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Petrovic B, Martin R, Romero AM, Askounis P, Buchanan L, Rossi F, Bernat R, Alves JG. EURADOS ISO/IEC 17025 guidance for IMS: suggestions on how to interpret and implement the requirements including examples from accredited laboratories. Radiat Prot Dosimetry 2023; 199:1707-1709. [PMID: 37819287 DOI: 10.1093/rpd/ncac186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 07/22/2022] [Accepted: 08/22/2022] [Indexed: 10/13/2023]
Abstract
Individual monitoring of external radiation is an activity usually regulated by national regulatory bodies in most countries. Regulations generally contain technical requirements to be met by the individual monitoring services (IMS), in order to ensure that the measurements are correct and therefore the dosimetry results are reliable. In some countries, the requirements include or even consist of the accreditation of the service according to the standard ISO/IEC 17025: 'General requirements for the competence of testing and calibration laboratories.' It is a fact that accreditation is a growing trend among European IMS as a way to guarantee confidence in their technical competence. The acceptance of the dosimetry results between countries and their indentation in the respective National Dose Registries is facilitated if laboratories conform to the ISO/IEC 17025 standard. In the framework of the activities of EURADOS (European Radiation Dosimetry Group) working group 2 'Harmonization of Individual Monitoring in Europe' and attending to the concern of many European IMS in the process of accreditation, a guide has been prepared. The purpose was to assist and encourage IMS to apply for accreditation and to share the authors' own experience with the process. The guide intends to be a practical reference for IMS on how to interpret and implement the ISO/IEC 17025 requirements to the specific activity of a personal dosimetry service for external radiation, emphasizing those aspects of special interest. It includes examples from dosimetry laboratories already accredited. The major novelties from a new edition of ISO/IEC 17025: 2017 are also identified in the guide. Finally, the guide aims to assist the auditing process, giving examples of auditor's questions and how to show evidence of compliance. The main findings are presented.
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Affiliation(s)
- B Petrovic
- Public Health Institute of Republic of Srpska (PHIRS), Banja Luka, Bosnia and Herzegovina
| | - R Martin
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid, Spain
| | - A M Romero
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid, Spain
| | - P Askounis
- Greek Atomic Energy Commission (EEAE), Athens, Greece
| | - L Buchanan
- Atomic Weapon Establishment (AWE), Berkshire, UK
| | - F Rossi
- AOU Careggi, Florence, Italy
| | - R Bernat
- Ruđer Bošković Institute (RBI), Zagreb, Croatia
| | - J G Alves
- University of Lisboa, Instituto Superior Técnico, Lisbon, Portugal
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Perles LA, Niedzielski J, Sawakuchi G, Martin R, Schueler E, Taniguchi CM, Ludmir EB, Vivar OI, Das P, Koong AC, Farber LA, Koay EJ, Beddar S. Assessment of the Spatial Bio-Distribution of NBTXR3 for Locally Advanced or Borderline-Resectable Pancreatic Ductal Adenocarcinoma (LAPC or BRPC) Patients Undergoing Radiation Therapy. Int J Radiat Oncol Biol Phys 2023; 117:e332-e333. [PMID: 37785172 DOI: 10.1016/j.ijrobp.2023.06.2385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) NBTXR3 is a novel radioenhancer composed of functionalized hafnium oxide nanoparticles that are injected directly into the tumor. An ongoing phase I trial is assessing the application of NBTXR3 in the treatment of locally-advanced or borderline-resectable pancreatic ductal adenocarcinoma, with the primary goal of determining the recommended NBTXR3 dose for a subsequent phase II trial. Using patients from the ongoing phase I trial, we evaluated the spatial bio-distribution of NBTXR3 in the pancreas as function of time and assessed if there is migration of the compound during radiation therapy. MATERIALS/METHODS Adult patients with LAPC or BRPC were enrolled. Analysis of 8 patients who underwent CT simulation at least 24 hours after receiving the NBTXR3 intratumoral injection in the pancreatic lesion under general anesthesia guided by an endoscopic ultrasound was conducted. Patients were simulated with and without iodinated intravenous contrast under breath hold, with 3mm CT slice thickness and 50-60cm FoV. A contrast-enhanced CT series was chosen for RT planning purposes. All patients were planned for a 15-fraction IMRT course using 6-MV beam energy, with 45Gy and 37.5Gy dose levels (using a simultaneous integrated boost technique) to gross primary tumor and microscopic disease/regional nodes, respectively. Daily image guidance included either cone-beam CT (CBCT, n = 1) or CT-on-Rails (CTOR, n = 7) and were fused to the planning CT images using Velocity, ver. 3.0.1. The NBTXR3 volume was determined by thresholding the images to 165 HU and 300 HU for CTOR and CBCT images, respectively. Bones, stents, and artifacts were manually removed from the NBTXR3 volume. The volumes for the NBTXR3 and the NBTXR3 overlapping with the GTV for each patient were individually fit to a linear model in R, ver. 4.1.3. RESULTS One patient from the CTOR cohort was excluded from analysis due to the small volume of NBTXR3 (0.02 cm3) compared to the rest of the cohort (0.716 - 6.917 cm3). The total volume of NBTXR3 in the CBCT images could not be analyzed due the substantial image artifacts, only the volume overlapping the GTV was calculated. There were no statistically significant changes (p > 0.1 Adj-R2 = 0.99) in the raw volume of NBTXR3 for the duration of the treatment in all CTOR patients. For the NBTXR3 volume overlapping with the GTV, five cases did not present with a volume change during the treatment (p > 0.1 Adj-R2 = 0.99), while one CTOR case had a reduction in volume of about 1.5%/day (p = 0.7), and the CBCT case had a reduction of 3%/day (p < 0.001). CONCLUSION The raw volume of NBTXR3 injected in the pancreas did not significantly change over the duration of the three weeks of treatment. We also did not observe significant changes in the NBTXR3 volume overlapping the GTV in most cases. The stability of NBTXR3 was demonstrated during RT.
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Affiliation(s)
- L A Perles
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Niedzielski
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - G Sawakuchi
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - R Martin
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E Schueler
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C M Taniguchi
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E B Ludmir
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - P Das
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A C Koong
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L A Farber
- The Farber Center for Radiation Oncology, New York, NY
| | - E J Koay
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Beddar
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
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Chang E, Wong FCL, Erwin WD, Das P, Holliday E, Koong AC, Ludmir EB, Smith GL, Taniguchi CM, Beddar S, Martin R, Niedzielski J, Perles LA, Park PC, Kaseb A, Lee S, Tzeng CW, Vauthey JN, Koay EJ. Phase 1 Trial of SPECT-Guided Liver-Directed Ablative Radiotherapy for Patients with Low Functional Liver Volume. Int J Radiat Oncol Biol Phys 2023; 117:S106. [PMID: 37784280 DOI: 10.1016/j.ijrobp.2023.06.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Traditional liver dose constraints specify that a critical volume of 700 cc of non-tumor liver should be spared from receiving a hepatotoxic dose. We evaluated the safety of liver-directed ablative radiotherapy for patients with hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (iCCA), or liver metastases (LM) with Child-Pugh (CP) A5 liver function at baseline and with low functional liver volume as estimated by Tc-99m sulfur colloid single photon emission computed tomography (SPECT). We hypothesized that functional liver image guidance with SPECT would allow safe delivery of ablative radiotherapy in patients with limited liver volume. MATERIALS/METHODS A phase 1 trial with a 3+3 design was conducted to evaluate the safety of comprehensive ablative radiotherapy to the liver disease using escalating functional non-target liver radiation dose constraints. Eligibility criteria included (1) a diagnosis of HCC, iCCA, or LM, (2) prior treatment with irinotecan or oxaliplatin chemotherapy or liver resection, and (3) a minimum functional liver volume of 400 cc as estimated by SPECT using a threshold of 40% maximum intensity. Patients with CP >A5 liver function, prior liver-directed radiotherapy, or prior Yttrium-90 therapy were excluded. The prescription dose was 67.5-75 Gy in 15 fractions or 75-100 Gy in 25 fractions. The volumetric dose constraint for functional non-target liver receiving <24 Gy for 15 fractions or <27 Gy for 25 fractions was determined by the dose level of trial enrollment: level 0 was ≥400 cc and level +1 was ≥300 cc. A level -1 was included if needed. We used standard 15 and 25 fraction dose constraints for other organs at risk. The following dose limiting toxicities (DLTs) were assessed within 6-8 weeks of completing radiotherapy: Grade 3 hypoalbuminemia, increase in INR, increase in bilirubin, or ascites, or Grade 4 hepatic failure or any radiation-related toxicity. RESULTS Twelve patients enrolled between February 2016 and June 2022. The median (range) GTV was 36 (2-651) cc. The median CT anatomical non-tumor liver volume was 1584 (764-2699) cc, and the median SPECT functional liver volume was 1117 (570-1928) cc, with a Pearson correlation coefficient of 0.98 (p<0.001). The median non-target SPECT functional liver volume below the volumetric dose constraint was 684 (429-1244) cc. None of the 3 patients treated in dose level 0, and none of the 9 patients treated in dose level +1 experienced any DLTs. The 1-year in-treatment-field control rate was 55%, and 1-year overall survival was 71%. CONCLUSION Ablative radiotherapy can be safely delivered using functional SPECT image guidance, which enables sparing lower volumes of functional liver than traditionally accepted in patients with CP A5 liver function. Further evaluation with a phase 2 study is warranted.
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Affiliation(s)
- E Chang
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - F C L Wong
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - W D Erwin
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P Das
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E Holliday
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A C Koong
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E B Ludmir
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - G L Smith
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C M Taniguchi
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Beddar
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - R Martin
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Niedzielski
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L A Perles
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P C Park
- University of California, Davis, Davis, CA
| | - A Kaseb
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Lee
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C W Tzeng
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J N Vauthey
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E J Koay
- The University of Texas MD Anderson Cancer Center, Houston, TX
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Martin R. Symptoms of dry eye related to the relative humidity of living places. Cont Lens Anterior Eye 2023; 46:101865. [PMID: 37208284 DOI: 10.1016/j.clae.2023.101865] [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: 09/01/2022] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 05/21/2023]
Abstract
PURPOSE To investigate the impact of relative humidity (RH) and climate variables of the place of residence on symptoms of dry eye disease (DED) in primary eye care practice. METHODS A cross-sectional analysis of the Ocular Surface Disease Index (OSDI) dry eye classification of 1.033 patients [classified as non-DED (OSDI ≤22) and DED (OSDI >22)] was conducted in a multicentre study in Spain. Participants were classified according to the 5-year RH value (data from the Spanish Climate Agency -www.aemet.es) into two groups: those who lived in low RH (<70%) places and those who lived in high RH (≥70%) places. Additionally, differences in daily climate records (EU Copernicus Climate Change Service) were assessed. RESULTS The prevalence of DED symptoms was 15.5% (95% CI 13.2%-17.6%). Participants who lived in places with <70% RH showed a higher prevalence of DED (17.7%; 95% CI 14.5%-21.1%; P < 0.01 adjusted for age and sex) than those who lived in places with ≥70% RH (13.6%; 95% CI 11.1%-16.7%) and a closer, but not statistically significant, risk for DED (OR = 1.34, 95% CI 0.96 to 1.89; P = 0.09) than previously described DED risk factors [age older than 50 years (OR = 1.51, 95% CI 1.06 to 2.16; P = 0.02) and female sex (OR = 1.99, 95% CI 1.36 to 2.90; P < 0.01)]. Some climate data showed statistically significant differences (P < 0.05) between participants with DED and non-DED (mean wind gusts; atmospheric pressure; mean and minimum relative humidity); these variables did not significantly increase DED risk (OR close to 1.0 and P > 0.05). CONCLUSION This study is the first to describe the impact of climate data on dryness symptomatology in Spain, confirming that participants who live in locations with RH <70% have a higher prevalence (corrected for age and sex) of DED. These findings support the use of climate databases in DED research.
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Affiliation(s)
- R Martin
- Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA), Paseo de Belén, 17 - Campus Miguel Delibes, Valladolid 47011, España; Universidad de Valladolid, Departamento de Física Teórica, Atómica y Óptica, Paseo de Belén, 7 - Campus Miguel Delibes, Valladolid 47011, España; Optometry Research Group, IOBA Eye Institute, School of Optometry, University of Valladolid, Valladolid, Spain.
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Ryan DA, Martin R, Appel L, Ayed NB, Kogan L, Kirk A. Initial progress of the magnetic diagnostics of the MAST-U tokamak. Rev Sci Instrum 2023; 94:073501. [PMID: 37404097 DOI: 10.1063/5.0156334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/15/2023] [Indexed: 07/06/2023]
Abstract
MAST Upgrade has just begun its third physics campaign in April of 2023. The set of magnetic probes used to diagnose the magnetic field and currents on MAST Upgrade are described, and their calibration procedures are outlined including calculation of uncertainties. The median uncertainty in the calibration factors of the flux loops and pickup coils are calculated as 1.7% and 6.3%. The arrays of installed instability diagnostics are described, and the detection and diagnosis of a specimen MHD mode are demonstrated. Plans for the improvement of the magnetics arrays are outlined.
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Affiliation(s)
| | | | - L Appel
- UKAEA, Abingdon, United Kingdom
| | | | - L Kogan
- UKAEA, Abingdon, United Kingdom
| | - A Kirk
- UKAEA, Abingdon, United Kingdom
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Brilli L, Martin R, Argenti G, Bassignana M, Bindi M, Bonet R, Choler P, Cremonese E, Della Vedova M, Dibari C, Filippa G, Galvagno M, Leolini L, Moriondo M, Piccot A, Stendardi L, Targetti S, Bellocchi G. Uncertainties in the adaptation of alpine pastures to climate change based on remote sensing products and modelling. J Environ Manage 2023; 336:117575. [PMID: 36893538 DOI: 10.1016/j.jenvman.2023.117575] [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: 12/06/2022] [Revised: 02/02/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Over the last century, the management of pastoral systems has undergone major changes to meet the livelihood needs of alpine communities. Faced with the changes induced by recent global warming, the ecological status of many pastoral systems has seriously deteriorated in the western alpine region. We assessed changes in pasture dynamics by integrating information from remote-sensing products and two process-based models, i.e. the grassland-specific, biogeochemical growth model PaSim and the generic crop-growth model DayCent. Meteorological observations and satellite-derived Normalised Difference Vegetation Index (NDVI) trajectories of three pasture macro-types (high, medium and low productivity classes) in two study areas - Parc National des Écrins (PNE) in France and Parco Nazionale Gran Paradiso (PNGP) in Italy - were used as a basis for the model calibration work. The performance of the models was satisfactory in reproducing pasture production dynamics (R2 = 0.52 to 0.83). Projected changes in alpine pastures due to climate-change impacts and adaptation strategies indicate that: i) the length of the growing season is expected to increase between 15 and 40 days, resulting in changes in the timing and amount of biomass production, ii) summer water stress could limit pasture productivity; iii) earlier onset of grazing could enhance pasture productivity; iv) higher livestock densities could increase the rate of biomass regrowth, but major uncertainties in modelling processes need to be considered; and v) the carbon sequestration potential of pastures could decrease under limited water availability and warming.
