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Odogwu S, Morris S, Addison S, Abbott S. Laparoscopic cholecystectomy performed by a surgical care practitioner: a review of outcomes. Ann R Coll Surg Engl 2024. [PMID: 38660827 DOI: 10.1308/rcsann.2023.0058] [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: 04/26/2024] Open
Abstract
INTRODUCTION Surgical care practitioners (SCPs) are non-medical workers involved in various aspects of the management of surgical patients. The role includes assisting and performing surgical procedures. More than 60,000 laparoscopic cholecystectomies (LC) are performed annually in the UK. With ever-increasing pressure on waiting lists, it is important to look at fully utilising the skills of our entire workforce. We report what we believe is the first published series of LC performed by an SCP. METHODS A retrospective review of a prospectively collected database was performed. The primary outcome was any complication requiring intervention. Secondary outcomes were minor complications, operative time, length of stay, conversion and readmission. RESULTS In total, 170 patients were operated on. Indications were biliary colic in 127 (74.7%), cholecystitis in 30 (17.6%) and pancreatitis in 13 (7.6%). Mean operating time was 65min (range 35-152min). Fifty-three operations were assisted by a consultant, 110 by a specialist or associate specialist grade (SAS) doctor and 7 by a core trainee (CT2). Some 139 (81.7%) patients were discharged on the day of surgery and 24 (14.1%) stayed one night in hospital. There were no major complications. Five patients required readmission, three with pain and two with port site infections. There were no conversions or transfusions required. CONCLUSIONS There is a paucity of published data on surgical outcomes of procedures performed by SCPs. With a structured, supervised approach, SCPs could be trained to take on more complex procedures and further strengthen the surgical workforce. This study demonstrates that elective LC can be safely performed by an appropriately trained and supervised SCP.
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Affiliation(s)
- S Odogwu
- Walsall Healthcare NHS Trust, UK
| | - S Morris
- Walsall Healthcare NHS Trust, UK
| | - S Addison
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - S Abbott
- Walsall Healthcare NHS Trust, UK
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Gould JF, Roberts RM, Anderson PJ, Makrides M, Sullivan TR, Gibson RA, McPhee AJ, Doyle LW, Bednarz JM, Best KP, Opie G, Travadi J, Cheong JLY, Davis PG, Sharp M, Simmer K, Tan K, Morris S, Lui K, Bolisetty S, Liley H, Stack J, Collins CT. High-Dose Docosahexaenoic Acid in Newborns Born at Less Than 29 Weeks' Gestation and Behavior at Age 5 Years: Follow-Up of a Randomized Clinical Trial. JAMA Pediatr 2024; 178:45-54. [PMID: 37983037 PMCID: PMC10660239 DOI: 10.1001/jamapediatrics.2023.4924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/14/2023] [Indexed: 11/21/2023]
Abstract
Importance Children born at less than 29 weeks' gestation are at risk of behavioral difficulties. This may be due in part to the lack of transplacental supply of docosahexaenoic acid (DHA), a key fatty acid with structural and functional roles in the brain. Objective To determine whether meeting the neonatal DHA requirement through supplementation is associated with improved behavioral functioning of children born at less than 29 weeks' gestation. Design, Setting and Participants This was a follow-up of children from 10 Australian participating centers in a multi-center, blinded, parallel group randomized clinical trial of infants born at less than 29 weeks' gestation conducted from June 2012 and September 2015, excluding those with additional fatty acid supplementation or major congenital or chromosomal abnormalities. Follow-up took place from August 2018 to May 2021. Parents of surviving children who had not withdrawn from the original trial were invited to complete questionnaires when the child turned 5 years' corrected age. Interventions Infants were randomized to receive daily enteral emulsions providing 60 mg/kg/d of DHA or a soy-oil emulsion (with no DHA) from within the first 3 days of enteral feeding until 36 weeks' postmenstrual age or discharge home, whichever occurred first. Main Outcomes and Measures The primary outcome of this follow-up was parent-rated behavior and emotional functioning as indicated by the Total Difficulties score of the Strengths and Difficulties Questionnaire. Parents also completed questionnaires about their child's behavioral manifestations of executive functioning, as well as a range of health outcomes to assess potential longer-term side effects of DHA intervention. Results Primary outcome data were available for 731 children (76% of 958 surviving eligible children; 361 in the intervention group and 370 in the control group). Of these 731, 452 (47%) were female, and the mean (SD) corrected age at follow-up was 5.4 (0.5) years. Following imputation for missing data, the mean Total Difficulties score was the same in both groups (intervention group, n = 465; mean [SD], 11.8 [6.3]; control group, n = 493; mean [SD], 11.8 [6.0]; mean difference adjusted for sex, gestational age stratum, and hospital, 0.01; 95% CI, -0.87 to 0.89; P = .98). There was no evidence for differences between the groups in any secondary outcomes of behavior, executive functioning, or health. Conclusions and Relevance In this follow-up of a randomized clinical trial, enteral DHA supplementation at the equivalent of the estimated in utero dose for infants born at less than 29 weeks' gestation did not improve behavioral functioning at age 5 years. There were no indications of adverse effects with DHA supplementation. Trial Registration Australian New Zealand Clinical Trial Registry: ACTRN12612000503820.
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Affiliation(s)
- Jacqueline F. Gould
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia
- Discipline of Paediatrics, Faculty of Health and Medical Sciences, The University of Adelaide, North Terrace Adelaide, South Australia, Australia
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, North Terrace Adelaide, Adelaide, South Australia, Australia
| | - Rachel M. Roberts
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, North Terrace Adelaide, Adelaide, South Australia, Australia
| | - Peter J. Anderson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Maria Makrides
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia
- Discipline of Paediatrics, Faculty of Health and Medical Sciences, The University of Adelaide, North Terrace Adelaide, South Australia, Australia
| | - Thomas R. Sullivan
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia
- School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, North Terrace Adelaide, South Australia, Australia
| | - Robert A. Gibson
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia
- School of Agriculture, Food and Wine, The University of Adelaide, Waite Campus, Glen Osmond, South Australia, Australia
| | - Andrew J. McPhee
- Neonatal Medicine, Women’s and Children’s Hospital, North Adelaide, South Australia, Australia
| | - Lex W. Doyle
- Department of Obstetrics and Gynaecology, The Royal Women’s Hospital, Parkville, Melbourne, Victoria, Australia
| | - Jana M. Bednarz
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia
| | - Karen P. Best
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia
- Discipline of Paediatrics, Faculty of Health and Medical Sciences, The University of Adelaide, North Terrace Adelaide, South Australia, Australia
| | - Gillian Opie
- Neonatal Services, Mercy Hospital for Women, Heidelberg, Melbourne, Victoria, Australia
| | - Javeed Travadi
- Newborn Services, John Hunter Children’s Hospital, New Lambton Heights, New South Wales, Australia
- Neonatal Intensive Care Unit, Department of Paediatrics, Te Whatu Ora Waikato, Waikato Hospital, Hamilton, New Zealand
| | - Jeanie L. Y. Cheong
- Neonatal Medicine, The Royal Women’s Hospital, Parkville, Melbourne, Victoria, Australia
| | - Peter G. Davis
- Neonatal Medicine, The Royal Women’s Hospital, Parkville, Melbourne, Victoria, Australia
| | - Mary Sharp
- King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - Karen Simmer
- The University of Western Australia, Perth, Western Australia, Australia
| | - Kenneth Tan
- Department of Paediatrics, Monash University, Monash Children’s Hospital, Clayton, Victoria, Australia
| | - Scott Morris
- Neonatal-Perinatal Medicine, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia, Australia
| | - Kei Lui
- School of Clinical Medicine, Discipline of Paediatrics and Child Health, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Helen Liley
- Mater Research – The Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
| | - Jacqueline Stack
- Neonatal Intensive Care Unit, Liverpool Hospital, Elizabeth, Liverpool, New South Wales, Australia
| | - Carmel T. Collins
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia
- Discipline of Paediatrics, Faculty of Health and Medical Sciences, The University of Adelaide, North Terrace Adelaide, South Australia, Australia
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Stark MJ, Collins CT, Andersen CC, Crawford TM, Sullivan TR, Bednarz J, Morton R, Marks DC, Dieng M, Owen LS, Opie G, Travadi J, Tan K, Morris S. Study protocol of the WashT Trial: transfusion with washed versus unwashed red blood cells to reduce morbidity and mortality in infants born less than 28 weeks' gestation - a multicentre, blinded, parallel group, randomised controlled trial. BMJ Open 2023; 13:e070272. [PMID: 37487676 PMCID: PMC10373745 DOI: 10.1136/bmjopen-2022-070272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/26/2023] Open
Abstract
INTRODUCTION Many extremely preterm newborns develop anaemia requiring a transfusion, with most receiving three to five transfusions during their admission. While transfusions save lives, the potential for transfusion-related adverse outcomes is an area of growing concern. Transfusion is an independent predictor of death and is associated with increased morbidity, length of hospital stay, risk of infection and immune modulation. The underlying mechanisms include adverse pro-inflammatory and immunosuppressive responses. Evidence supports an association between transfusion of washed red cells and fewer post-transfusion complications potentially through removal of chemokines, lipids, microaggregates and other biological response modifiers. However, the clinical and cost-effectiveness of washed cells have not been determined. METHODS AND ANALYSIS This is a multicentre, randomised, double-blinded trial of washed versus unwashed red cells. Infants <28 weeks' gestation requiring a transfusion will be enrolled. Transfusion approaches will be standardised within each study centre and will occur as soon as possible with a recommended fixed transfusion volume of 15 mL/kg whenever the haemoglobin is equal to or falls below a predefined restrictive threshold, or when clinically indicated. The primary outcome is a composite of mortality and/or major morbidity to first discharge home, defined as one or more of the following: physiologically defined bronchopulmonary dysplasia; unilateral or bilateral retinopathy of prematurity grade >2, and; necrotising enterocolitis stage ≥2. To detect a 10% absolute reduction in the composite outcome from 69% with unwashed red blood cell (RBCs) to 59% with washed RBCs with 90% power, requires a sample size of 1124 infants (562 per group). Analyses will be performed on an intention-to-treat basis with a prespecified statistical analysis plan. A cost-effectiveness analysis will also be undertaken. ETHICS AND DISSEMINATION Ethics approval has been obtained from the Women's and Children's Health Network Human Research Ethics Committee (HREC/12/WCHN/55). The study findings will be disseminated through peer-reviewed articles and conferences. TRIAL REGISTRATION NUMBER ACTRN12613000237785 Australian New Zealand Clinical Trials Registry.
