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Crew KD, Anderson GL, Arnold KB, Stieb AP, Amenta JN, Collins N, Law CW, Pruthi S, Sandoval-Leon A, Bertoni D, Grosse Perdekamp MT, Colonna S, Krisher S, King T, Yee LD, Ballinger TJ, Braun-Inglis C, Mangino D, Wisinski KB, DeYoung CA, Ross M, Floyd J, Kaster A, Vander Walde L, Saphner T, Zarwan C, Lo S, Graham C, Conlin A, Yost K, Agnese D, Jernigan C, Hershman DL, Neuhouser ML, Arun B, Kukafka R. Making informed choices on incorporating chemoprevention into carE (MiCHOICE, SWOG 1904): Design and methods of a cluster randomized controlled trial. Contemp Clin Trials 2024; 142:107564. [PMID: 38704119 DOI: 10.1016/j.cct.2024.107564] [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: 12/12/2023] [Revised: 04/15/2024] [Accepted: 05/01/2024] [Indexed: 05/06/2024]
Abstract
INTRODUCTION Women with atypical hyperplasia (AH) or lobular carcinoma in situ (LCIS) have a significantly increased risk of breast cancer, which can be substantially reduced with antiestrogen therapy for chemoprevention. However, antiestrogen therapy for breast cancer risk reduction remains underutilized. Improving knowledge about breast cancer risk and chemoprevention among high-risk patients and their healthcare providers may enhance informed decision-making about this critical breast cancer risk reduction strategy. METHODS/DESIGN We are conducting a cluster randomized controlled trial to evaluate the effectiveness and implementation of patient and provider decision support tools to improve informed choice about chemoprevention among women with AH or LCIS. We have cluster randomized 26 sites across the U.S. through the SWOG Cancer Research Network. A total of 415 patients and 200 healthcare providers are being recruited. They are assigned to standard educational materials alone or combined with the web-based decision support tools. Patient-reported and clinical outcomes are assessed at baseline, after a follow-up visit at 6 months, and yearly for 5 years. The primary outcome is chemoprevention informed choice after the follow-up visit. Secondary endpoints include other patient-reported outcomes, such as chemoprevention knowledge, decision conflict and regret, and self-reported chemoprevention usage. Barriers and facilitators to implementing decision support into clinic workflow are assessed through patient and provider interviews at baseline and mid-implementation. RESULTS/DISCUSSION With this hybrid effectiveness/implementation study, we seek to evaluate if a multi-level intervention effectively promotes informed decision-making about chemoprevention and provide valuable insights on how the intervention is implemented in U.S. CLINICAL SETTINGS TRIAL REGISTRATION NCT04496739.
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Affiliation(s)
- K D Crew
- Columbia University Irving Medical Center, New York, NY, USA.
| | - G L Anderson
- SWOG Statistics and Data Management Center, Seattle, WA, USA
| | - K B Arnold
- SWOG Statistics and Data Management Center, Seattle, WA, USA
| | - A P Stieb
- Columbia University Irving Medical Center, New York, NY, USA
| | - J N Amenta
- Columbia University Irving Medical Center, New York, NY, USA
| | - N Collins
- Columbia University Irving Medical Center, New York, NY, USA
| | - C W Law
- Columbia University Irving Medical Center, New York, NY, USA
| | - S Pruthi
- Mayo Clinic, Rochester, MN, United States of America
| | - A Sandoval-Leon
- Miami Cancer Institute at Baptist Health South Florida, Miami, FL, USA
| | - D Bertoni
- Good Samaritan Hospital Corvallis, Corvallis, OR , USA
| | | | - S Colonna
- Huntsman Cancer Institute / University of Utah Medical Center, Salt Lake City, UT, USA
| | - S Krisher
- Holy Redeemer Hospital and Medical Center, Meadowbrook, PA, USA
| | - T King
- Dana-Farber Brigham Cancer Center, Brigham and Women's Hospital, Boston, MA, USA
| | - L D Yee
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - T J Ballinger
- Indiana University Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| | | | - D Mangino
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - K B Wisinski
- University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | | | - M Ross
- Virginia Commonwealth University, Richmond, VA, USA
| | - J Floyd
- Cancer Care Specialists of Illinois, Heartland NCORP, Decatur, IL, USA
| | - A Kaster
- Sanford Roger Maris Cancer Center, Fargo, ND, United States of America
| | - L Vander Walde
- Baptist Memorial Health Care, Memphis, TN, United States of America
| | | | - C Zarwan
- Lahey Hospital & Medical Center, Burlington, MA, USA
| | - S Lo
- Loyola University Stritch School of Medicine, Maywood, IL, USA
| | - C Graham
- Emory University Hospital/Winship Cancer Institute, Atlanta, GA, USA
| | - A Conlin
- Providence Cancer Institute, Portland, OR, USA
| | - K Yost
- Cancer Research Consortium of West Michigan NCORP, Kalamazoo, MI, USA
| | - D Agnese
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - C Jernigan
- SWOG Statistics and Data Management Center, Seattle, WA, USA
| | - D L Hershman
- Columbia University Irving Medical Center, New York, NY, USA
| | | | - B Arun
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - R Kukafka
- Columbia University Irving Medical Center, New York, NY, USA
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Rice SM, Nelson B, Amminger GP, Francey SM, Phillips LJ, Simmons MB, Ross M, Yuen HP, Yung AR, O'Gorman K, McGorry PD, Wood SJ, Berger GE. An open label pilot trial of low-dose lithium for young people at ultra-high risk for psychosis. Early Interv Psychiatry 2024. [PMID: 38600049 DOI: 10.1111/eip.13526] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/11/2024] [Accepted: 03/28/2024] [Indexed: 04/12/2024]
Abstract
AIM Lithium, even at low doses, appears to offer neuroprotection against a wide variety of insults. In this controlled pilot, we examined the safety (i.e., side-effect profile) of lithium in a sample of young people identified at ultra-high risk (UHR) for psychosis. The secondary aim was to explore whether lithium provided a signal of clinical efficacy in reducing transition to psychosis compared with treatment as usual (TAU). METHODS Young people attending the PACE clinic at Orygen, Melbourne, were prescribed a fixed dose (450 mg) of lithium (n = 25) or received TAU (n = 78). The primary outcome examined side-effects, with transition to psychosis, functioning and measures of psychopathology assessed as secondary outcomes. RESULTS Participants in both groups were functionally compromised (lithium group GAF = 56.6; monitoring group GAF = 56.9). Side-effect assessment indicated that lithium was well-tolerated. 64% (n = 16) of participants in the lithium group were lithium-adherent to week 12. Few cases transitioned to psychosis across the study period; lithium group 4% (n = 1); monitoring group 7.7% (n = 6). There was no difference in time to transition to psychosis between the groups. No group differences were observed in other functioning and symptom domains, although all outcomes improved over time. CONCLUSIONS With a side-effect profile either comparable to, or better than UHR antipsychotic trials, lithium might be explored for further research with UHR young people. A definitive larger trial is needed to determine the efficacy of lithium in this cohort.
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Affiliation(s)
- Simon M Rice
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Barnaby Nelson
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - G Paul Amminger
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Shona M Francey
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lisa J Phillips
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Magenta B Simmons
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Margaret Ross
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Hok Pan Yuen
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alison R Yung
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, Victoria, Australia
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Kieran O'Gorman
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Patrick D McGorry
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Stephen J Wood
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Gregor E Berger
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
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Talreja VK, Mannion M, Ross M, Kinirons B. Can't intubate, can't oxygenate' (CICO) how to be better prepared. Ir Med J 2024; 117:904. [PMID: 38260979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
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van den Broek N, van Meulen F, Ross M, Cerny A, Anderer P, van Gilst M, Pillen S, Overeem S, Fonseca P. Automated sleep staging in people with intellectual disabilities using heart rate and respiration variability. J Intellect Disabil Res 2023. [PMID: 37291951 DOI: 10.1111/jir.13060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/14/2023] [Accepted: 05/17/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND People with intellectual disabilities (ID) have a higher risk of sleep disorders. Polysomnography (PSG) remains the diagnostic gold standard in sleep medicine. However, PSG in people with ID can be challenging, as sensors can be burdensome and have a negative influence on sleep. Alternative methods of assessing sleep have been proposed that could potentially transfer to less obtrusive monitoring devices. The goal of this study was to investigate whether analysis of heart rate variability and respiration variability is suitable for the automatic scoring of sleep stages in sleep-disordered people with ID. METHODS Manually scored sleep stages in PSGs of 73 people with ID (borderline to profound) were compared with the scoring of sleep stages by the CardioRespiratory Sleep Staging (CReSS) algorithm. CReSS uses cardiac and/or respiratory input to score the different sleep stages. Performance of the algorithm was analysed using input from electrocardiogram (ECG), respiratory effort and a combination of both. Agreement was determined by means of epoch-per-epoch Cohen's kappa coefficient. The influence of demographics, comorbidities and potential manual scoring difficulties (based on comments in the PSG report) was explored. RESULTS The use of CReSS with combination of both ECG and respiratory effort provided the best agreement in scoring sleep and wake when compared with manually scored PSG (PSG versus ECG = kappa 0.56, PSG versus respiratory effort = kappa 0.53 and PSG versus both = kappa 0.62). Presence of epilepsy or difficulties in manually scoring sleep stages negatively influenced agreement significantly, but nevertheless, performance remained acceptable. In people with ID without epilepsy, the average kappa approximated that of the general population with sleep disorders. CONCLUSIONS Using analysis of heart rate and respiration variability, sleep stages can be estimated in people with ID. This could in the future lead to less obtrusive measurements of sleep using, for example, wearables, more suitable to this population.