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Affiliation(s)
- L Brilli
- National Research Council - Institute of BioEconomy (IBE-CNR), 50145, Sesto Fiorentino, Italy; University of Florence, DAGRI, 50144, Florence, Italy.
| | - R Martin
- Université Clermont Auvergne, INRAE, VetAgro Sup, UREP, 63000, Clermont-Ferrand, France
| | - G Argenti
- University of Florence, DAGRI, 50144, Florence, Italy
| | | | - M Bindi
- University of Florence, DAGRI, 50144, Florence, Italy
| | - R Bonet
- Parc National des Ecrins, Domaine de Charance, 05000, Gap, France
| | - P Choler
- Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, LECA, 38000, Grenoble, France
| | - E Cremonese
- Climate Change Unit, Environmental Protection Agency of Aosta Valley, Saint-Christophe, Italy
| | - M Della Vedova
- Parc National des Ecrins, Domaine de Charance, 05000, Gap, France
| | - C Dibari
- University of Florence, DAGRI, 50144, Florence, Italy
| | - G Filippa
- Climate Change Unit, Environmental Protection Agency of Aosta Valley, Saint-Christophe, Italy
| | - M Galvagno
- Climate Change Unit, Environmental Protection Agency of Aosta Valley, Saint-Christophe, Italy
| | - L Leolini
- University of Florence, DAGRI, 50144, Florence, Italy
| | - M Moriondo
- National Research Council - Institute of BioEconomy (IBE-CNR), 50145, Sesto Fiorentino, Italy; University of Florence, DAGRI, 50144, Florence, Italy
| | - A Piccot
- Institut Agricole Régional, 11100, Aosta, Italy
| | - L Stendardi
- University of Florence, DAGRI, 50144, Florence, Italy
| | - S Targetti
- University of Bologna, Department of Agricultural and Food Sciences, Viale Fanin, 50, 40127, Bologna, Italy
| | - G Bellocchi
- Université Clermont Auvergne, INRAE, VetAgro Sup, UREP, 63000, Clermont-Ferrand, France
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Bhutta HE, Moharamzadeh K, Martin R, Martin N. Patient Satisfaction with Upper and Lower Complete Dentures: A Service Evaluation Report. Eur J Prosthodont Restor Dent 2023; 31:59-71. [PMID: 35852120 DOI: 10.1922/ejprd_2416bhutta13] [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] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 04/20/2022] [Indexed: 03/03/2023]
Abstract
PURPOSE The purpose of this questionnaire-based service evaluation was to assess patient satisfaction with complete dentures provided in a dental teaching hospital. METHODS Patients completed the self-administered questionnaire before, immediately after, and 2-months following provision of new complete dentures. The questionnaire consisted of the following sections: Patient characteristics, current denture history and satisfaction with the fit of upper/lower complete dentures, chewing ability, speech, and aesthetics. Descriptive analysis, chi-square test, student t-test, and 2-way-ANOVA were performed on satisfaction levels pre-and post-treatment to assess denture fit, chewing ability, speech, and appearance. Age and gender-wise satisfaction levels along with correlations and associations between patient satisfaction levels and various factors were assessed. RESULTS 147 participants, including 91 males (61.9%) and 56 females (38.1%) completed the study. A statistically significant improvement in satisfaction scores was seen post-treatment in all domains (p⟨0.05), with most respondents showing great satisfaction. Overall, satisfaction levels were: Upper complete denture fit (82%), appearance (87%), speech (67%), chewing ability and lower complete denture fit (39%). A strong positive correlation was observed between the number of previous dentures used and patient satisfaction with upper denture fit (R=1). CONCLUSION Denture replacement positively impacts the satisfaction of patients and improves complete denture acceptance.
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Affiliation(s)
- H E Bhutta
- School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - K Moharamzadeh
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - R Martin
- School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - N Martin
- School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
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Martin R, Belahsen Y, Noujeim J, Lefebvre Y, Deforche M, Lemort M, Sirtaine N, Roumeguere T, Peltier A, Diamand R. Optimizing multiparametric magnetic resonance imaging-targeted biopsy and detection of clinically significant prostate cancer: The role of core number and location. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00341-x] [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: 02/12/2023]
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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian V, Al Mahmeed WAR, Kzhdryan H, Dumont C, Geppert A, Bajramovic NS, Cader FA, Beauloye C, Quesada D, Hlinomaz O, Liebetrau C, Marandi T, Shokry K, Bueno H, Kovacevic M, Crnomarkovic B, Cankovic M, Dabovic D, Jarakovic M, Pantic T, Trajkovic M, Pupic L, Ruzicic D, Cvetanovic D, Mansourati J, Obradovic I, Stankovic M, Loh PH, Kong W, Poh KK, Sia CH, Saw K, Liška D, Brozmannová D, Gbur M, Gale CP, Maxian R, Kovacic D, Poznic NG, Keric T, Kotnik G, Cercek M, Steblovnik K, Sustersic M, Cercek AC, Djokic I, Maisuradze D, Drnovsek B, Lipar L, Mocilnik M, Pleskovic A, Lainscak M, Crncic D, Nikojajevic I, Tibaut M, Cigut M, Leskovar B, Sinanis T, Furlan T, Grilj V, Rezun M, Mateo VM, Anguita MJF, Bustinza ICM, Quintana RB, Cimadevilla OCF, Fuertes J, Lopez F, Dharma S, Martin MD, Martinez L, Barrabes JA, Bañeras J, Belahnech Y, Ferreira-Gonzalez I, Jordan P, Lidon RM, Mila L, Sambola A, Orvin K, Sionis A, Bragagnini W, Cambra AD, Simon C, Burdeus MV, Ariza-Solé A, Alegre O, Alsina M, Ferrando JIL, Bosch X, Sinha A, Vidal P, Izquierdo M, Marin F, Esteve-Pastor MA, Tello-Montoliu A, Lopez-Garcia C, Rivera-Caravaca JM, Gil-Pérez P, Nicolas-Franco S, Keituqwa I, Farhan HA, Silva L, Blasco A, Escudier JM, Ortega J, Zamorano JL, Sanmartin M, Pereda DC, Rincon LM, Gonzalez P, Casado T, Sadeghipour P, Lopez-Sendon JL, Manjavacas AMI, Marin LAM, Sotelo LR, Rodriguez SOR, Bueno H, Martin R, Maruri R, Moreno G, Moris C, Gudmundsdottir I, Avanzas P, Ayesta A, Junco-Vicente A, Cubero-Gallego H, Pascual I, Sola NB, Rodriguez OA, Malagon L, Martinez-Basterra J, Arizcuren AM, Indolfi C, Romero J, Calleja AG, Fuertes DG, Crespín Crespín M, Bernal FJC, Ojeda FB, Padron AL, Cabeza MM, Vargas CM, Yanes G, Kitai T, Gonzalez MJG, Gonzalez Gonzalez J, Jorge P, De La Fuente B, Bermúdez MG, Perez-Lopez CMB, Basiero AB, Ruiz AC, Pamias RF, Chamero PS, Mirrakhimov E, Hidalgo-Urbano R, Garcia-Rubira JC, Seoane-Garcia T, Arroyo-Monino DF, Ruiz AB, Sanz-Girgas E, Bonet G, Rodríguez-López J, Scardino C, 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Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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Hayes B, Vabistsevits M, Robinson T, Martin R, Lawlor D, Richmond R. Orienting causal relationships between sleep and adiposity traits using Mendelian randomisation. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Murphy C, Bray X, Martin R. Recruitment and organising 3rd year pharmacy undergraduates into summer placements in primary care in Southwest England. International Journal of Pharmacy Practice 2022. [DOI: 10.1093/ijpp/riac089.040] [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: 12/03/2022]
Abstract
Abstract
Introduction
Primary care is facing a workforce shortage, especially in Southwest England (SW).1 Funding for clinical pharmacist roles in GP has an impact on community pharmacy with pharmacists leaving to take up PCN positions.2 SW has higher rate of vacancies in than nationally.3 Oriel data showed that fill rate for split foundation training placements in GP is high, however, in SW is significantly low.
Aim
To increase recruitment of future pharmacists in SW by offering pharmacy undergraduates paid 5-week summer placements in GP or GP/community pharmacy partnership, gaining primary care experience, showcasing benefits of cross-sector working and encouraging development of partnerships for increased cross-sector training placements.
Objectives
Students enjoy SW area placement, Students recommend placement to other students, Students preference GP foundation placement, Supervisors express interest in a summer placement for 2022, Supervisors express interest in the GP split trainee pharmacist programme.
Methods
Expressions of interest (EOIs) sought from primary care placements in SW and 16 sites selected. Applicants shortlisted and interviewed online. 16 offered placements based on preference of location. Funding by HEE South reimbursed for student’s wages. Planning booklets provided to GPs, workbooks to students and online induction attended. During the placement, students completed an audit and case-based discussion, shadowed healthcare professionals, assisted administration and pharmacy tasks and practised basic procedural skills. Students attended end-of-placement event to share learning and sent questionnaire focusing on enjoyment of the placement and likelihood of returning to the Southwest and primary care for future employment. Supervisors sent questionnaire separately focusing on likelihood to partake in future. Questionnaires were sent, completed and analysed via Jisc. Ethics approval was not required.
Results
10 students and 11 supervisors completed the survey. 60% students enjoyed SW. 90% students would recommend placement to other students and 90% would like to see them in other areas. 70% students very likely to or definitely would apply for GP foundation placement. 63% supervisors benefitted from having a student and 81% would recommend having summer placement student. 55% supervisors would definitely EOI in future summer placement programme and 55% would definitely EOI in GP split foundation programme. 25% students chose GP/Community placements in SW, 18% other placements in SW, 12% GP placements in other regions. Oriel fill rates in SW increased from 36.67% in 2020 to 39.30% in 2021, GP/Community placements remained the same in 2021 at 28.2% and community placements increased in from 18.14% in 2020 to 18.75% in 2021.
Discussion/Conclusion
The students enjoyed their placements and would recommend to other students. Supervisors found having students useful and would have a student in the future. Although some students were successful in securing a placement in SW for foundation training, due to nature of Oriel it’s not possible to determine how many preferenced SW and GP split programme, this is a limitation to the evaluation. Oriel fill rates didn’t increase for SW community/GP placements as desired, however this was a very small cohort. This pilot will be repeated summer 2022 so fill rates can be evaluated in 2023.
References
1. NHS. The NHS Long Term Plan. Long Term Plan. [Online] 2019. Available from: https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf.
2. BMA. Investment and Evolution: A five year gramework for GP contract reform to implement the NHS long term plan. England NHS. [Online] 2019. Available from: https://www.england.nhs.uk/wp-content/uploads/2019/01/gp-contract-2019.pdf.
3. Community Pharmacy Workforce Development Group. A Review of the Community Pharmacy Workforce. Community Pharmacy Workforce. [Online] 2021. Available from: https://communitypharmacyworkforce.files.wordpress.com/2021/06/cpwdg-report-a-review-of-the-community-pharmacy-workforce-final.pdf.
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Mahon CM, Ryan M, Kennelly SM, Martin R. 204 DEDICATED NURSING HOME SERVICE IN A TERTIARY HOSPITAL: EFFECT ON ADMISSION NUMBERS AND LENGTH OF STAY. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In 2019 a dedicated Nursing Home (NH) in-patient service was established in a tertiary hospital, comprising a Consultant Geriatrician, clinical nurse specialist, NCHD and administrative support. All NH residents over 65 with medical diagnoses were admitted by the NH team who also provide a consult service for NH residents under other specialties.
Methods
Data were sourced from the Hospital Inpatient Enquiry system on length of stay of patients identified as admitted from a nursing home compared to those admitted under the NH team and their average lengths of stay over 2019-2021.
Results
In 2019, 749 NH residents were admitted to hospital with an average length of stay (ALOS) of 7.93 days, the NH inpatient service was established in July 2019 and showed a reduction of ALOS from 9.25 to 6.6 days in the 6 months following its establishment (29% difference.) In 2020, 707 NH residents were admitted with 352 admitted under the NH team. The ALOS of NH residents admitted under the NH team was 5.66 days in 2020 compared to 8.65 overall (35% difference.) In 2021, 765 NH residents were admitted with 402 under the NH team. ALOS of NH residents admitted under the NH team was 5.33 days in 2021 compared to 8.28 overall (36% difference.)
Conclusion
Within six months of its commencement the dedicated NH service had decreased length of stay by 29%. The average length of stay across all services has decreased year on year from 6.6 to 5.3 days from 2019 to 2021. The ALOS in the total cohort (including residents admitted surgically and those under 65) was 29-36% higher. Though difficult to accurately compare these cohorts due to different presenting diagnoses and medical backgrounds in those admitted surgically or those under 65, the overall reduction in length of stay over the three years does highlight the benefit from this dedicated service.
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Affiliation(s)
- CM Mahon
- Connolly Hospital, Blanchardstown , Dublin, Ireland
| | - M Ryan
- Connolly Hospital, Blanchardstown , Dublin, Ireland
| | - SM Kennelly
- Royal College of Surgeons Ireland , Dublin, Ireland
| | - R Martin
- Connolly Hospital, Blanchardstown , Dublin, Ireland
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Mahon CM, Dunne A, Garcia R, Martin R, Kennelly SM. 203 TRANSITIONS TO LONG-TERM CARE: EXPERIENCE OF A COHORT OF COMMUNITY-DWELLING OLDER ADULTS RECEIVING INTEGRATED CARE. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Data from the Nursing Home support scheme 2018 (NHSS) shows the majority of applications to the NHSS come from acute hospitals (44%) followed by referrals from the community (38%). We examined this transition in a cohort of community dwelling older adults to assess how many transition from home to nursing home and, when admission to nursing home from hospital occurred, the indications for same.
Methods
Retrospective examination of Integrated Care Team (ICT) and Acute Hospital data from 2019 in respect of a cohort of older adults. Transitions in care to nursing home including residence at time of admission, last acute hospital presentation prior to nursing home admission and commencement of NHSS application recorded.
Results
319 patients referred to the integrated care service in 2019, average age 81 and 58% female, predominantly from outpatient clinics in the Medicine for the Older Person’s service. 47 patients had moved to nursing home; within this cohort 14 (29.7%) transitioned from home, 28 (59.6%) transitioning after acute hospital admission. Main reasons for presentation to hospital were: Intercurrent acute illness (n=11); Falls (n=6); progression of dementia (n=4). Fair Deal application commenced in community by ICT in 20 of the 47 (42.5%) patients including 8 of 28 patients (28.5%) admitted to hospital prior to moving to nursing home.
Conclusion
This preliminary evaluation highlights the importance of advance care planning in this population when acute hospital admissions can be difficult to predict. Involvement of the ICT can help this transition and lead to shorter hospital stays.
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Affiliation(s)
- CM Mahon
- Connolly Hospital, Blanchardstown , Dublin, Ireland
| | - A Dunne
- Connolly Hospital, Blanchardstown , Dublin, Ireland
| | - R Garcia
- Connolly Hospital, Blanchardstown , Dublin, Ireland
| | - R Martin
- Connolly Hospital, Blanchardstown , Dublin, Ireland
| | - SM Kennelly
- Royal College of Surgeons Ireland , Dublin, Ireland
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Brar SK, Sheehan O, Martin R, Rasheed M. 160 A CLOSED-LOOP AUDIT EXAMINING THE USE OF PROPHYLACTIC ANTI-COAGULATION IN OLDER ADULTS ADMITTED TO A SPECIALIST GERIATRIC SERVICE. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Guidelines recommend prescription of Prophylactic Anticoagulation (PA) to all hospitalized older adults unless a contraindication exits. In many cases this does not happen at the time of admission increasing the risk of thromboembolic events. We aimed to assess the use of PA across the medicine for the geriatric service of a level 3 hospital (average daily census of service 120) then use quality improvement to achieve our goal of 95% prescription of prophylactic anticoagulation when appropriate.
Methods
Medication kardexes and clinical notes were reviewed to collect variables including age, length of stay, creatinine clearance, weight, mobility status, use and dose of antithrombotic medications and documentation of reason if not prescribed. Following initial data collection, cause and effect analysis was performed to identify reasons for under-prescription and small tests of change were conducted across 4 PDSA cycles before data collection was repeated.
Results
Initial data collection revealed that only 80% of older adults admitted to the service were receiving prophylactic anticoagulation. Cause and effect analysis identified many reasons for failure to prescribe PA including inadequate history taking, lack of clinician education and training, poor documentation, lack of handover between clinicians, failure to complete medication reconciliation on admission and lack of pharmacy support on some wards. Each of these contributory factors were addressed in turn. After a month of QI activities prescription of PA improved to 83% and by 3 months 98.1% (104/106) of patients were receiving PA with only 2 patients for whom PA was not prescribed without clear documentation of the reason.
Conclusion
Sustained quality improvement resulted in a culture change across our service improving rates of appropriate prescription of PA and raising the quality of care delivered to older adults. This model of quality improvement is now being replicated across our department to address other gaps in service delivery.