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Affiliation(s)
- Michael J Stark
- Department of Neonatal Medicine, The Women's and Children's Hospital Adelaide, Adelaide, South Australia, Australia
- Robinson Research Institute, The University of Adelaide, North Adelaide, South Australia, Australia
- SAHMRI Women and Kids Theme, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia
| | - Carmel T Collins
- SAHMRI Women and Kids Theme, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia
| | - Chad C Andersen
- Department of Neonatal Medicine, The Women's and Children's Hospital Adelaide, Adelaide, South Australia, Australia
- Robinson Research Institute, The University of Adelaide, North Adelaide, South Australia, Australia
| | - Tara M Crawford
- Department of Neonatal Medicine, The Women's and Children's Hospital Adelaide, Adelaide, South Australia, Australia
- Robinson Research Institute, The University of Adelaide, North Adelaide, South Australia, Australia
- SAHMRI Women and Kids Theme, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia
| | - Thomas R Sullivan
- SAHMRI Women and Kids Theme, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Jana Bednarz
- SAHMRI Women and Kids Theme, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Rachael Morton
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Denese C Marks
- Research and Development, Australian Red Cross Lifeblood New South Wales and Australian Capital Territory, Teams, New South Wales, Australia
| | - Mbathio Dieng
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Louise S Owen
- Newborn Research Centre, The Royal Women's Hospital, Melbourne, Victoria, Australia
- Critical Care and Neurosciences Division, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Gillian Opie
- Department of Obstetrics & Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
- Neonatal Services, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Javeed Travadi
- Department of Paediatrics, Royal Darwin Hospital, Casuarina, Northern Territory, Australia
| | - Kenneth Tan
- Monah Newborn, Monash Children's Hospital, Clayton, Victoria, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Scott Morris
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Department of Neonatal Medicine, Flinders Medical Centre, Bedford Park, South Australia, Australia
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Grzeskowiak LE, Tao B, Aliakbari K, Chegeni N, Morris S, Chataway T. Oral immunotherapy using boiled peanuts for treating peanut allergy: An open-label, single-arm trial. Clin Exp Allergy 2023; 53:327-336. [PMID: 36628520 DOI: 10.1111/cea.14254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/21/2022] [Accepted: 10/27/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Peanut allergy affects 1%-3% of children in Western countries. Boiling peanuts has been demonstrated to result in a hypoallergenic product that may provide a safer way of inducing desensitization in peanut-allergic patients by first inducing tolerance to boiled peanut. We aimed to assess the efficacy and safety of oral immunotherapy (OIT) using sequential doses of boiled peanuts followed by roasted peanuts for treating peanut allergy in children. METHODS In this open-label, phase 2, single-arm clinical trial, children aged 6-18 years with a positive history of peanut allergy and positive peanut skin prick test ≥ 8 mm and/or peanut-specific IgE ≥ 15 kU/L at screening underwent OIT involving sequential up-dosing with 12-hour boiled peanut for 12 weeks, 2-hour boiled peanut for 20 weeks and roasted peanut for 20 weeks, to a target maintenance dose of 12 roasted peanuts daily. PRIMARY OUTCOME proportion of children passing open-label oral food challenge involving cumulative administration of 12 roasted peanuts (12 g peanuts; approximately 3000 mg peanut protein) 6-8 weeks after reaching the target maintenance dose. Secondary outcomes included treatment-related adverse events and use of medications for treating allergy symptoms. RESULTS Between 1 July 2017 and 22 June 2018, 70 participants were enrolled and commenced OIT. Desensitization was successfully induced in 56 of 70 (80%) participants. Withdrawal due to treatment-related adverse events was infrequent (n = 3). Treatment-related adverse events were reported in 43 (61%) participants, corresponding to a rate of 6.58 per 1000 OIT doses. Medication use associated with treatment-related adverse events was infrequent, with rescue epinephrine use reported by three (4%) participants (0.05 per 1000 doses). CONCLUSION Oral immunotherapy using boiled followed by roasted peanuts represents a pragmatic approach that appears effective in inducing desensitization and is associated with a favourable safety profile.
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Affiliation(s)
- Luke E Grzeskowiak
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Billy Tao
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Allergy SA, Adelaide, South Australia, Australia
| | - Kamelya Aliakbari
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Nusha Chegeni
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Scott Morris
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Department of Neonatal-Perinatal Medicine, Flinders Medical Centre, SA Health, Adelaide, South Australia, Australia
| | - Tim Chataway
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
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Shand J, Gomes M, Morris S. The impact of having a carer on adult health and social care utilisation across five settings of care: A matched cohort study. Health Policy 2023; 129:104705. [PMID: 36639309 DOI: 10.1016/j.healthpol.2022.104705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 03/10/2021] [Accepted: 12/30/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION An estimated 6.8 million people are (informal) carers in the UK. The economic value of annual carer contributions is an estimated .·132bn. Reliance on carers appears to be increasing. There is mixed evidence on whether carers are substitutes for formal care. This study investigated the association between having a carer and service use patterns across five care settings when compared to a matched cohort without a carer. MATERIALS AND METHODS A matched case-control group analysis using person-level data in Barking and Dagenham (B&D), a London borough in the U.K., to assess the impact of having a carer in terms of the differences in cost-weighted utilisation relative to a matched control group. RESULTS In 2016/17, for adult residents of B&D, having a carer (n = 1,295) was associated with 27% increased cost-weighted utilisation (mean difference of £2,662, CI £1,595, £3,729, p<0.001) compared to a matched cohort without a carer. 39% of the cost difference was social care. CONCLUSIONS Findings suggest additional service use induced by carers may dominate any substitution effect. Having a carer may be a key element in enabling access to services. As such, there may be wider inequalities in service access for people without a carer. For an ageing society with projections suggesting there will be more people without carers in the future, these inequalities need to be addressed.
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Affiliation(s)
- J Shand
- University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom.
| | - M Gomes
- University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom
| | - S Morris
- University of Cambridge, East Forvie Building, Cambridge Biomedical Campus, Cambridge, CB2 0SR, United Kingdom
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Xia R, Morris S, Klappa SG, Colgrove Y. A Longitudinal Study of Journal Club to Enhance Physical Therapy Students' Research Appraisal Skill for Evidence-Based Practice: A Mixed-Methods Study. J Allied Health 2023; 52:e113-e122. [PMID: 37728359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/05/2023] [Indexed: 09/21/2023]
Abstract
Evidence-based practice (EBP) requires that clinicians possess skills in appraisal of evidence. Journal club (JC) is demonstrated to increase EBP skills in medicine, nursing, and occupational therapy. Study in physical therapy remains elusive. The objective of this study was to examine the impact of JC on appraisal skills in student physical therapists (SPTs) and explore factors enhancing or hindering the utility of JC. One hundred fifteen SPTs from three cohorts participated in this mixed-methods study. In the first year, participants completed a survey assessing self-reported confidence level on EBP skills before and after attending multiple JCs. Cohorts I and II continued participation in the second year. Additionally, 36 participants attended focus-group interviews after completing 2 years of JC. All cohorts' confidence level increased. Wilcoxon signed-rank test revealed a significant increase (p < 0.001) for cohort III. Remaining cohorts' confidence continuously increased in the subsequent year. Thematic analysis revealed themes on benefits and barriers of JC, strategies for improvements, and connection of JC to clinical practice. The findings indicate that integration of JC promotes SPTs' confidence in EBP skills and connects with practice. Utilizing JC as a pedagogical strategy impacts curricular design and strengthens future health professionals' EBP skills pivotal for delivering quality healthcare.
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Affiliation(s)
- R Xia
- Dep. of Physical Therapy, Franklin Pierce University, 14455 W. Van Buren Street, Goodyear, AZ 85338, USA. Tel 623-518-2386.
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Puttasiddaiah PM, Morris S, Costello RC, Whittet HB. Paediatric quality-of-life following adenotonsillectomy: an evaluation of T14 paediatric throat disorder quality-of-life outcomes according to operative indication. Ann R Coll Surg Engl 2023; 105:68-71. [PMID: 35446710 PMCID: PMC9891077 DOI: 10.1308/rcsann.2022.0011] [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] [Accepted: 04/21/2021] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Adenotonsillectomy is the most common surgical intervention for obstructive sleep apnoea (OSA) or recurrent tonsillitis. The Paediatric Throat Disorder Quality of Life Outcome (T14) questionnaire is a validated tool completed by parents to compare the outcome of surgery by measuring the pre- and postoperative scores. This study was undertaken to evaluate the quality-of-life outcome in children undergoing surgical intervention for recurrent tonsillitis and/or OSA. METHODS This was a prospective, uncontrolled study of 117 children who underwent adenotonsillectomy and tonsillectomy at a single tertiary ear, nose and throat department. An analysis of pre- and postoperative T14 paediatric throat disorder quality-of-life outcomes was undertaken at 12 months. RESULTS Of the 117 children, 105 were included in the study sample; 75 with recurrent tonsillitis, 8 with OSA and 22 with both tonsillitis and OSA. All children had an improved T14 score postoperatively. The greatest change in pre- and postoperative T14 score was observed in the tonsillitis and OSA combined group (mean change -29.36, p<0.001). However, an improvement in T14 score was also noted in the tonsilitis (-24.453, p<0.001) and OSA groups (-14.25, p<0.001). CONCLUSIONS This study found a statistically significant improvement in the T14 quality-of-life score at 12 months postoperatively in children undergoing adenotonsillectomy. This demonstrates improved parental perception of their child's symptoms for all operative indications of adenotonsillectomy.
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Affiliation(s)
| | - S Morris
- Swansea Bay University Health Board, UK
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Parthasarathy S, Hyman D, Doherty J, Saad R, Zhang J, Morris S, Eldemir L, Fox B, Vang M, Schroeder J, Marshall N, Parks G. A Real-World Study Assessing the Relationship Between Positive Airway Pressure Treatment, Excessive Daytime Sleepiness, and Patient Satisfaction in Obstructive Sleep Apnoea. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Afshari M, Morris S, Geulig LD, Chitgar ZM, Gibbon P, Thirolf PG, Schreiber J. The role of collisional ionization in heavy ion acceleration by high intensity laser pulses. Sci Rep 2022; 12:18260. [PMID: 36309599 PMCID: PMC9617862 DOI: 10.1038/s41598-022-23148-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/25/2022] [Indexed: 12/31/2022] Open
Abstract
We present here simulation results of the laser-driven acceleration of gold ions using the EPOCH code. Recently, an experiment reported the acceleration of gold ions up to 7 MeV/nucleon with a strong dependency of the charge-state distribution on target thickness and the detection of the highest charge states [Formula: see text]. Our simulations using a developmental branch of EPOCH (4.18-Ionization) show that collisional ionization is the most important cause of charge states beyond Z = 51 up to He-like Au.