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Affiliation(s)
- N van den Broek
- Centre for Sleep Medicine, Kempenhaeghe, Heeze, The Netherlands
| | - F van Meulen
- Centre for Sleep Medicine, Kempenhaeghe, Heeze, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - M Ross
- Sleep and Respiratory Care, Home Healthcare Solutions, Philips Austria GmbH, Vienna, Austria
| | - A Cerny
- Sleep and Respiratory Care, Home Healthcare Solutions, Philips Austria GmbH, Vienna, Austria
| | - P Anderer
- Sleep and Respiratory Care, Home Healthcare Solutions, Philips Austria GmbH, Vienna, Austria
| | - M van Gilst
- Centre for Sleep Medicine, Kempenhaeghe, Heeze, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - S Pillen
- Centre for Sleep Medicine, Kempenhaeghe, Heeze, The Netherlands
| | - S Overeem
- Centre for Sleep Medicine, Kempenhaeghe, Heeze, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - P Fonseca
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Philips Research, Eindhoven, The Netherlands
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Uhomoibhi J, Hooper LO, Ghallab S, Ross M, Staples G. The impact of COVID-19 on professionalism in practice and future directions. IJILT 2022. [DOI: 10.1108/ijilt-05-2022-0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PurposeThis paper seeks to assess the level of impact of COVID-19 pandemic on professional practice for members of professional organisations and the general public in the conduct of business. Investigations into practice using events, attendance records and registered views are carried out. The aim is to identify the challenges and actions being taken to mitigate against them in moving from physical (face-to-face) to virtual (online) mode of operations.Design/methodology/approachThe past two years have seen a complete change in the way we live from life at home, at work and in education. This has impacted the way professional organisations now conduct business including the need to revise ways of upskilling and sustaining practice. Core to all of this is the role of computing and communication for all persons in all works of life. The current study focusses on professional activities and support provided to members of British Computer Society (BCS), The Chartered Institute for IT. The authors examine the events provided, the conduct support provided to members and the general public. The method includes use of surveys of all stakeholders and analysis of data obtained.FindingsThe onset of COVID-19 pandemic was perceived as a real shock for everyone everywhere. Contrary to expectations, faced with the reality of having to do everyone online, the current study found that there were observed increased in the number of activities of professional organisations worldwide. Most interesting is that fact that the number of people participating in these events was found to be increasing using e-learning and other associated online tools and resources. Participants of these events were no longer restricted to local members but widespread globally. There was the appetite for more events to be put up and willingness for more individual and groups to volunteer and/or participate.Research limitations/implicationsThe limitations of current study are that only a few of the many activities have been investigated in this one professional body, BCS, The Chartered Institute for IT. The fact that more events are now being carried out for the many groups and branches implies a lot more digital data would be available for further study to inform developments of members and the general public.Practical implicationsThe impact of COVID-19 pandemic is a huge and evolving. It remains and presents a complicated case for the world to deal with. Amongst the many realities is that living life online has become a new normal and one everybody must learn to adjust to. Professional organisations such as the BCS would need to think of not only their members but also the general public and how well society and business can be sustained going forward. This involves considering developments of educational resources and appropriate platforms to meet the needs of the public, private and the voluntary sectors in society.Social implicationsDue to restricted physical (face-to-face) interactions, previously developed processes would require reviewing. New informed policies would need to be developed and implemented by professional organisations on revised practices resulting from impact of the pandemic. The emanating global participation from local activities presents challenges involving time, space (geographical location) and cultural differences. The digital divide that exists in society and access to the fast and reliable Internet services are also worth considering.Originality/valueThe impact of COVID-19 on professional practice applied to education and business is important in the face of the many and varied challenges everyone is facing everywhere in the world. This has been intense at home and at work globally. Although the true cause is yet to be established, it is important that ways to address challenges and continue with life are found and implemented. This paper establishes some of the impacts and present recommendations that are useful in forging ahead for people in the information technology profession.
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Heidenreich S, Phillips-Beyer A, Ross M, Nie Chua G, Fietze I, Mayleben D. A benefit-risk assessment of daridorexant for the treatment of insomnia using patient preference data from two phase 3 trials. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Ross M, Obolensky A, Averbukh E, Desrosiers M, Ezra-Elia R, Honig H, Yamin E, Rosov A, Dvir H, Gootwine E, Banin E, Dalkara D, Ofri R. Outer retinal transduction by AAV2-7m8 following intravitreal injection in a sheep model of CNGA3 achromatopsia. Gene Ther 2022; 29:624-635. [PMID: 34853444 DOI: 10.1038/s41434-021-00306-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 10/26/2021] [Accepted: 11/15/2021] [Indexed: 01/09/2023]
Abstract
Sheep carrying a mutated CNGA3 gene exhibit diminished cone function and provide a naturally occurring large animal model of achromatopsia. Subretinal injection of a vector carrying the CNGA3 transgene resulted in long-term recovery of cone function and photopic vision in these sheep. Research is underway to develop efficacious vectors that would enable safer transgene delivery, while avoiding potential drawbacks of subretinal injections. The current study evaluated two modified vectors, adeno-associated virus 2-7m8 (AAV2-7m8) and AAV9-7m8. Intravitreal injection of AAV2-7m8 carrying enhanced green fluorescent protein under a cone-specific promoter resulted in moderate photoreceptor transduction in wild-type sheep, whereas peripheral subretinal delivery of AAV9-7m8 resulted in the radial spread of the vector beyond the point of deposition. Intravitreal injection of AAV2-7m8 carrying human CNGA3 in mutant sheep resulted in mild photoreceptor transduction, but did not lead to the clinical rescue of photopic vision, while day-blind sheep treated with a subretinal injection exhibited functional recovery of photopic vision. Transgene messenger RNA levels in retinas of intravitreally treated eyes amounted to 4-23% of the endogenous CNGA3 levels, indicating that expression levels >23% are needed to achieve clinical rescue. Overall, our results indicate intravitreal injections of AAV2.7m8 transduce ovine photoreceptors, but not with sufficient efficacy to achieve clinical rescue in CNGA3 mutant sheep.
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Affiliation(s)
- M Ross
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - A Obolensky
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - E Averbukh
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - M Desrosiers
- Department of Therapeutics, Institut de la Vision, Paris, France
| | - R Ezra-Elia
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - H Honig
- Department of Animal Science, ARO, The Volcani Center, Rishon LeZion, Israel
| | - E Yamin
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - A Rosov
- Department of Animal Science, ARO, The Volcani Center, Rishon LeZion, Israel
| | - H Dvir
- Department of Animal Science, ARO, The Volcani Center, Rishon LeZion, Israel
| | - E Gootwine
- Department of Animal Science, ARO, The Volcani Center, Rishon LeZion, Israel
| | - E Banin
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - D Dalkara
- Department of Therapeutics, Institut de la Vision, Paris, France
| | - R Ofri
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel.
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Ho JY, Mattei J, Tetzlaff M, Williams M, Davies M, Diab A, Glitza I, Mcquade J, Patel S, Tawbi H, Wong M, Yee C, Fisher S, Hanna E, Keung E, Ross M, Su S, Faria S, Nagaraja P, Amaria R. 801P Neoadjuvant checkpoint inhibitor immunotherapy (IMT) for resectable mucosal melanoma (MM). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Abdel-Fattah AR, Bell F, Boden L, Ferry J, McCormick C, Ross M, Cameron I, Smith T, Baliga S, Myint P. 327 To Fuse or Not to Fuse: The Elderly Patient with Lumbar Stenosis and Low-Grade Spondylolisthesis. Systematic Review and Meta-Analysis of Randomised Controlled Trials. Br J Surg 2022. [DOI: 10.1093/bjs/znac268.003] [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: 11/06/2022]
Abstract
Abstract
Aim
The optimum surgical intervention for elderly patients with lumbar spinal stenosis(LSS) and low-grade degenerative-spondylolisthesis(LGDS) has been extensively debated. We conducted a systematic review and meta-analysis of randomised-controlled-trials(RCTs) comparing the effectiveness of decompression-alone against gold-standard decompression-with-fusion(D+F) in elderly patients with LSS and LGDS.
Method
A systematic literature search was performed on published databases from inception to October-2021. English-language RCTs of elderly patients (mean age over-65) with LSS and LGDS, who had undergone DA or D+F were included. The quality and weight of evidence was assessed, and a meta-analysis performed.
Results
Seven RCTs (n=581; mean age:65.9 years; 59.9% female) were included. There was no difference in visual-analogue-scale(VAS) scores of back-pain(BP) or leg-pain(LP) at mean follow-up of 28.6 months between both DA and D+F groups (BP: mean-difference (MD)-0.22, 95%CI:-0.76–0.32; LP: MD:-0.26, 95%CI:-0.79–0.27). In addition, subgroup analysis of long-term follow-up (>3 years) showed lower VAS scores for BP and LP in patients who underwent DA (BP MD:-1.70, 95%CI:-2.8-(-0.60); LP MD:-1.00, 95%CI:-1.77-(-0.23)). No difference in disability, measured by Oswestry-Disability-Index(ODI) scores, was found between both groups (MD:0.50, 95%CI: -3.31–4.31). However, patients in DA group had less hospital complications and fewer adverse events (total-surgical-complications OR:0.57, 95%CI:0.36–0.90), despite a higher rate of post-operative DS (OR:8.63, 95%CI:3.35–22.26).
Conclusions
DA is not inferior to D+F in elderly patients with LSS and LGDS. DA has better pain outcomes at three-years follow-up and carries lower risk hospital-complications and fewer adverse-events. Surgeons should weigh these findings with increased risk of DS-progression.
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Affiliation(s)
- AR Abdel-Fattah
- University of Aberdeen , Aberdeen , United Kingdom
- Ageing Clinical and Experimental Research (ACER) Team, Institute of Applied Health Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen , Aberdeen , United Kingdom
| | - F Bell
- University of Aberdeen , Aberdeen , United Kingdom
| | - L Boden
- University of Aberdeen , Aberdeen , United Kingdom
| | - J Ferry
- University of Aberdeen , Aberdeen , United Kingdom
| | - C McCormick
- University of Aberdeen , Aberdeen , United Kingdom
| | - M Ross
- University of Aberdeen , Aberdeen , United Kingdom
| | - I Cameron
- University of Aberdeen , Aberdeen , United Kingdom
| | - T Smith
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford , Oxford , United Kingdom
| | - S Baliga
- Department of Trauma & Orthopaedics , Aberdeen Royal Infirmary, Aberdeen , United Kingdom
| | - P Myint
- University of Aberdeen , Aberdeen , United Kingdom
- Ageing Clinical and Experimental Research (ACER) Team, Institute of Applied Health Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen , Aberdeen , United Kingdom
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Neubeck L, Mchale S, Ross M, Galbraith M, Hanson C. Spontaneous coronary artery dissection; a systematic review of physical and psychosocial recovery following discharge from hospital. Eur J Cardiovasc Nurs 2022. [DOI: 10.1093/eurjcn/zvac060.042] [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: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Edinburgh Napier University
Introduction
Spontaneous coronary artery dissection (SCAD) is increasingly recognised as an important cause of myocardial infarction, particularly among women. SCAD survivors may not know what physical activity is safe and effective and there may be a psychosocial burden of living with a SCAD diagnosis. This review aimed to determine the evidence regarding physical activity, cardiovascular risk factors, or associated factors, and the psychosocial impact of SCAD for SCAD survivors after hospital discharge.
Methods
A systematic review completed in accordance with PRISMA guidelines
Results
The review included 28 studies. These used a range of methods. None were randomised controlled trials. There were 4167 SCAD participants although some were sourced from the same SCAD registries, so may not be unique. They were mainly female (n=3897 93.5%, range=57.7%-100%), with mean age 48.0±9.8 years at index event. Participants mostly came from the USA, Canada, or the Netherlands. We found very limited evidence for cardiorespiratory fitness improvements following cardiac rehabilitation (CR). Existing CR was not tailored to SCAD specific needs and SCAD survivors lacked guidance about appropriate physical activity. Some participants had high levels of psychosocial distress. SCAD survivors highlighted the need for tailored support that included family members. Many SCAD survivors have traditional risk factors including hypertension, hyperlipidaemia and overweight/obesity. Chest pain following SCAD is common.
Conclusions
There is an urgent need to develop physical and psychological recovery programmes for SCAD survivors, and test effectiveness via randomised controlled trials. Psychosocial support is particularly required, given the high burden of psychosocial issues.
