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Ibraheim MK, Elsensohn A, Kraus C, Dao H, Luke J, Leigh R, Anderson N, Chow C. Satisfaction guaranteed? A need for evidence-based practices pertaining to patient reviews. Int J Dermatol 2024. [PMID: 38634623 DOI: 10.1111/ijd.17193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/19/2024]
Affiliation(s)
| | - Ashley Elsensohn
- Department of Dermatology, Loma Linda University, Loma Linda, CA, USA
- Department of Pathology, Loma Linda University, Loma Linda, CA, USA
| | - Christina Kraus
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
| | - Harry Dao
- Department of Dermatology, Loma Linda University, Loma Linda, CA, USA
| | - Janiene Luke
- Department of Dermatology, Loma Linda University, Loma Linda, CA, USA
| | - Rebekah Leigh
- Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Nancy Anderson
- Department of Dermatology, Loma Linda University, Loma Linda, CA, USA
| | - Conroy Chow
- Department of Dermatology, Loma Linda University, Loma Linda, CA, USA
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2
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Leigh R, Kim D, Ibraheim MK, Kraus C, Chow C, Luke J, Dao H, Anderson N, Chou FS, Elsensohn A. Perceptions and impact of patient reviews: a survey of academic dermatologists. Int J Dermatol 2024; 63:512-516. [PMID: 38305475 DOI: 10.1111/ijd.17066] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Patient reviews (PRs) have emerged as a method to assess patient experiences with healthcare in order to improve the quality of care. Both institutional and third-party organizations collect quantitative data and comments from these patient surveys, usually accessible to the public for review. Our study examined dermatologists' perceptions of PRs and assessed their impact on dermatologists. METHODS A survey was sent to the Association of Professors of Dermatology listserv (response rate 30%). RESULTS Most respondents disagreed with the statements that PRs are good for doctors (63%), good for patients (58%), helpful for doctors (58%), or that high PRs indicate being a good doctor (65%). The majority disagreed that PRs should be available publicly (60%). Respondents agreed that PRs contribute to depersonalization (60%), energy depletion or exhaustion (55%), added stress at work (70%), negativism/cynicism about work (60%), and diminished professional efficacy (29%). Self-identified female respondents were more likely to agree that PRs added stress to work compared to self-identified males (66% vs. 42%, P < 0.05). CONCLUSIONS Overall, these findings suggest that PRs may negatively impact dermatologists' well-being and perceived stress levels.
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Affiliation(s)
- Rebekah Leigh
- Loma Linda University, School of Medicine, Loma Linda, CA, USA
| | - Dahyeon Kim
- Loma Linda University, School of Medicine, Loma Linda, CA, USA
| | | | - Christina Kraus
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
| | - Conroy Chow
- Loma Linda University, Department of Dermatology, Loma Linda, CA, USA
| | - Janiene Luke
- Loma Linda University, Department of Dermatology, Loma Linda, CA, USA
| | - Harry Dao
- Loma Linda University, Department of Dermatology, Loma Linda, CA, USA
| | - Nancy Anderson
- Loma Linda University, Department of Dermatology, Loma Linda, CA, USA
| | - Fu-Sheng Chou
- Southern California Permanente Medical Group, Pasadena, CA, USA
- Kaiser Permanente Riverside Medical Center, Riverside, CA, USA
| | - Ashley Elsensohn
- Loma Linda University, Department of Dermatology, Loma Linda, CA, USA
- Loma Linda University, Department of Pathology and Human Anatomy, Loma Linda, CA, USA
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3
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Earwaker M, Anderson N, Egli V. Developing nursing interventions in Paediatric Emergence Delirium: a scoping review. Contemp Nurse 2024; 60:82-95. [PMID: 38427706 DOI: 10.1080/10376178.2024.2319852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/12/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Children who experience Emergence Delirium following an anaesthetic are at an increased risk of injury, harm to the surgical site, delayed discharge from the recovery room/ post anaesthetic care unit, an increased length of stay in hospital, the requirement of additional nursing staff to care for them and may display additional emotional and behavioural upsets in the weeks following surgery. Many factors have been postulated to be associated with the development of Emergence Delirium in children. However, to date the strength and nature of these associations has not been thoroughly investigated nor discussed considering the specific implications for contemporary nursing practice. AIM The aim of this scoping review is to provide an overview of Emergence Delirium in children, and a critical synthesis of evidence informing development of nursing interventions to prevent or minimise paediatric Emergence Delirium. METHODS This scoping review was conducted guided by the PRISMA checklist. 14 peer-reviewed studies and guidelines published between 2000 and 2020 on Emergence Delirium in children and nursing practice were included in the deductive thematic analysis stage. RESULTS The results found the anxiety of the child, the post-operative phase, continuity of care and medication administration were key themes in the nursing management of Emergence Delirium. CONCLUSION There is opportunity for further research to be conducted on child Emergence Delirium in different hospital systems with further exploration of nurse-led interventions.
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Affiliation(s)
- M Earwaker
- The School of Nursing, Faculty of Medical and Health Sciences the University of Auckland, Aotearoa New Zealand
| | - N Anderson
- The School of Nursing, Faculty of Medical and Health Sciences the University of Auckland, Aotearoa New Zealand
| | - V Egli
- The School of Nursing, Faculty of Medical and Health Sciences the University of Auckland, Aotearoa New Zealand
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4
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Kwon Y, Salvo JJ, Anderson N, Holubecki AM, Lakshman M, Yoo K, Kay K, Gratton C, Braga RM. Situating the parietal memory network in the context of multiple parallel distributed networks using high-resolution functional connectivity. bioRxiv 2023:2023.08.16.553585. [PMID: 37645962 PMCID: PMC10462098 DOI: 10.1101/2023.08.16.553585] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
A principle of brain organization is that networks serving higher cognitive functions are widely distributed across the brain. One exception has been the parietal memory network (PMN), which plays a role in recognition memory but is often defined as being restricted to posteromedial association cortex. We hypothesized that high-resolution estimates of the PMN would reveal small regions that had been missed by prior approaches. High-field 7T functional magnetic resonance imaging (fMRI) data from extensively sampled participants was used to define the PMN within individuals. The PMN consistently extended beyond the core posteromedial set to include regions in the inferior parietal lobule; rostral, dorsal, medial, and ventromedial prefrontal cortex; the anterior insula; and ramus marginalis of the cingulate sulcus. The results suggest that, when fine-scale anatomy is considered, the PMN matches the expected distributed architecture of other association networks, reinforcing that parallel distributed networks are an organizing principle of association cortex.
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Affiliation(s)
- Y Kwon
- Northwestern University Department of Neurology
| | - J J Salvo
- Northwestern University Department of Neurology
| | - N Anderson
- Northwestern University Department of Neurology
| | | | - M Lakshman
- Northwestern University Department of Neurology
| | - K Yoo
- Yale University Department of Psychology
| | - K Kay
- University of Minnesota Department of Radiology
| | - C Gratton
- Florida State University Department of Psychology
| | - R M Braga
- Northwestern University Department of Neurology
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5
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Gorbunova T, Segadelli J, Anderson N, Ciupitu-Plath C. Could Education Be the Best Galactagogue? Development and Content Validation of Provider and Patient Checklists to Promote Lactation Among Black Parents. J Hum Lact 2023:8903344231172989. [PMID: 37226763 DOI: 10.1177/08903344231172989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
One of the factors contributing to the disparities still present by race in the United States may be inequitable access to lactation education. In order to ensure that all parents receive the education they deserve to make informed infant feeding decisions, two checklists were created for patient and healthcare professional use, respectively. This paper describes the process of creating and validating the healthcare professional and patient checklists. The authors completed a review of the most recent literature surrounding barriers to lactation initiation and retention in the Black community to create the initial version of the checklists. Expert consultation was then utilized to assess their content validity. Local healthcare providers unanimously agreed that pregnant and postpartum parents need more education and support than currently provided. The consulted experts described the two checklists as useful and comprehensive and offered feedback for their revision and optimization. Implementing these checklists offer the possibility of increasing provider accountability in delivering adequate lactation education and enhancing client lactation knowledge and self-efficacy. Further research is needed to assess the effect of implementation of the checklists in a healthcare setting.
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Affiliation(s)
| | | | - Nancy Anderson
- Department of Midwifery, Bastyr University, Kenmore, WA, USA
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Marsack-Topolewski C, Milberger S, Janks E, Anderson N, Bray M, Samuel PS. Evaluation of peer-mediated systems navigation for ageing families of individuals with developmental disabilities. J Intellect Disabil Res 2023; 67:462-474. [PMID: 36866717 DOI: 10.1111/jir.13024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 02/01/2023] [Accepted: 02/06/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND As individuals with intellectual and developmental disabilities (I/DD) age, services often diminish, with many family caregivers experiencing challenges finding and navigating services. The purpose of this study was to examine the benefits of a state-wide family support project for ageing caregivers (50+) of adults with I/DD in accessing and using services. METHOD A one-group pre-test-post-test design was used to determine if participation in the MI-OCEAN intervention grounded in the Family Quality of Life (FQOL) theory reduced ageing caregivers' (n = 82) perceptions of barriers to accessing, using and needing formal services. RESULTS After participating in the study, there was a reduction in reported barriers to accessing services. There was also greater use and reduced need for 10 of the 23 listed formal services. CONCLUSIONS Findings indicate that a peer-mediated intervention grounded in FQOL theory can be beneficial in empowering ageing caregivers by reducing perceived barriers to accessing services and increasing their use of advocacy and support services.
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Affiliation(s)
- C Marsack-Topolewski
- School of Social Work, Eastern Michigan University, Ypsilanti, MI, USA
- Michigan Developmenal Disabilities Institute, Wayne State University, Detroit, MI, USA
| | - S Milberger
- Michigan Developmenal Disabilities Institute, Wayne State University, Detroit, MI, USA
| | - E Janks
- Michigan Developmenal Disabilities Institute, Wayne State University, Detroit, MI, USA
| | - N Anderson
- Michigan Developmenal Disabilities Institute, Wayne State University, Detroit, MI, USA
| | - M Bray
- Michigan Developmenal Disabilities Institute, Wayne State University, Detroit, MI, USA
| | - P S Samuel
- Department of Health Care Sciences, Wayne State University, Detroit, MI, USA
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Barraclough ML, Diaz-Martinez JP, Knight A, Bingham K, Su J, Kakvan M, Grajales CM, Tartaglia MC, Ruttan L, Wither J, Choi MY, Bonilla D, Anderson N, Appenzeller S, Parker B, Katz P, Beaton D, Green R, Bruce IN, Touma Z. In-person versus virtual administration of the American College of Radiology gold standard cognitive battery in systemic lupus erythematosus: Are they interchangeable? Lupus 2023; 32:737-745. [PMID: 37036020 DOI: 10.1177/09612033231168477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
OBJECTIVE During the COVID-19 pandemic, many research studies were adapted, including our longitudinal study examining cognitive impairment (CI) in systemic lupus erythematosus (SLE). Cognitive testing was switched from in-person to virtual. This analysis aimed to determine if the administration method (in-person vs. virtual) of the ACR-neuropsychological battery (ACR-NB) affected participant cognitive performance and classification. METHODS Data from our multi-visit, SLE CI study included demographic, clinical, and psychiatric characteristics, and the modified ACR-NB. Three analyses were undertaken for cognitive performance: (1) all visits, (2) non-CI group visits only and (3) intra-individual comparisons. A retrospective preferences questionnaire was given to participants who completed the ACR-NB both in-person and virtually. RESULTS We analysed 328 SLE participants who had 801 visits (696 in-person and 105 virtual). Demographic, clinical, and psychiatric characteristics were comparable except for ethnicity, anxiety and disease-related damage. Across all three comparisons, six tests were consistently statistically significantly different. CI classification changed in 11/71 (15%) participants. 45% of participants preferred the virtual administration method and 33% preferred in-person. CONCLUSIONS Of the 19 tests in the ACR-NB, we identified one or more problems with eight (42%) tests when moving from in-person to virtual administration. As the use of virtual cognitive testing will likely increase, these issues need to be addressed - potentially by validating a virtual version of the ACR-NB. Until then, caution must be taken when directly comparing virtual to in-person test results. If future studies use a mixed administration approach, this should be accounted for during analysis.