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Affiliation(s)
- M. Afshari
- grid.5252.00000 0004 1936 973XFakultät für Physik, Ludwig-Maximilians-Universität München, 85748 Garching bei München, Germany
| | - S. Morris
- grid.7372.10000 0000 8809 1613Department of Physics, University of Warwick, Coventry, CV4 7AL UK
| | - L. D. Geulig
- grid.5252.00000 0004 1936 973XFakultät für Physik, Ludwig-Maximilians-Universität München, 85748 Garching bei München, Germany
| | - Z. M. Chitgar
- grid.8385.60000 0001 2297 375XInstitute for Advanced Simulation, Jülich Supercomputing Centre, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
| | - P. Gibbon
- grid.8385.60000 0001 2297 375XInstitute for Advanced Simulation, Jülich Supercomputing Centre, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany ,grid.5596.f0000 0001 0668 7884Centre for Mathematical Plasma Astrophysics, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - P. G. Thirolf
- grid.5252.00000 0004 1936 973XFakultät für Physik, Ludwig-Maximilians-Universität München, 85748 Garching bei München, Germany
| | - J. Schreiber
- grid.5252.00000 0004 1936 973XFakultät für Physik, Ludwig-Maximilians-Universität München, 85748 Garching bei München, Germany
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Kuo KH, Oluyadi A, Shao H, Morris S, Zaidi AU, Beers EJV, Thein SL. A PHASE 2/3, RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY OF MITAPIVAT IN PATIENTS WITH SICKLE CELL DISEASE. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.021] [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: 11/11/2022] Open
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Tinker M, Betten A, Morris S, Gibson N, Allison G, Ng L, Williams G, Chappell A. A comparison of the kinematics and kinetics of barefoot and shod running in children with cerebral palsy. Gait Posture 2022; 98:271-278. [PMID: 36215856 DOI: 10.1016/j.gaitpost.2022.09.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 09/19/2022] [Accepted: 09/24/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The biomechanics of barefoot and shod running are different for typically developing children but unknown for children with cerebral palsy (CP). Such differences may have implications for injury and performance. AIMS The primary aims of this study were to compare the lower limb biomechanics of barefoot and shod running in children with CP, and to determine whether any differences were the same in GMFCS levels I and II. METHODS This cross-sectional study examined 38 children with CP (n = 24 (GMFCS) level I; n = 14 GMFCS II), running overground at 3 speeds (jog, run, sprint) in barefoot and shod conditions. Marker trajectories and force plate data were recorded, and lower limb kinematics, kinetics and spatiotemporal variables were derived. Differences between barefoot and shod running were analysed using linear mixed models. RESULTS For both GMFCS levels, barefoot running resulted in higher loading rates, but smaller impact peaks at all speeds. Barefoot running was associated with greater hip and knee power; less ankle dorsiflexion and hip flexion at initial contact, and less ankle and knee range of motion during stance, compared to shod running, at all speeds. Barefoot stride length was shortened, and cadence increased compared to shod during jogging and running but not sprinting. For GMFCS level I only, barefoot running involved a higher incidence of forefoot strike, greater ankle power generation and less hip range of motion during stance. SIGNIFICANCE Running barefoot may facilitate running performance by increasing power generation at the ankle in children with CP, GMFCS level I. Higher barefoot loading rates may have implications for performance and injury.
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Affiliation(s)
- M Tinker
- School of Allied Health, Curtin University, Bentley WA 6102, Australia
| | - A Betten
- School of Allied Health, Curtin University, Bentley WA 6102, Australia
| | - S Morris
- School of Allied Health, Curtin University, Bentley WA 6102, Australia
| | - N Gibson
- School of Allied Health, Curtin University, Bentley WA 6102, Australia; Perth Children's Hospital, Nedlands WA 6009, Australia
| | - G Allison
- School of Allied Health, Curtin University, Bentley WA 6102, Australia
| | - L Ng
- School of Allied Health, Curtin University, Bentley WA 6102, Australia
| | - G Williams
- School of Physiotherapy, University of Melbourne, Victoria 3010, Australia
| | - A Chappell
- School of Allied Health, Curtin University, Bentley WA 6102, Australia; Western Kids Health, Mt Hawthorn WA 6016, Australia.
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Setton J, Gallo D, Glodzik D, Kaiser B, Braverman S, Ubhi T, Fournier S, Selenica P, Laterreur N, Roulston A, Brown G, Morris S, Reis-Filho J, Zimmermann M. CDK12 loss leads to replication stress and sensitivity to combinations of the ATR inhibitor camonsertib (RP-3500) with PARP inhibitors. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01063-2] [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: 11/03/2022]
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Fourtounis J, Gallo D, Roulston A, Stocco R, Martino G, Fournier S, Aguado E, Kryczka R, Bhaskaran V, Morris S, Marshall C. The PKMYT1 inhibitor RP-6306 has synergistic efficacy with carboplatin in CCNE1 amplified tumor models. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00965-0] [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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14
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Lee S, Schulz C, Prabhash K, Han B, Szczesna A, Cortinovis D, Rittmeyer A, Baz DV, Califano R, Anh LT, Liu G, Cappuzzo F, Contreras JR, Reck M, Hu Y, Morris S, Hoeglander E, Connors M, Vollan H, Peters S. LBA11 IPSOS: Results from a phase III study of first-line (1L) atezolizumab (atezo) vs single-agent chemotherapy (chemo) in patients (pts) with NSCLC not eligible for a platinum-containing regimen. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.08.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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15
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Keir A, Rumbold A, Collins CT, McPhee AJ, Varghese J, Morris S, Sullivan TR, Leemaqz S, Middleton P, Makrides M, Best KP. Breastfeeding outcomes in late preterm infants: A multi-centre prospective cohort study. PLoS One 2022; 17:e0272583. [PMID: 35969612 PMCID: PMC9377594 DOI: 10.1371/journal.pone.0272583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 07/21/2022] [Indexed: 11/19/2022] Open
Abstract
Objectives To describe (1) infant feeding practices during initial hospitalisation and up to 6 months corrected age (CA) in infants born late preterm with mothers intending to breastfeed, (2) the impact of early feeding practices on hospital length of stay and (3) maternal and infant factors associated with duration of breastfeeding. Methods We conducted a prospective cohort study of infants born at 34+0 to 36+6 weeks gestational age during 2018–2020. Families were followed up until the infant reached 6 months of age (corrected for prematurity). Feeding practices during the birth hospitalisation, length of initial hospital stay, and the prevalence of exclusive or any breastfeeding at 6 weeks, 3 months, and 6 months CA were examined. Associations between maternal and infant characteristics and breastfeeding at 6 weeks, 3 months and 6 months CA were assessed using multivariable logistic regression models. Results 270 infants were enrolled, of these, 30% were multiple births. Overall, 78% of infants received only breastmilk as their first feed, and 83% received formula during the hospitalisation. Seventy-four per cent of infants were exclusively breastfed at discharge, 41% at 6 weeks CA, 35% at 3 months CA, and 29% at 6 months CA. The corresponding combined exclusive and partial breastfeeding rates (any breastfeeding) were 72%, 64%, and 53% of babies at 6 weeks CA, 3 months CA, and 6 months CA, respectively. The mean duration of hospitalisation was 2.9 days longer (95% confidence interval (CI) 0.31, 5.43 days) in infants who received any formula compared with those receiving only breastmilk (adjusted for GA, maternal age, multiple birth, site, and neonatal intensive care unit admission). In multivariable models, receipt of formula as the first milk feed was associated with a reduction in exclusive breastfeeding at 6 weeks CA (odds ratio = 0.22; 95% CI 0.09 to 0.53) and intention to breastfeed >6 months with an increase (odds ratio = 4.98; 95% CI 2.39 to 10.40). Intention to breastfeed >6 months remained an important predictor of exclusive breastfeeding at 3 and 6 months CA. Conclusions Our study demonstrates that long-term exclusive breastfeeding rates were low in a cohort of women intending to provide breastmilk to their late preterm infants, with approximately half providing any breastmilk at 6 months CA. Formula as the first milk feed and intention to breastfeed >6 months were significant predictors of breastfeeding duration. Improving breastfeeding outcomes may require strategies to support early lactation and a better understanding of the ongoing support needs of this population.
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Affiliation(s)
- Amy Keir
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia
- Department of Neonatal Medicine, Women’s and Children’s Hospital, North Adelaide, South Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia
- * E-mail:
| | - Alice Rumbold
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia
| | - Carmel T. Collins
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia
| | - Andrew J. McPhee
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia
| | - Jojy Varghese
- Lyell McEwin Hospital, Elizabeth Vale, South Australia
| | - Scott Morris
- Department of Neonatology, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Thomas R. Sullivan
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia
- School of Public Health, The University of Adelaide, Adelaide, South Australia
| | - Shalem Leemaqz
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia
| | - Philippa Middleton
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia
| | - Maria Makrides
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia
| | - Karen P. Best
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia
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Cheetham M, Atkinson PJ, Gibson M, Katikireddi SV, Moffatt S, Morris S, Munford L, Shenton F, Wickham S, Craig P. Exploring the mental health effects of Universal Credit: a journey of co-production. Perspect Public Health 2022; 142:209-212. [PMID: 35833554 PMCID: PMC9284081 DOI: 10.1177/17579139221103178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- M Cheetham
- Research Fellow, National Institute for Health and Care Research (NIHR), Applied Research Collaboration North East and North Cumbria (NIHR200173), based at Department of Nursing, Midwifery and Health, Northumbria University, Coach Lane Campus East, Room H213, Newcastle-u-Tyne, NE7 7XA, UK
| | | | - M Gibson
- Investigator Scientist, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - S V Katikireddi
- Professor of Public Health & Health Inequalities, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - S Moffatt
- Professor of Social Gerontology, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne, UK
| | - S Morris
- Post Doctoral Research Associate, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne, UK
| | - L Munford
- Senior Lecturer in Health Economics, Division of Population Health, Health Services Research & Primary Care, School of Social Sciences, University of Manchester, Manchester, UK
| | - F Shenton
- Public Involvement and Community Engagement Manager, National Institute for Health and Care Research (NIHR), Applied Research Collaboration North East and North Cumbria (NIHR200173), based at CNTW NHS Foundation Trust, St Nicholas' Hospital, Newcastle Upon Tyne, NE3 3XT, UK
| | - S Wickham
- Wellcome Trust Research Fellow, Department of Public Health, Policy & Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - P Craig
- Professor of Public Health Evaluation, Inequalities and Health, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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17
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Howarth AR, Apea V, Michie S, Morris S, Sachikonye M, Mercer CH, Evans A, Delpech VC, Sabin C, Burns FM. Associations with sub-optimal clinic attendance and reasons for missed appointments among heterosexual women and men living with HIV in London. AIDS Behav 2022; 26:3620-3629. [PMID: 35536520 PMCID: PMC9550732 DOI: 10.1007/s10461-022-03681-x] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 11/28/2022]
Abstract
Poor engagement in HIV care is associated with poorer health outcomes and increased mortality. Our survey examined experiential and circumstantial factors associated with clinic attendance among women (n = 250) and men (n = 106) in London with heterosexually-acquired HIV. While no associations were found for women, among men, sub-optimal attendance was associated with insecure immigration status (25.6% vs. 1.8%), unstable housing (32.6% vs. 10.2%) and reported effect of HIV on daily activities (58.7% vs. 40.0%). Among women and men on ART, it was associated with missing doses of ART (OR = 2.96, 95% CI:1.74-5.02), less belief in the necessity of ART (OR = 0.56, 95% CI:0.35-0.90) and more concern about ART (OR = 3.63, 95% CI:1.45-9.09). Not wanting to think about being HIV positive was the top reason for ever missing clinic appointments. It is important to tackle stigma and the underlying social determinants of health to improve HIV prevention, and the health and well-being of people living with HIV.
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Affiliation(s)
- A R Howarth
- Institute for Global Health, University College London, London, UK.