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Affiliation(s)
- SK Brar
- Connolly Hospital Royal College of Surgeons in Ireland Hospitals Group, , Dublin, Ireland
| | - O Sheehan
- Connolly Hospital Royal College of Surgeons in Ireland Hospitals Group, , Dublin, Ireland
| | - R Martin
- Connolly Hospital Royal College of Surgeons in Ireland Hospitals Group, , Dublin, Ireland
| | - M Rasheed
- Connolly Hospital Royal College of Surgeons in Ireland Hospitals Group, , Dublin, Ireland
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Ruperto N, Chertok E, Dehoorne J, Horneff G, Kallinich T, Louw I, Compeyrot-Lacassagne S, Lauwerys B, Martin N, Marzan K, Knibbe W, Martin R, Zhu X, Whelan S, Pricop L, Martini A, Lovell DJ, Brunner H. OP0221 EFFICACY OF SECUKINUMAB IN ENTHESITIS-RELATED ARTHRITIS: RESULTS FROM A RANDOMISED, DOUBLE-BLIND, PLACEBO-CONTROLLED, TREATMENT WITHDRAWAL, PHASE 3 STUDY (JUNIPERA). Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.126] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundEnthesitis-related Arthritis (ERA) is a category of juvenile idiopathic arthritis (JIA) characterised by heterogeneous and insidious manifestations comprising axial and/or peripheral arthritis, and enthesitis.1 Secukinumab (SEC) demonstrated efficacy and safety in both ERA and juvenile psoriatic arthritis (JPsA) in the JUNIPERA trial.2ObjectivesTo evaluate the rate of flare risk reduction and efficacy of SEC on axial and peripheral manifestations in patients (pts) with active ERA.MethodsERA pts (2 to <18 years of age) with active disease (both ≥3 active joints and ≥1 active enthesitis site) were included. In the open-label (OL) treatment-period (TP)1, s.c. SEC (75/150 mg in pts <50/ ≥50 kg) was administered at baseline (BL), and at Week (Wk) 1–4, 8 and 12. Pts who achieved at least JIA-ACR30 response at Wk 12 were randomised into the double-blinded TP2 to continue SEC or placebo (PBO) every 4 wk until a disease flare, or up to Wk 100. The primary endpoint was time to flare in ERA and JPsA pts. The juvenile spondyloarthritis disease activity Index (JSpADA) is a disease activity assessment tool that contains 8 items to measure axial and peripheral disease activity.3 Evaluation of axial and peripheral manifestations at the end of TP1 and TP2 in pts who experienced these symptoms at BL included modified Schober test (lumbar flexion), inflammatory back pain, FABER (Flexion, ABduction, External Rotation) test, JIA-ACR responses, Juvenile Arthritis Disease Activity Score (JADAS)-27, and resolution of enthesitis and dactylitis for peripheral disease. These outcomes were also used to assess JIA disease course at the end of TP2.ResultsA total of 52/86 (60.5%) pts with ERA were enrolled in the OL period TP1 (mean age, 13.7 years; male, 78.8%). In total, 51/52 (98.1%) pts completed TP1 and 41/44 (93.2%) completed TP2. At BL, mean JADAS-27 was 14.8, mean JSpADA index was 3.9, mean enthesitis and dactylitis counts were 2.7 and 0.4, respectively, mean number of active joints was 6.2 and of mean joints with limited range of motion 4.9. The relative risk reduction of experiencing a disease flare in TP2 was 55% (HR 0.45, 95% CI: 0.16–1.28, p=0.075) in ERA pts (Figure 1). The overall axial and peripheral disease symptoms improved over time and are presented in the Table 1. At the end of TP1, 84.6% (44/52) of pts achieved JIA-ACR 30 and 65.4% (34/52) achieved JIA-ACR 70. Clinically relevant reduction of functional ability as assessed by Childhood Health Assessment Questionnaire (CHAQ) also occurred (see Table 1).Table 1.Resolution of axial and peripheral disease symptoms and JIA ACR responses at the end of TP1 and 2Clinical response, mean (SD) change from BL (unless otherwise stated)TP1-Wk 12End of TP2*SEC (N=52)SEC (N=22)PBO (N=22)JSpADA index−2.4 (1.7)−2.7 (1.7)−2.3 (2.1)JSpADA Schöber, %58.3100.0100.0Inflammatory back pain, %77.8100.050.0FABER test, %52.6100.083.3Clinical sacroiliitis, %53.3100.050.0Enthesitis−2.2 (1.9)−2.5 (2.1)−1.3 (1.8)Dactylitis−0.2 (0.8)−0.2 (1)−0.1 (0.4)JIA ACR30, %84.690.968.2JIA ACR50, %78.881.868.2JIA ACR70, %65.468.254.5JIA ACR90, %32.745.550.0JIA ACR100, %26.936.445.5Inactive disease, %38.550.050.0CHAQ−0.5 (0.5)−0.6 (0.7)−0.4 (0.5)CRP, median (SD) change from BL−1.8 (38.7)−5.8 (38.3)0 (35.9)JADAS-27−9.6 (7.5)−11.0 (8.9)−7.6 (8.9)Resolution of enthesitis#, %72.378.683.3Resolution of dactylitis#, %5066.70*End of TP2 is based on individual pts’ last visit at TP2. #At BL, in TP1, enthesitis (n= 46); dactylitis (n=5). In TP2, no. of pts who had presence at BL and showed complete resolution at the end of TP2: enthesitis, SEC 14, PBO 18; dactylitis, SEC 3, PBO, 0. CRP, C-reactive proteinConclusionIn pts with ERA, SEC demonstrated longer time to disease flare vs PBO and exhibited rapid and sustained improvement of axial and peripheral manifestations up to Wk 104.References[1]Pagnini I, et al. Front Med 2021;8:6673052.[2]Brunner H, et al. Arthritis Rheumatol 2021;73 (suppl 10).[3]Weiss PF, et al. Arthritis Care Res 2014;66:1775-82.Disclosure of InterestsNicolino Ruperto Speakers bureau: Eli Lilly, GlaxoSmith and Kline, Pfizer, SOBI and UCB, Paid instructor for: Eli Lilly and Pfizer, Consultant of: Ablynx, Amgen, Astrazeneca-Medimmune, Aurinia, Bayer, Bristol Myers and Squibb, Cambridge Healthcare Research (CHR), Celegene, Domain therapeutic, Eli Lilly, EMD Serono, GlaxoSmith and Kline, Idorsia, Janssen, Novartis, Pfizer, SOBI and UCB, Grant/research support from: Bristol Myers and Squibb, Eli Lilly, F Hoffmann-La Roche, Novartis, Pfizer and SOBI, Elena Chertok: None declared, Joke Dehoorne Speakers bureau: Abbvie, Roche, Consultant of: Abbvie, Roche, Pfizer, Grant/research support from: Abbvie, Roche, Gerd Horneff Speakers bureau: Novartis, Pfizer, Janssen, Grant/research support from: Pfizer, Novartis, Roche, MSD, Tilmann Kallinich Speakers bureau: Roche, Ingrid Louw Speakers bureau: Pfizer, Abbvie, BMS, Consultant of: Pfizer, Abbvie, Janssen, Amgen and Cipla, Sandrine Compeyrot-Lacassagne: None declared, Bernard Lauwerys Employee of: UCB Pharma, Neil Martin: None declared, Katherine Marzan Grant/research support from: Novartis, Sanofi, William Knibbe Speakers bureau: Novartis, Amgen, UCB, Abbvie, Ruvie Martin Shareholder of: Novartis, Employee of: Novartis, Xuan Zhu Shareholder of: Novartis, Employee of: Novartis, sarah whelan Shareholder of: Novartis, Employee of: Novartis, Luminita Pricop Shareholder of: Novartis, Employee of: Novartis, Alberto Martini Speakers bureau: Aurinia, Bristol Myers and Squibb, Eli Lilly, EMD, Janssen, Pfizer, Roche and Serono, Consultant of: Aurinia, Bristol Myers and Squibb, Eli Lilly and EMD, Daniel J Lovell Consultant of: Astra Zeneca, Boehringer Ingelheim, GSK, Hoffman LaRoche, Novartis, UBC, Grant/research support from: Astra Zeneca, Boehringer Ingelheim, GSK, Hoffman LaRoche, Novartis, UBC, Hermine Brunner Consultant of: Novartis, Grant/research support from: Novartis
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Martin R, Vincent B, Olivier P, Marie-Agnès G, Ulricke S, François L. PO-1265 Title: DLCO decrease in a prospective cohort of VMAT-treated lung cancer patients (NCT03931356). Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03229-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bye T, Martin R. Static postural differences between male and female equestrian riders on a riding simulator. Comparative Exercise Physiology 2022. [DOI: 10.3920/cep210003] [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: 11/19/2022]
Abstract
This study aimed to compare static posture of male and female riders on a riding simulator. Ten female and five male riders underwent a 5 min standardised exercise programme on the simulator, they were then videoed for 10 s from each the left, right, and rear views whilst stationary on the simulator. Two-dimensional kinematic analysis of the videos showed that male riders had a more neutrally positioned pelvis in the sagittal plane (median left: 6.47°, right: 5.24°) with females demonstrating a posterior pelvic tilt (L: 14.04°, R: 13.55°). Females showed significantly greater pelvic obliquity (median female: 1.99°, male: 0.73°), trunk lean (F: 1.60°, M: 0.43°), and shoulder tilt (F: 1.79°, M: 0.57°) in the frontal plane, demonstrating an overall greater postural asymmetry. Previous studies of elite riders have shown a more anteriorly rotated pelvis to be more desirable. Symmetry of riding position is favourable as it allows movements to be performed with ease and ensures even force distribution through the saddle to the horse. Male riders may therefore have a biomechanical advantage over females when it comes to maintaining a desirable riding position. This research should now be extended to study riders on the horse in motion.
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Affiliation(s)
- T.L. Bye
- University Centre Bishop Burton, York Road, Bishop Burton, East Yorkshire, HU17 8QG, United Kingdom
- School of Sport, Health and Exercise Sciences, Loughborough University, Epinal Way, Loughborough, Leicestershire, LE11 3TU, United Kingdom
| | - R. Martin
- University Centre Bishop Burton, York Road, Bishop Burton, East Yorkshire, HU17 8QG, United Kingdom
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McDuffie E, Martin R, Yin H, Brauer M. Global Burden of Disease from Major Air Pollution Sources (GBD MAPS): A Global Approach. Res Rep Health Eff Inst 2021; 2021:1-45. [PMID: 36148817 PMCID: PMC9501767] [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: 02/14/2023] Open
Abstract
Ambient fine particulate matter (particles <2.5 μm in aerodynamic diameter [PM2.5]) is the world's leading environmental health risk factor. Reducing the PM2.5 disease burden requires specific strategies that target dominant sources across multiple spatial scales. The Global Burden of Disease from Major Air Pollution Sources (GBD MAPS) project provides a contemporary and comprehensive evaluation of contributions to the ambient PM2.5 disease burden from source sectors and fuels across 21 regions, 204 countries, and 200 subnational areas. We first derived quantitative contributions from 24 emission sensitivity simulations using an updated global atmospheric chemistry-transport model, input with a newly developed detailed anthropogenic emissions dataset that includes emissions specific to source sector and fuels. These simulation results were integrated with newly available high-resolution satellite-derived PM2.5 exposure estimates and disease-specific concentration-response relationships consistent with the GBD project to quantify contributions of specific source sector and fuel to the ambient PM2.5 disease burden across all regions, countries, and subnational areas. To improve the transparency and reproducibility of this and future work, we publicly provided the global atmospheric chemistry-transport model source code, emissions dataset and emissions model source code, analysis scripts, and source sensitivity results, and further described the emissions dataset and source contribution results in two publications. We found that nearly 1.05 million (95% uncertainty interval [UI]: 0.74-1.36 million) deaths worldwide (27.3% of the total mortality attributable to PM2.5) would be avoidable by eliminating fossil fuel combustion, with coal contributing over half of that burden. Residential (19.2%; 736,000 deaths [95% UI: 521,000-955,000]), industrial (11.7%; 448,000 deaths [95% UI: 318,000-582,000]), and energy (10.2%; 391,000 deaths [95% UI: 277,000-507,000]) sector emissions are among the dominant global sources Uncertainty in these estimates reflects those of the input datasets. Regions with the largest anthropogenic contributions generally have the highest numbers of attributable deaths, which clearly demonstrates the importance of reducing these emissions to realize reductions in global air pollution and its disease burden.
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Affiliation(s)
- E McDuffie
- Washington University in St. Louis, St. Louis, Missouri, U.S.A
| | - R Martin
- Washington University in St. Louis, St. Louis, Missouri, U.S.A
- co-principal investigator
| | - H Yin
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - M Brauer
- The University of British Columbia, Vancouver, British Columbia, Canada
- co-principal investigator
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Rahmani M, Ortiz-Toquero S, Martin R. Referral pattern and co-management of keratoconus patients in primary eye care: A survey of three European countries. Cont Lens Anterior Eye 2021; 45:101518. [PMID: 34772626 DOI: 10.1016/j.clae.2021.101518] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To explore current primary care practices in keratoconus management in Portugal and compare with previous reported results in two European countries (the UK and Spain), with a special focus on interdisciplinary collaboration and referral practice patterns. METHODS An online survey adapted to European professional practice was distributed (via newsletters) by the Portuguese Optometrist Association to explore keratoconus patient management and referral practice patterns among Portuguese practitioners. RESULTS Responses of 119 optometrists were compared with previous reported of 464 eye-care practitioners (126 in the UK and 338 in Spain). Most respondents (79% in Portugal, 71% in the UK and 76% in Spain; p = 0.31) had < 5 new keratoconus patients each year. No accepted referral criterion was found (p < 0.01) because small number of the respondents (14%) in Portugal referred out at initial diagnosis (50% in the UK and Spain); 32% referred out when progression was detected (17% in the UK and 30% in Spain); and a minority (10% in Portugal, 9% in the UK, and 6% in Spain) referred out when visual acuity was affected. A majority of respondents (83%) in Portugal reported no co-management with ophthalmologists (60% in the UK and 73% in Spain; p < 0.01). CONCLUSION The results of this study suggest that it is necessary to encourage interdisciplinary collaboration between practitioners to improve referral of patients with suspected keratoconus to an ophthalmology specialist to change the course of this disease, to reduce keratoconus progression and visual acuity impairment and to minimize the impact of this disease on patients' quality of life.
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Affiliation(s)
- M Rahmani
- Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA), Paseo de Belén 17 - Campus Miguel Delibes, 47011 Valladolid, Spain
| | - S Ortiz-Toquero
- Ramón y Cajal Hospital, Department of Ophthalmology, Ctra. Colmenar Viejo, Km. 9, 28034 Madrid, Spain
| | - R Martin
- Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA), Paseo de Belén 17 - Campus Miguel Delibes, 47011 Valladolid, Spain; Universidad de Valladolid, Departamento de Física Teórica, Atómica y Óptica. Paseo de Belén, 7 - Campus Miguel Delibes, 47011 Valladolid, Spain; Optometry Research Group, IOBA Eye Institute. School of Optometry, University of Valladolid. Valladolid, Spain; Faculty of Health and Human Sciences, Plymouth University, Derriford Road, PL6 8BH Plymouth, United Kingdom.
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Vazquez F, Marrufo O, Solis-Najera SE, Martin R, Rodriguez AO. External Waveguide Magnetic Resonance Imaging for lower limbs at 3 T. Med Phys 2021; 49:158-168. [PMID: 34633673 DOI: 10.1002/mp.15281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/01/2021] [Accepted: 09/21/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION We report a method based on the travelling-wave MRI approach, in order to acquire images of human lower limbs with an external waveguide at 3 T. METHOD We use a parallel-plate waveguide and an RF surface coil for reception, while a whole-body birdcage is used for transmission. The waveguide and the surface coil are located right outside the magnet, in the MR conditional devices zone. We ran numerical simulations to investigate the B1 field generated by the surface coil located at one of the waveguides, as well as a saline-solution phantom positioned on the opposite side (150 cm away) inside the magnet. RESULTS We obtained phantom images by varying the distance between the coil and the phantom, in order to investigate the signal-to-noise ratio and to validate our numerical simulations. Lower limb images of a healthy volunteer were also acquired, demonstrating the viability of this approach. Standard pulse sequences were used and no physical modifications were made to the MR imager. CONCLUSIONS These numerical and experimental results show that travelling-wave MRI can produce high-quality images with only a simple waveguide and an RF coil located outside the magnet. This can be particularly favorable when acquiring images of lower limbs requiring a larger field of view.
