods. The DNA adsorbs onto the surface of AIRSS through physical (vander Waals force) and chemical interactions, as demonstrated by kinetics and spectroscopic analyses. Changes in enthalpy (H), free energy (G), and entropy (S) indicate that adsorption is a spontaneous and exothermic process, according to thermodynamic parameters. The results of the experiments showed that the prepared AIRSP adsorbent could be used to remove DNA from water. The efficacy of AIRSS for the removal of DNA has decreased after nine months of storage and use. Low pH and the presence of AIRSS improved DNA-AIRSS adsorption, according to our findings.
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Affiliation(s)
- B Vijila
- Department of Chemistry, Noorul Islam Centre for Higher Education, Kumaracoil, Tamil Nadu, India
| | - E H Edinsha Gladis
- Department of Chemistry, Noorul Islam Centre for Higher Education, Kumaracoil, Tamil Nadu, India
| | - N Keerthi
- Department of Chemistry, Noorul Islam Centre for Higher Education, Kumaracoil, Tamil Nadu, India
| | - J Joseph
- Department of Chemistry, Noorul Islam Centre for Higher Education, Kumaracoil, Tamil Nadu, India
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Venkatesh KK, Kiefer MK, Fareed N, Ware CA, Thung S, Landon MB, Costantine MM, Gabbe S, Joseph J. Change in Hemoglobin A1C during pregnancy between Non-Hispanic Black versus White women with prepregnancy diabetes. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.11.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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28
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Venkatesh KK, Germann K, Joseph J, Kiefer MK, Thung S, Costantine MM, Landon MB, Gabbe S, Fareed N. Association between Social Vulnerability and Achieving Glycemic Control among Pregnant Women with Pregestational Diabetes. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.11.1129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Zuberi S, Mushtaq Y, Patel K, Joseph J, Gurprashad R. 684 The Standard of Emergency Operation Note Documentation at A District General Hospital Compared Against The Royal College of Surgeons of England (RCSEng) Standard. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Meticulous operation note documentation is essential for seamless, safe continuity of care in postoperative surgical patients. This study evaluated the standard of emergency operation note documentation at a district general hospital, when compared to the Royal College of Surgeons of England (RCSEng) guidelines and assessed the impact of a new operation note proforma.
Method
A retrospective review of 50 emergency operation notes was conducted between December 2019 and March 2020 and compared to RCSEng guidelines. Initial findings were presented at a local clinical governance meeting and a new electronic operation note was introduced. A further 50 emergency operation notes using the new proforma were analysed between August 2020 and December 2020.
Results
RCSEng mentions 19 main points that all operation notes must include. A total of 100 operation notes were reviewed and each given a score out of 19. Intervention of the new proforma showed significant improvement to the average score (15.64 vs 17.94; p < 0.0001) when compared to RCSEng guidelines. In particular, there was significant improvement in the documentation of assistants involved in the procedure (58% vs 98%; p < 0.0001), estimated blood loss (2% vs 63%; p < 0.0001) and specific mention whether the operation was emergency or elective (20% vs 86%; p < 0.0001).
Conclusions
Implementation of the new proforma showed significant improvement in operation note documentation when compared to the RCSEng standard. Therefore, this study emphasises the need for surgeons to familiarise themselves with the current guidelines and highlights the importance of tailoring local operation note proformas to match this national standard closely.
