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O'Brien JM, Dinh D, Roberts L, Teh A, Brennan A, Duffy SJ, Clark D, Ajani A, Oqueli E, Sebastian M, Reid C, Econ CH, Freeman M, Chandrasekhar J. Associations Between Metabolic Syndrome and Long-Term Mortality in Patients who underwent Percutaneous Coronary Intervention: An Australian Cohort Analysis. Am J Cardiol 2024; 219:25-34. [PMID: 38447892 DOI: 10.1016/j.amjcard.2024.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 02/06/2024] [Accepted: 02/23/2024] [Indexed: 03/08/2024]
Abstract
Metabolic syndrome (MetS) provides significant risk for coronary disease, however long-term prognosis after percutaneous coronary intervention (PCI) has been understudied. We assessed the prevalence and outcomes of patients with MetS from an Australian PCI cohort. We retrospectively examined data from the Melbourne Interventional Group multicenter PCI registry using a modified definition for MetS including ≥3 of the following: hypertension, diabetes mellitus, dyslipidemia, and body mass index ≥30 kg/m2. Thirty-day outcomes and long-term mortality were compared with patients without MetS. Cox regression methods were used to assess the multivariable effect of MetS on long-term mortality. Of 41,146 patients, 12,228 (34%) had MetS. Patients with MetS experienced greater 30-day myocardial infarction (2.2% vs 1.8%, p = 0.013), whereas patients without MetS had a trend for greater 30-day mortality (3.0% vs 3.4%, p = 0.051) and greater in-hospital major bleeding (1.7% vs 2.4%, p <0.001). After a median follow-up of 5.62 years (Q1 2.03, Q3 8.89), patients with MetS experienced greater mortality (24% vs 19%, p <0.001). After adjustment, MetS was not an independent predictor of long-term mortality (hazard ratio 0.95 confidence interval 0.86 to 1.05, p = 0.35). In sensitivity analyses, MetS-Diabetic patients had the highest, and MetS-NonDiabetic obese patients had the lowest long-term mortality. One in 3 patients who underwent all-comer PCI presented with MetS and experienced greater long-term mortality compared with others. However, this association was lost after adjustment for baseline confounders, highlighting that MetS is a marker of risk after PCI. Our findings support the obesity paradox and confirm robust associations between diabetes mellitus and long-term mortality.
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Affiliation(s)
- Joseph M O'Brien
- Department of Cardiology, Eastern Health, Box Hill, Victoria, Australia
| | - Diem Dinh
- Centre of Cardiovascular Research & Education in Therapeutics, Department of Epidemiology and Preventive Medicine
| | - Louise Roberts
- Department of Cardiology, Eastern Health, Box Hill, Victoria, Australia
| | - Andrew Teh
- Department of Cardiology, Eastern Health, Box Hill, Victoria, Australia; Eastern Health Clinical School, Monash University, Victoria, Australia
| | - Angela Brennan
- Centre of Cardiovascular Research & Education in Therapeutics, Department of Epidemiology and Preventive Medicine
| | - Stephen J Duffy
- Centre of Cardiovascular Research & Education in Therapeutics, Department of Epidemiology and Preventive Medicine
| | - David Clark
- Department of Cardiology, Austin Health, Heidelberg, Victoria Australia; Department of Cardiology, University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Ajani
- Department of Cardiology, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Ernesto Oqueli
- Department of Cardiology, Ballarat Health Service, Ballarat, Victoria, Australia
| | - Martin Sebastian
- Department of Cardiology, Barwon Health, University Hospital Geelong, Geelong, Victoria Australia
| | - Christopher Reid
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Cert Health Econ
- Centre of Cardiovascular Research & Education in Therapeutics, Department of Epidemiology and Preventive Medicine; Royal Melbourne Hospital, Curtin University, Perth, Western Australia, Australia
| | - Melanie Freeman
- Department of Cardiology, Eastern Health, Box Hill, Victoria, Australia
| | - Jaya Chandrasekhar
- Department of Cardiology, Eastern Health, Box Hill, Victoria, Australia; Eastern Health Clinical School, Monash University, Victoria, Australia.
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Adolph L, Mann A, Liu XQ, Roberts L, Robinson C, Popowich S, Dean E, Kean S, Fischer G, Altman AD. Follow-up of women with cervical adenocarcinoma in situ treated by conization: A single centre clinical experience. Gynecol Oncol 2024; 187:74-79. [PMID: 38733955 DOI: 10.1016/j.ygyno.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 04/25/2024] [Accepted: 05/05/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVE Hysterectomy has been the historical gold standard final step in the treatment algorithm of adenocarcinoma in situ (AIS) recommended by most North American colposcopy guidelines. AIS disproportionately affects young childbearing age women, therefore a fertility sparing treatment option is desirable. Our study examines the impact of conservative treatment of AIS with conization followed by serial surveillance. METHODS A retrospective chart review was completed of patients treated for AIS from 2006 to 2020. Charts were identified by pathologic diagnosis of AIS on cervical and uterine specimens. Charts were excluded if AIS was not treated with conization, if AIS was not confirmed on initial conization specimen, or if invasive disease was found at initial conization. RESULTS 121 patient charts were analyzed. Median age of patients at first conization and hysterectomy was 34.8 and 40.9, respectively. First conization was by Cold Knife Cone in 58% of patients, and by Loop Electrosurgical Excisional Procedure in 42% of patients. Median follow-up period in our study was 609 days. 5% of patients had recurrence, with only one patient who recurred as cancer. One case of recurrence had a positive initial conization margin. Median time to recurrence was 700 days. 47% of patients underwent eventual hysterectomy. Residual AIS was found in 23% of hysterectomy specimens. Adenocarcinoma was diagnosed on hysterectomy specimen in four patients. CONCLUSION Our study demonstrates the oncologic safety of treating AIS with conization and serial surveillance. Routine hysterectomy completed as a part of the AIS treatment algorithm, as in current clinical guidelines, is unnecessary.
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Affiliation(s)
- L Adolph
- Department of Obstetrics, Gynecology and Reproductive Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
| | - A Mann
- Department of Obstetrics, Gynecology and Reproductive Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - X Q Liu
- Department of Obstetrics, Gynecology and Reproductive Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - L Roberts
- Department of Obstetrics, Gynecology and Reproductive Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - C Robinson
- Department of Obstetrics, Gynecology and Reproductive Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - S Popowich
- Department of Obstetrics, Gynecology and Reproductive Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - E Dean
- Department of Obstetrics, Gynecology and Reproductive Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - S Kean
- Department of Obstetrics, Gynecology and Reproductive Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - G Fischer
- Department of Pathology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - A D Altman
- Department of Obstetrics, Gynecology and Reproductive Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; CancerCare Manitoba, Winnipeg, Manitoba, Canada
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Lawn S, Waddell E, Roberts L, Rioseco P, Beks T, Sharp T, McNeill L, Everitt D, Bowes L, Mordaunt D, Tarrant A, Van Hooff M, Lane J, Wadham B. No Women's Land: Australian Women Veterans' Experiences of the Culture of Military Service and Transition. Int J Environ Res Public Health 2024; 21:479. [PMID: 38673390 PMCID: PMC11050049 DOI: 10.3390/ijerph21040479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/01/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
Women's experiences of military service and transition occur within a highly dominant masculinized culture. The vast majority of research on military veterans reflects men's experiences and needs. Women veterans' experiences, and therefore their transition support needs, are largely invisible. This study sought to understand the role and impact of gender in the context of the dominant masculinized culture on women veterans' experiences of military service and transition to civilian life. In-depth qualitative interviews with 22 Australian women veterans elicited four themes: (1) Fitting in a managing identity with the military; (2) Gender-based challenges in conforming to a masculinized culture-proving worthiness, assimilation, and survival strategies within that culture; (3) Women are valued less than men-consequences for women veterans, including misogyny, sexual harassment and assault, and system failures to recognize women's specific health needs and role as mothers; and (4) Separation and transition: being invisible as a woman veteran in the civilian world. Gendered military experiences can have long-term negative impacts on women veterans' mental and physical health, relationships, and identity due to a pervasive masculinized culture in which they remain largely invisible. This can create significant gender-based barriers to services and support for women veterans during their service, and it can also impede their transition support needs.
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Affiliation(s)
- Sharon Lawn
- Flinders University, Adelaide, SA 5042, Australia; (E.W.); (L.R.); (L.M.); (D.M.); (B.W.)
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia; (T.B.); (T.S.); (D.E.); (L.B.); (A.T.)
- Lived Experience Australia, Adelaide, SA 5042, Australia
| | - Elaine Waddell
- Flinders University, Adelaide, SA 5042, Australia; (E.W.); (L.R.); (L.M.); (D.M.); (B.W.)
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia; (T.B.); (T.S.); (D.E.); (L.B.); (A.T.)
| | - Louise Roberts
- Flinders University, Adelaide, SA 5042, Australia; (E.W.); (L.R.); (L.M.); (D.M.); (B.W.)
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia; (T.B.); (T.S.); (D.E.); (L.B.); (A.T.)
| | - Pilar Rioseco
- Australian Institute of Family Studies, Melbourne, VIC 3006, Australia;
| | - Tiffany Beks
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia; (T.B.); (T.S.); (D.E.); (L.B.); (A.T.)
- School of Education, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Tiffany Sharp
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia; (T.B.); (T.S.); (D.E.); (L.B.); (A.T.)
- Cambrian Executive, Adelaide, SA 5000, Australia
| | - Liz McNeill
- Flinders University, Adelaide, SA 5042, Australia; (E.W.); (L.R.); (L.M.); (D.M.); (B.W.)
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia; (T.B.); (T.S.); (D.E.); (L.B.); (A.T.)
| | - David Everitt
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia; (T.B.); (T.S.); (D.E.); (L.B.); (A.T.)
- Defence Force Welfare Association SA, Adelaide, SA 5000, Australia
| | - Lee Bowes
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia; (T.B.); (T.S.); (D.E.); (L.B.); (A.T.)
- Defence Force Welfare Association SA, Adelaide, SA 5000, Australia
| | - Dylan Mordaunt
- Flinders University, Adelaide, SA 5042, Australia; (E.W.); (L.R.); (L.M.); (D.M.); (B.W.)
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia; (T.B.); (T.S.); (D.E.); (L.B.); (A.T.)
- Southern Adelaide Local Health Network, Adelaide, SA 5042, Australia
| | - Amanda Tarrant
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia; (T.B.); (T.S.); (D.E.); (L.B.); (A.T.)
- Veterans SA, Adelaide, SA 5000, Australia
| | - Miranda Van Hooff
- Military and Services Health Australia (MESHA), Adelaide, SA 5011, Australia;
| | - Jonathan Lane
- Department of Psychiatry, University of Tasmania, Hobart, TAS 7005, Australia;
| | - Ben Wadham
- Flinders University, Adelaide, SA 5042, Australia; (E.W.); (L.R.); (L.M.); (D.M.); (B.W.)
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia; (T.B.); (T.S.); (D.E.); (L.B.); (A.T.)
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Scully TG, Kelsang T, Backhouse B, Sajeev JK, Roberts L, Pathik B, Teh AW. Correlation of ventricular pacing burden and left ventricular function in patients with heart failure with reduced ejection fraction. J Cardiovasc Electrophysiol 2024; 35:301-306. [PMID: 38100289 DOI: 10.1111/jce.16155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/20/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Pacemaker-induced cardiomyopathy is a well described phenomenon in patients with preserved ejection fraction at the time of permanent pacemaker implant. One of the identified risk factors for pacemaker-induced cardiomyopathy is the degree of ventricular pacing burden. However, it is unclear how a high right ventricular pacing burden affects patients with depressed left ventricular function at the time of pacemaker implantation. We sought to assess the relationship between right ventricular pacing and change in left ventricular function over time. METHODS We conducted an analysis of all patients who had received either a single or dual lead cardiac implantable electronic devices, excluding biventricular devices, and had a prior transthoracic echocardiogram demonstrating an ejection fraction of less than 50%. The primary end-point was the correlation between the percentage of ventricular pacing and the change in LV ejection fraction. RESULTS Fifty eight patients with preceding heart failure had pacemakers implanted and had follow up echocardiograms. There was no correlation between the degree of ventricular pacing and the absolute change in LV function (r = .04, p = .979). None of the previously identified risk factors for pacemaker induced cardiomyopathy were predictive of a significant fall in ejection fraction. CONCLUSION The degree of RV pacing and other established risk factors for pacemaker-induced cardiomyopathy in patients with normal left ventricular function at the time of implantation do not appear to carry the same risk in patients with pre-existing heart failure who receive either single or dual lead pacemakers.
