1
|
Arthur H, Butscher L, Moore L, Warren K. Lieutenant Governor's Challenge:: Motivating and Honoring Delawareans to Improve Their Health and Well-Being. Dela J Public Health 2024; 10:116-120. [PMID: 38572134 PMCID: PMC10987034 DOI: 10.32481/djph.2024.03.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
The Lieutenant Governor's Challenge 2.0, Wellness Award Initiative, is an opportunity for everyone to drive change and to elevate the well-being, productivity, and prosperity among communities in Delaware. The 2.0 reference is rooted in the mission of former Lieutenant Governor, and now Governor, John Carney to address physical activity and fitness levels of youth and adults. The Lieutenant Governor's Challenge 2.0 presents the opportunity to unite the entire state in an ongoing effort to create an overall healthier population. Mobilizing communities to get healthier, promote better health outcomes, and lower health care costs are the goals of this statewide initiative.
Collapse
Affiliation(s)
- Helen Arthur
- Chief, Health Promotion and Disease Prevention Section, Division of Public Health, Delaware Department of Health and Social Services
| | - Lauren Butscher
- Program Administrator, Physical Activity, Nutrition and Obesity Prevention Program, Division of Public Health, Delaware Department of Health and Social Services
| | - Lisa Moore
- Chief, Health Promotion Bureau, Division of Public Health, Delaware Department of Health and Social Services
| | - Keith Warren
- Chief of Staff, Office of Lieutenant Governor Bethany Hall-Long, State of Delaware
| |
Collapse
|
2
|
Arthur H, Butscher L, Moore L. Advancing Healthy Lifestyles:: A Multicomponent Initiative to Reduce the Burden of Obesity In Delaware. Dela J Public Health 2024; 10:122-129. [PMID: 38572133 PMCID: PMC10987024 DOI: 10.32481/djph.2024.03.17] [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] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Chronic Disease, Health Equity, & COVID-19 ("Advancing Healthy Lifestyles" or "AHL") is a statewide initiative launched in January 2021 by the Delaware Department of Health and Social Services, Division of Public Health (DPH). DPH's Physical Activity, Nutrition and Obesity Prevention Program (PANO) introduced the initiative as Coronavirus 2019 (COVID-19) swept through the state, exacerbating health burdens already faced by many Delawareans. The PANO Program provides administrative staff support to the Delaware Cancer Consortium's Cancer Risk Reduction Committee (CRRC). In December 2019, the CRRC launched the Healthy Lifestyles Subcommittee (HLSC) in response to Governor John Carney's request to develop actionable policy recommendations to positively influence healthy lifestyles in Delaware. The HLSC efforts led to the recommendation of 14 policy recommendations for action in three population health strategic focus areas: 1) birth to age 18; 2) employee health and wellness; and 3) community wellness. The AHL initiative builds from the work of the HLSC and promotes the use of policy, systems, and environmental change (PSE) strategies to reduce obesity and other chronic conditions among Delawareans across the lifespan. Ideally, the AHL initiative is categorized into three component strategies: school, community, and workplace. This article highlights both completed and ongoing projects under the AHL Initiative that aim to address the burden of obesity in Delaware.
Collapse
Affiliation(s)
- Helen Arthur
- Chief, Health Promotion and Disease Prevention Section, Division of Public Health, Delaware Department of Health and Social Services
| | - Lauren Butscher
- Program Administrator, Physical Activity, Nutrition, and Obesity Prevention Program, Division of Public Health, Delaware Department of Health and Social Services
| | - Lisa Moore
- Chief, Health Promotion Bureau, Division of Public Health, Delaware Department of Health and Social Services
| |
Collapse
|
3
|
Johnson KA, Dosenbach NUF, Gordon EM, Welle CG, Wilkins KB, Bronte-Stewart HM, Voon V, Morishita T, Sakai Y, Merner AR, Lázaro-Muñoz G, Williamson T, Horn A, Gilron R, O'Keeffe J, Gittis AH, Neumann WJ, Little S, Provenza NR, Sheth SA, Fasano A, Holt-Becker AB, Raike RS, Moore L, Pathak YJ, Greene D, Marceglia S, Krinke L, Tan H, Bergman H, Pötter-Nerger M, Sun B, Cabrera LY, McIntyre CC, Harel N, Mayberg HS, Krystal AD, Pouratian N, Starr PA, Foote KD, Okun MS, Wong JK. Proceedings of the 11th Annual Deep Brain Stimulation Think Tank: pushing the forefront of neuromodulation with functional network mapping, biomarkers for adaptive DBS, bioethical dilemmas, AI-guided neuromodulation, and translational advancements. Front Hum Neurosci 2024; 18:1320806. [PMID: 38450221 PMCID: PMC10915873 DOI: 10.3389/fnhum.2024.1320806] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/05/2024] [Indexed: 03/08/2024] Open
Abstract
The Deep Brain Stimulation (DBS) Think Tank XI was held on August 9-11, 2023 in Gainesville, Florida with the theme of "Pushing the Forefront of Neuromodulation". The keynote speaker was Dr. Nico Dosenbach from Washington University in St. Louis, Missouri. He presented his research recently published in Nature inn a collaboration with Dr. Evan Gordon to identify and characterize the somato-cognitive action network (SCAN), which has redefined the motor homunculus and has led to new hypotheses about the integrative networks underpinning therapeutic DBS. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers, and researchers (from industry and academia) can freely discuss current and emerging DBS technologies, as well as logistical and ethical issues facing the field. The group estimated that globally more than 263,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. This year's meeting was focused on advances in the following areas: cutting-edge translational neuromodulation, cutting-edge physiology, advances in neuromodulation from Europe and Asia, neuroethical dilemmas, artificial intelligence and computational modeling, time scales in DBS for mood disorders, and advances in future neuromodulation devices.
Collapse
Affiliation(s)
- Kara A. Johnson
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
- Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Nico U. F. Dosenbach
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
| | - Evan M. Gordon
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Cristin G. Welle
- Department of Physiology and Biophysics, University of Colorado School of Medicine, Aurora, CO, United States
- Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, United States
| | - Kevin B. Wilkins
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Helen M. Bronte-Stewart
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Takashi Morishita
- Department of Neurosurgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Yuki Sakai
- ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Amanda R. Merner
- Center for Bioethics, Harvard Medical School, Boston, MA, United States
| | - Gabriel Lázaro-Muñoz
- Center for Bioethics, Harvard Medical School, Boston, MA, United States
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Theresa Williamson
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, United States
| | - Andreas Horn
- Department of Neurology, Center for Brain Circuit Therapeutics, Harvard Medical School, Brigham & Women's Hospital, Boston, MA, United States
- MGH Neurosurgery and Center for Neurotechnology and Neurorecovery (CNTR) at MGH Neurology Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | | | | | - Aryn H. Gittis
- Biological Sciences and Center for Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Wolf-Julian Neumann
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Simon Little
- Department of Neurological Surgery, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Nicole R. Provenza
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Sameer A. Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease, Division of Neurology, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network (UHN), University of Toronto, Toronto, ON, Canada
- Krembil Brain Institute, Toronto, ON, Canada
| | - Abbey B. Holt-Becker
- Restorative Therapies Group Implantables, Research, and Core Technology, Medtronic Inc., Minneapolis, MN, United States
| | - Robert S. Raike
- Restorative Therapies Group Implantables, Research, and Core Technology, Medtronic Inc., Minneapolis, MN, United States
| | - Lisa Moore
- Boston Scientific Neuromodulation Corporation, Valencia, CA, United States
| | | | - David Greene
- NeuroPace, Inc., Mountain View, CA, United States
| | - Sara Marceglia
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Lothar Krinke
- Newronika SPA, Milan, Italy
- Department of Neuroscience, West Virginia University, Morgantown, WV, United States
| | - Huiling Tan
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Hagai Bergman
- Edmond and Lily Safar Center (ELSC) for Brain Research and Department of Medical Neurobiology (Physiology), Institute of Medical Research Israel-Canada, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Neurosurgery, Hadassah Medical Center, Jerusalem, Israel
| | - Monika Pötter-Nerger
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bomin Sun
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Laura Y. Cabrera
- Neuroethics, Department of Engineering Science and Mechanics, Philosophy, and Bioethics, and the Rock Ethics Institute, Pennsylvania State University, State College, PA, United States
| | - Cameron C. McIntyre
- Department of Biomedical Engineering, Duke University, Durham, NC, United States
- Department of Neurosurgery, Duke University, Durham, NC, United States
| | - Noam Harel
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States
| | - Helen S. Mayberg
- Department of Neurology, Neurosurgery, Psychiatry, and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Andrew D. Krystal
- Departments of Psychiatry and Behavioral Science and Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Nader Pouratian
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Philip A. Starr
- Department of Neurological Surgery, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Kelly D. Foote
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
- Department of Neurosurgery, University of Florida, Gainesville, FL, United States
| | - Michael S. Okun
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
- Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Joshua K. Wong
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
- Department of Neurology, University of Florida, Gainesville, FL, United States
| |
Collapse
|
4
|
O'Farrell R, Maguire S, Moore L, Murray K, Gorman A, Ball E, Riddell C, O'Neill M, Jordan N, O'Shea F, Veale D, Donnelly S, Murphy G, Fitzgerald G. Delivering Care for Pregnant Women with Rheumatic and Musculoskeletal Diseases. Ir Med J 2024; 117:894. [PMID: 38259237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
|
5
|
Moore L, Munir A, Bae S, Miller J, Jordan A, Segal B. Transverse myelitis associated with Mpox infection. J Neuroimmunol 2023; 383:578190. [PMID: 37689031 DOI: 10.1016/j.jneuroim.2023.578190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/21/2023] [Accepted: 08/26/2023] [Indexed: 09/11/2023]
Abstract
Neurologic manifestations of mpox (monkeypox) infection are common. Rarely, transverse myelitis has been associated with mpox infection. We describe a case of longitudinally extensive transverse myelitis in a patient with recently diagnosed mpox, presenting as acute flaccid paraplegia. The patient underwent an extensive work-up that included serological and cerebrospinal fluid (CSF) testing and magnetic resonance imaging (MRI). They were treated with tecoviromat, high dose steroids, and intravenous immunoglobulin, followed by plasma exchange. Despite these interventions, there was minimal neurologic improvement. This case underscores the importance of instituting measures designed to prevent mpox infection, including public education initiatives.
Collapse
Affiliation(s)
- Lisa Moore
- Ohio State University Wexner Medical Center, 395 W 12(th) Ave, Columbus, OH 43210, USA.
| | - Armin Munir
- Ohio State University Wexner Medical Center, 395 W 12(th) Ave, Columbus, OH 43210, USA.
| | - Sonu Bae
- Ohio State University Wexner Medical Center, 395 W 12(th) Ave, Columbus, OH 43210, USA.
| | - Jaret Miller
- Ohio State University Wexner Medical Center, 395 W 12(th) Ave, Columbus, OH 43210, USA.
| | - Allison Jordan
- Ohio State University Wexner Medical Center, 395 W 12(th) Ave, Columbus, OH 43210, USA.
| | - Benjamin Segal
- Ohio State University Wexner Medical Center, 395 W 12(th) Ave, Columbus, OH 43210, USA.
| |
Collapse
|
6
|
Anderson BM, Moore L, Moore KL, Bojechko C. EPIDEEP: Using a Deep Learning Model to Predict In Vivo Electronic Portal Imaging Device (EPID) Transit Images. Int J Radiat Oncol Biol Phys 2023; 117:e645. [PMID: 37785921 DOI: 10.1016/j.ijrobp.2023.06.2060] [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) To create a deep-learning model to predict in-vivo electronic portal imaging device (EPID) transit images for IMRT treatments. This model was created to predict in-vivo images to identify machine and patient-related errors that occur during beam delivery and are undetectable with current QA approaches. The deep-learning model can make image predictions much faster than Monte Carlo approaches, making image prediction feasible for application in online adaptive radiotherapy. Additionally, the model does not rely on any proprietary information and can be easily utilized by other clinics. MATERIALS/METHODS Our approach separates the primary and scatter components of in-vivo transit images. The attenuation of primary radiation reaching the EPID panel is modeled analytically, using attenuation measurements from phantoms of known thicknesses. The scatter component is estimated using a convolutional neural network (CNN). The CNN training uses information from the on-treatment cone-beam CTs (CBCTs), and a pretreatment EPID image with no patient in the beam. We acquired 193 IMRT fields/images from 118 patients previously treated on the Varian Halcyon. Treatment sites included the pelvis, abdomen, lungs, and extremities. CBCTs were collected immediately before treatment, to provide an accurate representation of the anatomy. A 3-channel input image was used, consisting of the pretreatment EPID image, a ray tracing projection through the CBCT to the EPID panel, and a projection to isocenter. Model training:validation:test set ratios were 133:20:40 images. The primary and scatter components are added together to give the predicted transit image. Prediction accuracy was assessed by comparing model-predicted and measured in-vivo EPID images with a 3%/3mm and 5%/3mm gamma pass rate. RESULTS The gamma pass rate for the patients in the training:validation:test was 91.5%:90.4%:92.1% for 3%/3mm and 96.7%:96.6%:97.0% for 5%/3mm. The model can make image predictions in 20 milliseconds. The poor passing rates of some images may be due to CBCT artifacts and patient motion that occurs between the time of CBCT and treatment. CONCLUSION This model can predict in-vivo EPID images with an average gamma pass rate greater than 90%. Image predictions from this model can be used to detect in-vivo treatment errors and changes in patient anatomy, providing an additional layer of patient-specific quality assurance. The speed of image predictions is 20 milliseconds, making use feasible for online adaptive treatments, which currently do not utilize patient-specific measurements of the delivered radiation. Upcoming studies will assess the model's ability in detecting clinically relevant errors and changes in patient anatomy that can adversely affect treatment. Future goals include acquiring more data to further improve the model and extending the model to make predictions for VMAT treatments.