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Affiliation(s)
- F Vazquez
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - O Marrufo
- Department of Neuroimage, Instituto Nacional de Neurologia y Neurocirugia MVS, Mexico City, 14269, Mexico
| | - S E Solis-Najera
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - R Martin
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - A O Rodriguez
- Department of Electrical Engineering, Universidad Autonoma Metropolitama Iztapalapa, Mexico City, 09340, Mexico
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Prost A, Handel T, Rothmaler K, Schreiber M, Martin R, Urban D, Geisler D, Lippmann S, JB T, Iacovazzi D, Claßen J, Ivanova G, Michalski D. Der PostStroke-Manager: Entwicklung eines eHealth-basierten und durch Schlaganfalllotsen unterstützen Schlaganfallnachsorge-Konzepts. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732742] [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: 10/20/2022]
Affiliation(s)
- A Prost
- Klinik und Poliklinik für Neurologie, Universität Leipzig/Medizinische Fakultät
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Leipzig
| | - T Handel
- Institut für Angewandte Informatik (InfAI)
| | - K Rothmaler
- Institut für Angewandte Informatik (InfAI)
- Max-Planck-Institut für Kognitions- und Neurowissenschaften
| | | | - R Martin
- Institut für Angewandte Informatik (InfAI)
| | - D Urban
- Klinik und Poliklinik für Neurologie, Universität Leipzig/Medizinische Fakultät
| | - D Geisler
- Klinik und Poliklinik für Neurologie, Universität Leipzig/Medizinische Fakultät
| | - S Lippmann
- Selbstständige Abteilung für Allgemeinmedizin, Universität Leipzig
| | - Tylcz JB
- Institut für Angewandte Informatik (InfAI)
| | | | - J Claßen
- Klinik und Poliklinik für Neurologie, Universität Leipzig/Medizinische Fakultät
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Leipzig
| | - G Ivanova
- Institut für Angewandte Informatik (InfAI)
- Innovation Center Computer Assisted Surgery (ICCAS), Universität Leipzig/Medizinische Fakultät
| | - D Michalski
- Klinik und Poliklinik für Neurologie, Universität Leipzig/Medizinische Fakultät
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Leipzig
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Murtagh E, Shalash A, Martin R, Abu Rmeileh N. Measurement and prevalence of adult physical activity levels in Arab countries. Public Health 2021; 198:129-140. [PMID: 34418764 DOI: 10.1016/j.puhe.2021.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/14/2021] [Accepted: 07/09/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVES This study aims to examine the reported prevalence of sufficient physical activity among adults in Arab countries and to determine the use of validated instruments for assessing physical activity. STUDY DESIGN This is a systematic literature review. METHODS This review follows recommendations outlined in the Meta-Analysis of Observational Studies in Epidemiology guidelines. The protocol for this study was preregistered with PROSPERO. Cross-sectional, cohort and intervention studies with a minimum of 300 adults aged ≥18 years assessing physical activity using a questionnaire or other self-report measure in the Arabic language were identified from seven electronic databases (MEDLINE, Embase, Cochrane Database of Systematic Reviews, CINAHL, PsycINFO, SPORTDiscu and PubMed). Databases were searched from 1st January 2008 to 17th September 2018. Descriptive analysis was performed using frequency and percentages. The prevalence of physical activity was calculated as the average prevalence for the reported percentages from the studies with similar tools. RESULTS Fifty studies involving 298,242 participants were included in this review. The mean (range) sample size was 5964.8.1 (323-197,681). Data were collected from participants in 16 of the 22 Arab countries. Great variation exists across the studies in determining whether adults were sufficiently active or not. Twenty studies reported usable data from the Global Physical Activity Questionnaire and the International Physical Activity Questionnaire (moderate & high categories). In these studies, prevalence of physical activity ranged from 34.2 to 96.9%. It was not possible to compare the other studies owing to variation in instruments used to assess physical activity and in the case definition used for 'physically active'. CONCLUSIONS This study highlights the need for wider reporting of physical activity and the adoption of valid and reliable instruments to support the development of evidence-informed policy and programmes at both country and regional level. International tools need to be correctly validated, or context-specific tools must be developed to accurately measure physical activity.
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Affiliation(s)
- E Murtagh
- Department of Physical Education and Sport Sciences, University of Limerick, Ireland; Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Ireland.
| | - A Shalash
- Institute of Community and Public Health, Birzeit University, Palestine; School of Medicine, University of Limerick, Ireland
| | - R Martin
- Mary Immaculate College, Limerick, Ireland
| | - N Abu Rmeileh
- Institute of Community and Public Health, Birzeit University, Palestine
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Goupille P, Behrens F, Coates LC, Gratacos-Masmitja J, Mease PJ, Gladman DD, Nash P, Kavanaugh A, Martin R, Bao W, Gaillez C, Mcinnes I. POS1044 EFFECT OF SECUKINUMAB VERSUS ADALIMUMAB ON ACR CORE COMPONENTS AND HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH PSORIATIC ARTHRITIS: RESULTS FROM THE EXCEED STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1562] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:EXCEED (NCT02745080) was the first fully blinded head-to-head trial to evaluate the efficacy and safety of secukinumab (SEC) versus (vs) adalimumab (ADA) monotherapy in patients with active psoriatic arthritis (PsA) with a primary endpoint of American College of Rheumatology (ACR) 20 at Week 52. Although SEC narrowly missed statistical significance for superiority vs ADA, numerically higher response for other musculoskeletal endpoints and composite indices were observed with SEC.1Objectives:To explore the effect of SEC and ADA on ACR core components, function and Health-related Quality of Life (HRQoL) outcomes.Methods:Patients were randomised 1:1 to receive SEC 300 mg (N=426) subcutaneous (s.c.) at baseline, Week 1-4, followed by every 4 weeks until Week 48 or ADA 40 mg (N=427) s.c. at baseline followed by same dosing every 2 weeks until Week 50. The primary, key secondary and some exploratory endpoints at Week 52 were previously reported.1 A supportive analysis for ACR50 response using logistic regression model and trimmed means model for Health Assessment Questionnaire-Disability Index (HAQ-DI) with gender and smoking status as factors was performed to adjust for imbalances in baseline characteristics. An exploratory analysis of ACR core components with SEC vs ADA at Week 52 was conducted using a mixed-effects repeated measures model that included tender and swollen joint counts, patient and physician global assessment, PsA pain (VAS) and erythrocyte sedimentation rate. HRQoL variables were also exploratory and assessed based on Short Form Health Survey Physical/Mental Component Summary (SF-36 PCS/MCS) scores and Dermatology Life Quality Index (DLQI).Results:The demographic and baseline disease characteristics were comparable across treatment groups, except for an imbalance in sex (females: 51.2% vs 46.4%) and smoking status (yes: 21.8% vs 17.8%) in SEC and ADA group, respectively. At Week 52, ACR50 responses were 49.0% and 44.8% (P=0.0929) and HAQ-DI mean change from baseline were −0.69 and −0.58 (P=0.0314) in SEC and ADA treatment groups, respectively after adjusting for gender and smoking status. No major difference across ACR core components was observed in both treatment groups at Week 52 (Table 1). At Week 52, SEC presented similar improvement in SF-36 PCS/MCS score and numerically higher improvement in DLQI compared to ADA (Figure 1).Conclusion:Secukinumab provided similar improvements in ACR core components and SF-36 based quality of life at Week 52 with adalimumab. Greater improvement in HAQ-DI response and DLQI was demonstrated with secukinumab compared to adalimumab.References:[1]McInnes IB, et al. Lancet. 2020; 395:1496–505.Table 1.ACR Core Components at Week 52VariablesSecukinumab 300 mg(N=426)Adalimumab 40 mg(N=427)P-valueBL, mean ± SELSM change from BL ± SEBL, mean ± SELSM change from BL ± SETender joint score(based on 78 joints)19.4 ± 13.86−14.27 ± 0.4420.6 ± 14.81−13.90 ± 0.450.5549Swollen joint score(based on 76 joints)9.7 ± 7.30−8.41 ± 0.1910.2 ± 7.86−8.06 ± 0.200.1962Patients global assessment64.0 ± 19.67−33.81 ± 1.1461.9 ± 20.75−31.61 ± 1.190.1825Physicians global assessment60.0 ± 17.12−46.24 ± 0.8061.4 ± 15.92−43.63 ± 0.840.0243Psoriatic arthritis pain (VAS)58.6 ± 23.49−30.21 ± 1.1857.9 ± 22.42−29.44 ± 1.230.6500Erythrocyte sedimentation rate (mm/h)23.8 ± 18.93−9.63 ± 0.6223.9 ± 17.99−9.28 ± 0.640.7029LS mean and nominal P-values are from a mixed-effects repeated measures model with treatment group, analysis visit as factors, weight and BL score as covariates, and by treatment and BL score as interaction terms, unstructured covariance structure. ACR, American College of Rheumatology; BL, baseline; LSM, least squares mean; N, total number of randomised patients; SE, standard error; VAS, visual analogue scaleFigure 1.HRQoL Analysis at Week 52Disclosure of Interests:Philippe Goupille Speakers bureau: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Janssen, Eli Lilly, Medac, MSD, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Consultant of: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Janssen, Eli Lilly, Medac, MSD, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Grant/research support from: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Janssen, Eli Lilly, Medac, MSD, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Frank Behrens Paid instructor for: Eli Lilly, Consultant of: Pfizer, AbbVie, Sanofi, Eli Lilly, Novartis, Genzyme, Boehringer Ingelheim, Janssen, MSD, Celgene, Roche and Chugai, Grant/research support from: Pfizer, Janssen, Chugai, Celgene and Roche, Laura C Coates Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Biogen, BMS, Celgene, Domain, Eli Lilly, Gilead, GSK, Janssen, Medac, Novartis, Pfizer, Serac and UCB, Grant/research support from: AbbVie, Amgen, Celgene, Eli Lilly, Janssen, Novartis, Pfizer and UCB, Jordi Gratacos-Masmitja Speakers bureau: AbbVie, Amgen, BMS, Celgene, Janssen, Eli Lilly, Novartis and Pfizer, Consultant of: AbbVie, Amgen, BMS, Celgene, Janssen, Eli Lilly, Novartis and Pfizer, Grant/research support from: AbbVie, Amgen, BMS, Celgene, Janssen, Eli Lilly, Novartis and Pfizer, Philip J Mease Speakers bureau: AbbVie, Amgen, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Boehringer Ingelheim, Galapagos, Celgene, Genentech, Gilead, Janssen, Eli Lilly, Novartis, Pfizer, SUN Pharma, and UCB, Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Galapagos, Genentech, Gilead, Janssen, Eli Lilly, Merck, Novartis, Pfizer, SUN Pharma, and UCB, Dafna D Gladman Consultant of: Amgen, AbbVie, BMS, Celgene, Eli Lilly, Gilead, Galapagos, Janssen, Novartis, Pfizer and UCB, Grant/research support from: Amgen, AbbVie, Celgene, Eli Lilly, Janssen, Novartis, Pfizer and UCB, Peter Nash Speakers bureau: Novartis, Abbvie, Roche, Pfizer, BMS, Janssen, Celgene, UCB, Eli Lilly, MSD, Sanofi, Gilead, Consultant of: Novartis, Abbvie, Roche, Pfizer, BMS, Janssen, Celgene, UCB, Eli Lilly, MSD, Sanofi, Gilead, Grant/research support from: Novartis, Abbvie, Roche, Pfizer, BMS, Janssen, Celgene, UCB, Eli Lilly, MSD, Sanofi, Gilead, Arthur Kavanaugh Consultant of: AbbVie, Amgen, Celgene, Eli Lilly, Janssen, Novartis, and UCB, Grant/research support from: AbbVie, Amgen, Celgene, Eli Lilly, Janssen, Novartis, and UCB, Ruvie Martin Shareholder of: Novartis, Employee of: Novartis, Weibin Bao Shareholder of: Novartis, Employee of: Novartis, Corine Gaillez Shareholder of: Novartis and BMS, Employee of: Novartis, Iain McInnes Speakers bureau: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Janssen, Eli Lilly, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Janssen, Eli Lilly, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Janssen, Eli Lilly, Novartis, Pfizer, and UCB.
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Vlachos K, Denis A, Kitamura T, Takigawa M, Frontera A, Martin R, Bourier F, Martin CA, Cheniti G, Pambrun T, Sacher F, Hocini M, Haissaguerre M, Jais P, Derval N. The role of marshall bundle epicardial connections in atrial tachycardias after atrial fibrillation ablation. Europace 2021. [DOI: 10.1093/europace/euab116.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Atrial tachycardias (ATs) are often seen in the context of AF ablation.
Objectives
We evaluated the role of the Marshall bundle (MB) network in left atrial (LA) ATs using high-density high-spatial resolution 3D mapping.
Methods
199 post-AF ablation LA tachycardias were mapped in 140 consecutive patients (112 (80%) males, mean age: 61.8 years); 133 (66.8%) were macro-reentrant and 66 (33.2%) were scar-related re-entry. MB-dependent perimitral AT (PMAT) was diagnosed where the difference between the post pacing interval and the tachycardia cycle length (PPI-TCL) was <20ms in parts of the expected MB-dependent perimitral circuit (within the VOM, the ridge between the left pulmonary veins and LA appendage (LAA), the anterior LA and between 6- and 11-o’clock of the mitral annulus) and the PPI-TCL was >20ms in areas bypassed by the VOM (the distal coronary sinus (CS), the posterior LA and the mitral isthmus). MB-related re-entry was diagnosed by PPI-TCL <20ms at the left lateral ridge, posterior base of LAA, inferolateral LA or VOM ostium; and PPI-TCL >20ms in the septal annulus. Typically, in MB-dependent localized re-entry, the earliest activation was found along the MB-LA endocardial connection or MB-CS epicardial connection.
Results
The MB network was found to participate in 60 (30.2%) re-entrant ATs, 31 PMATs and 29 localized re-entries. High-frequency multiphasic fragmented electrograms with long duration were often recorded endocardially or epicardially at the MB-LA or MB-CS connections. The amplitude and duration of these signals were 0.5 ± 0.79 mV and 65 ± 40 ms for MB-PMATs and 0.26 ± 0.28mV and 122 ± 67 ms for MB-localized re-entries. Unipolar EGMs at the site of endocardial-epicardial breakthrough had a rS pattern in all MB-related ATs. Of 60 MB-related ATs, 49 (81.6%) terminated with RF ablation, 44 (73.3%) at the MB-LA junction and 5 (8.3%) at the MB-CS junction, while 9 (15%) terminated after 2.5-5 cc of alcohol infusion inside the vein of Marshall (VOM). Of the 31 MB-related macroreentrant ATs, 17 (54.8%) terminated at the MB-LA junction, 5 (16.1%) at the MB-CS junction and 7 (22.6%) with alcohol infusion inside the VOM. Two macroreentries (6.5%) using the MB did not terminate with RF energy either endocardially at the MB-LA junction or epicardially at the MB-CS junction, and we were unable to identify or cannulate the VOM for ethanol infusion. Of the 29 localized re-entrant ATs using the MB, 27 (93.1%) terminated at the MB-LA junction, none terminated at the MB-CS junction and 2 (6.9%) terminated after alcohol infusion. After a mean follow up of 12 months, only 4 patients (6.7%) had AT recurrence.
Conclusions
MB re-entrant ATs accounted for up to 29% of the left ATs after AF ablation. Ablation of the MB-LA or CS-MB connections or alcohol infusion inside the VOM is required to treat these arrhythmias. Abstract Figure.
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Affiliation(s)
- K Vlachos
- University of Bordeaux, Bordeaux, France
| | - A Denis
- University of Bordeaux, Bordeaux, France
| | - T Kitamura
- University of Bordeaux, Bordeaux, France
| | - M Takigawa
- University of Bordeaux, Bordeaux, France
| | - A Frontera
- University of Bordeaux, Bordeaux, France
| | - R Martin
- University of Bordeaux, Bordeaux, France
| | - F Bourier
- University of Bordeaux, Bordeaux, France
| | - CA Martin
- University of Bordeaux, Bordeaux, France
| | - G Cheniti
- University of Bordeaux, Bordeaux, France
| | - T Pambrun
- University of Bordeaux, Bordeaux, France
| | - F Sacher
- University of Bordeaux, Bordeaux, France
| | - M Hocini
- University of Bordeaux, Bordeaux, France
| | | | - P Jais
- University of Bordeaux, Bordeaux, France
| | - N Derval
- University of Bordeaux, Bordeaux, France
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Launay C, Constantin J, Chlebowski F, Houot S, Graux AI, Klumpp K, Martin R, Mary B, Pellerin S, Therond O. Estimating the carbon storage potential and greenhouse gas emissions of French arable cropland using high-resolution modeling. Glob Chang Biol 2021; 27:1645-1661. [PMID: 33421219 DOI: 10.1111/gcb.15512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 01/04/2021] [Indexed: 06/12/2023]
Abstract
Many studies have assessed the potential of agricultural practices to sequester carbon (C). A comprehensive evaluation of impacts of agricultural practices requires not only considering C storage but also direct and indirect emissions of greenhouse gases (GHG) and their side effects (e.g., on the water cycle or agricultural production). We used a high-resolution modeling approach with the Simulateur mulTIdisciplinaire pour les Cultures Standard soil-crop model to quantify soil organic C (SOC) storage potential, GHG balance, biomass production and nitrogen- and water-related impacts for all arable land in France for current cropping systems (baseline scenario) and three mitigation scenarios: (i) spatial and temporal expansion of cover crops, (ii) spatial insertion and temporal extension of temporary grasslands (two sub-scenarios) and (iii) improved recycling of organic resources as fertilizer. In the baseline scenario, SOC decreased slightly over 30 years in crop-only rotations but increased significantly in crop/temporary grassland rotations. Results highlighted a strong trade-off between the storage rate per unit area (kg C ha-1 year-1 ) of mitigation scenarios and the areas to which they could be applied. As a result, while the most promising scenario at the field scale was the insertion of temporary grassland (+466 kg C ha-1 year-1 stored to a depth of 0.3 m compared to the baseline, on 0.68 Mha), at the national scale, it was by far the expansion of cover crops (+131 kg C ha-1 year-1 , on 17.62 Mha). Side effects on crop production, water irrigation and nitrogen emissions varied greatly depending on the scenario and production situation. At the national scale, combining the three mitigation scenarios could mitigate GHG emissions of current cropping systems by 54% (-11.2 from the current 20.5 Mt CO2 e year-1 ), but the remaining emissions would still lie far from the objective of C-neutral agriculture.