- UCL Institute for Global Health, Mortimer Market Centre, off Capper Street, WC1E 6JB, London, UK.
| | - V Apea
- Barts Health NHS Trust, London, UK
| | - S Michie
- Centre for Behaviour Change, University College London, London, UK
| | - S Morris
- Department of Applied Health Research, University College London, London, UK
| | | | - C H Mercer
- Institute for Global Health, University College London, London, UK
| | - A Evans
- Royal Free London NHS Foundation Trust, London, UK
| | | | - C Sabin
- Institute for Global Health, University College London, London, UK
| | - F M Burns
- Institute for Global Health, University College London, London, UK
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18
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Ponsford R, Bragg S, Meiksin R, Tilouche N, Van Dyck L, Sturgess J, Allen E, Elbourne D, Hadley A, Lohan M, Mercer CH, Melendez Torres GJ, Morris S, Young H, Campbell R, Bonell C. Feasibility and acceptability of a whole-school social-marketing intervention to prevent unintended teenage pregnancies and promote sexual health: evidence for progression from a pilot to a phase III randomised trial in English secondary schools. Pilot Feasibility Stud 2022; 8:52. [PMID: 35246272 PMCID: PMC8895534 DOI: 10.1186/s40814-022-00971-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 01/06/2022] [Indexed: 11/24/2022] Open
Abstract
Background Reducing unintended teenage pregnancy and promoting adolescent sexual health remains a priority in England. Both whole-school and social-marketing interventions are promising approaches to addressing these aims. However, such interventions have not been rigorously trialled in the UK and it is unclear if they are appropriate for delivery in English secondary schools. We developed and pilot trialled Positive Choices, a new whole-school social marketing intervention to address unintended teenage pregnancy and promote sexual health. Our aim was to assess the feasibility and acceptability of the intervention and trial methods in English secondary schools against pre-defined progression criteria (relating to randomisation, survey follow-up, intervention fidelity and acceptability and linkage to birth/abortion records) prior to carrying out a phase III trial of effectiveness and cost-effectiveness. Methods Pilot RCT with integral process evaluation involving four intervention and two control schools in south-east England. The intervention comprised a student needs survey; a student/staff-led school health promotion council; a classroom curriculum for year-9 students (aged 13–14); whole-school student-led social-marketing activities; parent information; and a review of local and school-based sexual health services. Baseline surveys were conducted with year 8 (aged 12–13) in June 2018. Follow-up surveys were completed 12 months later. Process evaluation data included audio recording of staff training, surveys of trained staff, staff log books and researcher observations of intervention activities. Survey data from female students were linked to records of births and abortions to assess the feasibility of these constituting a phase III primary outcome. Results All six schools were successfully randomised and retained in the trial. Response rates to the survey were above 80% in both arms at both baseline and follow-up. With the exception of the parent materials, the fidelity target for implementation of essential elements in three out of four schools was achieved. Student surveys indicated 80% acceptability among those who reported awareness of the programme and interviews with staff suggested strong acceptability. Linkage to birth/abortion records was feasible although none occurred among participants. Conclusions The criteria for progression to a phase III trial were met. Our data suggest that a whole-school social-marketing approach may be appropriate for topics that are clearly prioritised by schools. A phase III trial of this intervention is now warranted to establish effectiveness and cost-effectiveness. Births and terminations are not an appropriate primary outcome measure for such a trial. Trial registration ISRCTN65324176.
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Affiliation(s)
- R Ponsford
- Department of Public Health, Environments & Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - S Bragg
- Department of Education, Practice and Society, University College London, 20 Bedford Way, WC1H 0AL, London, UK
| | - R Meiksin
- Department of Public Health, Environments & Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - N Tilouche
- Department of Public Health, Environments & Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - L Van Dyck
- Clinical Trials Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - J Sturgess
- Clinical Trials Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - E Allen
- Clinical Trials Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - D Elbourne
- Clinical Trials Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - A Hadley
- Teenage Pregnancy Knowledge Exchange, University of Bedfordshire, University Square, Luton, LU1 3JU, UK
| | - M Lohan
- School of Nursing and Midwifery, Queens University Belfast, University Road, Belfast, BT7 1NN, UK
| | - C H Mercer
- University College London, Gower Street, London, WC1E 6BT, UK
| | | | - S Morris
- Department of Health and Primary Care, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - H Young
- School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK
| | - R Campbell
- School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - C Bonell
- Department of Public Health, Environments & Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
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Berry I, Mangtani P, Rahman M, Greer A, Morris S, Anwar R, Lisa M, Shirin T, Islam M, Chowdhury F, Dunkle S, Brum E, Osmani M, Flora M, Fisman D. Seasonality of Human Influenza and Co-Seasonality with Avian Influenza in Bangladesh, 2010-2019. Int J Infect Dis 2022. [DOI: 10.1016/j.ijid.2021.12.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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20
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Robledo KP, Tarnow-Mordi WO, Rieger I, Suresh P, Martin A, Yeung C, Ghadge A, Liley HG, Osborn D, Morris J, Hague W, Kluckow M, Lui K, Soll R, Cruz M, Keech A, Kirby A, Simes J, Popat H, Reid S, Gordon A, De Waal K, Wright IM, Wright A, Buchan J, Stubbs M, Newnham J, Simmer K, Young C, Loh D, Kok Y, Gill A, Strunk T, Jeffery M, Chen Y, Morris S, Sinhal S, Cornthwaite K, Walker SP, Watkins AM, Collins CL, Holberton JR, Noble EJ, Sehgal A, Yeomans E, Elsayed K, Mohamed AL, Broom M, Koh G, Lawrence A, Gardener G, Fox J, Cartwright DW, Koorts P, Pritchard MA, McKeown L, Lainchbury A, Shand AW, Michalowski J, Smyth JP, Bolisetty S, Adno A, Lee G, Seidler AL, Askie LM, Groom KM, Eaglen DA, Baker EC, Patel H, Wilkes N, Gullam JE, Austin N, Leishman DE, Weston P, White N, Cooper NA, Broadbent R, Stitely M, Dawson P, El-Naggar W, Furlong M, Hatfield T, de Luca D, Benachi A, Letamendia-Richard E, Escourrou G, Dell'Orto V, Sweet D, Millar M, Shah S, Sheikh L, Ariff S, Morris EA, Young L, Evans SK, Belfort M, Aagaard K, Pammi M, Mandy G, Gandhi M, Davey J, Shenton E, Middleton J, Black R, Cheng A, Murdoch J, Jacobs C, Meyer L, Medlin K, Woods H, O'Connor KA, Bice C, Scott K, Hayes M, Cruickshank D, Sam M, Ireland S, Dickinson C, Poulsen L, Fucek A, Hegarty J, Rogers J, Sanchez D, Zupan Simunek V, Hanif B, Pahl A, Metayer J, Duley L, Marlow N, Schofield D, Bowen J. Effects of delayed versus immediate umbilical cord clamping in reducing death or major disability at 2 years corrected age among very preterm infants (APTS): a multicentre, randomised clinical trial. The Lancet Child & Adolescent Health 2022; 6:150-157. [DOI: 10.1016/s2352-4642(21)00373-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/04/2021] [Accepted: 11/17/2021] [Indexed: 01/07/2023]
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21
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Pérol M, Felip E, Dafni U, Polito L, Pal N, Tsourti Z, Ton TGN, Merritt D, Morris S, Stahel R, Peters S. Effectiveness of PD-(L)1 Inhibitors Alone or in Combination With Platinum-Doublet Chemotherapy in First-Line (1L) Non-Squamous Non-Small Cell Lung Cancer (nsq-NSCLC) With PD-L1-High Expression Using Real-World Data. Ann Oncol 2022; 33:511-521. [PMID: 35218887 DOI: 10.1016/j.annonc.2022.02.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [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: 11/15/2021] [Revised: 02/09/2022] [Accepted: 02/14/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Anti-PD-(L)1 therapy alone (cancer immunotherapy [CIT]-mono) or combined with platinum-based chemotherapy (CIT-chemo) is used as first-line treatment for patients with metastatic non-small cell lung cancer (NSCLC). Our study compared clinical outcomes with CIT-mono vs CIT-chemo in the specific clinical scenario of non-squamous (Nsq)-NSCLC with a high PD-L1 expression of ≥50% (tumor proportion score (TPS) or tumor cells (TC)). METHODS This was a retrospective cohort study using a real-world de-identified database. Patients with metastatic Nsq-NSCLC with high PD-L1 expression initiating first-line CIT-mono or CIT-chemo between 24 October 2016 and 28 February 2019 were followed up to 28 February 2020. We compared overall survival (OS) and real-world progression-free survival (rwPFS) using Kaplan-Meier methodology. Hazard ratios (HR) were adjusted (aHR) for differences in baseline key prognostic characteristics using inverse probability of treatment weighting methodology. RESULTS Patients with PD-L1-high Nsq-NSCLC treated with CIT-mono (n=351), were older and less often presented with de novo stage IV disease than patients treated with CIT-chemo (n=169). With a median follow-up of 19.9 months for CIT-chemo vs 23.5 months for CIT-mono, median OS and rwPFS did not differ between the two groups (median OS: CIT-chemo, 21.0 months vs CIT-mono, 22.1 months, aHR=1.03, 95% CI 0.77-1.39, P=0.83; median rwPFS: CIT-chemo, 10.8 months vs CIT-mono, 11.5 months, aHR=1.04, 95% CI 0.78-1.37, P=0.81). CIT-chemo showed significant and meaningful improvement in OS and rwPFS vs CIT-mono only in the never-smoker subgroup, albeit among a small sample of patients (n=50; OS HR=0.25, 95% CI 0.07-0.83, interaction P=0.02; rwPFS HR=0.40, 95% CI 0.17-0.95, interaction P=0.04). CONCLUSION Except in the subgroup of never-smoker patients, sparing the chemotherapy in first-line CIT treatment does not appear to impact survival outcomes in Nsq-NSCLC patients with high PD-L1 expression.
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Affiliation(s)
- M Pérol
- Medical Oncology, Centre Leon Berard, Lyon, France
| | - E Felip
- Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - U Dafni
- National and Kapodistrian University of Athens, Athens, & Frontier Science Foundation Hellas, Athens, Greece
| | - L Polito
- Product Development Data Sciences, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - N Pal
- Product Development Data Sciences, Genentech, Inc., South San Francisco, CA, USA
| | - Z Tsourti
- Frontier Science Foundation Hellas, Athens, Greece
| | - T G N Ton
- Product Development Data Sciences, Genentech, Inc., South San Francisco, CA, USA
| | - D Merritt
- Product Development Medical Affairs, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - S Morris
- Product Development Medical Affairs, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - R Stahel
- European Thoracic Oncology Platform (ETOP), Coordinating Office, Bern, Switzerland.
