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Davis SR, Taylor S, Hemachandra C, Magraith K, Ebeling PR, Jane F, Islam RM. The 2023 Practitioner's Toolkit for Managing Menopause. Climacteric 2023; 26:517-536. [PMID: 37902335 DOI: 10.1080/13697137.2023.2258783] [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: 09/10/2023] [Accepted: 09/11/2023] [Indexed: 10/31/2023]
Abstract
OBJECTIVE The Practitioner's Toolkit for Managing the Menopause, developed in 2014, provided an accessible desk-top tool for health-care practitioners caring for women at midlife. To ensure the Toolkit algorithms and supporting information reflect current best practice, the Toolkit has been revised in accordance with the published literature. METHODS A systematic search for guidelines, position and consensus statements pertaining to the menopause and published after 2014 was undertaken, and key recommendations extracted from the Clinical Practice Guidelines determined to be the most robust by formal evaluation. The peer-reviewed literature was further searched for identified information gaps. RESULTS The revised Toolkit provides algorithms that guide the clinical assessment and care of women relevant to menopause. Included are the reasons why women present, information that should be ascertained, issues that may influence shared decision-making and algorithms that assist with determination of menopausal status, menopause hormone therapy (MHT) and non-hormonal treatment options for symptom relief. As clear guidelines regarding when MHT might be indicated to prevent bone loss and subsequent osteoporosis in asymptomatic women were found to be lacking, the Toolkit has been expanded to support shared decision-making regarding bone health. CONCLUSIONS The 2023 Toolkit and supporting document provide accessible desk-top information to support health-care providers caring for women at midlife.The Toolkit has been endorsed by the International Menopause Society, Australasian Menopause Society, British Menopause Society, Endocrine Society of Australia and Jean hailes for Women's Health.
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Affiliation(s)
- S R Davis
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Department of Endocrinology and Diabetes, Alfred Health, Melbourne, VIC, Australia
| | - S Taylor
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - C Hemachandra
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Ministry of Health, Colombo, Sri Lanka
| | - K Magraith
- Cascade Road General Practice, TAS, Australia
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - P R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - F Jane
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - R M Islam
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Taylor S, D'Souza D, Moinuddin S, Gains J, Gaze MN, Gaunt T, Veiga C, Lim P. Pancreas: An Organ-at-Risk to Consider in Future Pediatric Abdominal Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:S135. [PMID: 37784347 DOI: 10.1016/j.ijrobp.2023.06.538] [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) Irradiation to the pancreas during pediatric radiotherapy is associated with secondary late effects, yet the pancreas is not typically considered an organ-at-risk (OAR) during radiotherapy planning. This audit investigated incidental pancreatic doses to estimate the relative risk (RR) of developing diabetes in later life. MATERIALS/METHODS Incidental pancreas doses were audited from 92 patients aged 2 to 19 historically treated with photons for craniospinal irradiation (CSI, N = 73) and for abdominal neuroblastoma (N = 19). Prescription doses ranged 21-36 Gy and 21-39 Gy (with boost to spine up to 50 Gy) for neuroblastoma and CSI patients, respectively. The pancreas was segmented on all planning CT scans following RTOG guidelines. Furthermore, the pancreas was split into its sub-volumes (head, body and tail) for abdominal cases only, since these scans were acquired with contrast enhancement. The RR of developing subsequent diabetes was estimated as a function of dose (D): RR = 1+0.65 × D × exp(-0.3 × D). Dose to the pancreas tail was used for neuroblastoma cases, whereas dose to the whole pancreas was used for CSI patients given that the pancreas could not be split in non-contrast scans. RESULTS The mean dose delivered to the whole pancreas was 15.4±7.5 Gy for all patients, 12.7±4.7 Gy for CSI patients and 25.9±7.4 Gy for abdominal patients. Pancreas V10Gy was 61.2% for all patients, 51.5% for CSI, and 98.6% for abdominal patients; V30Gy = 0% in all cases. These doses represented an estimated diabetes RR of 7.3±1.5, 6.6±1.3, and 8.7±0.6, respectively; RR>5 in 88%, 85% and 100% of all patients, CSI and abdominal patients audited, respectively. CONCLUSION Current incidental doses were associated with a diabetes RR>5 in all patients treated for abdominal neuroblastoma and the majority who received CSI. These findings suggest the pancreas should be routinely delineated and considered as an OAR in radiotherapy planning. This may help to identify higher risk patients and inform late-effect monitoring during survivorship. Further work in underway to assess if proton therapy could reduce the RR of diabetes particularly in abdominal cases. Improved availability of high-quality imaging during radiotherapy planning, such as contrast administration or planning MRI, is becoming more necessary to accurately delineate subsegments of the pancreas for improved RR estimations.
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Affiliation(s)
- S Taylor
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - D D'Souza
- Radiotherapy, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - S Moinuddin
- Radiotherapy, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - J Gains
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - M N Gaze
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - T Gaunt
- Department of Radiology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - C Veiga
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - P Lim
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
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Elgohari B, Patwardhan PP, Abdelhakiem MK, Bhargava R, Sukumvanich P, Courtney-Brooks M, Boisen MM, Berger JL, Taylor S, Olawaiye A, Lesnock J, Edwards RP, Beriwal S, Soong TR, Vargo JAA. Is Programmed Death Ligand 1(PD-L1) Expression in Vulvar Cancer Prognostic for Locoregional Control? Int J Radiat Oncol Biol Phys 2023; 117:e511. [PMID: 37785600 DOI: 10.1016/j.ijrobp.2023.06.1768] [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) Vulvar cancer is a rare female genital neoplasm in which surgery and radiotherapy play an integral role in the treatment paradigm; however, locoregional recurrence remains the predominant pattern of failure. Little is known about the impact of PD-L1 status in vulvar cancer and its value for clinical outcomes and response prediction to immunotherapy. We sought to explore clinical outcomes of patients with positive PD-L1 expression in vulvar cancer. MATERIALS/METHODS Single-institution retrospective analysis of patients with surgically resectable invasive vulvar carcinoma from 2001-2021 was performed. Patients with locally advanced disease not amendable to upfront surgery or de novo metastatic disease were excluded. Immunohistochemical PD-L1 expression was assessed using the Combined Positive Score (CPS) with positive expression defined as ≥1, and Tumor Proportion Score (TPS) with positive expression defined as ≥1%. Survival and disease control outcomes were calculated using the Kaplan-Meier Method with log-rank t-test. Multivariable analysis was conducted using a parsimonious cox regression analysis using forward conditional selection. RESULTS A total of 85 patients were identified with a median age of 69 years old (IQR: 59-78), 54% (n = 46) FIGO stage I-II, 97% (n = 82) squamous cell carcinoma histology, 41% (n = 35) p16 positive status, 74% (n = 63) without a history of lichen sclerosis, 40% (n = 34) without co-existing vulvar intraepithelial neoplasm (VIN), and 49% (n = 42) treated with surgery alone. There were 72% (n = 61) with positive PD-L1 TPS (≥1%), and 81% (n = 69) with positive PD-L1 CPS (≥1) expression. The median follow up was 49 months (IQR: 21-75 months). The 5-year OS was 79% (95% CI, 70%-89%), DFS 55% (95% CI, 43%-67%), local control (LC) 59% (95% CI, 47%-72%), regional control (RC) 86% (95% CI, 78%-94%), and distant metastasis (DM) 96% (95% CI, 92%-100%). PD-L1 expression was associated with lower LC and DFS by TPS ≥1%. The 5-year LC of 82% (95% CI, 65%-98%) for PD-L1 negative versus 50% (95% CI, 34%-65%) positive disease (p = 0.03). The 5-year DFS was 77% (95% CI, 59%-95%) for PD-L1 negative versus 46% (95% CI, 31%-61%) positive disease (p = 0.03). No significant DFS or LC difference was noted by CPS levels ≥1. No significant difference was observed for RC, DM, or OS. On multivariable analysis, PD-L1 TPS remained a significant predictor for LC (HR = 3.01, 95% CI, 1.07-8.95, p = 0.04). No significant difference in DFS was observed for PD-L1 TPS on multivariable analysis. CONCLUSION PD-L1 expression is associated with higher rates of local recurrence and may represents a potentially important actionable target independent of p16 status to improve the predominant pattern of relapse in this uncommon malignancy.
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Affiliation(s)
- B Elgohari
- UPMC Hillman Cancer Center, Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - P P Patwardhan
- UPMC Hillman Cancer Center, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - M K Abdelhakiem
- UPMC Hillman Cancer Center, Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - R Bhargava
- UPMC Hillman Cancer Center, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - P Sukumvanich
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - M Courtney-Brooks
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - M M Boisen
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - J L Berger
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - S Taylor
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - A Olawaiye
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - J Lesnock
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - R P Edwards
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - S Beriwal
- Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
| | - T R Soong
- UPMC Hillman Cancer Center, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - J A A Vargo
- UPMC Hillman Cancer Center, Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Lisiecki J, Buta M, Taylor S, Tait M, Farina N, Levin J, Schulz J, Sangji N, Friedstat J, Hemmila M, Wang S, Levi B, Goverman J. Efficacy of Mepliex ® Ag Versus Xeroform ® As A Split-Thickness Skin Graft Donor Site Dressing: Bad Habits Die Hard. Ann Burns Fire Disasters 2023; 36:243-250. [PMID: 38680433 PMCID: PMC11041881] [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: 02/12/2022] [Accepted: 03/01/2022] [Indexed: 05/01/2024]
Abstract
Autografting with split-thickness skin grafts (STSG) remains an essential procedure in burn and reconstructive surgery. The process of harvesting STSG, however, leaves behind a donor site, an exposed area of partial-thickness dermis left to heal by secondary intention. There has yet to be a consensus amongst surgeons regarding optimal management of the donor site. The ideal donor site dressing is one that allows for expeditious healing while minimizing pain and infection. Despite numerous studies demonstrating the superiority of moist wound healing, many surgeons continue to treat STSG donor sites dry, with petroleum-based gauze. In this study, two burn centers performed a retrospective review of burn patients whose STSG donor sites were treated with either Xeroform® or Mepilex® Ag dressings. Infections were documented and in a subgroup analysis of patients, postoperative pain scores were noted and total opiate usage during hospitalization was calculated. Analysis revealed an overall infection rate of 1.2% in the Mepilex® Ag group and 11.4% in the Xeroform® group (p<0.0001). Patients with Xeroform® donor site dressings had increased odds of donor site infection (OR=10.8, p=0.002). In subgroup analysis, there were no significant differences in maximum pain scores between Mepilex® Ag and Xeroform® groups, nor were there differences in opiate usage. STSG donor sites dressed with silver foam dressings have a lower rate of donor site infection relative to those dressed with petroleum-based gauze. Moist donor site dressings such as foam dressings (including Mepilex® Ag) should be the standard of care in STSG donor site wound care.