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Affiliation(s)
- M L Barraclough
- Schroeder Arthritis Institute, Krembil Research Institute, 7989University Health Network, Toronto, ON, Canada
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, 5292The University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - J P Diaz-Martinez
- Schroeder Arthritis Institute, Krembil Research Institute, 7989University Health Network, Toronto, ON, Canada
- Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, 7938University of Toronto Lupus Clinic, Toronto, ON, Canada
| | - A Knight
- Division of Rheumatology, 7979Hospital for Sick Children, Toronto, ON, Canada
- Neurosciences and Mental Health Program, SickKids Research Institute, Toronto, ON, Canada
| | - K Bingham
- Centre for Mental Health, 7989University Health Network, Toronto, ON, Canada
- Department of Psychiatry, 7938University of Toronto, Toronto, ON, Canada
| | - J Su
- Schroeder Arthritis Institute, Krembil Research Institute, 7989University Health Network, Toronto, ON, Canada
- Division of Rheumatology, 7979Hospital for Sick Children, Toronto, ON, Canada
| | - M Kakvan
- Schroeder Arthritis Institute, Krembil Research Institute, 7989University Health Network, Toronto, ON, Canada
- Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, 7938University of Toronto Lupus Clinic, Toronto, ON, Canada
| | - C Muñoz Grajales
- Schroeder Arthritis Institute, Krembil Research Institute, 7989University Health Network, Toronto, ON, Canada
- Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, 7938University of Toronto Lupus Clinic, Toronto, ON, Canada
| | - M C Tartaglia
- Krembil Research Institute, 7989University Health Network Memory Clinic, Toronto, ON, Canada
| | - L Ruttan
- 7961University Health Network-Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - J Wither
- Schroeder Arthritis Institute, Krembil Research Institute, 7989University Health Network, Toronto, ON, Canada
| | - M Y Choi
- Cumming School of Medicine, 70401University of Calgary, Calgary, AB, Canada
| | - D Bonilla
- Schroeder Arthritis Institute, Krembil Research Institute, 7989University Health Network, Toronto, ON, Canada
- Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, 7938University of Toronto Lupus Clinic, Toronto, ON, Canada
| | - N Anderson
- Schroeder Arthritis Institute, Krembil Research Institute, 7989University Health Network, Toronto, ON, Canada
- Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, 7938University of Toronto Lupus Clinic, Toronto, ON, Canada
| | - S Appenzeller
- Department of Orthopaedics, Rheumatology and Traumatology, 7938University of Campinas, São Paulo, Brazil
| | - B Parker
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, 5292The University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - P Katz
- 8785University of California, San Francisco, CA, USA
| | - D Beaton
- Institute for Work and Health, 7966University of Toronto, Toronto, ON, Canada
| | - R Green
- Krembil Research Institute, 7989University Health Network Memory Clinic, Toronto, ON, Canada
| | - I N Bruce
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, 5292The University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Z Touma
- Schroeder Arthritis Institute, Krembil Research Institute, 7989University Health Network, Toronto, ON, Canada
- Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, 7938University of Toronto Lupus Clinic, Toronto, ON, Canada
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Xia Y, Anderson N. Increases in CLIA-Waived Testing Sites Since the Start of the COVID-19 Pandemic. Lab Med 2023; 54:126-129. [PMID: 36638188 DOI: 10.1093/labmed/lmac154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
The number of testing sites receiving their first Certificate of Waiver (CoW) under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) increased significantly after the start of the COVID-19 pandemic. We compared the first-time CoWs in 2020-2021 to those in 2018-2019. The total number of first-time CoWs during 2020-2021 was more than twice what it was in 2018-2019, corresponding to population testing needs during the COVID-19 pandemic, especially in assisted living facility, pharmacy, physician office, and school/student health service settings. This study highlighted the need to strengthen clinical testing strategies to be better prepared for future public health emergencies.
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Affiliation(s)
- Yang Xia
- Division of Laboratory Systems, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Nancy Anderson
- Division of Laboratory Systems, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA
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9
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Yu J, Tawfik M, Anderson N, Furukawa B. Generalized Essential Telangiectasia Treated With Pulsed Dye Laser. Cutis 2023; 111:E12-E14. [PMID: 37224500 DOI: 10.12788/cutis.0735] [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: 05/26/2023]
Affiliation(s)
- Jasmine Yu
- Ms. Yu is from the School of Medicine, University of California, Riverside. Drs. Tawfik, Anderson, and Furukawa are from the Department of Dermatology, Loma Linda University Medical Center, California
| | - Melanie Tawfik
- Ms. Yu is from the School of Medicine, University of California, Riverside. Drs. Tawfik, Anderson, and Furukawa are from the Department of Dermatology, Loma Linda University Medical Center, California
| | - Nancy Anderson
- Ms. Yu is from the School of Medicine, University of California, Riverside. Drs. Tawfik, Anderson, and Furukawa are from the Department of Dermatology, Loma Linda University Medical Center, California
| | - Betsy Furukawa
- Ms. Yu is from the School of Medicine, University of California, Riverside. Drs. Tawfik, Anderson, and Furukawa are from the Department of Dermatology, Loma Linda University Medical Center, California
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10
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Pandya R, Zhou Y, Desai M, Anderson N, Elsensohn A. Post-Pemphigus Acanthomata Presenting as an Isolated, Hyperkeratotic Plaque. Dermatopathology (Basel) 2023; 10:86-90. [PMID: 36810570 PMCID: PMC9944895 DOI: 10.3390/dermatopathology10010012] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/22/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
Post-pemphigus acanthomas have been rarely discussed in the literature. A prior case series identified 47 cases of pemphigus vulgaris and 5 cases of pemphigus foliaceus, out of which 13 developed acanthomata as a part of the healing process. Additionally, a case report by Ohashi et al. reported similar recalcitrant lesions on the trunk of a patient with pemphigus foliaceus being treated with prednisolone, IVIG, plasma exchange, and cyclosporine. Some view post-pemphigus acanthomas as variants of hypertrophic pemphigus vulgaris, being difficult to diagnose when they present as only single lesions, with a clinical differential of an inflamed seborrheic keratosis or squamous cell carcinoma. Here, we present a case of a 52-year-old female with a history of pemphigus vulgaris and four months of only topical therapy (fluocinonide 0.05%) who presented with a painful, hyperkeratotic plaque on the right mid-back that was found to be a post-pemphigus acanthoma.
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Affiliation(s)
- Rachita Pandya
- California University of Science and Medicine, Colton, CA 92324, USA
| | - Yanjia Zhou
- Department of Dermatology, Loma Linda University, Loma Linda, CA 92354, USA
| | - Mansee Desai
- Department of Dermatology, Loma Linda University, Loma Linda, CA 92354, USA
| | - Nancy Anderson
- Department of Dermatology, Loma Linda University, Loma Linda, CA 92354, USA
| | - Ashley Elsensohn
- Department of Dermatology, Loma Linda University, Loma Linda, CA 92354, USA
- Correspondence: ; Tel.: +1-909-558-2167
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11
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Powers CR, Snipes GE, Harbin KB, Fischer A, Anderson N, Cheng K, Ford-Scales K, Siefert BC. Integration of the Verbatim Exercise into a Hospice and Palliative Medicine Fellowship. Palliat Med Rep 2023; 4:133-138. [PMID: 37180053 PMCID: PMC10171960 DOI: 10.1089/pmr.2022.0025] [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] [Accepted: 03/14/2023] [Indexed: 05/15/2023] Open
Abstract
One of the more challenging aspects of specialty level training in any medical fellowship is learning to communicate mindfully and effectively with patients and families in the face of serious illness. For the past five years, our accredited Hospice and Palliative Medicine (HPM) fellowship program has been integrating the "verbatim"-an exercise with a long and integral history in the training of health care chaplains. Verbatims are word-for-word accounts of a clinician's encounter with a patient and/or the patient's family. The verbatim serves as a formative educational exercise offering a method to hone one's clinical skills and competencies, while providing a unique space to practice self-awareness and self-reflection. Although sometimes difficult and intense for the fellow, we have found this to be a helpful exercise in improving the fellow's ability to make meaningful connections with patients and leading to improved outcomes of communication episodes. This potential growth in self-awareness supports both resiliency and mindfulness, which are essential skills for longevity and reduction of burnout risk in the field of HPM. The verbatim invites all participants to reflect on their own participation in facilitating whole person care to patients and families. Out of the six HPM milestone metrics for fellowship training, the verbatim exercise supports achievement in at least three of the milestones. We present survey data over the past five years of our fellowship in support of the utility of this exercise and for consideration to include this exercise in a palliative medicine fellowship. We offer additional suggestions for further study of this formative tool. This article delineates the verbatim technique and its specific integration into our accredited ACGME Hospice and Palliative Medicine fellowship training program.
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Affiliation(s)
- Christopher R. Powers
- Spartanburg Regional Medical Center, Spartanburg, South Carolina, USA
- Address correspondence to: Christopher R. Powers, MD, MS, FAAHPM, Spartanburg Regional Medical Center, Spartanburg, SC 29303, USA.
| | - Garrett E. Snipes
- Spartanburg Regional Medical Center, Spartanburg, South Carolina, USA
| | | | - Andrew Fischer
- Spartanburg Regional Medical Center, Spartanburg, South Carolina, USA
| | - Nancy Anderson
- Spartanburg Regional Medical Center, Spartanburg, South Carolina, USA
| | - Kevin Cheng
- Novant Health Presbyterian Medical Center, Charlotte, North Carolina, USA
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12
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Kim J, Jiang X, Forenzo D, Liu Y, Anderson N, Greco CM, He B. Immediate effects of short-term meditation on sensorimotor rhythm-based brain-computer interface performance. Front Hum Neurosci 2022; 16:1019279. [PMID: 36606248 PMCID: PMC9807599 DOI: 10.3389/fnhum.2022.1019279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Meditation has been shown to enhance a user's ability to control a sensorimotor rhythm (SMR)-based brain-computer interface (BCI). For example, prior work have demonstrated that long-term meditation practices and an 8-week mindfulness-based stress reduction (MBSR) training have positive behavioral and neurophysiological effects on SMR-based BCI. However, the effects of short-term meditation practice on SMR-based BCI control are still unknown. Methods In this study, we investigated the immediate effects of a short, 20-minute meditation on SMR-based BCI control. Thirty-seven subjects performed several runs of one-dimensional cursor control tasks before and after two types of 20-minute interventions: a guided mindfulness meditation exercise and a recording of a narrator reading a journal article. Results We found that there is no significant change in BCI performance and Electroencephalography (EEG) BCI control signal following either 20-minute intervention. Moreover, the change in BCI performance between the meditation group and the control group was found to be not significant. Discussion The present results suggest that a longer period of meditation is needed to improve SMR-based BCI control.