| | - S Peters
- Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland
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Wymant C, Bezemer D, Blanquart F, Ferretti L, Gall A, Hall M, Golubchik T, Bakker M, Ong SH, Zhao L, Bonsall D, de Cesare M, MacIntyre-Cockett G, Abeler-Dörner L, Albert J, Bannert N, Fellay J, Grabowski MK, Gunsenheimer-Bartmeyer B, Günthard HF, Kivelä P, Kouyos RD, Laeyendecker O, Meyer L, Porter K, Ristola M, van Sighem A, Berkhout B, Kellam P, Cornelissen M, Reiss P, Fraser C, Aubert V, Battegay M, Bernasconi E, Böni J, Braun DL, Bucher HC, Burton-Jeangros C, Calmy A, Cavassini M, Dollenmaier G, Egger M, Elzi L, Fehr J, Fellay J, Furrer H, Fux CA, Gorgievski M, Günthard H, Haerry D, Hasse B, Hirsch HH, Hoffmann M, Hösli I, Kahlert C, Kaiser L, Keiser O, Klimkait T, Kouyos R, Kovari H, Ledergerber B, Martinetti G, de Tejada BM, Marzolini C, Metzner K, Müller N, Nadal D, Nicca D, Pantaleo G, Rauch A, Regenass S, Rudin C, Schöni-Affolter F, Schmid P, Speck R, Stöckle M, Tarr P, Trkola A, Vernazza P, Weber R, Yerly S, van der Valk M, Geerlings SE, Goorhuis A, Hovius JW, Lempkes B, Nellen FJB, van der Poll T, Prins JM, Reiss P, van Vugt M, Wiersinga WJ, Wit FWMN, van Duinen M, van Eden J, Hazenberg A, van Hes AMH, Rajamanoharan S, Robinson T, Taylor B, Brewer C, Mayr C, Schmidt W, Speidel A, Strohbach F, Arastéh K, Cordes C, Pijnappel FJJ, Stündel M, Claus J, Baumgarten A, Carganico A, Ingiliz P, Dupke S, Freiwald M, Rausch M, Moll A, Schleehauf D, Smalhout SY, Hintsche B, Klausen G, Jessen H, Jessen A, Köppe S, Kreckel P, Schranz D, Fischer K, Schulbin H, Speer M, Weijsenfeld AM, Glaunsinger T, Wicke T, Bieniek B, Hillenbrand H, Schlote F, Lauenroth-Mai E, Schuler C, Schürmann D, Wesselmann H, Brockmeyer N, Jurriaans S, Gehring P, Schmalöer D, Hower M, Spornraft-Ragaller P, Häussinger D, Reuter S, Esser S, Markus R, Kreft B, Berzow D, Back NKT, Christl A, Meyer A, Plettenberg A, Stoehr A, Graefe K, Lorenzen T, Adam A, Schewe K, Weitner L, Fenske S, Zaaijer HL, Hansen S, Stellbrink HJ, Wiemer D, Hertling S, Schmidt R, Arbter P, Claus B, Galle P, Jäger H, Jä Gel-Guedes E, Berkhout B, Postel N, Fröschl M, Spinner C, Bogner J, Salzberger B, Schölmerich J, Audebert F, Marquardt T, Schaffert A, Schnaitmann E, Cornelissen MTE, Trein A, Frietsch B, Müller M, Ulmer A, Detering-Hübner B, Kern P, Schubert F, Dehn G, Schreiber M, Güler C, Schinkel CJ, Gunsenheimer-Bartmeyer B, Schmidt D, Meixenberger K, Bannert N, Wolthers KC, Peters EJG, van Agtmael MA, Autar RS, Bomers M, Sigaloff KCE, Heitmuller M, Laan LM, Ang CW, van Houdt R, Jonges M, Kuijpers TW, Pajkrt D, Scherpbier HJ, de Boer C, van der Plas A, van den Berge M, Stegeman A, Baas S, Hage de Looff L, Buiting A, Reuwer A, Veenemans J, Wintermans B, Pronk MJH, Ammerlaan HSM, van den Bersselaar DNJ, de Munnik ES, Deiman B, Jansz AR, Scharnhorst V, Tjhie J, Wegdam MCA, van Eeden A, Nellen J, Brokking W, Elsenburg LJM, Nobel H, van Kasteren MEE, Berrevoets MAH, Brouwer AE, Adams A, van Erve R, de Kruijf-van de Wiel BAFM, Keelan-Phaf S, van de Ven B, van der Ven B, Buiting AGM, Murck JL, de Vries-Sluijs TEMS, Bax HI, van Gorp ECM, de Jong-Peltenburg NC, de Mendonç A Melo M, van Nood E, Nouwen JL, Rijnders BJA, Rokx C, Schurink CAM, Slobbe L, Verbon A, Bassant N, van Beek JEA, Vriesde M, van Zonneveld LM, de Groot J, Boucher CAB, Koopmans MPG, van Kampen JJA, Fraaij PLA, van Rossum AMC, Vermont CL, van der Knaap LC, Visser E, Branger J, Douma RA, Cents-Bosma AS, Duijf-van de Ven CJHM, Schippers EF, van Nieuwkoop C, van Ijperen JM, Geilings J, van der Hut G, van Burgel ND, Leyten EMS, Gelinck LBS, Mollema F, Davids-Veldhuis S, Tearno C, Wildenbeest GS, Heikens E, Groeneveld PHP, Bouwhuis JW, Lammers AJJ, Kraan S, van Hulzen AGW, Kruiper MSM, van der Bliek GL, Bor PCJ, Debast SB, Wagenvoort GHJ, Kroon FP, de Boer MGJ, Jolink H, Lambregts MMC, Roukens AHE, Scheper H, Dorama W, van Holten N, Claas ECJ, Wessels E, den Hollander JG, El Moussaoui R, Pogany K, Brouwer CJ, Smit JV, Struik-Kalkman D, van Niekerk T, Pontesilli O, Lowe SH, Oude Lashof AML, Posthouwer D, van Wolfswinkel ME, Ackens RP, Burgers K, Schippers J, Weijenberg-Maes B, van Loo IHM, Havenith TRA, van Vonderen MGA, Kampschreur LM, Faber S, Steeman-Bouma R, Al Moujahid A, Kootstra GJ, Delsing CE, van der Burg-van de Plas M, Scheiberlich L, Kortmann W, van Twillert G, Renckens R, Ruiter-Pronk D, van Truijen-Oud FA, Cohen Stuart JWT, Jansen ER, Hoogewerf M, Rozemeijer W, van der Reijden WA, Sinnige JC, Brinkman K, van den Berk GEL, Blok WL, Lettinga KD, de Regt M, Schouten WEM, Stalenhoef JE, Veenstra J, Vrouenraets SME, Blaauw H, Geerders GF, Kleene MJ, Kok M, Knapen M, van der Meché IB, Mulder-Seeleman E, Toonen AJM, Wijnands S, Wttewaal E, Kwa D, van Crevel R, van Aerde K, Dofferhoff ASM, Henriet SSV, Ter Hofstede HJM, Hoogerwerf J, Keuter M, Richel O, Albers M, Grintjes-Huisman KJT, de Haan M, Marneef M, Strik-Albers R, Rahamat-Langendoen J, Stelma FF, Burger D, Gisolf EH, Hassing RJ, Claassen M, Ter Beest G, van Bentum PHM, Langebeek N, Tiemessen R, Swanink CMA, van Lelyveld SFL, Soetekouw R, van der Prijt LMM, van der Swaluw J, Bermon N, van der Reijden WA, Jansen R, Herpers BL, Veenendaal D, Verhagen DWM, Lauw FN, van Broekhuizen MC, van Wijk M, Bierman WFW, Bakker M, Kleinnijenhuis J, Kloeze E, Middel A, Postma DF, Schölvinck EH, Stienstra Y, Verhage AR, Wouthuyzen-Bakker M, Boonstra A, de Groot-de Jonge H, van der Meulen PA, de Weerd DA, Niesters HGM, van Leer-Buter CC, Knoester M, Hoepelman AIM, Arends JE, Barth RE, Bruns AHW, Ellerbroek PM, Mudrikova T, Oosterheert JJ, Schadd EM, van Welzen BJ, Aarsman K, Griffioen-van Santen BMG, de Kroon I, van Berkel M, van Rooijen CSAM, Schuurman R, Verduyn-Lunel F, Wensing AMJ, Bont LJ, Geelen SPM, Loeffen YGT, Wolfs TFW, Nauta N, Rooijakkers EOW, Holtsema H, Voigt R, van de Wetering D, Alberto A, van der Meer I, Rosingh A, Halaby T, Zaheri S, Boyd AC, Bezemer DO, van Sighem AI, Smit C, Hillebregt M, de Jong A, Woudstra T, Bergsma D, Meijering R, van de Sande L, Rutkens T, van der Vliet S, de Groot L, van den Akker M, Bakker Y, El Berkaoui A, Bezemer M, Brétin N, Djoechro E, Groters M, Kruijne E, Lelivelt KJ, Lodewijk C, Lucas E, Munjishvili L, Paling F, Peeck B, Ree C, Regtop R, Ruijs Y, Schoorl M, Schnörr P, Scheigrond A, Tuijn E, Veenenberg L, Visser KM, Witte EC, Ruijs Y, Van Frankenhuijsen M, Allegre T, Makhloufi D, Livrozet JM, Chiarello P, Godinot M, Brunel-Dalmas F, Gibert S, Trepo C, Peyramond D, Miailhes P, Koffi J, Thoirain V, Brochier C, Baudry T, Pailhes S, Lafeuillade A, Philip G, Hittinger G, Assi A, Lambry V, Rosenthal E, Naqvi A, Dunais B, Cua E, Pradier C, Durant J, Joulie A, Quinsat D, Tempesta S, Ravaux I, Martin IP, Faucher O, Cloarec N, Champagne H, Pichancourt G, Morlat P, Pistone T, Bonnet F, Mercie P, Faure I, Hessamfar M, Malvy D, Lacoste D, Pertusa MC, Vandenhende MA, Bernard N, Paccalin F, Martell C, Roger-Schmelz J, Receveur MC, Duffau P, Dondia D, Ribeiro E, Caltado S, Neau D, Dupont M, Dutronc H, Dauchy F, Cazanave C, Vareil MO, Wirth G, Le Puil S, Pellegrin JL, Raymond I, Viallard JF, Chaigne de Lalande S, Garipuy D, Delobel P, Obadia M, Cuzin L, Alvarez M, Biezunski N, Porte L, Massip P, Debard A, Balsarin F, Lagarrigue M, Prevoteau du Clary F, Aquilina C, Reynes J, Baillat V, Merle C, Lemoing V, Atoui N, Makinson A, Jacquet JM, Psomas C, Tramoni C, Aumaitre H, Saada M, Medus M, Malet M, Eden A, Neuville S, Ferreyra M, Sotto A, Barbuat C, Rouanet I, Leureillard D, Mauboussin JM, Lechiche C, Donsesco R, Cabie A, Abel S, Pierre-Francois S, Batala AS, Cerland C, Rangom C, Theresine N, Hoen B, Lamaury I, Fabre I, Schepers K, Curlier E, Ouissa R, Gaud C, Ricaud C, Rodet R, Wartel G, Sautron C, Beck-Wirth G, Michel C, Beck C, Halna JM, Kowalczyk J, Benomar M, Drobacheff-Thiebaut C, Chirouze C, Faucher JF, Parcelier F, Foltzer A, Haffner-Mauvais C, Hustache Mathieu M, Proust A, Piroth L, Chavanet P, Duong M, Buisson M, Waldner A, Mahy S, Gohier S, Croisier D, May T, Delestan M, Andre M, Zadeh MM, Martinot M, Rosolen B, Pachart A, Martha B, Jeunet N, Rey D, Cheneau C, Partisani M, Priester M, Bernard-Henry C, Batard ML, Fischer P, Berger JL, Kmiec I, Robineau O, Huleux T, Ajana F, Alcaraz I, Allienne C, Baclet V, Meybeck A, Valette M, Viget N, Aissi E, Biekre R, Cornavin P, Merrien D, Seghezzi JC, Machado M, Diab G, Raffi F, Bonnet B, Allavena C, Grossi O, Reliquet V, Billaud E, Brunet C, Bouchez S, Morineau-Le Houssine P, Sauser F, Boutoille D, Besnier M, Hue H, Hall N, Brosseau D, Souala F, Michelet C, Tattevin P, Arvieux C, Revest M, Leroy H, Chapplain JM, Dupont M, Fily F, Patra-Delo S, Lefeuvre C, Bernard L, Bastides F, Nau P, Verdon R, de la Blanchardiere A, Martin A, Feret P, Geffray L, Daniel C, Rohan J, Fialaire P, Chennebault JM, Rabier V, Abgueguen P, Rehaiem S, Luycx O, Niault M, Moreau P, Poinsignon Y, Goussef M, Mouton-Rioux V, Houlbert D, Alvarez-Huve S, Barbe F, Haret S, Perre P, Leantez-Nainville S, Esnault JL, Guimard T, Suaud I, Girard JJ, Simonet V, Debab Y, Schmit JL, Jacomet C, Weinberck P, Genet C, Pinet P, Ducroix S, Durox H, Denes É, Abraham B, Gourdon F, Antoniotti O, Molina JM, Ferret S, Lascoux-Combe C, Lafaurie M, Colin de Verdiere N, Ponscarme D, De Castro N, Aslan A, Rozenbaum W, Pintado C, Clavel F, Taulera O, Gatey C, Munier AL, Gazaigne S, Penot P, Conort G, Lerolle N, Leplatois A, Balausine S, Delgado J, Timsit J, Tabet M, Gerard L, Girard PM, Picard O, Tredup J, Bollens D, Valin N, Campa P, Bottero J, Lefebvre B, Tourneur M, Fonquernie L, Wemmert C, Lagneau JL, Yazdanpanah Y, Phung B, Pinto A, Vallois D, Cabras O, Louni F, Pialoux G, Lyavanc T, Berrebi V, Chas J, Lenagat S, Rami A, Diemer M, Parrinello M, Depond A, Salmon D, Guillevin L, Tahi T, Belarbi L, Loulergue P, Zak Dit Zbar O, Launay O, Silbermann B, Leport C, Alagna L, Pietri MP, Simon A, Bonmarchand M, Amirat N, Pichon F, Kirstetter M, Katlama C, Valantin MA, Tubiana R, Caby F, Schneider L, Ktorza N, Calin R, Merlet A, Ben Abdallah S, Weiss L, Buisson M, Batisse D, Karmochine M, Pavie J, Minozzi C, Jayle D, 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Summerfield H, Evans M, White C, Robertson R, Lean C, Morris S, Winter A, Faulkner S, Goorney B, Howard L, Fairley I, Stemp C, Short L, Gomez M, Young F, Roberts M, Green S, Sivakumar K, Minton J, Siminoni A, Calderwood J, Greenhough D, DeSouza C, Muthern L, Orkin C, Murphy S, Truvedi M, McLean K, Hawkins D, Higgs C, Moyes A, Antonucci S, McCormack S, Lynn W, Bevan M, Fox J, Teague A, Anderson J, Mguni S, Post F, Campbell L, Mazhude C, Russell H, Gilson R, Carrick G, Ainsworth J, Waters A, Byrne P, Johnson M, Fidler S, Kuldanek K, Mullaney S, Lawlor V, Melville R, Sukthankar A, Thorpe S, Murphy C, Wilkins E, Ahmad S, Green P, Tayal S, Ong E, Meaden J, Riddell L, Loay D, Peacock K, Blackman H, Harindra V, Saeed AM, Allen S, Natarajan U, Williams O, Lacey H, Care C, Bowman C, Herman S, Devendra SV, Wither J, Bridgwood A, Singh G, Bushby S, Kellock D, Young S, Rooney G, Snart B, Currie J, Fitzgerald M, Arumainayyagam J, Chandramani S. A highly virulent variant of HIV-1 circulating in the Netherlands. Science 2022; 375:540-545. [PMID: 35113714 DOI: 10.1126/science.abk1688] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We discovered a highly virulent variant of subtype-B HIV-1 in the Netherlands. One hundred nine individuals with this variant had a 0.54 to 0.74 log10 increase (i.e., a ~3.5-fold to 5.5-fold increase) in viral load compared with, and exhibited CD4 cell decline twice as fast as, 6604 individuals with other subtype-B strains. Without treatment, advanced HIV-CD4 cell counts below 350 cells per cubic millimeter, with long-term clinical consequences-is expected to be reached, on average, 9 months after diagnosis for individuals in their thirties with this variant. Age, sex, suspected mode of transmission, and place of birth for the aforementioned 109 individuals were typical for HIV-positive people in the Netherlands, which suggests that the increased virulence is attributable to the viral strain. Genetic sequence analysis suggests that this variant arose in the 1990s from de novo mutation, not recombination, with increased transmissibility and an unfamiliar molecular mechanism of virulence.