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Affiliation(s)
- L Neubeck
- Edinburgh Napier University , Edinburgh , United Kingdom of Great Britain & Northern Ireland
| | - S Mchale
- Edinburgh Napier University , Edinburgh , United Kingdom of Great Britain & Northern Ireland
| | - M Ross
- Edinburgh Napier University , Edinburgh , United Kingdom of Great Britain & Northern Ireland
| | - M Galbraith
- ESC Patient Forum , Western Isles , United Kingdom of Great Britain & Northern Ireland
| | - C Hanson
- Edinburgh Napier University , Edinburgh , United Kingdom of Great Britain & Northern Ireland
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Conduit C, Guo C, Smith AB, Rincones O, Baenziger O, Thomas B, Goad J, Lenaghan D, Lawrentschuk N, Wong LM, Corcoran NM, Ross M, Gibbs P, O'Haire S, Anton A, Liow E, Lewin J, Tran B. Distress in People with Newly Diagnosed Testicular Cancer – Role for an Online Intervention to Alleviate Distress? (Preprint). JMIR Cancer 2022; 8:e39725. [DOI: 10.2196/39725] [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: 05/19/2022] [Revised: 08/24/2022] [Accepted: 09/14/2022] [Indexed: 11/13/2022] Open
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Ross M, Smith M, Vicenzino B. Using the international classification of functioning to characterise tibialis posterior tendinopathy. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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13
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Ross M, Setchell J. Physiotherapists’ knowledge regarding and experience working with clients who identify as LGBTQIA+. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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14
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Dwyer J, O'Callaghan C, Ross M. The cancer care observation: an empathy training experience. Australas Psychiatry 2021; 29:275-277. [PMID: 32961101 DOI: 10.1177/1039856220956464] [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] [Indexed: 11/15/2022]
Abstract
OBJECTIVE A 'cancer care observation' (CCO) empathy training is described. This study examined psychiatry trainees' experience of CCO and cancer patients' experience of being observed. METHOD Trainees were paired with consenting patients undergoing cancer treatment; they observed a number of cancer treatment sessions and chronicled their experiences. The observations were discussed in supervision. Semi-structured interviews were conducted with trainees and observed patients. Observation journals and transcribed interviews were analysed using qualitative description. RESULTS Seven trainees participated. Three themes emerged: patients used trainees to support themselves while trainees struggled with role identities; CCO extends trainees' professional awareness and can benefit patients; and staff reactions were mixed. Trainees developed wide-ranging, empathic insights into cancer and hospital care experiences. No patient regarded CCO as intrusive. CONCLUSIONS Trainees garnered insights from CCO as they generated clinical hypotheses, learnt about professional boundaries and gained first-hand experience of unconscious mental processes based on their empathic connections. CCO lends itself to psychiatry and, potentially, other medical trainees.
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15
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Ross M, Muggeridge D, Dodd J. Moderate and vigorous physical activity levels are associated with circulating CD34+ progenitor cells which are predictive of all-cause and cardiovascular mortality. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.199] [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]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Edinburgh Napier University Research Excellence Grant
Background
Circulating progenitor cells (CPCs) play an important role in vascular repair and may influence cardiovascular (CV) health and longevity. Physical activity is known to promote vascular health and may do so by modulating CPC counts.
Purpose
The primary aims of this study were to evaluate the association of CPCs with mortality and explore the association between physical activity (PA) and CPCs.
Methods
We studied 1,751 individuals from the Framingham Offspring cohort (66 ± 9 years, 54% female). CPCs (CD34+, CD34 + CD133+, CD34 + CD133 + KDR+) were measured from blood samples by flow cytometry. Multivariable cox regression analyses were performed to investigate the relationship of CPCs with future CV event, mortality, and all-cause mortality. Multivariate regression analyses were performed to determine the relationship between self-reported PA and CPC counts.
Results
Following adjustment for standard risk factors, there was an inverse association between CD34+ CPCs and all-cause mortality (hazard ratio (HR) per unit increase in CD34+, 0.79; 95% CI 0.64 – 0.98). CD34 + CD133+ CPCs were inversely associated with CV mortality (HR 0.63, 95% CI 0.44 – 0.91, P = 0.013). Associations of CD34+ and CD34 + CD133+ with mortality were strongest in participants with pre-existing CVD. PA was associated with CD34+ CPCs only in CVD participants. This relationship was maintained after adjustment for confounding variables.
Conclusions
Higher number of CD34+ and CD34+ CD133+ CPCs were inversely associated with all-cause and CV mortality. These associations were strongest in participants already diagnosed with CVD. PA is independently associated with CD34+ CPCs in individuals with CVD only, suggestive of greater benefit for this population group.
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Affiliation(s)
- M Ross
- Edinburgh Napier University, Edinburgh, United Kingdom of Great Britain & Northern Ireland
| | - D Muggeridge
- Edinburgh Napier University, Edinburgh, United Kingdom of Great Britain & Northern Ireland
| | - J Dodd
- Edinburgh Napier University, Edinburgh, United Kingdom of Great Britain & Northern Ireland
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16
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Williams ML, Korevaar D, Harvey R, Fitzgerald PB, Liknaitzky P, O'Carroll S, Puspanathan P, Ross M, Strauss N, Bennett-Levy J. Translating Psychedelic Therapies From Clinical Trials to Community Clinics: Building Bridges and Addressing Potential Challenges Ahead. Front Psychiatry 2021; 12:737738. [PMID: 34803761 PMCID: PMC8599345 DOI: 10.3389/fpsyt.2021.737738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/12/2021] [Indexed: 01/01/2023] Open
Abstract
Research exploring the potential of psychedelic-assisted therapies to treat a range of mental illnesses is flourishing, after the problematic sociopolitical history of psychedelics led to the shutdown of clinical research for almost 40 years. Encouraged by positive results, clinicians and patients are now hopeful that further interruptions to research will be avoided, so that the early promise of these therapies might be fulfilled. At this early stage of renewed interest, researchers are understandably focusing more on clinical trials to investigate safety and efficacy, than on longer-term goals such as progression to community practice. Looking to identify and avoid potential pitfalls on the path to community clinics, the authors, a group of Australian clinicians and researchers, met to discuss possible obstacles. Five broad categories of challenge were identified: 1) inherent risks; 2) poor clinical practice; 3) inadequate infrastructure; 4) problematic perceptions; and 5) divisive relationships and fractionation of the field. Our analysis led us to propose some strategies, including public sector support of research and training to establish best practice and optimize translation, and funding to address issues of equitable access to treatment. Above all, we believe that strategic planning and professional cohesion will be crucial for success. Accordingly, our key recommendation is the establishment of a multidisciplinary advisory body, broadly endorsed and representing all major stakeholders, to guide policy and implementation of psychedelic-assisted therapies in Australia. Although these challenges and strategies are framed within the Australian context, we sense that they may generalize to other parts of the world. Wherever they apply, we believe that anticipation of potential difficulties, and creative responses to address them, will be important to avoid roadblocks in the future and keep the "psychedelic renaissance" on track.
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Affiliation(s)
- Martin L Williams
- Turner Institute, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia.,Psychedelic Research in Science & Medicine (PRISM) Ltd, Melbourne, VIC, Australia
| | - Diana Korevaar
- Department of Psychosocial Cancer Care & Palliative Care, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.,Centre for Mental Health, Department of Psychological Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | | | - Paul B Fitzgerald
- Epworth Centre for Innovation in Mental Health, Epworth Healthcare, Melbourne, VIC, Australia.,Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Paul Liknaitzky
- Turner Institute, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia.,Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | | | | | - Margaret Ross
- Department of Psychosocial Cancer Care & Palliative Care, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia
| | - Nigel Strauss
- Department of Psychosocial Cancer Care & Palliative Care, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.,Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia.,Centre for Mental Health, Swinburne University, Melbourne, VIC, Australia
| | - James Bennett-Levy
- University Centre for Rural Health, The University of Sydney, Lismore, NSW, Australia
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17
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van Gilst MM, Wulterkens BM, Fonseca P, Radha M, Ross M, Moreau A, Cerny A, Anderer P, Long X, van Dijk JP, Overeem S. Direct application of an ECG-based sleep staging algorithm on reflective photoplethysmography data decreases performance. BMC Res Notes 2020; 13:513. [PMID: 33168051 PMCID: PMC7653690 DOI: 10.1186/s13104-020-05355-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/23/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE The maturation of neural network-based techniques in combination with the availability of large sleep datasets has increased the interest in alternative methods of sleep monitoring. For unobtrusive sleep staging, the most promising algorithms are based on heart rate variability computed from inter-beat intervals (IBIs) derived from ECG-data. The practical application of these algorithms is even more promising when alternative ways of obtaining IBIs, such as wrist-worn photoplethysmography (PPG) can be used. However, studies validating sleep staging algorithms directly on PPG-based data are limited. RESULTS We applied an automatic sleep staging algorithm trained and validated on ECG-data directly on inter-beat intervals derived from a wrist-worn PPG sensor, in 389 polysomnographic recordings of patients with a variety of sleep disorders. While the algorithm reached moderate agreement with gold standard polysomnography, the performance was significantly lower when applied on PPG- versus ECG-derived heart rate variability data (kappa 0.56 versus 0.60, p < 0.001; accuracy 73.0% versus 75.9% p < 0.001). These results show that direct application of an algorithm on a different source of data may negatively affect performance. Algorithms need to be validated using each data source and re-training should be considered whenever possible.
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Affiliation(s)
- M M van Gilst
- Department of Electrical Engineering, Eindhoven University of Technology, PO Box 513, 5600 MB, Eindhoven, The Netherlands. .,Sleep Medicine Centre Kempenhaeghe, Sterkselseweg 65, 5591 VE, Heeze, The Netherlands.
| | - B M Wulterkens
- Department of Electrical Engineering, Eindhoven University of Technology, PO Box 513, 5600 MB, Eindhoven, The Netherlands.,Philips Research, High Tech Campus 34, 5656 AE, Eindhoven, The Netherlands
| | - P Fonseca
- Department of Electrical Engineering, Eindhoven University of Technology, PO Box 513, 5600 MB, Eindhoven, The Netherlands.,Philips Research, High Tech Campus 34, 5656 AE, Eindhoven, The Netherlands
| | - M Radha
- Department of Electrical Engineering, Eindhoven University of Technology, PO Box 513, 5600 MB, Eindhoven, The Netherlands.,Philips Research, High Tech Campus 34, 5656 AE, Eindhoven, The Netherlands
| | - M Ross
- Sleep and Respiratory Care, Home Healthcare Solutions, Philips Austria GmbH, Kranichberggasse 4, 1120, Vienna, Austria
| | - A Moreau
- Sleep and Respiratory Care, Home Healthcare Solutions, Philips Austria GmbH, Kranichberggasse 4, 1120, Vienna, Austria
| | - A Cerny
- Sleep and Respiratory Care, Home Healthcare Solutions, Philips Austria GmbH, Kranichberggasse 4, 1120, Vienna, Austria
| | - P Anderer
- Sleep and Respiratory Care, Home Healthcare Solutions, Philips Austria GmbH, Kranichberggasse 4, 1120, Vienna, Austria
| | - X Long
- Department of Electrical Engineering, Eindhoven University of Technology, PO Box 513, 5600 MB, Eindhoven, The Netherlands.,Philips Research, High Tech Campus 34, 5656 AE, Eindhoven, The Netherlands
| | - J P van Dijk
- Department of Electrical Engineering, Eindhoven University of Technology, PO Box 513, 5600 MB, Eindhoven, The Netherlands.,Sleep Medicine Centre Kempenhaeghe, Sterkselseweg 65, 5591 VE, Heeze, The Netherlands
| | - S Overeem
- Department of Electrical Engineering, Eindhoven University of Technology, PO Box 513, 5600 MB, Eindhoven, The Netherlands.,Sleep Medicine Centre Kempenhaeghe, Sterkselseweg 65, 5591 VE, Heeze, The Netherlands
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18
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Chipps B, Murphy K, Wise R, McCann W, Beuther D, Reibman J, George M, Eudicone J, Gandhi H, Harding G, Ross M, Zeiger R. P223 EVALUATING PERFORMANCE OF THE ASTHMA IMPAIRMENT AND RISK QUESTIONNAIRE (AIRQ™) AT 3-MONTH INTERVALS. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.120] [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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19
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Kirwan PD, Hibbert M, Kall M, Nambiar K, Ross M, Croxford S, Nash S, Webb L, Wolton A, Delpech VC. HIV prevalence and HIV clinical outcomes of transgender and gender-diverse people in England. HIV Med 2020; 22:131-139. [PMID: 33103840 DOI: 10.1111/hiv.12987] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 08/07/2020] [Accepted: 09/23/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We provide the first estimate of HIV prevalence among trans and gender-diverse people living in England and compare outcomes of people living with HIV according to gender identity. METHODS We analysed a comprehensive national HIV cohort and a nationally representative self-reported survey of people accessing HIV care in England (Positive Voices). Gender identity was recorded using a two-step question co-designed with community members and civil society. Responses were validated by clinic follow-up and/or self-report. Population estimates were obtained from national government offices. RESULTS In 2017, HIV prevalence among trans and gender-diverse people was estimated at 0.46-4.78 per 1000, compared with 1.7 (95% credible interval: 1.6-1.7) in the general population. Of 94 885 people living with diagnosed HIV in England, 178 (0.19%) identified as trans or gender-diverse. Compared with cisgender people, trans and gender-diverse people were more likely to be London residents (57% vs. 43%), younger (median age 42 vs. 46 years), of white ethnicity (61% vs. 52%), under psychiatric care (11% vs. 4%), to report problems with self-care (37% vs. 13%), and to have been refused or delayed healthcare (23% vs. 11%). Antiretroviral uptake and viral suppression were high in both groups. CONCLUSIONS HIV prevalence among trans and gender-diverse people living in England is relatively low compared with international estimates. Furthermore, no inequalities were observed with regard to HIV care. Nevertheless, trans and gender-diverse people with HIV report poorer mental health and higher levels of discrimination compared with cisgender people.