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Affiliation(s)
- S Zuberi
- Luton and Dunstable University Hospital, Bedfordshire Hospitals NHS Foundation Trust, Luton, United Kingdom
| | - Y Mushtaq
- Luton and Dunstable University Hospital, Bedfordshire Hospitals NHS Foundation Trust, Luton, United Kingdom
| | - K Patel
- Luton and Dunstable University Hospital, Bedfordshire Hospitals NHS Foundation Trust, Luton, United Kingdom
| | - J Joseph
- Luton and Dunstable University Hospital, Bedfordshire Hospitals NHS Foundation Trust, Luton, United Kingdom
| | - R Gurprashad
- Luton and Dunstable University Hospital, Bedfordshire Hospitals NHS Foundation Trust, Luton, United Kingdom
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30
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Shrodes J, Spees C, Radabaugh J, Braun A, Joseph J, Williams A. Adaptation, Implementation, and Impact of Cooking Matters® for Diabetes on Dietary Outcomes, Food Security, and Quality of Life. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.08.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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31
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Walker D, DePuccio M, Hefner J, Garner J, Joseph J, Headings A, Clark A. Utilization Patterns of a
Clinic‐Based
Food Referral Program: Findings from the
Mid‐Ohio
Farmacy. Health Serv Res 2021. [DOI: 10.1111/1475-6773.13836] [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] Open
Affiliation(s)
- Daniel Walker
- The Ohio State University College of Medicine Columbus Ohio USA
| | | | - Jennifer Hefner
- Ohio State University College of Public Health Columbus Ohio USA
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32
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Joseph J, Moll M, Hessamfar M. Proposition systématique d’un suivi alterné ville–hôpital aux patients sous PrEP : enquête de pratique auprès des médecins généralistes. Infect Dis Now 2021. [DOI: 10.1016/j.idnow.2021.06.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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33
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Joy A, Kumar A, Joseph J, Krishna K M J, Natarajan N, M Nair L, V James F. PO-0191 Plan evaluation of the interstitial contribution in brachytherapy for cancer cervix. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06350-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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35
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Radaideh MI, Wolverton I, Joseph J, Tusar JJ, Otgonbaatar U, Roy N, Forget B, Shirvan K. Physics-informed reinforcement learning optimization of nuclear assembly design. Nuclear Engineering and Design 2021. [DOI: 10.1016/j.nucengdes.2020.110966] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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36
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Coccaro EF, Lazarus S, Joseph J, Wyne K, Drossos T, Phillipson L, de Groot M. Emotional Regulation and Diabetes Distress in Adults With Type 1 and Type 2 Diabetes. Diabetes Care 2021; 44:20-25. [PMID: 33444157 PMCID: PMC8742145 DOI: 10.2337/dc20-1059] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 09/27/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To explore the correlates of diabetes-related distress (DD) with psychometrically valid assessments of emotional regulation in individuals with type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODS Adults with diabetes (n = 298) were assessed for psychological issues possibly associated with diabetes and were further evaluated with measures of negative emotional experience (ER-Exp) and skill at regulating such experiences (ER-Skill) and measures of DD, perceived psychosocial stress, diabetes literacy, and diabetes self-care. RESULTS ER-Exp was directly related to DD, while ER-Skill was inversely related to DD. Together, these ER variables displayed a medium-size relationship (β = 0.45) with DD. Inclusion of variables related to diabetes self-care and perceived psychosocial stress was associated with only an 18% reduction (i.e., β = 0.45 to β = 0.38) in the strength of this relationship, while the magnitude of relationships between DD and perceived psychosocial stress (β = 0.15) and diabetes self-care (β = -0.09) was relatively small. CONCLUSIONS These data suggest that DD is meaningfully linked with negative emotionality, and skill at regulating such emotions, in adults with diabetes. This relationship appears to be stronger than that between DD and perceived psychological stress or diabetes self-care. If so, DD (and possibly A1C) may be improved in those with diabetes and difficulties with negative emotionality.