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Affiliation(s)
- Chris Wymant
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - François Blanquart
- Centre for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, PSL Research University, Paris, France.,IAME, UMR 1137, INSERM, Université de Paris, Paris, France
| | - Luca Ferretti
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Astrid Gall
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - Matthew Hall
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Tanya Golubchik
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Margreet Bakker
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Swee Hoe Ong
- Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Lele Zhao
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - David Bonsall
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Mariateresa de Cesare
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - George MacIntyre-Cockett
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Lucie Abeler-Dörner
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Jan Albert
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Norbert Bannert
- Division for HIV and Other Retroviruses, Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| | - Jacques Fellay
- School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.,Swiss Institute of Bioinformatics, Lausanne, Switzerland.,Precision Medicine Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - M Kate Grabowski
- Department of Pathology, John Hopkins University, Baltimore, MD, USA
| | | | - Huldrych F Günthard
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Pia Kivelä
- Department of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland
| | - Roger D Kouyos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | | | - Laurence Meyer
- INSERM CESP U1018, Université Paris Saclay, APHP, Service de Santé Publique, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France
| | - Kholoud Porter
- Institute for Global Health, University College London, London, UK
| | - Matti Ristola
- Department of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland
| | | | - Ben Berkhout
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Paul Kellam
- Kymab Ltd., Cambridge, UK.,Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Marion Cornelissen
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.,Molecular Diagnostic Unit, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Peter Reiss
- Stichting HIV Monitoring, Amsterdam, Netherlands.,Department of Global Health, Amsterdam University Medical Centers, University of Amsterdam and Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands
| | - Christophe Fraser
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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O'Halloran A, Gallagher N, Farrell T, Darwish S, Morris S. 1456 Back-To-Back Surgeries: A Clinic Case Report Regarding Multiple Complex Spinal Surgeries for Treatment of Multiple Osteochondroma With Histological Conversion to Chondrosarcoma. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.380] [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
Background
Multiple Hereditary Osteochondromas [MHO], previously known as multiple hereditary exostoses, is a rare disorder of bone growth, whereby osseous transformation of the cartilage caps within the diaphyses of long bones or flat bones within the skeleton occurs. A significant complication of MHO is the conversion of any present osteochondroma into a malignant chondrosarcoma. Chondrosarcomas are mesenchymal, non-meningothelial tumours and most commonly present with insidious pain, associated neurological deficit by means of impingement of underlying nerves.
Case presentation
We present a clinical case of a 29-year-old female medical student with a background history of multiple hereditary osteochondromas. A previously competitive cross-fitter, she developed the conversion of MHO into a malignant chondrosarcoma. Presenting to outpatient clinic in late 2017, this lady had a 2-year history of lower back pain and an associated palpable lump. An MRI of the thoracolumbar spine demonstrated a large mass arising from the posterior elements of T11 to L2. A biopsy at the time was found to be of benign pathology, most likely in keeping with this patient’s diagnosis of MHO. The patient returned for review in early 2018, where a repeat MRI showed extension of the previously described lesion into the spinal canal at the level of L1 vertebra. This was concerning that this previously identified osteochondroma lesion could be undergoing malignant transformation. The patient went on to have a series of complex spinal surgeries which we will discuss below.
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Affiliation(s)
- A O'Halloran
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - N Gallagher
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - T Farrell
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - S Darwish
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - S Morris
- Mater Misericordiae University Hospital, Dublin, Ireland
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Gibson K, Sharp R, Ullman A, Morris S, Kleidon T, Esterman A. Adverse events associated with umbilical catheters: a systematic review and meta-analysis. J Perinatol 2021; 41:2505-2512. [PMID: 34272469 DOI: 10.1038/s41372-021-01147-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/11/2021] [Accepted: 06/30/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To determine the incidence of adverse events (AEs) associated with umbilical catheters in the neonatal population. STUDY DESIGN Systematic review and meta-analysis of observational studies and randomized controlled trials published between 2010 and 2020. RESULTS In total 14,226 umbilical venous catheters (UVCs) and 4228 umbilical arterial catheters (UACs) were included. Overall, 13.4% of UVCs were associated with an AE (95% CI: 10.1-17.0) or 2.4 per 1000 catheter days (95% CI: 1.8-3.0). UACs had an AE rate of 9% (95% CI: 5.9-12.8) or 0.87 per 1000 catheter days (95% CI: 0.4-1.3). UVC malposition was the most common (41.7% [95% CI: 27.6-56.5]). Local injury from UAC taping was the most common AE in one study. CONCLUSIONS Umbilical catheters have a high incidence of AEs. Research into accurate methods of tip verification, tip surveillance, and securement is required.
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Affiliation(s)
- Kim Gibson
- Clinical and Health Sciences, Rosemary Bryant AO Research Centre, University of South Australia, Adelaide, SA, Australia.
| | - Rebecca Sharp
- Clinical and Health Sciences, Rosemary Bryant AO Research Centre, University of South Australia, Adelaide, SA, Australia
| | - Amanda Ullman
- Children's Health Queensland and Health Service, Centre of Children's Health Research, South Brisbane, QLD, Australia.,School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD, Australia
| | - Scott Morris
- Neonatal Unit, Flinders Medical Centre, Bedford Park, SA, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Tricia Kleidon
- Queensland Children's Hospital, South Brisbane, QLD, Australia
| | - Adrian Esterman
- Clinical and Health Sciences, Rosemary Bryant AO Research Centre, University of South Australia, Adelaide, SA, Australia
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Sarkar S, White C, Stevenson R, Knight H, Morris S, MacLeod J, Legare J. IMPLEMENTATION OF STANDARDIZED SCREENING OF CARDIOGENIC SHOCK (CS) FOR ALL PATIENTS ADMITTED TO THE CCU AT THE NEW BRUNSWICK HEART CENTRE. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.034] [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] Open
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26
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Chappell A, Allison GT, Gibson N, Williams G, Morris S. The effect of a low-load plyometric running intervention on leg stiffness in youth with cerebral palsy: A randomised controlled trial. Gait Posture 2021; 90:441-448. [PMID: 34600178 DOI: 10.1016/j.gaitpost.2021.09.194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/14/2021] [Accepted: 09/22/2021] [Indexed: 02/02/2023]
Abstract
AIM To determine whether a running intervention utilising plyometric activities improved leg stiffness in youth with cerebral palsy (CP), GMFCS levels I and II. METHOD This stratified randomised controlled trial examined the lower limb kinetics and kinematics of a sample of youths with CP during sub-maximal hopping and running, prior to and immediately following a 12-week running intervention that incorporated low load plyometric training. Included participants were 13 in the control group (mean age 13 years 2 months [SD 2 years 7 months]; six males; nine GMFCS level I; six unilateral) and 18 in the intervention group (mean age 12 years 9 months [SD 2 years 10 months]; 13 males; 11 GMFCS level I; nine unilateral). Derived variables included three-dimensional leg stiffness as well as resultant ground reaction force and change in leg length. Generalised linear mixed models were developed for statistical analysis. RESULTS At follow-up the intervention group had greater leg stiffness than the control group during submaximal hopping (Intervention median = 3278Nm-1; Control median = 1556Nm-1; p < 0.01). At follow-up, participants in the intervention group in GMFCS Level I had greater leg stiffness than the control group during jogging (Intervention mean=38.84 (SD=25.55); Control mean=29.38 (SD=11.11); t = 2.61 p = 0.01). INTERPRETATION A running training intervention which includes plyometric activities can improve leg stiffness in young people with CP, especially those in GMFCS level I.