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Affiliation(s)
- Jeehyun Kim
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Xiyuan Jiang
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Dylan Forenzo
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Yixuan Liu
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Nancy Anderson
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Carol M. Greco
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Bin He
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, United States
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13
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Ho R, Kim K, Fan A, Gan A, Nakamoto S, Tong M, Vajjala S, Anderson N, Viereck J, Gorenflo R, Morden F, Liow K. Characteristics of Central Sleep Apnea in Hawai’i Ethnic Groups. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.459] [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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Park A, Wong L, Lang A, Kraus C, Anderson N, Elsensohn A. Cutaneous T-cell lymphoma following dupilumab use: a systematic review. Int J Dermatol 2022. [PMID: 36073768 DOI: 10.1111/ijd.16388] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/20/2022] [Accepted: 07/28/2022] [Indexed: 11/30/2022]
Abstract
In recent years, studies have associated dupilumab with unmasking or progression of cutaneous T-cell lymphoma (CTCL). The objective of this study was to synthesize reported cases of CTCL in the setting of dupilumab use. Two independent reviewers conducted a systematic review using PubMed and Embase databases. Twelve studies, of 27 total patients, were included. Dupilumab-associated CTCL was diagnosed on average 7.8 months following dupilumab initiation. Of reports that included body surface area (BSA), 100% had a BSA >50% prior to diagnosis, and the majority of patients were diagnosed at later stages of disease: stage III (4/18) or IV (6/18). Post-dupilumab biopsies revealed a greater density of cells and a predominant lichenoid pattern, compared to various histologic patterns and less cell density in pre-dupilumab biopsies. The majority of TCR gene rearrangement studies were equivocal (20%) or negative (60%), posing a potential diagnostic pitfall. Limitations included lack of standardized data collection and reporting and a small number of studies. We suggest that earlier biopsies, three to four months after initiation of dupilumab, may be helpful for earlier recognition of CTCL in patients who are not improving, progressing, or have morphologic changes on dupilumab.
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Affiliation(s)
- Ariel Park
- Department of Dermatology, Loma Linda University, Loma Linda, CA, USA
| | - Lulu Wong
- Department of Dermatology, Loma Linda University, Loma Linda, CA, USA
| | - Annalise Lang
- Department of Dermatology, Loma Linda University, Loma Linda, CA, USA
| | - Christina Kraus
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
| | - Nancy Anderson
- Department of Dermatology, Loma Linda University, Loma Linda, CA, USA
| | - Ashley Elsensohn
- Department of Dermatology, Loma Linda University, Loma Linda, CA, USA
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Armitage C, Braybrook E, Anderson N, Grammatopoulos D. T167 Measurement of plasma allopregnanolone levels and the impact of solid phase extraction step on competitive immunoassay performance. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Anderson N. SP-0208 RTT advanced practice in IGRT: Ancient history or new era? Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03923-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Anderson N, Hornby C, Karanika K. PO-1045 The impact of COVID-19 restrictions on radiotherapy referral pathways in Victoria, Australia. Radiother Oncol 2022. [PMCID: PMC9153886 DOI: 10.1016/s0167-8140(22)03009-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Pandey S, Anderson N, Lara B, Parr D, Grammatopoulos D D. W128 Discrepancy between molecular genotyping and phenotyping of alpha-1-antitrypsin results due to a novel null mutation. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.883] [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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Yang YH, Meerveld-Eggink A, Bex A, Jackson-Spence F, Rallis K, Brian P, Choy J, Sng C, Adeniran P, Amin J, Galope S, Anderson N, Fernandezgomez S, Powles T, Szabados B. 18P Baseline and dynamic changes in haemoglobin levels predict treatment response and disease progression in metastatic renal cell carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Lewis T, Flores S, Sabacan L, Choy P, Thannickal H, Shieh Y, Tice J, Ziv E, Madlensky L, Eklund M, Yau C, Blanco A, Tong B, Goodman D, Anderson N, Harvey H, Fors S, Park HL, Raouf S, Stewart S, Wernisch J, Koenig B, Kaplan C, Hiatt R, Wenger N, Lee V, Heditsian D, Brain S, Moorehead D, Parker BA, Borowsky A, Anton-Culver H, Naeim A, Kaster A, van ‘t Veer L, LaCroix AZ, Olopade OI, Sheth D, Garcia A, Lancaster R, Plaza M, Fiscalini AS, Esserman L. Abstract P5-19-04: The WISDOM study: Reducing sequential steps and implementing parallel workflows in pragmatic trials. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p5-19-04] [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: 11/16/2022]
Abstract
Abstract
Background:The WISDOM Study is a preference-tolerant pragmatic study, comparing annual mammograms to a risk-based screening. Eligibility includes women ages 40-74 years with no history of breast cancer or DCIS. Participants are enrolled to one study arm: annual screening or risk-based screening (includes genetic testing). Pragmatic trials often involve gathering real-time data over multiple time points. Collecting real-time data sequentially can limit enrollment, delay study assignments, and reduce participant engagement. The WISDOM Study has identified such bottlenecks and has implemented parallel workflows, reducing the overall wait time for participants to complete required study steps. These data highlight how moving participants through the study more efficiently can improve enrollment and retention and inform other pragmatic trials. Methods: WISDOM participants have the option to either choose their study arm or be randomized into one as part of the preference tolerant randomized trial design. Participants then complete breast health questionnaires and genetic testing (if in the risk-based arm). This information is analyzed by the WISDOM breast cancer risk assessment algorithm, the result of which is then communicated to the participant through a screening assignment letter (SAL). Specific data elements, such as breast density found participants’ mammogram reports and genetic testing results are required for study randomization process and risk assessment calculations, respectively. The WISDOM randomization algorithm is stratified by several factors, including breast cancer risk estimated using the Breast Cancer Surveillance Consortium (BCSC) model, which uses mammographic density as a key input variable. The study team changed the workflow to allow participants to proceed to randomization without specific information by imputing both density and risk. Additionally, a parallel workflow improvement process was implemented to obtain mammogram reports while genetic testing was being completed. Results: Before the weighted BCSC and imputed density algorithms were introduced, it took an average of 47 days to randomize participants after completion of the baseline enrollment questionnaires. Now, participants are randomized immediately which has reduced delays by 100%. Prior to implementing the parallel workflow for genetic testing and mammogram ascertainment, genetic testing kits were sent only after mammogram reports were collected and validated. The expected turnaround time for genetic testing results was 30-60 days and on average, results were returned to participants in 42 days. Streamlining the study design to obtain mammogram reports while participants complete their genetic testing has shortened the time for participants to receive their screening assignment letters (SALs) from an average of 160 days to 78 days, a reduction by 49%. In comparison, participants in the annual arm of the study who do not complete genetic testing, receive their SALs after an average of 38 days from enrollment. This is due to long wait times to obtain mammographic densities from outside medical facilities. Conclusions: Creating parallel data ascertainment workflows and reducing sequential steps in the study process has increased completion of individual enrollment activities. Participants now are randomized immediately upon joining the study and have access to their SALs and genetic results more rapidly. This approach eliminated randomization wait times and improved efficiency of the early in the enrollment process. We are evaluating the impact on participant retention going forward. Workflow efficiency is critical to improve the patient experience, and our learnings can inform future trial design, particularly for studies requiring data from outside sources.
Citation Format: Tomiyuri Lewis, Stephanie Flores, Leah Sabacan, Patricia Choy, Halle Thannickal, Yiwey Shieh, Jeffrey Tice, Elad Ziv, Lisa Madlensky, Martin Eklund, Christina Yau, Amie Blanco, Barry Tong, Deborah Goodman, Nancy Anderson, Heather Harvey, Steele Fors, Hannah L Park, Samrrah Raouf, Skye Stewart, Janet Wernisch, Barbara Koenig, Celia Kaplan, Robert Hiatt, Neil Wenger, Vivian Lee, Diane Heditsian, Susie Brain, Dolores Moorehead, Barbara A Parker, Alexander Borowsky, Hoda Anton-Culver, Arash Naeim, Andrea Kaster, Laura van ‘t Veer, Andrea Z LaCroix, Olufunmilayo I Olopade, Deepa Sheth, Agustin Garcia, Rachel Lancaster, Michael Plaza, Wisdom Study, Athena Breast Health Network Investigators, Advocate Partners, Allison S Fiscalini, Laura Esserman. The WISDOM study: Reducing sequential steps and implementing parallel workflows in pragmatic trials [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P5-19-04.
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Affiliation(s)
- Tomiyuri Lewis
- University of California, San Francisco, San Francisco, CA
| | | | - Leah Sabacan
- University of California, San Francisco, San Francisco, CA
| | - Patricia Choy
- University of California, San Francisco, San Francisco, CA
| | | | - Yiwey Shieh
- University of California, San Francisco, San Francisco, CA
| | - Jeffrey Tice
- University of California, San Francisco, San Francisco, CA
| | - Elad Ziv
- University of California, San Francisco, San Francisco, CA
| | | | | | - Christina Yau
- University of California, San Francisco, San Francisco, CA
| | - Amie Blanco
- University of California, San Francisco, San Francisco, CA
| | - Barry Tong
- University of California, San Francisco, San Francisco, CA
| | | | | | | | - Steele Fors
- University of California, San Diego, San Diego, CA
| | | | | | | | | | - Barbara Koenig
- University of California, San Francisco, San Francisco, CA
| | - Celia Kaplan
- University of California, San Francisco, San Francisco, CA
| | - Robert Hiatt
- University of California, San Francisco, San Francisco, CA
| | - Neil Wenger
- University of California, Los Angeles, Los Angeles, CA
| | - Vivian Lee
- University of California, San Francisco, San Francisco, CA
| | | | - Susie Brain
- University of California, San Francisco, San Francisco, CA
| | | | | | | | | | - Arash Naeim
- University of California, Los Angeles, Los Angeles, CA
| | | | | | | | | | | | | | | | | | | | - Laura Esserman
- University of California, San Francisco, San Francisco, CA
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Choy P, Lewis T, Flores S, Sabacan L, Thannickal H, Goodman S, Shieh Y, Madlensky L, Tice JA, Ziv E, Eklund M, Blanco A, Tong B, Goodman D, Anderson N, Harvey H, Fors S, Park HL, Petruse A, Stewart S, Raouf S, Wernisch J, Koenig B, Kaplan C, Hiatt R, Wenger N, Lee V, Heditsian D, Brain S, Moorehead D, Parker BA, Borowsky A, Anton-Culver H, Naeim A, Kaster A, van 't Veer L, LaCroix AZ, Olopade OI, Sheth D, Garcia A, Lancaster R, James J, Joseph G, Study W, Fiscallini AS, Esserman L. Abstract P5-19-01: The impact of streamlined processes and patient-directed messaging to improve enrollment in a remote, pragmatic clinical trial. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p5-19-01] [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: 11/16/2022]
Abstract
Abstract
Background Recent advances in technology have made it possible to conduct remote clinical trials that allow individuals to participate from home with comfort, privacy, and ease. Despite these advances, challenges persist in running remote trials, such as survey question redundancies, lack of patient-initiated data-sharing tools, and unclear patient communication around critical enrollment steps. The Women Informed to Screen Depending on Measures of risk (WISDOM) Study is a pragmatic, preference-tolerant randomized control breast cancer screening trial comparing personalized risk-based screening to traditional, annual screening. The study population includes women ages 40-74 without a history of breast cancer or DCIS. Since 2016, study enrollment has been available to all women in the U.S. who meet study eligibility criteria. Since October 2020, WISDOM has implemented multiple strategies to improve participant experience: participant-initiated data-sharing tools and clear participant messaging. This abstract presents the efficacy of these interventions as they relate to increasing patient enrollment in remote, pragmatic clinical trials. Methods The WISDOM Study online enrollment process includes registration, participant study arm selection or randomization, online consent, and enrollment (submission of multiple study surveys over a secure, online platform). Barriers to online enrollment were uncovered through an internally-conducted needs assessment of participants who enrolled between 2019-2020, and participant feedback obtained through phone interviews conducted by WISDOM’s embedded ethics study. Improvements to our online enrollment procedures were executed in October 2020 and included: improving the clarity of study arm selection options, streamlining data collection surveys, and enacting a secure, patient-initiated online data-sharing tool and an online portal feature with auto-launch of critical information. Study metrics were obtained through Google Analytics and Salesforce. Results Prior to the end of 2020, only 62% of the 30,046 participants who registered for the WISDOM Study completed study enrollment. After improving the enrollment process, of the 5,334 participants registered for the study between Jan-June 2021, 69% completed the enrollment process finishing both the online consent and survey forms. Conversion from consent to enrollment went from 78% in January 2020 to 93% in June 2021. Currently, 56% participants complete enrollment in one day. Streamlining online patient questionnaires led to an increase in completion rates, with 75% of participants completing their yearly surveys, compared to 59% prior to April 2021. A secure patient upload feature for data sharing led to 1,054 participants successfully sharing their mammogram reports with WISDOM between March - June 2021. Previously, mammogram reports were missing for 20% of enrolled participants. This feature has enabled WISDOM to process 300 additional mammogram reports per month. Integration of an auto-launch feature in the participant’s portal in Feb 2021 has led to a 17% increase in participants viewing their screening recommendations in Yr 1. Prior to auto-launch, only 59% (n=6328) of Yr 1 screening recommendations and 61% (n=3681) of genetic testing reports were viewed by participants. Since implementation, the numbers increased to 78% (n=8406) and 85% (n=5160), respectively. Conclusions. Streamlining data to the most essential elements, and minimizing the steps required to share clinical documents, complete questionnaires and open key study notification is essential to improving enrollment rates in virtual, pragmatic trials. Patient-initiated data-sharing tools such as the ability for participants to share documents through secure, online portals is one example of success.