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Affiliation(s)
- Camille Launay
- Université de Toulouse, INRAE, UMR AGIR, Castanet-Tolosan, France
- INRAE, DEPE, Paris, France
| | - Julie Constantin
- Université de Toulouse, INRAE, UMR AGIR, Castanet-Tolosan, France
| | - Florent Chlebowski
- BioEcoAgro Joint Research Unit, INRAE, Université de Liège, Université de Lille, Université de Picardie Jules Verne, Barenton-Bugny, France
| | - Sabine Houot
- Université Paris-Saclay, INRAE, AgroParisTech, UMR Ecosys, Thiverval-Grignon, France
| | | | - Katja Klumpp
- Université Clermont Auvergne, INRAE, VetAgroSup, UMR UREP, Clermont-Ferrand, France
| | - Raphaël Martin
- Université Clermont Auvergne, INRAE, VetAgroSup, UMR UREP, Clermont-Ferrand, France
| | - Bruno Mary
- BioEcoAgro Joint Research Unit, INRAE, Université de Liège, Université de Lille, Université de Picardie Jules Verne, Barenton-Bugny, France
| | - Sylvain Pellerin
- INRAE, Bordeaux Sciences Agro, UMR ISPA, Villenave d'Ornon, France
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Semelka C, Seachrist K, Semelka C, Martin R, Miller D, Provchy J, Shada V. Improving Transitions of Care After Discharge from Skilled Nursing Facility. J Am Med Dir Assoc 2021; 22:B14. [PMID: 34287152 DOI: 10.1016/j.jamda.2021.01.032] [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: 10/22/2022]
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Vazquez F, Solis-Najera SE, Lazovic J, Zopf LM, Martin R, Medina L, Marrufo O, Rodriguez AO. Remote RF excitation for small-bore MR imager at 15.2 T. J Magn Reson 2021; 323:106896. [PMID: 33412512 DOI: 10.1016/j.jmr.2020.106896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/09/2020] [Accepted: 12/16/2020] [Indexed: 06/12/2023]
Abstract
We report a method for remote excitation of the RF signal for preclinical-equivalent ultra high field Magnetic Resonance Imaging (MRI). A parallel-plate waveguide together with a bio-inspired surface coil were used to perform remote excitation experiments to acquire images with a small-bore MR imager at 15.2 T. The imager bore size limits the RF coil transmitter dimensions, so the Gielis super-formula was used to design an RF coil with small dimensions. Electromagnetic simulations of the principal mode were run to study the waveguide filled with air and loaded with a saline solution-filled tube. Radiation patterns were also computed in a semi-anechoic chamber for the same scenarios as above. A saline solution-filled spherical phantom and a formaldehyde-fixed mouse phantom were used to acquire images. Radiation patterns showed an omnidirectional distribution with no side lobes, and a very smooth behaviour with almost no loss of information in the saline solution-filled tube and without. The theoretical wave impedance was calculated and compared with simulated results showing an excellent correspondence. Spherical phantom image data and simulation results of B1 were contrasted and showed an important correlation. Ex vivo mouse images were of high quality and exhibited clear delineation of anatomical structures. These imaging results are in very good agreement with the simulations. Numerical, theoretical and experimental results validate this approach, using a bio-inspired surface coil with a simple waveguide for preclinical small-bore MRI at ultra high field.
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Affiliation(s)
- F Vazquez
- Departamento de Física, Facultad de Ciencias, Universidad Nacional Autónoma de México, CdMx 04510, Mexico
| | - S E Solis-Najera
- Departamento de Física, Facultad de Ciencias, Universidad Nacional Autónoma de México, CdMx 04510, Mexico
| | - J Lazovic
- Campus Science Support Facilities GmbH, Vienna 1030, Austria
| | - L M Zopf
- Campus Science Support Facilities GmbH, Vienna 1030, Austria
| | - R Martin
- Departamento de Física, Facultad de Ciencias, Universidad Nacional Autónoma de México, CdMx 04510, Mexico
| | - L Medina
- Departamento de Física, Facultad de Ciencias, Universidad Nacional Autónoma de México, CdMx 04510, Mexico
| | - O Marrufo
- Department of Neuroimage, Instituto Nacional de Neurologia y Neurociruga MVS, CdMx 14269, Mexico
| | - A O Rodriguez
- Department of Electrical Engineering, Universidad Autonoma Metropolitana Iztapalapa, CdMx 09340, Mexico.
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Surette S, Narang A, Bae R, Hong H, Thomas Y, Cadieu C, Chaudhry A, Martin R, Rubenson D, Goldstein S, Little S, Lang R, Weissman N, Thomas J. Artificial intelligence-guided image acquisition on patients with implanted electrophysiological devices: results from a pivotal prospective multi-center clinical trial. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
A novel, recently FDA-authorized software uses deep learning (DL) to provide prescriptive transthoracic echocardiography (TTE) guidance, allowing novices to acquire standard TTE views. The DL model was trained by >5,000,000 observations of the impact of probe motion on image orientation/quality. This study evaluated whether novice-acquired TTE images guided by this software were of diagnostic quality in patients with and without implanted electrophysiological (EP) devices, focusing on RV size and function, which were thought to be sensitive to EP devices. Some aspects of the study have previously been presented.
Methods
240 patients (61±16 years old, 58% male, 33% BMI >30 kg/m2, 91% with cardiac pathology) were recruited. 8 nurses without echo experience each acquired 10 view TTEs in 30 patients guided by the software. 235 of the patients were also scanned by a trained sonographer without assistance from the software. 5 Level 3 echocardiographers independently assessed the diagnostic quality of the TTEs acquired by the nurses and sonographers to evaluate the effect of EP devices on DL software performance.
Results
Nurses using the AI-guided acquisition software acquired TTEs of sufficient quality to make qualitative assessments of right ventricular (RV) size and function in greater than 80% of cases for patients with and without implanted EP devices (Table). There was no significant difference between nurse- and sonographer-acquired scans.
Conclusion
These results indicate that new DL software can guide novices to obtain TTEs that enable qualitative assessment of RV size even in the presence of implanted EP devices. The results of the comparison to sonographer-acquired exams indicate the software performance is robust to presence of pacemaker/ICD leads visible in the images (Figure).
Nurse-acquired TTE with visible ICD lead
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Caption Health, Inc.
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Affiliation(s)
- S Surette
- Caption Health, Brisbane, United States of America
| | - A Narang
- Northwestern University, Chicago, United States of America
| | - R Bae
- Minneapolis Heart Institute Foundation, Minneapolis, United States of America
| | - H Hong
- Caption Health, Brisbane, United States of America
| | - Y Thomas
- Caption Health, Brisbane, United States of America
| | - C Cadieu
- Caption Health, Brisbane, United States of America
| | - A Chaudhry
- Caption Health, Brisbane, United States of America
| | - R Martin
- Caption Health, Brisbane, United States of America
| | - D Rubenson
- Scripps Clinic, La Jolla, United States of America
| | - S Goldstein
- MedStar Washington Hospital Center, Washington, United States of America
| | - S Little
- Houston Methodist, Houston, United States of America
| | - R Lang
- The University of Chicago, Chicago, United States of America
| | - N Weissman
- MedStar Health Research Institute, Washington, United States of America
| | - J.D Thomas
- Northwestern University, Chicago, United States of America
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Lancet J, Lin T, Hogge D, Solomon S, Schiller G, Wieduwilt M, Martin R, Faderl S, Chang Y, Cortes J. FIVE-YEAR FINAL RESULTS OF A PHASE 3 STUDY OF CPX-351 VERSUS 7+3 IN OLDER ADULTS WITH NEWLY DIAGNOSED HIGH-RISK/SECONDARY ACUTE MYELOID LEUKEMIA (AML). Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.10.257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Martin R, Garcia-Arumí C, Andrade A, Bisbe L. Endothelial deposits of exfoliative material imaged by slit lamp photography and high definition anterior segment optical coherence tomography. J Fr Ophtalmol 2020; 44:284-286. [PMID: 33127180 DOI: 10.1016/j.jfo.2020.02.031] [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] [Received: 01/12/2020] [Accepted: 02/14/2020] [Indexed: 10/23/2022]
Affiliation(s)
- R Martin
- Department of ophthalmology, Hospital Universitario Vall d'Hebron, Passeig Vall d'Hebron 119, 08035 Barcelona, Spain.
| | - C Garcia-Arumí
- Department of ophthalmology, Hospital Universitario Vall d'Hebron, Passeig Vall d'Hebron 119, 08035 Barcelona, Spain
| | - A Andrade
- Department of ophthalmology, Hospital Universitario Vall d'Hebron, Passeig Vall d'Hebron 119, 08035 Barcelona, Spain
| | - L Bisbe
- Department of ophthalmology, Hospital Universitario Vall d'Hebron, Passeig Vall d'Hebron 119, 08035 Barcelona, Spain
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Goereci Y, Schweitzer F, Wellstein A, Silling S, Borchmann S, Tresckow B, Adams O, Martin R, Schlamann M, Schroeter M, Fink GR, Wattjes MP, Warnke C. Clearance of JC polyomavirus from cerebrospinal fluid following treatment with interleukin‐2 and pembrolizumab in an individual with progressive multifocal leukoencephalopathy and no underlying immune deficiency syndrome. Eur J Neurol 2020; 27:2375-2377. [DOI: 10.1111/ene.14435] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/26/2020] [Indexed: 01/13/2023]
Affiliation(s)
- Y. Goereci
- Department of Neurology Medical Faculty University Hospital of Köln Köln Germany
| | - F. Schweitzer
- Department of Neurology Medical Faculty University Hospital of Köln Köln Germany
| | - A. Wellstein
- Georgetown University Medical School Washington DC USA
| | - S. Silling
- Institute for Virology Medical Faculty University Hospital of Köln KölnGermany
| | - S. Borchmann
- Department of Haematology Medical Faculty University Hospital of Köln KölnGermany
| | - B. Tresckow
- Department of Haematology University Hospital Essen EssenGermany
| | - O. Adams
- Institute for Virology Medical Faculty University Hospital of Düsseldorf Düsseldorf Germany
| | - R. Martin
- Department of Neurology University Medical Center Zürich Zürich Switzerland
| | - M. Schlamann
- Department of Radiology Medical Faculty University Hospital of Köln KölnGermany
| | - M. Schroeter
- Department of Neurology Medical Faculty University Hospital of Köln Köln Germany
| | - G. R. Fink
- Department of Neurology Medical Faculty University Hospital of Köln Köln Germany
- Cognitive Neuroscience Institute of Neuroscience and Medicine (INM‐3) Research Centre Jülich JülichGermany
| | - M. P. Wattjes
- Department of Diagnostic and Interventional Neuroradiology Hannover Medical School Hannover Germany
| | - C. Warnke
- Department of Neurology Medical Faculty University Hospital of Köln Köln Germany
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Martin R, Kim M, Lee CJ, Mehar V, Albertin S, Hejral U, Merte LR, Lundgren E, Asthagiri A, Weaver JF. High-Resolution X-ray Photoelectron Spectroscopy of an IrO 2(110) Film on Ir(100). J Phys Chem Lett 2020; 11:7184-7189. [PMID: 32787312 DOI: 10.1021/acs.jpclett.0c01805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
High-resolution X-ray photoelectron spectroscopy (XPS) and density functional theory (DFT) were used to characterize IrO2(110) films on Ir(100) with stoichiometric as well as OH-rich terminations. Core-level Ir 4f and O 1s peaks were identified for the undercoordinated Ir and O atoms and bridging and on-top OH groups at the IrO2(110) surfaces. Peak assignments were validated by comparison of the core-level shifts determined experimentally with those computed using DFT, quantitative analysis of the concentrations of surface species, and the measured variation of the Ir 4f peak intensities with photoelectron kinetic energy. We show that exposure of the IrO2(110) surface to O2 near room temperature produces a large quantity of on-top OH groups because of reaction of background H2 with the surface. The peak assignments made in this study can serve as a foundation for future experiments designed to utilize XPS to uncover atomic-level details of the surface chemistry of IrO2(110).