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Affiliation(s)
- P D Kirwan
- Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, Public Health England, London, UK.,Medical Research Council Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - M Hibbert
- Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, Public Health England, London, UK
| | - M Kall
- Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, Public Health England, London, UK
| | - K Nambiar
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | | | - S Croxford
- Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, Public Health England, London, UK
| | - S Nash
- Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, Public Health England, London, UK
| | - L Webb
- LGBT Foundation, Manchester, UK
| | - A Wolton
- Chelsea and Westminster Hospital NHS Trust, London, UK
| | - V C Delpech
- Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, Public Health England, London, UK
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20
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Zager J, Sarnaik A, Pilon-Thomas S, Beatty M, Han D, Lu G, Agarwala S, Ross M, Shirai K, Essner R, Smithers B, Atkinson VV, Wachter E. 1123P A phase Ib study of rose bengal disodium and anti-PD-1 in metastatic cutaneous melanoma: Initial results in patients refractory to checkpoint blockade. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1246] [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: 10/23/2022] Open
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21
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Agarwala S, Ross M, Zager J, Sarnaik A, Shirai K, Lu G, Essner R, Smithers B, Atkinson VV, Wachter E. 1125P A phase Ib study of rose bengal disodium and anti-PD-1 in metastatic cutaneous melanoma: Results in patients naïve to immune checkpoint blockade. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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22
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O'Callaghan C, Hubik DJ, Dwyer J, Williams M, Ross M. Experience of Music Used With Psychedelic Therapy: A Rapid Review and Implications. J Music Ther 2020; 57:282-314. [PMID: 32227084 DOI: 10.1093/jmt/thaa006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Bonny Method of Guided Imagery and Music emerged following discontinuation of psychedelic therapy research in the early 1970s, but psychedelic therapy research has since revived. Music remains a vital component. This study examined participants' experiences of music in psychedelic therapy research. A rapid review of qualitative and quantitative journal articles in four major databases was conducted in February to April, 2019, using the terms hallucinogens, psychedelic, "lysergic acid diethylamide," psilocybin, ayahuasca, music, and/or "music therapy." Of 406 articles retrieved, 10 were included (n = 180; 18-69 years old). Participants had varied backgrounds. Music was widely considered integral for meaningful emotional and imagery experiences and self-exploration during psychedelic therapy. Music transformed through its elicitation of anthropomorphic, transportive, synesthetic, and material sensations. Music could convey love, carry listeners to other realms, be something to "hold," inspire, and elicit a deep sense of embodied transformation. Therapeutic influence was especially evident in music's dichotomous elicitations: Music could simultaneously anchor and propel. Participant openness to music and provision of participant-centered music were associated with optimal immediate and longer-term outcomes. Many studies reported scarce details about the music used and incidental findings of music experienced. Further understanding of participants' idiosyncratic and shared responses to music during drug therapy phases will inform optimal development of flexible music protocols which enhance psychedelic therapy. Music therapists could be involved in the psychedelic therapy research renaissance through assisting with research to optimize music-based protocols used. If psychedelics become approved medicines, music therapists may be involved in offering psychedelic therapy as part of therapeutic teams.
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Affiliation(s)
- Clare O'Callaghan
- Caritas Christi Hospice & Department of Psychosocial Cancer Care Research, St Vincent's Hospital, Melbourne, AustraliaDepartment of Medicine, St Vincent's Hospital, and Melbourne Conservatorium of Music, The University of Melbourne, Melbourne, Australia
| | - Daniel J Hubik
- Department of Psychosocial Cancer Care Research, St Vincent's Hospital, Melbourne, Australia
| | - Justin Dwyer
- Department of Psychosocial Cancer Care Research, St Vincent's Hospital, Melbourne, Australia
| | - Martin Williams
- Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, AustraliaPRISM Inc., Melbourne, Australia
| | - Margaret Ross
- Caritas Christi Hospice & Department of Psychosocial Cancer Care Research, St Vincent's Hospital, Melbourne, Australia
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23
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Anderer P, Ross M, Cerny A, Radha M, Fonseca P. 0436 Deep Learning for Scoring Sleep Based on Signals Available in Home Sleep Apnea Test Studies: Cardiorespiratory Sleep Staging. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Typically, neurological signals are not recorded in home sleep apnea testing (HSAT) and thus standard sleep scoring is not applicable. The respiratory event index is calculated using total recording time rather than total sleep time (TST) resulting in a risk of underestimating sleep apnea severity. The objective of the study was to evaluate if artificial intelligence approaches can provide sleep scoring based on cardiorespiratory signals (CReSS) with reasonable accuracy.
Methods
Supervised deep learning for scoring sleep was trained with 472 and tested in 116 polysomnographies (PSG), scored independently by two experts and by a consensus scorer. The resulting bidirectional long short-term memory recurrent neural network (RNN) was integrated in the Somnolyzer system and validated in 97 PSGs of patients with obstructive sleep apnea (OSA) which had been scored independently by four human experts. Cohen’s kappa agreement for four stages (W, L: N1+N2, D: N3, R) was determined as compared to a consensus scoring.
Results
Epoch-by-epoch comparison between CReSS autoscoring and manual consensus scoring resulted in Cohen’s kappa of 0.68 (W: 0.74, L: 0.63, D: 0.54, R: 0.79). The intra-class correlation coefficient (ICC) between TST derived from CReSS and from neurological scoring was 0.86 (95%-CI: 0.79-0.90), while the ICC between subjective TST from sleep questionnaire and the objective TST was only 0.65 (95%-CI: 0.45-0.77). REM-related OSA had a prevalence of 16% and was detected with an accuracy of 95%.
Conclusion
With a kappa of 0.68, the cardiorespiratory-based RNN classifier is far above previously published values and reflects a substantial agreement with the manual consensus scoring in patients with sleep-disordered breathing. Thus, applying CReSS allows a more accurate determination of the OSA-severity and even a detection of REM related OSA in HSAT studies.
Support
All authors are employees of Philips
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Affiliation(s)
- P Anderer
- Philips Austria GmbH, Vienna, AUSTRIA
| | - M Ross
- Philips Austria GmbH, Vienna, AUSTRIA
| | - A Cerny
- Philips Austria GmbH, Vienna, AUSTRIA
| | - M Radha
- Royal Philips, Eindhoven, NETHERLANDS
- Eindhoven University of Technology, Eindhoven, NETHERLANDS
| | - P Fonseca
- Royal Philips, Eindhoven, NETHERLANDS
- Eindhoven University of Technology, Eindhoven, NETHERLANDS
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24
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Anderer P, Ross M, Cerny A, Moreau A. 0435 Autoscoring of Sleep and Associated Events Versus a Reference Scorer Competing with Three Additional Manual Scorings: A Clinical Validation Study. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Manual scoring of polysomnographic (PSG) data is a time-consuming and tedious process with noticeable inter-rater variability. Autoscoring may overcome these limitations if it delivers valid results. The goal of this study was to validate a comprehensive autoscoring system in a clinically representative population.
Methods
The validation data consisted of 97 PSGs in patients with sleep-related breathing disorder, scored manually by a reference scorer and three further experts. The Somnolyzer autoscoring system combined pattern recognition for events such as spindles, k-complexes, slow-waves, eye-movements, apneas, hypopneas, desaturations and leg movements with an artificial intelligence classifier consisting of a bidirectional long short-term memory recurrent neural network (RNN) architecture. Intra-class correlation coefficients (ICC) for absolute agreement were determined for the commonly used metrics in sleep medicine to compare both, the three human expert scorings and the autoscoring versus the reference scoring.
Results
ICC coefficients for autoscoring and the three manual scorings versus the reference scoring were for sleep efficiency: .95, .83, .91, .93; N1(%): .71, .44, .39, .56; N2(%): .87, .63, .55, .45; N3(%): .80, .62, .44, .32; R(%): .92, .89, .91, .88; arousal index: .88, .81, .22, .78; PLMI: .97, .88, .86, .91; AHI: .91, .89, .87, .78; OA: .94, .89, .91, .90; CA: .96, .96, .96, .82; MA: .93, .77, .43, .41. Thus, the ICCs between autoscoring and the reference scoring were equal or higher than the ICCs between any of the three manual scorings and the reference scoring for all endpoints.
Conclusion
Autoscoring of PSGs based on artificial intelligence outperformed even the best of three human expert scorers. Since the autoscoring performs pattern recognition in real-time, the final autoscoring results are available immediately after the end of the recording.