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Affiliation(s)
- Timothy G Scully
- Department of Cardiology, Eastern Health, Box Hill Hospital, Box Hill, Victoria, Australia
| | - Tenzin Kelsang
- Department of Cardiology, Eastern Health, Box Hill Hospital, Box Hill, Victoria, Australia
| | - Brendan Backhouse
- Department of Cardiology, Eastern Health, Box Hill Hospital, Box Hill, Victoria, Australia
| | - Jithin K Sajeev
- Department of Cardiology, Eastern Health, Box Hill Hospital, Box Hill, Victoria, Australia
| | - Louise Roberts
- Department of Cardiology, Eastern Health, Box Hill Hospital, Box Hill, Victoria, Australia
| | - Bhupesh Pathik
- Department of Cardiology, Eastern Health, Box Hill Hospital, Box Hill, Victoria, Australia
| | - Andrew W Teh
- Department of Cardiology, Eastern Health, Box Hill Hospital, Box Hill, Victoria, Australia
- Eastern Health Clinical School, Box Hill Hospital, Monash University, Victoria, Australia
- Department of Cardiology, Austin Hospital Clinical School, The University of Melbourne, Parkville, Victoria, Australia
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Waddell E, Rioseco P, Van Hooff M, Daraganova G, Lawrence D, Rikkers W, Roberts L, Beks T, Sharp T, Wadham B, Lawn S. Families' experiences of supporting Australian veterans to seek help for a mental health problem: a linked data analysis of national surveys with families and veterans. J Ment Health 2023; 32:899-909. [PMID: 36880331 DOI: 10.1080/09638237.2023.2182418] [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: 05/21/2022] [Revised: 11/11/2022] [Accepted: 11/16/2022] [Indexed: 03/08/2023]
Abstract
BACKGROUND Families play a critical role in supporting currently serving and transitioned veterans' wellbeing and help-seeking for mental health concerns; however, little is known about families' experiences. AIMS This study used Australian national survey linked-data (n = 1217) from families (Family Wellbeing Study-FWS) and veterans (Mental Health Wellbeing Transition Study-MHWTS) to understand veteran-family help-seeking relationships. METHODS Veterans' and family members' responses to mental health and help-seeking questions in FWS and MHWTS datasets from perspective of family members were cross-tabulated. Help-seeking support provided by family members was compared by veterans' probable disorder. RESULTS Results highlighted high levels of involvement and continuous assistance provided by families. Two in three family members thought the veteran had probable mental health concerns although they have never been diagnosed or treated. Clear disparities between family and veteran perspectives regarding mental health concerns indicates the extent of non-treatment seeking in this population, missed opportunities for early intervention, and need for greater support to families to promote help-seeking. CONCLUSIONS Encouraging help-seeking is complex for veteran families particularly where veterans' reluctance to seek help may lead to family relationship strain and conflict. Families need early information, support, and recognition by service agencies of the role of the family in encouraging help-seeking.
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Affiliation(s)
- Elaine Waddell
- Flinders University, Adelaide, South Australia, Australia
- Open Door Initiative, Flinders University, Adelaide, South Australia, Australia
| | - Pilar Rioseco
- Australian Institute of Family Studies, Melbourne, Victoria, Australia
| | - Miranda Van Hooff
- Military and Emergency Services Health Australia (MESHA), The Hospital Research Foundation Group, Adelaide, South Australia, Australia
- University of South Australia Adelaide, South Australia, Australia
- University of Adelaide, Adelaide, South Australia
| | - Galina Daraganova
- Australian Institute of Family Studies, Melbourne, Victoria, Australia
- South-Eastern Melbourne Primary Health Network, Melbourne, Victoria, Australia
| | - David Lawrence
- Open Door Initiative, Flinders University, Adelaide, South Australia, Australia
- Curtin University, Perth, Western Australia, Australia
| | - Wavne Rikkers
- Curtin University, Perth, Western Australia, Australia
| | - Louise Roberts
- Flinders University, Adelaide, South Australia, Australia
- Open Door Initiative, Flinders University, Adelaide, South Australia, Australia
| | - Tiffany Beks
- Open Door Initiative, Flinders University, Adelaide, South Australia, Australia
- University of Calgary, Calgary, Alberta, Canada
| | - Tiffany Sharp
- Flinders University, Adelaide, South Australia, Australia
- Open Door Initiative, Flinders University, Adelaide, South Australia, Australia
| | - Ben Wadham
- Flinders University, Adelaide, South Australia, Australia
- Open Door Initiative, Flinders University, Adelaide, South Australia, Australia
| | - Sharon Lawn
- Flinders University, Adelaide, South Australia, Australia
- Open Door Initiative, Flinders University, Adelaide, South Australia, Australia
- Lived Experience Australia Ltd, Adelaide, South Australia, Australia
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Roberts L, Rice AN. Vibrational and acoustic communication in fishes: The overlooked overlap between the underwater vibroscape and soundscape. J Acoust Soc Am 2023; 154:2708-2720. [PMID: 37888943 DOI: 10.1121/10.0021878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/20/2023] [Indexed: 10/28/2023]
Abstract
Substrate-borne communication via mechanical waves is widespread throughout the animal kingdom but has not been intensively studied in fishes. Families such as the salmonids and sculpins have been documented to produce vibratory signals. However, it is likely that fish taxa on or close to the substrate that produce acoustic signals will also have a vibratory component to their signal due to their proximity to substrates and energy transfer between media. Fishes present an intriguing opportunity to study vibrational communication, particularly in the context of signal production and detection, detection range, and how vibratory signals may complement or replace acoustic signals. It is highly likely that the vibrational landscape, the vibroscape, is an important component of their sensory world, which certainly includes and overlaps with the soundscape. With the wide range of anthropogenic activities modifying underwater substrates, vibrational noise presents similar risks as acoustic noise pollution for fishes that depend on vibrational communication. However, in order to understand vibrational noise, more empirical studies are required to investigate the role of vibrations in the fish environment.
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Affiliation(s)
- Louise Roberts
- School of Environmental Sciences, University of Liverpool, Liverpool, L69 3GP, United Kingdom
| | - Aaron N Rice
- K. Lisa Yang Center for Conservation Bioacoustics Cornell Lab of Ornithology, Cornell University, Ithaca, New York 14850, USA
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Rajakariar K, Andrianopoulos N, Gayed D, Liang D, Backhouse B, Ajani AE, Duffy SJ, Brennan A, Roberts L, Reid CM, Oqueli E, Clark D, Freeman M. Outcomes of thrombus aspiration during primary percutaneous coronary intervention for ST-elevation myocardial infarction. Intern Med J 2023; 53:1376-1382. [PMID: 35670161 DOI: 10.1111/imj.15828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 06/01/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Previous large multi-centre randomised controlled trials have not provided clear benefit with routine intracoronary thrombus aspiration (TA) as an adjunct to primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). AIM To determine whether there is a difference in outcomes with the use of manual TA prior to PCI, compared with PCI alone in a cohort of patients with STEMI. METHODS We analysed data from 6270 consecutive patients undergoing primary PCI for STEMI prospectively enrolled in the Melbourne Interventional Group registry between 2007 and 2018. Multivariable analysis was performed to determine predictors of 30-day major adverse cardiovascular and cerebrovascular events (MACCE) and long-term mortality. RESULTS We compared 1621 (26%) patients undergoing primary PCI with TA to 4649 (74%) patients undergoing PCI alone. Male gender (81% vs 78%; P < 0.01), younger age (61 vs 63 years; P = 0.03), GP-IIb/IIIa use (76% vs 58%, P < 0.01), and current smoking (40% vs 36%; P < 0.01) were more common in the TA group. TA was more likely to be used in patients with complex lesions (83% vs 66%; P < 0.01) with TIMI 0 flow (77% vs 56%; P < 0.01). No significant difference in post-procedural TIMI flow, stroke, 30-day mortality, or long-term mortality were identified. Multivariable analysis demonstrated a reduction in 30-day MACCE (hazard ratio (HR) 0.75; confidence interval (CI) 0.63-0.89; P < 0.01) in the TA group, but was not associated with long-term mortality (HR 0.98; CI 0.85-1.1; P = 0.73). CONCLUSION The use of TA in patients undergoing primary PCI for STEMI was not associated with improved short or long-term mortality when compared with PCI alone.
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Affiliation(s)
- Kevin Rajakariar
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
| | - Nick Andrianopoulos
- Centre of Cardiovascular Research and Education in Therapeutics (CCRE), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Daniel Gayed
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
| | - Danlu Liang
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
| | - Brendan Backhouse
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
| | - Andrew E Ajani
- Department of Cardiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Stephen J Duffy
- Department of Cardiology, Alfred Health, Melbourne, Victoria, Australia
| | - Angela Brennan
- Centre of Cardiovascular Research and Education in Therapeutics (CCRE), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Louise Roberts
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
| | - Christopher M Reid
- Centre of Cardiovascular Research and Education in Therapeutics (CCRE), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ernesto Oqueli
- Department of Cardiology, Ballarat Health Services, Ballarat, Victoria, Australia
| | - David Clark
- Department of Cardiology, Austin Health, Melbourne, Victoria, Australia
| | - Melanie Freeman
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
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Popper AN, Haxel J, Staines G, Guan S, Nedelec SL, Roberts L, Deng ZD. Marine energy converters: Potential acoustic effects on fishes and aquatic invertebrates. J Acoust Soc Am 2023; 154:518-532. [PMID: 37497961 DOI: 10.1121/10.0020150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/26/2023] [Indexed: 07/28/2023]
Abstract
The potential effects of underwater anthropogenic sound and substrate vibration from offshore renewable energy development on the behavior, fitness, and health of aquatic animals is a continuing concern with increased deployments and installation of these devices. Initial focus of related studies concerned offshore wind. However, over the past decade, marine energy devices, such as a tidal turbines and wave energy converters, have begun to emerge as additional, scalable renewable energy sources. Because marine energy converters (MECs) are not as well-known as other anthropogenic sources of potential disturbance, their general function and what is known about the sounds and substrate vibrations that they produce are introduced. While most previous studies focused on MECs and marine mammals, this paper considers the potential of MECs to cause acoustic disturbances affecting nearshore and tidal fishes and invertebrates. In particular, the focus is on particle motion and substrate vibration from MECs because these effects are the most likely to be detected by these animals. Finally, an analysis of major data gaps in understanding the acoustics of MECs and their potential impacts on fishes and aquatic invertebrates and recommendations for research needed over the next several years to improve understanding of these potential impacts are provided.