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Affiliation(s)
- A Chappell
- School of Physiotherapy and Exercise Sciences, Curtin University, Kent St., Bentley, Western Australia 6102, Australia.
| | - G T Allison
- School of Physiotherapy and Exercise Sciences, Curtin University, Kent St., Bentley, Western Australia 6102, Australia
| | - N Gibson
- Perth Children's Hospital, Locked Bag 2010, Nedlands, Western Australia 6909, Australia
| | - G Williams
- School of Health Sciences, University of Melbourne, Victoria 3010, Australia
| | - S Morris
- School of Physiotherapy and Exercise Sciences, Curtin University, Kent St., Bentley, Western Australia 6102, Australia
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Tang S, Johnson JC, Jarto I, Smith B, Morris S. Milk Components by In-Line Fiber Optic Probe-Based FT-NIR: Commercial Scale Evaluation of a Potential Alternative Measurement Approach for Milk Payment. J AOAC Int 2021; 104:1328-1337. [PMID: 34263310 DOI: 10.1093/jaoacint/qsaa146] [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: 03/31/2020] [Revised: 09/24/2020] [Accepted: 10/01/2020] [Indexed: 11/13/2022]
Abstract
BACKGROUND Mid-infrared (MIR) spectroscopy has traditionally been used to determine the macronutrients in bovine milk, as the basis of milk payment. Recent studies have demonstrated that NIR/FT-NIR spectroscopic systems can not only achieve MIR measurement performance, but are also generally simpler, more robust, and thus much more amenable to actual industrial process applications. OBJECTIVE The goal of this unique study was to investigate the feasibility of in-line FT-NIR spectroscopy for milk fat, protein, and total solids (TS) determination in a large industrial dairy processing facility, as an alternative basis for milk payment. METHOD Multivariant chemometric models using partial least squares (PLS) regression were built to predict the milk components. Over 1000 composite FT-NIR results gathered from the milk unloading process were compared directly to independent third-party FT-IR results. RESULTS Accuracy, precision, and linearity of the method were shown by Standard Error of Prediction (SEP) and Range/SEP of individual components. The SEP for fat, protein, and TS models were 0.09, 0.11, and 0.52, respectively. Range/SEP were 25.10, 12.60, and 6.40 for fat, protein, and TS, respectively. Accuracy and precision for the three components were further evaluated by the mean differences (0.01, 0.05, and 0.51) from dairy FT-IR results and the standard deviations of the mean difference (0.09, 0.09, and 0.13). Robustness was demonstrated by evaluating milk with natural variation over 6 months and using multiple instrumentation setups. The repeatability was also evaluated. CONCLUSIONS Overall, the in-line FT-NIR technology was found to have accurate, reliable, consistent performance similar to dairy FT-IR technology.
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Affiliation(s)
- Shuaikun Tang
- Hilmar Cheese Company, 9001 North Lander Avenue, P.O. Box 910, Hilmar, CA 95324, USA
| | - J Chris Johnson
- Hilmar Cheese Company, 9001 North Lander Avenue, P.O. Box 910, Hilmar, CA 95324, USA
| | - Iswandi Jarto
- Hilmar Cheese Company, 9001 North Lander Avenue, P.O. Box 910, Hilmar, CA 95324, USA
| | - Bridgette Smith
- Hilmar Cheese Company, 9001 North Lander Avenue, P.O. Box 910, Hilmar, CA 95324, USA
| | - Scott Morris
- Hilmar Cheese Company, 9001 North Lander Avenue, P.O. Box 910, Hilmar, CA 95324, USA
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Beeken RJ, Leurent B, Vickerstaff V, Wilson R, Croker H, Morris S, Omar RZ, Nazareth I, Wardle J. Correction to: A brief intervention for weight control based on habit-formation theory delivered through primary care: results from a randomised controlled trial. Int J Obes (Lond) 2021; 45:2137-2138. [PMID: 34099843 PMCID: PMC8380537 DOI: 10.1038/s41366-021-00862-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- R J Beeken
- Department of Epidemiology and Public Health, University College London, London, UK.
| | - B Leurent
- Department of Primary Care and Population Health, University College London, London, UK
| | - V Vickerstaff
- Department of Primary Care and Population Health, University College London, London, UK
| | - R Wilson
- Department of Epidemiology and Public Health, University College London, London, UK
| | - H Croker
- Department of Epidemiology and Public Health, University College London, London, UK
| | - S Morris
- Department of Epidemiology and Public Health, University College London, London, UK
| | - R Z Omar
- Department of Statistical Science, University College London, London, UK
| | - I Nazareth
- Department of Primary Care and Population Health, University College London, London, UK
| | - J Wardle
- Department of Epidemiology and Public Health, University College London, London, UK
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Gibson K, Sharp R, Ullman A, Morris S, Kleidon T, Esterman A. Risk factors for umbilical vascular catheter-related adverse events: A scoping review. Aust Crit Care 2021; 35:89-101. [PMID: 34088575 DOI: 10.1016/j.aucc.2021.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/24/2021] [Accepted: 02/28/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Adverse events associated with umbilical catheters include malposition, bloodstream infections, thrombosis, tip migration, and extravasation, resulting in loss of vascular access and increased risk of morbidity and mortality. There is a need for greater understanding of risk factors associated with adverse events to inform safe practice. OBJECTIVES The aim of the study was to summarise the existing evidence regarding risk factors for umbilical catheter-related adverse events to inform the undertaking of future research. REVIEW METHOD USED A scoping review of peer-reviewed original research and theses was performed. DATA SOURCES The US National Library of Medicine National Institutes of Health, Embase, EMcare, and ProQuest Dissertations and Theses were the data sources. REVIEW METHODS Informed by the Joanna Briggs Institute Reviewer's Manual, all types of original research studies reporting adverse events published in English from 2009 to 2020 were eligible for inclusion. Studies where umbilical artery catheter and umbilical venous catheter data could not be extracted separately were excluded. RESULTS Searching identified 1954 publications and theses, 1533 were excluded at screening, and 418 were assessed for eligibility at full text. A total of 89 studies met the inclusion criteria. A range of potential risk factors for umbilical arterial and venous catheters were identified. Longer dwell time and prematurity were associated with increased risk of bloodstream infection and thrombosis in cohort studies. Case studies detailed analogous factors such as insertion techniques and lack of catheter surveillance during dwell warrant further investigation. CONCLUSIONS We identified a vast range of patient, device, and provider risk factors that warrant further investigation. There was a lack of large cohort studies and randomised controlled trials to demonstrate the significance of these risk factors. Improvement in methods to ensure correct catheter tip location and to detect adverse events early is essential. In addition, policy needs to be developed to guide clinicians in catheter surveillance measures to reduce the risk of adverse events.
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Affiliation(s)
- Kim Gibson
- Clinical and Health Sciences, University of South Australia, PO Box 2471, South Australia, 5000, Australia.
| | - Rebecca Sharp
- Clinical and Health Sciences, University of South Australia, PO Box 2471, South Australia, 5000, Australia.
| | - Amanda Ullman
- School of Nursing and Midwifery, Menzies Health Institute Queensland, Nathan Campus, 170 Kessels Road Queensland 4111, Australia; Children's Health Queensland and Health Service Centre of Children's Health Research, South Brisbane QLD 4101, Australia; School of Nursing, Midwifery and Social Work The University of Queensland, Brisbane QLD 4072, Australia.
| | - Scott Morris
- College of Medicine and Public Health, Flinders University, Neonatal Unit, Flinders Medical Centre, Bedford Drive, Bedford Park, South Australia 5042, Australia.
| | - Tricia Kleidon
- Queensland Children's Hospital, 401 Stanley Street, South Brisbane, Q. 4101, Australia; School of Nursing and Midwifery, Griffith University, 170 Kessels Raod, Nathan, Q. 4111, Australia.
| | - Adrian Esterman
- Clinical and Health Sciences, University of South Australia, PO Box 2471, South Australia, 5000, Australia.
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30
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Gould JF, Roberts RM, Anderson PJ, Makrides M, Sullivan TR, Gibson RA, McPhee AJ, Doyle LW, Opie G, Travadi J, Cheong JLY, Davis PG, Sharp M, Simmer K, Tan K, Morris S, Lui K, Bolisetty S, Liley H, Stack J, Best KP, Collins CT. Protocol for assessing if behavioural functioning of infants born <29 weeks' gestation is improved by omega-3 long-chain polyunsaturated fatty acids: follow-up of a randomised controlled trial. BMJ Open 2021; 11:e044740. [PMID: 33952546 PMCID: PMC8103387 DOI: 10.1136/bmjopen-2020-044740] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 03/10/2021] [Accepted: 03/17/2021] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION During the last trimester of pregnancy, the fetal brain undergoes a rapid growth spurt and accumulates essential nutrients including docosahexaenoic acid (DHA). This takes place ex-utero for infants born <29 weeks' gestation, without the in-utero provisions of DHA. Infants born <29 weeks' are more likely to experience behavioural and emotional difficulties than their term-born counterparts. It has been hypothesised that supplementing preterm infants with dietary DHA may alleviate insufficiency and subsequently prevent or minimise behavioural problems. This protocol describes a follow-up of infants born <29 weeks gestation who were enrolled in a randomised controlled trial (RCT) of DHA supplementation. We aim to determine whether DHA supplementation improves the behaviour, and general health of these infants. METHODS AND ANALYSIS Infants born <29 weeks' gestation were enrolled in a multicentre blinded RCT of enteral DHA supplementation. Infants were randomised to receive an enteral emulsion that provided 60 mg/kg/day of DHA or a control emulsion commenced within the first 3 days of enteral feeding, until 36 weeks' postmenstrual age or discharge home, whichever occurred first. Families of surviving children (excluding those who withdrew from the study) from the Australian sites (up to 955) will be invited to complete a survey. The survey will include questions regarding child behavioural and emotional functioning, executive functioning, respiratory health and general health. We hypothesise that the DHA intervention will have a benefit on the primary outcome, parent-rated behaviour and emotional status as measured using the Total Difficulties score of the Strengths and Difficulties Questionnaire. Detecting a 2-point difference between groups (small effect size of 0.25 SD) with 90% power will require follow-up of 676 participants. ETHICS AND DISSEMINATION The Women's and Children Health Network Human Research Ethics Committee reviewed and approved the study (HREC/16/WCHN/184). Results will be disseminated in peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER ACTRN12612000503820.