Citation Format: Patricia Choy, Tomiyuri Lewis, Stephanie Flores, Leah Sabacan, Halle Thannickal, Steffanie Goodman, Yiwey Shieh, Lisa Madlensky, Jeffrey A. Tice, Elad Ziv, Martin Eklund, Amie Blanco, Barry Tong, Deborah Goodman, Nancy Anderson, Heather Harvey, Steele Fors, Hannah Lui Park, Antonia Petruse, Skye Stewart, Samrrah Raouf, Janet Wernisch, Barbara Koenig, Celia Kaplan, Robert Hiatt, Neil Wenger, Vivian Lee, Diane Heditsian, Susie Brain, Dolores Moorehead, Barbara A Parker, Alexander Borowsky, Hoda Anton-Culver, Arash Naeim, Andrea Kaster, Laura van 't Veer, Andrea Z LaCroix, Olufunmilayo I. Olopade, Deepa Sheth, Agustin Garcia, Rachel Lancaster, Jennifer James, Galen Joseph, Wisdom Study, Athena Breast Health Network Investigators and Advocates, Allison Stover Fiscallini, Laura Esserman. The impact of streamlined processes and patient-directed messaging to improve enrollment in a remote, pragmatic clinical trial [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P5-19-01.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Elad Ziv
- UC San Francisco, San Francisco, CA
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Williams G, Anderson N, Jones J. Improving Radiation Oncology (RO) Quality and Workflow by Implementation of a Standardized Daily Huddle. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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23
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Bernasconi SM, Daëron M, Bergmann KD, Bonifacie M, Meckler AN, Affek HP, Anderson N, Bajnai D, Barkan E, Beverly E, Blamart D, Burgener L, Calmels D, Chaduteau C, Clog M, Davidheiser‐Kroll B, Davies A, Dux F, Eiler J, Elliott B, Fetrow AC, Fiebig J, Goldberg S, Hermoso M, Huntington KW, Hyland E, Ingalls M, Jaggi M, John CM, Jost AB, Katz S, Kelson J, Kluge T, Kocken IJ, Laskar A, Leutert TJ, Liang D, Lucarelli J, Mackey TJ, Mangenot X, Meinicke N, Modestou SE, Müller IA, Murray S, Neary A, Packard N, Passey BH, Pelletier E, Petersen S, Piasecki A, Schauer A, Snell KE, Swart PK, Tripati A, Upadhyay D, Vennemann T, Winkelstern I, Yarian D, Yoshida N, Zhang N, Ziegler M. InterCarb: A Community Effort to Improve Interlaboratory Standardization of the Carbonate Clumped Isotope Thermometer Using Carbonate Standards. Geochem Geophys Geosyst 2021; 22:e2020GC009588. [PMID: 34220359 PMCID: PMC8244079 DOI: 10.1029/2020gc009588] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 06/12/2023]
Abstract
Increased use and improved methodology of carbonate clumped isotope thermometry has greatly enhanced our ability to interrogate a suite of Earth-system processes. However, interlaboratory discrepancies in quantifying carbonate clumped isotope (Δ47) measurements persist, and their specific sources remain unclear. To address interlaboratory differences, we first provide consensus values from the clumped isotope community for four carbonate standards relative to heated and equilibrated gases with 1,819 individual analyses from 10 laboratories. Then we analyzed the four carbonate standards along with three additional standards, spanning a broad range of δ47 and Δ47 values, for a total of 5,329 analyses on 25 individual mass spectrometers from 22 different laboratories. Treating three of the materials as known standards and the other four as unknowns, we find that the use of carbonate reference materials is a robust method for standardization that yields interlaboratory discrepancies entirely consistent with intralaboratory analytical uncertainties. Carbonate reference materials, along with measurement and data processing practices described herein, provide the carbonate clumped isotope community with a robust approach to achieve interlaboratory agreement as we continue to use and improve this powerful geochemical tool. We propose that carbonate clumped isotope data normalized to the carbonate reference materials described in this publication should be reported as Δ47 (I-CDES) values for Intercarb-Carbon Dioxide Equilibrium Scale.
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Affiliation(s)
| | - M. Daëron
- Laboratoire des Sciences du Climat et de l’EnvironnementLSCE/IPSLCEA‐CNRS‐UVSQUniversité Paris‐SaclayGif‐sur‐YvetteFrance
| | - K. D. Bergmann
- Department of Earth, Atmospheric and Planetary SciencesMassachusetts Institute of TechnologyCambridgeMAUSA
| | - M. Bonifacie
- Université de ParisInstitut de Physique du Globe de ParisCNRSParisFrance
| | - A. N. Meckler
- Bjerknes Centre for Climate Research and Department of Earth ScienceUniversity of BergenBergenNorway
| | - H. P. Affek
- Institute of Earth SciencesHebrew University of JerusalemJerusalemIsrael
| | - N. Anderson
- Department of Earth, Atmospheric and Planetary SciencesMassachusetts Institute of TechnologyCambridgeMAUSA
| | - D. Bajnai
- Institute of GeosciencesGoethe University FrankfurtFrankfurt am MainGermany
| | - E. Barkan
- Institute of Earth SciencesHebrew University of JerusalemJerusalemIsrael
| | - E. Beverly
- Now at Department of Earth and Atmospheric SciencesUniversity of HoustonHoustonTXUSA
- Department of Earth and Environmental SciencesUniversity of MichiganAnn ArborMIUSA
| | - D. Blamart
- Laboratoire des Sciences du Climat et de l’EnvironnementLSCE/IPSLCEA‐CNRS‐UVSQUniversité Paris‐SaclayGif‐sur‐YvetteFrance
| | - L. Burgener
- Department of Marine, Earth and Atmospheric SciencesNorth Carolina State UniversityRaleighNCUSA
| | - D. Calmels
- Université de ParisInstitut de Physique du Globe de ParisCNRSParisFrance
- Now at Geosciences Paris Sud (GEOPS)Université Paris‐SaclayCNRSOrsayFrance
| | - C. Chaduteau
- Université de ParisInstitut de Physique du Globe de ParisCNRSParisFrance
| | - M. Clog
- Scottish Universities Environmental Research Centre (SUERC)ScotlandUK
| | | | - A. Davies
- Now at Stockholm UniversityStockholmSweden
- Imperial CollegeLondonUK
| | - F. Dux
- Now at School of Earth and Life SciencesUniversity of WollongongWollongongAustralia
- School of GeographyUniversity of MelbourneMelbourneAustralia
| | - J. Eiler
- Geological and Planetary SciencesCalifornia Institute of TechnologyPasadenaCAUSA
| | - B. Elliott
- Department of Earth, Planetary, and Space SciencesUniversity of California Los AngelesLos AngelesCAUSA
| | | | - J. Fiebig
- Institute of GeosciencesGoethe University FrankfurtFrankfurt am MainGermany
| | - S. Goldberg
- Department of Earth, Atmospheric and Planetary SciencesMassachusetts Institute of TechnologyCambridgeMAUSA
| | - M. Hermoso
- Université de ParisInstitut de Physique du Globe de ParisCNRSParisFrance
- Univ. Littoral Côte d’OpaleUniv. LilleCNRSLaboratoire d’Océanologie et de Géosciences (UMR 8187 LOG)WimereuxFrance
| | | | - E. Hyland
- Department of Marine, Earth and Atmospheric SciencesNorth Carolina State UniversityRaleighNCUSA
| | - M. Ingalls
- Geological and Planetary SciencesCalifornia Institute of TechnologyPasadenaCAUSA
- Now at Department of GeosciencesThe Pennsylvania State UniversityUniversity ParkPAUSA
| | - M. Jaggi
- Geological InstituteETH ZürichZürichSwitzerland
| | | | - A. B. Jost
- Department of Earth, Atmospheric and Planetary SciencesMassachusetts Institute of TechnologyCambridgeMAUSA
| | - S. Katz
- Department of Earth and Environmental SciencesUniversity of MichiganAnn ArborMIUSA
| | - J. Kelson
- Department of Earth and Environmental SciencesUniversity of MichiganAnn ArborMIUSA
| | - T. Kluge
- Imperial CollegeLondonUK
- Now at Karlsruher Institut für Technologie KITKarlsruheGermany
| | - I. J. Kocken
- Department of Earth SciencesUniversity of UtrechtUtrechtThe Netherlands
| | - A. Laskar
- Institute of Earth SciencesAcademia SinicaTaipeiTaiwan
| | - T. J. Leutert
- Bjerknes Centre for Climate Research and Department of Earth ScienceUniversity of BergenBergenNorway
- Now at Max Planck Institute for ChemistryMainzGermany
| | - D. Liang
- Institute of Earth SciencesAcademia SinicaTaipeiTaiwan
| | - J. Lucarelli
- Department of Earth, Planetary, and Space SciencesUniversity of California Los AngelesLos AngelesCAUSA
| | - T. J. Mackey
- Department of Earth, Atmospheric and Planetary SciencesMassachusetts Institute of TechnologyCambridgeMAUSA
- Now at Department of Earth and Planetary SciencesUniversity of New MexicoAlbuquerqueNMUSA
| | - X. Mangenot
- Université de ParisInstitut de Physique du Globe de ParisCNRSParisFrance
- Geological and Planetary SciencesCalifornia Institute of TechnologyPasadenaCAUSA
| | - N. Meinicke
- Bjerknes Centre for Climate Research and Department of Earth ScienceUniversity of BergenBergenNorway
| | - S. E. Modestou
- Bjerknes Centre for Climate Research and Department of Earth ScienceUniversity of BergenBergenNorway
| | - I. A. Müller
- Department of Earth SciencesUniversity of UtrechtUtrechtThe Netherlands
| | | | - A. Neary
- Department of Earth and Environmental SciencesUniversity of MichiganAnn ArborMIUSA
| | - N. Packard
- Department of Earth and Environmental SciencesUniversity of MichiganAnn ArborMIUSA
| | - B. H. Passey
- Department of Earth and Environmental SciencesUniversity of MichiganAnn ArborMIUSA
| | - E. Pelletier
- Department of Earth and Environmental SciencesUniversity of MichiganAnn ArborMIUSA
| | - S. Petersen
- Department of Earth and Environmental SciencesUniversity of MichiganAnn ArborMIUSA
| | - A. Piasecki
- Bjerknes Centre for Climate Research and Department of Earth ScienceUniversity of BergenBergenNorway
- Now at Department of Earth SciencesDartmouth CollegeHanoverNHUSA
| | | | | | - P. K. Swart
- Department of Marine GeosciencesRostiel School of Marine and Atmospheric SciencesUniversity of MiamiMiamiFLUSA
| | - A. Tripati
- Department of Earth, Planetary, and Space SciencesUniversity of California Los AngelesLos AngelesCAUSA
| | - D. Upadhyay
- Department of Earth, Planetary, and Space SciencesUniversity of California Los AngelesLos AngelesCAUSA
| | - T. Vennemann
- Institute of Earth Surface DynamicsUniversity of LausanneLausanneSwitzerland
| | - I. Winkelstern
- Department of Earth and Environmental SciencesUniversity of MichiganAnn ArborMIUSA
- Now at Geology DepartmentGrand Valley State UniversityAllendaleMIUSA
| | - D. Yarian
- Department of Earth and Environmental SciencesUniversity of MichiganAnn ArborMIUSA
| | - N. Yoshida
- Earth‐Life Science InstituteTokyo Institute of TechnologyTokyoJapan
- National Institute of Information and Communications TechnologyTokyoJapan
| | - N. Zhang
- Earth‐Life Science InstituteTokyo Institute of TechnologyTokyoJapan
| | - M. Ziegler
- Department of Earth SciencesUniversity of UtrechtUtrechtThe Netherlands