Collapse
Affiliation(s)
- B M Anderson
- University of California San Diego, Department of Radiation Medicine and Applied Sciences, La Jolla, CA
| | - L Moore
- University of California San Diego, Department of Radiation Medicine and Applied Sciences, La Jolla, CA
| | - K L Moore
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA
| | - C Bojechko
- University of California San Diego, Department of Radiation Medicine and Applied Sciences, La Jolla, CA
| |
Collapse
|
7
|
Driver C, Moore L, Mohamed A, Boyes A, Sacks DD, Mills L, McLoughlin LT, Lagopoulos J, Hermens DF. Structural connectivity and its association with social connectedness in early adolescence. Behav Brain Res 2023; 440:114259. [PMID: 36528168 DOI: 10.1016/j.bbr.2022.114259] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022]
Abstract
Adolescence is a critical period of social and neural development. Brain regions which process social information develop throughout adolescence as young people learn to navigate social environments. Studies investigating brain structural connectivity (indexed by white matter (WM) integrity), and social connectedness in adolescents have been limited until recently, with literature stemming mostly from adult samples, broad age ranges within adolescence or based on social network characteristics as opposed to social connectedness. This cross-sectional study of 12-year-olds (N = 73) explored the relationship between social connectedness (SCS) and structural connectivity in early adolescence, to gauge how this snapshot of WM development is associated with social behaviour. Whole brain voxel-wise diffusion tensor imaging was undertaken to determine correlations between SCS and fractional anisotropy (FA), radial (RD) and axial (AD) diffusivity of clusters within WM tracts. Significant negative relationships between FA and SCS scores were found in clusters within 11 WM tracts, with significant positive correlations between SCS and both RD and AD across clusters within 13 and 8 clusters, respectively. Clusters within the genu of the corpus callosum (CCgn) showed strong correlations for all three metrics, and regression models that included gender, age, and psychological distress, revealed SCS to be the only significant predictor of CCgn FA, RD and AD values. Overall, these findings suggest that those with lower social connectedness had a WM profile suggestive of reduced axonal density and/or coherence. Longitudinal research is needed to track such WM profiles during adolescent development and determine the associations with mental health and well-being outcomes.
Collapse
Affiliation(s)
- Christina Driver
- Thompson Institute, University of the Sunshine Coast, Innovation Parkway, Birtinya, QLD, Australia.
| | - Lisa Moore
- Thompson Institute, University of the Sunshine Coast, Innovation Parkway, Birtinya, QLD, Australia
| | - Abdalla Mohamed
- Thompson Institute, University of the Sunshine Coast, Innovation Parkway, Birtinya, QLD, Australia
| | - Amanda Boyes
- Thompson Institute, University of the Sunshine Coast, Innovation Parkway, Birtinya, QLD, Australia
| | - Dashiell D Sacks
- Thompson Institute, University of the Sunshine Coast, Innovation Parkway, Birtinya, QLD, Australia
| | - Lia Mills
- Thompson Institute, University of the Sunshine Coast, Innovation Parkway, Birtinya, QLD, Australia
| | - Larisa T McLoughlin
- Behaviour-Brain-Body Research Centre, University of South Australia, Australia
| | - Jim Lagopoulos
- Thompson Institute, University of the Sunshine Coast, Innovation Parkway, Birtinya, QLD, Australia
| | - Daniel F Hermens
- Thompson Institute, University of the Sunshine Coast, Innovation Parkway, Birtinya, QLD, Australia
| |
Collapse
|
8
|
Abernathy S, Moore L, Morales M. PATIENT CHARACTERISTICS AND RESPONSE TO BIOLOGIC THERAPIES IN MODERATE-TO-SEVERE PEDIATRIC ASTHMA. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.644] [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: 11/11/2022]
|
9
|
Duval C, Sirois C, Savoie-White F, Tardif P, Bérubé M, Turgeon-Fournier A, Cook D, Lauzier F, Moore L. 83 - Compression pneumatique intermittente adjuvante : revue systématique et méta-analyse. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.06.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
10
|
Campbell A, Smith R, Petersen B, Moore L, Khan A, Barrie A. O-125 Application of artificial intelligence using big data to devise and train a machine learning model on over 63,000 human embryos to automate time-lapse embryo annotation. Hum Reprod 2022. [DOI: 10.1093/humrep/deac105.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Can a machine learning (ML) model, developed using modern neural network architecture produce comparable annotation data; utilisable for algorithmic outcome prediction, to manual time-lapse annotations?
Summary answer
The model automatically annotated unseen embryos with comparable results to manual methods, generating morphokinetic data to enable comparably predictive outputs from an embryo selection algorithm.
What is known already
The application of artificial intelligence across healthcare industries, including fertility, is increasing. Several ML models are available that seek to generate or analyse embryo images and morphokinetic data, and to determine embryo viability potential. Along with photographic images, the use of time-lapse in IVF laboratories has amassed numeric data, resulting predominantly from annotated manual assessment of images over time. Embryo annotation practice is variable in quality, can be subjective and is time-consuming; commonly taking several minutes per embryo. The development of rapid, accurate automatic annotation would represent a significant time-saving as well as an increase in reproducibility and accuracy.
Study design, size, duration
Multicentre quality assured annotation data from 63,383 time-lapse monitored embryos (EmbryoScope®), comprising over 400 million individual images, were used to train a ML model to automatically generate morphokinetic annotations. Data was derived from 8 UK clinics within a cohesive group between 2012-2021. Accuracy was assessed using 900 unseen embryos (with live birth outcome) by comparing the output of an established in-house, prospectively validated embryo selection model when the input was either ML-automated, or manual annotations.
Participants/materials, setting, methods
Multi-focal plane images were processed on the Azure cloud (Microsoft) and resampled to 300x300 pixels. A Laplacian-based focal stacking algorithm merged frames into a single image. The model consisted of an EfficientNetB4 Convolutional Neural Network classifier to extract features and classify the stage of embryo images. A Temporal Convolutional Network interpreted a time-series of image features; producing annotations from pronuclear fading through to blastocyst. Soft localisation loss function used QA data to integrate annotation subjectivities.
Main results and the role of chance
The ML model rapidly and automatically generated annotations. Efficacy and comparability of the ML model to automate reliable, utilisable annotations was demonstrated by comparison with manual annotation data and the ML model’s ability to auto-generate annotations which could be used to predict live birth by providing annotation data to an established, validated in house embryo selection model. Live birth-predictive capability was measured, and benchmarked against manual annotation, using the area under the receiver operating characteristic curve (AUC).
When tested on time-lapse images, collected from pronuclear fading to full blastulation, representing 900 previously unseen, transferred blastocysts where live birth outcomes were blinded, the in-house developed auto-annotation ML model resulted in an AUC of 0.686 compared with 0.661 for manual annotations, for live birth prediction.
Auto annotation using the developed model took only milliseconds to complete per embryo. The developed auto-annotation model, built and tested on large data, is considered suitable for productionisation with the aim of being validated and integrated into an application to support IVF laboratory practice.
Limitations, reasons for caution
Whilst this model was trained to recognise key morphokinetic events, there are other morphokinetic variables that may be useful in the prediction of live birth and further improve embryo selection, or deselection, ability. Akin to manual interpretation, some embryos may fail to be annotated or need second opinion.
Wider implications of the findings
There is increasing evidence supporting the application of ML to utilise big data from time-lapse imaging and fertility care generally. Whilst promising benefits to IVF clinics and patients, responsible use of data is required alongside large high-quality datasets, and rigorous validation, to ensure safe and robust applications.
Trial registration number
N/A
Collapse
Affiliation(s)
- A Campbell
- CARE Fertility Group , Embryology, Nottingham, United Kingdom
| | - R Smith
- CARE Fertility Group , Embryology, Nottingham, United Kingdom
| | - B Petersen
- BMP Analytics, Mathematics , Aarhus, Denmark
| | - L Moore
- BJSS, Data Science , Leeds, United Kingdom
| | - A Khan
- BJSS, Data Science , Leeds, United Kingdom
| | - A Barrie
- CARE Fertility Group , Embryology, Nottingham, United Kingdom
| |
Collapse
|
11
|
Donnez J, Taylor H, Gemzell-Danielsson K, Catherino W, Bestel E, Gotteland J, Humberstone A, Moore L, Garner E. O-306 LINZAGOLIX FOR ENDOMETRIOSIS-ASSOCIATED PAIN: SAFETY RESULTS FROM EDELWEISS 3, A PHASE 3, RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL. Hum Reprod 2022. [DOI: 10.1093/humrep/deac105.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Is once-daily linzagolix treatment for women with moderate to severe endometriosis-associated pain (EAP) safe for use for up to 6 months of treatment?
Summary answer
Both doses of linzagolix were well-tolerated with minimal BMD decrease and few TEAEs >5% in either linzagolix arm.
What is known already
Linzagolix (LGX) is an investigational once-daily oral GnRH receptor antagonist that reduces serum estradiol in a dose-dependent manner and is being developed in two dosages for the treatment of endometriosis-associated pain (EAP): 75 mg, and 200 mg dose with hormonal add-back therapy (ABT).
Study design, size, duration
EDELWEISS 3 is a randomized, double-blind, placebo-controlled, multicenter Phase 3 trial of linzagolix in women with moderate to severe EAP. The trial includes 3 treatment arms: 75 mg LGX, 200 mg LGX with ABT (E2 1 mg/ NETA 0.5 mg), or placebo. Here we present safety results up to 6 months (24 weeks) of treatment.
Participants/materials, setting, methods
Eligible reproductive-aged women with moderate-to-severe EAP were randomized and treated (n = 484) for 6 months with 75 mg LGX, 200 mg LGX with ABT (E2 1 mg/ NETA 0.5 mg), or placebo. Safety and tolerability objectives reported here include 6-month results for treatment emergent adverse events (TEAEs), assessment of mean percent change from baseline (CfB) in lumbar spine (LS) bone mineral density (BMD) and Z-scores.
The safety analysis set included 484 subjects across the 3 treatment groups.
Main results and the role of chance
The overall incidence of TEAEs was similar between the placebo and LGX 75 mg group (46.9%) and slightly higher (56.8%) in the LGX 200 mg + ABT group. There were few (3) serious TEAEs, and none were related to LGX. TEAEs that occurred in over 5% of patients in either active treatment arm included headache (10.5%, 8.1%, and 8.0%), hot flush (6.8%, 7.5%, and 2.5%), and fatigue (6.8%, 3.8%, and 2.5%) for the 200 mg LGX with ABT, 75 mg LGX, and placebo groups, respectively. Mean percent CfB (95% CI) in LS BMD was -0.79% (-1.15, -0.43%), -0.89% (-1.31, -0.47%), and +0.78% (0.41, 1.15%) for the 200 mg LGX with ABT, 75 mg LGX, and placebo groups, respectively. Z-scores at 6 months remained within the same range as baseline in all groups.
Limitations, reasons for caution
Additional efficacy and safety results from the trial's 24 weeks (6 mo) extension phase are pending. (Edelweiss 6 protocol: NCT04335591)
Wider implications of the findings
These results support further development of ABT and non-ABT doses of linzagolix that have potential to provide flexibility and choice for women seeking treatment for EAP. A non-ABT option is important for women who have a contraindication to, are at increased risk for complications, or prefer not to use ABT.