Support
All authors are employees of Philips
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Affiliation(s)
- P Anderer
- Philips Austria GmbH, Vienna, AUSTRIA
| | - M Ross
- Philips Austria GmbH, Vienna, AUSTRIA
| | - A Cerny
- Philips Austria GmbH, Vienna, AUSTRIA
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25
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Ducournau F, Arianni M, Awwad S, Baur EM, Beaulieu JY, Bouloudhnine M, Caloia M, Chagar K, Chen Z, Chin AY, Chow EC, Cobb T, David Y, Delgado PJ, Woon Man Fok M, French R, Golubev I, Haugstvedt JR, Ichihara S, Jorquera RA, Koo SCJJ, Lee JY, Lee YK, Lee YJ, Liu B, Kaleli T, Mantovani GR, Mathoulin C, Messina JC, Muccioli C, Nazerani S, Ng CY, Obdeijn MC, Van Overstraeten L, Prasetyono TOH, Ross M, Shih JT, Smith N, Suarez R FA, Chan PT, Tiemdjo H, Wahegaonkar A, Wells MC, Wong WY, Wu F, Yang XF, Yanni D, Yao J, Liverneaux PA. COVID-19: Initial experience of an international group of hand surgeons. Hand Surg Rehabil 2020; 39:159-166. [PMID: 32278932 PMCID: PMC7194873 DOI: 10.1016/j.hansur.2020.04.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/01/2020] [Accepted: 04/05/2020] [Indexed: 12/29/2022]
Abstract
The emergence of the COVID-19 pandemic has severely affected medical treatment protocols throughout the world. While the pandemic does not affect hand surgeons at first glance, they have a role to play. The purpose of this study was to describe the different measures that have been put in place in response to the COVID-19 pandemic by hand surgeons throughout the world. The survey comprised 47 surgeons working in 34 countries who responded to an online questionnaire. We found that the protocols varied in terms of visitors, health professionals in the operating room, patient waiting areas, wards and emergency rooms. Based on these preliminary findings, an international consensus on hand surgery practices for the current viral pandemic, and future ones, needs to be built rapidly.
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Affiliation(s)
- F Ducournau
- Icube CNRS 7357, department of hand surgery, hôpital de Hautepierre, university hospital of Strasbourg, FMTS, university of Strasbourg, 1, avenue Molière, 67200 Strasbourg cedex, France
| | - M Arianni
- Department of Surgery, RSUD Pasar Minggu Hospital, Jl. TB Simatupang No.1, RT.1/RW.5, Ragunan, Kec. Ps. Minggu, Kota Jakarta Selatan, Daerah Khusus Ibukota Jakarta 12550, Indonesia
| | - S Awwad
- National Guard Hospital Medina, Ad Dar, Medina, Saudi Arabia
| | - E-M Baur
- Practice of Plastic and Hand Surgery, James-Loeb-Straße 13, 82418 Murnau am Staffelsee, Germany
| | - J-Y Beaulieu
- Hôpitaux universitaire de Genève, département de chirurgie, rue Gabrielle-Perret-Gentil 4, 1205 Genève, Switzerland
| | - M Bouloudhnine
- Les Cliniques El Manar, 2092 rue Habib Echatti, Tunis, Tunisia
| | - M Caloia
- Department of Orthopaedic Surgery, Facultad de Ciencias Biomedicas, Universidad Austral, Hospital Universitario Austral, Pilar, Buenos Aires, Argentina
| | - K Chagar
- Pôle de chirurgie orthopédique, hôpital Militaire d'Instruction Mohamed V, Hay Riad, Rabat, Morocco
| | - Z Chen
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 328 Qi'an Ave, Xinzhou, Wuhan, Hubei, China
| | - A Y Chin
- Department of Hand and Reconstructive Microsurgery, Singapore General Hospital, Academia Building, Outram Rd, Singapour 169608, Singapore
| | - E C Chow
- Department of Orthopaedics and Traumatology, United Christian Hospital, 130 Hip Wo St, Kwun Tong, Hong Kong
| | - T Cobb
- Orthopedic Specialists, P.C., 4622 Progress Drive Suite C, Davenport, IA 52807, USA
| | - Y David
- Hand surgery unit and microsurgery, Hospital Kaplan medical center, Derech Pasternak, Rehovot, Israel
| | - P J Delgado
- Hand Surgery and Microsurgery Department, University Hospital HM Monteprincipe, CEU San Pablo University, Calle de Julián Romea 23, 28003 Madrid, Spain
| | - M Woon Man Fok
- Department of Orthopaedics and Traumatology 5/F, Professorial Block, Queen Mary Hospital, The University of Hong Kong, Queen Mary Hospital Main Block, Pok Fu Lam Rd, Pok Fu Lam, Hong Kong
| | - R French
- The Specialist Referral Clinic, 555W 12th Ave #121, Vancouver, BC V5Z 3X7, Canada
| | - I Golubev
- N. Priorov Research Institute of Trauma Surgery and Orthopaedics, 10 Moscow Ulitsa Priorova, Russia
| | - J R Haugstvedt
- Division of Handsurgery, Department of Orthopedics, Østfold Hospital, Per Gynts vei 78, 1535 Moss, Norway
| | - S Ichihara
- Department of Hand Surgery, Juntendo University Urayasu Hospital, 2 Chome-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan
| | - R A Jorquera
- Department of Hand Surgery and Microsurgery, Clínica Indisa, Andrés Bello University, Av. Sta. María 1810, Santiago, Providencia, Región Metropolitana, Chile
| | - S C J J Koo
- Department of Orthoapedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital, 11 Chuen On Road, Tai Po, NT, Hong Kong
| | - J Y Lee
- Department of Orthopedic Surgery, The Catholic University of Korea, Eunpyeong St. Mary's Hospital, 1021 Tongil-ro, Eunpyeong-gu, 03312 Seoul, Korea
| | - Y K Lee
- Department of Orthopedic Surgery, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, 567 Baekje-daero, Geumam 1(il)-dong, Deokjin-gu, Jeonju-si, Jeollabuk-do, Republic of Korea
| | - Y J Lee
- Department of Orthopaedic Surgery, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Republic of Korea
| | - B Liu
- Department of Hand Surgery, Beijing Ji Shui Tan Hospital, the 4th Clinical College of Peking University, 31 Xinjiekou E Rd, Beijing Xicheng District, China
| | - T Kaleli
- Uludag University, Faculty of Medicine, Department of Orthopaedics, Hand Surgery Clinic, Özlüce, Görükle Kampüsü, 16059 Nilüfer/Bursa, Turkey
| | - G R Mantovani
- Department of Hand Surgery, Sao Paolo Hand center, Ben Portuguesa Hospital, R. Maestro Cardim 769, Bela Vista, São Paulo, SP, 01323-001, Brazil
| | - C Mathoulin
- International Wrist Center, clinique Bizet, Institut de la main, 23, rue Georges-Bizet, 75116 Paris, France
| | - J C Messina
- Gaetano Pini- CTO Orthopaedic Institute, First Orthopaedic Clinic University of Milan, Piazza Cardinale Andrea Ferrari 1, 20122 Milano MI, Italy
| | - C Muccioli
- Icube CNRS 7357, department of hand surgery, hôpital de Hautepierre, university hospital of Strasbourg, FMTS, university of Strasbourg, 1, avenue Molière, 67200 Strasbourg cedex, France
| | - S Nazerani
- Department of Hand and Reconstructive Microsurgery, Mehr General Hospital, W Zartosht St, District 6, Tehran, Tehran Province, IR, Iran
| | - C Y Ng
- Upper Limb Unit, Wrightington Hospital, Appley Bridge, Wigan, UK
| | - M C Obdeijn
- Department of Plastic, Reconstructive and Hand surgery, Amsterdam University Medical Centers, AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - L Van Overstraeten
- Hôpital Erasme, ULB, route de Lennik 808, 1070 Bruxelles, Belgium; Hand and foot surgery unit, Rue Pierre Caille 9, 7500 Tournai, Belgium
| | - T O H Prasetyono
- Division of Plastic Surgery, Department of Surgery, Cipto Mangunkusumo Hospital/Faculty of Medicine Universitas Indonesia, Jl. Pangeran Diponegoro No.71, RW.5, Kenari, Kec. Senen, Kota Jakarta Pusat, Daerah Khusus Ibukota Jakarta 10430, Indonesia
| | - M Ross
- Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, 259 Wickham Terrace, Brisbane City QLD 4000, Australia
| | - J T Shih
- Department of Orthopaedic Surgery, Armed Forces Taoyuan General Hospital, No. 168, Zhongxing Road, Longtan District, Taoyuan City, Taiwan
| | - N Smith
- Southern Highlands Private Hospital, St Jude Specialist Centre, 21 St Jude St, Bowral NSW 2576, Australia
| | - F A Suarez R
- Universidad Militar Nueva Granada, Bogota, Colombia/Private clinic Centro de Cirugia Minimamente Invasiva CECIMIN, 76, Autopista Nte. #104, Bogotá, Colombia
| | - P-T Chan
- Department of Orthopaedics and Traumatology, Tuen Mun Hospital, Block H, Tsing Chung Koon Rd, Tuen Mun, Hong Kong
| | - H Tiemdjo
- Centre de chirurgie de la main et des paralysies de Douala, Bonamoussadi, Douala, Cameroon
| | - A Wahegaonkar
- Dept of Upper Limb, Hand and Microvascular Reconstructive Surgery, Brachial Plexus and Peripheral Nerve Surgery, Sancheti Institute for Orthopaedics and Rehabilitation, Jehangir Hospital, 32, Sasoon Road Opposite Railway Station, Central Excise Colony, Sangamvadi, Pune, Maharashtra 411001, India; The Hand Surgery Clinics, 81/A/11 Giridarshan Society, Behind NEXA Showroom, Baner Road, Pune, Maharashtra 411007, India
| | - M C Wells
- Orthopaedic hand surgeon, Mediclinic Panorama, Panorama, Rothschild Blvd, Panorama, Cape Town, 7500, South Africa
| | - W-Y Wong
- Department of Orthopaedics and Traumatology, the Chinese University of Hong Kong, Central Ave, Hong Kong
| | - F Wu
- Dept of Orthopaedics, University Hospitals Birmingham, Bordesley Green East, Bordesley Green E, Birmingham B9 5SS, UK
| | - X F Yang
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiang'an District, Wuhan, Hubei, China
| | - D Yanni
- KIMS Hospital, Newnham Ct Way, Weavering, Maidstone ME14 5FT, Kent, UK
| | - J Yao
- Robert A. Chase Hand and Upper Limb Center, Stanford University Medical Center, 450 Broadway, Redwood City, CA 94063, USA
| | - P A Liverneaux
- Icube CNRS 7357, department of hand surgery, hôpital de Hautepierre, university hospital of Strasbourg, FMTS, university of Strasbourg, 1, avenue Molière, 67200 Strasbourg cedex, France.
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Meikle SE, Liknaitzky P, Rossell SL, Ross M, Strauss N, Thomas N, Murray G, Williams M, Castle DJ. Psilocybin-assisted therapy for depression: How do we advance the field? Aust N Z J Psychiatry 2020; 54:225-231. [PMID: 31752499 DOI: 10.1177/0004867419888575] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In the quest for new treatment options for depression, attention is being paid to the potential role of psychedelic drugs. Psilocybin is of particular interest given its mechanism of action, its benefits in early trials and its relatively low side effects burden. This viewpoint outlines a number of key issues that remain to be elucidated about its potential use in the clinical environment, including clarification of the profile of people most likely to benefit and those who might experience adverse effects, longer-term outcomes and the role of psychotherapeutic input alongside the drug itself. There are also opportunities to understand better, the neurobiology underpinning its effects.