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Affiliation(s)
- Emil F Coccaro
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Sophie Lazarus
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Joshua Joseph
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Kathline Wyne
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Tina Drossos
- Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, University of Chicago, Chicago, IL
| | - Louis Phillipson
- Kovler Diabetes Center, Section of Endocrinology, Department of Medicine, Pritzker School of Medicine, University of Chicago, Chicago, IL
| | - Mary de Groot
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
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Bell JF, Maki JN, Mehall GL, Ravine MA, Caplinger MA, Bailey ZJ, Brylow S, Schaffner JA, Kinch KM, Madsen MB, Winhold A, Hayes AG, Corlies P, Tate C, Barrington M, Cisneros E, Jensen E, Paris K, Crawford K, Rojas C, Mehall L, Joseph J, Proton JB, Cluff N, Deen RG, Betts B, Cloutis E, Coates AJ, Colaprete A, Edgett KS, Ehlmann BL, Fagents S, Grotzinger JP, Hardgrove C, Herkenhoff KE, Horgan B, Jaumann R, Johnson JR, Lemmon M, Paar G, Caballo-Perucha M, Gupta S, Traxler C, Preusker F, Rice MS, Robinson MS, Schmitz N, Sullivan R, Wolff MJ. The Mars 2020 Perseverance Rover Mast Camera Zoom (Mastcam-Z) Multispectral, Stereoscopic Imaging Investigation. Space Sci Rev 2021; 217:24. [PMID: 33612866 PMCID: PMC7883548 DOI: 10.1007/s11214-020-00755-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/25/2020] [Indexed: 05/16/2023]
Abstract
Mastcam-Z is a multispectral, stereoscopic imaging investigation on the Mars 2020 mission's Perseverance rover. Mastcam-Z consists of a pair of focusable, 4:1 zoomable cameras that provide broadband red/green/blue and narrowband 400-1000 nm color imaging with fields of view from 25.6° × 19.2° (26 mm focal length at 283 μrad/pixel) to 6.2° × 4.6° (110 mm focal length at 67.4 μrad/pixel). The cameras can resolve (≥ 5 pixels) ∼0.7 mm features at 2 m and ∼3.3 cm features at 100 m distance. Mastcam-Z shares significant heritage with the Mastcam instruments on the Mars Science Laboratory Curiosity rover. Each Mastcam-Z camera consists of zoom, focus, and filter wheel mechanisms and a 1648 × 1214 pixel charge-coupled device detector and electronics. The two Mastcam-Z cameras are mounted with a 24.4 cm stereo baseline and 2.3° total toe-in on a camera plate ∼2 m above the surface on the rover's Remote Sensing Mast, which provides azimuth and elevation actuation. A separate digital electronics assembly inside the rover provides power, data processing and storage, and the interface to the rover computer. Primary and secondary Mastcam-Z calibration targets mounted on the rover top deck enable tactical reflectance calibration. Mastcam-Z multispectral, stereo, and panoramic images will be used to provide detailed morphology, topography, and geologic context along the rover's traverse; constrain mineralogic, photometric, and physical properties of surface materials; monitor and characterize atmospheric and astronomical phenomena; and document the rover's sample extraction and caching locations. Mastcam-Z images will also provide key engineering information to support sample selection and other rover driving and tool/instrument operations decisions.
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Affiliation(s)
| | | | | | - M. A. Ravine
- Malin Space Science Systems, Inc., San Diego, CA USA
| | | | | | - S. Brylow
- Malin Space Science Systems, Inc., San Diego, CA USA
| | | | | | | | | | | | | | - C. Tate
- Cornell Univ., Ithaca, NY USA
| | | | | | - E. Jensen
- Malin Space Science Systems, Inc., San Diego, CA USA
| | - K. Paris
- Arizona State Univ., Tempe, AZ USA
| | | | - C. Rojas
- Arizona State Univ., Tempe, AZ USA
| | | | | | | | - N. Cluff
- Arizona State Univ., Tempe, AZ USA
| | | | - B. Betts
- The Planetary Society, Pasadena, CA USA
| | | | - A. J. Coates
- Mullard Space Science Laboratory, Univ. College, London, UK
| | - A. Colaprete
- NASA/Ames Research Center, Moffett Field, CA USA
| | - K. S. Edgett
- Malin Space Science Systems, Inc., San Diego, CA USA
| | - B. L. Ehlmann
- JPL/Caltech, Pasadena, CA USA
- Caltech, Pasadena, CA USA
| | | | | | | | | | | | - R. Jaumann
- Inst. of Geological Sciences, Free University Berlin, Berlin, Germany
| | | | - M. Lemmon
- Space Science Inst., Boulder, CO USA
| | - G. Paar
- Joanneum Research, Graz, Austria
| | | | | | | | - F. Preusker