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Acerbi I, Fiscalini AS, Che M, Shieh Y, Madlensky L, Tice J, Ziv E, Eklund M, Blanco A, Tong B, Goodman D, Nassereddine L, Anderson N, Harvey H, Fors S, Park HL, Petruse A, Stewart S, Wernisch J, Risty L, Hurley I, Koenig B, Kaplan C, Hiatt R, Wenger N, Lee V, Heditsian D, Brain S, Sabacan L, Wang T, Parker BA, Borowsky A, Anton-Culver H, Naeim A, Kaster A, Talley M, van 't Veer L, LaCroix AZ, Olopade OI, Sheth D, Garcia A, Lancaster R, Esserman L. Abstract OT-21-01: Personalized breast cancer screening in a population-based study: Women informed to screen depending on measures of risk (WISDOM). Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-ot-21-01] [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: 11/16/2022]
Abstract
Abstract
Background: WISDOM is a 100,000 healthy women preference-tolerant, pragmatic study comparing traditional annual screening to personalized risk-based breast screening. The novelty of WISDOM personalized screening is the integration of previously validated genetic and clinical risk factors (age, family history, breast biopsy results, ethnicity, mammographic density) into a single risk assessment model that directs the starting age, timing, and frequency of screening. The goal of WISDOM is to determine if personalized screening, compared to annual screening, is as safe, less morbid, enables prevention, and is more accepted by women. The study is registered on ClinicalTrials.gov, NCT02620852. Methods: Women aged 40-74 years with no history of breast cancer, DCIS or previous double mastectomy can join the study online at wisdomstudy.org. Participants can either elect randomization or self-select a study arm. Then, they provide electronic consent and sign the Release for Medical Information via DocuSign. For all participants, 5-year risk of developing breast cancer is calculated according to the Breast Cancer Surveillance Consortium (BCSC) model. Participants in the personalized arm undergo panel-based mutation testing (BRCA1, BRCA2, TP53, PTEN, STK11, CDH1, ATM, PALB2, and CHEK2), and their 5-year risk is calculated using the BCSC score combined with a Polygenic Risk Score (BCSC-PRS) that includes 229 single nucleotide polymorphisms (SNPs) known to increase breast cancer risk. The SNPs and mutations are assessed by saliva-based testing through Color Genomics. Five-year risk level thresholds are used to stratify participants as low-, moderate- and high risk. Risk stratification determines age to start, stop, and frequency of screening in the personalized arm. Accrual: As of July 2020 the WISDOM Study is open to all eligible women in the United States. To date, 38,762 eligible women have registered, and 28,706 women have consented to participate in the trial. The median age is 56 years. Seventy-seven percent of participants are Caucasian, 2% African-American, 5% Asian, and 8% of self-reported Hispanic ethnicity. WISDOM is partnering with Blue Cross Blue Shield Association for regional plan opt-in coverage, self-insured companies (Salesforce, Genentech, Qualcomm, CalPERS) and Medi-Cal (Inland Empire Health Plan) using a coverage with evidence progression approach. Accrual expansion and diversity: To ensure that resulting data are meaningful and potentially practice-changing for all populations of women, the WISDOM Study is enhancing the diversity of our participant population by establishing WISDOM sites in diverse areas with large African-American (Alabama, Louisiana, Illinois) and Latina (Florida) populations. These new recruitment sites, intentionally selected for the diverse communities they serve, have established partnerships with community organizations and outreach navigators. Additionally, we have translated the WISDOM Study to Spanish to facilitate access by Latina communities. With the engagement of patient advocates and community partnerships, expanding diversity in the study population will strengthen our scientific knowledge of breast cancer risk and improve access to personalized breast cancer screening recommendations for all women. Enrollment will continue through 2022. Conclusions: Results of 5 years follow-up will enable us to demonstrate whether personalized screening improves outcomes for future patients and it improves healthcare value by reducing screen volumes and costs without jeopardizing outcomes.
Citation Format: Irene Acerbi, Allison Stover Fiscalini, Mandy Che, Yiwey Shieh, Lisa Madlensky, Jeffrey Tice, Elad Ziv, Martin Eklund, Amie Blanco, Barry Tong, Deborah Goodman, Lamees Nassereddine, Nancy Anderson, Heather Harvey, Steele Fors, Hannah L Park, Antonia Petruse, Skye Stewart, Janet Wernisch, Larissa Risty, Ian Hurley, Barbara Koenig, Celia Kaplan, Robert Hiatt, Neil Wenger, Vivian Lee, Diane Heditsian, Susie Brain, Leah Sabacan, Tianyi Wang, Barbara A Parker, Alexander Borowsky, Hoda Anton-Culver, Arash Naeim, Andrea Kaster, Melinda Talley, Laura van 't Veer, Andrea Z LaCroix, Olufunmilayo I Olopade, Deepa Sheth, Augustin Garcia, Rachel Lancaster, Wisdom Study and Athena Breast Health Network Investigators and Advocate Partners, Laura Esserman. Personalized breast cancer screening in a population-based study: Women informed to screen depending on measures of risk (WISDOM) [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr OT-21-01.
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Affiliation(s)
- Irene Acerbi
- 1University of California, San Francisco, San Francisco, CA
| | | | - Mandy Che
- 1University of California, San Francisco, San Francisco, CA
| | - Yiwey Shieh
- 1University of California, San Francisco, San Francisco, CA
| | | | - Jeffrey Tice
- 1University of California, San Francisco, San Francisco, CA
| | - Elad Ziv
- 1University of California, San Francisco, San Francisco, CA
| | | | - Amie Blanco
- 1University of California, San Francisco, San Francisco, CA
| | - Barry Tong
- 1University of California, San Francisco, San Francisco, CA
| | | | | | | | | | - Steele Fors
- 2University of California, San Diego, San Diego, CA
| | - Hannah L Park
- 7University of California, Irvine, San Francisco, CA
| | | | | | | | | | | | - Barbara Koenig
- 1University of California, San Francisco, San Francisco, CA
| | - Celia Kaplan
- 1University of California, San Francisco, San Francisco, CA
| | - Robert Hiatt
- 1University of California, San Francisco, San Francisco, CA
| | - Neil Wenger
- 5University of California, Los Angeles, Los Angeles, CA
| | - Vivian Lee
- 1University of California, San Francisco, San Francisco, CA
| | | | - Susie Brain
- 1University of California, San Francisco, San Francisco, CA
| | - Leah Sabacan
- 1University of California, San Francisco, San Francisco, CA
| | - Tianyi Wang
- 1University of California, San Francisco, San Francisco, CA
| | | | | | | | - Arash Naeim
- 5University of California, Los Angeles, Los Angeles, CA
| | | | | | | | | | | | | | | | | | - Laura Esserman
- 1University of California, San Francisco, San Francisco, CA
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Hill G, Sharman J, Campbell J, Murray T, Anderson N, Foale S, Ruigrok M, Singh R, Hayat U, Barthwal R, Burley M, Eberhardt E, Dare L, Black A. Tasmanian STEMI Network - A Whole of System Evaluation. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Seernani D, Damania K, Ioannou C, Penkalla N, Hill H, Foulsham T, Kingstone A, Anderson N, Boccignone G, Bender S, Smyrnis N, Biscaldi M, Ebner-Priemer U, Klein C. Visual search in ADHD, ASD and ASD + ADHD: overlapping or dissociating disorders? Eur Child Adolesc Psychiatry 2021; 30:549-562. [PMID: 32314021 PMCID: PMC8041680 DOI: 10.1007/s00787-020-01535-2] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 04/09/2020] [Indexed: 01/25/2023]
Abstract
Recent debates in the literature discuss commonalities between Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) at multiple levels of putative causal networks. This debate requires systematic comparisons between these disorders that have been studied in isolation in the past, employing potential markers of each disorder to be investigated in tandem. The present study, choose superior local processing, typical to ASD, and increased Intra-Subject Variability (ISV), typical to ADHD, for a head-to-head comparison of the two disorders, while also considering the comorbid cases. It directly examined groups of participants aged 10-13 years with ADHD, ASD with (ASD+) or without (ASD-) comorbid ADHD and a typically developing (TD) group (total N = 85). A visual search task consisting of an array of paired words was designed. The participants needed to find the specific pair of words, where the first word in the pair was the cue word. This visual search task was selected to compare these groups on overall search performance and trial-to-trial variability of search performance (i.e., ISV). Additionally, scanpath analysis was also carried out using Recurrence Quantification Analysis (RQA) and the Multi-Match Model. Results show that only the ASD- group exhibited superior search performance; whereas, only the groups with ADHD symptoms showed increased ISV. These findings point towards a double dissociation between ASD and ADHD, and argue against an overlap between ASD and ADHD.
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Affiliation(s)
- D. Seernani
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Freiburg, Hauptstrasse 8, 79104 Freiburg, Germany
| | | | - C. Ioannou
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Freiburg, Hauptstrasse 8, 79104 Freiburg, Germany
| | - N. Penkalla
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Freiburg, Hauptstrasse 8, 79104 Freiburg, Germany
| | - H. Hill
- Institute of Sports and Sports Sciences, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - T. Foulsham
- Department of Psychology, University of Essex, Colchester, UK
| | - A. Kingstone
- Brain, Attention and Reality Lab, University of British Columbia, Vancouver, Canada
| | - N. Anderson
- Brain, Attention and Reality Lab, University of British Columbia, Vancouver, Canada
| | - G. Boccignone
- Department of Computer Science, University of Milan, Milan, Italy
| | - S. Bender
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
| | - N. Smyrnis
- Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - M. Biscaldi
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Freiburg, Hauptstrasse 8, 79104 Freiburg, Germany
| | | | - Christoph Klein
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Freiburg, Hauptstrasse 8, 79104, Freiburg, Germany. .,Department of Child and Adolescent Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany. .,Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece.
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Kirk B, Larsen JWA, Anderson N, Stevenson MA. The effects of parasitism on ewes for prime lamb production in western Victoria. Anim Prod Sci 2021. [DOI: 10.1071/an20414] [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: 11/23/2022]
Abstract
Context
Internal parasites are estimated to cost the Australian sheep industry AUD436 million per annum (p.a.).