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Affiliation(s)
- Arthur N Popper
- Department of Biology, University of Maryland, College Park, Maryland 20742, USA
| | - Joseph Haxel
- Pacific Northwest National Laboratory, Coastal Sciences Division, Sequim, Washington 98382, USA
| | - Garrett Staines
- Pacific Northwest National Laboratory, Coastal Sciences Division, Sequim, Washington 98382, USA
| | - Shane Guan
- Bureau of Ocean Energy Management, Environmental Studies Program, Sterling, Virginia 20166, USA
| | - Sophie L Nedelec
- Department of Biosciences, University of Exeter, Exeter, United Kingdom
| | - Louise Roberts
- Department of Earth, Ocean and Ecological Sciences, School of Environmental Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Zhiqun D Deng
- Pacific Northwest National Laboratory, Earth Systems Science Division, Richland, Washington 99354, USA
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Enayati A, Gin JH, Sajeev JK, Cooke JC, Carey P, MacPherson M, Roberts L, Buntine P, Teh AW, Nogic J. Efficacy of intravenous magnesium for the management of non-post operative atrial fibrillation with rapid ventricular response: A systematic review and meta-analysis. J Cardiovasc Electrophysiol 2023; 34:1286-1295. [PMID: 37186322 DOI: 10.1111/jce.15911] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/05/2023] [Accepted: 04/09/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Intravenous magnesium (IV Mg), a commonly utilized therapeutic agent in the management of atrial fibrillation (AF) with rapid ventricular response, is thought to exert its influence via its effect on cellular automaticity and prolongation of atrial and atrioventricular nodal refractoriness thus reducing ventricular rate. We sought to undertake a systematic review and meta-analysis of the effectiveness of IV Mg versus placebo in addition to standard pharmacotherapy in the rate and rhythm control of AF in the nonpostoperative patient cohort given that randomized control trials (RCTs) have shown conflicting results. METHODS Randomized controlled trials comparing IV Mg versus placebo in addition to standard of care were identified via electronic database searches. Nine RCTs were returned with a total of 1048 patients. Primary efficacy endpoints were study-defined rate control and rhythm control/reversion to sinus rhythm. The secondary endpoint was patient experienced side effects. RESULTS Our analysis found IV Mg in addition to standard care was successful in achieving rate control (odd ratio [OR] 1.87, 95% confidence interval [CI] 1.13-3.11, p = .02) and rhythm control (OR 1.45, 95% CI 1.04-2.03, p = .03). Although not well reported among studies, there was no significant difference between groups regarding the likelihood of experiencing side effects. CONCLUSIONS IV Mg, in addition to standard-of-care pharmacotherapy, increases the rates of successful rate and rhythm control in nonpostoperative patients with AF with rapid ventricular response and is well tolerated.
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Affiliation(s)
- Anees Enayati
- Department of Cardiology, Austin Hospital, Melbourne, Victoria, Australia
| | - Julian H Gin
- Department of Cardiology, Austin Hospital, Melbourne, Victoria, Australia
| | - Jithin K Sajeev
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Jennifer C Cooke
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Patrick Carey
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
| | - Michael MacPherson
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
| | - Louise Roberts
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Paul Buntine
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
- Emergency Medicine Program, Eastern Health, Melbourne, Victoria, Australia
| | - Andrew W Teh
- Department of Cardiology, Austin Hospital, Melbourne, Victoria, Australia
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
- Austin Health Clinical School, University of Melbourne, Melbourne, Victoria, Australia
| | - Jason Nogic
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
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10
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Harrison SL, Lawrence J, Suri S, Rapley T, Loughran K, Edwards J, Roberts L, Martin D, Lally JE. Online comic-based art workshops as an innovative patient and public involvement and engagement approach for people with chronic breathlessness. Res Involv Engagem 2023; 9:19. [PMID: 36997996 PMCID: PMC10062249 DOI: 10.1186/s40900-023-00423-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/10/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Talking about breathlessness can be emotionally challenging. People can feel a sense of illegitimacy and discomfort in some research contexts. Comic-based illustration (cartooning) offers an opportunity to communicate in a more creative and inclusive way. We used cartooning in patient and public involvement and engagement (PPIE) work to explore symptoms of breathlessness and their impact on peoples' everyday lives. MAIN BODY Five, 90-min cartooning workshops were delivered online to members of Breathe Easy Darlington (UK). The workshop series involved 5-10 Breathe Easy members and were facilitated by a professional cartoonist supported by three researchers. The experience of living with breathlessness was represented via illustrations of cartoon characters and ideas explored in subsequent conversations. Cartooning was fun and the majority found it a nostalgic experience. Sharing the experience helped the research team develop new understandings of breathlessness and fostered relationships with the Breathe Easy members. The illustrations showed characters leaning against objects, sweating and sitting down, demonstrating living with the sensation of not being in control. CONCLUSION Comic-based art, as a fun and innovative PPIE approach. It facilitated the research team becoming embedded in an existing group who will act as PPIE members on a long-term research programme. Illustrations enabled storytelling and fostered novel insights into the lived experiences of people with breathlessness including sensations of a loss of control, disorientation, and unsteadiness. This will impact on work investigating balance in people with chronic obstructive pulmonary disease. This model has potential to be applied in a range of PPIE and research contexts.
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Affiliation(s)
- Samantha L Harrison
- School of Health and Life Sciences, Teesside University, Borough Road, Middlesbrough, TS1 3BA, UK.
| | - Julian Lawrence
- School of Health and Life Sciences, Teesside University, Borough Road, Middlesbrough, TS1 3BA, UK
| | - Sophie Suri
- School of Health and Life Sciences, Teesside University, Borough Road, Middlesbrough, TS1 3BA, UK
| | - Tim Rapley
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Coach Lane Campus West, Newcastle Upon Tyne, NE7 7XA, UK
| | - Kirsti Loughran
- School of Health and Life Sciences, Teesside University, Borough Road, Middlesbrough, TS1 3BA, UK
| | | | | | - Denis Martin
- School of Health and Life Sciences, Teesside University, Borough Road, Middlesbrough, TS1 3BA, UK
| | - Joanne E Lally
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle Upon Tyne, NE2 4AX, UK
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11
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Fahey JK, Prosser H, Lescai P, Sajeev JK, Yao H, Roberts L, Buntine P, Teh AW. Diabetes mellitus is an independent predictor of obstructive coronary artery disease in patients presenting with atrial fibrillation and elevated troponin. Intern Med J 2023; 53:436-438. [PMID: 36938633 DOI: 10.1111/imj.16027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/12/2022] [Indexed: 03/21/2023]
Abstract
Atrial fibrillation can present with symptoms of myocardial infarction and elevated troponin, even in the absence of obstructive coronary artery disease (CAD). We sought to determine the characteristics that predict underlying obstructive CAD. Obstructive CAD was far more likely in those with troponin elevation. In those with elevated troponin, diabetes mellitus was an independent predictor of obstructive CAD.
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Affiliation(s)
- James K Fahey
- Cardiology Department, Eastern Health, Victoria, Melbourne, Australia
| | - Hamish Prosser
- Cardiology Department, Eastern Health, Victoria, Melbourne, Australia
| | - Prue Lescai
- Cardiology Department, Eastern Health, Victoria, Melbourne, Australia
| | - Jithin K Sajeev
- Cardiology Department, Eastern Health, Victoria, Melbourne, Australia
| | - Harrison Yao
- Cardiology Department, Eastern Health, Victoria, Melbourne, Australia
| | - Louise Roberts
- Cardiology Department, Eastern Health, Victoria, Melbourne, Australia
| | - Paul Buntine
- Cardiology Department, Eastern Health, Victoria, Melbourne, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Andrew W Teh
- Cardiology Department, Eastern Health, Victoria, Melbourne, Australia.,Department of Cardiology, The University of Melbourne, Austin Hospital Clinical School, Victoria, Melbourne, Australia
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12
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Manze M, Kwan A, Jones H, Roberts L, Romero D. P094Sexual and reproductive health advocacy successes, failures, and needs in the US: Perspectives from key stakeholders. Contraception 2022. [DOI: 10.1016/j.contraception.2022.09.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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13
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Lawn S, Waddell E, Rikkers W, Roberts L, Beks T, Lawrence D, Rioseco P, Sharp T, Wadham B, Daraganova G, Van Hooff M. Families' experiences of supporting Australian veterans and emergency service first responders (ESFRs) to seek help for mental health problems. Health Soc Care Community 2022; 30:e4522-e4534. [PMID: 35662301 PMCID: PMC10084143 DOI: 10.1111/hsc.13856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 03/26/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
The objective of this phenomenological study was to describe families' experiences of supporting veterans and emergency service first responders (ESFRs) (known also as public safety personnel) to seek help for a mental health problem. In-depth semi-structured open-ended interviews were undertaken with 25 family members of Australian veterans and ESFRs. Fourteen participants were family members of police officers. Data were analysed thematically. Participants described a long and difficult journey of supporting the person's help-seeking across six themes. Traumatic exposures, bullying in the workplace and lack of organisational support experienced by veterans/ESFRs caused significant family distress. Families played a vital role in help-seeking but were largely ignored by veteran/ESFR organisations. The research provides a rich understanding of distress and moral injury that is experienced not only by the service members but is transferred vicariously to their family within the mental health help-seeking journey. Veteran and ESFR organisations and mental health services need to shift from a predominant view of distress as located within an individual (intrapsychic) towards a life-course view of distress as impacting families and which is more relational, systemic, cultural and contextual.
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Affiliation(s)
- Sharon Lawn
- Flinders UniversityAdelaideSouth AustraliaAustralia
- Lived Experience Australia LtdAdelaideSouth AustraliaAustralia
- Flinders UniversityOpen Door InitiativeAdelaideSouth AustraliaAustralia
| | - Elaine Waddell
- Flinders UniversityAdelaideSouth AustraliaAustralia
- Flinders UniversityOpen Door InitiativeAdelaideSouth AustraliaAustralia
| | - Wavne Rikkers
- Curtin UniversityPerthWestern AustraliaAustralia
- University of Western AustraliaPerthWestern AustraliaAustralia
| | - Louise Roberts
- Flinders UniversityAdelaideSouth AustraliaAustralia
- Flinders UniversityOpen Door InitiativeAdelaideSouth AustraliaAustralia
| | | | - David Lawrence
- Curtin UniversityPerthWestern AustraliaAustralia
- University of Western AustraliaPerthWestern AustraliaAustralia
| | - Pilar Rioseco
- Australian Institute of Family StudiesMelbourneVictoriaAustralia
| | | | - Ben Wadham
- Flinders UniversityAdelaideSouth AustraliaAustralia
- Flinders UniversityOpen Door InitiativeAdelaideSouth AustraliaAustralia
| | - Galina Daraganova
- Australian Institute of Family StudiesMelbourneVictoriaAustralia
- South‐Eastern Melbourne Primary Health NetworkMelbourneVictoriaAustralia
| | - Miranda Van Hooff
- Military and Emergency Services Health Australia (MESHA)The Hospital Research Foundation GroupAdelaideSouth AustraliaAustralia
- University of South Australia AdelaideSouth AustraliaAustralia
- University of AdelaideAdelaideSouth AustraliaAustralia
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14
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Crowley R, Youssef G, Henry A, Roberts L, Brown MA, Hoffman A, Mangos G, O'Sullivan A, Petit F, Xu L, Davis GK. Echocardiographic assessment of left ventricular structure and function in hypertensive disorders of pregnancy at six months and two years postpartum. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Purpose
Hypertensive disorders of pregnancy (HDP) are associated with longer term postpartum cardiovascular sequelae, including double the risk of ischaemic heart disease and cardiovascular mortality (1).
Transthoracic echocardiograms (TTE) were performed in women with pregnancies complicated by gestational hypertension and pre-eclampsia, or uncomplicated pregnancy, at six months and two years postpartum. The aim was to longitudinally assess cardiac structure and function in women with HDP and compare this to women who had a normotensive pregnancy. The six-month results have been previously reported, we now present the two-year data.
Methods
A prospective cohort study was conducted in a pre-specified subgroup of 126 patients within a single, tertiary referral centre as part of the P4 (Post Partum, Physiology, Psychology, and Paediatric Follow Up) study (2). 74 (59%) women had a normotensive pregnancy, and 52 (41%) had a pregnancy complicated by HDP.
Women with pre-existing hypertension were excluded from the study. The mean patient age at time of six-month postpartum TTE was 32 years (range 22–47 years). TTEs were performed by blinded experienced sonographers and reported by a single blinded imaging cardiologist.
Results
Six months postpartum. 126 women underwent TTE at six months postpartum. Although all results fell within normal ranges, compared to women with a normotensive pregnancy, those with HDP had increased left ventricle (LV) wall thickness, higher relative wall thickness, and increased LV mass. E/A ratio was lower, and E/E' ratios higher in the group with pregnancy complicated by HDP, indicating a trend towards poorer diastolic function (2,3).