Trial registration number
ClinicalTrials.gov: NCT02778399
Collapse
Affiliation(s)
- J Donnez
- Catholic University of Louvain , Ob/Gyn, Brussels, Belgium
| | - H Taylor
- Yale University , Ob/Gyn, New Haven, U.S.A
| | | | - W Catherino
- Uniformed Services University of the Health Sciences , Ob/Gyn, Bethesda, U.S.A
| | - E Bestel
- ObsEva SA, Research & Development , Geneva, Switzerland
| | - J.P Gotteland
- ObsEva SA, Research & Development , Geneva, Switzerland
| | | | - L Moore
- ObsEva Inc., Medical Affairs , Boston, U.S.A
| | - E Garner
- ObsEva Inc., Medical Affairs , Boston, U.S.A
| |
Collapse
|
12
|
Esmail A, Kodali S, Graviss E, Nguyen D, Moore L, Saharia A, Uosef A, Victor D, Abdelrahim M. P-163 Tyrosine kinase inhibitors (TKIs) plus transarterial chemoembolization (TACE) compared to TACE alone as downstaging therapy in transplant recipients with hepatocellular carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
13
|
Cassidy C, Moore L, Ryan J, Brennan S. Audit on Oral Health Examinations in an Approved Psychiatric Centre. Ir Med J 2022; 115:527. [PMID: 35279061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- C Cassidy
- Department of Psychiatry, South Tipperary Hospital, Clonmel, Tipperary
| | - L Moore
- Department of Psychiatry, South Tipperary Hospital, Clonmel, Tipperary
| | - J Ryan
- Suirside Medical Practice, Clonmel, Tipperary
| | - S Brennan
- Department of Psychiatry, South Tipperary Hospital, Clonmel, Tipperary
| |
Collapse
|
14
|
Ford BA, Sullivan GJ, Moore L, Varkey D, Zhu H, Ostrowski M, Mabbutt BC, Paulsen IT, Shah BS. Functional characterisation of substrate-binding proteins to address nutrient uptake in marine picocyanobacteria. Biochem Soc Trans 2021; 49:2465-2481. [PMID: 34882230 PMCID: PMC8786288 DOI: 10.1042/bst20200244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/03/2021] [Accepted: 11/16/2021] [Indexed: 12/05/2022]
Abstract
Marine cyanobacteria are key primary producers, contributing significantly to the microbial food web and biogeochemical cycles by releasing and importing many essential nutrients cycled through the environment. A subgroup of these, the picocyanobacteria (Synechococcus and Prochlorococcus), have colonised almost all marine ecosystems, covering a range of distinct light and temperature conditions, and nutrient profiles. The intra-clade diversities displayed by this monophyletic branch of cyanobacteria is indicative of their success across a broad range of environments. Part of this diversity is due to nutrient acquisition mechanisms, such as the use of high-affinity ATP-binding cassette (ABC) transporters to competitively acquire nutrients, particularly in oligotrophic (nutrient scarce) marine environments. The specificity of nutrient uptake in ABC transporters is primarily determined by the peripheral substrate-binding protein (SBP), a receptor protein that mediates ligand recognition and initiates translocation into the cell. The recent availability of large numbers of sequenced picocyanobacterial genomes indicates both Synechococcus and Prochlorococcus apportion >50% of their transport capacity to ABC transport systems. However, the low degree of sequence homology among the SBP family limits the reliability of functional assignments using sequence annotation and prediction tools. This review highlights the use of known SBP structural representatives for the uptake of key nutrient classes by cyanobacteria to compare with predicted SBP functionalities within sequenced marine picocyanobacteria genomes. This review shows the broad range of conserved biochemical functions of picocyanobacteria and the range of novel and hypothetical ABC transport systems that require further functional characterisation.
Collapse
Affiliation(s)
- Benjamin A. Ford
- Department of Molecular Sciences, Macquarie University, Sydney, Australia
| | | | - Lisa Moore
- Department of Molecular Sciences, Macquarie University, Sydney, Australia
| | - Deepa Varkey
- Department of Molecular Sciences, Macquarie University, Sydney, Australia
| | - Hannah Zhu
- Department of Molecular Sciences, Macquarie University, Sydney, Australia
| | - Martin Ostrowski
- Climate Change Cluster (C3), University of Technology Sydney, Sydney, Australia
| | - Bridget C. Mabbutt
- Department of Molecular Sciences, Macquarie University, Sydney, Australia
| | - Ian T. Paulsen
- Department of Molecular Sciences, Macquarie University, Sydney, Australia
- ARC Centre of Excellence in Synthetic Biology, Macquarie University, Sydney, Australia
| | - Bhumika S. Shah
- Department of Molecular Sciences, Macquarie University, Sydney, Australia
- ARC Centre of Excellence in Synthetic Biology, Macquarie University, Sydney, Australia
| |
Collapse
|
15
|
Moore L. An evaluation of the nutritional requirements of post-operative colorectal patients. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.594] [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]
|
16
|
Ahrens L, List R, Gott K, Lonabaugh K, Haney H, Moore L, Knight D, Garrod A, Mason K, Froh D. 140: Oh gee! Time tested OGTT annual screening improvement: A single-center experience. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01565-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
17
|
Abstract
Abstract
Few interventions are truly simple; complexity can arise from various sources, e.g.:
Aspects of the intervention itself, such as the number of intervention components, the number of groups targeted, how dynamic the intervention is permitted to be. The context in which the intervention is developed and delivered, such as the social, political, economic, and geographical context.
Complex intervention research should be approached with an awareness of these sources of complexity. Systems thinking can be helpful to understanding the dynamic interaction between interventions and their context. This presentation will introduce concepts of complex adaptive systems, e.g. feedback loops, adaptation, emergence, that should be considered when developing and evaluating complex interventions. It will then introduce participants to the research perspectives set out in the new framework: efficacy, effectiveness, theory-based, and systems perspectives. Each perspective is associated with a different type of research question, and therefore appropriate in different circumstances. The presentation will provide information to support participants to consider the research perspective(s) most suited to the research challenge that they are aiming to address.
Main messages
There are multiple sources of complexity, each of which can affect how the intervention works or contributes to change. Complex intervention research can take an efficacy, effectiveness, theory-based, or systems perspective, the choice of which is based on what is known already and what further evidence would be most useful.
Collapse
Affiliation(s)
- K Skivington
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - P Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - L Moore
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - L Matthews
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - S Simpson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| |
Collapse
|
18
|
Craig P, Skivington K, Moore L, Simpson S, Matthews L. The new Framework and the Core Elements of complex intervention research. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
The new framework will be presented. The main phases of intervention research: development or identification, feasibility, evaluation and implementation are connected to 6 core elements:
Context: any feature of the circumstances in which an intervention is conceived, developed, evaluated and implemented Programme theory: how an intervention is expected to lead to its effects and under what conditions. Programme theory should be tested and refined at all stages and used to guide the identification of uncertainties and research questions Stakeholders: those who are targeted by the intervention, involved in its development or delivery, or more broadly those whose personal or professional interests are affected, that is who have a stake in the topic. This includes patients, the public, and professionals Refinement: the process of ‘fine tuning' or making changes to the intervention once a preliminary version has been developed Uncertainties: identifying key uncertainties that exist given what is already known and what the programme theory, researchers and stakeholders identify as being most important to find out. These judgements inform the framing of research questions that, in turn, govern research perspective choice Economic considerations: exploring the comparative resource and outcome consequences of the interventions for those people and organisations affected
The presentation will discuss how to use the framework, highlighting that complex intervention research can be an iterative process. Repeating of phases is preferable to automatic progression to the next phase if uncertainties remain unresolved.
Main messages
Complex intervention research may begin at any phase, depending on what is appropriate for the intervention in question, and does not necessarily move sequentially through the phases. The core elements should be considered early and revisited continually throughout, as this will make it most likely that the intervention will be implementable in practice.
Collapse
Affiliation(s)
- P Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - K Skivington
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - L Moore
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - S Simpson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - L Matthews
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| |
Collapse
|
19
|
Fong JN, Miketinas D, Moore L, Everts H, Warren C, Juma S, Patterson M. Precision Nutrition Model Predicts Postprandial Glucose Response Following Potato Intake. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.08.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
20
|
Loibl S, Loirat D, Tolaney S, Punie K, Oliveira M, Rugo H, Bardia A, Hurvitz S, Brufsky A, Kalinsky K, Cortés J, O'Shaughnessy J, Dieras V, Carey L, Gianni L, Gharaibeh M, Moore L, Shi L, Piccart M. 257P Health-related quality of life (HRQoL) in the ASCENT study of sacituzumab govitecan (SG) in metastatic triple-negative breast cancer (mTNBC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.540] [Citation(s) in RCA: 3] [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: 11/16/2022] Open
|
21
|
O'Donoghue J, Moore L, Bhakyapaibul T, Melin H, Stallard T, Connerney JEP, Tao C. Global upper-atmospheric heating on Jupiter by the polar aurorae. Nature 2021; 596:54-57. [PMID: 34349293 PMCID: PMC8338559 DOI: 10.1038/s41586-021-03706-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/08/2021] [Indexed: 11/18/2022]
Abstract
Jupiter's upper atmosphere is considerably hotter than expected from the amount of sunlight that it receives1-3. Processes that couple the magnetosphere to the atmosphere give rise to intense auroral emissions and enormous deposition of energy in the magnetic polar regions, so it has been presumed that redistribution of this energy could heat the rest of the planet4-6. Instead, most thermospheric global circulation models demonstrate that auroral energy is trapped at high latitudes by the strong winds on this rapidly rotating planet3,5,7-10. Consequently, other possible heat sources have continued to be studied, such as heating by gravity waves and acoustic waves emanating from the lower atmosphere2,11-13. Each mechanism would imprint a unique signature on the global Jovian temperature gradients, thus revealing the dominant heat source, but a lack of planet-wide, high-resolution data has meant that these gradients have not been determined. Here we report infrared spectroscopy of Jupiter with a spatial resolution of 2 degrees in longitude and latitude, extending from pole to equator. We find that temperatures decrease steadily from the auroral polar regions to the equator. Furthermore, during a period of enhanced activity possibly driven by a solar wind compression, a high-temperature planetary-scale structure was observed that may be propagating from the aurora. These observations indicate that Jupiter's upper atmosphere is predominantly heated by the redistribution of auroral energy.
Collapse
Affiliation(s)
- J O'Donoghue
- Department of Solar System Science, JAXA Institute of Space and Astronautical Science, Sagamihara, Japan.
- NASA Goddard Space Flight Center, Greenbelt, MD, USA.
| | - L Moore
- Center for Space Physics, Boston University, Boston, MA, USA
| | - T Bhakyapaibul
- Center for Space Physics, Boston University, Boston, MA, USA
| | - H Melin
- Department of Physics and Astronomy, University of Leicester, Leicester, UK
| | - T Stallard
- Department of Physics and Astronomy, University of Leicester, Leicester, UK
| | - J E P Connerney
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
- Space Research Corporation, Annapolis, MD, USA
| | - C Tao
- National Institute of Information and Communications Technology (NICT), Tokyo, Japan
| |
Collapse
|
22
|
Ouellet V, Boucher V, Beauchamp F, Neveu X, Archambault P, Berthelot S, Chauny JM, De Guise E, Émond M, Frenette J, Lang E, Lee J, Mercier, Moore L, Ouellet MC, Perry J, Le Sage N. Influence of concomitant injuries on post-concussion symptoms after a mild traumatic brain injury - a prospective multicentre cohort study. Brain Inj 2021; 35:1028-1034. [PMID: 34224275 DOI: 10.1080/02699052.2021.1945145] [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: 10/20/2022]
Abstract
Objectives: To compare post-concussion symptoms (PCS) and return to normal activities between mild Traumatic Brain Injury (mTBI) patients with or without concomitant injuries at 7-and 90 days post-mTBI.Methods: Design: Sub-analysis of a multicentre prospective cohort study. PARTICIPANTS AND SETTING patients with mTBI from 7 Canadian Emergency Departments. PROCEDURE Research assistants conducted telephone follow-ups using the Rivermead Postconcussion Symptoms Questionnaire (RPQ) at 7-, 30- and 90 days post-mTBI. MAIN OUTCOME Presence of PCS (RPQ: ≥3 symptoms) at 90 days. SECONDARY OUTCOMES RPQ score ≥21, prevalence of individual RPQ symptoms and patients' return to normal activities, at 7- and 90-days. Adjusted risk ratios (RR) were calculated.Results: 1725 mTBI patients were included and 1055 (61.1%) had concomitant injuries. Patients with concomitant injuries were at higher risk of having ≥3 symptoms on the RPQ (RR:1.26 [95% CI 1.01-1.58]) at 90 days. They were also at higher risk of experiencing specific symptoms (dizziness, fatigue, headaches and taking longer to think) and of non-return to their normal activities (RR:2.11 [95% CI 1.30-3.45]).Conclusion: Patients with concomitant injuries have slightly more PCS and seemed to be at higher risk of non-return to their normal activities 90 days, compared to patients without concomitant injuries.