- DLR/German Aerospace Center, Berlin, Germany
| | - M. S. Rice
- Western Washington Univ., Bellingham, WA USA
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Naik P, Dave V, Joseph J. Multidrug-resistant Pseudomonas aeruginosa accelerates innate immune response in human microglial cells. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Gladis EHE, Nagashri K, Suman A, Joseph J. Multifunctional 1,10-phenanthroline derivative and its metal complexes as an anti-Alzheimer’s agent: structure-based drug design, synthesis, characterization and pharmacological studies. J COORD CHEM 2020. [DOI: 10.1080/00958972.2020.1852223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- E. H. Edinsha Gladis
- Department of Chemistry, Manonmaniam Sundaranar University, Tirunelveli, Tamilnadu, India
- Department of Chemistry, Noorul Islam Centre for Higher Education, Kumaracoil, Tamilnadu, India
| | - K. Nagashri
- Department of Chemistry, Manonmaniam Sundaranar University, Tirunelveli, Tamilnadu, India
| | - A. Suman
- Department of Chemistry, Manonmaniam Sundaranar University, Tirunelveli, Tamilnadu, India
| | - J. Joseph
- Department of Chemistry, Noorul Islam Centre for Higher Education, Kumaracoil, Tamilnadu, India
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Edinsha Gladis E, Nagashri K, Joseph J. Design, synthesis, characterization, DNA binding, acetyl and butyryl cholinesterase activities of metal chelates with 1,10-Phenanthroline derivative. INORG CHEM COMMUN 2020. [DOI: 10.1016/j.inoche.2020.108232] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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41
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Gandhi J, Dave V, Joseph J. Cytokine profiling plays a crucial role in activating immune system in fungal endophthalmitis. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.11.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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42
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Nair L, Krishna KJ, Kumar A, Mathews S, Joseph J, James F. 208P Prognostic factors and outcomes of non-seminomatous germ cell tumours of testis: Experience from a tertiary cancer centre in India. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
Abstract
The fourth target of Sustainable Development Goal (SDG) 3 advocates for the promotion of mental health and wellbeing. The Indian state of Kerala is recognized for its gains in health and development but has substantial burden of mental health ailments. Historical analysis is vital to understand the pattern of mental health morbidity. The current study focusses on comparable estimates available from three largescale population-based surveys in India to explore trends in prevalence of mental health disorders over the years and map resources and infrastructure available for mental health care in Kerala.
We undertook a secondary analysis of national demographic surveys from 2002 to 2018 which reported information on mental health and availability of health infrastructure and human resources. Data were collated and descriptive analyses were conducted. We compared the national and state level estimates over the years to study the trend in the prevalence of mental health disability.
The prevalence of mental retardation and intellectual disability in Kerala increased from 194 per hundred thousand persons in 2002 to 300 per hundred thousand persons in 2018, two times higher to the national average. The prevalence of mental illness increased from 272 per hundred thousand people to 400 per hundred thousand people in sixteen years. The prevalence was higher among males (statistical significance was not indicated) in mental illness and mental retardation. 2018 data showed that the public sector had 0.01 hospitals and 5.53 beds per hundred thousand persons available for mental health treatment.
Results showed a substantial increase in mental health illness over the 16-year study period that has affected males and females, as well as all social classes of the state. The current health infrastructure and human resources in the public sector of the state are inadequate to meet the current burden of the problem and to ensure universal access to care for its population.
Key messages
The trend in prevalence of mental health disorders in the state is increasing across the years. There is a mismatch between the extend of the problem and resources available in public sector.