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Affiliation(s)
- Sally E Meikle
- Melbourne School of Psychological Science, The University of Melbourne, Melbourne, VIC, Australia
| | - Paul Liknaitzky
- School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Susan L Rossell
- Centre for Mental Health, Swinburne University, Hawthorn, VIC, Australia
| | - Margaret Ross
- Department of Psychosocial Cancer Care and Palliative Medicine. St Vincent's Hospital Melbourne, VIC, Australia
| | - Nigel Strauss
- Honorary Research Fellow with Psychiatry, University of Melbourne, Millswyn Psychiatric Clinic, South Yarra, VIC, Australia
| | - Neil Thomas
- School of Psychology, Deakin University, Burwood, VIC, Australia.,Centre for Mental Health, Swinburne University, Hawthorn, VIC, Australia
| | - Greg Murray
- School of Psychology, Deakin University, Burwood, VIC, Australia.,Centre for Mental Health, Swinburne University, Hawthorn, VIC, Australia
| | - Martin Williams
- Medicinal Chemistry and Drug Action, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia
| | - David J Castle
- Department of Psychiatry, St Vincent's Hospital, Fitzroy, VIC, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
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27
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Middleton M, Harrington K, Ross M, Ohrling K, Radcliffe HS, Collichio F. Efficacy of talimogene laherparepvec (T-VEC) in melanoma patients (pts) with locoregional (LR) recurrence, including in-transit metastases (ITM): Subgroup analysis of the phase III OPTiM study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.031] [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: 11/14/2022] Open
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28
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Ross M, Smith M, Vicenzino B. Hip extension deficits and psychosocial features in tibialis posterior tendinopathy: a cross sectional study. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.182] [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: 10/25/2022]
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29
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Marshall L, Lee K, Strachan FE, Fujisawa T, Stewart S, Dhaun N, Ferry A, Ross M, Mills NL. P3598Cardiac Cycle - The effect of exercise on cardiac troponin release. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0458] [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
International guidelines recommend the use of low concentrations of high-sensitivity cardiac troponin to risk stratify patients with suspected acute coronary syndrome, however, troponin concentration may also rise due to physical exercise. Interpreting cardiac troponin concentration in this context is challenging because the magnitude and duration of troponin elevation following physical exercise is uncertain.
Purpose
To determine the effect of intensity and duration of physical exercise on cardiac troponin concentration.
Methods
We invited 10 physically active healthy volunteers (7 male and 3 female; mean age: 34±7) to attend 3 study visits, during which they underwent exercise on a stationary bicycle at prespecified intensities and durations. The first visit involved low intensity cycling (50–60% of the participant's lactate threshold [LT]) for 60 minutes. During the second visit, participants cycled at high intensity (80–90% LT) for 60 minutes and during the third study visit, participants cycled at moderate intensity (60–70% LT) for 4 hours. High-sensitivity cardiac troponin I (hs-cTnI) concentration was measured at the start of exercise and every hour up to 6 hours during each study visit and subsequently at 1, 2 and 7 days after each exercise visit.
Results
Study participants had a median hs-cTnI concentration of 1.8 ng/L (interquartile range [IQR] 0.8–5.7 ng/L) at baseline. Cardiac troponin concentration was elevated following moderate- and high-intensity exercise (P=0.006 and P<0.001, respectively) but not following low-intensity exercise (P=0.137). Troponin concentrations were significantly higher following the shorter duration of high-intensity exercise (peak hs-cTnI concentration = 13 ng/L [IQR 6.5–27.1 ng/L]) compared to the longer duration moderate-intensity exercise (peak hs-cTnI concentration = 6.9 ng/L [2.9–7.9 ng/L]; P-value <0.001). Following both moderate- and high-intensity exercise, cardiac troponin concentration returned to baseline within 48 hours (Figure 1).
Troponin concentrations ng/L / time
Conclusions
Our study suggests that elevation in cardiac troponin concentration is associated with the intensity rather than duration of physical exercise, and that exercise-induced troponin elevations resolve within 48 hours. These findings have important implications for the interpretation of cardiac troponin in the risk stratification and diagnosis of patients who present with symptoms suggestive of acute coronary syndrome following physical exercise.
Acknowledgement/Funding
British Heart Foundation
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Affiliation(s)
- L Marshall
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - K Lee
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - F E Strachan
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - T Fujisawa
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - S Stewart
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - N Dhaun
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - A Ferry
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - M Ross
- Edinburgh Napier University, School of Applied Science, Edinburgh, United Kingdom
| | - N L Mills
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
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30
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Dwyer J, Dwyer J, Hiscock R, O'Callaghan C, Taylor K, Ross M, Bugeja L, Philip J. Characteristics of patients with cancer who die by suicide: Coronial case series in an Australian state. Psychooncology 2019; 28:2195-2200. [PMID: 31418507 DOI: 10.1002/pon.5207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 08/08/2019] [Accepted: 08/12/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Suicide rates are elevated in epidemiological studies, but extrapolating population level data to the individual patient cancer is difficult, and there is a dearth of studies examining how suicidality might be linked to the cancer experience. We examine the cancer-suicide correlates to explore clinical implications and future research directions. METHOD We used a novel database to examine all suicide deaths reported to the Coroners Court of Victoria between 2009 and 2013 in individuals with active, diagnosed cancer. Cases were classified in relation to whether cancer had been a probable, possible, or unlikely influence on suicidal ideation. Sociodemographic, clinical, health service contacts, and suicide method data were analysed to describe the characteristics of individuals with cancer at the time of their suicide. RESULTS There were 2870 suicide deaths, and 118 cases met inclusion criteria. Clinically distinct patient subgroups emerged through a contrast between those cases where the data suggested a correlate between cancer and suicide, and those where the data did not. The former group had many more cancer-related health problems than the latter group, who had a higher burden of psychiatric illness that predated their cancer diagnosis. The intent to suicide was known to most clinicians. CONCLUSIONS All clinicians working with cancer patients should be prepared to explore suicidal ideation. Understanding how the patient conceptualises suicidality with respect to cancer experience and mental health may be of central importance in determining whether mental health care is best provided as part of cancer care, or through a separate mental health service.
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Affiliation(s)
- Justin Dwyer
- Psychosocial Cancer Care, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Jeremy Dwyer
- Coroners Court of Victoria, Southbank, Victoria, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Richard Hiscock
- Department of Anaesthesia, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Clare O'Callaghan
- Psychosocial Cancer Care, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Keryn Taylor
- Psychosocial Cancer Care, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.,Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Margaret Ross
- Department of Psychosocial Cancer Care, St Vincent's Hospital, Fitzroy, Victoria, Australia
| | - Lyndal Bugeja
- Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia.,School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Jennifer Philip
- Department of Medicine, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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Li Y, Cifuentes-Pagano E, DeVallance ER, de Jesus DS, Sahoo S, Meijles DN, Koes D, Camacho CJ, Ross M, St Croix C, Pagano PJ. NADPH oxidase 2 inhibitors CPP11G and CPP11H attenuate endothelial cell inflammation & vessel dysfunction and restore mouse hind-limb flow. Redox Biol 2019; 22:101143. [PMID: 30897521 PMCID: PMC6435978 DOI: 10.1016/j.redox.2019.101143] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 02/05/2019] [Accepted: 02/13/2019] [Indexed: 02/07/2023] Open
Abstract
First described as essential to the phagocytic activity of leukocytes, Nox2-derived ROS have emerged as mediators of a range of cellular and tissue responses across species from salubrious to deleterious consequences. Knowledge of their role in inflammation is limited, however. We postulated that TNFα-induced endothelial reactive oxygen species (ROS) generation and pro-inflammatory signaling would be ameliorated by targeting Nox2. Herein, we in silico-modelled two first-in-class Nox2 inhibitors developed in our laboratory, explored their cellular mechanism of action and tested their efficacy in in vitro and mouse in vivo models of inflammation. Our data show that these inhibitors (CPP11G and CPP11H) disrupted canonical Nox2 organizing factor, p47phox, translocation to Nox2 in the plasma membrane; and abolished ROS production, markedly attenuated stress-responsive MAPK signaling and downstream AP-1 and NFκB nuclear translocation in human cells. Consequently, cell adhesion molecule expression and monocyte adherence were significantly inhibited by both inhibitors. In vivo, TNFα-induced ROS and inflammation were ameliorated by targeted Nox2 inhibition, which, in turn, improved hind-limb blood flow. These studies identify a proximal role for Nox2 in propagated inflammatory signaling and support therapeutic value of Nox2 inhibitors in inflammatory disease.
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Affiliation(s)
- Y Li
- Vascular Medicine Institute, USA; Department of Pharmacology & Chemical Biology, USA
| | - E Cifuentes-Pagano
- Vascular Medicine Institute, USA; Department of Pharmacology & Chemical Biology, USA
| | - E R DeVallance
- Vascular Medicine Institute, USA; Department of Pharmacology & Chemical Biology, USA
| | - D S de Jesus
- Vascular Medicine Institute, USA; Department of Pharmacology & Chemical Biology, USA
| | - S Sahoo
- Vascular Medicine Institute, USA; Department of Pharmacology & Chemical Biology, USA
| | | | - D Koes
- Computational and Systems Biology, University of Pittsburgh, USA
| | - C J Camacho
- Computational and Systems Biology, University of Pittsburgh, USA
| | - M Ross
- Center for Biologic Imaging, University of Pittsburgh, PA, 15261, USA
| | - C St Croix
- Center for Biologic Imaging, University of Pittsburgh, PA, 15261, USA
| | - P J Pagano
- Vascular Medicine Institute, USA; Department of Pharmacology & Chemical Biology, USA.
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Ross M, Smith M, Mellor R, Vicenzino B. A systematic review of clinical trials of exercise for tibialis posterior tendinopathy. J Sci Med Sport 2018. [DOI: 10.1016/j.jsams.2018.09.188] [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: 10/28/2022]
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33
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Ross M, Reid S, Boateng H, Lubin J, Richardson J, Kamnetz J, Lukosius E, Broom A, Tung L. 117 Alternating Compression for Pelvic Ring Injury Stabilization. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Zhang J, Sinha N, Ross M, Tejada-Martínez AE. Computational fluid dynamics analysis of the hydraulic (filtration) efficiency of a residential swimming pool. J Water Health 2018; 16:750-761. [PMID: 30285956 DOI: 10.2166/wh.2018.110] [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] [Indexed: 06/08/2023]
Abstract
Hydraulic or filtration efficiency of residential swimming pools, quantified in terms of residence time characteristics, is critical to disinfection and thus important to public health. In this study, a three-dimensional computational fluid dynamics model together with Eulerian and Lagrangian-based techniques are used for investigating the residence time characteristics of a passive tracer and particles in the water, representative of chemicals and pathogens, respectively. The flow pattern in the pool is found to be characterized by dead zone regions where water constituents may be retained for extended periods of times, thereby potentially decreasing the pool hydraulic efficiency. Two return-jet configurations are studied in order to understand the effect of return-jet location and intensity on the hydraulic efficiency of the pool. A two-jet configuration is found to perform on par with a three-jet configuration in removing dissolved constituents but the former is more efficient than the latter in removing or flushing particles. The latter result suggests that return-jet location and associated flow circulation pattern have an important impact on hydraulic efficiency. Thus return-jet configuration should be incorporated as a key parameter in the design of swimming pools complementing current design standards.