Collapse
Affiliation(s)
- V Ouellet
- CHU De Québec-Université Laval Research Center, Quebec, Canada.,Centre De Recherche Sur Les Soins Et Les Services De Première Ligne De l'Université Laval (CERSSPL-UL), Canada.,Département De Médecine Familiale Et De Médecine D'urgence, Faculté De Médecine, Université Laval Québec Canada
| | - V Boucher
- CHU De Québec-Université Laval Research Center, Quebec, Canada.,Centre De Recherche Sur Les Soins Et Les Services De Première Ligne De l'Université Laval (CERSSPL-UL), Canada
| | - F Beauchamp
- CHU De Québec-Université Laval Research Center, Quebec, Canada.,Centre De Recherche Sur Les Soins Et Les Services De Première Ligne De l'Université Laval (CERSSPL-UL), Canada.,Département De Médecine Familiale Et De Médecine D'urgence, Faculté De Médecine, Université Laval Québec Canada
| | - X Neveu
- CHU De Québec-Université Laval Research Center, Quebec, Canada.,Centre De Recherche Sur Les Soins Et Les Services De Première Ligne De l'Université Laval (CERSSPL-UL), Canada
| | - P Archambault
- Département De Médecine Familiale Et De Médecine D'urgence, Faculté De Médecine, Université Laval Québec Canada.,Centre Intégré De Santé Et De Services Sociaux De Chaudière-Appalaches, Centre Hospitalier Affilié Universitaire Hôtel-Dieu De Lévis, Lévis (Quebec) Canada
| | - S Berthelot
- CHU De Québec-Université Laval Research Center, Quebec, Canada.,Centre De Recherche Sur Les Soins Et Les Services De Première Ligne De l'Université Laval (CERSSPL-UL), Canada.,Département De Médecine Familiale Et De Médecine D'urgence, Faculté De Médecine, Université Laval Québec Canada
| | - J M Chauny
- Université De Montréal, Montréal, Québec, Canada
| | - E De Guise
- Université De Montréal, Montréal, Québec, Canada.,Research-Institute, McGill University Health CentreMontreal, Quebec, Canada.,Centre De Recherche Interdisciplinaire En Réadaptation Du Montréal Métropolitain (CRIR), Montreal, Quebec, Canada
| | - M Émond
- CHU De Québec-Université Laval Research Center, Quebec, Canada.,Centre De Recherche Sur Les Soins Et Les Services De Première Ligne De l'Université Laval (CERSSPL-UL), Canada.,Département De Médecine Familiale Et De Médecine D'urgence, Faculté De Médecine, Université Laval Québec Canada
| | - J Frenette
- Centre De Recherche Sur Les Soins Et Les Services De Première Ligne De l'Université Laval (CERSSPL-UL), Canada
| | - E Lang
- University of Calgary, Calgary, Alberta, Canada
| | - J Lee
- Schwartz/Reisman Emergency Medicine Institute, Toronto, Ontario, Canada
| | - Mercier
- CHU De Québec-Université Laval Research Center, Quebec, Canada.,Centre De Recherche Sur Les Soins Et Les Services De Première Ligne De l'Université Laval (CERSSPL-UL), Canada.,Département De Médecine Familiale Et De Médecine D'urgence, Faculté De Médecine, Université Laval Québec Canada
| | - L Moore
- Department of Social and Preventive Medicine, Faculté De Médecine, Université Laval Québec Canada
| | - M C Ouellet
- Département De Psychologie, Université Laval Québec Canada.,Centre Interdisciplinaire De Recherche En Réadaptation Et Intégration Sociale CIRRIS, Quebec, Canada
| | - J Perry
- Department of Emergency Medicine, Ottawa Hospital Research Institute, University of Ottawa Ottawa Canada
| | - N Le Sage
- CHU De Québec-Université Laval Research Center, Quebec, Canada.,Centre De Recherche Sur Les Soins Et Les Services De Première Ligne De l'Université Laval (CERSSPL-UL), Canada.,Département De Médecine Familiale Et De Médecine D'urgence, Faculté De Médecine, Université Laval Québec Canada
| |
Collapse
|
23
|
Hachem R, Parikh UM, Reitzel R, Rosenblatt J, Kaul A, Vargas-Cruz N, Hill L, Moore L, Meyer J, Chaftari AM, Gagea M, Balaji S, Raad II. Novel antimicrobial ointment for infected wound healing in an in vitro and in vivo porcine model. Wound Repair Regen 2021; 29:830-842. [PMID: 33956391 DOI: 10.1111/wrr.12922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/23/2021] [Accepted: 04/06/2021] [Indexed: 12/01/2022]
Abstract
Microbial contamination of wounds is a significant problem that delays healing, particularly when bacterial biofilms are present. A novel combination of pectinic acid (PG) + caprylic acid (CAP) was previously found in vitro to be highly effective in eradicating various pathogens in biofilms with minimal cytotoxicity. In this study, a novel wound ointment was formulated with PG + CAP and first assessed in vitro using a well-established biofilm eradication model. In vitro, the PG + CAP ointment was shown to be efficacious in reducing the microbial biofilms. This ointment was then tested in vivo in two pilot porcine wound healing models, with and without Staphylococcus aureus microbial challenge. Ointments were applied to each wound daily, and healing by wound closure area measurement was assessed weekly over 4 weeks. After 4 weeks, pigs were sacrificed and wounds were scored for reepithelialization, inflammation, granulation tissue, and collagen deposition. We compared PG + CAP to hydroxyethylcellulose + glycerol ointment base (control) and MediHoney (comparator). In the porcine microbial challenge model, the novel antimicrobial PG + CAP wound ointment rapidly eradicated bacterial organisms embedded in wounds, was safe and well-tolerated, and was associated with enhanced healing compared to ointment base and MediHoney. Specifically, the cumulative histopathology, reepithelialization of epidermis, and mature granulation tissue in the wound bed was significantly better with PG + CAP than with control and MediHoney treatments. This ointment warrants further study as a non-antibiotic ointment for use in treating a wide array of infected wounds.
Collapse
Affiliation(s)
- Ray Hachem
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Umang M Parikh
- Division of Pediatric Surgery, Department of Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Ruth Reitzel
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Joel Rosenblatt
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Aditya Kaul
- Division of Pediatric Surgery, Department of Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Nylev Vargas-Cruz
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lori Hill
- Department of Veterinary Medicine and Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lisa Moore
- Department of Veterinary Medicine and Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jennifer Meyer
- Department of Veterinary Medicine and Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Anne-Marie Chaftari
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mihai Gagea
- Division of Pediatric Surgery, Department of Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Swathi Balaji
- Division of Pediatric Surgery, Department of Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Issam I Raad
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
24
|
Low R, Young K, Verani L, Cotton DT, Welman T, Moore L, Horwitz MD. 540 Point of Care Testing for Tetanus Immunity: A Systematic Review. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
All patients presenting to emergency departments (EDs) with traumatic injuries require tetanus immunity assessments. Inaccurate tetanus vaccination history based on patient recall incurs unnecessary costs on the NHS. Point-of-care immunochromatographic tests (Tetanus Quick Sticks [TQS]) quickly identify tetanus immunity status. We aim to evaluate the diagnostic accuracy and cost-efficacy of TQS to assess their relevance in emergency care.
Method
The systematic review followed PRISMA guidelines. A retrospective search of MEDLINE, Embase, Global Health, HMIC and The Cochrane Library was conducted. Studies were eligible if sensitivity, specificity, or cost-efficacy of TQS were reported. At least two authors independently analysed the data from each study.
Results
12 studies were suitable for inclusion (n = 1,662,865 participants): one retrospective and 11 prospective observational cohort studies. Eight studies assessed diagnostic accuracy with the median sensitivity at 86% (55-100) and the median specificity at 97.5% (1-100). All six studies investigating cost-efficacy reported greater savings when using TQS instead of using vaccination history, due to a decrease in unnecessary tetanus vaccine and immunoglobulin administration.
Conclusions
TQS is a safe diagnostic tool, especially when used by trained operators. TQS widely reduces costs in comparison to traditional vaccination history. We recommend the use of TQS in Emergency Departments throughout the NHS.
Collapse
Affiliation(s)
- R Low
- Imperial College London, London, United Kingdom
| | - K Young
- Imperial College London, London, United Kingdom
| | - L Verani
- Imperial College London, London, United Kingdom
| | - D T Cotton
- Imperial College London, London, United Kingdom
| | - T Welman
- Hand Unit Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
- Department of Plastic Surgery, The Royal London Hospital, Barts Health NHS Foundation Trust, London, United Kingdom
| | - L Moore
- Imperial College London, London, United Kingdom
- Hand Unit Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
- North West London Pathology, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - M D Horwitz
- Hand Unit Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
| |
Collapse
|
25
|
O'Brien J, Fryer S, Parker J, Moore L. The effect of ego depletion on challenge and threat evaluations during a potentially stressful public speaking task. Anxiety Stress Coping 2021; 34:266-278. [PMID: 33141603 DOI: 10.1080/10615806.2020.1839732] [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: 04/29/2019] [Revised: 06/05/2020] [Accepted: 08/11/2020] [Indexed: 06/11/2023]
Abstract
It has been well established that challenge and threat evaluations affect the performance of potentially stressful tasks. However, the factors that influence these evaluations have rarely been examined. Objective: This study examined the effects of ego depletion on challenge and threat evaluations during a public speaking task. Method: 262 participants (150 males, 112 females; Mage = 20.5, SD = 4.3) were randomly assigned to either an ego depletion or control group. Participants then completed self-report measures of trait self-control. The ego depletion group performed a written transcription task requiring self-control, while the control group transcribed the text normally. Before the public speaking task, participant's challenge and threat evaluations and subjective ratings of performance were assessed via self-report items. Results: The results of independent t-tests supported the effectiveness of the self-control manipulation. There were no significant differences between the ego depletion and control groups in terms of challenge and threat evaluations or subjective performance. Additional correlation analyses revealed that trait measures of self-control were significantly and negatively related to challenge and threat evaluations and subjective performance. Conclusion: Findings suggest that ego depletion might not influence appraisals of potentially stressful tasks, and thus add to recent evidence questioning the ego-depletion phenomenon.
Collapse
Affiliation(s)
- J O'Brien
- Faculty of Applied Sciences, School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
| | - S Fryer
- Faculty of Applied Sciences, School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
| | - J Parker
- Higher Education Sport, Hartpury University, Gloucester, UK
| | - L Moore
- Department for Health, University of Bath, Bath, UK
| |
Collapse
|
26
|
McDevitt B, Moore L, Akhtar N, Connolly J, Doherty R, Scott W. Validity of a Novel Research-Grade Physical Activity and Sleep Monitor for Continuous Remote Patient Monitoring. Sensors (Basel) 2021; 21:2034. [PMID: 33805690 PMCID: PMC7998122 DOI: 10.3390/s21062034] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/04/2021] [Accepted: 03/09/2021] [Indexed: 11/23/2022]
Abstract
In the midst of the COVID-19 pandemic, Remote Patient Monitoring technologies are highly important for clinicians and researchers. These connected-health technologies enable monitoring of patients and facilitate remote clinical trial research while reducing the potential for the spread of the novel coronavirus. There is a growing requirement for monitoring of the full 24 h spectrum of behaviours with a single research-grade sensor. This research describes a free-living and supervised protocol comparison study of the Verisense inertial measurement unit to assess physical activity and sleep parameters and compares it with the Actiwatch 2 actigraph. Fifteen adults (11 males, 23.4 ± 3.4 years and 4 females, 29 ± 12.6 years) wore both monitors for 2 consecutive days and nights in the free-living study while twelve adults (11 males, 23.4 ± 3.4 years and 1 female, 22 ± 0 years) wore both monitors for the duration of a gym-based supervised protocol study. Agreement of physical activity epoch-by-epoch data with activity classification of sedentary, light and moderate-to-vigorous activity and sleep metrics were evaluated using Spearman's rank-order correlation coefficients and Bland-Altman plots. For all activity, Verisense showed high agreement for both free-living and supervised protocol of r = 0.85 and r = 0.78, respectively. For physical activity classification, Verisense showed high agreement of sedentary activity of r = 0.72 for free-living but low agreement of r = 0.36 for supervised protocol; low agreement of light activity of r = 0.42 for free-living and negligible agreement of r = -0.04 for supervised protocol; and moderate agreement of moderate-to-vigorous activity of r = 0.52 for free-living with low agreement of r = 0.49 for supervised protocol. For sleep metrics, Verisense showed moderate agreement for sleep time and total sleep time of r = 0.66 and 0.54, respectively, but demonstrated high agreement for determination of wake time of r = 0.83. Overall, our results showed moderate-high agreement of Verisense with Actiwatch 2 for assessing epoch-by-epoch physical activity and sleep, but a lack of agreement for activity classifications. Future validation work of Verisense for activity cut-point potentially holds promise for 24 h continuous remote patient monitoring.
Collapse
Affiliation(s)
- Bríd McDevitt
- Department of Computing, Letterkenny Institute of Technology, Letterkenny, F92 FC93 Donegal, Ireland;
| | - Lisa Moore
- Department of Science, Letterkenny Institute of Technology, Letterkenny, F92 FC93 Donegal, Ireland; (L.M.); (W.S.)
| | - Nishat Akhtar
- Department of Computing, Letterkenny Institute of Technology, Letterkenny, F92 FC93 Donegal, Ireland;
| | - James Connolly
- Department of Computing, Letterkenny Institute of Technology, Letterkenny, F92 FC93 Donegal, Ireland;
| | - Rónán Doherty
- Department of Law & Humanities, Letterkenny Institute of Technology, Letterkenny, F92 FC93 Donegal, Ireland;
| | - William Scott
- Department of Science, Letterkenny Institute of Technology, Letterkenny, F92 FC93 Donegal, Ireland; (L.M.); (W.S.)
| |
Collapse
|
27
|
Moore L, Ghannam M, Manousakis G. A first presentation of multiple sclerosis with concurrent COVID-19 infection. eNeurologicalSci 2021; 22:100299. [PMID: 33313429 PMCID: PMC7717878 DOI: 10.1016/j.ensci.2020.100299] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 11/15/2020] [Accepted: 11/25/2020] [Indexed: 12/21/2022] Open
Abstract
Infection from SARS-CoV-2 virus has developed into a worldwide pandemic. Potential neurological complications include meningitis, encephalitis, Guillain-Barre syndrome, cerebrovascular disease, seizures, and demyelinating disease. In this paper, we describe a case of newly diagnosed multiple sclerosis co-occurring with active COVID-19 infection.