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Affiliation(s)
- J.L. Lisiecki
- Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - M.R. Buta
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - S. Taylor
- Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - M. Tait
- Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - N. Farina
- Department of Pharmacy Services, University of Michigan Health System, Ann Arbor, MI, USA
| | - J. Levin
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - J. Schulz
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - N. Sangji
- Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - J. Friedstat
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - M.R. Hemmila
- Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - S. Wang
- Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - B. Levi
- Department of Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - J. Goverman
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
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Wheelwright S, Maunsell R, Taylor S, Drinkwater N, Erridge C, Foster C, Hardcastle M, Hogden A, Lawson I, Lisiecka D, Mcdermott C, Morrison KE, Muir C, Recio-Saucedo A, White S. Development of 'gastrostomy tube - is it for me?', a web-based patient decision aid for people living with motor neurone disease considering having a gastrostomy tube placed. Amyotroph Lateral Scler Frontotemporal Degener 2023; 24:1-9. [PMID: 37332172 DOI: 10.1080/21678421.2023.2220743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 05/28/2023] [Indexed: 06/20/2023]
Abstract
Objective: To develop and pilot a web-based patient decision aid (PDA) to support people living with motor neurone disease (plwMND) considering having a gastrostomy tube placed. Methods: In Phase 1, content and design were informed by semi-structured interviews, literature reviews and a prioritization survey. In Phase 2, the prototype PDA was tested with users and developed iteratively with feedback from surveys and 'think-aloud' interviews. Phase 1 and 2 participants were plwMND, carers and healthcare professionals (HCPs). In Phase 3, the PDA was evaluated by plwMND using validated questionnaires and HCPs provided feedback in focus groups. Results: Sixteen plwMND, 16 carers and 25 HCPs took part in Phases 1 and 2. Interviews and the literature review informed a prioritization survey with 82 content items. Seventy-seven per cent (63/82) of the content of the PDA was retained. A prototype PDA, which conforms to international standards, was produced and improved during Phase 2. In Phase 3, 17 plwMND completed questionnaires after using the PDA. Most plwMND (94%) found the PDA completely acceptable and would recommend it to others in their position, 88% had no decisional conflict, 82% were well prepared and 100% were satisfied with their decision-making. Seventeen HCPs provided positive feedback and suggestions for use in clinical practice. Conclusion: Gastrostomy Tube: Is it for me? was co-produced with stakeholders and found to be acceptable, practical and useful. Freely available from the MND Association website, the PDA is a valuable tool to support the shared decision-making process for gastrostomy tube placement.
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Affiliation(s)
| | - R Maunsell
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | - S Taylor
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | - N Drinkwater
- Motor Neurone Disease Association, Northampton, UK
| | - C Erridge
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C Foster
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | | | - A Hogden
- School of Population Health, University of New South Wales, Sydney, Australia
| | - I Lawson
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | - D Lisiecka
- Munster Technological University - Kerry Campus, Republic of Ireland, Tralee, UK
| | | | - K E Morrison
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - C Muir
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | - A Recio-Saucedo
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | - S White
- University of Sheffield, Sheffield, UK, and
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Taylor S, Lim P, Cantwell J, D’Souza D, Moinuddin S, Chang YC, Gaze MN, Gains J, Veiga C. Image guidance and interfractional anatomical variation in paediatric abdominal radiotherapy. Br J Radiol 2023; 96:20230058. [PMID: 37102707 PMCID: PMC10230397 DOI: 10.1259/bjr.20230058] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 04/28/2023] Open
Abstract
OBJECTIVES To identify variables predicting interfractional anatomical variations measured with cone-beam CT (CBCT) throughout abdominal paediatric radiotherapy, and to assess the potential of surface-guided radiotherapy (SGRT) to monitor these changes. METHODS Metrics of variation in gastrointestinal (GI) gas volume and separation of the body contour and abdominal wall were calculated from 21 planning CTs and 77 weekly CBCTs for 21 abdominal neuroblastoma patients (median 4 years, range: 2 - 19 years). Age, sex, feeding tubes, and general anaesthesia (GA) were explored as predictive variables for anatomical variation. Furthermore, GI gas variation was correlated with changes in body and abdominal wall separation, as well as simulated SGRT metrics of translational and rotational corrections between CT/CBCT. RESULTS GI gas volumes varied 74 ± 54 ml across all scans, while body and abdominal wall separation varied 2.0 ± 0.7 mm and 4.1 ± 1.5 mm from planning, respectively. Patients < 3.5 years (p = 0.04) and treated under GA (p < 0.01) experienced greater GI gas variation; GA was the strongest predictor in multivariate analysis (p < 0.01). Absence of feeding tubes was linked to greater body contour variation (p = 0.03). GI gas variation correlated with body (R = 0.53) and abdominal wall (R = 0.63) changes. The strongest correlations with SGRT metrics were found for anterior-posterior translation (R = 0.65) and rotation of the left-right axis (R = -0.36). CONCLUSIONS Young age, GA, and absence of feeding tubes were linked to stronger interfractional anatomical variation and are likely indicative of patients benefiting from adaptive/robust planning pathways. Our data suggest a role for SGRT to inform the need for CBCT at each treatment fraction in this patient group. ADVANCES IN KNOWLEDGE This is the first study to suggest the potential role of SGRT for the management of internal interfractional anatomical variation in paediatric abdominal radiotherapy.
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Affiliation(s)
- Sabrina Taylor
- University College London, Centre for Medical Image Computing, London, United Kingdom
| | - Pei Lim
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Jessica Cantwell
- Radiotherapy, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Derek D’Souza
- Radiotherapy, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Syed Moinuddin
- Radiotherapy, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Yen-Ching Chang
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Mark N Gaze
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Jennifer Gains
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Catarina Veiga
- University College London, Centre for Medical Image Computing, London, United Kingdom
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Szmul A, Taylor S, Lim P, Cantwell J, Moreira I, Zhang Y, D’Souza D, Moinuddin S, Gaze MN, Gains J, Veiga C. Deep learning based synthetic CT from cone beam CT generation for abdominal paediatric radiotherapy. Phys Med Biol 2023; 68:105006. [PMID: 36996837 PMCID: PMC10160738 DOI: 10.1088/1361-6560/acc921] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 03/13/2023] [Accepted: 03/30/2023] [Indexed: 04/01/2023]
Abstract
Objective. Adaptive radiotherapy workflows require images with the quality of computed tomography (CT) for re-calculation and re-optimisation of radiation doses. In this work we aim to improve the quality of on-board cone beam CT (CBCT) images for dose calculation using deep learning.Approach. We propose a novel framework for CBCT-to-CT synthesis using cycle-consistent Generative Adversarial Networks (cycleGANs). The framework was tailored for paediatric abdominal patients, a challenging application due to the inter-fractional variability in bowel filling and small patient numbers. We introduced to the networks the concept of global residuals only learning and modified the cycleGAN loss function to explicitly promote structural consistency between source and synthetic images. Finally, to compensate for the anatomical variability and address the difficulties in collecting large datasets in the paediatric population, we applied a smart 2D slice selection based on the common field-of-view (abdomen) to our imaging dataset. This acted as a weakly paired data approach that allowed us to take advantage of scans from patients treated for a variety of malignancies (thoracic-abdominal-pelvic) for training purposes. We first optimised the proposed framework and benchmarked its performance on a development dataset. Later, a comprehensive quantitative evaluation was performed on an unseen dataset, which included calculating global image similarity metrics, segmentation-based measures and proton therapy-specific metrics.Main results. We found improved performance for our proposed method, compared to a baseline cycleGAN implementation, on image-similarity metrics such as Mean Absolute Error calculated for a matched virtual CT (55.0 ± 16.6 HU proposed versus 58.9 ± 16.8 HU baseline). There was also a higher level of structural agreement for gastrointestinal gas between source and synthetic images measured using the dice similarity coefficient (0.872 ± 0.053 proposed versus 0.846 ± 0.052 baseline). Differences found in water-equivalent thickness metrics were also smaller for our method (3.3 ± 2.4% proposed versus 3.7 ± 2.8% baseline).Significance. Our findings indicate that our innovations to the cycleGAN framework improved the quality and structure consistency of the synthetic CTs generated.
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Affiliation(s)
- Adam Szmul
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom
| | - Sabrina Taylor
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Pei Lim
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Jessica Cantwell
- Radiotherapy, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Isabel Moreira
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Ying Zhang
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Derek D’Souza
- Radiotherapy Physics Services, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Syed Moinuddin
- Radiotherapy, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Mark N. Gaze
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Jennifer Gains
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Catarina Veiga
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
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Silkens MEWM, Alexander K, Viney R, O'Keeffe C, Taylor S, Noble LM, Griffin A. A national qualitative investigation of the impact of service change on doctors' training during Covid-19. BMC Med Educ 2023; 23:174. [PMID: 36941665 PMCID: PMC10027255 DOI: 10.1186/s12909-023-04143-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The Covid-19 crisis sparked service reconfigurations in healthcare systems worldwide. With postgraduate medical education sitting within these systems, service reconfigurations substantially impact trainees and their training environment. This study aims to provide an in-depth qualitative understanding of the impact of service reconfiguration on doctors' training during the pandemic, identifying opportunities for the future as well as factors that pose risks to education and training and how these might be mitigated. METHODS Qualitative parallel multi-centre case studies examined three Trusts/Health Boards in two countries in the United Kingdom. Data were collected from online focus groups and interviews with trainees and supervisors using semi-structured interview guides (September to December 2020). A socio-cultural model of workplace learning, the expansive-restrictive continuum, informed data gathering, analysis of focus groups and coding. RESULTS Sixty-six doctors participated, representing 25 specialties/subspecialties. Thirty-four participants were male, 26 were supervisors, 17 were specialty trainees and 23 were foundation doctors. Four themes described the impact of pandemic-related service reconfigurations on training: (1) Development of skills and job design, (2) Supervision and assessments, (3) Teamwork and communication, and (4) Workload and wellbeing. Service changes were found to both facilitate and hinder education and training, varying across sites, specialties, and trainees' grades. Trainees' jobs were redesigned extensively, and many trainees were redeployed to specialties requiring extra workforce during the pandemic. CONCLUSIONS The rapid and unplanned service reconfigurations during the pandemic caused unique challenges and opportunities to doctors' training. This impaired trainees' development in their specialty of interest, but also presented new opportunities such as cross-boundary working and networking.