Two years postpartum. 35 women completed a two year postpartum TTE (18 normotensive, 17 HDP). Measurements fell within normal ranges in both groups of women.
At two years postpartum, women with HDP had larger BSA (1.9 vs 1.71 m2 p=0.003), larger LV internal diastolic diameter (48.4 vs 45.5mm p=0.017) and increased inter-ventricular septum thickness (8.5 vs 7.7mm p=0.007) compared to those with normotensive pregnancy. LV mass was greater in women with HDP (98.1 vs 81.5g), as was LA volume indexed (25.4 vs 23.4 cm3/m3), however these differences did not reach significance (p=0.053 and 0.196 respectively). Compared to normotensive women, those with HDP had higher septal (8.7 vs 7.3 p=0.014) and lateral (6.6 vs 5.4 p=0.017) E/E' ratios, indicating a trend towards diastolic dysfunction.
Conclusion
Despite measurements falling within normal ranges, our results indicate that women with HDP have changes in cardiac structure and function that persist out to two years postpartum. Limitations exist due to incomplete follow up, leading to small sample size; this was partially due to restrictions on service provision in the context of the COVID-19 pandemic.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): The St George and Sutherland Research Foundation.Philanthropic donation from Emeritus Professor Richard Henry.
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Affiliation(s)
- R Crowley
- St George Hospital , Sydney , Australia
| | - G Youssef
- St George Hospital , Sydney , Australia
| | - A Henry
- St George Hospital , Sydney , Australia
| | - L Roberts
- St George Hospital , Sydney , Australia
| | - M A Brown
- St George Hospital , Sydney , Australia
| | - A Hoffman
- St George Hospital , Sydney , Australia
| | - G Mangos
- St George Hospital , Sydney , Australia
| | | | - F Petit
- St George Hospital , Sydney , Australia
| | - L Xu
- St George Hospital , Sydney , Australia
| | - G K Davis
- St George Hospital , Sydney , Australia
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15
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Tan M, Dinh D, Gayed D, Liang D, Brennan A, Duffy S, Clark D, Ajani A, Oqueli E, Roberts L, Reid C, Freeman M, Chandrasekhar J. Associations between DAPT score and long-term mortality post PCI. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The dual antiplatelet therapy (DAPT) score was developed to identify patients more likely to derive benefit (score ≥2) or harm (score <2) from DAPT beyond 1-year post PCI. There is no study which looked at the DAPT score and long term outcomes post PCI in Australia.
Purpose
We sought to examine long-term mortality after PCI by the DAPT score in patients treated with DAPT per local guidelines.
Methods
We examined data from the MIG PCI database from 2005 to 2018 in whom the DAPT score could be derived and grouped them as score ≥2 or <2. Long-term mortality was assessed from National Death Index linkage. The primary endpoint was long-term mortality examined using survival analysis. Secondary endpoints included 30-day ischaemic outcomes and in-hospital major bleeding.
Results
Out of 27,740 patients in the study, 9,401 (33.9%) had DAPT score ≥2. They were younger and included more females and higher prevalence of renal impairment. DAPT score ≥2 patients had higher in-hospital major bleeding, 30-day mortality, MI and target vessel revascularisation. DAPT score ≥2 patients had lower long-term survival to 12 years (p<0.001 for all).
Conclusion
A third of all-comer PCI patients had DAPT score ≥2 with greater short-term risk of ischaemic and bleeding outcomes, as well as long-term mortality. Theoretically, those with DAPT score ≥2 would benefit from longer duration of DAPT as ischaemic risk outweighs bleeding risk. However, given our finding of increased short-term bleeding risk and long-term mortality, dynamic bleeding risk assessment should be undertaken to guide pharmacotherapy strategies.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Tan
- Eastern Health , Melbourne , Australia
| | - D Dinh
- Monash University , Melbourne , Australia
| | - D Gayed
- Eastern Health , Melbourne , Australia
| | - D Liang
- Eastern Health , Melbourne , Australia
| | - A Brennan
- Monash University , Melbourne , Australia
| | - S Duffy
- Alfred Health , Melbourne , Australia
| | - D Clark
- Austin Hospital , Melbourne , Australia
| | - A Ajani
- Royal Melbourne Hospital , Melbourne , Australia
| | - E Oqueli
- Ballarat Health , Melbourne , Australia
| | - L Roberts
- Eastern Health , Melbourne , Australia
| | - C Reid
- Curtin University , Perth , Australia
| | - M Freeman
- Eastern Health , Melbourne , Australia
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16
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Roberts L, DeSesso J. CEC06-01 A framework for occupational risk management for pregnant workers. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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17
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Dodds RM, Hurst C, Hillman SJ, Davies K, Roberts L, Aspray TJ, Granic A, Sayer AA. Advancing our understanding of skeletal muscle across the lifecourse: Protocol for the MASS_Lifecourse study and characteristics of the first 80 participants. Exp Gerontol 2022; 166:111884. [PMID: 35788023 DOI: 10.1016/j.exger.2022.111884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/17/2022] [Accepted: 06/28/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Sarcopenia, the age-related loss of skeletal muscle strength and mass, carries a significant burden for affected individuals. There has been little investigation of sarcopenia using experimental medicine techniques to study human muscle tissue in detail. The aim of the Muscle Ageing Sarcopenia Studies Lifecourse (MASS_Lifecourse) study is to recruit up to 160 participants, equally divided between females and males between ages 45 and 85 years for detailed phenotyping of skeletal muscle health. Here we describe the protocol for the study and the characteristics of the first 80 participants. METHODS We are recruiting participants from three sources in the north-east of England. Study fieldwork comprises a home visit (or videocall) for consent and assessment of health, cognition, lifestyle, and wellbeing. This is followed by a visit to a clinical research facility for assessment of sarcopenia status and collection of samples including a vastus lateralis muscle biopsy. We produced descriptive statistics for the first 80 participants, including expressing their grip strength relative to normative data in the form of Z-scores. RESULTS The first 80 participants (53.8 % female) covered the target ages, ranging from 48 to 84 years. They were regularly physically active, reported good physical function and had a prevalence of sarcopenia (including probable sarcopenia) of 11.3 % based on the revised European consensus. Their grip strength was similar to that in the general population, with a mean Z-score of 0.09 standard deviations (95 % CI: -1.64, 1.83) above that expected. CONCLUSIONS The MASS_Lifecourse study combines comprehensive health and lifestyle data with a range of biological samples including skeletal muscle. The findings from planned analyses should contribute to improvements in the diagnosis, treatment, and prevention of sarcopenia.
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Affiliation(s)
- R M Dodds
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, UK; NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - C Hurst
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, UK; NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - S J Hillman
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, UK; NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - K Davies
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, UK
| | - L Roberts
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, UK; NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - T J Aspray
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, UK; NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - A Granic
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, UK; NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - A A Sayer
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, UK; NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK.
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18
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Ford C, Xie CX, Low A, Rajakariar K, Koshy AN, Sajeev JK, Roberts L, Pathik B, Teh AW. Comparison of 2 Smart Watch Algorithms for Detection of Atrial Fibrillation and the Benefit of Clinician Interpretation: SMART WARS Study. JACC Clin Electrophysiol 2022; 8:782-791. [PMID: 35738855 DOI: 10.1016/j.jacep.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/23/2022] [Accepted: 02/27/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Smart watches and wearable technology capable of heart rhythm assessment have increased in use in the general population. The Apple Watch Series 4 (AW4) and KardiaBand (KB) are devices capable of obtaining single-lead electrocardiographic recordings, presenting a novel opportunity for the detection of paroxysmal arrhythmias. OBJECTIVES The aim of this study was to assess the diagnostic utility of the AW4 and KB in an elderly outpatient population. METHODS Consecutive recordings were taken from patients attending cardiology outpatient clinic from the AW4 and KB concurrently with 12-lead electrocardiography. Automated diagnoses and blinded single-lead electrocardiographic tracing interpretations by 2 cardiologists were analyzed. Analysis was also conducted to assess the effect of combined device and clinician interpretation. RESULTS One hundred twenty-five patients were prospectively recruited (mean age 76 ± 7 years, 62% men). The accuracy of the automated rhythm assessment was higher with the KB than the AW4 (74% vs 65%). For the detection of atrial fibrillation, the sensitivity and negative predictive value of the KB were 89% and 97%, respectively, and of the AW4 were 19% and 82%, respectively. Using hybrid automated and clinician interpretation, the overall accuracy of the KB and AW4 was 91% and 87%, respectively. CONCLUSIONS The KB automated algorithm outperformed the AW4 in its accuracy and sensitivity for detecting atrial fibrillation in the outpatient setting. Clinician assessment of the single-lead electrocardiogram improved accuracy. These findings suggest that although these devices' tracings are of sufficient quality, automated diagnosis alone is not sufficient for making clinical decisions about atrial fibrillation diagnosis and management.
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Affiliation(s)
- Christopher Ford
- Department of Cardiology, Monash University, Eastern Health Clinical School, Box Hill, Australia
| | - Charis Xuan Xie
- Department of Cardiology, Monash University, Eastern Health Clinical School, Box Hill, Australia
| | - Ashlea Low
- Department of Cardiology, Monash University, Eastern Health Clinical School, Box Hill, Australia
| | - Kevin Rajakariar
- Department of Cardiology, Monash University, Eastern Health Clinical School, Box Hill, Australia
| | - Anoop N Koshy
- Department of Cardiology, Monash University, Eastern Health Clinical School, Box Hill, Australia; Department of Cardiology, The University of Melbourne, Austin Hospital Clinical School, Melbourne, Australia
| | - Jithin K Sajeev
- Department of Cardiology, Monash University, Eastern Health Clinical School, Box Hill, Australia
| | - Louise Roberts
- Department of Cardiology, Monash University, Eastern Health Clinical School, Box Hill, Australia
| | - Bhupesh Pathik
- Department of Cardiology, Monash University, Eastern Health Clinical School, Box Hill, Australia
| | - Andrew W Teh
- Department of Cardiology, Monash University, Eastern Health Clinical School, Box Hill, Australia; Department of Cardiology, The University of Melbourne, Austin Hospital Clinical School, Melbourne, Australia.
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19
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Nogic J, MacPherson M, Aldridge E, Sajeev JK, Roberts L, Lowman D, Sze S, Kwong A, Buntine P, Teh AW. Magnesium in the Management of Atrial Fibrillation With Rapid Ventricular Response. JACC Clin Electrophysiol 2022; 8:800-802. [PMID: 35738858 DOI: 10.1016/j.jacep.2022.01.017] [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] [Received: 12/22/2021] [Revised: 01/13/2022] [Accepted: 01/16/2022] [Indexed: 10/18/2022]
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20
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Wood N, Straw S, Scalabrin M, Espino-Gonzalez E, Smith J, Wheatcroft S, Witte KK, Roberts L, Bowen TS. Effects of heart failure and diabetes on invasive biomarkers of skeletal muscle wasting. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Muscle wasting is common in patients with diabetes mellitus (DM) and chronic heart failure (HF), which exacerbates cachexia and poor quality of life. However, a gap in clinical translation remains as the mechanisms underlying muscle wasting in DM and HF remain poorly validated, with most evidence assumed from experimental small-animal models.
Purpose
Validate if markers of muscle wasting (e.g., autophagy, proteolysis, myogenesis) were correlated to muscle phenotype and clinical indices in humans with DM and HF.
Method
Male patients with DM (n=4), HF (n=4; NYHA=2), DMHF (n=7; NYHA=2) were included. DM was classified as a HbA1c level ≥48mmol/mol and HF classified as a left ventricular ejection fraction (LVEF) ≤40%, with patients on optimised medication. Muscle biopsies of pectoralis major were excised during routine pacemaker surgery and frozen at -80°C for both histological and gene expression analysis. Muscle samples were sectioned, stained, and imaged for fibre cross-sectional area and fibre type. RT-PCR gene expression was conducted for markers of muscle regeneration (myod, myogenin), protein degradation (myostatin and autophagy-related LC3B, ATG7, CTSL), and anabolic signalling (IGF-1). Statistical analysis included ANOVAs and correlation analysis to identify relationships between variables. Values of p<0.05 were accepted as significant.