Collapse
Affiliation(s)
- Lisa Moore
- Department of Neurology, University of Minnesota, Minneapolis, MN, United States
| | - Malik Ghannam
- Department of Neurology, University of Minnesota, Minneapolis, MN, United States
| | - Georgios Manousakis
- Department of Neurology, University of Minnesota, Minneapolis, MN, United States
| |
Collapse
|
28
|
Nielsen DA, Fierer N, Geoghegan JL, Gillings MR, Gumerov V, Madin JS, Moore L, Paulsen IT, Reddy TBK, Tetu SG, Westoby M. Aerobic bacteria and archaea tend to have larger and more versatile genomes. OIKOS 2021. [DOI: 10.1111/oik.07912] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
| | - Noah Fierer
- Dept of Ecology and Evolutionary Biology, Cooperative Inst. for Research in Environmental Sciences, Univ. of Colorado Boulder CO USA
| | - Jemma L. Geoghegan
- Dept of Biological Sciences, Macquarie Univ. Sydney NSW Australia
- Dept of Microbiology and Immunology, Univ. of Otago New Zealand
| | | | - Vadim Gumerov
- Dept of Microbiology, Ohio State Univ. Columbus Ohio USA
| | - Joshua S. Madin
- Hawaii Inst. of Marine Biology, Univ. of Hawaii Kaneohe HI USA
| | - Lisa Moore
- Dept of Molecular Sciences, Macquarie Univ. Sydney NSW Australia
| | | | - T. B. K. Reddy
- Dept of Molecular Sciences, Macquarie Univ. Sydney NSW Australia
| | - Sasha G. Tetu
- Dept of Molecular Sciences, Macquarie Univ. Sydney NSW Australia
| | - Mark Westoby
- Dept of Biological Sciences, Macquarie Univ. Sydney NSW Australia
| |
Collapse
|
29
|
Moore L, Moses JI, Melin H, Stallard TS, O’Donoghue J. Atmospheric implications of the lack of H 3+ detection at Neptune. Philos Trans A Math Phys Eng Sci 2020; 378:20200100. [PMID: 33161862 PMCID: PMC7658779 DOI: 10.1098/rsta.2020.0100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/02/2020] [Indexed: 05/04/2023]
Abstract
H3+ has been detected at all of the solar system giant planets aside from Neptune. Current observational upper limits imply that there is far less H3+ emission at Neptune than rudimentary modelling would suggest. Here, we explore via modelling a range of atmospheric conditions in order to find some that could be consistent with observational constraints. In particular, we consider that the upper atmosphere might be much cooler than it was during the 1989 Voyager 2 encounter, and we examine the impact of an enhanced influx of external material that could act to reduce H3+ density. Resulting ionosphere models that are consistent with existing H3+ observational constraints have an exospheric temperature of 450 K or less, 300 K lower than the Voyager 2 value. Alternatively, if a topside CO influx of 2 × 108 cm-2 s-1 is imposed, the upper atmospheric temperature can be higher, up to 550 K. The potential cooling of Neptune's atmosphere is relevant for poorly understood giant planet thermospheric energetics, and would also impact aerobreaking manoeuvers for any future spacecraft. Such a large CO influx, if present, could imply Triton is a very active moon with prominent atmospheric escape, and/or that Neptune's rings significantly modify its upper atmosphere, and the introduction of so much exogenic material would complicate interpretation of the origin of species observed in Neptune's lower atmosphere. This article is part a discussion meeting issue 'Future exploration of ice giant systems'.
Collapse
Affiliation(s)
- L. Moore
- Boston University, Boston, MA, USA
| | | | - H. Melin
- University of Leicester, Leicester, UK
| | | | - J. O’Donoghue
- JAXA Institute of Space and Astronautical Science, Tokyo, Japan
| |
Collapse
|
30
|
Meyer BC, Friedman LS, Payne K, Moore L, Cressler J, Holberg S, Partridge B, Prince B, Sylwestrzak M, Jenusaitis M, Kremer B, Kane CJ, Sitapati A, Clay B, Millen M, Longhurst C. Medical Undistancing Through Telemedicine: A Model Enabling Rapid Telemedicine Deployment in an Academic Health Center During the COVID-19 Pandemic. Telemed J E Health 2020; 27:625-634. [PMID: 33030985 DOI: 10.1089/tmj.2020.0327] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: The authors draw upon their experience with a successful, enterprise-level, telemedicine program implementation to present a "How To" paradigm for other academic health centers that wish to rapidly deploy such a program in the setting of the COVID-19 pandemic. The advent of social distancing as essential for decreasing viral transmission has made it challenging to provide medical care. Telemedicine has the potential to medically undistance health care providers while maintaining the quality of care delivered and fulfilling the goal of social distancing. Methods: Rather than simply reporting enterprise telemedicine successes, the authors detail key telemedicine elements essential for rapid deployment of both an ambulatory and inpatient telemedicine solution. Such a deployment requires a multifaceted strategy: (1) determining the appropriateness of telemedicine use, (2) understanding the interface with the electronic health record, (3) knowing the equipment and resources needed, (4) developing a rapid rollout plan, (5) establishing a command center for post go-live support, (6) creating and disseminating reference materials and educational guides, (7) training clinicians, patients, and clinic schedulers, (8) considering billing and credentialing implications, (9) building a robust communications strategy, and (10) measuring key outcomes. Results: Initial results are reported, showing a telemedicine rate increase to 45.8% (58.6% video and telephone) in just the first week of rollout. Over a 5-month period, the enterprise has since conducted over 119,500 ambulatory telemedicine evaluations (a 1,000-fold rate increase from the pre-COVID-19 time period). Conclusion: This article is designed to offer a "How To" potential best practice approach for others wishing to quickly implement a telemedicine program during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Brett C Meyer
- University of California, San Diego Enterprise Telehealth Program, San Diego, California, USA
| | - Lawrence S Friedman
- University of California, San Diego Enterprise Telehealth Program, San Diego, California, USA
| | - Keith Payne
- University of California, San Diego Enterprise Telehealth Program, San Diego, California, USA
| | - Lisa Moore
- University of California, San Diego Enterprise Telehealth Program, San Diego, California, USA
| | - John Cressler
- University of California, San Diego Enterprise Telehealth Program, San Diego, California, USA
| | - Stacy Holberg
- University of California, San Diego Enterprise Telehealth Program, San Diego, California, USA
| | - Brittany Partridge
- University of California, San Diego Enterprise Telehealth Program, San Diego, California, USA
| | - Britney Prince
- University of California, San Diego Enterprise Telehealth Program, San Diego, California, USA
| | - Marc Sylwestrzak
- University of California, San Diego Enterprise Telehealth Program, San Diego, California, USA
| | - Matthew Jenusaitis
- University of California, San Diego Enterprise Telehealth Program, San Diego, California, USA
| | - Brendan Kremer
- University of California, San Diego Enterprise Telehealth Program, San Diego, California, USA
| | - Christopher J Kane
- University of California, San Diego Enterprise Telehealth Program, San Diego, California, USA
| | - Amy Sitapati
- University of California, San Diego Enterprise Telehealth Program, San Diego, California, USA
| | - Brian Clay
- University of California, San Diego Enterprise Telehealth Program, San Diego, California, USA
| | - Marlene Millen
- University of California, San Diego Enterprise Telehealth Program, San Diego, California, USA
| | - Christopher Longhurst
- University of California, San Diego Enterprise Telehealth Program, San Diego, California, USA
| |
Collapse
|
31
|
Davies A, Teare L, Falder S, Dumville J, Shah M, Jenkins A, Collins D, Dheansa B, Coy K, Booth S, Moore L, Marlow K, Agha R, Young A. Consensus demonstrates four indicators needed to standardize burn wound infection reporting across trials in a single-country study (ICon-B study). J Hosp Infect 2020; 106:217-225. [DOI: 10.1016/j.jhin.2020.07.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 07/22/2020] [Indexed: 01/10/2023]
|
32
|
Abstract
Aims:To compare the effectiveness of a manualised group cognitive behaviour therapy (CBT) programme for people with bipolar disorder (BPD) and major depressive disorder (MDD).Method:In addition to treatment as usual (TAU), 17 people with BPD and 17 matched controls with MDD completed 8 or 12 sessions of twice weekly group CBT, followed by 6 booster sessions, held at monthly intervals. Participants completed the Structured Clinical Interview for DSM-IV Axis 1 Disorders, Clinician Version (SCID-1) and the University of Rhode Island Change Assessment (URICA) prior to therapy. They completed the Beck Depression Inventory - II (BDI), the Beck Anxiety Inventory (BAI), the Clinical Outcomes in Routine Evaluation (CORE), the World Health Organisation Quality of Life Brief Version (WHOQoL - BREF) and the Dysfunctional Attitudes Scale (DAS) before and after therapy and at the final follow-up session. The BDI and BAI were also completed at each group session.Results:Both groups showed statistically and clinically significant improvement on the BDI and BAI after treatment and at follow-up. Both groups showed a significant improvement on the psychological health sub-scale on the WHOQoL-BREF.Conclusions:Manualised group CBT leads to a reduction in the symptoms of depression and anxiety in people with both BPD and MDD and helps improve their perceived quality of life.Declaration of interest:None.
Collapse
|
33
|
Sawadogo D, Moore L, Tardif PA, Farhat I, Lauzier F, Turgeon AF. Trends of clinical outcomes in patients with a Traumatic Brain Injury (TBI) in Canada between 2006 and 2012. Injury 2020; 51:76-83. [PMID: 31515061 DOI: 10.1016/j.injury.2019.08.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 07/11/2019] [Accepted: 08/17/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Traumatic brain injuries (TBI) are the leading cause of death for people aged <40 years. In Canada, the structure of trauma care has evolved independently across provinces during the last decade. However, little is known about the evolution of clinical outcomes. We aimed to compare trends in hospital mortality, unplanned readmission, hospital length of stay (LOS) and intensive care unit (ICU) LOS for TBI between 2006 and 2012 across Canadian provinces. METHODS We conducted a retrospective multicentre cohort study based on TBI admissions across Canadian level I and II trauma centres. Data were extracted from the National Trauma Registry linked to hospital discharge databases. All adults with an injury severity score ≥12 were included. Multilevel generalized linear models were used to evaluate trends in clinical outcomes. RESULTS Between 2006 and 2012, we observed a decrease in mortality in Canada (odd ratio [OR] = 0.95; 95% confidence intervals [CI] = 0.92-0.98) mostly driven by Ontario (OR = 0.95; 95% CI = 0.93-0.98). We observed a significant decrease in hospital length of stay in Canada (hazard ratio [HR]: hazard of being discharged alive from hospital = 1.02; 95% CI = 1.01-1.02) mostly driven by a decrease in Quebec (HR = 1.03; 95% CI = 1.01-1.04). We observed a decrease in ICU Length of stay only in Alberta (HR = 1.05; 95% CI = 1.01-1.09). No trend was observed for hospital readmissions. CONCLUSION We observed significant decreases in mortality, hospital and ICU length of stay for TBI in Canada between 2006 and 2012 but only in certain provinces. This study may represent the first step towards a better understanding of the influence of trauma system configuration on the burden of injuries in Canada.
Collapse
Affiliation(s)
- D Sawadogo
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec - Hôpital de l'Enfant Jésus, Québec, Canada.
| | - L Moore
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec - Hôpital de l'Enfant Jésus, Québec, Canada
| | - P A Tardif
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec - Hôpital de l'Enfant Jésus, Québec, Canada
| | - I Farhat
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec - Hôpital de l'Enfant Jésus, Québec, Canada
| | - F Lauzier
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec - Hôpital de l'Enfant Jésus, Québec, Canada; Département d'anesthésiologie, Faculté de médecine, Université Laval, Québec, Canada
| | - A F Turgeon
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec - Hôpital de l'Enfant Jésus, Québec, Canada
| |
Collapse
|
34
|
Brown R, Bauld L, de Lacy E, Hallingberg B, Maynard O, McKell J, Moore L, Moore G. A qualitative study of e-cigarette emergence and the potential for renormalisation of smoking in UK youth. Int J Drug Policy 2019; 75:102598. [PMID: 31785547 PMCID: PMC6983925 DOI: 10.1016/j.drugpo.2019.11.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 10/09/2019] [Accepted: 11/10/2019] [Indexed: 12/21/2022]
Abstract
Background Growth of e-cigarette use among smokers has raised concerns over uptake by non-smokers, particularly young people. Legislative changes aimed in part at reducing youth exposure to e-cigarettes include the EU Tobacco Products Directive (TPD). A core justification for such measures is the belief that e-cigarettes can lead to tobacco smoking through mechanisms of renormalisation including: mimicking and normalizing the act of smoking; increasing product acceptability via marketing; nicotine exposure. These mechanisms are here explored in relation to findings from qualitative research. Methods This paper reports results from twenty-one group interviews with 14–15 year olds in Wales, England and Scotland, conducted as part of an ongoing evaluation of the impact of the TPD on youth smoking and e-cigarette use. Interviews were conducted around the end of the transitional period for TPD implementation, and explored perceptions of e-cigarettes and tobacco, as well as similarities and differences between them. Results Young people differentiated between tobacco and e-cigarettes, rejecting the term e-cigarette in favour of alternatives such as ‘vapes’. Experimental or occasional use was common and generally approved of where occurring within social activity with peers. However, regular use outside of this context was widely disapproved of, unless for the purpose of stopping smoking. Increased prevalence of e-cigarettes did not challenge strongly negative views of smoking or reduce perceived harms caused by it, with disapproval of smoking remaining high. Nicotine use was variable, with flavour a stronger driver for choice of e-liquid, and interest more generally. Conclusion The extent to which participants differentiated between vaping and smoking, including styles and reasons for use in adults and young people; absence of marketing awareness; and continued strong disapproval of smoking provides limited support for some of the potential mechanisms through which e-cigarettes may renormalise smoking. However caution over nicotine exposure is still necessary.