Aims
To assess the effects of parasitism in flocks producing prime lambs in the 500–700 mm p.a rainfall. area of Victoria.
Methods
Ewes on two farms that followed ‘best practice’ gastrointestinal parasite control programs (BP) and two farms that did not (regionally typical, TYP) were compared. Separate cohorts of ewes were monitored from pregnancy scanning to their subsequent joining each year for three consecutive seasons. Observations included worm egg count (WEC), bodyweight, condition score and presence of breech soiling (dag). These were compared between groups that were treated to suppress parasitism (SUP) and those treated according to the usual program used on that farm (NSUP). Data from individual ewes were analysed using a multivariable, mixed-effects regression model.
Key results
After adjusting for known confounders, SUP ewes were 1.2 (95% CI 0.80–1.6) kg heavier than NSUP ewes. Mature SUP ewes were significantly heavier than NSUP ewes at their next joining on 6 of 18 occasions, mostly following winters when ewes experienced nutritional stress. Ewe hoggets and Merino ewes were generally more susceptible to parasitism than mature non-Merino ewes; single-bearing ewes were less susceptible than those bearing twins. The effects of parasitism were reduced when peri-parturient ewes had an optimal condition score and grazed adequate pastures.
Conclusions
Ewes were more vulnerable to parasitism when immature, twin-bearing, or under nutritional stress. Some of the greatest differences between SUP and NSUP ewes occurred following periods of low feed availability and/or ewe condition score. The difference between the mean bodyweight of SUP and NSUP Merinos was not always greater than that of the non-Merinos. WECs are not a sole reliable indicator of the effects of parasitism in this class of sheep.
Implications
Immature or twin-bearing ewes, and those in suboptimal body condition, should be managed considering their increased vulnerability to parasitism, and WEC interpreted alongside other factors. Controlled release capsules were not cost effective in reducing production loss from gastrointestinal nematodes in most years but may be effective in reducing the effects of clinical parasitism in some cases.
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Robbins T, Kyrou I, Laird S, Morgan N, Anderson N, Imray C, Patel K, Sankar S, Randeva H, Jones C. Healthcare staff perceptions and misconceptions regarding antibody testing in the United Kingdom: implications for the next steps for antibody screening. J Hosp Infect 2020; 111:102-106. [PMID: 33309938 PMCID: PMC7834281 DOI: 10.1016/j.jhin.2020.11.019] [Citation(s) in RCA: 4] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/22/2020] [Accepted: 11/23/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Healthcare workers have been at increased risk of exposure, infection and serious complications from COVID-19. Antibody testing has been used to identify staff members who have been previously infected by SARS-CoV-2, and has been rolled out rapidly in the United Kingdom. A number of comment and editorial articles have been published that raise concerns about antibody testing in this context. We present perceptions of National Health Service (NHS) healthcare workers in relation to SARS-CoV-2 antibody testing. METHODS An electronic survey regarding perceptions towards SARS-CoV-2 antibody testing was distributed to all healthcare workers at a major NHS tertiary hospital following implementation of antibody testing. RESULTS In total, 560 healthcare workers completed the survey (80% female; 25% of Black and Minority Ethnic background; 58% from frontline clinical staff). Exploring whether they previously had COVID-19 was the primary reported reason for choosing to undergo antibody testing (85.2%). In case of a positive antibody test, 72% reported that they would feel relieved, whilst 48% felt that they would be happier to work in a patient-facing area. Moreover, 12% responded that a positive test would mean "social distancing is less important", with 34% of the responders indicating that in this case they would be both less likely to catch COVID-19 and happier to visit friends/relatives. CONCLUSIONS NHS staff members primarily seek out SARS-CoV-2 antibody testing for an appropriate reason. Based on our findings and given the lack of definite data regarding the extent of immunity protection from a positive SARS-CoV-2 antibody test, significant concerns may be raised regarding the reported interpretation by healthcare workers of positive antibody test results. This needs to be further explored and addressed to protect NHS staff and patients.
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Affiliation(s)
- T Robbins
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK; Institute of Digital Healthcare, WMG, University of Warwick, Coventry, UK.
| | - I Kyrou
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK; Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, UK; Warwick Medical School, University of Warwick, Coventry, UK
| | - S Laird
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK; Warwick Medical School, University of Warwick, Coventry, UK
| | - N Morgan
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - N Anderson
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - C Imray
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK; Warwick Medical School, University of Warwick, Coventry, UK
| | - K Patel
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK; Warwick Medical School, University of Warwick, Coventry, UK
| | - S Sankar
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK; Warwick Medical School, University of Warwick, Coventry, UK
| | - H Randeva
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK; Warwick Medical School, University of Warwick, Coventry, UK
| | - C Jones
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
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Guillen D, Anderson N, Krome C, Boza R, Griffel L, Zouabe J, Al Rashdan A. A RELAP5-3D/LSTM model for the analysis of drywell cooling fan failure. Progress in Nuclear Energy 2020. [DOI: 10.1016/j.pnucene.2020.103540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Barsky A, Lin H, Mendes A, Wright C, Berman A, Levin W, Cengel K, Anderson N, Dong L, Metz J, Li T, Feigenberg S. Initial Clinical Experience Treating Patients with Lung Cancer on a 6MV Flattening Filter Free O-Ring Linear Accelerator. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1344] [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]
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Yoon S, Lin H, Alonso-Basanta M, Anderson N, Apinorasethkul O, Cooper K, Dong L, Kempsey B, Marcel J, Metz J, Scheuermann R, Li T. Evaluation of the Auto-Segmentation Performance of a Novel Online Adaptive Radiotherapy System for Head and Neck Cancer Treatment. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2338] [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]
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Scheuermann R, Marcel J, Anderson N, Apinorasethkul O, Cooper K, Kempsey B, Yoon S, Alonso-Basanta M, Li T, Metz J, Dong L. Evaluation of Dosimetric Quality of Auto-Generated Plans by a Novel Online Adaptive System for Head and Neck Radiotherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2344] [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]
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Anderson N, Thiru S, Chenzbraun A. Three-D measurements of LVOT: impact on quantification of aortic stenosis (AS). Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Discrepancies between aortic valve area (AVA) and gradients are recognized in patients with AS and normal LVEF and can impact on surgical referral decisions.
Purpose
Pilot study to determine whether using 3D rather than 2D LVOT dimensions leads to fewer discrepancies and less patients diagnosed with severe AS by continuity equation.
Methods
AS was quantified as per BSE guidelines in 55 consecutive patients (M: 32, age: 73±10) with LVEF>50% and at least moderate AS by AVA. LVOT was imaged with 3D zoom and its two orthogonal diameters were used to calculate the LVOT area for the continuity equation.
Results
Severe AS was diagnosed by AVA in 24/55 (44%) patients (Table 1). By 3D measurements the LVOT eccentricity index (D1/D2) was 0.8±0.1 and the LVOT area and SVi were larger than the ones calculated by 2D measurements:3.74±0.7 cm2 vs. 3.29±0.5 cm2 and 51.4±13 ml/BSA, vs. 45.3±9 ml/BSA, respectively, p<0.05. 3D measurements reduced the number of severe AS cases from 24 to 18 (AVA) and from 33 to 24 (AVAi) (25% and 27% respectively, p<0.05). AS severity agreement for all parameters slightly improved from 34/55 (62%) to 37/55/ (67%), p: ns
Conclusions
1) In this pilot study, the use of 3D-derived LVOT measurements reduced by 25% the frequency of severe AS diagnosis.
2) If these results are confirmed in larger studies, use of 3D LVOT measurements may become standard of practice.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- N Anderson
- The Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - S Thiru
- The Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - A Chenzbraun
- The Royal Liverpool University Hospital, Liverpool, United Kingdom
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Schink JC, Filiaci V, Huang HQ, Tidy J, Winter M, Carter J, Anderson N, Moxley K, Yabuno A, Taylor SE, Kushnir C, Horowitz N, Miller DS. An international randomized phase III trial of pulse actinomycin-D versus multi-day methotrexate for the treatment of low risk gestational trophoblastic neoplasia; NRG/GOG 275. Gynecol Oncol 2020; 158:354-360. [PMID: 32460997 PMCID: PMC7432963 DOI: 10.1016/j.ygyno.2020.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/11/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Methotrexate and actinomycin-D are both effective first-line drugs for low-risk (WHO score 0-6) Gestational Trophoblastic Neoplasia (GTN) with considerable debate about which is more effective, less toxic, and better tolerated. The primary trial objective was to test if treatment with multi-day methotrexate (MTX) was inferior to pulse actinomycin-D (ACT-D). Secondary objectives included evaluation of severity and frequency of adverse events, and impact on quality of life (QOL). METHODS This was a prospective international cooperative group randomized phase III two arm non-inferiority study (Clinical Trials Identifier: (NCT01535053). The control arm was ACT-D; the experimental arm was multi-day MTX regimen (institutional preference of 5 or 8 day). Outcome measures included complete response rate, recurrence rate, toxicity, and QOL as measured by FACT-G and FACIT supplemental items. RESULTS The complete response rates for multi-day methotrexate and pulse actinomycin-D were 88% (23/26 patients) and 79% (22/28 patients) (p = NS) respectively, there were two recurrences in each arm, and 100% of patients survived. Significant toxicity was minimal, but mouth sores (mucositis), and eye pain were significantly more common in the MTX arm (p = 0.001 and 0.01 respectively). Quality of life showed no significant difference in overall quality of life, body image, sexual function, or treatment related side effects. The study was closed for low accrual rate (target 384, actual accrual 57), precluding statistical analysis of the primary objective. CONCLUSIONS The complete response rate for multi-day methotrexate was higher than actinomycin-D, but did not reach statistical significance. The multi-day MTX regimens were associated with significantly more mucositis and were significantly less convenient.
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Affiliation(s)
- Julian C Schink
- Cancer Treatment Centers of America, Comprehensive Care and Research Center, Chicago, IL, USA.
| | - Virginia Filiaci
- NRG Oncology Statistics and Data Management Center, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
| | - Helen Q Huang
- NRG Oncology Statistics and Data Management Center, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
| | - John Tidy
- Sheffield Teaching Hospitals, NHS Trust, Royal Hallamshire Hospital, Glossop Rd, Sheffield S10 2JF, UK.
| | - Matthew Winter
- Sheffield Teaching Hospitals, NHS Trust, Royal Hallamshire Hospital, Glossop Rd, Sheffield S10 2JF, UK.
| | - Jeanne Carter
- Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, New York, NY, USA.
| | | | - Katherine Moxley
- Oklahoma University Health Science Center, Oklahoma City, OK, USA.
| | - Akira Yabuno
- Saitama Medical University International Medical Center, Saitama, Japan.
| | - Sarah E Taylor
- Gynecologic Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - Christina Kushnir
- Gynecologic Oncology, Women's Cancer Center of Nevada, Las Vegas, NV, USA.
| | - Neil Horowitz
- Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
| | - David S Miller
- University of Texas Southwestern Medical Center, Dallas, TX, USA.
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Che M, Fiscallini AS, Acerbi I, Shieh Y, Madlensky L, Tice J, Ziv E, Eklund M, Blanco A, Tong B, Goodman D, Nassereddine L, Anderson N, Harvey H, Fors S, Park HL, Petruse A, Stewart S, Wernisch J, Risty L, Hurley I, Koenig B, Kaplan C, Hiatt R, Wenger N, Lee V, Heditsian D, Brain S, Sabacan L, Parker B, Borowsky A, Anton-Culver H, Anton-Culver H, Naeim A, Kaster A, Talley M, van't Veer L, LaCroix A, Olopade OI, Sheth D. Abstract OT3-03-02: Personalized breast cancer screening in a population-based study: Women informed to screen depending on measures of risk (WISDOM). Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-ot3-03-02] [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: 11/16/2022]
Abstract
Abstract
Background: WISDOM is a 100,000 healthy women preference-tolerant, pragmatic study comparing traditional annual screening to personalized risk-based breast screening. The novelty of WISDOM personalized screening is the integration of previously validated genetic and clinical risk factors (age, family history, breast biopsy results, ethnicity, mammographic density) into a single risk assessment model that directs the starting age, timing, and frequency of screening. The goal of WISDOM is to determine if personalized screening, compared to annual screening, is as safe, less morbid, enables prevention, and is more accepted by women. The study is registered on ClinicalTrials.gov, NCT02620852.