Results
Groups (DM, HF, DMHF) were not different (P>0.05) in relation to age (79±9, 72±8, 72±10 years) or BMI (24.5±3.6, 28.5±4.2, 29.5±6.0) respectively. Fibre size or fibre type were not different (P>0.05) between groups. In line with this, gene expression for markers of myogenesis and anabolism as well as myostatin were not different (P>0.05) between groups, but a trend in downregulation of the proteolytic autophagy-related genes (LC3B, ATG7, CTSL) in DMHF vs DM or HF was found on average by 21, 36, and 30% respectively. Autophagy-related genes LC3B, ATG7, CTSL were positively correlated (P<0.05) to type IIa fibre numerical density (R=0.82, 0.86, 0.89) and LVEF (R=0.85, 0.92, 0.83), respectively.
Conclusion
Our findings indicate that gene expression of autophagy could represent a robust marker of muscle wasting and cardiac dysfunction in humans with DM and HF. Muscle biopsies from patients with DM and HF identified the proteolytic system of autophagy, important for cellular homeostasis, may be inhibited and this was correlated to fibre phenotype and LVEF. However, the process of muscle wasting in DM and HF within the clinical setting may not necessarily reflect those reported in animal models given various other markers were not changed.
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Affiliation(s)
- N Wood
- University of Leeds, Faculty of Biological Sciences, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - S Straw
- University of Leeds, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - M Scalabrin
- University of Leeds, Faculty of Biological Sciences, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - E Espino-Gonzalez
- University of Leeds, Faculty of Biological Sciences, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - J Smith
- University of Leeds, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - S Wheatcroft
- University of Leeds, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - KK Witte
- University of Leeds, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - L Roberts
- University of Leeds, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - TS Bowen
- University of Leeds, Faculty of Biological Sciences, Leeds, United Kingdom of Great Britain & Northern Ireland
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Ralota KK, Lim H, Rajakariar K, Maher N, Ganeshanathan V, Wong G, Roberts L, Gayed D, Liang D, Backhouse B, Chandrasekhar J. DIFFERENCES IN CARDIAC PRESENTATIONS BETWEEN THE COVID AND PRE-COVID ERA: SINGLE TERTIARY CENTRE EXPERIENCE FROM MELBOURNE, AUSTRALIA. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)03130-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Joslin R, Roberts L, Donovan-Hall M. Communication preferences of young people experiencing persistent musculoskeletal pain. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.020] [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]
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23
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Jarvis H, Roberts L. As practice evolves, are consultants and advanced practitioners considered clinical academics? Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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24
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Dudley J, Rajakariar K, Roberts L, Chandrasekhar J. Differences in STEMI, Door-to-Balloon Time and Mortality Between Pre-COVID and COVID Era: A Systematic Review. Heart Lung Circ 2022. [PMCID: PMC9345536 DOI: 10.1016/j.hlc.2022.06.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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25
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Liang D, L'Abbate C, Backhouse B, Roberts L, Chandrasekhar J. Complications of Aortic Valve Infective Endocarditis Causing Extrinsic Left Main Coronary Artery Compression. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.326] [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]
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26
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Popper AN, Hice-Dunton L, Jenkins E, Higgs DM, Krebs J, Mooney A, Rice A, Roberts L, Thomsen F, Vigness-Raposa K, Zeddies D, Williams KA. Offshore wind energy development: Research priorities for sound and vibration effects on fishes and aquatic invertebrates. J Acoust Soc Am 2022; 151:205. [PMID: 35105040 DOI: 10.1121/10.0009237] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
There are substantial knowledge gaps regarding both the bioacoustics and the responses of animals to sounds associated with pre-construction, construction, and operations of offshore wind (OSW) energy development. A workgroup of the 2020 State of the Science Workshop on Wildlife and Offshore Wind Energy identified studies for the next five years to help stakeholders better understand potential cumulative biological impacts of sound and vibration to fishes and aquatic invertebrates as the OSW industry develops. The workgroup identified seven short-term priorities that include a mix of primary research and coordination efforts. Key research needs include the examination of animal displacement and other behavioral responses to sound, as well as hearing sensitivity studies related to particle motion, substrate vibration, and sound pressure. Other needs include: identification of priority taxa on which to focus research; standardization of methods; development of a long-term highly instrumented field site; and examination of sound mitigation options for fishes and aquatic invertebrates. Effective assessment of potential cumulative impacts of sound and vibration on fishes and aquatic invertebrates is currently precluded by these and other knowledge gaps. However, filling critical gaps in knowledge will improve our understanding of possible sound-related impacts of OSW energy development to populations and ecosystems.
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Affiliation(s)
- Arthur N Popper
- Department of Biology, University of Maryland, College Park, Maryland 20742, USA
| | - Lyndie Hice-Dunton
- Responsible Offshore Science Alliance, 1050 Connecticut Avenue NW #65036, Washington, DC 20036, USA
| | - Edward Jenkins
- Biodiversity Research Institute, 276 Canco Road, Portland, Maine 04103, USA
| | - Dennis M Higgs
- Department of Integrative Biology, University of Windsor, Windsor, Ontario N9B 3P4, Canada
| | - Justin Krebs
- AKRF, 7250 Parkway Drive, Suite 210, Hanover, Maryland 21076, USA
| | - Aran Mooney
- Biology Department, Woods Hole Oceanographic Institution, Woods Hole, Massachusetts 02543, USA
| | - Aaron Rice
- K. Lisa Yang Center for Conservation Bioacoustics Cornell Lab of Ornithology, Cornell University, Ithaca, New York 14850, USA
| | - Louise Roberts
- Department of Entomology, Cornell University, Ithaca, New York 14853, USA
| | | | - Kathy Vigness-Raposa
- INSPIRE Environmental, 513 Broadway, Suite 314, Newport, Rhode Island 02840, USA
| | - David Zeddies
- JASCO Applied Sciences, 8630 Fenton Street, Suite 218, Silver Spring, Maryland 20910, USA
| | - Kathryn A Williams
- Biodiversity Research Institute, 276 Canco Road, Portland, Maine 04103, USA
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Fahey J, Prosser H, Lescai P, Sajeev J, Yao H, Buntine P, Roberts L, Teh A. Elevated Troponin and Diabetes Mellitus are Independent Predictors of Obstructive Coronary Artery Disease in Patients Presenting With Atrial Fibrillation. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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28
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Osborn-Jenkins L, Roberts L, Al-Abbadey M, MacPherson H, Stuart B, Carnes D, Fawkes C, Yardley L, Bradbury K, Bishop F. Advice-giving practice in physiotherapy, osteopathy and acupuncture for people with low back pain. Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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29
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Lucocq J, Khalil M, Roberts L, Dalgleish S, Jariwala A. Improving day surgery rates of anterior cruciate ligament reconstruction surgery in surgical units not dedicated to performing day surgery: A retrospective observational cohort study. J Eval Clin Pract 2021; 27:1321-1325. [PMID: 33709465 DOI: 10.1111/jep.13558] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 02/22/2021] [Accepted: 02/25/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS Current guidance advises that at least 90% of anterior cruciate ligament reconstructions are performed as day-case operations. Same-day surgery rates achieved by surgical units have significant clinical and financial implications. The primary aim of this multi-centre study was to determine the rate of admission and causes for admissions in patients undergoing anterior cruciate ligament reconstruction. METHOD Patient documentations were studied for those who underwent an elective anterior cruciate ligament reconstruction between January 2015 and April 2019. Contributing factors related to admission length were investigated and included patient age, gender, body mass index (BMI), operating surgeon, operating hospital, American Society of Anaesthesiology (ASA) grade, and position of the patient on the operating list. Both univariate and multivariate analysis were conducted using the STATA/IC 16.1 statistical package. RESULTS The day surgery rate of anterior cruciate ligament reconstructions were 52% (50/95). Patients positioned later on the operating list were more likely to be admitted post-operatively (OR, 4.49; P = .002; 95% CI, 1.72-11.69) and this was the only factor associated with admission. A large majority of admitted patients (95.6%) were admitted without a clinical cause and were otherwise safe for same-day discharge. CONCLUSIONS The day surgery rate for ACL reconstruction remains low, despite an extremely low complication rate. Reconfiguration of the operating lists and positioning anterior cruciate ligament reconstructions earlier in the day will likely increase the same-day discharge rate and reduce associated costs.
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Affiliation(s)
- James Lucocq
- University Department of Trauma and Orthopaedic Surgery (UDOTS), Ninewells Hospital, Dundee, DD2 1UB, Dundee, Scotland.,University of Dundee, Dundee, Scotland
| | - Mostafa Khalil
- University Department of Trauma and Orthopaedic Surgery (UDOTS), Ninewells Hospital, Dundee, DD2 1UB, Dundee, Scotland
| | - Louise Roberts
- University Department of Trauma and Orthopaedic Surgery (UDOTS), Ninewells Hospital, Dundee, DD2 1UB, Dundee, Scotland
| | - Stephen Dalgleish
- University Department of Trauma and Orthopaedic Surgery (UDOTS), Ninewells Hospital, Dundee, DD2 1UB, Dundee, Scotland
| | - Arpit Jariwala
- University Department of Trauma and Orthopaedic Surgery (UDOTS), Ninewells Hospital, Dundee, DD2 1UB, Dundee, Scotland.,University of Dundee, Dundee, Scotland
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Payne H, White R, Day E, Osborn-Jenkins L, Roberts L. Advice-giving skills in pre-registration physiotherapy training. Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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31
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Bourne M, Duhig S, Hajek M, Headrick J, Mingin C, Morris N, Roberts L, Shield A, Williams M. Relationships between trunk morphology and strength with non-contact lower limb injuries in elite rugby league and Australian football players. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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32
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Kennedy R, Roberts L, Davis G, Mangos G, Pettit F, Brown MA, O'Sullivan AJ, Henry A. The P4 study: Subsequent pregnancy maternal physiology after hypertensive and normotensive pregnancies. Pregnancy Hypertens 2021; 27:29-34. [PMID: 34864294 DOI: 10.1016/j.preghy.2021.10.004] [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: 06/08/2021] [Revised: 09/09/2021] [Accepted: 10/22/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Hypertensive disorders of pregnancy are associated with subsequent increased risk of cardiometabolic disease. Adverse cardiometabolic measures are noted soon after hypertensive versus normotensive pregnancy (NP); to what degree these persist into a subsequent pregnancy (SP) is unknown. This study aimed to assess women's physiology early in SP after hypertensive pregnancy (HP: preeclampsia or gestational hypertension) or NP and compare SP to 6 months postpartum findings from the index pregnancy. STUDY DESIGN Prospective sub-study of the P4 (Postpartum, Physiology, Psychology and Paediatric) observational cohort. Measurements six months after NP versus HP, and the SP at 11-13 weeks gestation. MAIN OUTCOME MEASURES Blood pressure (BP), blood and urine tests (urine ACR, HOMA-IR, LDL cholesterol), body composition, and contribution of maternal characteristics and inter-pregnancy factors to BP and body fat (FM%) in SP. RESULTS 49 women (34 NP, 15 HP). In the SP, post-HP women had higher BP (112/70 mmHg HP vs 102/64 mmHg NP; p < .001), with no significant drop from six months postpartum to early SP. On regression analysis, systolic and diastolic BP at 6-months were the major predictors for SP systolic (p < 0.001) and diastolic (p = 0.009) BP respectively in the SP. Longer interpregnancy interval and increased FM% 6-months postpartum were associated with higher SP FM% (p < 0.001). CONCLUSIONS BP and body fat six months postpartum were similar early in the SP for HP group, and postpartum BP and FM% were major predictors of their corresponding SP measurements. Postpartum/inter-pregnancy intervention programs to improve these cardiometabolic risk markers might help improve women's long-term health and require investigation.