Collapse
Affiliation(s)
- R Brown
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, Cardiff University, UK.
| | - L Bauld
- Usher Institute of Population Health Sciences & Informatics, University of Edinburgh, UK; Director, SPECTRUM Consortium
| | - E de Lacy
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, Cardiff University, UK
| | - B Hallingberg
- Department of Applied Psychology, Cardiff Metropolitan University
| | - O Maynard
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, UK/UK Centre for Tobacco and Alcohol Studies (UKCTAS) and School of Psychological Science, University of Bristol, Bristol, UK
| | - J McKell
- Institute for Social Marketing, University of Stirling and UK Centre for Tobacco and Alcohol Studies, UK
| | - L Moore
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK
| | - G Moore
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, Cardiff University, UK; SPECTRUM Consortium
| |
Collapse
|
35
|
Melin H, Fletcher LN, Stallard TS, Miller S, Trafton LM, Moore L, O'Donoghue J, Vervack RJ, Dello Russo N, Lamy L, Tao C, Chowdhury MN. The H 3+ ionosphere of Uranus: decades-long cooling and local-time morphology. Philos Trans A Math Phys Eng Sci 2019; 377:20180408. [PMID: 31378181 PMCID: PMC6710888 DOI: 10.1098/rsta.2018.0408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/07/2019] [Indexed: 05/04/2023]
Abstract
The upper atmosphere of Uranus has been observed to be slowly cooling between 1993 and 2011. New analysis of near-infrared observations of emission from H3+ obtained between 2012 and 2018 reveals that this cooling trend has continued, showing that the upper atmosphere has cooled for 27 years, longer than the length of a nominal season of 21 years. The new observations have offered greater spatial resolution and higher sensitivity than previous ones, enabling the characterization of the H3+ intensity as a function of local time. These profiles peak between 13 and 15 h local time, later than models suggest. The NASA Infrared Telescope Facility iSHELL instrument also provides the detection of a bright H3+ signal on 16 October 2016, rotating into view from the dawn sector. This feature is consistent with an auroral signal, but is the only of its kind present in this comprehensive dataset. This article is part of a discussion meeting issue 'Advances in hydrogen molecular ions: H3+, H5+ and beyond'.
Collapse
Affiliation(s)
- Henrik Melin
- Department of Physics & Astronomy, University of Leicester, Leicester, UK
| | - L. N. Fletcher
- Department of Physics & Astronomy, University of Leicester, Leicester, UK
| | - T. S. Stallard
- Department of Physics & Astronomy, University of Leicester, Leicester, UK
| | - S. Miller
- Department of Physics & Astronomy, University College London, London, UK
| | - L. M. Trafton
- Department of Astronomy, University of Texas, Austin, TX, USA
| | - L. Moore
- Center for Space Physics, Boston University, Boston, MA, USA
| | | | - R. J. Vervack
- Johns Hopkins Applied Physics Laboratory, Laurel, MD, USA
| | - N. Dello Russo
- Johns Hopkins Applied Physics Laboratory, Laurel, MD, USA
| | - L. Lamy
- LESIA, Observatoire de Paris, PSL, CNRS, Sorbonne Université, Meudon, France
| | - C. Tao
- National Institute of Information and Communications Technology, Tokyo, Japan
| | - M. N. Chowdhury
- Department of Physics & Astronomy, University of Leicester, Leicester, UK
| |
Collapse
|
36
|
Moore L, Melin H, O'Donoghue J, Stallard TS, Moses JI, Galand M, Miller S, Schmidt CA. Modelling H 3+ in planetary atmospheres: effects of vertical gradients on observed quantities. Philos Trans A Math Phys Eng Sci 2019; 377:20190067. [PMID: 31378180 PMCID: PMC6710898 DOI: 10.1098/rsta.2019.0067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/07/2019] [Indexed: 05/20/2023]
Abstract
Since its detection in the aurorae of Jupiter approximately 30 years ago, the H3+ ion has served as an invaluable probe of giant planet upper atmospheres. However, the vast majority of monitoring of planetary H3+ radiation has followed from observations that rely on deriving parameters from column-integrated paths through the emitting layer. Here, we investigate the effects of density and temperature gradients along such paths on the measured H3+ spectrum and its resulting interpretation. In a non-isothermal atmosphere, H3+ column densities retrieved from such observations are found to represent a lower limit, reduced by 20% or more from the true atmospheric value. Global simulations of Uranus' ionosphere reveal that measured H3+ temperature variations are often attributable to well-understood solar zenith angle effects rather than indications of real atmospheric variability. Finally, based on these insights, a preliminary method of deriving vertical temperature structure is demonstrated at Jupiter using model reproductions of electron density and H3+ measurements. The sheer diversity and uncertainty of conditions in planetary atmospheres prohibits this work from providing blanket quantitative correction factors; nonetheless, we illustrate a few simple ways in which the already formidable utility of H3+ observations in understanding planetary atmospheres can be enhanced. This article is part of a discussion meeting issue 'Advances in hydrogen molecular ions: H3+, H5+ and beyond'.
Collapse
Affiliation(s)
- L. Moore
- Boston University, Boston, MA, USA
| | - H. Melin
- University of Leicester, Leicester, UK
| | - J. O'Donoghue
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | | | | | - M. Galand
- Department of Physics, Imperial College London, London, UK
| | - S. Miller
- University College London, London, UK
| | | |
Collapse
|
37
|
Moore L, Jayaweera H, Redshaw M, Quigley M. Migration, ethnicity and mental health: evidence from mothers participating in the Millennium Cohort Study. Public Health 2019; 171:66-75. [PMID: 31103615 DOI: 10.1016/j.puhe.2019.03.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 10/14/2018] [Revised: 03/21/2019] [Accepted: 03/29/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Over a quarter of UK births are to women who were born outside of the UK. Black and Minority Ethnic (BME) women are disproportionately affected by poor mental health and inequitable access to mental health care in the perinatal period, yet the influence of the migrant status (mothers' UK vs. non-UK birth) is poorly understood. This study aimed to explore the relationship between ethnicity, migration and mental health indicators among mothers participating in a large nationally representative cohort study. STUDY DESIGN This is a secondary analysis of data from the Millennium Cohort Study. METHODS Logistic regression quantified the crude and adjusted effects of self-reported ethnicity and migrant status on prevalence of psychological distress and treatment for anxiety/depression at 9-month and 5-year postpartum. RESULTS We found substantial variation in the prevalence of distress according to ethnicity and migrant status, with Indian and Pakistani women at greatest risk. Despite equal or greater risk, BME and migrant women were less likely to report treatment for anxiety/depression. Mutually adjusted analyses showed ethnicity to be a stronger predictor of both outcomes than migrant status; however, at 5 years, being a migrant independently predicted lower odds of treatment, for a statistically similar level of distress. CONCLUSIONS Migrant women are likely to be at high risk of poor mental health in the perinatal period and beyond, yet may face significant barriers to accessing mental health care. A better understanding of ethnicity and migration as interrelated risk factors for perinatal mental ill-health is needed to help National Health Service organisations develop policy and practice that is flexible and responsive to diversity.
Collapse
Affiliation(s)
- L Moore
- Oxford School of Public Health, Old Road Campus, Headington, Oxford OX3 7LF, UK.
| | - H Jayaweera
- School of Anthropology, University of Oxford, 53 Banbury Rd, Oxford OX2 6PF, UK.
| | - M Redshaw
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK.
| | - M Quigley
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK.
| |
Collapse
|
38
|
Stanczak H, Nastasi N, Helmick D, CHEN X, Windreich R, Barnum J, Carella B, Byersdorfer C, Donnenberg A, Moore L, Szabolcs P. Processing and CD3+/CD19+ depletion of cadaveric vertebral bone marrow for primary immunodeficiency patients undergoing sequential bilateral orthotopic lung transplant (BOLT) and bone marrow transplant (BMT). Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.04.012] [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]
|
39
|
Beaudoin C, Moore L, Gagné M, Bessette L, Ste-Marie LG, Brown JP, Jean S. Performance of predictive tools to identify individuals at risk of non-traumatic fracture: a systematic review, meta-analysis, and meta-regression. Osteoporos Int 2019; 30:721-740. [PMID: 30877348 DOI: 10.1007/s00198-019-04919-6] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [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: 10/18/2018] [Accepted: 02/26/2019] [Indexed: 01/28/2023]
Abstract
UNLABELLED There is no consensus on which tool is the most accurate to assess fracture risk. The results of this systematic review suggest that QFracture, Fracture Risk Assessment Tool (FRAX) with BMD, and Garvan with BMD are the tools with the best discriminative ability. More studies assessing the comparative performance of current tools are needed. INTRODUCTION Many tools exist to assess fracture risk. This review aims to determine which tools have the best predictive accuracy to identify individuals at high risk of non-traumatic fracture. METHODS Studies assessing the accuracy of tools for prediction of fracture were searched in MEDLINE, EMBASE, Evidence-Based Medicine Reviews, and Global Health. Studies were eligible if discrimination was assessed in a population independent of the derivation cohort. Meta-analyses and meta-regressions were performed on areas under the ROC curve (AUCs). Gender, mean age, age range, and study quality were used as adjustment variables. RESULTS We identified 53 validation studies assessing the discriminative ability of 14 tools. Given the small number of studies on some tools, only FRAX, Garvan, and QFracture were compared using meta-regression models. In the unadjusted analyses, QFracture had the best discriminative ability to predict hip fracture (AUC = 0.88). In the adjusted analysis, FRAX with BMD (AUC = 0.81) and Garvan with BMD (AUC = 0.79) had the highest AUCs. For prediction of major osteoporotic fracture, QFracture had the best discriminative ability (AUC = 0.77). For prediction of osteoporotic or any fracture, FRAX with BMD and Garvan with BMD had higher discriminative ability than their versions without BMD (FRAX: AUC = 0.72 vs 0.69, Garvan: AUC = 0.72 vs 0.65). A significant amount of heterogeneity was present in the analyses. CONCLUSIONS QFracture, FRAX with BMD, and Garvan with BMD have the highest discriminative performance for predicting fracture. Additional studies in which the performance of current tools is assessed in the same individuals may be performed to confirm this conclusion.
Collapse
Affiliation(s)
- C Beaudoin
- Department of Social and Preventive Medicine, Medicine Faculty, Laval University, Ferdinand Vandry Pavillon, 1050 Avenue de la Médecine, Quebec City, QC, G1V 0A6, Canada.
- CHU de Québec-Université Laval Research Center, Québec, QC, Canada.
- Bureau d'information et d'études en santé des populations, Institut National de Santé Publique du Québec, 945, Avenue Wolfe, Québec, G1V 5B3, Canada.
| | - L Moore
- Department of Social and Preventive Medicine, Medicine Faculty, Laval University, Ferdinand Vandry Pavillon, 1050 Avenue de la Médecine, Quebec City, QC, G1V 0A6, Canada
- CHU de Québec-Université Laval Research Center, Québec, QC, Canada
| | - M Gagné
- Bureau d'information et d'études en santé des populations, Institut National de Santé Publique du Québec, 945, Avenue Wolfe, Québec, G1V 5B3, Canada
| | - L Bessette
- CHU de Québec-Université Laval Research Center, Québec, QC, Canada
- Department of Medicine, Medicine Faculty, Laval University, Ferdinand Vandry Pavillon, 1050 Avenue de la Médecine, Quebec City, QC, G1V 0A6, Canada
| | - L G Ste-Marie
- Department of Medicine, Medicine Faculty, University of Montréal, Montréal, QC, Canada
| | - J P Brown
- CHU de Québec-Université Laval Research Center, Québec, QC, Canada
- Department of Medicine, Medicine Faculty, Laval University, Ferdinand Vandry Pavillon, 1050 Avenue de la Médecine, Quebec City, QC, G1V 0A6, Canada
| | - S Jean
- Bureau d'information et d'études en santé des populations, Institut National de Santé Publique du Québec, 945, Avenue Wolfe, Québec, G1V 5B3, Canada
- Department of Medicine, Medicine Faculty, Laval University, Ferdinand Vandry Pavillon, 1050 Avenue de la Médecine, Quebec City, QC, G1V 0A6, Canada
| |
Collapse
|
40
|
Goranova T, Ennis D, Piskorz AM, Macintyre G, Lewsley LA, Stobo J, Wilson C, Kay D, Glasspool RM, Lockley M, Brockbank E, Montes A, Walther A, Sundar S, Edmondson R, Hall GD, Clamp A, Gourley C, Hall M, Fotopoulou C, Gabra H, Freeman S, Moore L, Jimenez-Linan M, Paul J, Brenton JD, McNeish IA. Correction: Safety and utility of image-guided research biopsies in relapsed high-grade serous ovarian carcinoma-experience of the BriTROC consortium. Br J Cancer 2019; 120:868. [PMID: 30862952 PMCID: PMC6474310 DOI: 10.1038/s41416-019-0433-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
This article was originally published under a CC BY NC SA License, but has now been made available under a CC BY 4.0 License.