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Affiliation(s)
- J Joseph
- Health Systems, The George Institute for Global Health, New Delhi, India
| | - H Sankar
- Health Systems, The George Institute for Global Health, New Delhi, India
| | - D Nambiar
- Health Systems, The George Institute for Global Health, New Delhi, India
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Sakthivel A, Thangagiri B, Raman N, Joseph J, Guda R, Kasula M, Mitu L. Spectroscopic, SOD, anticancer, antimicrobial, molecular docking and DNA binding properties of bioactive VO(IV), Cu(II), Zn(II), Co(II), Mn(II) and Ni(II) complexes obtained from 3-(2-hydroxy-3-methoxybenzylidene)pentane-2,4-dione. J Biomol Struct Dyn 2020; 39:6500-6514. [PMID: 32794423 DOI: 10.1080/07391102.2020.1801508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Novel macrocyclic Schiff base complexes [[ML]X; where M = Cu(II), Co(II), Ni(II), Zn(II), Mn(II) and VO(IV); L = macrocyclic ligand; X = Cl2 and SO42-] have been synthesized and characterized by microanalytical, 1H, 13C NMR, IR, Mass, UV-Vis, EPR spectral studies, as well as conductivity data. All the complexes exhibit square-planar geometry except vanadium complex. Magnetic susceptibility measurements and high conductance data reveal the monomeric and electrolytic nature of the complexes. Electronic absorption, cyclic voltammetry, viscosity measurements have been carried out on the interaction of the complexes with DNA. The results suggest that the complexes bind to DNA by intercalation via the aromatic ring of the macrocycle into the base pairs of DNA. Using gel electrophoresis experiment in the presence and absence of oxidant (H2O2) the nuclease cleavage activity of the complexes has been performed on plasmid DNA. The results demonstrate that most of the complexes have promising superoxide dismutase (SOD)-mimetic activity. The in vitro cytotoxicity of ligand and its complexes has also been evaluated against human breast and colon carcinoma cells. Binding interactions and energies of ligand and its metal complexes [ML]2+ (M = VO(IV), Mn(II), Co(II), Ni(II), Cu(II), Zn(II)) against the receptors EGFR and HER2 are performed using the Auto dock module. Consequently, it is found that the ligand is strong inhibitor for EGFR and HER2 while [VOL]SO4 is good inhibitor for EGFR and [ZnL]Cl2 is moderate inhibitor for HER2. The antimicrobial activity of the ligand and its complexes against bacteria Salmonella typhi, Staphylococcus aureus, Escherichia coli and Bacillus subtilis and fungi Aspergillus niger, Aspergillus flavus, Candida Albicans and Rhizoctonia bataicola. The complexes have higher activities than the macrocyclic free Schiff base. Interaction of [VOL]SO4 to the binding sites of target protein EGFR (PDB ID: 4HJ0). Research HighlightsMacrocyclic Schiff base and its metal complexes were synthesized.Complexes bind to DNA by intercalation via the aromatic ring of the macrocycle into the base pairs of DNA.Vanadyl complex is a good inhibitor for EGFR.The complexes of copper, zinc and vanadium show efficient antitumor activity.Copper and vanadium complexes have superior antimicrobial activity than the standards.
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Affiliation(s)
- A Sakthivel
- Department of Chemistry, Mepco Schlenk Engineering College, Sivakasi, India
| | - B Thangagiri
- Department of Chemistry, Mepco Schlenk Engineering College, Sivakasi, India
| | - N Raman
- Research Department of Chemistry, VHNSN College, Virudhunagar, India
| | - J Joseph
- Department of Chemistry, Noorul Islam Centre for Higher Education, Kumaracoil, Tamil Nadu, India
| | - Ramu Guda
- Department of Chemistry, Kakatiya University, Warangal, India
| | - Mamatha Kasula
- Department of Chemistry, Kakatiya University, Warangal, India
| | - L Mitu
- Department of Nature Sciences, University of Pitesti, Pitesti, Romania
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Jin Q, Shi N, Aroke D, Joseph J, Donneyong M, Adesanya T, Conwell D, Hart P, Spees C, Clinton S, Cruz-Monserrate Z, Brasky T, Jackson R, Tinker L, Liu S, Phillips L, Shadyab A, Nassir R, Bao W, Tabung F. The Insulinemic, Inflammatory, and Glycemic Potential of the Diet in Relation to Risk of Type 2 Diabetes. Curr Dev Nutr 2020. [DOI: 10.1093/cdn/nzaa061_048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
Dietary patterns that promote chronic systemic inflammation, hyperinsulinemia, or hyperglycemia may influence type 2 diabetes (T2D) risk. We evaluated an empirical dietary index for hyperinsulinemia (EDIH), empirical dietary inflammatory pattern (EDIP), glycemic index (GI), and glycemic load (GL), and risk of T2D among US postmenopausal women. EDIH and EDIP assess the insulinemic or inflammatory potential of habitual diets, irrespective of macronutrient content, and are based on plasma concentrations of insulin response or inflammatory biomarkers, respectively. The GI and GL assess postprandial glycemic potential based on carbohydrate content of the diet.