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Affiliation(s)
- R Martin
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611, United States
| | - M Kim
- William G. Lowrie Chemical & Biomolecular Engineering, The Ohio State University, Columbus, Ohio 43210, United States
| | - C J Lee
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611, United States
| | - V Mehar
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611, United States
| | - S Albertin
- Division of Synchrotron Radiation Research, Lund University, SE-22100 Lund, Sweden
| | - U Hejral
- Division of Synchrotron Radiation Research, Lund University, SE-22100 Lund, Sweden
| | - L R Merte
- Materials Science and Applied Mathematics, Malmö University, SE-205 06 Malmö, Sweden
| | - E Lundgren
- Division of Synchrotron Radiation Research, Lund University, SE-22100 Lund, Sweden
| | - A Asthagiri
- William G. Lowrie Chemical & Biomolecular Engineering, The Ohio State University, Columbus, Ohio 43210, United States
| | - J F Weaver
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611, United States
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Mcinnes I, Behrens F, Mease PJ, Kavanaugh A, Ritchlin CT, Nash P, Gratacos-Masmitja J, Goupille P, Korotaeva T, Gottlieb AB, Martin R, Ding K, Pellet P, Mpofu S, Pricop L. OP0227 SECUKINUMAB VERSUS ADALIMUMAB HEAD-TO-HEAD COMPARISON IN BIOLOGIC-NAÏVE PATIENTS WITH ACTIVE PSORIATIC ARTHRITIS THROUGH 52-WEEKS (EXCEED): A RANDOMISED, DOUBLE-BLIND, PHASE-3B STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Secukinumab (SEC), an interleukin-17A inhibitor, has demonstrated improvements on multiple domains of psoriatic arthritis (PsA).1Adalimumab (ADA), a TNF inhibitor, is widely used as a first–line biologic in PsA.Objectives:To report efficacy and safety outcomes from the head-to-head EXCEED trial (NCT02745080) that compares SECvs.ADA as first–line biologic monotherapy through 52-weeks (wks), with a musculoskeletal primary endpoint in pts with active PsA.Methods:Head-to-head, phase-3b, randomised, double-blind trial: biologic naïve active PsA pts were randomised to receive SEC 300mg subcutaneous at baseline, Wk1-4, and then every 4wks (q4w) until Wk48 or ADA 40mg subcutaneous at baseline and then q2w until Wk50. The primary endpoint was superiority of SECvs.ADA on ACR20 response at Wk52. Binary and continuous variables were analysed using logistic-regression model and MMRM, respectively. Safety analysis included patients who received ≥1 dose of study-drug.Results:853 pts were randomised to receive SEC (n=426) or ADA (n=427). Baseline demographics and disease characteristics were comparable between treatment-groups except higher proportion of female pts and pts without enthesitis in the SEC group. ACR20 response at Wk52 for SECvs.ADA were 67·4%vs.61·5%, respectively (p=0·0719) (Figure). Higher clinical responses were observed with SECvs.ADA for a range of musculoskeletal, skin, and higher-hurdle outcomes (Table). A higher retention rate was observed for SEC (85.7%)vs.ADA (76.3%). Safety profiles of SEC and ADA were consistent with previous reports.2,3Conclusion:Results suggest that SEC is at least as efficacious as ADA on musculoskeletal endpoints whilst providing higher responses on skin endpoints, and is associated with a higher retention rate. No new safety signals were reported.References:[1]van der Heijde, et al. Rheumatol. (Oxford).2019; DOI10.1093/rheumatology/kez420.[2]Deodhar A, et al. Arthritis Res Ther. 2019;21:111.[3]Burmester GR, et al. Ann Rheum Dis.2013; 72:517-24.Figure.ACR20 Response through Wk 52Table.Efficacy Outcomes at Wk 52Endpoints, % response unless specified otherwiseSEC 300 mg(N=426)ADA 40 mg(N=427)P-value (unadjusted)*ACR2067·461·50·0719aACR2066·959·50·0239Key SecondarybPASI 9065·443·2<0·0001ACR5049·044·80·2251HAQ-DI mean change from baseline ± SE-0·58 ± 0.03-0·56 ± 0.030·5465cResolution of enthesitis (based on LEI)60·554·20·1498ExploratoryMDA43·037·90·1498VLDA18·116·60·6107DAPSA LDA+Remission61·753·10·0178PASDAS LDA+Remission51·144·10·0557*Unadjusted P-valuesvsADABinary variables were analysed using logistic regression. Pts who discontinued study treatment prematurely or took csDMARDs after week-36 were considered non-responders. Multiple imputation was used for all other missing data. HAQ-DI mean change from baseline was analysed using mixed-effect model repeated measuresaNon-responder imputation was used for pre-specified sensitivity analysisbN=215 in SEC and N=202 in ADA in psoriasis subsetcN=234 in SEC and N=264 in ADA in enthesitis subsetDisclosure of Interests:Iain McInnes Grant/research support from: Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Janssen, and UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Gilead, Janssen, Novartis, Pfizer, and UCB, Frank Behrens Grant/research support from: Pfizer, Janssen, Chugai, Celgene, Lilly and Roche, Consultant of: Pfizer, AbbVie, Sanofi, Lilly, Novartis, Genzyme, Boehringer, Janssen, MSD, Celgene, Roche and Chugai, Philip J Mease Grant/research support from: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – grant/research support, Consultant of: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – consultant, Speakers bureau: Abbott, Amgen, Biogen Idec, BMS, Eli Lilly, Genentech, Janssen, Pfizer, UCB – speakers bureau, Arthur Kavanaugh Grant/research support from: Abbott, Amgen, AstraZeneca, BMS, Celgene Corporation, Centocor-Janssen, Pfizer, Roche, UCB – grant/research support, Christopher T. Ritchlin Grant/research support from: UCB Pharma, AbbVie, Amgen, Consultant of: UCB Pharma, Amgen, AbbVie, Lilly, Pfizer, Novartis, Gilead, Janssen, Peter Nash Grant/research support from: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Gilead, Janssen, MSD, Novartis, Pfizer Inc, Roche, Sanofi, UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, MSD, Novartis, Pfizer Inc, Roche, Sanofi, UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, MSD, Novartis, Pfizer Inc, Roche, Sanofi, UCB, Jordi Gratacos-Masmitja Grant/research support from: a grant from Pfizzer to study implementation of multidisciplinary units to manage PSA in SPAIN, Consultant of: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly, Speakers bureau: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly, Philippe Goupille Grant/research support from: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Lilly, Janssen, Medac, MSD France, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Consultant of: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Lilly, Janssen, Medac, MSD France, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Speakers bureau: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Lilly, Janssen, Medac, MSD France, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Tatiana Korotaeva Grant/research support from: Pfizer, Consultant of: Abbvie, BIOCAD, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Novartis-Sandoz, Pfizer, UCB, Speakers bureau: Abbvie, BIOCAD, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Novartis-Sandoz, Pfizer, UCB, Alice B Gottlieb Grant/research support from:: Research grants, consultation fees, or speaker honoraria for lectures from: Pfizer, AbbVie, BMS, Lilly, MSD, Novartis, Roche, Sanofi, Sandoz, Nordic, Celltrion and UCB., Consultant of:: Research grants, consultation fees, or speaker honoraria for lectures from: Pfizer, AbbVie, BMS, Lilly, MSD, Novartis, Roche, Sanofi, Sandoz, Nordic, Celltrion and UCB., Speakers bureau:: Research grants, consultation fees, or speaker honoraria for lectures from: Pfizer, AbbVie, BMS, Lilly, MSD, Novartis, Roche, Sanofi, Sandoz, Nordic, Celltrion and UCB., Ruvie Martin Shareholder of: Novartis, Employee of: Novartis, Kevin Ding Employee of: Novartis, Pascale Pellet Shareholder of: Novartis, Employee of: Novartis, Shephard Mpofu Shareholder of: Novartis, Employee of: Novartis, Luminita Pricop Shareholder of: Novartis, Employee of: Novartis
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Oczkowski A, Santos E, Gray A, Miller K, Huertas E, Hanson A, Martin R, Watson EB, Wigand C. Tracking the dynamic ecological history of a tropical urban estuary as it responds to human pressures. Ecosystems 2020; 23:231-245. [PMID: 32327932 DOI: 10.1007/s10021-019-00399-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Coastal cities in tropical areas are often low-lying and vulnerable to the effects of flooding and storms. San Juan, Puerto Rico is a good example of this. It is built around a lagoon-channel complex called the San Juan Bay Estuary (SJBE). A critical channel in the estuary, the Caño Martín Peña, has filled in and now frequently floods the surrounding communities with sewage-enriched waters, causing a series of human health and ecological problems. Sediment core analyses indicate that portions of the SJBE now function as settling basins. High urban and sewage runoff to the Caño contributes nitrogen (N), but stable isotope and sediment nutrient analyses indicate that this runoff may also enhance conditions for coupled sulfate reduction-nitrogen fixation. The amount of 'new' bioavailable N created from inert atmospheric N2 gas may meet or exceed that from the runoff into the Caño Martín Peña. The ecological consequences of this appear to extend beyond the ponded channel, potentially contributing to the poor water quality of the SJBE, greater than contaminated runoff alone.
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Affiliation(s)
- A Oczkowski
- US Environmental Protection Agency, Atlantic Ecology Division, 27 Tarzwell Drive, Narragansett, RI 02882
| | - E Santos
- Humboldt State University, College of Natural Resources and Sciences, 1 Harpst St. Arcata, CA 95521
| | - A Gray
- University of California, Riverside, Department of Environmental Sciences, Riverside, CA 92521
| | - K Miller
- CSRA LLC, 6361 Walker Lane Suite 300, Alexandria, VA 22310
| | - E Huertas
- US Environmental Protection Agency, Region 2 Caribbean Office, City View Plaza 2, Suite 7000 Guaynabo, PR 00968
| | - A Hanson
- US Environmental Protection Agency, Atlantic Ecology Division, 27 Tarzwell Drive, Narragansett, RI 02882
| | - R Martin
- Dataquest, 548 Market Street, 73537, San Francisco, CA 94104
| | - E B Watson
- The Academy of Natural Sciences of Drexel University, 1900 Benjamin Franklin Parkway, Philadelphia, PA 19103
| | - C Wigand
- US Environmental Protection Agency, Atlantic Ecology Division, 27 Tarzwell Drive, Narragansett, RI 02882
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Ericson Morgan G, Martin R, Welch H. Quantitative Weight Bearing and non-weight Bearing Measures of Stiffness in the Achilles Tendon and Gastrocnemius Muscle. Muscles Ligaments Tendons J 2020. [DOI: 10.32098/mltj.01.2020.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- G. Ericson Morgan
- Orthopaedics, Prince Charles Hospital, Merthyr Tudful, CF47 9DT, Wales, UK
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Abstract
We investigated adsorption of N2 on stoichiometric and O-rich IrO2(110) surfaces using temperature programmed desorption (TPD) experiments and density functional theory (DFT) calculations. TPD shows that N2 desorbs predominantly from the stoichiometric-IrO2(110) surface in a well-defined peak at 270 K for N2 coverages below about 0.5 ML and that a shoulder centered near 235 K develops in the N2 TPD traces as the coverage approaches saturation, indicating that adsorbed N2 molecules destabilize at high N2 coverages. Experiments of N2 adsorption onto O-rich IrO2(110) surfaces provide evidence that N2 adsorbs exclusively on the coordinatively unsaturated Ir atoms (Ircus) of the surface and that pre-adsorbed O-atoms ("on-top" oxygen) stabilize adsorbed N2 molecules, causing the main N2 TPD peak to shift toward higher temperature with increasing oxygen coverages. Consistent with prior results, our DFT calculations predict that an N2 molecule preferentially adsorbs into an upright configuration on an Ircus atom of the IrO2(110) surface and achieves a binding energy of about 100 kJ/mol. The computed binding energy agrees well with our experimental estimate of ∼90 kJ/mol for low N2 coverages on stoichiometric IrO2(110). The DFT calculations also quantitatively reproduce the observed stabilization of N2 by co-adsorption on-top O-atoms and predict the destabilization of N2 on IrO2(110) as the N2 adlayer becomes crowded at high coverages.
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Affiliation(s)
- R Martin
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611, USA
| | - M Kim
- William G. Lowrie Chemical and Biomolecular Engineering, The Ohio State University, Columbus, Ohio 43210, USA
| | - C J Lee
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611, USA
| | - M S Shariff
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611, USA
| | - F Feng
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611, USA
| | - R J Meyer
- ExxonMobil Research and Engineering, Annandale, New Jersey 08801, USA
| | - A Asthagiri
- William G. Lowrie Chemical and Biomolecular Engineering, The Ohio State University, Columbus, Ohio 43210, USA
| | - J F Weaver
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611, USA
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Coste Mazeau P, Hessas M, Martin R, Eyraud JL, Margueritte F, Aubard Y, Sallee C, Sire F, Gauthier T. Is there an interest in repeating the vaginal administration of dinoprostone (Propess®), to promote induction of labor of pregnant women at term? (RE-DINO): study protocol for a randomized controlled trial. Trials 2020; 21:51. [PMID: 31915047 PMCID: PMC6950885 DOI: 10.1186/s13063-019-3985-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 12/11/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Labor is induced in over 20% of women in France. Prostaglandins, especially intravaginal dinoprostone (Propess®), are widely used to initiate cervical ripening. If labor does not start within 24 h, there is uncertainty about whether to administer a second dinoprostone pessary or to use oxytocin to induce labor in order to achieve a vaginal delivery. METHODS RE-DINO is a prospective, open-label, multicenter, randomized superiority trial with two parallel arms running in six French hospitals. A total of 360 patients ≥ 18 years of age at > 37 weeks of gestation who exhibit unfavorable cervical conditions (Bishop score < 6) 24 h after placement of the first Propess®, with fetuses in cephalic presentation, will be included. Patients with premature membrane rupture, uterine scars, or multiple pregnancies will be excluded. Our principal objective is to determine whether placement of a second Propess® (followed by oxytocin [Syntocinon®], if necessary) in women for whom the first Propess® failed to induce cervical ripening increases the vaginal delivery rate compared to direct oxytocin injection. The vaginal delivery rate is therefore the primary outcome. The secondary outcomes are the induction failure rates and maternofetal morbidity and mortality. DISCUSSION This study may help in determining the optimal way to induce labor after failure of a first Propess®, an unresolved problem to date. This trial explores the effectiveness and safety of placing a second Propess® and may contribute to development of an obstetric consensus. TRIAL REGISTRATION Registered on 2 September 2016 at clinicaltrials.gov (identification number NCT02888041).
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Affiliation(s)
- P Coste Mazeau
- Department of Gynaecology and Obstetrics, Mother and Children's Hospital, Limoges Regional University Hospitals, 8 Avenue Dominique Larrey, 87000, Limoges, France.
| | - M Hessas
- Department of Gynaecology and Obstetrics, Mother and Children's Hospital, Limoges Regional University Hospitals, 8 Avenue Dominique Larrey, 87000, Limoges, France
| | - R Martin
- Clinical Investigation Center, CHRU Limoges, 2 Avenue Dominique Larrey, 87000, Limoges, France
| | - J-L Eyraud
- Department of Gynaecology and Obstetrics, Mother and Children's Hospital, Limoges Regional University Hospitals, 8 Avenue Dominique Larrey, 87000, Limoges, France
| | - F Margueritte
- Department of Gynaecology and Obstetrics, Mother and Children's Hospital, Limoges Regional University Hospitals, 8 Avenue Dominique Larrey, 87000, Limoges, France
| | - Y Aubard
- Department of Gynaecology and Obstetrics, Mother and Children's Hospital, Limoges Regional University Hospitals, 8 Avenue Dominique Larrey, 87000, Limoges, France
| | - C Sallee
- Department of Gynaecology and Obstetrics, Mother and Children's Hospital, Limoges Regional University Hospitals, 8 Avenue Dominique Larrey, 87000, Limoges, France
| | - F Sire
- Department of Gynaecology and Obstetrics, Mother and Children's Hospital, Limoges Regional University Hospitals, 8 Avenue Dominique Larrey, 87000, Limoges, France
| | - T Gauthier
- Department of Gynaecology and Obstetrics, Mother and Children's Hospital, Limoges Regional University Hospitals, 8 Avenue Dominique Larrey, 87000, Limoges, France
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Moine T, Martin R, Lairez O, Lapebie F, Cazalbou S, Bataille V, Labrunee M, Biendel-Piquet C, Galinier M, Elbaz M, Delmas C, Bura-Riviere A. Post-pulmonary embolism syndrome phenotyping with systematic multiparametric evaluation: A Prospective Study on 153 patients. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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McCleary BV, McNally M, Monaghan D, Mugford DC, Black C, Broadbent R, Chin M, Cormack M, Fox R, Gaines C, Gothard P, Home S, Howes; E, Johnson C, Keeping R, Koliatsou M, Lindhauer M, Marins de Sa R, Martin R, Monaghan D, Nees U, Nishwitz; R, Palmer G, Panozzo J, Recabarren J, Roumeliotis S, Seddig S, Solah V, Sonnet M, Themeier H. Measurement of α-Amylase Activity in White Wheat Flour, Milled Malt, and Microbial Enzyme Preparations, Using the Ceralpha Assay: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/85.5.1096] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [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
This study was conducted to evaluate the method performance of a rapid procedure for the measurement of α-amylase activity in flours and microbial enzyme preparations. Samples were milled (if necessary) to pass a 0.5 mm sieve and then extracted with a buffer/salt solution, and the extracts were clarified and diluted. Aliquots of diluted extract (containing α-amylase) were incubated with substrate mixture under defined conditions of pH, temperature, and time. The substrate used was nonreducing end-blocked p-nitrophenyl maltoheptaoside (BPNPG7) in the presence of excess quantities of thermostable α-glucosidase. The blocking group in BPNPG7 prevents hydrolysis of this substrate by exo-acting enzymes such as amyloglucosidase, α-glucosidase, and β-amylase. When the substrate is cleaved by endo-acting α-amylase, the nitrophenyl oligosaccharide is immediately and completely hydrolyzed to p-nitrophenol and free glucose by the excess quantities of α-glucosidase present in the substrate mixture. The reaction is terminated, and the phenolate color developed by the addition of an alkaline solution is measured at 400 nm. Amylase activity is expressed in terms of Ceralpha units; 1 unit is defined as the amount of enzyme required to release 1 μmol p-nitrophenyl (in the presence of excess quantities of α-glucosidase) in 1 min at 40°C. In the present study, 15 laboratories analyzed 16 samples as blind duplicates. The analyzed samples were white wheat flour, white wheat flour to which fungal α-amylase had been added, milled malt, and fungal and bacterial enzyme preparations. Repeatability relative standard deviations ranged from 1.4 to 14.4%, and reproducibility relative standard deviations ranged from 5.0 to 16.7%.
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Affiliation(s)
- Barry V McCleary
- Megazyme International Ireland Ltd., Bray Business Park, Bray, County Wicklow, Ireland
| | - Marian McNally
- Megazyme International Ireland Ltd., Bray Business Park, Bray, County Wicklow, Ireland
| | - Dympna Monaghan
- Megazyme International Ireland Ltd., Bray Business Park, Bray, County Wicklow, Ireland
| | - David C Mugford
- BRI Australia Ltd., North Ryde, New South Wales 2113, Australia
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Casas F, Sánchez D, Boada M, Munoz D, Cabrera C, Martin R, Martinez D, Paredes P, Vollmer I, Cortes K, Barreto T, Oses G, Parera M, Castillo S. P2.18-19 Radiological and Pathological Response to the Induction of Surgery in the NSCLC Stage III. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1973] [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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Lowe A, Martin R. 15AN EVALUATION OF THE CURRENT USE OF THE CWM TAF DELIRIUM PATHWAY AND THE DEVELOPMENT OF SUPPLEMENTARY EDUCATIONAL MATERIAL. Age Ageing 2019. [DOI: 10.1093/ageing/afz055.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Lowe
- Cardiff University, Wales
| | - R Martin
- Royal Glamorgan Hospital, Llantrisant, Wales
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Braun J, Haibel H, de Hooge M, Landewé R, Rudwaleit M, Fox T, Readie A, Richards HB, Porter B, Martin R, Poddubnyy D, Sieper J, van der Heijde D. Spinal radiographic progression over 2 years in ankylosing spondylitis patients treated with secukinumab: a historical cohort comparison. Arthritis Res Ther 2019; 21:142. [PMID: 31174584 PMCID: PMC6555995 DOI: 10.1186/s13075-019-1911-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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: 11/29/2018] [Accepted: 05/07/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare radiographic progression in patients with ankylosing spondylitis (AS) treated for up to 2 years with secukinumab (MEASURE 1) with a historical cohort of biologic-naïve patients treated with NSAIDs (ENRADAS). METHODS Baseline and 2-year lateral cervical and lumbar spine radiographs were independently evaluated using mSASSS by two readers, who were blinded to the chronology and cohort of the radiographs. The primary endpoint was the proportion of patients with no radiographic progression (mSASSS change ≤ 0 from baseline to year 2). The Primary Analysis Set included patients with baseline (≤ day 30) and post-baseline day 31-743 radiographs. Sensitivity analyses were performed to assess the robustness of the comparison between the two cohorts, as follows: Sensitivity Analysis Set 1 included all patients with baseline (≤ day 30) and year 2 (days 640-819) radiographs; Sensitivity Analysis Set 2 included all patients with baseline and post-baseline (> day 30) radiographs. RESULTS A total of 168 patients (84%) from the MEASURE 1 cohort and 69 (57%) from the ENRADAS cohort qualified for the Primary Analysis Set. Over 2 years, the LS (SE) mean change from baseline in mSASSS for the primary analysis was 0.55 (0.139) for MEASURE 1 vs 0.89 (0.216) for ENRADAS (p = 0.1852). Mean changes from baseline in mSASSS were lower in MEASURE 1 vs ENRADAS for the primary and sensitivity analyses. The proportion of patients with no radiographic progression was consistently higher in the MEASURE 1 vs ENRADAS cohort across all cutoffs for no radiographic progression (change in mSASSS from baseline to year 2 of ≤ 0, ≤ 0.5, ≤ 1, and ≤ 2), but the differences were not statistically significant. CONCLUSION Secukinumab-treated patients demonstrated a numerical, but statistically non-significant, higher proportion of non-progressors and lower change in mSASSS over 2 years versus a cohort of biologic-naïve patients treated with NSAIDs.