Collapse
Affiliation(s)
- T Goranova
- Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK
| | - D Ennis
- Institute of Cancer Sciences, University of Glasgow, Glasgow, G61 1QH, UK
| | - A M Piskorz
- Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK
| | - G Macintyre
- Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK
| | - L A Lewsley
- Cancer Research UK Clinical Trials Unit, Glasgow, G12 0YN, UK
| | - J Stobo
- Cancer Research UK Clinical Trials Unit, Glasgow, G12 0YN, UK
| | - C Wilson
- Cancer Research UK Clinical Trials Unit, Glasgow, G12 0YN, UK
| | - D Kay
- Department of Radiology, Gartnavel General Hospital, Glasgow, G12 0YN, UK
| | - R M Glasspool
- Beatson West of Scotland Cancer Centre, Glasgow, G12 0YN, UK
| | - M Lockley
- Barts Cancer Institute, London, EC1M 6BQ, UK
- University College Hospital, London, WC1E 6BD, UK
| | - E Brockbank
- Barts Cancer Institute, London, EC1M 6BQ, UK
| | - A Montes
- Guy's Hospital, London, SE1 9RT, UK
| | - A Walther
- Bristol Haematology and Oncology Centre, Bristol, BS2 8ED, UK
| | - S Sundar
- City Hospital, Birmingham, B18 7QH, UK
| | | | - G D Hall
- St James Hospital, Leeds, LS9 7TF, UK
| | - A Clamp
- The Christie Hospital, Manchester, M20 4BX, UK
| | - C Gourley
- Edinburgh Cancer Research Centre, Edinburgh, EH4 2XR, UK
| | - M Hall
- Mount Vernon Cancer Centre, Northwood, HA6 2RN, UK
| | | | - H Gabra
- Imperial College, London, W12 0HS, UK
| | - S Freeman
- Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - L Moore
- Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | | | - J Paul
- Cancer Research UK Clinical Trials Unit, Glasgow, G12 0YN, UK
| | - J D Brenton
- Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK.
- Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.
| | - I A McNeish
- Institute of Cancer Sciences, University of Glasgow, Glasgow, G61 1QH, UK.
- Beatson West of Scotland Cancer Centre, Glasgow, G12 0YN, UK.
| |
Collapse
|
41
|
Vetsch J, Wakefield CE, Doolan EL, Signorelli C, McGill BM, Moore L, Techakesari P, Pieters R, Patenaude AF, McCarthy M, Cohn RJ. 'Why us?' Causal attributions of childhood cancer survivors, survivors' parents and community comparisons - a mixed methods analysis. Acta Oncol 2019; 58:209-217. [PMID: 30614350 DOI: 10.1080/0284186x.2018.1532600] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Understanding the cause of their cancer is important for many cancer patients. Childhood cancer survivors'/survivors' parents' beliefs about cancer etiology are understudied. We aimed to assess survivors'/parents' beliefs about what causes childhood cancer, compared with beliefs in the community. We also investigated the influence of clinical and socio-demographic characteristics on the participants' beliefs about cancer etiology. METHODS This two-stage study investigated the participants' beliefs, by using questionnaires assessing causal attributions related to childhood cancer (stage 1) and then undertaking telephone interviews (stage 2; survivors/survivors' parents only) to get an in-depth understanding of survivors'/survivors' parents beliefs. We computed multivariable regressions to identify factors associated with the most commonly endorsed attributions: bad luck/chance, environmental factors and genetics. We analyzed interviews using thematic analysis. RESULTS Six hundred one individuals (64.6% survivors and 35.4% survivors' parents) and 510 community comparisons (53.1% community adults, 46.9% community parents) completed the question on causal attributions. We conducted 87 in-depth interviews. Survivors/survivors' parents (73.9%) were more likely to believe that chance/bad luck caused childhood cancer than community participants (42.4%). Community participants more frequently endorsed that genetics (75.3%) and environmental factors (65.3%) played a major role in childhood cancer etiology (versus survivors' and survivors' parents: genetics 20.6%, environmental factors: 19.3%). Community participants, participants with a first language other than English, and reporting a lower quality of life were less likely to attribute bad luck as a cause of childhood cancer. Community participants, all participants with a higher income and higher education were more likely to attribute childhood cancer etiology to environmental factors. CONCLUSION Causal attributions differed between survivors/survivors' parents and community participants. Most of the parents and survivors seem to understand that there is nothing they have done to cause the cancer. Understanding survivors' and survivors' parents' causal attributions may be crucial to address misconceptions, offer access to services and to adapt current and future health behaviors.
Collapse
Affiliation(s)
- J. Vetsch
- School of Women’s and Children’s Health, UNSW, Sydney, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
| | - C. E. Wakefield
- School of Women’s and Children’s Health, UNSW, Sydney, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
| | - E. L. Doolan
- School of Women’s and Children’s Health, UNSW, Sydney, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
| | - C. Signorelli
- School of Women’s and Children’s Health, UNSW, Sydney, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
| | - B. M. McGill
- School of Women’s and Children’s Health, UNSW, Sydney, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
| | - L. Moore
- John Hunter Children’s Hospital, New Lambton Heights NSW, Sydney, Australia
| | - P. Techakesari
- School of Women’s and Children’s Health, UNSW, Sydney, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
| | - R. Pieters
- School of Women’s and Children’s Health, UNSW, Sydney, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
| | - A. F. Patenaude
- Department of Psychiatry at The Children’s Hospital, Boston, MA, USA
- Department of Psychiatry at Harvard Medical School, Boston, MA, USA
| | - M. McCarthy
- Royal Children’s Hospital, Melbourne, Australia
- Murdoch Children’s Hospital, Melbourne, Australia
| | - R. J. Cohn
- School of Women’s and Children’s Health, UNSW, Sydney, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
| | | |
Collapse
|
42
|
Dunn C, Moore L. GENETIC TESTING IDENTIFIES CAUSE OF ENTEROPATHY AND GROWTH FAILURE IN A 10 YEAR OLD MALE. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.312] [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: 11/25/2022]
|
43
|
Waite JH, Perryman RS, Perry ME, Miller KE, Bell J, Cravens TE, Glein CR, Grimes J, Hedman M, Cuzzi J, Brockwell T, Teolis B, Moore L, Mitchell DG, Persoon A, Kurth WS, Wahlund JE, Morooka M, Hadid LZ, Chocron S, Walker J, Nagy A, Yelle R, Ledvina S, Johnson R, Tseng W, Tucker OJ, Ip WH. Chemical interactions between Saturn’s atmosphere and its rings. Science 2018; 362:362/6410/eaat2382. [DOI: 10.1126/science.aat2382] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 09/10/2018] [Indexed: 11/03/2022]
Abstract
The Pioneer and Voyager spacecraft made close-up measurements of Saturn’s ionosphere and upper atmosphere in the 1970s and 1980s that suggested a chemical interaction between the rings and atmosphere. Exploring this interaction provides information on ring composition and the influence on Saturn’s atmosphere from infalling material. The Cassini Ion Neutral Mass Spectrometer sampled in situ the region between the D ring and Saturn during the spacecraft’s Grand Finale phase. We used these measurements to characterize the atmospheric structure and material influx from the rings. The atmospheric He/H2 ratio is 10 to 16%. Volatile compounds from the rings (methane; carbon monoxide and/or molecular nitrogen), as well as larger organic-bearing grains, are flowing inward at a rate of 4800 to 45,000 kilograms per second.
Collapse
|
44
|
Walker GJ, Moore L, Heerasing N, Hendy P, Perry MH, McDonald TJ, Debenham T, Bethune R, Bewshea C, Hyde C, Heap GA, Singh A, Calvert C, Kennedy NA, Goodhand JR, Ahmad T. Faecal calprotectin effectively excludes inflammatory bowel disease in 789 symptomatic young adults with/without alarm symptoms: a prospective UK primary care cohort study. Aliment Pharmacol Ther 2018; 47:1103-1116. [PMID: 29508423 DOI: 10.1111/apt.14563] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 11/13/2017] [Revised: 12/16/2017] [Accepted: 01/22/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Primary care faecal calprotectin testing distinguishes inflammatory bowel disease (IBD) from functional gut disorder in young patients presenting with abdominal symptoms; however, previous evaluations have excluded patients with alarm symptoms. AIMS We sought to evaluate the diagnostic accuracy of calprotectin to distinguish IBD from functional gut disorder in young adults in whom general practitioners (GPs) suspected IBD; including patients reporting gastrointestinal alarm symptoms. We hypothesised that calprotectin would reduce secondary care referrals and healthcare costs. METHODS We undertook a prospective cohort study of 789 young adults (18-46 years old) presenting with gastrointestinal symptoms to 49 local general practices that had undergone calprotectin testing (1053 tests: between Jan 2014 and May 2016) because of suspected IBD. We considered calprotectin levels of ≥100 μg/g positive. Primary and secondary care records over 12 months from the point of calprotectin testing were used as the reference standard. RESULTS Overall, 39% (308/789) patients reported gastrointestinal alarm symptoms and 6% (50/789) tested patients were diagnosed with IBD. The positive and negative predictive values of calprotectin testing for distinguishing IBD from functional gut disorder in patients with gastrointestinal alarm symptoms were 50% (95% CI 36%-64%) and 98% (96%-100%): and in patients without gastrointestinal alarm symptoms were 27% (16%-41%) and 99% (98%-100%), respectively. We estimate savings of 279 referrals and £160 per patient. CONCLUSIONS Calprotectin testing of young adults with suspected IBD in primary care accurately distinguishes IBD from functional gut disorder, even in patients with gastrointestinal alarm symptoms and reduces secondary care referrals and diagnostic healthcare costs.
Collapse
|
45
|
McCarthy D, Matz B, Wright J, Moore L. Investigation of the HotDog patient warming system: detection of thermal gradients. J Small Anim Pract 2018; 59:298-304. [PMID: 29363138 DOI: 10.1111/jsap.12816] [Citation(s) in RCA: 2] [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] [Received: 06/15/2017] [Revised: 12/05/2017] [Accepted: 12/11/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the performance of an active patient-warming device. MATERIALS AND METHODS Temperatures of an active patient-warming device (HotDog system) were measured at various time points using an infrared thermometer. The study was conducted in two phases: Phase 1 compared temperatures among four different areas of the warming blanket. Phase 2 compared conditions simulating different scenarios using a weighted patient simulator. RESULTS Phase 1: Three out of four positions on the warming blanket had significantly different temperature measurements. Phase 2: Temperature output by the warming blanket was reduced: (1) in the absence of the patient simulator placed across the blanket (-1·9°C, P=0·013); (2) if the patient simulator was placed away from the blanket sensor (-2·0°C, P=0·009); and (3) if there was fluid between the patient simulator and warming blanket (-2·2°C, P=0·004). In a majority of measurements (95%), the set temperature of 43°C on the control unit was not reached (range, 29·8 to 42·9°C) and 2·3% of measurements were higher (range, 43·1 to 45·8°C) than the control unit set temperature of 43°C. CLINICAL SIGNIFICANCE Measured temperatures on the active warming blanket did not reflect control unit settings. This could result in the potential for hyperthermic injury, ineffectual heating and uneven heat distribution.