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Affiliation(s)
- M E W M Silkens
- Research Department of Medical Education (RDME), UCL Medical School, University College London, The Directorate, 74 Huntley Street, London, WC1E 6AU, UK
- Centre for Healthcare Innovation Research, Department of Health Services Research and Management, City University of London, London, UK
| | - K Alexander
- Research Department of Medical Education (RDME), UCL Medical School, University College London, The Directorate, 74 Huntley Street, London, WC1E 6AU, UK
- School of Medicine, University of Dundee, Dundee, UK
| | - R Viney
- Research Department of Medical Education (RDME), UCL Medical School, University College London, The Directorate, 74 Huntley Street, London, WC1E 6AU, UK
| | - C O'Keeffe
- UCL Medical School, University College London, London, UK
| | - S Taylor
- Institute of Education, University College London, London, UK
| | - L M Noble
- UCL Medical School, University College London, London, UK
| | - A Griffin
- Research Department of Medical Education (RDME), UCL Medical School, University College London, The Directorate, 74 Huntley Street, London, WC1E 6AU, UK.
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Sultana F, Davis SR, Bell RJ, Taylor S, Islam RM. Association between testosterone and cognitive performance in postmenopausal women: a systematic review of observational studies. Climacteric 2023; 26:5-14. [PMID: 36366914 DOI: 10.1080/13697137.2022.2139600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This review was conducted to explore the association between endogenous testosterone blood concentrations and cognitive performance among community dwelling postmenopausal women. We searched Ovid MEDLINE, EMBASE, PsycINFO and Web of Science databases for observational studies with at least 100 postmenopausal participants. The results were categorized by study design, reporting of total or free testosterone and risk of bias assessments, narratively. Ten of the 26 articles retrieved for full-text review met the inclusion criteria, six provided cross-sectional data, seven provided longitudinal data and one provided case-control data. Cognitive performance tests differed between studies. Eight studies measured testosterone by immunoassay, one by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and one did not specify their methodology. Eleven different cognitive domains were tested by 37 different instruments. Irrespective of the study design, the findings were inconsistent and inconclusive. Both positive and inverse associations were reported for each of global cognition and immediate and delayed verbal recall. The majority of studies reported no association between total or free testosterone and cognitive performance. Although this review did not demonstrate an association between testosterone and cognitive performance in postmenopausal women, the findings should be considered inconclusive due to the imprecision of testosterone measurement and the methodological heterogeneity of the included studies.
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Affiliation(s)
- F Sultana
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Environmental Interventions Unit, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - S R Davis
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Department of Endocrinology and Diabetes, Alfred Health, Melbourne, VIC, Australia
| | - R J Bell
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - S Taylor
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - R M Islam
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Yau T, Rimmer SN, Taylor S. Can’t see, can’t climb a tree, can’t defecate pain free: reactive arthritis due to chlamydial proctitis. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00326-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Elgohari B, Abdelhakiem M, Lesnock J, Sukumvanich P, Courtney-Brooks M, Boisen M, Berger J, Taylor S, Mahdi H, Olawaiye A, Edwards R, Beriwal S, Vargo J. Can Adjuvant Chemoradiotherapy Replace Inguinal Lymph Node Dissection after a Positive Sentinel Lymph Node Biopsy in Vulvar Cancer? Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1289] [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: 10/31/2022]
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Gama F, Rosmini S, Bandula S, Patel KP, Thornton GD, Bennett JB, Wechelakar A, Gillmore JD, Whelan C, Lachmann H, Taylor S, Fontana M, Moon J, Hawkins PN, Treibel T. Extracellular volume fraction by computed tomography predicts long-term prognosis among patients with cardiac amyloidosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
This study sought to investigate the association of extracellular volume fraction by computed tomography (ECVCT), myocardial remodeling and mortality in patients with systemic amyloidosis.
Background
Light chain (AL) and transthyretin (ATTR) amyloid fibrils are deposited in the extracellular space of the myocardium, resulting in heart failure and premature mortality. Extracellular expansion can be quantified by CT, offering a rapid and cost-effective alternative to cardiovascular magnetic resonance (CMR), especially among patients with cardiac devices or on renal dialysis.
Methods
Patients with confirmed systemic amyloidosis and varying degrees of cardiac involvement underwent ECG-gated cardiac CT. ECVCT was analysed in the inter-ventricular septum. All patients also underwent clinical assessment, ECG, echocardiography, serum amyloid protein component (SAP) and/or technetium-99m (99mTc) 3,3-diphosphono-1,2-propanodicarboxylic acid scintigraphy. ECVCT was compared across different extents of cardiac infiltration (ATTR Perugini Grade / AL Mayo Class) and evaluated for its association with myocardial remodelling and all-cause mortality.
Results
72 patients were studied (AL n=35, ATTR n=37; age 67 (59–76) years, 71% males). Mean septal ECVCT was 42.7±13.1% and 55.8±10.9% in AL and ATTR, respectively, and correlated with indexed left ventricular (LV) mass (r=0.426, p<0.001), LV ejection fraction [LVEF, (r=0.460, p<0.001)], NT-proBNP (r=0.563, p<0.001) and hsTnT (r=0.546, p=0.02). ECVCT increased with cardiac amyloid involvement in both AL and ATTR (Figure 1). Over a mean follow-up of 5.3±2.4 years, 40 deaths occurred (AL 14 [35%]; ATTR 26 [65%]). ECVCT was independently associated with all-cause mortality in ATTR (not AL) after adjustment for age and IV septal wall thickness (HR: 1.046, 95% CI: 1.003–1.090, p=0.037).
Conclusion
Cardiac amyloid burden quantified by ECVCT is associated with adverse cardiac remodelling as well as all-cause mortality among ATTR amyloid patients. ECVCT may address the need for better identification and risk stratification of amyloid patients, using a widely-accessible imaging modality (Figure 2).
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- F Gama
- Barts Heart Centre, St Bartholomew's Hospital, Cardiac imaging , London , United Kingdom
| | - S Rosmini
- Barts Heart Centre , London , United Kingdom
| | - S Bandula
- University College of London , London , United Kingdom
| | - K P Patel
- Barts Heart Centre, St Bartholomew's Hospital, Cardiac imaging , London , United Kingdom
| | - G D Thornton
- Barts Heart Centre, St Bartholomew's Hospital, Cardiac imaging , London , United Kingdom
| | - J B Bennett
- Barts Heart Centre, St Bartholomew's Hospital, Cardiac imaging , London , United Kingdom
| | - A Wechelakar
- Queen Mary University of London , London , United Kingdom
| | - J D Gillmore
- Queen Mary University of London , London , United Kingdom
| | - C Whelan
- University College of London , London , United Kingdom
| | - H Lachmann
- Queen Mary University of London , London , United Kingdom
| | - S Taylor
- University College of London , London , United Kingdom
| | - M Fontana
- University College of London , London , United Kingdom
| | - J Moon
- Barts Heart Centre, St Bartholomew's Hospital, Cardiac imaging , London , United Kingdom
| | - P N Hawkins
- Queen Mary University of London , London , United Kingdom
| | - T Treibel
- Barts Heart Centre, St Bartholomew's Hospital, Cardiac imaging , London , United Kingdom
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Rodrigues JCL, O'Regan T, Darekar A, Taylor S, Goh V. Current pressure on the UK imaging workforce deters imaging research in the NHS and requires urgent attention. Clin Radiol 2022; 77:913-919. [PMID: 36167569 DOI: 10.1016/j.crad.2022.07.015] [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] [Received: 03/26/2022] [Revised: 06/08/2022] [Accepted: 07/15/2022] [Indexed: 11/25/2022]
Abstract
Medical imaging is a multidisciplinary specialty, combining clinical expertise from medical physics, radiography, and radiology, and plays a key role in patient care. Research is vital to ensure the care delivered to patients is evidence-based, and is a core component of clinical governance; however, there are pressures on the imaging workforce, which are significantly impeding imaging research. This commentary presents a research gap analysis pertaining to the multidisciplinary imaging workforce on behalf of the National Institute for Health Research (NIHR) Imaging Workforce Group. Data were summarised from membership surveys of the Royal College of Radiologists, Society and College of Radiographers, and Institute of Physics and Engineering in Medicine; national reports; and feedback from NIHR Clinical Research Network Imaging Champions meeting in 2020/2021. Common barriers to delivering research were found across the multidisciplinary workforce. The key issues were lack of staff, lack of time, and lack of funding to backfill clinical services. Given the ongoing workforce shortages and increasing clinical demands on radiologists, diagnostic radiographers, and medical physicists, these issues must be tackled with a high priority to ensure the future of clinical research within the NHS.
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Affiliation(s)
- J C L Rodrigues
- Department of Radiology, Royal United Hospitals Bath NHS Foundation Trust and Department of Health, University of Bath, Bath, UK.