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Affiliation(s)
- J Zhang
- Department of Civil and Environmental Engineering, University of South Florida, 4202 E. Fowler Ave, Tampa, FL 33620, USA E-mail: ; Carollo Engineers, Inc., 1218 Third Ave, Suite 1600, Seattle, WA 98101, USA
| | - N Sinha
- Department of Civil and Environmental Engineering, University of South Florida, 4202 E. Fowler Ave, Tampa, FL 33620, USA E-mail:
| | - M Ross
- Department of Civil and Environmental Engineering, University of South Florida, 4202 E. Fowler Ave, Tampa, FL 33620, USA E-mail:
| | - A E Tejada-Martínez
- Department of Civil and Environmental Engineering, University of South Florida, 4202 E. Fowler Ave, Tampa, FL 33620, USA E-mail:
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Hibbert M, Crenna-Jennings W, Kirwan P, Benton L, Lut I, Okala S, Asboe D, Jeffries J, Kunda C, Mbewe R, Morris S, Morton J, Nelson M, Thorley L, Paterson H, Ross M, Reeves I, Sharp L, Sseruma W, Valiotis G, Wolton A, Jamal Z, Hudson A, Delpech V. The people living with HIV stigma survey UK 2015: HIV-related sexual rejection and other experiences of stigma and discrimination among gay and heterosexual men. AIDS Care 2018; 30:1189-1196. [PMID: 29806466 DOI: 10.1080/09540121.2018.1479027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
We aim to understand the difference in stigma and discrimination, in particular sexual rejection, experienced between gay and heterosexual men living with HIV in the UK. The People Living with HIV StigmaSurvey UK 2015 recruited a convenience sample of persons with HIV through over 120 cross sector community organisations and 46 HIV clinics to complete an online survey. 1162 men completed the survey, 969 (83%) gay men and 193 (17%) heterosexual men, 92% were on antiretroviral therapy. Compared to heterosexual men, gay men were significantly more likely to report worrying about workplace treatment in relation to their HIV (21% vs. 11%), worrying about HIV-related sexual rejection (42% vs 21%), avoiding sex because of their HIV status (37% vs. 23%), and experiencing HIV-related sexual rejection (27% vs. 9%) in the past 12 months. In a multivariate logistic regression controlling for other sociodemographic factors, being gay was a predictor of reporting HIV-related sexual rejection in the past 12 months (aOR 2.17, CI 1.16, 4.02). Both gay and heterosexual men living with HIV experienced stigma and discrimination in the past 12 months, and this was higher for gay men in terms of HIV-related sexual rejection. Due to the high proportion of men reporting sexual rejection, greater awareness and education of the low risk of transmission of HIV among people on effective treatment is needed to reduce stigma and sexual prejudice towards people living with HIV.
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Affiliation(s)
- M Hibbert
- a HIV & STI Department, Public Health England , London , UK
| | | | - P Kirwan
- a HIV & STI Department, Public Health England , London , UK
| | | | - I Lut
- b StigmaIndexUK , London , UK
| | - S Okala
- a HIV & STI Department, Public Health England , London , UK.,b StigmaIndexUK , London , UK
| | - D Asboe
- c British HIV Association , London , UK.,d Positively UK , London , UK
| | - J Jeffries
- a HIV & STI Department, Public Health England , London , UK
| | - C Kunda
- b StigmaIndexUK , London , UK
| | - R Mbewe
- b StigmaIndexUK , London , UK.,d Positively UK , London , UK
| | | | - J Morton
- b StigmaIndexUK , London , UK.,e Terrence Higgins Trust , London , UK
| | - M Nelson
- f Chelsea & Westminster Hospital , London , UK
| | | | | | - M Ross
- c British HIV Association , London , UK.,h CliniQ , London , UK
| | - I Reeves
- i Homerton University Hospital , London , UK
| | - L Sharp
- g University of Glasgow , Glasgow , UK
| | - W Sseruma
- b StigmaIndexUK , London , UK.,j NAZ, London , London , UK
| | - G Valiotis
- b StigmaIndexUK , London , UK.,k HIV Scotland , Edinburgh , UK
| | - A Wolton
- b StigmaIndexUK , London , UK.,f Chelsea & Westminster Hospital , London , UK.,h CliniQ , London , UK
| | | | | | - V Delpech
- a HIV & STI Department, Public Health England , London , UK
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36
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Anderer P, Moreau A, Ross M, Cerny A, Thusoo S. 0306 Scoring of Sleep According to AASM: Artificial Intelligence versus Multiple Human Expert Scorings. Sleep 2018. [DOI: 10.1093/sleep/zsy061.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- P Anderer
- Philips Austria GmbH, Vienna, AUSTRIA
| | - A Moreau
- Philips Austria GmbH, Vienna, AUSTRIA
| | - M Ross
- Philips Austria GmbH, Vienna, AUSTRIA
| | - A Cerny
- Philips Austria GmbH, Vienna, AUSTRIA
| | - S Thusoo
- Philips Austria GmbH, Vienna, AUSTRIA
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37
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Hibbert M, Wolton A, Crenna-Jennings W, Benton L, Kirwan P, Lut I, Okala S, Ross M, Furegato M, Nambiar K, Douglas N, Roche J, Jeffries J, Reeves I, Nelson M, Weerawardhana C, Jamal Z, Hudson A, Delpech V. Experiences of stigma and discrimination in social and healthcare settings among trans people living with HIV in the UK. AIDS Care 2018; 30:836-843. [PMID: 29409344 DOI: 10.1080/09540121.2018.1436687] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The People Living with HIV StigmaSurvey UK 2015 was a community led national survey investigating experiences of people living with HIV in the UK in the past 12 months. Participants aged 18 and over were recruited through over 120 cross-sector community organisations and 46 HIV clinics to complete an anonymous online survey. Trans is an umbrella term which refers to individuals whose current gender identity is different to the gender they were assigned at birth. Trans participants self-identified via gender identity and gender at birth questions. Descriptive analyses of reported experiences in social and health care settings were conducted and multivariate logistic regression analyses were used to identify sociodemographic predictors of reporting being treated differently to non-HIV patients, and being delayed or refused healthcare treatment in the past 12 months. 31 out of 1576 participants (2%) identified as trans (19 trans women, 5 trans men, 2 gender queer/non-binary, 5 other). High levels of social stigma were reported for all participants, with trans participants significantly more likely to report worrying about verbal harassment (39% vs. 23%), and exclusion from family gatherings (23% vs. 9%) in the last 12 months, compared to cisgender participants. Furthermore, 10% of trans participants reported physical assault in the last 12 months, compared to 4% of cisgender participants. Identifying as trans was a predictor of reporting being treated differently to non-HIV patients (48% vs. 30%; aOR 2.61, CI 1.06, 6.42) and being delayed or refused healthcare (41% vs. 16%; aOR 4.58, CI 1.83, 11.44). Trans people living with HIV in the UK experience high levels of stigma and discrimination, including within healthcare settings, which is likely to impact upon health outcomes. Trans-specific education and awareness within healthcare settings could help to improve service provision for this demographic.
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Affiliation(s)
- M Hibbert
- a HIV & STI Department , Public Health England , London , UK
| | - A Wolton
- b StigmaIndexUK, FPA , London , UK.,c CliniQ , London , UK.,d Chelsea & Westminster Hospital , London , UK
| | | | | | - P Kirwan
- a HIV & STI Department , Public Health England , London , UK
| | | | - S Okala
- a HIV & STI Department , Public Health England , London , UK
| | - M Ross
- b StigmaIndexUK, FPA , London , UK.,c CliniQ , London , UK
| | - M Furegato
- a HIV & STI Department , Public Health England , London , UK
| | - K Nambiar
- f Brighton and Sussex University NHS Trust , Brighton , UK
| | - N Douglas
- g Policy Innovation Research Unit , London School of Hygiene and Tropical Medicine , London , UK
| | | | | | - I Reeves
- h Homerton University Hospital , London , UK
| | - M Nelson
- d Chelsea & Westminster Hospital , London , UK
| | | | | | - A Hudson
- b StigmaIndexUK, FPA , London , UK.,e FPA , London , UK
| | - V Delpech
- a HIV & STI Department , Public Health England , London , UK
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Clark SJ, Wakefield J, McCormick T, Ross M. Hyak mortality monitoring system: innovative sampling and estimation methods - proof of concept by simulation. Glob Health Epidemiol Genom 2018; 3:e3. [PMID: 29868228 PMCID: PMC5870438 DOI: 10.1017/gheg.2017.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 10/13/2017] [Accepted: 10/16/2017] [Indexed: 01/21/2023] Open
Abstract
Traditionally health statistics are derived from civil and/or vital registration. Civil registration in low- to middle-income countries varies from partial coverage to essentially nothing at all. Consequently the state of the art for public health information in low- to middle-income countries is efforts to combine or triangulate data from different sources to produce a more complete picture across both time and space - data amalgamation. Data sources amenable to this approach include sample surveys, sample registration systems, health and demographic surveillance systems, administrative records, census records, health facility records and others. We propose a new statistical framework for gathering health and population data - Hyak - that leverages the benefits of sampling and longitudinal, prospective surveillance to create a cheap, accurate, sustainable monitoring platform. Hyak has three fundamental components: Data amalgamation: A sampling and surveillance component that organizes two or more data collection systems to work together: (1) data from HDSS with frequent, intense, linked, prospective follow-up and (2) data from sample surveys conducted in large areas surrounding the Health and Demographic Surveillance System (HDSS) sites using informed sampling so as to capture as many events as possible;Cause of death: Verbal autopsy to characterize the distribution of deaths by cause at the population level; andSocioeconomic status (SES): Measurement of SES in order to characterize poverty and wealth. We conduct a simulation study of the informed sampling component of Hyak based on the Agincourt HDSS site in South Africa. Compared with traditional cluster sampling, Hyak's informed sampling captures more deaths, and when combined with an estimation model that includes spatial smoothing, produces estimates of both mortality counts and mortality rates that have lower variance and small bias.
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Affiliation(s)
- S. J. Clark
- Department of Sociology, The Ohio State University, Columbus, Ohio, USA
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, University of the Witwatersrand, School of Public Health, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
- ALPHA Network, London, UK
| | - J. Wakefield
- Department of Statistics, University of Washington Seattle, Washington, USA
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - T. McCormick
- Department of Statistics, University of Washington Seattle, Washington, USA
- Department of Sociology, University of Washington, Seattle, Washington, USA
| | - M. Ross
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Clifton D, Ross M, O'Callaghan C. Psychiatric sequelae of corticosteroid use in hematology in Australia: A qualitative study. Nurs Health Sci 2018; 20:125-131. [PMID: 29345096 DOI: 10.1111/nhs.12395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 09/01/2017] [Accepted: 09/24/2017] [Indexed: 11/30/2022]
Abstract
Despite widespread steroid usage for treating hematological conditions, minimal attention focuses on associated psychiatric side-effects. In the present study, we examined hematology patients' experiences of high-dose steroid treatment. This was undertaken by the use of a qualitative, descriptive design, which included convenience sampling and the inductive, cyclic, and constant comparative thematic analysis of interview transcripts. Eighteen patients participated, who were diagnosed with lymphoma, myeloma, leukemia, or idiopathic thrombocytopenia purpura. Four themes emerged: side-effects, misattribution of cause, self-management, and fragmented information. The study results revealed that hematology patients administered steroids can experience negligible to extensive erratic side-effects, with severe adverse repercussions. Psychological reactions to steroids are often misattributed. Patients mostly self-manage adverse effects experienced and receive only fragmented preparatory information, often not understanding steroid side-effects. Nurses could provide helpful "in the moment" education for inpatients who misunderstood steroid-related adverse effects, such as aggressive urges. Adverse repercussions for family were occasionally evident. Education, support, and ongoing care for patients experiencing adverse steroid side-effects are inadequate. Health professionals need to develop patient- and family-centered educational resources for potential, unpredictable, and usually adverse steroid side-effects.