Methods: Women aged 40-74 years with no history of breast cancer or DCIS, and no previous double mastectomy can join the study online at wisdomstudy.org. Participants can either elect randomization or self-select a study arm. Then, they can provide electronic consent and sign the Release for Medical Information via DocuSign. For all participants, 5-year risk of developing breast cancer is calculated according to the Breast Cancer Screening Consortium (BCSC) model. Participants in the personalized arm undergo panel-based mutation testing (BRCA1, BRCA2, TP53, PTEN, STK11, CDH1, ATM, PALB2, and CHEK2), and their 5-year risk is calculated using the BCSC score combined with a Polygenic Risk Score (BCSC-PRS) that includes 75 single nucleotide polymorphisms (SNPs) known to increase breast cancer risk (will increase to 229). The SNPs and mutations are assessed by saliva-based testing through Color Genomics. 5-year risk level thresholds are used to stratify for low-, moderate- and high risk. Risk stratification determines age to start, stop, and frequency of screening.
Accrual: As of July 2019, the WISDOM study is open to all eligible women in California, North Dakota, South Dakota, Minnesota, Iowa, Illinois, and New Jersey. To date, 30,392 eligible women have registered, and 21,392 women have consented to participate in the trial. The median age was 56 years. 85% of participants were Caucasian, 2% African-American, and 5% Asian. 6% self-reported Hispanic ethnicity. WISDOM is actively partnering with Blue Cross Blue Shield Association for national coverage, self-insured companies (Salesforce, Genentech, Qualcomm, CalPERS) and Medi-Cal (Inland Empire Health Plan) using a coverage with evidence progression approach.
Accrual expansion and diversity: To strengthen generalizability, the WISDOM Study is enhancing the diversity of our potential participant population by expanding to other states (Alabama, Louisiana), and partnering with other health insurers and self-insured companies. Future expansion regions include Texas, Florida, South Carolina, Oklahoma, Montana, and New Mexico. Additionally, we have translated the whole study experience to Spanish to further reach Spanish-speaking communities. With the engagement of patient advocates and community partnerships, expanding diversity recruitment will strengthen our scientific knowledge of breast cancer risk and increase access to personalized breast cancer screening recommendations for all women. WISDOM enrollment will continue through 2020.
Conclusions: Results at 5 years will enable us to demonstrate that personalized screening improves healthcare value by reducing screen volumes and costs without jeopardizing outcomes.
Citation Format: Mandy Che, Allison Stover Fiscallini, Irene Acerbi, Yiweh Shieh, Lisa Madlensky, Jeffrey Tice, Elad Ziv, Martin Eklund, Amie Blanco, Barry Tong, Deborah Goodman, Lamees Nassereddine, Nancy Anderson, Heather Harvey, Steele Fors, Hannah L Park, Antonia Petruse, Skye Stewart, Janet Wernisch, Larissa Risty, Ian Hurley, Barbara Koenig, Celia Kaplan, Robert Hiatt, Neil Wenger, Vivian Lee, Diane Heditsian, Susie Brain, Leah Sabacan, Barbara Parker, Alexander Borowsky, Hoda Anton-Culver, Hoda Anton-Culver, Arash Naeim, Andrea Kaster, Melinda Talley, Laura van't Veer, Andrea LaCroix, Olufunmilayo I Olopade, Deepa Sheth, WISDOM Study and Athena Breast Health Network Investigators and Advocate Partners and Laura Esserman. Personalized breast cancer screening in a population-based study: Women informed to screen depending on measures of risk (WISDOM) [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr OT3-03-02.
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Affiliation(s)
- Mandy Che
- 1University of California-San Francisco (UCSF), San Francisco, CA
| | | | - Irene Acerbi
- 1University of California-San Francisco (UCSF), San Francisco, CA
| | - Yiweh Shieh
- 1University of California-San Francisco (UCSF), San Francisco, CA
| | - Lisa Madlensky
- 2University of California-San Diego (UCSD), La Jolla, CA
| | - Jeffrey Tice
- 1University of California-San Francisco (UCSF), San Francisco, CA
| | - Elad Ziv
- 1University of California-San Francisco (UCSF), San Francisco, CA
| | | | - Amie Blanco
- 1University of California-San Francisco (UCSF), San Francisco, CA
| | - Barry Tong
- 1University of California-San Francisco (UCSF), San Francisco, CA
| | | | | | | | | | - Steele Fors
- 2University of California-San Diego (UCSD), La Jolla, CA
| | | | - Antonia Petruse
- 5University of California-Los Angeles (UCLA), Los Angeles, CA
| | - Skye Stewart
- 7University of California-Davis (UCD), Sacramento, CA
| | | | | | | | - Barbara Koenig
- 1University of California-San Francisco (UCSF), San Francisco, CA
| | - Celia Kaplan
- 1University of California-San Francisco (UCSF), San Francisco, CA
| | - Robert Hiatt
- 1University of California-San Francisco (UCSF), San Francisco, CA
| | - Neil Wenger
- 5University of California-Los Angeles (UCLA), Los Angeles, CA
| | - Vivian Lee
- 1University of California-San Francisco (UCSF), San Francisco, CA
| | - Diane Heditsian
- 1University of California-San Francisco (UCSF), San Francisco, CA
| | - Susie Brain
- 1University of California-San Francisco (UCSF), San Francisco, CA
| | - Leah Sabacan
- 1University of California-San Francisco (UCSF), San Francisco, CA
| | - Barbara Parker
- 2University of California-San Diego (UCSD), La Jolla, CA
| | | | | | | | - Arash Naeim
- 5University of California-Los Angeles (UCLA), Los Angeles, CA
| | | | | | - Laura van't Veer
- 1University of California-San Francisco (UCSF), San Francisco, CA
| | - Andrea LaCroix
- 2University of California-San Diego (UCSD), La Jolla, CA
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Palmer IS, Thiex N, Allen R, Alley E, Anderson N, Bell J, Carpenter N, Cunningham W, Deuschle L, Kane P, Marts R, Rottinghaus G, Rutta S, Torma L, Vindiola A, Wenger J, Whanger P, Williams A, Wo C. Determination of Selenium in Feeds and Premixes: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.3.469] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A total of 17 laboratories participated in a collaborative study for the determination of selenium in feeds and premixes using either a fluorometric or a continuous hydride generation atomic absorption (HGAA) method. Each collaborator analyzed 16 blind duplicate samples of feed and premixes from various feed manufacturers. The amount of Se in these materials ranged from 0.2 to 5500 μg/g. Six laboratories used only the fluorometric procedure, 8 laboratories used only the hydride generation atomic absorption procedure, and 3 laboratories used both procedures. One laboratory in the fluorometric study and 3 laboratories in the HGAA study were initially excluded because of invalid data. Poor agreement between the blind duplicates indicated probable sample interchange and/or dilution error. The data from 8 laboratories were submitted to statistical analysis, including data from 2 laboratories participating in both studies. The repeatability standard deviation (RSDr) for samples analyzed by the fluorometric procedure ranged from 5.9 to 33%, and the reproducibility standard deviation (RSDR) ranged from 12 to 33%. RSDf for samples analyzed by HGAA ranged from 2.8 to 18%, and RSDR ranged from 4.0 to 36%. Both fluorometric and continuous hydride generation atomic absorption methods for the determination of Se in feeds and premixes have been adopted first action by AOAC INTERNATIONAL.
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Affiliation(s)
- Ivan S Palmer
- South Dakota State University, Department of Chemistry and Biochemistry, Brookings, SD 57007
| | - Nancy Thiex
- South Dakota State University, Department of Chemistry and Biochemistry, Brookings, SD 57007
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Cronin R, Li M, Thompson J, Gordon A, Greenow CR, Heazell A, Stacey T, Culling V, Bowring V, Anderson N, O'Brien L, Mitchell E, McCowan L. Maternal sleep position in the third trimester of pregnancy and the risk of stillbirth. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.225] [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: 10/25/2022]
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Johnson C, Zumwalt M, Anderson N. Correction: Latex hypersensitivity to injection devices for biologic therapies in psoriasis patients. Cutis 2019; 103:299. [PMID: 31233582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The Table in the article "Latex Hypersensitivity to Injection Devices for Biologic Therapies in Psoriasis Patients" (Cutis. 2018;102:116-118.) incorrectly stated that guselkumab contains latex. The article has been corrected online at www.mdedge.com/dermatology, and the revised Table appears reflecting that guselkumab does not contain latex.
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Affiliation(s)
| | - Michael Zumwalt
- Department of Dermatology, Loma Linda University, California, USA
| | - Nancy Anderson
- Department of Dermatology, Loma Linda University, California, USA
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Bussey M, McLean M, Pinfold J, Anderson N, Kiely R, Romanchuk J, Salmon D. History of concussion is associated with higher head acceleration and reduced cervical muscle activity during simulated rugby tackle: An exploratory study. Phys Ther Sport 2019; 37:105-112. [DOI: 10.1016/j.ptsp.2019.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/21/2019] [Accepted: 03/22/2019] [Indexed: 10/27/2022]
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Acerbi I, Shieh Y, Madlensky L, Tice J, Ziv E, Eklund M, Blanco A, DeRosa D, Tong B, Goodman D, Nassereddine L, Anderson N, Harvey H, Layton T, Park HL, Petruse A, Stewart S, Wernisch J, Risty L, Koenig B, Sarrafan S, Firouzian R, Kaplan C, Hiatt R, Parker BA, Wenger N, Lee V, Heditsian D, Brain S, Stover Fiscalini A, Borowsky AD, Anton-Culver H, Naeim A, Kaster A, Talley M, van 't Veer LJ, LaCroix A, Esserman LJ. Abstract OT2-08-01: Personalized breast cancer screening in a population based study: Women Informed to Screen Depending On Measures of risk (WISDOM). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot2-08-01] [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: 11/16/2022]
Abstract
Abstract
Background: WISDOM is a 100,000 healthy women preference-tolerant, pragmatic study comparing annual to personalized risk-based breast screening. The novelty of WISDOM personalized screening is the integration of previously validated genetic and clinical risk factors (age, family history, breast biopsy results, ethnicity, mammographic density) into a single risk assessment model that directs the starting age, timing, and frequency of screening. The goal of WISDOM is to determine if personalized screening, compared to annual screening, is as safe, less morbid, enables prevention, and is preferred by women. The study is registered on ClinicalTrials.gov, NCT02620852.
Methods: Women aged 40-74 years with no history of breast cancer or DCIS, and no previous double mastectomy can join the study online at wisdomstudy.org. Participants can elect randomization or self-select a study arm, and provide electronic consent and Release for Medical Information using DocuSign. For all participants, 5-year risk of developing breast cancer is calculated according to the Breast Cancer Screening Consortium (BCSC) model. Participants in the personalized arm undergo panel-based mutation testing, and their 5-year risk is calculated using the BCSC score combined with a Polygenic Risk Score (BCSC-PRS) that includes 75 single nucleotide polymorphisms (SNPs, increase to 229) known to increase breast cancer risk. SNPs and mutations (BRCA1, BRCA2, TP53, PTEN, STK11, CDH1, ATM, PALB2, and CHEK2) are assessed by saliva-based testing through Color Genomics. 5-year risk level thresholds are used to stratify for low-, moderate- and high risk. Risk stratification determines age to start, stop, and frequency of screening.