Methods
We calculated dietary scores from baseline food frequency questionnaires among 73,495 participants aged 50–79 years in the Women's Health Initiative Observational Study and Clinical Trials. We used multivariable-adjusted Cox regression to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for risk of T2D according to quintiles of dietary scores.
Results
There were 11,009 incident cases of T2D during a median 13.3 years of follow-up. In multivariable-adjusted analyses, participants in the highest dietary score quintiles (consuming the most hyperinsulinemic, proinflammatory, or hyperglycemic diets) were at highest risk of T2D compared to those in the lowest quintiles: EDIH: HR, 1.54(1.37, 1.74); Ptrend < .0001; EDIP: HR, 1.45 (1.29, 1.64); Ptrend < .0001). GI and GL were not associated with T2D risk: GI: HR, 0.99 (0.88, 1.12); Ptrend = 0.94; GL: HR, 0.98 (0.85, 1.12); Ptrend = 0.32. In subgroup analyses, associations of EDIH and EDIP with T2D risk were stronger among overweight or obese than normal-weight women (Pinteraction: EDIH = 0.02, EDIP = 0.003), and findings did not significantly vary by race/ethnicity.
Conclusions
In this large sample of postmenopausal women, hyperinsulinemic, and pro-inflammatory dietary patterns were associated with higher risk of T2D, more so among overweight and obese women, whereas dietary glycemic potential was not associated with T2D risk.
Funding Sources
NCI grant # R00CA207736 and the WHI program is funded by NHLBI grant #s HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C.
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Affiliation(s)
- Qi Jin
- Interdisciplinary Ph.D. Program in Nutrition, The Ohio State University, Columbus, OH; Ohio State University Comprehensive Cancer Center – James
| | - Ni Shi
- Ohio State University Comprehensive Cancer Center – James
| | - Desmond Aroke
- Ohio State University Comprehensive Cancer Center – James
| | - Joshua Joseph
- College of Medicine, The Ohio State University Wexner Medical Center
| | | | - Timothy Adesanya
- College of Medicine, The Ohio State University Wexner Medical Center
| | - Darwin Conwell
- College of Medicine, The Ohio State University Wexner Medical Center; Ohio State University Comprehensive Cancer Center – James
| | - Philip Hart
- Ohio State University Comprehensive Cancer Center – James; College of Medicine, The Ohio State University Wexner Medical Center
| | - Colleen Spees
- Ohio State University Comprehensive Cancer Center – James; College of Medicine, The Ohio State University Wexner Medical Center
| | - Steven Clinton
- Ohio State University Comprehensive Cancer Center – James; College of Medicine, The Ohio State University Wexner Medical Center
| | - Zobeida Cruz-Monserrate
- Ohio State University Comprehensive Cancer Center – James; College of Medicine, The Ohio State University Wexner Medical Center
| | - Theodore Brasky
- Ohio State University Comprehensive Cancer Center – James; College of Medicine, The Ohio State University Wexner Medical Center
| | - Rebecca Jackson
- Ohio State University Comprehensive Cancer Center – James; College of Medicine, The Ohio State University Wexner Medical Center
| | - Lesley Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center
| | - Simin Liu
- Department of Epidemiology, Brown University