| | - T O'Regan
- Society and College of Radiographers, UK
| | - A Darekar
- Department of Medical Physics, University Hospital Southampton NHS Trust, Southampton, UK
| | - S Taylor
- Centre for Medical Imaging, University College London and Department of Radiology, University College Hospital NHS Foundation Trust, London, UK
| | - V Goh
- Cancer Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London and Department of Radiology, Guy's & St Thomas' NHS Foundation Trust, London, UK
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Morgan R, Clamp A, Barnes B, Schlecht H, Yarram-Smith L, Wallis Y, Morgan S, Valganon M, Hudson E, McKenna S, Sundar S, Nicum S, Brenton J, Kristeleit R, Banerjee S, McNeish I, Ledermann J, Taylor S, Evans G, Jayson G. 575P Homologous recombination deficiency in newly diagnosed FIGO stage III/IV high-grade serous or endometrioid ovarian cancer: A multi-national observational study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.703] [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: 11/17/2022] Open
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Taylor S, Lim PS, Veiga C. Identifying patient variables predisposing greater bowel gas variation in paediatric abdominal radiotherapy. Clin Oncol (R Coll Radiol) 2022. [DOI: 10.1016/j.clon.2022.08.008] [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: 11/03/2022]
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Simpson C, Taylor S. Could Alveogyl cause nerve injury? Br Dent J 2022; 233:245. [PMID: 36028664 DOI: 10.1038/s41415-022-4930-2] [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: 11/09/2022]
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Shitara K, Golan T, Mileham K, Voskoboynik M, Rha S, Gutierrez M, Perets R, Taylor S, Chen D, Keenan T, Rajasagi M, Healy J, Shoji H. PD-3 Phase 1 trial of vibostolimab plus pembrolizumab for PD-1/PD-L1 inhibitor-naive advanced gastric cancer: The KEYVIBE-001 trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Morlock R, Divino V, Dekoven M, Lamoreaux B, Powers A, Barretto N, Holt R, Taylor S. AB1051 CLINICAL OUTCOMES AND HEALTHCARE RESOURCE UTILIZATION OF UNCONTROLLED GOUT PRIOR TO PEGLOTICASE THERAPY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2502] [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
BackgroundBy definition, uncontrolled gout (UG) cannot be managed with oral urate lowering therapies (ULTs) and is associated with substantial morbidity. UG, also known as refractory gout, results in escalated treatment and management. Recent American College of Rheumatology guidelines recommend treating gout to serum uric acid targets; if targets are not achieved or patients continue to have symptoms, pegloticase is recommended. There is a paucity of data documenting the clinical and economic burden of UG patients.ObjectivesAssess clinical outcomes and healthcare resource utilization (HCRU) of UG prior to pegloticase initiation.MethodsA retrospective observational database analysis was conducted among patients initiating pegloticase between April 1, 2011 and August 31, 2020 using the PharMetrics Plus database. Eligible subjects had ≥1 pegloticase claim (first claim = index date) and continuous enrollment for 24 months prior to index. Relevant clinical and economic (HCRU) outcomes were evaluated over a 24-month pre-index period and compared between two different time intervals prior to index: time interval 1 (Day -720 to Day -361) and time interval 2 (Day -360 to Day -1). Assessment of comorbid disease burden included Charlson Comorbidity Index (CCI) and relevant health conditions. Dependent pairwise comparisons were conducted to compare clinical and economic outcomes between time intervals prior to pegloticase initiation. To assess statistical differences, paired t-tests (continuous variables) or McNemar’s tests (categorical variables) were used.ResultsOf the 408 eligible subjects, most were male (88.5%), with an average age (SD) of 55.2 (11.3) years, 66.9% were between the ages of 45-64 years and 78.2% had a preferred provider organization (PPO) health plan. Most often (34.8% of patients), a rheumatologist was associated with initiation of pegloticase therapy, while primary care physicians accounted for 23.8% of initiations. Mean (SD) CCI score was 2.4 (2.4) with 37.3% of subjects having a CCI score of >3. Prevalence of relevant health conditions over the 24-month pre-index period included tophi (62.5%), urolithiasis (8.6%), chronic kidney disease (34.6%) and chronic pain/fibromyalgia (76.5%), all of which significantly increased from time interval 1 (Day -720 to Day -361) to time interval 2 (Day -360 to Day -1) prior to pegloticase initiation (Table 1). Of patients initiating pegloticase, 57.4% had 1 ULT (excluding probenecid), 11.3% had >2 ULT (excluding probenecid), and 10.3% UG patients had ≥1 probenecid claim over the 24-month pre-index period. Most patients (98.3%) had ≥1 physician office visit, 27.2% had ≥1 hospitalization and 45.3% had ≥1 emergency room (ER) visit over the 24-month pre-index period. HCRU significantly increased from time interval 1 to time interval 2, prior to pegloticase (Figure 1).Table 1.Relevant Health Conditions and Disease-specific Health Care Resource Utilization (HCRU)Overall N= 408Time Interval 1Time Interval 2Tophi62.5%15.4%61.5%***Urolithiasis8.6%4.2%6.9%*Chronic kidney disease34.6%22.5%31.6%***Cardiovascular disease32.6%21.3%28.4%**Type 2 diabetes mellitus31.4%23.3%28.9%**Hypertension76.2%58.1%70.3%***≥1 gout flare87.7%48.5%83.8%***Mean number of gout flare (SD)3.5 (2.4)1.02.1***Gout-related medications ≥1 claim for colchicine56%39.5%63.7%***≥1 claim for opioids71%52.9%60.3%*≥1 claim for oral corticosteroids80%50.2%75.7%***≥1 claim for injectable corticosteroids64%38.5%53.7%***†Time Interval 1: Day -720 to Day -361 prior to pegloticase initiation; ††Time Interval 2: Day -360 to Day -1 prior to pegloticase initiation***, p<0.0001; **, p<0.001; *, p<0.05ConclusionOverall, these data demonstrate the progressive nature of UG as confirmed by significant increases in gout-related conditions and healthcare resource utilization prior to pegloticase initiation. Further research is needed on healthcare resource utilization among patients with UG post-pegloticase use.Disclosure of InterestsRobert Morlock Consultant of: Horizon Therapeutics, Victoria Divino Grant/research support from: Horizon Therapeutics, Mitchell DeKoven Grant/research support from: Horizon Therapeutics, Brian LaMoreaux Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Atsuko Powers Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Naina Barretto Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Robert Holt Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Stephanie Taylor Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics
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Khanna D, Furst D, LI JW, Shah S, Lesperance T, Ali F, Lamoreaux B, Taylor S. POS0867 COMORBIDITY AND COMPLICATIONS PRIOR TO SYSTEMIC SCLEROSIS DIAGNOSIS: A RETROSPECTIVE COHORT ANALYSIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1888] [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
BackgroundSystemic sclerosis (SSc) is a rare autoimmune disease characterized by progressive microvascular damage, collagen deposition and subsequent fibrosis of the skin and internal organs which contributes to substantial morbidity and premature death.1-2ObjectivesThe objective was to evaluate the disease burden of SSc patients prior to their SSc diagnosis.MethodsPatients with SSc were identified in a claims dataset (IBM MarketScan Commercial Database, 2015-2019) using ICD 10 diagnosis codes for SSc. Eligible subjects were required to have > 1 inpatient or >2 outpatient/office claims with a scleroderma diagnosis code on separate days and > 24 months of continuous health plan enrollment without a SSc diagnosis before the first SSc claim (‘index date’) and > 12 months of enrollment after the index date. Overall comorbid disease burden was assessed via the Charlson Comorbidity Index (CCI) 13-24 and 12 months before and 12 months after index date. The prevalence of SSc-related complications for atherosclerosis, pulmonary arterial hypertension (PAH), pulmonary fibrosis (PF), Raynaud’s Phenomenon (RP), and gastrointestinal (GI) complications (e.g., GERD, dysphagia, etc.) were identified using ICD codes and reported as percentages for the aforementioned time intervals relative to patients’ index dates.Results902 eligible SSc patients were identified for analysis. The mean age at index SSc diagnosis was 54.3 years and 84.7% of patients were female. Mean CCI scores 13-24 months before, 12 months before, and 12 months after index SSc diagnosis were 0.84, 1.13 and 1.30, respectively. From the time points 13-24 months before, 12 months before, and 12 months after index SSc diagnosis, increasing rates were also observed of atherosclerosis, PAH, PF, RP, and GI complications (Table 1).Table 1.Charlson Comorbidity Index (CCI) and systemic sclerosis-related complications by time-intervalClinical characteristic13-24 months before Index12 months before Index12 months after IndexMean CCI (std dev)0.84 (1.58)1.13 (1.71)1.30 (1.75)Systemic sclerosis-related complicationsAtherosclerosis7%9%14%Pulmonary arterial hypertension (PAH)1%4%12%Pulmonary fibrosis (PF)5%8%16%Raynaud’s Phenomenon (RP)13%29%43%GI complications23%32%46%ConclusionResults from this analysis suggests that SSc-related sequalae are present at least two years prior to SSc diagnosis and rates of these complications increased markedly over time. Patients’ overall comorbid disease burden also worsened substantially over this period, likely because of these complications. The internal organ involvement is likely under reported due to requirements to link each diagnosis with an ICD-10 code. These data indicate the significant burden of SSc, prior to and after diagnosis, highlighting the need for awareness, prompt diagnosis, and effective therapies for SSc and its related complications.References[1]Cutolo M, et al. Expert Rev Clin Immunol. 2019;15(7):753-764.[2]Steen VD, Medsger TA. Ann Rheum Dis. 2007;66(7):940-944.Disclosure of InterestsDinesh Khanna Consultant of: Horizon Therapeutics, Daniel Furst Consultant of: Horizon Therapeutics, Justin W. Li Grant/research support from: Horizon Therapeutics, Saloni Shah Grant/research support from: Horizon Therapeutics, Tamara Lesperance Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Farah Ali Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Brian LaMoreaux Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Stephanie Taylor Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics
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Szmul A, Taylor S, Lim P, Cantwell J, D’Souza D, Moinuddin S, Gaze M, Gains J, Veiga C. OC-0773 CBCT-to-CT synthesis using weakly-paired cycle-consistent generative adversarial networks. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02679-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Pifer P, Jaishankar S, Bhargava R, Keller A, Musunuru H, Cohen M, Sukumvanich P, Courtney-Brooks M, Boisen M, Berger J, Taylor S, Olawaiye A, Lesnock J, Edwards R, Vargo J, Beriwal S. PD-0913 Is substantial LVSI prognostic in patients with pathological lymph node-negative endometrial cancer? Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02992-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Taylor S, Lim P, Cantwell J, D’Souza D, Moinuddin S, Ching-Chang Y, Gaze M, Gains J, Veiga C. OC-0786 Surface imaging to track inter-fractional anatomical variation in paediatric abdominal radiotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02692-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mehta A, Taylor S, Halliday E, Chiu M, Needleman S. Irradiation of the Internal Mammary Chain in the Adjuvant Treatment of Breast Cancer – a Retrospective, Single Institution Review of Outcomes. Clin Oncol (R Coll Radiol) 2022. [DOI: 10.1016/j.clon.2021.12.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Samarasekara N, Dinsdale E, Taylor S, Sulaiman M, Gittens A, Ahmed E, Jain A, Tang M, Ninan S. 715 REDUCING OVERTREATMENT OF TYPE 2 DIABETES IN OLDER PEOPLE LIVING IN CARE HOMES. Age Ageing 2022. [DOI: 10.1093/ageing/afac034.715] [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
Introduction
Older people in care homes living with frailty are less likely to benefit from tight glycaemic control in the management of type 2 diabetes with increased risk of adverse effects for example hypoglycaemia, falls and hospital admission. We wished to ascertain the scale of the problem and reduce overtreatment. We defined overtreatment based on American Diabetes Association guidelines as being on an agent that can cause hypoglycaemia and having an HBA1C of ≤53 mmol/mol or, an HbA1c 53–64 mmol/mol with either three or more co-morbidities.