Collapse
Affiliation(s)
- D McCarthy
- Coral Springs Animal Hospital, 2160 North University Drive, Coral Springs, FL, 33071, USA
| | - B Matz
- Department of Clinical Sciences, Auburn University, Auburn, AL 36849, USA.,Auburn University College of Veterinary Medicine, 1220 Wire Rd, Auburn, AL 36849, USA
| | - J Wright
- Auburn University College of Veterinary Medicine, 1220 Wire Rd, Auburn, AL 36849, USA.,Department of Pathobiology, Auburn University, Auburn, AL 36849, USA
| | - L Moore
- IndyVet Emergency & Specialty Hospital, 5425 Victory Drive, Indianapolis, IN 46203, USA
| |
Collapse
|
46
|
Krieger N, Birn AE, Aviles L, Bailey Z, Cubbin C, Dearfield C, Jones MM, Lee R, Moore L, Munoz N, Simonds V, Waterman PD. To: Dr. Alfredo Morabia, Editor, AJPH. Am J Public Health 2017; 107:e10. [PMID: 28787201 PMCID: PMC5551622 DOI: 10.2105/ajph.2017.303976] [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] [Accepted: 05/06/2017] [Indexed: 03/27/2024]
Affiliation(s)
- Nancy Krieger
- Nancy Krieger, Rebekka Lee, and Pamela D. Waterman are with the Harvard T. H. Chan School of Public Health, Boston, MA. Anne-Emanuelle Birn is with the Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario. Luis Avilés and Nylca Munoz are with the Graduate School of Public Health, University of Puerto Rico, San Juan. Zinzi Bailey is with the Center for Health Equity, New York City Department of Health and Mental Hygiene, New York, NY. Catherine Cubbin is with the School of Social Work, University of Texas, Austin. Craig Dearfield is with Akeso Consulting, Vienna, VA. Marian Moser Jones is with the University of Maryland School of Public Health, College Park. Lisa Moore is with Health Education, San Francisco State University, San Francisco, CA. Vanessa Simonds is with Health & Human Development, Montana State University, Bozeman
| | - Anne-Emanuelle Birn
- Nancy Krieger, Rebekka Lee, and Pamela D. Waterman are with the Harvard T. H. Chan School of Public Health, Boston, MA. Anne-Emanuelle Birn is with the Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario. Luis Avilés and Nylca Munoz are with the Graduate School of Public Health, University of Puerto Rico, San Juan. Zinzi Bailey is with the Center for Health Equity, New York City Department of Health and Mental Hygiene, New York, NY. Catherine Cubbin is with the School of Social Work, University of Texas, Austin. Craig Dearfield is with Akeso Consulting, Vienna, VA. Marian Moser Jones is with the University of Maryland School of Public Health, College Park. Lisa Moore is with Health Education, San Francisco State University, San Francisco, CA. Vanessa Simonds is with Health & Human Development, Montana State University, Bozeman
| | - Luis Aviles
- Nancy Krieger, Rebekka Lee, and Pamela D. Waterman are with the Harvard T. H. Chan School of Public Health, Boston, MA. Anne-Emanuelle Birn is with the Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario. Luis Avilés and Nylca Munoz are with the Graduate School of Public Health, University of Puerto Rico, San Juan. Zinzi Bailey is with the Center for Health Equity, New York City Department of Health and Mental Hygiene, New York, NY. Catherine Cubbin is with the School of Social Work, University of Texas, Austin. Craig Dearfield is with Akeso Consulting, Vienna, VA. Marian Moser Jones is with the University of Maryland School of Public Health, College Park. Lisa Moore is with Health Education, San Francisco State University, San Francisco, CA. Vanessa Simonds is with Health & Human Development, Montana State University, Bozeman
| | - Zinzi Bailey
- Nancy Krieger, Rebekka Lee, and Pamela D. Waterman are with the Harvard T. H. Chan School of Public Health, Boston, MA. Anne-Emanuelle Birn is with the Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario. Luis Avilés and Nylca Munoz are with the Graduate School of Public Health, University of Puerto Rico, San Juan. Zinzi Bailey is with the Center for Health Equity, New York City Department of Health and Mental Hygiene, New York, NY. Catherine Cubbin is with the School of Social Work, University of Texas, Austin. Craig Dearfield is with Akeso Consulting, Vienna, VA. Marian Moser Jones is with the University of Maryland School of Public Health, College Park. Lisa Moore is with Health Education, San Francisco State University, San Francisco, CA. Vanessa Simonds is with Health & Human Development, Montana State University, Bozeman
| | - Catherine Cubbin
- Nancy Krieger, Rebekka Lee, and Pamela D. Waterman are with the Harvard T. H. Chan School of Public Health, Boston, MA. Anne-Emanuelle Birn is with the Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario. Luis Avilés and Nylca Munoz are with the Graduate School of Public Health, University of Puerto Rico, San Juan. Zinzi Bailey is with the Center for Health Equity, New York City Department of Health and Mental Hygiene, New York, NY. Catherine Cubbin is with the School of Social Work, University of Texas, Austin. Craig Dearfield is with Akeso Consulting, Vienna, VA. Marian Moser Jones is with the University of Maryland School of Public Health, College Park. Lisa Moore is with Health Education, San Francisco State University, San Francisco, CA. Vanessa Simonds is with Health & Human Development, Montana State University, Bozeman
| | - Craig Dearfield
- Nancy Krieger, Rebekka Lee, and Pamela D. Waterman are with the Harvard T. H. Chan School of Public Health, Boston, MA. Anne-Emanuelle Birn is with the Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario. Luis Avilés and Nylca Munoz are with the Graduate School of Public Health, University of Puerto Rico, San Juan. Zinzi Bailey is with the Center for Health Equity, New York City Department of Health and Mental Hygiene, New York, NY. Catherine Cubbin is with the School of Social Work, University of Texas, Austin. Craig Dearfield is with Akeso Consulting, Vienna, VA. Marian Moser Jones is with the University of Maryland School of Public Health, College Park. Lisa Moore is with Health Education, San Francisco State University, San Francisco, CA. Vanessa Simonds is with Health & Human Development, Montana State University, Bozeman
| | - Marian Moser Jones
- Nancy Krieger, Rebekka Lee, and Pamela D. Waterman are with the Harvard T. H. Chan School of Public Health, Boston, MA. Anne-Emanuelle Birn is with the Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario. Luis Avilés and Nylca Munoz are with the Graduate School of Public Health, University of Puerto Rico, San Juan. Zinzi Bailey is with the Center for Health Equity, New York City Department of Health and Mental Hygiene, New York, NY. Catherine Cubbin is with the School of Social Work, University of Texas, Austin. Craig Dearfield is with Akeso Consulting, Vienna, VA. Marian Moser Jones is with the University of Maryland School of Public Health, College Park. Lisa Moore is with Health Education, San Francisco State University, San Francisco, CA. Vanessa Simonds is with Health & Human Development, Montana State University, Bozeman
| | - Rebekka Lee
- Nancy Krieger, Rebekka Lee, and Pamela D. Waterman are with the Harvard T. H. Chan School of Public Health, Boston, MA. Anne-Emanuelle Birn is with the Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario. Luis Avilés and Nylca Munoz are with the Graduate School of Public Health, University of Puerto Rico, San Juan. Zinzi Bailey is with the Center for Health Equity, New York City Department of Health and Mental Hygiene, New York, NY. Catherine Cubbin is with the School of Social Work, University of Texas, Austin. Craig Dearfield is with Akeso Consulting, Vienna, VA. Marian Moser Jones is with the University of Maryland School of Public Health, College Park. Lisa Moore is with Health Education, San Francisco State University, San Francisco, CA. Vanessa Simonds is with Health & Human Development, Montana State University, Bozeman
| | - Lisa Moore
- Nancy Krieger, Rebekka Lee, and Pamela D. Waterman are with the Harvard T. H. Chan School of Public Health, Boston, MA. Anne-Emanuelle Birn is with the Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario. Luis Avilés and Nylca Munoz are with the Graduate School of Public Health, University of Puerto Rico, San Juan. Zinzi Bailey is with the Center for Health Equity, New York City Department of Health and Mental Hygiene, New York, NY. Catherine Cubbin is with the School of Social Work, University of Texas, Austin. Craig Dearfield is with Akeso Consulting, Vienna, VA. Marian Moser Jones is with the University of Maryland School of Public Health, College Park. Lisa Moore is with Health Education, San Francisco State University, San Francisco, CA. Vanessa Simonds is with Health & Human Development, Montana State University, Bozeman
| | - Nylca Munoz
- Nancy Krieger, Rebekka Lee, and Pamela D. Waterman are with the Harvard T. H. Chan School of Public Health, Boston, MA. Anne-Emanuelle Birn is with the Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario. Luis Avilés and Nylca Munoz are with the Graduate School of Public Health, University of Puerto Rico, San Juan. Zinzi Bailey is with the Center for Health Equity, New York City Department of Health and Mental Hygiene, New York, NY. Catherine Cubbin is with the School of Social Work, University of Texas, Austin. Craig Dearfield is with Akeso Consulting, Vienna, VA. Marian Moser Jones is with the University of Maryland School of Public Health, College Park. Lisa Moore is with Health Education, San Francisco State University, San Francisco, CA. Vanessa Simonds is with Health & Human Development, Montana State University, Bozeman
| | - Vanessa Simonds
- Nancy Krieger, Rebekka Lee, and Pamela D. Waterman are with the Harvard T. H. Chan School of Public Health, Boston, MA. Anne-Emanuelle Birn is with the Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario. Luis Avilés and Nylca Munoz are with the Graduate School of Public Health, University of Puerto Rico, San Juan. Zinzi Bailey is with the Center for Health Equity, New York City Department of Health and Mental Hygiene, New York, NY. Catherine Cubbin is with the School of Social Work, University of Texas, Austin. Craig Dearfield is with Akeso Consulting, Vienna, VA. Marian Moser Jones is with the University of Maryland School of Public Health, College Park. Lisa Moore is with Health Education, San Francisco State University, San Francisco, CA. Vanessa Simonds is with Health & Human Development, Montana State University, Bozeman
| | - Pamela D Waterman
- Nancy Krieger, Rebekka Lee, and Pamela D. Waterman are with the Harvard T. H. Chan School of Public Health, Boston, MA. Anne-Emanuelle Birn is with the Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario. Luis Avilés and Nylca Munoz are with the Graduate School of Public Health, University of Puerto Rico, San Juan. Zinzi Bailey is with the Center for Health Equity, New York City Department of Health and Mental Hygiene, New York, NY. Catherine Cubbin is with the School of Social Work, University of Texas, Austin. Craig Dearfield is with Akeso Consulting, Vienna, VA. Marian Moser Jones is with the University of Maryland School of Public Health, College Park. Lisa Moore is with Health Education, San Francisco State University, San Francisco, CA. Vanessa Simonds is with Health & Human Development, Montana State University, Bozeman
| |
Collapse
|
47
|
Rule A, Moore L. The commissioning and implementation of total body irradiation at Livingstone Hospital. Phys Med 2017. [DOI: 10.1016/s1120-1797(17)30290-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
48
|
Chan O, Moore L, Lai B, Jeong E, Nelson L, Malik F, Sykes J, Mathur S, Wu K. WS04.5 Predicting six-minute walk distance in adults with cystic fibrosis during hospitalisation. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30179-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
49
|
Goranova T, Ennis D, Piskorz AM, Macintyre G, Lewsley LA, Stobo J, Wilson C, Kay D, Glasspool RM, Lockley M, Brockbank E, Montes A, Walther A, Sundar S, Edmondson R, Hall GD, Clamp A, Gourley C, Hall M, Fotopoulou C, Gabra H, Freeman S, Moore L, Jimenez-Linan M, Paul J, Brenton JD, McNeish IA. Safety and utility of image-guided research biopsies in relapsed high-grade serous ovarian carcinoma-experience of the BriTROC consortium. Br J Cancer 2017; 116:1294-1301. [PMID: 28359078 PMCID: PMC5482731 DOI: 10.1038/bjc.2017.86] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 02/28/2017] [Accepted: 03/03/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Investigating tumour evolution and acquired chemotherapy resistance requires analysis of sequential tumour material. We describe the feasibility of obtaining research biopsies in women with relapsed ovarian high-grade serous carcinoma (HGSC). METHODS Women with relapsed ovarian HGSC underwent either image-guided biopsy or intra-operative biopsy during secondary debulking, and samples were fixed in methanol-based fixative. Tagged-amplicon sequencing was performed on biopsy DNA. RESULTS We screened 519 patients in order to enrol 220. Two hundred and two patients underwent successful biopsy, 118 of which were image-guided. There were 22 study-related adverse events (AE) in the image-guided biopsies, all grades 1 and 2; pain was the commonest AE. There were pre-specified significant AE in 3/118 biopsies (2.5%). 87% biopsies were fit-for-purpose for genomic analyses. Median DNA yield was 2.87 μg, and was higher in biopsies utilising 14 G or 16 G needles compared to 18 G. TP53 mutations were identified in 94.4% patients. CONCLUSIONS Obtaining tumour biopsies for research in relapsed HGSC is safe and feasible. Adverse events are rare. The large majority of biopsies yield sufficient DNA for genomic analyses-we recommend use of larger gauge needles and methanol fixation for such biopsies, as DNA yields are higher but with no increase in AEs.
Collapse
Affiliation(s)
- T Goranova
- Cancer Research UK Cambridge Institute, Cambridge CB2 0RE, UK
| | - D Ennis
- Institute of Cancer Sciences, University of Glasgow, G61 1QH, UK
| | - A M Piskorz
- Cancer Research UK Cambridge Institute, Cambridge CB2 0RE, UK
| | - G Macintyre
- Cancer Research UK Cambridge Institute, Cambridge CB2 0RE, UK
| | - L A Lewsley
- Cancer Research UK Clinical Trials Unit, Glasgow G12 0YN, UK
| | - J Stobo
- Cancer Research UK Clinical Trials Unit, Glasgow G12 0YN, UK
| | - C Wilson
- Cancer Research UK Clinical Trials Unit, Glasgow G12 0YN, UK
| | - D Kay
- Department of Radiology, Gartnavel General Hospital, Glasgow G12 0YN, UK
| | - R M Glasspool
- Beatson West of Scotland Cancer Centre, Glasgow G12 0YN, UK
| | - M Lockley
- Barts Cancer Institute, London EC1M 6BQ, UK
- University College Hospital, London WC1E 6BD, UK
| | | | - A Montes
- Guy’s Hospital, London SE1 9RT, UK
| | - A Walther
- Bristol Haematology and Oncology Centre, Bristol BS2 8ED, UK
| | - S Sundar
- City Hospital, Birmingham B18 7QH, UK
| | | | - G D Hall
- St James Hospital, Leeds LS9 7TF, UK
| | - A Clamp
- The Christie Hospital, Manchester M20 4BX, UK
| | - C Gourley
- Edinburgh Cancer Research Centre, Edinburgh EH4 2XR, UK
| | - M Hall
- Mount Vernon Cancer Centre, Northwood HA6 2RN, UK
| | | | - H Gabra
- Imperial College, London W12 0HS, UK
| | - S Freeman
- Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK
| | - L Moore
- Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK
| | | | - J Paul
- Cancer Research UK Clinical Trials Unit, Glasgow G12 0YN, UK
| | - J D Brenton
- Cancer Research UK Cambridge Institute, Cambridge CB2 0RE, UK
- Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK
| | - I A McNeish
- Institute of Cancer Sciences, University of Glasgow, G61 1QH, UK
- Beatson West of Scotland Cancer Centre, Glasgow G12 0YN, UK
| |
Collapse
|
50
|
Evans S, Moore L, Jeyarajan H, Cole D, Calhoun D, Withrow K. 0579 HYPOGLOSSAL NERVE STIMULATION: A HIGHLY EFFECTIVE, LOW MORBIDITY ALTERNATIVE FOR TREATMENT OF OBSTRUCTIVE SLEEP APNEA IN SELECT CPAP-INTOLERANT PATIENTS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|