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Affiliation(s)
- J Braun
- Rheumazentrum Herne, Herne, Germany.
| | - H Haibel
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - M de Hooge
- VIB Inflammation Research Center, Ghent University, Ghent, Belgium
| | - R Landewé
- Maastricht University Medical Center, Maastricht, Netherlands
| | | | - T Fox
- Novartis Pharma AG, Basel, Switzerland
| | - A Readie
- Novartis Pharmaceuticals Corporation, East Hanover, USA
| | | | - B Porter
- Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - R Martin
- Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - D Poddubnyy
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - J Sieper
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - D van der Heijde
- VIB Inflammation Research Center, Ghent University, Ghent, Belgium
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Martin R, Arden M, Porritt J, Wildman M, Naughton F. P418 A pilot study using the CFHealthHub digital platform to investigate the relationship between adherence to treatment and symptoms in people with cystic fibrosis. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30710-6] [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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Achtnichts L, Chan A, Czaplinski A, Derfuss T, Du Pasquier R, Findling O, Gobbi C, Hoepner R, Kamber N, Kamm CP, Kuhle J, Lalive P, Lutterotti A, Martin R, Müller S, Papadopoulou A, Pot C, Salmen A, Schippling S, Zecca C. Specific aspects of immunotherapy for multiple sclerosis in Switzerland: A structured commentary. Clinical and Translational Neuroscience 2019. [DOI: 10.1177/2514183x18822073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
More than a dozen substances are meanwhile available for the disease-modifying immunotherapy of multiple sclerosis (MS). However, for some substances, there is a clear difference between approval in Switzerland (Swissmedic) and neighboring countries (European Medicines Agency (EMA)). In addition, limitations imposed by the Swiss Federal Office of Public Health in the specialties list (SL) have significant effects on use in daily clinical practice. In the following, we present consensus recommendations, which were reviewed and agreed upon by the Scientific Advisory Board of the Swiss Multiple Sclerosis Society and the Swiss Neurological Society. We explicitly focus on practice-relevant differences in the approval of MS immunotherapies in Switzerland compared with the EMA area and discuss further limitations (SL) and their impact on the use in clinical practice. Immunotherapies with the same approval in Switzerland and the EMA area and symptomatic therapies are not discussed here.
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Affiliation(s)
- L Achtnichts
- Department of Neurology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - A Chan
- Department of Neurology, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - T Derfuss
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - R Du Pasquier
- Division of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
| | - O Findling
- Department of Neurology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - C Gobbi
- Division of Neurology, Multiple Sclerosis Center, Neurocenter of Southern Switzerland, Ospedale Regionale, Lugano, Switzerland
| | - R Hoepner
- Department of Neurology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - N Kamber
- Department of Neurology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - CP Kamm
- Department of Neurology, Bern University Hospital, University of Bern, Bern, Switzerland
- Neurology and Neurorehabilitation Center, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - J Kuhle
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - P Lalive
- Department of Neurosciences, Division of Neurology, Unit of Neuroimmunology and Neuromuscular Diseases, University Hospital of Geneva, Geneva, Switzerland
| | - A Lutterotti
- Neuroimmunology and Multiple Sclerosis Research (nims), Department of Neurology, University Hospital Zurich and University of Zurich, Zürich, Switzerland
| | - R Martin
- Neuroimmunology and Multiple Sclerosis Research (nims), Department of Neurology, University Hospital Zurich and University of Zurich, Zürich, Switzerland
| | - S Müller
- Department of Neurology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - A Papadopoulou
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - C Pot
- Division of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
| | - A Salmen
- Department of Neurology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - S Schippling
- Neuroimmunology and Multiple Sclerosis Research (nims), Department of Neurology, University Hospital Zurich and University of Zurich, Zürich, Switzerland
- Neuroscience Center Zurich, University of Zurich and Federal Institute of Technology (ETH) Zurich, Zürich, Switzerland
| | - C Zecca
- Division of Neurology, Multiple Sclerosis Center, Neurocenter of Southern Switzerland, Ospedale Regionale, Lugano, Switzerland
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McLean K, Glasbey J, Borakati A, Brooks T, Chang H, Choi S, Goodson R, Nielsen M, Pronin S, Salloum N, Sewart E, Vanniasegaram D, Drake T, Gillies M, Harrison E, Chapman S, Khatri C, Kong C, Claireaux H, Bath M, Mohan M, McNamee L, Kelly M, Mitchell H, Fitzgerald J, Bhangu A, Nepogodiev D, Antoniou I, Dean R, Davies N, Trecarten S, Henderson I, Holmes C, Wylie J, Shuttleworth R, Jindal A, Hughes F, Gouda P, Fleck R, Hanrahan M, Karunakaran P, Chen J, Sykes M, Sethi R, Suresh S, Patel P, Patel M, Varma R, Mushtaq J, Gundogan B, Bolton W, Khan T, Burke J, Morley R, Favero N, Adams R, Thirumal V, Kennedy E, Ong K, Tan Y, Gabriel J, Bakhsh A, Low J, Yener A, Paraoan V, Preece R, Tilston T, Cumber E, Dean S, Ross T, McCance E, Amin H, Satterthwaite L, Clement K, Gratton R, Mills E, Chiu S, Hung G, Rafiq N, Hayes J, Robertson K, Dynes K, Huang H, Assadullah S, Duncumb J, Moon R, Poo S, Mehta J, Joshi K, Callan R, Norris J, Chilvers N, Keevil H, Jull P, Mallick S, Elf D, Carr L, Player C, Barton E, Martin A, Ratu S, Roberts E, Phan P, Dyal A, Rogers J, Henson A, Reid N, Burke D, Culleton G, Lynne S, Mansoor S, Brennan C, Blessed R, Holloway C, Hill A, Goldsmith T, Mackin S, Kim S, Woin E, Brent G, Coffin J, Ziff O, Momoh Z, Debenham R, Ahmed M, Yong C, Wan J, Copley H, Raut P, Chaudhry F, Nixon G, Dorman C, Tan R, Kanabar S, Canning N, Dolaghan M, Bell N, McMenamin M, Chhabra A, Duke K, Turner L, Patel T, Chew L, Mirza M, Lunawat S, Oremule B, Ward N, Khan M, Tan E, Maclennan D, McGregor R, Chisholm E, Griffin E, Bell L, Hughes B, Davies J, Haq H, Ahmed H, Ungcharoen N, Whacha C, Thethi R, Markham R, Lee A, Batt E, Bullock N, Francescon C, Davies J, Shafiq N, Zhao J, Vivekanantham S, Barai I, Allen J, Marshall D, McIntyre C, Wilson H, Ashton A, Lek C, Behar N, Davis-Hall M, Seneviratne N, Esteve L, Sirakaya M, Ali S, Pope S, Ahn J, Craig-McQuaide A, Gatfield W, Leong S, Demetri A, Kerr A, Rees C, Loveday J, Liu S, Wijesekera M, Maru D, Attalla M, Smith N, Brown D, Sritharan P, Shah A, Charavanamuttu V, Heppenstall-Harris G, Ng K, Raghvani T, Rajan N, Hulley K, Moody N, Williams M, Cotton A, Sharifpour M, Lwin K, Bright M, Chitnis A, Abdelhadi M, Semana A, Morgan F, Reid R, Dickson J, Anderson L, McMullan R, Ahern N, Asmadi A, Anderson L, Boon Xuan JL, Crozier L, McAleer S, Lees D, Adebayo A, Das M, Amphlett A, Al-Robeye A, Valli A, Khangura J, Winarski A, Ali A, Woodward H, Gouldthrope C, Turner M, Sasapu K, Tonkins M, Wild J, Robinson M, Hardie J, Heminway R, Narramore R, Ramjeeawon N, Hibberd A, Winslow F, Ho W, Chong B, Lim K, Ho S, Crewdson J, Singagireson S, Kalra N, Koumpa F, Jhala H, Soon W, Karia M, Rasiah M, Xylas D, Gilbert H, Sundar-Singh M, Wills J, Akhtar S, Patel S, Hu L, Brathwaite-Shirley C, Nayee H, Amin O, Rangan T, Turner E, McCrann C, Shepherd R, Patel N, Prest-Smith J, Auyoung E, Murtaza A, Coates A, Prys-Jones O, King M, Gaffney S, Dewdney C, Nehikhare I, Lavery J, Bassett J, Davies K, Ahmad K, Collins A, Acres M, Egerton C, Cheng K, Chen X, Chan N, Sheldon A, Khan S, Empey J, Ingram E, Malik A, Johnstone M, Goodier R, Shah J, Giles J, Sanders J, McLure S, Pal S, Rangedara A, Baker A, Asbjoernsen C, Girling C, Gray L, Gauntlett L, Joyner C, Qureshi S, Mogan Y, Ng J, Kumar A, Park J, Tan D, Choo K, Raman K, Buakuma P, Xiao C, Govinden S, Thompson O, Charalambos M, Brown E, Karsan R, Dogra T, Bullman L, Dawson P, Frank A, Abid H, Tung L, Qureshi U, Tahmina A, Matthews B, Harris R, O'Connor A, Mazan K, Iqbal S, Stanger S, Thompson J, Sullivan J, Uppal E, MacAskill A, Bamgbose F, Neophytou C, Carroll A, Rookes C, Datta U, Dhutia A, Rashid S, Ahmed N, Lo T, Bhanderi S, Blore C, Ahmed S, Shaheen H, Abburu S, Majid S, Abbas Z, Talukdar S, Burney L, Patel J, Al-Obaedi O, Roberts A, Mahboob S, Singh B, Sheth S, Karia P, Prabhudesai A, Kow K, Koysombat K, Wang S, Morrison P, Maheswaran Y, Keane P, Copley P, Brewster O, Xu G, Harries P, Wall C, Al-Mousawi A, Bonsu S, Cunha P, Ward T, Paul J, Nadanakumaran K, Tayeh S, Holyoak H, Remedios J, Theodoropoulou K, Luhishi A, Jacob L, Long F, Atayi A, Sarwar S, Parker O, Harvey J, Ross H, Rampal R, Thomas G, Vanmali P, McGowan C, Stein J, Robertson V, Carthew L, Teng V, Fong J, Street A, Thakker C, O'Reilly D, Bravo M, Pizzolato A, Khokhar H, Ryan M, Cheskes L, Carr R, Salih A, Bassiony S, Yuen R, Chrastek D, Rosen O'Sullivan H, Amajuoyi A, Wang A, Sitta O, Wye J, Qamar M, Major C, Kaushal A, Morgan C, Petrarca M, Allot R, Verma K, Dutt S, Chilima C, Peroos S, Kosasih S, Chin H, Ashken L, Pearse R, O'Loughlin R, Menon A, Singh K, Norton J, Sagar R, Jathanna N, Rothwell L, Watson N, Harding F, Dube P, Khalid H, Punjabi N, Sagmeister M, Gill P, Shahid S, Hudson-Phillips S, George D, Ashwood J, Lewis T, Dhar M, Sangal P, Rhema I, Kotecha D, Afzal Z, Syeed J, Prakash E, Jalota P, Herron J, Kimani L, Delport A, Shukla A, Agarwal V, Parthiban S, Thakur H, Cymes W, Rinkoff S, Turnbull J, Hayat M, Darr S, Khan U, Lim J, Higgins A, Lakshmipathy G, Forte B, Canning E, Jaitley A, Lamont J, Toner E, Ghaffar A, McDowell M, Salmon D, O'Carroll O, Khan A, Kelly M, Clesham K, Palmer C, Lyons R, Bell A, Chin R, Waldron R, Trimble A, Cox S, Ashfaq U, Campbell J, Holliday R, McCabe G, Morris F, Priestland R, Vernon O, Ledsam A, Vaughan R, Lim D, Bakewell Z, Hughes R, Koshy R, Jackson H, Narayan P, Cardwell A, Jubainville C, Arif T, Elliott L, Gupta V, Bhaskaran G, Odeleye A, Ahmed F, Shah R, Pickard J, Suleman Y, North A, McClymont L, Hussain N, Ibrahim I, Ng G, Wong V, Lim A, Harris L, Tharmachandirar T, Mittapalli D, Patel V, Lakhani M, Bazeer H, Narwani V, Sandhu K, Wingfield L, Gentry S, Adjei H, Bhatti M, Braganza L, Barnes J, Mistry S, Chillarge G, Stokes S, Cleere J, Wadanamby S, Bucko A, Meek J, Boxall N, Heywood E, Wiltshire J, Toh C, Ward A, Shurovi B, Horth D, Patel B, Ali B, Spencer T, Axelson T, Kretzmer L, Chhina C, Anandarajah C, Fautz T, Horst C, Thevathasan A, Ng J, Hirst F, Brewer C, Logan A, Lockey J, Forrest P, Keelty N, Wood A, Springford L, Avery P, Schulz T, Bemand T, Howells L, Collier H, Khajuria A, Tharakan R, Parsons S, Buchan A, McGalliard R, Mason J, Cundy O, Li N, Redgrave N, Watson R, Pezas T, Dennis Y, Segall E, Hameed M, Lynch A, Chamberlain M, Peck F, Neo Y, Russell G, Elseedawy M, Lee S, Foster N, Soo Y, Puan L, Dennis R, Goradia H, Qureshi A, Osman S, Reeves T, Dinsmore L, Marsden M, Lu Q, Pitts-Tucker T, Dunn C, Walford R, Heathcote E, Martin R, Pericleous A, Brzyska K, Reid K, Williams M, Wetherall N, McAleer E, Thomas D, Kiff R, Milne S, Holmes M, Bartlett J, Lucas de Carvalho J, Bloomfield T, Tongo F, Bremner R, Yong N, Atraszkiewicz B, Mehdi A, Tahir M, Sherliker G, Tear A, Pandey A, Broyd A, Omer H, Raphael M, Chaudhry W, Shahidi S, Jawad A, Gill C, Fisher IH, Adeleja I, Clark I, Aidoo-Micah G, Stather P, Salam G, Glover T, Deas G, Sim N, Obute R, Wynell-Mayow W, Sait M, Mitha N, de Bernier G, Siddiqui M, Shaunak R, Wali A, Cuthbert G, Bhudia R, Webb E, Shah S, Ansari N, Perera M, Kelly N, McAllister R, Stanley G, Keane C, Shatkar V, Maxwell-Armstrong C, Henderson L, Maple N, Manson R, Adams R, Semple E, Mills M, Daoub A, Marsh A, Ramnarine A, Hartley J, Malaj M, Jewell P, Whatling E, Hitchen N, Chen M, Goh B, Fern J, Rogers S, Derbyshire L, Robertson D, Abuhussein N, Deekonda P, Abid A, Harrison P, Aildasani L, Turley H, Sherif M, Pandey G, Filby J, Johnston A, Burke E, Mohamud M, Gohil K, Tsui A, Singh R, Lim S, O'Sullivan K, McKelvey L, O'Neill S, Roberts H, Brown F, Cao Y, Buckle R, Liew Y, Sii S, Ventre C, Graham C, Filipescu T, Yousif A, Dawar R, Wright A, Peters M, Varley R, Owczarek S, Hartley S, Khattak M, Iqbal A, Ali M, Durrani B, Narang Y, Bethell G, Horne L, Pinto R, Nicholls K, Kisyov I, Torrance H, English W, Lakhani S, Ashraf S, Venn M, Elangovan V, Kazmi Z, Brecher J, Sukumar S, Mastan A, Mortimer A, Parker J, Boyle J, Elkawafi M, Beckett J, Mohite A, Narain A, Mazumdar E, Sreh A, Hague A, Weinberg D, Fletcher L, Steel M, Shufflebotham H, Masood M, Sinha Y, Jenvey C, Kitt H, Slade R, Craig A, Deall C, Reakes T, Chervenkoff J, Strange E, O'Bryan M, Murkin C, Joshi D, Bergara T, Naqib S, Wylam D, Scotcher S, Hewitt C, Stoddart M, Kerai A, Trist A, Cole S, Knight C, Stevens S, Cooper G, Ingham R, Dobson J, O'Kane A, Moradzadeh J, Duffy A, Henderson C, Ashraf S, McLaughin C, Hoskins T, Reehal R, Bookless L, McLean R, Stone E, Wright E, Abdikadir H, Roberts C, Spence O, Srikantharajah M, Ruiz E, Matthews J, Gardner E, Hester E, Naran P, Simpson R, Minhas M, Cornish E, Semnani S, Rojoa D, Radotra A, Eraifej J, Eparh K, Smith D, Mistry B, Hickling S, Din W, Liu C, Mithrakumar P, Mirdavoudi V, Rashid M, Mcgenity C, Hussain O, Kadicheeni M, Gardner H, Anim-Addo N, Pearce J, Aslanyan A, Ntala C, Sorah T, Parkin J, Alizadeh M, White A, Edozie F, Johnston