| | | | - Aladdin Shadyab
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego
| | - Rami Nassir
- School of Medicine, Umm Al-Qura'a University, Mecca, Saudi Arabia
| | | | - Fred Tabung
- Ohio State University Comprehensive Cancer Center – James; College of Medicine, The Ohio State University Wexner Medical Center
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Belany PA, Zhao S, Kluwe B, Kackley M, Buga A, Kline D, Brock G, Volek J, Joseph J. MON-LB106 The Effect of the Ketogenic Diet on Aldosterone Over 6 Weeks. J Endocr Soc 2020. [PMCID: PMC7208706 DOI: 10.1210/jendso/bvaa046.2220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction: A ketogenic diet improves type 2 diabetes, metabolic syndrome, and cardiovascular disease. Weight loss studies using caloric reduction have demonstrated a decrease in aldosterone, but there is limited data on the effect of a ketogenic diet on aldosterone. Thus, we evaluated the impact of a ketogenic diet on aldosterone in overweight or obese individuals over 6 weeks. Methods: This 3-arm prospective controlled feeding study evaluated aldosterone and renin concentrations over 6 weeks on a hypocaloric (25% energy restricted) ketogenic diet + placebo (KD+PL), ketogenic diet + ketone salt supplement (KD+KS), and a low-fat diet (LFD). Sodium intake consisted of 6100 mg, 2300 mg, and 2000 mg for the KD+KS, KD+PL, and LFD groups, respectively. Both ketogenic diets provided 40 grams(g) day of carbohydrates, 1.5 g/kg reference weight of protein and remaining calories provided as fat. The LFD provided 25% total fat, 1.5 g/kg reference weight of protein, and 100g of carbohydrates. Serum aldosterone was drawn fasting in upright position at 0, 2, 4, and 6 weeks. Scatter plots were used to explore the residual and predicted associations between aldosterone with other measures after accounting for time and group effect.Results: Twenty-four participants in the ketogenic diet groups were matched for age and body mass index, then randomized to either the KD+PL or KD+KS group. A separate group of 12 matched participants were specifically recruited for the LFD group. The median age was 33 years. Weight decreased 6, 8, and 7 kg on average in the KD+KS, KD+PL, and LFD groups, respectively, over 6 weeks (p<0.05 for all). Systolic blood pressure (SBP) improved from 117 and 115 mmHg in the KD+KS and KD+PL groups to 110 mmHg over 6 weeks while the baseline mean SBP 118 in the LF group did not change. Baseline mean aldosterone of 13.6 and 13.6 ng/dL in the KD+KS and KD+PL groups increased to 33.3 and 27.3 ng/dL over 6 weeks (p<0.001). Baseline mean aldosterone of 8 ng/dL in the LF group non-significantly changed to 11.5 ng/dL over 6 weeks (p>0.05). Using predicted value associations, increases in ketones were positively associated with higher aldosterone (R2=0.86; p<0.001). Conclusion: Participants on a ketogenic diet had significantly elevated aldosterone levels throughout the study while participants on low fat diet had little change. Unexpectedly, aldosterone was significantly higher in the high sodium vs. low sodium ketogenic diet. There was a significant association between ketones and aldosterone suggesting that ketones may play a stimulatory role on aldosterone synthesis or secretion.