Enrollment: As of July 2018, the WISDOM study is open to all eligible women in California, North Dakota, South Dakota, Minnesota and Iowa. To date, 23,329 eligible women have registered and 14,393 women have consented to participate in the trial. We analyzed 3,255 participants who have completed risk assessment in the personalized arm. The median age was 56 years. 82% were Caucasian, 1% African-American, and 6% Asian. 9% self-reported as Hispanic. We are partnering with health insurers and self-insured companies using coverage with evidence progression. To strengthen generalizability, we are expanding to other states. WISDOM enrollment will continue past 2019.
Feasibility: To evaluate the addition of PRS, we used paired statistical tests (McNemar) to compare the distributions of BCSC, and BCSC-PRS risk estimates around low-risk (<1.3%), and very-high risk (>6%) thresholds, the latter corresponding to 5-year risk of a BRCA mutation carrier. The median 5-year risk was 1.5% (IQR 1.0-2.1%) using the BCSC model, and 1.4% (IQR 0.8-2.5%) using the BCSC-PRS model. The BCSC-PRS model classified more women into the low (<1%) and very high (≥6%) risk categories compared to the BCSC model (p < 0.001).
Conclusions: Our findings demonstrate that incorporating genetic variants into a validated clinical model is feasible and impacts risk classification compared to a model without genetic risk factors. Results at 5 years will reveal if this classification improves healthcare value by reducing screen volumes and costs without jeopardizing outcomes.
Citation Format: Acerbi I, Shieh Y, Madlensky L, Tice J, Ziv E, Eklund M, Blanco A, DeRosa D, Tong B, Goodman D, Nassereddine L, Anderson N, Harvey H, Layton T, Park HL, Petruse A, Stewart S, Wernisch J, Risty L, Koenig B, Sarrafan S, Firouzian R, Kaplan C, Hiatt R, Parker BA, Wenger N, Lee V, Heditsian D, Brain S, Stover Fiscalini A, Borowsky AD, Anton-Culver H, Naeim A, Kaster A, Talley M, van 't Veer LJ, LaCroix A, Wisdom Study and Athena Breast Health Network Investigators and Advocate Partners, Esserman LJ. Personalized breast cancer screening in a population based study: Women Informed to Screen Depending On Measures of risk (WISDOM) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT2-08-01.
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Affiliation(s)
- I Acerbi
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - Y Shieh
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - L Madlensky
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - J Tice
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - E Ziv
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - M Eklund
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - A Blanco
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - D DeRosa
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - B Tong
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - D Goodman
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - L Nassereddine
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - N Anderson
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - H Harvey
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - T Layton
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - HL Park
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - A Petruse
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - S Stewart
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - J Wernisch
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - L Risty
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - B Koenig
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - S Sarrafan
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - R Firouzian
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - C Kaplan
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - R Hiatt
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - BA Parker
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - N Wenger
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - V Lee
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - D Heditsian
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - S Brain
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - A Stover Fiscalini
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - AD Borowsky
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - H Anton-Culver
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - A Naeim
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - A Kaster
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - M Talley
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - LJ van 't Veer
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - A LaCroix
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
| | - LJ Esserman
- University of California, San Francisco, San Francisco, CA; University of California, San Diego, San Diego, CA; University of California, Davis, Sacramento, CA; University of California, Irvine, Irvine, CA; University of California, Los Angeles, Los Angeles, CA; Sanford Health, Sioux Falls, SD; Karolinska Institutet, Stockholm, Sweden
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Gray J, Dare L, Burley M, Brown S, Hudson T, Murray T, Anderson N, Sanderson S, MacIntyre P, Black J, Eberhart E. Pre-hospital Notification of Patients with ST-elevation Myocardial Infarction is Associated with a Reduced Door-to-reperfusion Time. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.672] [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: 10/26/2022]
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Lwin N, Finucane K, Stirling J, Cormick M, Wright J, Artrip J, Anderson N, Buckley D, Gentles T. Reduction in Interstage Mortality with Implementation of a Standardised Monitoring Group – a Single Centre Experience. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.511] [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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Anderson N, Marshall MS, Stirling J, Wright J, MacCormick J, Artrip J, Hamer M, Thompson S, Kennedy A, Finucane K, Gentles T. A Designated Single Ventricle Group Improves Outcomes for Infants with Single Ventricle Physiology. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.494] [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: 10/26/2022]
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Abstract
BACKGROUND Disease activity in systemic lupus erythematosus follows three different courses: long quiescent, relapsing remitting and persistently active. However, the patterns of disease course since diagnosis are not known. This study aimed to assess the prevalence and characteristics of such patterns over 10 years. PATIENTS AND METHODS The inception cohort of the Toronto Lupus Clinic (≥10 year follow up, between visit interval ≤18 months) was investigated. Prolonged remission was defined as a clinical Systemic Lupus Erythematosus Disease Activity Index 2000 = 0 achieved within 5 years of enrolment and maintained for ≥10 years. The relapsing-remitting pattern was defined based on ≥2 remission periods (clinical Systemic Lupus Erythematosus Disease Activity Index 2000 = 0 for two consecutive visits). Patients with no remission were categorized as persistently active. Groups were compared for baseline characteristics, cumulative damage, flare rate, mortality and certain co-morbidities. RESULTS Of 267 patients, 27 (10.1%) achieved prolonged remission, 180 (67.4%) relapsing-remitting and 25 (9.4%) persistently active. In total, 35 (13.1%) had only one remission period (hybrid). At enrollment, there were no differences regarding clinical and immunological variables. At 10 years, persistently active patients had accumulated significantly more damage than the prolonged remission and relapsing-remitting patients. Being of Black race and higher adjusted mean Systemic Lupus Erythematosus Disease Activity Index 2000 over the first 2 years were associated with a more severe disease course. Relapsing-remitting and persistently active patients had an increased flare rate and accrued more osteoporosis, osteonecrosis and cardiovascular events. CONCLUSIONS Approximately 70% of systemic lupus erythematosus patients followed a relapsing-remitting course, whereas 10% displayed prolonged remission and another 10% a persistently active course. Early response to treatment was associated with a less severe course and better prognosis.
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Affiliation(s)
- K Tselios
- Centre for Prognosis Studies in Rheumatic Diseases, Toronto Lupus Clinic, Toronto, Canada
| | - D D Gladman
- Centre for Prognosis Studies in Rheumatic Diseases, Toronto Lupus Clinic, Toronto, Canada
| | - Z Touma
- Centre for Prognosis Studies in Rheumatic Diseases, Toronto Lupus Clinic, Toronto, Canada
| | - J Su
- Centre for Prognosis Studies in Rheumatic Diseases, Toronto Lupus Clinic, Toronto, Canada
| | - N Anderson
- Centre for Prognosis Studies in Rheumatic Diseases, Toronto Lupus Clinic, Toronto, Canada
| | - M B Urowitz
- Centre for Prognosis Studies in Rheumatic Diseases, Toronto Lupus Clinic, Toronto, Canada
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Sharma S, Guttmann D, Small D, Rareshide C, Kurtzman G, Jones J, Shabason J, Alonso-Basanta M, Lustig R, Maity A, Metz J, Lowitz S, Cohen M, Anderson N, Finlay J, Gabriel P, Patel M, Bekelman J. Effect of Introducing a Default Order Option on Unnecessary Daily Image Guidance During Palliative Radiation Therapy: A Cluster Randomized Stepped-Wedge Clinical Trial. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.382] [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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Anderson N, Carter P, Egerton J, Faragher T, Lepper T, Stewart D, Turner A. Leonard Charles Lloyd 1928-2018. Aust Vet J 2018. [DOI: 10.1111/avj.12736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Johnson C, Zumwalt M, Anderson N. Latex hypersensitivity to injection devices for biologic therapies in psoriasis patients. Cutis 2018; 102:116-118. [PMID: 30235360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
An allergic reaction provoked by reexposure to an allergen or antigen is known as a type I or immediate hypersensitivity reaction. Latex allergy is a common cause of type I hypersensitivity reactions. Allergic responses to latex in psoriasis patients receiving frequent injections with biologic agents are not commonly reported in the literature. We report the case of a patient with a long history of psoriasis who developed an allergic response after exposure to injection devices that contained latex components while undergoing treatment with biologic agents.
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Affiliation(s)
| | - Michael Zumwalt
- Department of Dermatology, Loma Linda University, California, USA
| | - Nancy Anderson
- Department of Dermatology, Loma Linda University, California, USA
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Ike CG, Anderson N. A proposal for teaching bioethics in high schools using appropriate visual education tools. Philos Ethics Humanit Med 2018; 13:11. [PMID: 30029667 PMCID: PMC6053790 DOI: 10.1186/s13010-018-0064-1] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 07/06/2018] [Indexed: 06/08/2023] Open
Abstract
Teaching bioethics with visual education tools, such as movies and comics, is a unique way of explaining the history and progress of human research and the art and science of medicine to high school students. For more than a decade, bioethical concepts have appeared in movies, and these films are useful for teaching medical and research ethics in high schools. Using visual tools to teach bioethics can have both interpretational and transformational effects on learners that will enhance their overall understanding of complex moral and legal issues in medicine and research.High school students are uniquely suited to learn bioethics because they will soon become legal adults. As adults, they will make moral decisions that may affect their health and wellbeing as well as that of their communities and societies.However, not all visual education tools are appropriate for bioethics pedagogy in high school. Bioethics film and comic producers must consider the specifics of student age, race, gender, belief, level of education, and sexual orientation. Such tools must not be dominated by either dystopic or utopic genres, must aim for objectivity, and must consider the complexity of ethical decision making. It is critical that the teacher, who is the final arbiter regarding the use of visual tools in the classroom, determines that the visual learning tool is acceptable for students in any particular education context. In addition, during the conceptualization and creation of these tools, bioethics film and comic producers must work harder to ensure that these visual tools are devoid of any form of stereotyping.
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Affiliation(s)
- Chiedozie G. Ike
- Department of Public Health, Irrua Specialist Teaching Hospital, Irrua, Edo State Nigeria
| | - Nancy Anderson
- Department of Midwifery, Bastyr University, Kenmore, Washington USA
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Abstract
SummaryVariations of antithrombin III were studied in a non-ran-domized population of consecutive cancer cases admitted to a referral hospital. Differences between functional and immunologic assay were observed.Decreases were observed in both assays when compared to a population of hospitalized controls. Patients with cancer of the colon, ovary and prostate showed a deficiency of antithrombin III more frequently than other common tumors. When all tumor cases were subdivided into those in remission compared to those with metastases, a significant decrease in antithrombin III also could be shown.Metastases to the liver were strikingly common in cancer patients with decreased antithrombin III. In these patients, the decrease in antithrombin III could be statistically correlated with reduction in serum albumin.
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Affiliation(s)
- H Honegger
- The Department of Medicine, New England Deaconess Hospital, Boston, MA, U.S.A
| | - N Anderson
- The Department of Medicine, New England Deaconess Hospital, Boston, MA, U.S.A
| | - L A Hewitt
- The Department of Medicine, New England Deaconess Hospital, Boston, MA, U.S.A
| | - J L Tullis
- The Department of Medicine, New England Deaconess Hospital, Boston, MA, U.S.A
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Thomas R, Turgeon G, Hofman M, Callahan J, Anderson N, Hardcastle N, Kron T, Bressel M, Steinfort D, Shaw M, Plumridge N, Macmanus M, Hicks R, Ball D, Siva S. P2.14-001 Mid-Treatment Perfusion PET/CT Is More Effective Than Ventilation PET/CT in Functionally-Adapted Radiotherapy for NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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