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Affiliation(s)
- R Kennedy
- School of Women's and Children's Health, UNSW Medicine and Health, UNSW Sydney, Australia; St George and Sutherland Clinical School, UNSW Medicine and Health, UNSW Sydney, Australia.
| | - L Roberts
- St George and Sutherland Clinical School, UNSW Medicine and Health, UNSW Sydney, Australia; Department of Women and Children's Health, St George Hospital, Sydney, Australia
| | - G Davis
- School of Women's and Children's Health, UNSW Medicine and Health, UNSW Sydney, Australia; St George and Sutherland Clinical School, UNSW Medicine and Health, UNSW Sydney, Australia; Department of Women and Children's Health, St George Hospital, Sydney, Australia
| | - G Mangos
- St George and Sutherland Clinical School, UNSW Medicine and Health, UNSW Sydney, Australia; Department of Renal Medicine, St George Hospital, Sydney, Australia
| | - F Pettit
- Department of Renal Medicine, St George Hospital, Sydney, Australia
| | - M A Brown
- St George and Sutherland Clinical School, UNSW Medicine and Health, UNSW Sydney, Australia; Department of Renal Medicine, St George Hospital, Sydney, Australia
| | - A J O'Sullivan
- St George and Sutherland Clinical School, UNSW Medicine and Health, UNSW Sydney, Australia; Department of Endocrinology, St George Hospital, Sydney, Australia
| | - A Henry
- School of Women's and Children's Health, UNSW Medicine and Health, UNSW Sydney, Australia; Department of Women and Children's Health, St George Hospital, Sydney, Australia; The George Institute for Global Health, Sydney, Australia.
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Mah A, Moustapha A, Roberts L, Leach A, Kaban G, Zimmermann R, Shavadia J, Orvold J, Mondal P, Martin L. CAN PATIENTS PRESENTING TO THE ED WITH CHEST PAIN WHO HAVE INTERMEDIATE-RISK HEART SCORES BE MANAGED AS OUTPATIENTS? A RETROSPECTIVE REVIEW OF TWO RAPID ACCESS CHEST PAIN CLINICS. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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34
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Roberts L, Rees A, Mannay D, Bayfield H, Corliss C, Diaz C, Vaughan R. Corporate parenting in a pandemic: Considering the delivery and receipt of support to care leavers in Wales during Covid-19. Child Youth Serv Rev 2021; 128:106155. [PMID: 36540703 PMCID: PMC9756298 DOI: 10.1016/j.childyouth.2021.106155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/16/2021] [Accepted: 07/02/2021] [Indexed: 05/07/2023]
Abstract
This paper considers the support available to care leavers during the Covid-19 pandemic from their corporate parents. The paper contributes to a developing evidence base concerned with social work efforts to adapt and maintain support provision during the unprecedented circumstances, and provides insight into how such support was perceived and experienced. Funded by Voices from Care Cymru and Cardiff University, a qualitative, mixed method study was conducted which included a survey of Welsh Local Authority professionals (n = 22) and interviews with Welsh care-experienced young people aged 17-24 (n = 17). The findings of this paper show the propensity of corporate parents to provide protection against the adversities of the pandemic, or to compound difficulties. While some young people reported being both practically and emotionally supported, for others corporate parenting support was perceived as unavailable, unhelpful and / or uncaring. The Covid-19 pandemic provides a unique lens to consider the strengths, flaws and future opportunities for corporate parenting. The findings emphasise the need for parity of support for young people leaving care and consideration of national, local and individual responses is included. Yet consistent with findings pre-dating the pandemic, the findings reaffirm the enduring importance of both relationships and resources in ensuring good support for care leavers.
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Affiliation(s)
- Louise Roberts
- CASCADE: Children's Social Care Research and Development Centre, School of Social Sciences, Cardiff University, 3 Museum Place, Cardiff CF10 3RL, United Kingdom
| | - Alyson Rees
- CASCADE: Children's Social Care Research and Development Centre, School of Social Sciences, Cardiff University, 3 Museum Place, Cardiff CF10 3RL, United Kingdom
| | - Dawn Mannay
- CASCADE: Children's Social Care Research and Development Centre, School of Social Sciences, Cardiff University, 3 Museum Place, Cardiff CF10 3RL, United Kingdom
| | - Hannah Bayfield
- CASCADE: Children's Social Care Research and Development Centre, School of Social Sciences, Cardiff University, 3 Museum Place, Cardiff CF10 3RL, United Kingdom
| | - Cindy Corliss
- CASCADE: Children's Social Care Research and Development Centre, School of Social Sciences, Cardiff University, 3 Museum Place, Cardiff CF10 3RL, United Kingdom
| | - Clive Diaz
- CASCADE: Children's Social Care Research and Development Centre, School of Social Sciences, Cardiff University, 3 Museum Place, Cardiff CF10 3RL, United Kingdom
| | - Rachael Vaughan
- CASCADE: Children's Social Care Research and Development Centre, School of Social Sciences, Cardiff University, 3 Museum Place, Cardiff CF10 3RL, United Kingdom
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Brown M, Roberts L, Hoffman A, Mangos G, Pettit F, Henry A, Worboys J, Ryan H, Davis G. SY7-4. Blood pressure after normal and pre-eclamptic pregnancy. Pregnancy Hypertens 2021. [DOI: 10.1016/j.preghy.2021.07.281] [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]
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36
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Nogic J, Nerlekar N, Soon K, Freeman M, Chan J, Roberts L, Brenan A, Dinh D, Lefkovits J, Brown AJ. Diabetes mellitus is independently associated with early stent thrombosis in patients undergoing drug eluting stent implantation: Analysis from the Victorian cardiac outcomes registry. Catheter Cardiovasc Interv 2021; 99:554-562. [PMID: 34390170 DOI: 10.1002/ccd.29913] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/31/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Diabetes mellitus (DM) is a predictor of restenosis and late stent thrombosis (ST) in patients undergoing percutaneous coronary intervention (PCI) with drug-eluting-stents (DES). Real-world data on rates of early ST is lacking. We compared clinical outcomes of patients with and without DM from the Victorian cardiac outcomes registry. METHODS Consecutive patients undergoing PCI with DES were analyzed with primary outcome being ST at 30-days. Secondary outcomes including major adverse cardiovascular events (MACE) and all-cause mortality. RESULTS Of 43,209 patients included, 9730 (22.5%) had DM. At 30 days, DM was independently associated with higher rates of early ST (0.7% vs. 0.5%) OR 1.41 (95% confidence interval; 1.05-1.87, p = 0.02), MACE (4.1% vs. 3.5%, p = 0.004) and mortality (1.9% vs. 1.5%, p = 0.01). Increased risk was not simply due to treatment. Patients with DM requiring insulin were equally affected in regard to MACE (4.7% vs. 3.9%, p = 0.069) and mortality (1.9%, vs. 1.8%, p = 0.746). On National Death Index linkage, patients with DM had increased all-cause mortality over five-year follow-up (OR 1.69 CI 1.55-1.83, p = < 0.001). CONCLUSION In this large real-world-registry, DM was an independent predictor of early ST, MACE and mortality at 30 days. These data suggest additional therapeutic strategies are required to reduce the risk of early complications in patients with DM undergoing PCI with DES.
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Affiliation(s)
- Jason Nogic
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Melbourne, Victoria, Australia.,Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
| | - Nitesh Nerlekar
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Melbourne, Victoria, Australia
| | - Kean Soon
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
| | - Melanie Freeman
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
| | - Jasmine Chan
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Melbourne, Victoria, Australia
| | - Louise Roberts
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
| | | | - Diem Dinh
- Monash University, Melbourne, Victoria, Australia
| | - Jeffrey Lefkovits
- Department of Cardiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Adam J Brown
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Melbourne, Victoria, Australia
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Roberts L. Crabby commotions: visual not vibrational-orientated searching behaviours guide aggregation formation around key resources. J ETHOL 2021. [DOI: 10.1007/s10164-021-00710-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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38
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Sajeev JK, Dewey H, Kalman JM, Chou B, Roberts L, Cooke JC, Koshy AN, Patel SK, Gould M, Ngoh J, Burrell LM, Teh AW. Angiotensin-Converting Enzyme 2 Activity Is Associated With Embolic Stroke of Undetermined Source. Stroke 2021; 52:e324-e325. [PMID: 34111949 DOI: 10.1161/strokeaha.121.034135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Jithin K Sajeev
- Eastern Health, Monash University, Melbourne, Victoria, Australia (J.K.S., H.D., B.C., L.R., J.C.C., M.G., J.N., A.W.T.)
| | - Helen Dewey
- Eastern Health, Monash University, Melbourne, Victoria, Australia (J.K.S., H.D., B.C., L.R., J.C.C., M.G., J.N., A.W.T.)
| | | | - Bon Chou
- Eastern Health, Monash University, Melbourne, Victoria, Australia (J.K.S., H.D., B.C., L.R., J.C.C., M.G., J.N., A.W.T.)
| | - Louise Roberts
- Eastern Health, Monash University, Melbourne, Victoria, Australia (J.K.S., H.D., B.C., L.R., J.C.C., M.G., J.N., A.W.T.)
| | - Jennifer C Cooke
- Eastern Health, Monash University, Melbourne, Victoria, Australia (J.K.S., H.D., B.C., L.R., J.C.C., M.G., J.N., A.W.T.)
| | - Anoop N Koshy
- Department of Medicine, University of Melbourne, Victoria, Australia (A.N.K., S.K.P., L.M.B., A.W.T.)
| | - Sheila K Patel
- Department of Medicine, University of Melbourne, Victoria, Australia (A.N.K., S.K.P., L.M.B., A.W.T.)
| | - Merryn Gould
- Eastern Health, Monash University, Melbourne, Victoria, Australia (J.K.S., H.D., B.C., L.R., J.C.C., M.G., J.N., A.W.T.)
| | - Jeremy Ngoh
- Eastern Health, Monash University, Melbourne, Victoria, Australia (J.K.S., H.D., B.C., L.R., J.C.C., M.G., J.N., A.W.T.)
| | - Louise M Burrell
- Department of Medicine, University of Melbourne, Victoria, Australia (A.N.K., S.K.P., L.M.B., A.W.T.)
| | - Andrew W Teh
- Eastern Health, Monash University, Melbourne, Victoria, Australia (J.K.S., H.D., B.C., L.R., J.C.C., M.G., J.N., A.W.T.)
- Department of Medicine, University of Melbourne, Victoria, Australia (A.N.K., S.K.P., L.M.B., A.W.T.)
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Parfrey S, Teh AW, Roberts L, Brennan A, Clark D, Duffy SJ, Ajani AE, Reid CM, Freeman M. The role of CHA2DS2-VASc score in evaluating patients with atrial fibrillation undergoing percutaneous coronary intervention. Coron Artery Dis 2021; 32:288-294. [PMID: 33394696 DOI: 10.1097/mca.0000000000000987] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the review was to assess whether CHA2DS2-VASc score is predictive of mortality in patients with atrial fibrillation undergoing percutaneous coronary intervention (PCI). BACKGROUND The CHA2DS2-VASc score is validated in predicting stroke risk in atrial fibrillation. The optimum management strategy for these patients undergoing PCI is still debated. METHODS The CHA2DS2-VASc score was calculated in consecutive patients with atrial fibrillation undergoing PCI in a large Australian registry between 2007 and 2013. Patients were divided into low (1-2), intermediate (3-4) and high (≥5) groups. Clinical and procedural data, 30-day, 1-year and long-term outcomes were compared between the groups. RESULTS A total of 564 patients were included in our analysis. Patients with high CHA2DS2-VASc scores had higher mortality rates at 1-year (2, 8, 15; P = 0.002) and long-term (6, 20, 37; P < 0.001). High-risk patients were more likely to have renal impairment and multivessel disease. Increasing CHA2DS2-VASc score was associated with increased risk of stroke (0, 2, 6; P = 0.03). However, only 41.9% received anticoagulation, with no difference across the risk groups. When compared to low-risk, intermediate [HR 3.57; 95% confidence interval (CI), 1.28-9.92; P = 0.015] and high (hazard ratio 7.82; 95% CI, 2.88-21.24; P < 0.001) CHA2DS2-VASc scores were significant predictors of long-term mortality. CONCLUSIONS Higher CHA2DS2-VASc scores in patients with atrial fibrillation undergoing PCI are associated with significantly worse outcomes. Despite being high-risk, the patients in this cohort are likely undertreated with anticoagulation. Close clinical follow-up with greater utilization of anticoagulation and optimal medical therapy has the potential to improve long-term outcomes.