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Affiliation(s)
- Paul A Belany
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Songzhu Zhao
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Bjoern Kluwe
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Madison Kackley
- The Ohio State University College of Education and Human Ecology, Columbus, OH, USA
| | - Alex Buga
- The Ohio State University College of Education and Human Ecology, Columbus, OH, USA
| | - David Kline
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Guy Brock
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Jeff Volek
- The Ohio State University College of Education and Human Ecology, Columbus, OH, USA
| | - Joshua Joseph
- The Ohio State University College of Medicine, Columbus, OH, USA
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Paul M, Karthik S, Joseph J, Sivaprakasam M, Kumutha J, Leonhardt S, Hoog Antink C. Non-contact sensing of neonatal pulse rate using camera-based imaging: a clinical feasibility study. Physiol Meas 2020; 41:024001. [PMID: 32148333 DOI: 10.1088/1361-6579/ab755c] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Neonates and infants are patients who would benefit from less invasive vital sign sensing, especially from fewer cables and the avoidance of adhesive electrodes. Photoplethysmography imaging (PPGI) has been studied for medical applications in recent years: it is possible to assess various vital signs remotely, non-invasively, and without contact by using video cameras and light. However, studies on infants and especially on neonates in clinical settings are still rare. Hence, we conducted a single-center study to assess heart activity by estimating the pulse rate (PR) of 19 neonates. APPROACH Time series were generated from tracked regions of interest (ROIs) and PR was estimated via a joint time-frequency analysis using a short-time Fourier transform. Artifacts, for example, induced by movement, were detected and flagged by applying a signal quality index in the frequency domain. MAIN RESULTS The feasibility of PR estimation was demonstrated using visible light and near-infrared light at 850 nm and 940 nm, respectively: the estimated PR was as close as 3 heartbeats per minute in artifact-free time segments. Furthermore, an improvement could be shown when selecting the best performing ROI compared to the ROI containing the whole body. The main challenges are artifacts from motion, light sources, medical devices, and the detection and tracking of suitable regions for signal retrieval. Nonetheless, the PR extracted was found to be comparable to the contact-based photoplethysmography reference and is, therefore, a viable replacement if robust signal retrieval is ensured. SIGNIFICANCE Neonates are seldom measured by PPGI and studies reporting measurements on darker skin tones are rare. In this work, not only a single camera was used, but a synchronized camera setup using multiple wavelengths. Various ROIs were used for signal extraction to examine the capabilities of PPGI. In addition, qualitative observations regarding camera parameters and noise sources were reported and discussed.
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Affiliation(s)
- M Paul
- Medical Information Technology (MedIT), Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Pauwelsstr. 20, Aachen, 52074, Germany
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Abstract
Vision assessments were provided to 297 Head Start children in nine Westchester County, New York programs. An optometrist and an orthoptist administered a protocol which included retinoscopy, visual acuity, fly, cover, motility and convergence tests. Sixty-three children (21.2%) were referred for further evaluation. The visual deficits detected by this screening included decreased acuity, strabismus combined with decreased acuity, astigmatism, and nonspecific visual problems. The protocol used provided a thorough evaluation of the visual system and required only seven minutes per patient.
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Affiliation(s)
- A. R. Morse
- The Jewish Guild for the Blind. 15 W. 65th Street, New York, NY 10023
| | - E. Trief
- The Jewish Guild for the Blind. 15 W. 65th Street, New York, NY 10023
| | - J. Joseph
- The Jewish Guild for the Blind. 15 W. 65th Street, New York, NY 10023
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Joseph J, Maharaj S. Otorrhoea - a parotid connection. S AFR J SURG 2020; 58:45. [PMID: 32243117] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 36-year-old patient presented with an 18-month history of intermittent right parotid swelling accompanied by otorrhoea. The symptoms started subsequent to a palm leaf injury to the right ear. At right parotidectomy, a fistula connecting the right external auditory canal and the right parotid was demonstrated. A small fibrotic mass probably due to a remnant of the palm leaf was found intraoperatively. The symptoms resolved completely after the mass was excised by superficial parotidectomy, and the fistula closed spontaneously.
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Affiliation(s)
- J Joseph
- Department of Otorhinolaryngology, University of the Witwatersrand, Johannesburg, South Africa
| | - S Maharaj
- Department of Otorhinolaryngology, University of the Witwatersrand, Johannesburg, South Africa
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Huang M, Krigstein M, Joseph J, Field A. 46. Classic histological features of gaucher disease: A case report. Pathology 2020. [DOI: 10.1016/j.pathol.2020.01.046] [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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