Methods
In 2016, we audited the management of type 2 diabetes in older people discharged from LTHT to care homes. We discussed our concerns with diabetes and geriatric medicine colleagues across medical, nursing and pharmacy disciplines. We engaged the support of the citywide diabetes network which comprises secondary care colleagues, general practitioners and pharmacists. We presented the findings of our initial audit to colleagues within primary and secondary care through departmental meetings and citywide network meetings. We wrote a new guideline, specifically for frail older people that was disseminated citywide through these networks. We re-audited in 2020.
Results
In total, 113 cases were reviewed in 2016 and 105 cases in 2020. In 2020, only 6% (6 patients) were overtreated compared to 38% (43 patients) in 2016.
Conclusions
There has been a marked reduction in overtreatment which should result in less adverse events. We believe the reasons for success lie in wide engagement of relevant stakeholder groups around an issue that is important, large in scale and meaningful to both patient and clinician. There are potential cost savings from reducing medications and reducing harm.
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Affiliation(s)
| | | | - S Taylor
- Leeds Teaching Hospitals Trust (LTHT)
| | | | - A Gittens
- Leeds Teaching Hospitals Trust (LTHT)
| | - E Ahmed
- Leeds Teaching Hospitals Trust (LTHT)
| | - A Jain
- Leeds Teaching Hospitals Trust (LTHT)
| | - M Tang
- Leeds Teaching Hospitals Trust (LTHT)
| | - S Ninan
- Leeds Teaching Hospitals Trust (LTHT)
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Gilmore S, Murray S, Taylor S, Ninan S. 771 LET’S TALK ABOUT RESUS. DO WE DO IT? WHO DOES IT? WHAT ARE THE OUTCOMES? Age Ageing 2022. [DOI: 10.1093/ageing/afac037.771] [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: 11/15/2022] Open
Abstract
Abstract
Introduction
Discussing preferences around cardiopulmonary resuscitation (CPR) is recommended to patients who wish to discuss this, or where there is foreseeable risk of life-threatening clinical deterioration. Our team felt that we discussed this routinely for our inpatients but wished to investigate how we did this, when we did this, why decisions were made and who led these discussions.
Methods
We retrospectively reviewed the electronic patient notes of 118 patients recently discharged from elderly medicine between February and November 2020 and recorded demographic details, co-morbidities and outcomes of discussions regarding resuscitation.
Results
100/118 patients had a RESPECT form documenting preferences. Of these 100 patients, 97% had a DNACPR recommendation, 2 had a ‘for resuscitation’ recommendation and one was undecided. 69% of patients had their preferences recorded during the current admission. 43% of discussions were led by a tier 1/2 doctor. 21% of discussions were led by a tier 3 doctor. 23% of discussions were led by a consultant. It was unclear who had led the discussion 13% of the time. 29/97 patients had a DNACPR due to their wishes. 16/97 patients had a DNACPR based on clinical grounds that it would not succeed. 33/97 patients had a DNACPR on the grounds that burden outweighed risks and they had capacity In 19/97 patients the reason for DNACPR was not clearly documented. There were 6 discussions where there was distress or disagreement—all of the discussions resulted in DNACPR recommendation 1 patient had a DNACPR reversed during their admission and none were reversed afterwards.
Conclusion
Systematically discussing preferences around resuscitation is feasible and rarely results in distress. The majority of patients have a recommendation for DNACPR and discussions are led by ‘junior’ doctors.
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Affiliation(s)
| | - S Murray
- Leeds Teaching Hospitals NHS Trust
| | - S Taylor
- Leeds Teaching Hospitals NHS Trust
| | - S Ninan
- Leeds Teaching Hospitals NHS Trust
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Jaishankar S, Pifer PM, Bhargava R, Keller A, Musunuru HB, Patel AK, Sukumvanich P, Boisen M, Berger JL, Taylor S, Courtney-Brooks M, Olawaiye A, Lesnock J, Edwards R, Vargo JA, Beriwal S. Is Substantial Lymphovascular Space Invasion Prognostic for Clinical Outcomes in Type II Endometrial Cancer? Clin Oncol (R Coll Radiol) 2022; 34:452-458. [PMID: 35264314 DOI: 10.1016/j.clon.2022.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/26/2022] [Accepted: 02/21/2022] [Indexed: 11/03/2022]
Abstract
AIMS Substantial lymphovascular space invasion (LVSI) compared with none or focal LVSI is predictive of lymph node involvement and worse clinical outcomes in endometrioid-type endometrial carcinoma. We aimed to quantify the incidence of substantial LVSI in type II (clear cell and serous) endometrial cancer and correlate the extent of LVSI with clinical outcomes. MATERIALS AND METHODS A retrospective review was conducted on type II endometrial cancer patients who underwent surgical management from July 2017 to December 2019 using the three-tier LVSI scoring system. Binary logistic regression and Cox regression were used to analyse predictors of lymph node involvement or survival outcomes, respectively. The Kaplan-Meier method and Log-rank test were used to analyse differences in locoregional disease-free survival (LR-DFS), distant metastasis disease-free survival (DM-DFS) and overall survival between patients with substantial versus none/focal LVSI. RESULTS In 79 patients with type II endometrial carcinoma, no LVSI, focal LVSI and substantial LVSI was present in 48.1%, 15.2% and 36.7% of patients, respectively. Lymph nodes were involved in 0.0% with no LVSI, 20.0% with focal LVSI and 60.0% with substantial LVSI (P < 0.001). The median follow-up was 22.2 months. In patients with none/focal versus substantial LVSI, the 2-year LR-DFS and DM-DFS rates were 91.5% versus 71.4% (P = 0.01) and 90.2% versus 63.8% (P = 0.005), respectively. On univariate analysis, myometrial invasion ≥50%, tumour size ≥3.6 cm, substantial versus none/focal LVSI, lymph node involvement and omission of adjuvant radiotherapy were significant predictors for worse LR-DFS and DM-DFS (P < 0.05). DISCUSSION Substantial LVSI has a high incidence in type II pathology at our institution and predicts for lymph node involvement and worse clinical outcomes.
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Affiliation(s)
- S Jaishankar
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - P M Pifer
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - R Bhargava
- Department of Pathology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - A Keller
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - H B Musunuru
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - A K Patel
- Division of Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA, USA
| | - P Sukumvanich
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - M Boisen
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - J L Berger
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - S Taylor
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - M Courtney-Brooks
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - A Olawaiye
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - J Lesnock
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - R Edwards
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - J A Vargo
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - S Beriwal
- Division of Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA, USA; Varian Medical Systems, Charlottesville, VA, USA.
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Yue JK, Phelps RRL, Hemmerle DP, Upadhyayula PS, Winkler EA, Deng H, Chang D, Vassar M, Taylor S, Schnyer D, Lingsma HF, Puccio A, Yuh E, Mukherjee P, Huang MC, Ngwenya LB, Valadka AB, Markowitz A, Okonkwo DO, Manley GT. 182 Predictors of Six-Month Inability to Return to Work in Previously Employed Subjects After Mild Traumatic Brain Injury: A TRACK-TBI Pilot Study. Neurosurgery 2022. [DOI: 10.1227/neu.0000000000001880_182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Zuniga C, Quintana E, Zuniga E, Lorca E, Cament R, Escobar L, Garcia B, Enos D, Taylor S, Castillo A, Hellman E, Aldunate T, Herrera P, Ruiz A, Arce I, Mª Francisca C, Sabando V, Letelier M. POS-319 TELENEPHROLOGY AS A PUBLIC POLICY FOR THE CARE OF PATIENTS WITH CKD AT THE PRIMARY HEALTH LEVEL. CHILEAN EXPERIENCE. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Boccardo A, Compiani R, Baldi G, Pravettoni D, Grossi S, Sala G, Taylor S, Neville E, Sgoifo Rossi C. Effects of a supplemental calcareous marine algae bolus
on blood calcium concentration in dairy heifers. J Anim Feed Sci 2022. [DOI: 10.22358/jafs/144919/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Thompson T, Zentner D, James P, Taylor S. Practise Changing Research – Adding DNAH11 to a Congenital Heart Disease Panel. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.04.042] [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: 10/18/2022]
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Rosello R, Girela-Serrano B, Gómez S, Baig B, Lim M, Taylor S. Characterizing the features and course of psychiatric symptoms in children and adolescents with autoimmune encephalitis. Eur Arch Psychiatry Clin Neurosci 2022; 272:477-482. [PMID: 34272976 PMCID: PMC8938365 DOI: 10.1007/s00406-021-01293-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 07/04/2021] [Indexed: 01/14/2023]
Abstract
Autoimmune encephalitis (AE) can present like a psychiatric disorder. We aimed to illustrate the psychiatric manifestations, course and management of AE in a paediatric cohort. Neuropsychiatric symptoms, investigations and treatment were retrospectively retrieved in 16 patients (mean age 11.31, SD 2.98) with an AE diagnosis at the liaison psychiatry services in two UK tertiary paediatric centres. Psychiatric presentation was characterised by an acute polysymptomatic (predominantly agitation, anger outbursts/aggressiveness, hallucinations, and emotional lability) onset. Antipsychotics produced side effects and significant worsening of symptoms in four cases, and benzodiazepines were commonly used. This psychiatric phenotype should make clinicians suspect the diagnosis of AE and carefully consider use of treatments.