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Affiliation(s)
| | - Andrew W Teh
- Department of Cardiology, Box Hill Hospital
- Department of Cardiology, Austin Hospital
| | | | - Angela Brennan
- Department of Epidemiology and Preventive Medicine, Centre of Cardiovascular Research and Education in Therapeutics (CCRE), Monash University
| | - David Clark
- Department of Cardiology, Austin Hospital
- University of Melbourne
| | - Stephen J Duffy
- Department of Epidemiology and Preventive Medicine, Centre of Cardiovascular Research and Education in Therapeutics (CCRE), Monash University
- Department of Cardiovascular Medicine, Alfred Hospital
| | - Andrew E Ajani
- Department of Epidemiology and Preventive Medicine, Centre of Cardiovascular Research and Education in Therapeutics (CCRE), Monash University
- University of Melbourne
- Department of Cardiology, Royal Melbourne Hospital
| | - Christopher M Reid
- Department of Epidemiology and Preventive Medicine, Centre of Cardiovascular Research and Education in Therapeutics (CCRE), Monash University
- John Curtain Distinguished Professor Director, Centre for Clinical Research and Education Director, WAHTN Clinical Trials and Data Management Centre, Curtain University, Perth, Western Australia, Australia
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Wood N, Cheng CW, Straw S, Scalabrin M, Espino-Gonzalez E, Wheatcroft S, Witte KK, Roberts L, Bowen TS. Divergent transcriptomic profiles in skeletal muscle of diabetics with and without heart failure. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Patients with type 2 diabetes mellitus (DM) that have coexistent heart failure (HF) have exacerbated symptoms and prognosis, however beside cardiac dysfunction the mechanisms governing these features are incompletely understood. Evidence indicates abnormalities in the periphery could contribute to this worse clinical phenotype, including a role for skeletal muscle whereby disturbances in the transcriptome could disrupt muscle homeostasis/repair to offer a novel therapeutic approach.
Purpose
Is the skeletal muscle transcriptome distinguishable between DM patients with and without HF?
Methods
DM patients without (n = 11) or with HF with reduced left ventricular ejection fraction (LVEF) (n = 16) were included. Muscle biopsies were collected from the pectoralis major during pacemaker implantation. Following RNA extraction and cDNA synthesis, non-bias RNA sequencing (RNAseq) was performed (Cambridge Genomic Services, UK) followed by targeted RT-PCR gene expression of relevant targets. DESeq2 identified differentially expressed genes (DEGs) with a false discovery rate (p < 0.05). Gene enrichment analysis was performed with clusterProfiler v3.16.0 to interrogate the gene ontology database, while pathway analysis was conducted using ReactomePA v1.32.0 to interrogate the Reactome database, using an adjusted p value. Values of p < 0.05 were accepted as significant.
Results
Groups were not different (p > 0.05) for age (74 ± 11 vs. 66 ± 10 years), BMI (31 ± 7 vs 29 ± 6), sex (n = 2 females per group), or HbA1c (56 ± 10 vs. 57 ± 8 mmol/mol), although LVEF was lower in the group with HF (27 ± 8 vs. 54 ± 2%; p < 0.05). Of the 19,544 genes analysed, RNAseq identified 53 DEGs between DM patients with and without HF, with several relevant targets related to myofiber homeostasis such as autophagy (RUBCN), protein synthesis (DGKζ), and inflammation/apoptosis (TLE1). Follow-up RT-PCR analysis confirmed a trend towards upregulation of the autophagy-related machinery p62 (p = 0.043) and BNIP3 (p = 0.085) in the HF group, but not ubiquitin-proteasome (MuRF1, MAFbx; p > 0.05). Gene-enrichment analysis of DEGs identified 7 overrepresented terms (P < 0.05), including lipid metabolism/signalling alongside epigenetic modifications related to histone deacetylases (HDAC6/10). Furthermore, pathway analysis identified 4 terms (p < 0.05) related to NOTCH signalling and phosphatidyl inositol-bisphosphate (PIP2) hydrolysis thus indicating alterations to muscle repair and lipid signalling respectively.
Conclusion(s): This study confirms that DM patients with and without HF demonstrate distinct skeletal muscle transcriptome profiles. Key differences related to skeletal muscle myogenesis, autophagy, epigenetic regulation, and lipid signalling were identified that could form part of important therapeutic targets. Whether these underlying muscle transcriptome differences contribute to poorer clinical outcomes in DM patients with HF remains to be determined.
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Affiliation(s)
- N Wood
- University of Leeds, Faculty of Biological Sciences, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - CW Cheng
- University of Leeds, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - S Straw
- University of Leeds, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - M Scalabrin
- University of Leeds, Faculty of Biological Sciences, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - E Espino-Gonzalez
- University of Leeds, Faculty of Biological Sciences, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - S Wheatcroft
- University of Leeds, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - KK Witte
- University of Leeds, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - L Roberts
- University of Leeds, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - TS Bowen
- University of Leeds, Faculty of Biological Sciences, Leeds, United Kingdom of Great Britain & Northern Ireland
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Ford C, Xie CX, Low A, Roberts L, Teh AW. SMART WARS - COMPARISON OF THE APPLE WATCH SERIES 4 AND KARDIABAND SMART WATCH TECHNOLOGY FOR THE DIAGNOSIS OF ATRIAL FIBRILLATION. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)04581-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Roberts L. Substrate-borne vibration and sound production by the land hermit crab Coenobita compressus during social interactions. J Acoust Soc Am 2021; 149:3261. [PMID: 34241129 DOI: 10.1121/10.0004988] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 04/27/2021] [Indexed: 06/13/2023]
Abstract
Despite the diversity of sound production in crustacea, sounds produced by the land hermit crabs (Coenobitidae) are not well understood. Here, sound and substrate-borne vibration production by the tropical species Coenobita compressus was characterized in relation to shell architecture and social context. Sound production rates were compared between group and solitary conditions. Chirps were measurable in the air (peak frequency 800-8400 Hz) and within the sediment (40-1120 Hz). On average, chirp pulses were 0.08 s, spaced 0.41-0.92 s apart, and had trains composed of 4-6 pulses. There were significant correlations between the shell architecture and chirp vibroacoustics. Notably, a correlation between the substrate-borne peak frequency and shell wall thickness was found, indicating that the shell remodeling process which crabs undertake (shell wall thinning) impacts the vibroacoustics of the chirps. Chirp production was significantly linked to sociality during increased individual proximity and shell contests; hence, the function is hypothesized to be intraspecific communication relative to personal space and defense. Although there have been anecdotal observations of chirping in the Coenobitidae, this paper provides a full characterization of C. compressus, which produces chirps in two sensory modes, indicating the potential of being a seismic signaler.
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Affiliation(s)
- Louise Roberts
- Department of Biological Sciences, Dartmouth College, Hanover, New Hampshire 03755, USA
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Maxwell K, Roberts L, Kramer M, Finlay K. Using the Working Model of Adjustment to Chronic Illness to explain the burden of recurrent urinary tract infection: A survey-based study. International Journal of Pharmacy Practice 2021. [DOI: 10.1093/ijpp/riab016.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
The treatment of recurrent urinary tract infection (RUTI) with antibiotics is causing concern as patients are often prescribed an inappropriate course of antibiotics, and the recurrence rate remains at 30–44% following treatment (1). Overprescription of antibiotics can also cause antimicrobial resistance. Given the current lack of adequate clinical guidelines for RUTI treatment, it is necessary for this population to adjust to living with a chronic condition, and research suggests that RUTI may be associated with poor mental health and a lower quality of life. Thus, there is a need for a more interdisciplinary approach to understanding RUTI, to inform additional treatment options.
Aim
The current study aimed to use the Working Model of Adjustment to Chronic Illness (WMACI) (see Figure 1) to explore the personal, physical and social burden of RUTI (2).
Methods
A cross-sectional survey was employed, which was informed by existing questionnaires and reviewed by experts including pain specialists (n = 6). 5,078 participants accessed liveutifree.com to seek information regarding their condition and completed the Live UTI Free survey. Participants provided information on their experiences with RUTI (recurrence rate, symptoms, pain intensity, triggers and comorbidity) and the associated burden. Binomial logistic regressions were conducted to assess the effect of RUTI characteristics on the likelihood of experiencing personal, physical and social burden.
Results
RUTI predicted greater likelihood of personal burden (enjoyment of life; enjoyment of favourite activities; mental health) (R² = 18.8 – 20.8, p = <.001), physical burden (sleep; activities of daily living; maintaining a healthy lifestyle; sexual behaviour) (R² = 21.1 – 35.9, p = <.001), and social burden (normal work; finances; relationships with friends and family; relationships with partners) (R² = 17.0 - 25.8, p = <.001), with the burden associated with sexual behaviour showing the largest amount of variance. Rate of recurrence, symptom burden, pain intensity, and having an additional diagnosis of Interstitial Cystitis (IC) were most predictive of participant burden.
Conclusion
RUTI was associated with all areas of burden. Some factors, including pain intensity and having an additional diagnosis of IC, affected a majority of areas. Predicted burden from having an additional diagnosis of IC may be a result of lack of clarity between the two diagnoses, which have shared symptom indicators and rely on urine culture testing, which has been demonstrated to be inaccurate. Misdiagnosis, or a dual diagnosis, may consequently contribute to burden. The WMACI was used to suggest how burden can lead to poor illness adjustment. Limitations of the study were that it did not explore the possibility of misdiagnosis and its impact, or investigate the effects of SES and country-level differences. However, the findings of the study have important clinical implications, as patients worldwide who are suffering with RUTI are required to manage significant burden that is associated with the condition, and this is an important issue which needs to be addressed in primary care settings. An interdisciplinary approach in primary care settings is recommended, which acknowledges the psychosocial burden that persists when treatment fails to resolve physical symptoms.
References
1. Gupta K, Trautner BW. Diagnosis and management of recurrent urinary tract infections in non-pregnant women. BMJ (Online). 2013; 346: f3140.
2. Moss-Morris R. Adjusting to chronic illness: Time for a unified theory. British Journal of Health Psychology. 2013; 681–686.
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Affiliation(s)
- K Maxwell
- University of Buckingham, Buckingham, UK
| | - L Roberts
- Oxford University Hospitals, Oxford, UK
| | | | - K Finlay
- University of Reading, Reading, UK
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Roberts L, White D, David L, Vadher B, Stoner N. The development and testing of a novel Cognitive Behavioural Therapy (CBT)-based intervention to support medicines-related consultations for healthcare professionals. International Journal of Pharmacy Practice 2021. [DOI: 10.1093/ijpp/riab016.002] [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
The cost to healthcare of wasted medicines has been estimated at around £300million per annum (1). In response to this figure and efforts to increase medicines management performance across pharmacy and patient outcomes, the practice of ‘medicines optimisation’ has developed into a key aspect of patient care. In particular, concerns exist around whether patients are deriving the optimum benefit from their medications and the extent to which adherence ‘drops off’ at varying intervals after prescription and collection.
In order to tackle medicines adherence and waste, a multi-disciplinary approach must be applied to ensure patients who are prescribed a new medicine take it as intended, experience no problems and receive as much information as they feel they need from healthcare professionals (HCP’s). Adapting Cognitive Behavioural Therapy (CBT)-based techniques to medicines-related consultations has proven effective in supporting medicines adherence in previous studies (2). Collectively, findings demonstrate scope for improving the way HCP’s communicate with patients around starting a new medication and monitoring ongoing use.