J, Kahar A, Navayogaarajah V, Patel B, Carter D, Khonsari P, Burgess A, Kong C, Ponweera A, Cody A, Tan Y, Ng A, Croall A, Allan C, Ng S, Raghuvir V, Telfer R, Greenhalgh A, McKerr C, Edison M, Patel B, Dear K, Hardy M, Williams P, Hassan S, Sajjad U, O'Neill E, Lopes S, Healy L, Jamal N, Tan S, Lazenby D, Husnoo S, Beecroft S, Sarvanandan T, Weston C, Bassam N, Rabinthiran S, Hayat U, Ng L, Varma D, Sukkari M, Mian A, Omar A, Kim J, Sellathurai J, Mahmood J, O'Connell C, Bose R, Heneghan H, Lalor P, Matheson J, Doherty C, Cullen C, Cooper D, Angelov S, Drislane C, Smith A, Kreibich A, Palkhi E, Durr A, Lotfallah A, Gold D, Mckean E, Dhanji A, Anilkumar A, Thacoor A, Siddiqui Z, Lim S, Piquet A, Anderson S, McCormack D, Gulati J, Ibrahim A, Murray S, Walsh S, McGrath A, Ziprin P, Chua E, Lou C, Bloomer J, Paine H, Osei-Kuffour D, White C, Szczap A, Gokani S, Patel K, Malys M, Reed A, Torlot G, Cumber E, Charania A, Ahmad S, Varma N, Cheema H, Austreng L, Petra H, Chaudhary M, Zegeye M, Cheung F, Coffey D, Heer R, Singh S, Seager E, Cumming S, Suresh R, Verma S, Ptacek I, Gwozdz A, Yang T, Khetarpal A, Shumon S, Fung T, Leung W, Kwang P, Chew L, Loke W, Curran A, Chan C, McGarrigle C, Mohan K, Cullen S, Wong E, Toale C, Collins D, Keane N, Traynor B, Shanahan D, Yan A, Jafree D, Topham C, Mitrasinovic S, Omara S, Bingham G, Lykoudis P, Miranda B, Whitehurst K, Kumaran G, Devabalan Y, Aziz H, Shoa M, Dindyal S, Yates J, Bernstein I, Rattan G, Coulson R, Stezaker S, Isaac A, Salem M, McBride A, McFarlane H, Yow L, MacDonald J, Bartlett R, Turaga S, White U, Liew W, Yim N, Ang A, Simpson A, McAuley D, Craig E, Murphy L, Shepherd P, Kee J, Abdulmajid A, Chung A, Warwick H, Livesey A, Holton P, Theodoreson M, Jenkin S, Turner J, Entwisle J, Marchal S, O'Connor S, Blege H, Aithie J, Sabine L, Stewart G, Jackson S, Kishore A, Lankage C, Acquaah F, Joyce H, McKevitt K, Coffey C, Fawaz A, Dolbec K, O'Sullivan D, Geraghty J, Lim E, Bolton L, FitzPatrick D, Robinson C, Ramtoola T, Collinson S, Grundy L, McEnhill P, Harbhajan Singh G, Loughran D, Golding D, Keeling R, Williams R, Whitham R, Yoganathan S, Nachiappan R, Egan R, Owasil R, Kwan M, He A, Goh R, Bhome R, Wilson H, Teoh P, Raji K, Jayakody N, Matthams J, Chong J, Luk C, Greig R, Trail M, Charalambous G, Rocke A, Gardiner N, Bulley F, Warren N, Brennan E, Fergurson P, Wilson R, Whittingham H, Brown E, Khanijau R, Gandhi K, Morris S, Boulton A, Chandan N, Barthorpe A, Maamari R, Sandhu S, McCann M, Higgs L, Balian V, Reeder C, Diaper C, Sale T, Ali H, Archer C, Clarke A, Heskin J, Hurst P, Farmer J, O'Flynn L, Doan L, Shuker B, Stott G, Vithanage N, Hoban K, Nesargikar P, Kennedy H, Grossart C, Tan E, Roy C, Sim P, Leslie K, Sim D, Abul M, Cody N, Tay A, Woon E, Sng S, Mah J, Robson J, Shakweh E, Wing V, Mills H, Li M, Barrow T, Balaji S, Jordan H, Phillips C, Naveed H, Hirani S, Tai A, Ratnakumaran R, Sahathevan A, Shafi A, Seedat M, Weaver R, Batho A, Punj R, Selvachandran H, Bhatt N, Botchey S, Khonat Z, Brennan K, Morrison C, Devlin E, Linton A, Galloway E, McGarvie S, Ramsay N, McRobbie H, Whewell H, Dean W, Nelaj S, Eragat M, Mishra A, Kane T, Zuhair M, Wells M, Wilkinson D, Woodcock N, Sun E, Aziz N, Ghaffar MKA. Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study. Br J Anaesth 2019; 122:42-50. [PMID: 30579405 DOI: 10.1016/j.bja.2018.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. METHODS This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. RESULTS Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. CONCLUSIONS After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.
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Schulmeister T, Martin R, Silva G, Garcia-Ascolani M, Ciriaco F, Henry D, Lamb G, Dubeux J, DiLorenzo N. 62 Characterization of the dietary protein in Brassica carinata meal when used as a supplement for beef cattle. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- T Schulmeister
- North Florida Research and Education Center, University of Florida,Marianna, FL, United States
| | - R Martin
- University of Florida, North Florida Research and Education Center,Gainesville, FL, United States
| | - G Silva
- North Florida Research and Education Center, University of Florida,Gainesville, FL, United States
| | - M Garcia-Ascolani
- University of Florida, North Florida Research and Education Center,Gainesville, FL, United States
| | - F Ciriaco
- North Florida Research and Education Center, University of Florida,Marianna, FL, United States
| | - D Henry
- Department of Animal and Food Sciences, Texas Tech University,Lubbock, TX, United States
| | - G Lamb
- Texas A&M University - Department of Animal Science,College Station, TX, United States
| | - J Dubeux
- North Florida Research and Education Center, University of Florida,Marianna, FL, United States
| | - N DiLorenzo
- North Florida Research and Education Center, University of Florida,Marianna, FL, United States
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Henry D, Ciriaco F, Araujo R, Fontes P, Oosthuizen N, Garcia-Ascolani M, Sanford C, Schulmeister T, Martin R, Dubeux J, Rostoll-Cangiano L, Lamb G, DiLorenzo N. 74 Effects of bismuth subsalicylate and encapsulated calcium-ammonium nitrate on enteric methane production and apparent total-tract nutrient digestibility of beef cattle. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- D Henry
- Department of Animal and Food Sciences, Texas Tech University,Lubbock, TX, United States
| | - F Ciriaco
- North Florida Research and Education Center, University of Florida,Marianna, FL, United States
| | - R Araujo
- GRASP Indústria e Comércio LTDA,Curitiba, Brazil
| | - P Fontes
- Texas A&M University - Department of Animal Science,College Station, TX, United States
| | - N Oosthuizen
- Texas A&M University - Department of Animal Science,College Station, TX, United States
| | - M Garcia-Ascolani
- University of Florida, North Florida Research and Education Center,Gainesville, FL, United States
| | - C Sanford
- North Florida Research and Education Center, University of Florida,Marianna, FL, United States
| | - T Schulmeister
- North Florida Research and Education Center, University of Florida,Marianna, FL, United States
| | - R Martin
- University of Florida, North Florida Research and Education Center,Gainesville, FL, United States
| | - J Dubeux
- North Florida Research and Education Center, University of Florida,Gainesville, FL, United States
| | - L Rostoll-Cangiano
- North Florida Research and Education Center, University of Florida,Gainesville, FL, United States
| | - G Lamb
- Texas A&M University - Department of Animal Science,College Station, TX, United States
| | - N DiLorenzo
- North Florida Research and Education Center, University of Florida,Marianna, FL, United States
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Sándor R, Ehrhardt F, Brilli L, Carozzi M, Recous S, Smith P, Snow V, Soussana JF, Dorich CD, Fuchs K, Fitton N, Gongadze K, Klumpp K, Liebig M, Martin R, Merbold L, Newton PCD, Rees RM, Rolinski S, Bellocchi G. The use of biogeochemical models to evaluate mitigation of greenhouse gas emissions from managed grasslands. Sci Total Environ 2018; 642:292-306. [PMID: 29902627 DOI: 10.1016/j.scitotenv.2018.06.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 05/15/2018] [Accepted: 06/02/2018] [Indexed: 06/08/2023]
Abstract
Simulation models quantify the impacts on carbon (C) and nitrogen (N) cycling in grassland systems caused by changes in management practices. To support agricultural policies, it is however important to contrast the responses of alternative models, which can differ greatly in their treatment of key processes and in their response to management. We applied eight biogeochemical models at five grassland sites (in France, New Zealand, Switzerland, United Kingdom and United States) to compare the sensitivity of modelled C and N fluxes to changes in the density of grazing animals (from 100% to 50% of the original livestock densities), also in combination with decreasing N fertilization levels (reduced to zero from the initial levels). Simulated multi-model median values indicated that input reduction would lead to an increase in the C sink strength (negative net ecosystem C exchange) in intensive grazing systems: -64 ± 74 g C m-2 yr-1 (animal density reduction) and -81 ± 74 g C m-2 yr-1 (N and animal density reduction), against the baseline of -30.5 ± 69.5 g C m-2 yr-1 (LSU [livestock units] ≥ 0.76 ha-1 yr-1). Simulations also indicated a strong effect of N fertilizer reduction on N fluxes, e.g. N2O-N emissions decreased from 0.34 ± 0.22 (baseline) to 0.1 ± 0.05 g N m-2 yr-1 (no N fertilization). Simulated decline in grazing intensity had only limited impact on the N balance. The simulated pattern of enteric methane emissions was dominated by high model-to-model variability. The reduction in simulated offtake (animal intake + cut biomass) led to a doubling in net primary production per animal (increased by 11.6 ± 8.1 t C LSU-1 yr-1 across sites). The highest N2O-N intensities (N2O-N/offtake) were simulated at mown and extensively grazed arid sites. We show the possibility of using grassland models to determine sound mitigation practices while quantifying the uncertainties associated with the simulated outputs.
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Affiliation(s)
- Renáta Sándor
- INRA, VetAgro Sup, UCA, Unité Mixte de Recherche sur l'Écosystème Prairial (UREP), 63000 Clermont-Ferrand, France; Agricultural Institute, CAR HAS, 2462 Martonvásár, Hungary
| | | | - Lorenzo Brilli
- University of Florence, DISPAA, 50144 Florence, Italy; IBIMET-CNR, 50145 Florence, Italy
| | - Marco Carozzi
- Agroscope Research Station, Climate Agriculture Group, Zurich, Switzerland
| | - Sylvie Recous
- FARE Laboratory, INRA, Université de Reims Champagne-Ardenne, 51100 Reims, France
| | - Pete Smith
- Institute of Biological & Environmental Sciences, School of Biological Sciences, University of Aberdeen, Aberdeen AB24 3UU, United Kingdom
| | - Val Snow
- AgResearch - Lincoln Research Centre, Private Bag 4749, Christchurch 8140, New Zealand
| | | | | | - Kathrin Fuchs
- Department of Environmental Systems Science, Institute of Agricultural Sciences, ETH Zürich, 8092 Zurich, Switzerland
| | - Nuala Fitton
- Institute of Biological & Environmental Sciences, School of Biological Sciences, University of Aberdeen, Aberdeen AB24 3UU, United Kingdom
| | - Kate Gongadze
- Rothamsted Research, Sustainable Soil and Grassland Systems Department, United Kingdom
| | - Katja Klumpp
- INRA, VetAgro Sup, UCA, Unité Mixte de Recherche sur l'Écosystème Prairial (UREP), 63000 Clermont-Ferrand, France
| | | | - Raphaël Martin
- INRA, VetAgro Sup, UCA, Unité Mixte de Recherche sur l'Écosystème Prairial (UREP), 63000 Clermont-Ferrand, France
| | - Lutz Merbold
- Department of Environmental Systems Science, Institute of Agricultural Sciences, ETH Zürich, 8092 Zurich, Switzerland; Mazingira Centre, International Livestock Research Institute, 00100 Nairobi, Kenya
| | - Paul C D Newton
- AgResearch Grasslands Research Centre, Private Bag 11008, Palmerston North 4442, New Zealand
| | - Robert M Rees
- Scotland's Rural College, EH9 3JG Edinburgh, United Kingdom
| | - Susanne Rolinski
- Potsdam Institute for Climate Impact Research, 14473 Potsdam, Germany
| | - Gianni Bellocchi
- INRA, VetAgro Sup, UCA, Unité Mixte de Recherche sur l'Écosystème Prairial (UREP), 63000 Clermont-Ferrand, France.
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Schwarze C, Voß T, Kliesch O, Bauer A, Braunisch S, Feil MG, Fellmann H, von Franqué F, Freese R, Gretenkord Y, Huchzermeier C, Jückstock V, Klemm T, Kroon-Heinzen H, Martin R, Pitzing J, Wegner K, Zisterer-Schick M. Qualitätskriterien forensischer Ambulanzen des Strafvollzugs. Forens Psychiatr Psychol Kriminol 2018. [DOI: 10.1007/s11757-018-0476-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Zusammenfassung
Mit dem Gesetz zur Reform der Führungsaufsicht 2007 wurde forensische Nachsorge sowohl für ehemalige Patienten aus dem Maßregelvollzug als auch für Straffällige aus dem Justizvollzug verbindlich etabliert. Im Lauf der vergangenen zehn Jahre entstanden somit bundesweit forensische Ambulanzen des Strafvollzugs, welche den gesetzlichen Auftrag zu Behandlung und Betreuung entlassener Straffälliger länderspezifisch umsetzen. Hierbei handelt es sich teils um neu gegründete Ambulanzen, teils um bereits lange in der Behandlung von straffälligen Menschen tätige Einrichtungen, die ihr bisheriges Angebot um die Betreuung von Menschen unter Führungsaufsicht erweiterten. Diese heterogenen Ambulanzen haben sich seit einigen Jahren in einem jährlich stattfindenden fachlichen Austausch bundesweit vernetzt und Gemeinsamkeiten, Unterschiede und Besonderheiten in der Umsetzung des gesetzlichen Auftrags diskutiert. Angestoßen von der Diskussion um Mindeststandards in forensisch-psychiatrischen Nachsorgeambulanzen des Maßregelvollzugs 2014 entwickelte diese Bundesarbeitsgemeinschaft der forensischen Ambulanzen des Strafvollzug Qualitätskriterien, die trotz verschiedener Länder- und Trägerspezifika gemeinsame inhaltliche und formale Parameter erfolgreicher ambulanter Behandlung zur Deliktprävention fokussieren. Der Artikel stellt das Ergebnis dieses Diskussionsprozesses mit den verabschiedeten Qualitätskriterien in den Kategorien Struktur‑, Prozess- und Ergebnisqualität vor.
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Holliday E, Sawakuchi G, Martin R, Williamson T, Melkun M, Mohan R. Intensity-Modulated Proton Therapy (IMPT) Reduces Dose to Pelvic Bone Marrow and Normal Pelvic Organs when Compared to Volumetric-Modulated Arc Therapy (VMAT) for patients with Anal Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.207] [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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