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Affiliation(s)
- R Rosello
- Division of Psychiatry, Imperial College, London, UK
| | | | - S Gómez
- Division of Psychiatry, King’s College, London, UK
| | - B Baig
- South London and Maudsley NHS Trust, London, UK
| | - M Lim
- Children's Neurosciences Centre, Evelina London Children's Hospital, London, UK. .,Department Women and Children's Health, School of Life Course Sciences (SoLCS), King's College London, London, UK.
| | - S Taylor
- Division of Psychiatry, Imperial College, London, UK
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Taylor S, Metz D. 283: Improving medication adherence and patient engagement in cystic fibrosis patients: Retrospective analysis of a mobile application using gamification and incentives. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01708-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lowe J, Taylor S, Wilson H, Rahme J, Fuller J. External workload patterns of injured elite Rugby League players before and after return to play. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Webster CS, Taylor S, Weller JM. Cognitive biases in diagnosis and decision making during anaesthesia and intensive care. BJA Educ 2021; 21:420-425. [PMID: 34707887 DOI: 10.1016/j.bjae.2021.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- C S Webster
- Centre for Medical and Health Sciences Education, University of Auckland, Auckland, New Zealand
| | - S Taylor
- Auckland City Hospital, Auckland, New Zealand
| | - J M Weller
- Centre for Medical and Health Sciences Education, University of Auckland, Auckland, New Zealand.,Auckland City Hospital, Auckland, New Zealand
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Hodgkinson-Brechenmacher V, Lounsberry J, Abrahao A, Benstead T, Breiner A, Briemberg H, Genge A, Grant I, Kalra S, Marrero A, Massie R, Matte G, O'Connell C, Pfeffer G, Schellenberg K, Shoesmith C, Taylor S, Izenberg A, Johnston W, Korngut L. MOTOR NEURON DISORDERS AND NEUROPATHIES. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gayman CM, Jimenez ST, Hammock S, Taylor S, Rocheleau JM. The Effects of Cumulative and Noncumulative Exams Within the Context of Interteaching. J Behav Educ 2021; 32:261-276. [PMID: 34511863 PMCID: PMC8423584 DOI: 10.1007/s10864-021-09451-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/15/2021] [Indexed: 06/13/2023]
Abstract
Interteaching is a behavioral teaching method that has been empirically shown to increase student learning outcomes. The present study investigated the effect of combining interteaching with cumulative versus noncumulative exams in two sections of an online asynchronous class. Interteaching was used in both sections of the course. The noncumulative exam section experienced weekly exams with test questions that only covered material learned in that week of class. The cumulative exam section was given weekly exams in which half of the questions were from material learned that current week and the other half were cumulative up to that point in the class. This was followed by a cumulative final exam given to both groups. All exam questions were multiple choice. On average, students in the cumulative exam group scored 4.91% higher on the final exam than students in the noncumulative exam group. Students exposed to weekly cumulative exams also earned more As and Bs on the final compared to the noncumulative exam group. Overall, our experiment provides evidence that interteaching may be further improved when combined with cumulative weekly exams.
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Affiliation(s)
- C. M. Gayman
- Department of Psychology, Troy University, 215 Whitley Hall, Montgomery, AL 36104 USA
| | - S. T. Jimenez
- Department of Psychology, University of Pittsburgh at Johnstown, Johnstown, PA USA
| | - S. Hammock
- Department of Psychology, Troy University, 215 Whitley Hall, Montgomery, AL 36104 USA
| | - S. Taylor
- Department of Psychology, Troy University, 215 Whitley Hall, Montgomery, AL 36104 USA
| | - J. M. Rocheleau
- Department of Psychology, Western Michigan University, Kalamazoo, MI USA
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Gelendi S, Taylor S, D'Aout C, Pitchford C, Coldrick O, Sanchez-Jimenez C, O'Halloran C. Mycobacterium avium infection associated with sterile polyarthritis in a dog. J Small Anim Pract 2021; 63:154-158. [PMID: 34468983 DOI: 10.1111/jsap.13420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 01/06/2023]
Abstract
A 1-year-old male neutered Portuguese Podengo dog was presented for lameness, inappetence, pyrexia, diarrhoea and abdominal moderate to severe lymphadenomegaly. Cytology of synovial fluid revealed neutrophilic inflammation in multiple joints suggestive of immune-mediated polyarthritis. Cytology of fine-needle-aspiration material obtained from lymph nodes revealed macrophages with intracytoplasmic, rod-like Ziehl-Neelsen positive staining structures, indicative of mycobacteria. Four-month treatment with enrofloxacin, rifampicin and clarithromycin resulted in clinical improvement and resolution of polyarthritis as evidenced on repeat synoviocentesis, but diarrhoea recurred, Ziehl-Neelsen positive organisms were again found on lymph node cytology and analysis of the 16S rRNA-gene using the Basic Local Alignment Search Tool facility resulted in a match to Mycobacterium avium with 100% sequence identity. Treatment was adjusted to include pradofloxacin, doxycycline, rifampicin and ethambutol and 3 months later the dog is clinically normal. Based on the literature search, this is the first time canine Mycobacterium avium infection associated with immune-mediated polyarthritis is reported. Based on scoping searches, this is the first report of canine Mycobacterium avium infection associated with immune-mediated polyarthritis.
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Affiliation(s)
- S Gelendi
- Department of Internal Medicine, Lumbry Park Veterinary Specialists, Alton, Hampshire, GU34 3HL, UK
| | - S Taylor
- Department of Internal Medicine, Lumbry Park Veterinary Specialists, Alton, Hampshire, GU34 3HL, UK
| | - C D'Aout
- Department of Internal Medicine, Lumbry Park Veterinary Specialists, Alton, Hampshire, GU34 3HL, UK
| | - C Pitchford
- Department of Clinical Pathology, Synlab VPG, Exeter, Devon, EX5 2FN, UK
| | - O Coldrick
- Department of Clinical Pathology, Synlab VPG, Exeter, Devon, EX5 2FN, UK
| | - C Sanchez-Jimenez
- Department of Internal Medicine, Lumbry Park Veterinary Specialists, Alton, Hampshire, GU34 3HL, UK
| | - C O'Halloran
- Division of Infection and Immunity, The Royal (Dick) School of Veterinary Studies, Edinburgh, Midlothian, EH25 9RG, UK
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Johnston E, Taylor S, Bannon F, McAllister S. 489 The Role of Sentinel Lymph Node Biopsy in Cutaneous Head and Neck Melanoma: A Systematic Review and Meta-Analysis. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.289] [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]
Abstract
Abstract
Introduction
and
Aims
The aim of this systematic review is to provide an up-to-date evaluation of the role and test performance of sentinel lymph node biopsy (SLNB) in the head and neck.
Method
This review follows the PRISMA guidelines. Database searches for MEDLINE and EMBASE were constructed to retrieve human studies published between 1st January 2010 and 1st July 2020 assessing the role and accuracy of sentinel lymph node biopsy in cutaneous malignant melanoma of the head and neck. Articles were independently screened by two reviewers and critically appraised using the MINORS criteria. The primary outcomes consisted of the sentinel node identification rate and test-performance measures, including the false-negative rate and the posttest probability negative.
Results
A total of 27 studies, including 4688 patients, met the eligibility criteria. Statistical analysis produced weighted summary estimates for the sentinel node identification rate of 97.3% (95% CI, 95.9% to 98.6%), the false-negative rate of 21.3% (95% CI, 17.0% to 25.4%) and the posttest probability negative of 4.8% (95% CI, 3.9% to 5.8%).
Discussion
Sentinel lymph node biopsy is accurate and feasible in the head and neck. Despite technical improvements in localisation techniques, the false negative rate remains disproportionately higher than for melanoma in other anatomical sites.
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Affiliation(s)
- E Johnston
- Queen's University, Belfast, United Kingdom
| | - S Taylor
- Queen's University, Belfast, United Kingdom
| | - F Bannon
- Queen's University, Belfast, United Kingdom
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Keller A, Rodríguez-López J, Patel A, Kim H, Houser C, Sukumvanich P, Berger J, Boisen M, Edwards R, Taylor S, Courtney-Brooks M, Olawaiye A, Orr B, Beriwal S. PO-0178 Feasibility and Outcomes for Cervical Cancer Patients Treated with Hybrid Brachytherapy Applicators. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06337-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wiles R, Taylor S. Re: Tumour markers and their utility in imaging of abdominal and pelvic malignancies. Clin Radiol 2021; 76:466. [PMID: 33832701 DOI: 10.1016/j.crad.2021.02.026] [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: 02/11/2021] [Accepted: 02/19/2021] [Indexed: 10/21/2022]
Affiliation(s)
- R Wiles
- Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
| | - S Taylor
- Liverpool Women's NHS Foundation Trust, United Kingdom
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Levin HS, Temkin NR, Barber J, Nelson LD, Robertson C, Brennan J, Stein MB, Yue JK, Giacino JT, McCrea MA, Diaz-Arrastia R, Mukherjee P, Okonkwo DO, Boase K, Markowitz AJ, Bodien Y, Taylor S, Vassar MJ, Manley GT. Association of Sex and Age With Mild Traumatic Brain Injury-Related Symptoms: A TRACK-TBI Study. JAMA Netw Open 2021; 4:e213046. [PMID: 33822070 PMCID: PMC8025125 DOI: 10.1001/jamanetworkopen.2021.3046] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
IMPORTANCE Knowledge of differences in mild traumatic brain injury (mTBI) recovery by sex and age may inform individualized treatment of these patients. OBJECTIVE To identify sex-related differences in symptom recovery from mTBI; secondarily, to explore age differences within women, who demonstrate poorer outcomes after TBI. DESIGN, SETTING, AND PARTICIPANTS The prospective cohort study Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) recruited 2000 patients with mTBI from February 26, 2014, to July 3, 2018, and 299 patients with orthopedic trauma (who served as controls) from January 26, 2016, to July 27, 2018. Patients were recruited from 18 level I trauma centers and followed up for 12 months. Data were analyzed from August 19, 2020, to March 3, 2021. EXPOSURES Patients with mTBI (defined by a Glasgow Coma Scale score of 13-15) triaged to head computed tomography in 24 hours or less; patients with orthopedic trauma served as controls. MAIN OUTCOMES AND MEASURES Measured outcomes included (1) the Rivermead Post Concussion Symptoms Questionnaire (RPQ), a 16-item self-report scale that assesses postconcussion symptom severity over the past 7 days relative to preinjury; (2) the Posttraumatic Stress Disorder Checklist for the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (PCL-5), a 20-item test that measures the severity of posttraumatic stress disorder symptoms; (3) the Patient Health Questionnaire-9 (PHQ-9), a 9-item scale that measures depression based on symptom frequency over the past 2 weeks; and (4) the Brief Symptom Inventory-18 (BSI-18), an 18-item scale of psychological distress (split into Depression and Anxiety subscales). RESULTS A total of 2000 patients with mTBI (1331 men [67%; mean (SD) age, 41.0 (17.3) years; 1026 White (78%)] and 669 women [33%; mean (SD) age, 43.0 (18.5) years; 505 (76%) White]). After adjustment of multiple comparisons, significant TBI × sex interactions were observed for cognitive symptoms (B = 0.76; 5% false discovery rate-corrected P = .02) and somatic RPQ symptoms (B = 0.80; 5% false discovery rate-corrected P = .02), with worse symptoms in women with mTBI than men, but no sex difference in symptoms in control patients with orthopedic trauma. Within the female patients evaluated, there was a significant TBI × age interaction for somatic RPQ symptoms, which were worse in female patients with mTBI aged 35 to 49 years compared with those aged 17 to 34 years (B = 1.65; P = .02) or older than 50 years (B = 1.66; P = .02). CONCLUSIONS AND RELEVANCE This study found that women were more vulnerable than men to persistent mTBI-related cognitive and somatic symptoms, whereas no sex difference in symptom burden was seen after orthopedic injury. Postconcussion symptoms were also worse in women aged 35 to 49 years than in younger and older women, but further investigation is needed to corroborate these findings and to identify the mechanisms involved. Results suggest that individualized clinical management of mTBI should consider sex and age, as some women are especially predisposed to chronic postconcussion symptoms even 12 months after injury.