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Affiliation(s)
- Dianne Clifton
- Department of Psychosocial Cancer Care, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Margaret Ross
- Department of Psychosocial Cancer Care, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Clare O'Callaghan
- Department of Psychosocial Cancer Care, St Vincent's Hospital, Melbourne, Victoria, Australia.,Department of Medicine, St Vincent's Hospital, University of Melbourne, Melbourne, Victoria, Australia
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Andtbacka R, Ross M, Agarwala S, Taylor M, Vetto J, Neves R, Daud A, Khong H, Ungerleider R, Tanaka M, Grossmann K. Subgroup analysis of a phase II multicenter trial of HF10, oncolytic virus immunotherapy, and ipilimumab combination treatment in unresectable or metastatic melanoma patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx667] [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: 11/14/2022] Open
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Osborne A, Rutz D, Ross M, Bodle C, Johnson R, Wheatley M. 81 The Effect of Compulsory Provider HEART Score Calculation on Chest Pain Patients Sent to Observation Units. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.106] [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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Ross M, Wiemann M, Peters SE, Benson R, Couzens GB. The influence of cartilage thickness at the sigmoid notch on inclination at the distal radioulnar joint. Bone Joint J 2017; 99-B:369-375. [PMID: 28249978 DOI: 10.1302/0301-620x.99b3.38051] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 02/29/2016] [Accepted: 11/08/2016] [Indexed: 11/05/2022]
Abstract
AIMS The aims of this study were: firstly, to investigate the influence of the thickness of cartilage at the sigmoid notch on the inclination of the distal radioulnar joint (DRUJ), and secondly, to compare the sensitivity and specificity of MRI with plain radiographs for the assessment of the inclination of the articular surface of the DRUJ in the coronal plane. PATIENTS AND METHODS Contemporaneous MRI images and radiographs of 100 wrists from 98 asymptomatic patients (mean age 43 years, (16 to 67); 52 male, 53%) with no history of a fracture involving the wrist or surgery to the wrist, were reviewed. The thickness of the cartilage at the sigmoid notch, inclination of the DRUJ and Tolat Type of each DRUJ were determined. RESULTS The assessment using MRI scans and cortical bone correlated well with radiographs, with a kappa value of 0.83. The mean difference between the inclination using the cortex and cartilage on MRI scans was 12°, leading to a change of Tolat type of inclination in 66% of wrists. No reverse oblique (Type 3) inclinations were found when using the cartilage to assess inclination. CONCLUSION These data revealed that when measuring the inclination of the DRUJ using cartilage, reverse oblique inclinations might not exist. The data suggest that performing an ulna shortening osteotomy might be reasonable even in distal radioulnar joints where the plain radiographic appearance suggests an unfavourable reverse oblique inclination in the coronal plane. We recommend using MRI to validate radiographs in those that appear to be reverse oblique (Tolat Type 3), as the true inclination might be different, thereby removing one possible contraindication to ulnar shortening. Cite this article: Bone Joint J 2017;99-B:369-75.
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Affiliation(s)
- M Ross
- Brisbane Hand and Upper Limb Research Institute, 9/259 Wickham Tce, Brisbane, Queensland, 4000, Australia
| | - M Wiemann
- Department of Foot and Ankle Surgery, Rhoen-Klinikum, Bad Neustadt, Germany
| | - S E Peters
- Harvard TH Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
| | - R Benson
- Tunbridge Wells Hospital, Tonbridge Road, Pembury, Tunbridge Wells, Kent TN2 4QJ, UK
| | - G B Couzens
- Brisbane Hand and Upper Limb Research Institute, 9/259 Wickham Terrace, Brisbane QLD 4000, Australia
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Peters SE, Johnston V, Ross M, Coppieters MW. Expert consensus on facilitators and barriers to return-to-work following surgery for non-traumatic upper extremity conditions: a Delphi study. J Hand Surg Eur Vol 2017; 42:127-136. [PMID: 27655647 DOI: 10.1177/1753193416669263] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
UNLABELLED This Delphi study aimed to reach consensus on important facilitators and barriers for return-to-work following surgery for non-traumatic upper extremity conditions. In Round 1, experts ( n = 42) listed 134 factors, which were appraised in Rounds 2 and 3. Consensus (⩾85% agreement) was achieved for 13 facilitators (high motivation to return-to-work; high self-efficacy for return-to-work and recovery; availability of modified/alternative duties; flexible return-to-work arrangements; positive coping skills; limited heavy work exertion; supportive return-to-work policies; supportive supervisor/management; no catastrophic thinking; no fear avoidance to return-to-work; no fear avoidance to pain/activity; return to meaningful work duties; high job satisfaction) and six barriers (mood disorder diagnosis; pain/symptoms at more than one musculoskeletal site; heavy upper extremity exertions at work; lack of flexible return-to-work arrangements; lack of support from supervisor/management; high level of pain catastrophizing). Future prognostic studies are required to validate these biopsychosocial factors to further improve return-to-work outcomes. LEVEL OF EVIDENCE V.
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Affiliation(s)
- S E Peters
- 1 Occupational Therapy, The University of Queensland, St Lucia, Brisbane, Australia.,2 Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Australia
| | - V Johnston
- 3 Physiotherapy, The University of Queensland, St Lucia, Brisbane, Australia
| | - M Ross
- 2 Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Australia.,4 Department of Orthopaedic Surgery, Princess Alexandra Hospital, Woolloongabba, Australia.,5 Orthopaedic Surgery, The University of Queensland, St Lucia, Brisbane, Australia
| | - M W Coppieters
- 3 Physiotherapy, The University of Queensland, St Lucia, Brisbane, Australia.,6 MOVE Research Institute Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Erford BT, Bardhoshi G, Ross M, Gunther C, Duncan K. Meta-Analysis of Counseling Outcomes for Youth With Conduct Disorders. Journal of Counseling & Development 2017. [DOI: 10.1002/jcad.12115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
| | - Gerta Bardhoshi
- Department of Rehabilitation and Counselor Education; University of Iowa
| | - Margaret Ross
- Education Specialties Department; Loyola University Maryland
| | - Chelsea Gunther
- Education Specialties Department; Loyola University Maryland
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Fizzano K, Claude A, Archer T, Kuo L, Hinz S, Thames B, Eells J, Ross M. Evaluation of a modified palatine nerve block in canine rhinoscopy with biopsy. Vet Anaesth Analg 2017. [DOI: 10.1016/j.vaa.2016.12.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Andtbacka R, Ross M, Agarwala S, Taylor M, Vetto J, Neves R, Daud A, Khong H, Ungerleider R, Welden S, Tanaka M, Grossmann K. Tumor response from phase II study of combination treatment with intratumoral HF10, a replication-competent HSV-1 oncolytic virus, and ipilimumab in patients with stage IIIB, IIIC, or IV unresectable or metastatic melanoma. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw379.41] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chesney J, Collichio F, Andtbacka R, Puzanov I, Glaspy J, Milhem M, Hamid O, Cranmer L, Saenger Y, Ross M, Chen L, Kim J, Kaufman H. Interim safety and efficacy of a randomized (1:1), open-label phase 2 study of talimogene laherparepvec (T) and ipilimumab (I) vs I alone in unresected, stage IIIB-IV melanoma. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw379.04] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Saiag P, Gutzmer R, Ascierto PA, Maio M, Grob JJ, Murawa P, Dreno B, Ross M, Weber J, Hauschild A, Rutkowski P, Testori A, Levchenko E, Enk A, Misery L, Vanden Abeele C, Vojtek I, Peeters O, Brichard VG, Therasse P. Prospective assessment of a gene signature potentially predictive of clinical benefit in metastatic melanoma patients following MAGE-A3 immunotherapeutic (PREDICT). Ann Oncol 2016; 27:1947-53. [PMID: 27502712 PMCID: PMC5035794 DOI: 10.1093/annonc/mdw291] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 05/26/2016] [Accepted: 07/20/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Genomic profiling of tumor tissue may aid in identifying predictive or prognostic gene signatures (GS) in some cancers. Retrospective gene expression profiling of melanoma and non-small-cell lung cancer led to the characterization of a GS associated with clinical benefit, including improved overall survival (OS), following immunization with the MAGE-A3 immunotherapeutic. The goal of the present study was to prospectively evaluate the predictive value of the previously characterized GS. PATIENTS AND METHODS An open-label prospective phase II trial ('PREDICT') in patients with MAGE-A3-positive unresectable stage IIIB-C/IV-M1a melanoma. RESULTS Of 123 subjects who received the MAGE-A3 immunotherapeutic, 71 (58.7%) displayed the predictive GS (GS+). The 1-year OS rate was 83.1%/83.3% in the GS+/GS- populations. The rate of progression-free survival at 12 months was 5.8%/4.1% in GS+/GS- patients. The median time-to-treatment failure was 2.7/2.4 months (GS+/GS-). There was one complete response (GS-) and two partial responses (GS+). The MAGE-A3 immunotherapeutic was similarly immunogenic in both populations and had a clinically acceptable safety profile. CONCLUSION Treatment of patients with MAGE-A3-positive unresectable stage IIIB-C/IV-M1a melanoma with the MAGE-A3 immunotherapeutic demonstrated an overall 1-year OS rate of 83.5%. GS- and GS+ patients had similar 1-year OS rates, indicating that in this study, GS was not predictive of outcome. Unexpectedly, the objective response rate was lower in this study than in other studies carried out in the same setting with the MAGE-A3 immunotherapeutic. Investigation of a GS to predict clinical benefit to adjuvant MAGE-A3 immunotherapeutic treatment is ongoing in another melanoma study.This study is registered at www.clinicatrials.gov NCT00942162.
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Affiliation(s)
- P Saiag
- General Dermatology and Oncology Service, Ambroise-Paré Hospital, AP-HP, University of Versailles-Saint-Quentin-en-Yvelines, Boulogne, France
| | - R Gutzmer
- Skin Cancer Center Hannover, Hannover Medical School, Hannover, Germany
| | - P A Ascierto
- National Institute for Tumors Foundation 'G. Pascale', Napoli
| | - M Maio
- Medical Oncology and Immunotherapy, Department of Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena, Italy
| | - J-J Grob
- Department of Dermatology and Skin Cancers, La Timone APHM Hospital, Aix-Marseille University, Marseille, France
| | - P Murawa
- Department of Biochemistry and Molecular Biology, Poznań University of Medical Sciences, Poznań, Poland
| | - B Dreno
- Dermatology Clinic, Hôtel-Dieu Hospital, CHU Nantes, Nantes, France
| | - M Ross
- Department of Surgical Oncology, UTMD Anderson Cancer Center, Houston
| | - J Weber
- Moffitt Cancer Center, Tampa, USA
| | - A Hauschild
- Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - P Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Center and Institute of Oncology, Warsaw, Poland
| | - A Testori
- Melanoma and Soft Tissue Sarcoma Division, European Institute of Oncology, Milan, Italy
| | - E Levchenko
- Petrov Research Institute of Oncology, St Petersburg, Russian Federation
| | - A Enk
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - L Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
| | | | - I Vojtek
- GSK Vaccines, Rixensart, Belgium
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Agarwala S, Andtbacka R, Hauschild A, Rice K, Ross M, Scoggins C, Smithers M, Whitman E, Wachter E. Intralesional rose bengal for stage III and IV melanoma. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw379.52] [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: 11/13/2022] Open
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