Aim
The study aim was to adapt an existing, Royal College of General Practitioners accredited ’10-minute CBT’ training package to be suitable for wider use by a range of healthcare professionals (HCP’s) (i.e. Practice Nurses, Community Pharmacists, Hospital Pharmacists and General Practitioners).
Methods
The research design adopted a repeated-measures, pre/ post questionnaire study that gathered data on HCP knowledge around the use of CBT-based techniques in consultations at the start and end of the training intervention. Two training days were attended by HCP’s that took place three weeks apart. The degree of satisfaction with the training intervention was assessed, along with a formulation exercise that was completed on a hypothetical patient case study pre- and post-training.
Results
Training of healthcare professionals took place at the Oxford Science Park and 105 NHS staff members participated. Feedback questionnaires were received by 96 HCP’s and 46 HCP’s provided additional follow-up questionnaires at 6-months, demonstrating favourable results regarding intervention content and delivery that were consistent with a prior feasibility study. Paired samples t-tests were performed on each formulation exercise rating scale domain and for total scores. There was a highly statistically significant increase in scores for all domains including total pre- and post-training scores as measured by the Formulation Rating Scale. Intra-class Correlation Coefficient for mean FRS ratings was 0.99 (p=.000) and there was no statistically significant change in any score when attendees repeated the skills assessment at 6 months, indicating once learning had been incorporated into practice, there was no recognisable training degradation over the 6-month period. See Table 1.
Conclusion
The training intervention was rated favourably by attendees and was reported by participants as providing a safe environment from which to increase knowledge of CBT-based techniques, practice implementation of formulation skills and access additional peer support to help integrate learning into medicines-related consultations. The study also demonstrates this group of HCP’s were able to integrate CBT-based techniques into hypothetical medicines-related scenarios and that learning was retained over a six-month period following training intervention.
References
1. York Health Economics Consortium and the School of Pharmacy, University of London. Evaluation of the Scale, Causes and Costs of Waste Medicines. 2010. http://php.york.ac.uk/inst/yhec/web/news/documents/Evaluation_of_NHS_Medicines_Waste_Nov_2010.pdf
2. Easthall C, Song F, Bhattacharya D. A meta-analysis of cognitive-based behaviour change techniques as interventions to improve medication Adherence. BMJ Open 2013;3:e002749.
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Affiliation(s)
- L Roberts
- Oxford University Hospitals NHS Foundation Trust, Department of Pharmacy, John Radcliffe Hospital, Old Road, Headington, OX3 9DU
| | - D White
- Oxford Health NHS Foundation Trust, Pharmacy Department, Warneford Hospital, Warneford Lane, Oxford OX3 7JX
| | | | - B Vadher
- Oxford University Hospitals NHS Foundation Trust, Department of Pharmacy, John Radcliffe Hospital, Old Road, Headington, OX3 9DU
| | - N Stoner
- Oxford University Hospitals NHS Foundation Trust, Department of Pharmacy, John Radcliffe Hospital, Old Road, Headington, OX3 9DU
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Lokuge K, Banks E, Davis S, Roberts L, Street T, O'Donovan D, Caleo G, Glass K. Exit strategies: optimising feasible surveillance for detection, elimination, and ongoing prevention of COVID-19 community transmission. BMC Med 2021; 19:50. [PMID: 33596902 PMCID: PMC7887417 DOI: 10.1186/s12916-021-01934-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 02/02/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Following implementation of strong containment measures, several countries and regions have low detectable community transmission of COVID-19. We developed an efficient, rapid, and scalable surveillance strategy to detect remaining COVID-19 community cases through exhaustive identification of every active transmission chain. We identified measures to enable early detection and effective management of any reintroduction of transmission once containment measures are lifted to ensure strong containment measures do not require reinstatement. METHODS We compared efficiency and sensitivity to detect community transmission chains through testing of the following: hospital cases; fever, cough and/or ARI testing at community/primary care; and asymptomatic testing; using surveillance evaluation methods and mathematical modelling, varying testing capacities, reproductive number (R) and weekly cumulative incidence of COVID-19 and non-COVID-19 respiratory symptoms using data from Australia. We assessed system requirements to identify all transmission chains and follow up all cases and primary contacts within each chain, per million population. RESULTS Assuming 20% of cases are asymptomatic and 30% of symptomatic COVID-19 cases present for testing, with R = 2.2, a median of 14 unrecognised community cases (8 infectious) occur when a transmission chain is identified through hospital surveillance versus 7 unrecognised cases (4 infectious) through community-based surveillance. The 7 unrecognised community upstream cases are estimated to generate a further 55-77 primary contacts requiring follow-up. The unrecognised community cases rise to 10 if 50% of cases are asymptomatic. Screening asymptomatic community members cannot exhaustively identify all cases under any of the scenarios assessed. The most important determinant of testing requirements for symptomatic screening is levels of non-COVID-19 respiratory illness. If 4% of the community have respiratory symptoms, and 1% of those with symptoms have COVID-19, exhaustive symptomatic screening requires approximately 11,600 tests/million population using 1/4 pooling, with 98% of cases detected (2% missed), given 99.9% sensitivity. Even with a drop in sensitivity to 70%, pooling was more effective at detecting cases than individual testing under all scenarios examined. CONCLUSIONS Screening all acute respiratory disease in the community, in combination with exhaustive and meticulous case and contact identification and management, enables appropriate early detection and elimination of COVID-19 community transmission. An important component is identification, testing, and management of all contacts, including upstream contacts (i.e. potential sources of infection for identified cases, and their related transmission chains). Pooling allows increased case detection when testing capacity is limited, even given reduced test sensitivity. Critical to the effectiveness of all aspects of surveillance is appropriate community engagement, messaging to optimise testing uptake and compliance with other measures.
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Affiliation(s)
- K Lokuge
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia.
| | - E Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - S Davis
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - L Roberts
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - T Street
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - D O'Donovan
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - G Caleo
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - K Glass
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
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Lokuge K, Banks E, Davis S, Roberts L, Street T, O'Donovan D, Caleo G, Glass K. Exit strategies: optimising feasible surveillance for detection, elimination, and ongoing prevention of COVID-19 community transmission. BMC Med 2021; 19:50. [PMID: 33596902 DOI: 10.1101/2020.04.19.20071217] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 02/02/2021] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Following implementation of strong containment measures, several countries and regions have low detectable community transmission of COVID-19. We developed an efficient, rapid, and scalable surveillance strategy to detect remaining COVID-19 community cases through exhaustive identification of every active transmission chain. We identified measures to enable early detection and effective management of any reintroduction of transmission once containment measures are lifted to ensure strong containment measures do not require reinstatement. METHODS We compared efficiency and sensitivity to detect community transmission chains through testing of the following: hospital cases; fever, cough and/or ARI testing at community/primary care; and asymptomatic testing; using surveillance evaluation methods and mathematical modelling, varying testing capacities, reproductive number (R) and weekly cumulative incidence of COVID-19 and non-COVID-19 respiratory symptoms using data from Australia. We assessed system requirements to identify all transmission chains and follow up all cases and primary contacts within each chain, per million population. RESULTS Assuming 20% of cases are asymptomatic and 30% of symptomatic COVID-19 cases present for testing, with R = 2.2, a median of 14 unrecognised community cases (8 infectious) occur when a transmission chain is identified through hospital surveillance versus 7 unrecognised cases (4 infectious) through community-based surveillance. The 7 unrecognised community upstream cases are estimated to generate a further 55-77 primary contacts requiring follow-up. The unrecognised community cases rise to 10 if 50% of cases are asymptomatic. Screening asymptomatic community members cannot exhaustively identify all cases under any of the scenarios assessed. The most important determinant of testing requirements for symptomatic screening is levels of non-COVID-19 respiratory illness. If 4% of the community have respiratory symptoms, and 1% of those with symptoms have COVID-19, exhaustive symptomatic screening requires approximately 11,600 tests/million population using 1/4 pooling, with 98% of cases detected (2% missed), given 99.9% sensitivity. Even with a drop in sensitivity to 70%, pooling was more effective at detecting cases than individual testing under all scenarios examined. CONCLUSIONS Screening all acute respiratory disease in the community, in combination with exhaustive and meticulous case and contact identification and management, enables appropriate early detection and elimination of COVID-19 community transmission. An important component is identification, testing, and management of all contacts, including upstream contacts (i.e. potential sources of infection for identified cases, and their related transmission chains). Pooling allows increased case detection when testing capacity is limited, even given reduced test sensitivity. Critical to the effectiveness of all aspects of surveillance is appropriate community engagement, messaging to optimise testing uptake and compliance with other measures.
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Affiliation(s)
- K Lokuge
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia.
| | - E Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - S Davis
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - L Roberts
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - T Street
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - D O'Donovan
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - G Caleo
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - K Glass
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
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de Azevedo SJ, de Melo AC, Roberts L, Caro I, Xue C, Wainstein A. First-line atezolizumab monotherapy in patients with advanced BRAF V600 wild-type melanoma. Pigment Cell Melanoma Res 2021; 34:973-977. [PMID: 33476492 DOI: 10.1111/pcmr.12960] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 12/14/2020] [Accepted: 01/11/2021] [Indexed: 01/17/2023]
Abstract
Anti-programmed death-1 agents are an established option for advanced melanoma, but the anti-programmed death-ligand 1 (anti-PD-L1) antibody atezolizumab, an agent approved for the treatment of multiple solid tumors, was not previously evaluated. This phase 1b study cohort (NCT03178851; cohort C) evaluated first-line atezolizumab 1,200 mg every 3 weeks in adults with BRAFV600 wild-type, histologically confirmed, advanced or metastatic melanoma. The co-primary end points were confirmed objective response rate (ORR) per Response Evaluation Criteria in Solid Tumors v1.1 and disease control rate (DCR = complete response [CR] +partial response [PR] +stable disease [SD] at 16 weeks). Of 52 enrolled patients, most had lactate dehydrogenase levels lower than the upper limit of normal (77%) and PD-L1-positive tumors (55%). Investigator-assessed confirmed ORR was 35% (95% CI, 22%-49%) and included three CRs (6%) and 15 PRs (29%); DCR was 46%. Median investigator-assessed progression-free survival was 3.7 months (95% CI, 2.1-7.3). The most common any-grade adverse events were anemia (27%), headache (19%), hypertension (19%), constipation (17%), diarrhea (17%), hypothyroidism (17%), asthenia (15%), and pain in extremity (15%). First-line atezolizumab monotherapy is safe and tolerable and has antitumor activity in patients with BRAFV600 wild-type advanced or metastatic melanoma.
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Affiliation(s)
- Sergio Jobim de Azevedo
- Hospital de Clínicas de Porto Alegre, Unidade de Pesquisa Clinica em Oncologia, Porto Alegre, Brazil
| | | | | | - Ivor Caro
- Genentech/Roche, South San Francisco, CA, USA
| | - Cloris Xue
- Hoffmann-La Roche Limited, Mississauga, ON, Canada
| | - Alberto Wainstein
- Cenantron Centro Avançado de Tratamento Oncológico, Ltda., Belo Horizonte, Brazil
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Nezafati P, Dinh D, Duffy S, Reid C, Ajani A, Clark D, Brennan A, Hiew C, Freeman M, Roberts L, Sharma A, Oqueli E. Percutaneous Coronary Intervention Outcomes Based on American College of Cardiology/American Heart Association Coronary Lesion Classification Over 14 Years – Melbourne Interventional Group (MIG) Registry. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.497] [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]
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Ye S, Yao H, Houlihan K, Kalubowilage S, Teo A, Lucarelli N, Koshy A, Teh A, Buntine P, Hamer A, Cooke J, Roberts L, Sajeev J. Outcomes and Trends: Recurrent Syncope Presentations to the Emergency Department. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ye S, Yao H, Kalubowilage S, Houlihan K, Teo A, Lucarelli N, Koshy A, Teh A, Buntine P, Hamer A, Cooke J, Roberts L, Sajeev J. Investigational Burden in Undifferentiated Syncope Presentations. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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