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Affiliation(s)
- Harvey S. Levin
- Baylor College of Medicine, Houston, Texas
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
| | - Nancy R. Temkin
- Department of Neurological Surgery, University of Washington, Seattle
- Department of Biostatistics, University of Washington, Seattle
| | - Jason Barber
- Department of Neurological Surgery, University of Washington, Seattle
| | - Lindsay D. Nelson
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee
- Department of Neurology, Medical College of Wisconsin, Milwaukee
| | | | | | | | | | - Joseph T. Giacino
- Spaulding Rehabilitation Center, Boston, Massachusetts
- Massachusetts General Hospital, Boston
| | - Michael A. McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee
- Department of Neurology, Medical College of Wisconsin, Milwaukee
| | | | | | - David O. Okonkwo
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh
| | - Kim Boase
- Department of Neurological Surgery, University of Washington, Seattle
| | | | - Yelena Bodien
- Spaulding Rehabilitation Center, Boston, Massachusetts
- Massachusetts General Hospital, Boston
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Taylor S, Cairns A, Glass B. Application of the PRECEDE-PROCEED model for the development of a community pharmacy ear health intervention for rural populations. International Journal of Pharmacy Practice 2021. [DOI: 10.1093/ijpp/riab016.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
The World Health Organisation has identified ear disease to be a major public health problem in rural and remote communities, with access to services an identified barrier. (1) Rural community pharmacists are recognised as highly skilled, accessible and trusted health professionals. An innovative service “LISTEN UP” (Locally Integrated Screening and Testing Ear aNd aUral Program) has been implemented in two remote community pharmacies in Australia. The service involves patients with an ear complaint self-presenting to a participating pharmacy and receiving a clinical examination by a pharmacist, who has completed accredited training in ear health, otoscopy and tympanometry. “LISTEN UP” has been developed using the PRECEDE-PROCEED planning model.(2) The PRECEDE component of the model assesses social, epidemiological, behavioural, environmental, educational and ecological factors to inform the development of an intervention.(2) The PROCEED-component consists of pilot testing and evaluation.
Aim
To describe an ecological approach to health promotion via the application of the PRECEDE-PROCEED planning model to develop a rural community pharmacy-based ear health intervention.
Methods
PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis) provided a framework to plan and develop a locally relevant and community focused program. This included research and engagement via meetings, surveys and interviews of consumers, pharmacists, health professionals and stakeholders. PROCEED (Policy, Regulatory, and Organisational Constructs in Educational and Environmental Development) outlined the structure for implementing and evaluating the intervention that was developed in the PRECEDE process. A pilot study has been included in PROCEED segment to allow improvement before implementing and evaluating the final model. Data will be collected in the pilot study via semi-structured interviews and surveys. This will be analysed using descriptive statistics and thematic analysis of qualitative data.
Results
As part of the PRECEDE segment a social assessment was undertaken via mixed method studies of rural consumers, pharmacists and health professionals. Hearing testing was ranked as the seventh (from twenty-six) most important expanded pharmacy service by both consumer and health professional groups. An epidemiological assessment found extensive ear disease in rural and remote locations resulting in complications and hearing loss. Behavioural and environment assessments identified eleven ear health interventions which include hearing screening [3], otoscopy pilot studies [2], audiometry services [1], specific education for undergraduate pharmacy students [2] and a pharmacy-based clinic [3]. However none of the interventions described a framework for continued service provision. Policy and regulation assessment was undertaken to align the intervention within the regulatory framework. The application of this model is partially complete with the study protocol for the intervention developed and the initial pilot study in progress. This study’s strengths include its applicability to rural populations and the limited evidence base that currently exists. It is however limited by the small size of the pilot study and application of this model to a national intervention would be useful for future.
Conclusions
The application of the PRECEDE-PROCEED model demonstrates the applicability of this planning model for developing and evaluating an ear health intervention with a particular focus on community pharmacies in rural and remote locations.
References
1. World Health Organisation. Deafness and hearing loss; 2020. Available from: https://www.who.int/health-topics/hearing-loss#tab=tab_1 [Accessed: 15/9/2020]
2. Binkley CJ, Johnson KW. Application of the PRECEDE-PROCEED Planning Model in Designing an Oral Health Strategy. J Theory Pract Dent Public Health. 2013;1(3):http://www.sharmilachatterjee.com/ojs-2.3.8/index.php/JTPDPH/article/view/89
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Affiliation(s)
- S Taylor
- Centre for Rural and Remote Health – Mount Isa, Australia
| | - A Cairns
- Centre for Rural and Remote Health – Mount Isa, Australia
| | - B Glass
- James Cook University, Townsville, Australia
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Dively GP, Kuhar TP, Taylor S, Doughty HB, Holmstrom K, Gilrein D, Nault BA, Ingerson-Mahar J, Whalen J, Reisig D, Frank DL, Fleischer SJ, Owens D, Welty C, Reay-Jones FPF, Porter P, Smith JL, Saguez J, Murray S, Wallingford A, Byker H, Jensen B, Burkness E, Hutchison WD, Hamby KA. Sweet Corn Sentinel Monitoring for Lepidopteran Field-Evolved Resistance to Bt Toxins. J Econ Entomol 2021; 114:307-319. [PMID: 33274391 DOI: 10.1093/jee/toaa264] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Indexed: 06/12/2023]
Abstract
As part of an insect resistance management plan to preserve Bt transgenic technology, annual monitoring of target pests is mandated to detect susceptibility changes to Bt toxins. Currently Helicoverpa zea (Boddie) monitoring involves investigating unexpected injury in Bt crop fields and collecting larvae from non-Bt host plants for laboratory diet bioassays to determine mortality responses to diagnostic concentrations of Bt toxins. To date, this monitoring approach has not detected any significant change from the known range of baseline susceptibility to Bt toxins, yet practical field-evolved resistance in H. zea populations and numerous occurrences of unexpected injury occur in Bt crops. In this study, we implemented a network of 73 sentinel sweet corn trials, spanning 16 U.S. states and 4 Canadian provinces, for monitoring changes in H. zea susceptibility to Cry and Vip3A toxins by measuring differences in ear damage and larval infestations between isogenic pairs of non-Bt and Bt hybrids over three years. This approach can monitor susceptibility changes and regional differences in other ear-feeding lepidopteran pests. Temporal changes in the field efficacy of each toxin were evidenced by comparing our current results with earlier published studies, including baseline data for each Bt trait when first commercialized. Changes in amount of ear damage showed significant increases in H. zea resistance to Cry toxins and possibly lower susceptibility to Vip3a. Our findings demonstrate that the sentinel plot approach as an in-field screen can effectively monitor phenotypic resistance and document field-evolved resistance in target pest populations, improving resistance monitoring for Bt crops.
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Affiliation(s)
- G P Dively
- Department of Entomology, University of Maryland, College Park, MD
| | - T P Kuhar
- Department of Entomology, Virginia Tech, Blacksburg, VA
| | - S Taylor
- Department of Entomology, Virginia Tech, Suffolk, VA
| | - H B Doughty
- Virginia Tech ESAREC/Entomology, Painter, VA
| | | | - D Gilrein
- LIHREC, Cornell University, Riverhead, NY
| | - B A Nault
- Department of Entomology, Cornell AgriTech, Geneva, NY
| | | | - J Whalen
- Private IPM Consultant, Millington, MD
| | - D Reisig
- Department of Entomology and Plant Pathology, NC State University, Plymouth, NC
| | | | - S J Fleischer
- Department of Entomology, Penn State University, University Park, PA
| | - David Owens
- University of Delaware Cooperative Extension, Carvel REC, Georgetown, DE
| | - C Welty
- Rothenbuhler Lab, Ohio State University, Columbus, OH
| | - F P F Reay-Jones
- Pee Dee Research and Education Center, Clemson University, Florence, SC
| | - P Porter
- Department of Entomology, Texas A&M University, AgriLife Research and Extension Center, Lubbock, TX
| | - J L Smith
- Field Crop Pest Management, University of Guelph, Ridgetown, Ontario, Canada
| | - J Saguez
- CEROM, 740 Chemin Trudeau, Saint-Mathieu-de-Beloeil, Quebec J3G 0E2, Canada
| | - S Murray
- Perennia Food and Agriculture, Kentville, Nova Scotia, Canada
| | - A Wallingford
- University of New Hampshire Cooperative Extension, Durham, NH
| | - H Byker
- Department of Plant Agriculture, University of Guelph, Winchester, Ontario, Canada
| | - B Jensen
- Department of Entomology, University of Wisconsin, Madison, WI
| | - E Burkness
- Department of Entomology, University of Minnesota, St. Paul, MN
| | - W D Hutchison
- Department of Entomology, University of Minnesota, St. Paul, MN
| | - K A Hamby
- Department of Entomology, University of Maryland, College Park, MD
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Barrera J, Greene S, Petyak E, Kenneson S, McGill E, Howell H, Billing D, Taylor S, Ewing A, Cull J. Reported rationales for HPV vaccination vs. Non-vaccination among undergraduate and medical students in South Carolina. J Am Coll Health 2021; 69:185-189. [PMID: 31513465 DOI: 10.1080/07448481.2019.1659279] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 07/28/2019] [Accepted: 08/18/2019] [Indexed: 06/10/2023]
Abstract
Objective: We sought to identify factors that influence Human Papillomavirus (HPV) vaccination rates in individuals at two higher education institutions in South Carolina (SC).Participants: We surveyed 1007 students with a mean age and standard deviation of 20.3 ± 3.3 from September 2018 to December 2018.Methods: Participants answered 13 questions, assessing HPV vaccination rates, demographics, and rationales for vaccination vs. non-vaccination.Results: Of 1007 respondents, 700 received HPV vaccination, 165 were unvaccinated, 75 received partial vaccination and 138 were uncertain. Commonalities in HPV vaccination existed between females (p = 0.037), individuals who received standard childhood vaccinations (p = 0.04), and those not native-born in SC (p < 0.001). Of non-vaccinated individuals, 37% "never thought about vaccination," 32% did not perceive a need for vaccination, and 31% reported vaccine safety as reasons for not receiving the vaccine.Conclusions: Promotion of HPV vaccination may benefit from targeting SC natives, males, and individuals who are under-vaccinated or unvaccinated.
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Affiliation(s)
- J Barrera
- University of South Carolina School of Medicine Greenville, Greenville, SC
| | - S Greene
- University of South Carolina School of Medicine Greenville, Greenville, SC
| | | | | | | | | | | | | | - A Ewing
- Prisma Health-Upstate Health Sciences Center, Greenville, SC
| | - J Cull
- Department of Surgery, Prisma Health-Upstate, Greenville, SC
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Hodgkinson V, Lounsberry J, M'Dahoma S, Russell A, Jewett G, Benstead T, Brais B, Campbell C, Johnston W, Lochmüller H, McCormick A, Nguyen CT, O'Ferrall E, Oskoui M, Abrahao A, Briemberg H, Bourque PR, Botez S, Cashman N, Chapman K, Chrestian N, Crone M, Dobrowolski P, Dojeiji S, Dowling JJ, Dupré N, Genge A, Gonorazky H, Grant I, Hasal S, Izenberg A, Kalra S, Katzberg H, Krieger C, Leung E, Linassi G, Mackenzie A, Mah JK, Marrero A, Massie R, Matte G, McAdam L, McMillan H, Melanson M, Mezei MM, O'Connell C, Pfeffer G, Phan C, Plamondon S, Poulin C, Rodrigue X, Schellenberg K, Selby K, Sheriko J, Shoesmith C, Smith RG, Taillon M, Taylor S, Venance S, Warman-Chardon J, Worley S, Zinman L, Korngut L. The Canadian Neuromuscular Disease Registry 2010-2019: A Decade of Facilitating Clinical Research Througha Nationwide, Pan-NeuromuscularDisease Registry. J Neuromuscul Dis 2021; 8:53-61. [PMID: 32925088 PMCID: PMC7902956 DOI: 10.3233/jnd-200538] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We report the recruitment activities and outcomes of a multi-disease neuromuscular patient registry in Canada. The Canadian Neuromuscular Disease Registry (CNDR) registers individuals across Canada with a confirmed diagnosis of a neuromuscular disease. Diagnosis and contact information are collected across all diseases and detailed prospective data is collected for 5 specific diseases: Amyotrophic Lateral Sclerosis (ALS), Duchenne Muscular Dystrophy (DMD), Myotonic Dystrophy (DM), Limb Girdle Muscular Dystrophy (LGMD), and Spinal Muscular Atrophy (SMA). Since 2010, the CNDR has registered 4306 patients (1154 pediatric and 3148 adult) with 91 different neuromuscular diagnoses and has facilitated 125 projects (73 academic, 3 not-for-profit, 3 government, and 46 commercial) using registry data. In conclusion, the CNDR is an effective and productive pan-neuromuscular registry that has successfully facilitated a substantial number of studies over the past 10 years.
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Affiliation(s)
- V Hodgkinson
- Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - J Lounsberry
- Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - S M'Dahoma
- Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - A Russell
- Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - G Jewett
- Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - T Benstead
- Division of Neurology, Dalhousie University, Halifax, Canada
| | - B Brais
- Montreal Neurological Institute and Hospital, Montreal, Canada
| | - C Campbell
- Department of Pediatrics, Children's Health Research Institute, London Health Sciences Centre, Western University, London, Canada
| | - W Johnston
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Alberta, Edmonton, Canada
| | - H Lochmüller
- Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada.,Department of Medicine, The Ottawa Hospital and Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada
| | - A McCormick
- Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada
| | - C T Nguyen
- CHU Sainte-Justine, Université de Montréal, Montréal, Canada
| | - E O'Ferrall
- Montreal Neurological Institute and Hospital, Montreal, Canada.,Department of Neurosciences, McGill University, Montréal, Canada
| | - M Oskoui
- Department of Neurosciences, McGill University, Montréal, Canada.,Departments of Pediatrics, Montreal Children's Hospital, McGill University, Montréal, Canada
| | - A Abrahao
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - H Briemberg
- GF Strong Rehabilitation Centre, University of British Columbia, Vancouver, Canada.,Division of Neurology, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - P R Bourque
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Ottawa, Ottawa, Canada
| | - S Botez
- Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, Canada
| | - N Cashman
- GF Strong Rehabilitation Centre, University of British Columbia, Vancouver, Canada.,Division of Neurology, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - K Chapman
- Division of Neurology, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - N Chrestian
- Department of Medicine, Université Laval, Quebec City, Canada, Neuroscience axis, CHU de Québec-Université Laval
| | - M Crone
- Division of Pediatric Neurology, Department of Neurology, University of Saskatchewan, Saskatoon, Canada
| | - P Dobrowolski
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Alberta, Edmonton, Canada
| | - S Dojeiji
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Ottawa, Ottawa, Canada
| | - J J Dowling
- Department of Pediatrics, Sick Kids Hospital, University of Toronto, Toronto, Canada
| | - N Dupré
- Department of Medicine, Laval University, Québec City, Canada
| | - A Genge
- Department of Neurosciences, McGill University, Montréal, Canada
| | - H Gonorazky
- Department of Pediatrics, Sick Kids Hospital, University of Toronto, Toronto, Canada
| | - I Grant
- Division of Neurology, Dalhousie University, Halifax, Canada
| | - S Hasal
- Division of Pediatric Neurology, Department of Neurology, University of Saskatchewan, Saskatoon, Canada
| | - A Izenberg
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - S Kalra
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Alberta, Edmonton, Canada
| | - H Katzberg
- University Health Network, University of Toronto, Toronto, Canada
| | - C Krieger
- GF Strong Rehabilitation Centre, University of British Columbia, Vancouver, Canada.,Division of Neurology, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - E Leung
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
| | - G Linassi
- Department of Physical Medicine and Rehabilitation University of Saskatchewan, Saskatoon, Canada
| | - A Mackenzie
- Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada
| | - J K Mah
- Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.,Department of Pediatrics, University of Calgary, Calgary, Canada
| | - A Marrero
- CHU Dr. Georges-L-Dumont, Université de Sherbrooke, Moncton, Canada
| | - R Massie
- Montreal Neurological Institute and Hospital, Montreal, Canada.,Department of Neurosciences, McGill University, Montréal, Canada
| | - G Matte
- Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, Canada
| | - L McAdam
- Department of Pediatrics, Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, University of Toronto, Toronto, Canada
| | - H McMillan
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Alberta, Edmonton, Canada
| | - M Melanson
- Department of Physical Medicine and Rehabilitation, Queen's University, Kingston, Canada
| | - M M Mezei
- Division of Neurology, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - C O'Connell
- Stan Cassidy Centre for Rehabilitation, Fredericton, Canada.,Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - G Pfeffer
- Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.,Department of Medical Genetics, and Alberta Child Health Research Institute, University of Calgary, Calgary, Canada
| | - C Phan
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Alberta, Edmonton, Canada
| | - S Plamondon
- Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - C Poulin
- Departments of Pediatrics, Montreal Children's Hospital, McGill University, Montréal, Canada
| | - X Rodrigue
- Department of Medicine, Laval University, Québec City, Canada
| | - K Schellenberg
- Department of Physical Medicine and Rehabilitation University of Saskatchewan, Saskatoon, Canada
| | - K Selby
- Division of Neurology, Department of Pediatrics, BC Children's Hospital, University of Vancouver, Vancouver, Canada
| | - J Sheriko
- Division of Neurology, Department of Pediatrics, Dalhousie University, Halifax, Canada
| | - C Shoesmith
- Division of Neurology, Clinical Neurological Sciences, Western University, London, Canada
| | - R G Smith
- Department of Pediatrics, KidsInclusive Centre for Child & Youth Development, Hotel Dieu Hospital, Queen's University, Kingston, Canada
| | - M Taillon
- Stan Cassidy Centre for Rehabilitation, Fredericton, Canada.,Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - S Taylor
- Division of Neurology, Dalhousie University, Halifax, Canada
| | - S Venance
- Division of Neurology, Clinical Neurological Sciences, Western University, London, Canada
| | - J Warman-Chardon
- Department of Medicine, The Ottawa Hospital and Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada
| | - S Worley
- Stan Cassidy Centre for Rehabilitation, Fredericton, Canada.,Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - L Zinman
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - L Korngut
- Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
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Van Der Pol B, Broache M, Torres-Chavolla E, Taylor S, Augenbraun M, Fife K, Davis T, Gaydos C. Testing for three common sexually transmitted infections with a single FDA-cleared amplified molecular assay. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2020.08.148] [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: 10/22/2022]
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47
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Yue JK, Xu L, Korley F, Puccio A, Yuh E, Sun X, Rabinowitz M, Vassar MJ, Taylor S, Winkler EA, Puffer R, Deng H, McCrea M, Stein M, Robertson CS, Levin H, Dikmen S, Temkin N, Giacino JT, Mukherjee P, Wang K, Okonkwo DO, Markowitz A, Jain S, Manley GT, Diaz-Arrastia R. High-sensitivity C-Reactive Protein is a Prognostic Biomarker of 6-month Disability After Traumatic Brain Injury. Neurosurgery 2020. [DOI: 10.1093/neuros/nyaa447_414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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48
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Yue JK, Satris G, Dalle Ore CL, Huie JR, Deng H, Winkler EA, Lee YM, Vassar M, Taylor S, Schnyer DM, Lingsma HF, Puccio A, Yuh E, Mukherjee P, Valadka AB, Ferguson A, Okonkwo DO, Manley GT. Polytrauma is Associated with Worse 3- and 6-month Disability After Traumatic Brain Injury. Neurosurgery 2020. [DOI: 10.1093/neuros/nyaa447_452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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49
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Yue JK, Yuh E, Stein M, Winkler E, Deng H, Dalle Ore CL, Vassar M, Taylor S, Schnyer D, Lingsma HF, Puccio A, Mukherjee P, Valadka AB, Okonkwo DO, Diaz-Arrastia R, Manley GT. Diffuse Axonal Injury and Cerebral Contusions on MRI Are Associated with Decreased Functional Outcome in CT-negative TBI. Neurosurgery 2020. [DOI: 10.1093/neuros/nyaa447_442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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50
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Bodien Y, Sherer M, Taylor S, Dikmen S, Yue J, Stein M, Corrigan J, Levin H, Temkin N, Machamer J, Boase K, Vassar M, McCrea M, McAllister T, Whyte J, Barber J, Gardner R, Kramer J, Nelson L, Manley G, Giacino J. Feasibility and Utility of a Flexible Outcome Assessment Battery for Use in Longitudinal Traumatic Brain Injury Research. Arch Phys Med Rehabil 2020. [DOI: 10.1016/j.apmr.2020.09.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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