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Affiliation(s)
- Jacqueline F Gould
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Psychology and Discipline of Paediatrics, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Rachel M Roberts
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Maria Makrides
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Discipline of Paediatrics, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Thomas R Sullivan
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Robert A Gibson
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Agriculture, Food and Wine, University of Adelaide, Waite Campus, Glen Osmond, South Australia, Australia
| | - Andrew J McPhee
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Neonatal Medicine, Women's and Children's Hospital Adelaide, North Adelaide, South Australia, Australia
| | - Lex William Doyle
- Department Obstetrics and Gynaecology, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Gillian Opie
- Neonatal Services, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Javeed Travadi
- Newborn Services, John Hunter Children's Hospital, New Lambton Heights, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Jeanie L Y Cheong
- Neonatal Medicine, Royal Women's Hospital, Parkville, Melbourne, Australia
| | - Peter G Davis
- Neonatal Medicine, Royal Women's Hospital, Parkville, Melbourne, Australia
| | - Mary Sharp
- Neonatal Follow up, King Edward Memorial Hospital for Women Perth, Perth, Western Australia, Australia
| | - Karen Simmer
- Neonatal Research, The University of Western Australia, Perth, Western Australia, Australia
| | - Kenneth Tan
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
- Monash Children's Hospital, Clayton, New South Wales, Australia
| | - Scott Morris
- Paediatric Neonatal Clinic, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Kei Lui
- Newborn Care Centre, Royal Hospital for Women, Randwick, New South Wales, Australia
| | - Srinivas Bolisetty
- Newborn Care Centre, Royal Hospital for Women, Randwick, New South Wales, Australia
| | - Helen Liley
- Mater Research - The Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
| | - Jacqueline Stack
- Neonatal Intensive Care Unit, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Karen P Best
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Discipline of Paediatrics, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Carmel T Collins
- Discipline of Paediatrics, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Women and Kids, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia
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Howarth AR, Apea V, Michie S, Morris S, Sachikonye M, Mercer CH, Evans A, Delpech VC, Sabin C, Burns FM. The association between use of chemsex drugs and HIV clinic attendance among gay and bisexual men living with HIV in London. HIV Med 2021; 22:641-649. [PMID: 33949070 DOI: 10.1111/hiv.13103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 11/27/2020] [Accepted: 03/02/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To investigate the association between chemsex drug use and HIV clinic attendance among gay and bisexual men in London. METHODS A cross-sectional survey of adults (> 18 years) diagnosed with HIV for > 4 months, attending seven London HIV clinics (May 2014 to August 2015). Participants self-completed an anonymous questionnaire linked to clinical data. Sub-optimal clinic attenders had missed one or more HIV clinic appointments in the past year, or had a history of non-attendance for > 1 year. RESULTS Over half (56%) of the 570 men who identified as gay or bisexual reported taking recreational drugs in the past 5 years and 71.5% of these men had used chemsex drugs in the past year. Among men reporting chemsex drug use (past year), 32.1% had injected any drugs in the past year. Sub-optimal clinic attenders were more likely than regular attenders to report chemsex drug use (past year; 46.9% vs. 33.2%, P = 0.001), injecting any drugs (past year; 17.1% vs. 8.9%, P = 0.011) and recreational drug use (past 5 years; 65.5% vs. 48.8%, P < 0.001). One in five sub-optimal attenders had missed an HIV clinic appointment because of taking recreational drugs (17.4% vs. 1.8%, P < 0.001). In multivariable logistic regression, chemsex drug use was significantly associated with sub-optimal clinic attendance (adjusted odds ratio = 1.71, 95% confidence interval: 1.10-2.65, P = 0.02). CONCLUSIONS Our findings highlight the importance of systematic assessment of drug use and development of tools to aid routine assessment. We suggest that chemsex drug use should be addressed when developing interventions to improve engagement in HIV care among gay and bisexual men.
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Affiliation(s)
- A R Howarth
- Institute for Global Health, University College London, London, UK
| | - V Apea
- Barts Health NHS Trust, London, UK
| | - S Michie
- Centre for Behaviour Change, University College London, London, UK
| | - S Morris
- Department of Applied Health Research, University College London, London, UK
| | | | - C H Mercer
- Institute for Global Health, University College London, London, UK
| | - A Evans
- Royal Free London NHS Foundation Trust, London, UK
| | | | - C Sabin
- Institute for Global Health, University College London, London, UK
| | - F M Burns
- Institute for Global Health, University College London, London, UK.,Royal Free London NHS Foundation Trust, London, UK
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Banjoko A, Boylan C, Kumar H, McCabe H, Morris S. 557 A Novel Peer-Led Anatomage-Based Teaching Programme for Medical Students. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.149] [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
Anatomical knowledge is an essential part of surgical practice. However, its delivery lacks a standardised approach across medical school curricula. A student-led anatomy programme was implemented at a single institution, using near-peer teaching and Anatomage virtual dissection. This study aims to describe the methodology of this programme and determine the benefit of a near-peer taught anatomy course.
Method
The programme was organised by senior medical students, utilising Anatomage virtual dissection and techniques in line with Bigg’s constructive alignment. Attendees were asked to complete questionnaires with Likert scales (0-10) and open answer text to determine learners’ benefit. Both quantitative and qualitative analyses are presented.
Results
73 students attended eight sessions from January to March 2020. Students reported a statistically significant (p < 0.01) increase in confidence after the sessions of 3.74±1.83. The quality and relevance of the teaching also scored highly (9.32±0.89 and 9.47±0.86 respectively). Qualitatively, students praised the "informal learning environment”, the structure of the sessions, the handout provided, and the interactivity of anatomage technology.
Conclusions
This study demonstrates how virtual dissection technology and near-peer teaching can derive significant benefit to undergraduate students, in line with previously published data.
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Affiliation(s)
- A Banjoko
- University of Birmingham College of Medical and Dental Sciences, Birmingham, United Kingdom
| | - C Boylan
- University of Birmingham College of Medical and Dental Sciences, Birmingham, United Kingdom
| | - H Kumar
- University of Birmingham College of Medical and Dental Sciences, Birmingham, United Kingdom
| | - H McCabe
- University of Birmingham College of Medical and Dental Sciences, Birmingham, United Kingdom
| | - S Morris
- Morriston Hospital, Swansea, United Kingdom
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Gonzalez Vaz R, Jones E, Begum R, Dobson A, Morris S, De Francesco I. PO-0266 Dosimetric comparison of brachytherapy and tomotherapy for a large SCC on the scalp. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06425-2] [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: 11/26/2022]
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Rivera G, Butka E, Jindal K, Kong W, Waye S, Hoffmann C, Kamimoto K, Morris S. 631 Lineage tracing at single-cell resolution unveils complex differentiation trajectories of adipocyte precursors in the skin. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Promoting health-related campaigns on Twitter has increasingly become a world-wide choice to raise awareness and disseminate health information. Data retrieved from Twitter are now being used to explore how users express their views, attitudes and personal experiences of health-related issues. We focused on Twitter discourse reproduced during Mental Health Awareness Week 2017 by examining 1,200 tweets containing the keywords 'mental health', 'mental illness', 'mental disorders' and '#MHAW'. The analysis revealed 'awareness and advocacy', 'stigmatization', and 'personal experience of mental health/illness' as the central discourses within the sample. The article concludes with some recommendations for future research on digitally-mediated health communication.
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Affiliation(s)
- Meiko Makita
- Statistical Cybermetrics Research Group, University of Wolverhampton, Wolverhampton, UK
| | - Amalia Mas-Bleda
- Statistical Cybermetrics Research Group, University of Wolverhampton, Wolverhampton, UK
| | | | - Mike Thelwall
- Statistical Cybermetrics Research Group, University of Wolverhampton, Wolverhampton, UK
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Peters S, Dafni U, Perol M, Felip E, Polito L, Pal N, Ton T, Merritt D, Morris S, Stahel R. VP2-2021: Effectiveness of PD-(L)1 inhibitors alone or in combination with platinum-doublet chemotherapy in first-line (1L) non-squamous non-small cell lung cancer (Nsq-NSCLC) with high PD-L1 expression using real-world data. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.195] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Reck M, Horn L, Mok T, Mansfield A, De Boer R, Losonczy G, Sugawara S, Dziadziuszko R, Krzakowski M, Smolin A, Hochmair M, Garassino M, Castro G, Bischoff H, Cardona A, Morris S, Liu S. OA11.06 IMpower133: Exploratory Analysis of Maintenance Therapy in Patients With Extensive-Stage Small-Cell Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.316] [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: 11/17/2022]
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Ong ELH, Paolino A, Grandi V, Morris S, Martin B, Calonje E. An unusual nodule in a patient with Kaposi sarcoma. Clin Exp Dermatol 2021; 46:764-768. [PMID: 33645856 DOI: 10.1111/ced.14604] [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] [Accepted: 06/07/2020] [Indexed: 11/26/2022]
Affiliation(s)
- E L H Ong
- Dermatopathology Department, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| | - A Paolino
- Dermatology Department, St John's Institute of Dermatology, Guy's Hospital, London, UK
| | - V Grandi
- Dermatology Department, St John's Institute of Dermatology, Guy's Hospital, London, UK
| | - S Morris
- Oncology Department, Guy's Hospital, London, UK
| | - B Martin
- Dermatopathology Department, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| | - E Calonje
- Dermatopathology Department, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
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Cheema P, Ton T, Lambert P, Merritt D, Morris S, Shankar G, Ganti A. TT01.01 Real-World Outcomes in Patients with EGFR/ALK-Positive NSCLC Treated with Chemotherapy Following 1 or 2 Lines of TKI Therapy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.090] [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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Devlin L, Millar S, Morris S, Sadozye A, Harrand R, Graham K, Kerr A, Duncanson C, Duffton A. PO-1882: The risk of pelvic insufficiency fractures after radiotherapy using planned dose analysis. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01900-9] [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: 11/16/2022]
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Farrent S, Coppin B, Morris S. Call for infant formula reconstitution uniformity and improvements in manufacturer feeding guides. Med J Aust 2020; 214:107-110.e1. [PMID: 32920875 DOI: 10.5694/mja2.50760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Hughes AJ, Feeley IH, Ahern DP, Dodds MK, Cassidy N, Timlin M, Morris S, Synnott K, Butler JS. New Technologies in the Field of Orthopaedic and Spine Surgery - Navigating the Learning Curve. Ir Med J 2020; 113:148. [PMID: 34520659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- A J Hughes
- National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - I H Feeley
- National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - D P Ahern
- National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - M K Dodds
- National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - N Cassidy
- National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - M Timlin
- National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - S Morris
- National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - K Synnott
- National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - J S Butler
- National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
- UCD School of Medicine & Medical Science, Mater Misericordiae University Hospital, Dublin, Ireland
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Liu S, Horn L, Mok T, Mansfield A, De Boer R, Losonczy G, Sugawara S, Dziadziuszko R, Krzakowski M, Smolin A, Hochmair M, Garassino M, Lam S, McCleland M, Cardona A, Morris S, Reck M. 1781MO IMpower133: Characterisation of long-term survivors treated first-line with chemotherapy ± atezolizumab in extensive-stage small cell lung cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Ó Doinn T, Hughes AJ, Ahern DP, McDonnell J, Kavanagh E, Morris S, Butler JS. Auto-Decompression - Preserved Neurological Function in Bilateral Cervical Facet Dislocations. Ir Med J 2020; 113:131. [PMID: 33205644] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Introduction Bilateral cervical facet dislocation (BCFD) is an uncommon injury with a high incidence of severe neurological impairment. We describe 4 cases of BCFD with preserved neurological function. Cases Case 1: A 78-year-old female who suffered two ground level falls (GLFs). Pre-operative American Spinal Injury Association (ASIA) Score was C5D. Imaging revealed a BCFD at C6/C7 and a C6 laminar fracture. Case 2: A 63-year-old male suffered a fall down 14 steps. Pre-operative ASIA score was E. Imaging demonstrated a BCFD at C7/T1, and a C6 laminar fracture. Case 3: A 46-year-old male collided with a tree while descending a hill on a bicycle. Pre-operative ASIA score was C6D. Imaging revealed a BCFD at C7/T1 and a C7 laminar fracture. Case 4: A 67-year-old male suffered a GLF while exiting a stationary car. Pre-operative ASIA score on admission was E. Imaging revealed a BCFD at C6/C7 with bilateral laminar fractures at C5 and C6. Outcome All cases underwent 2-stage surgical fixation. All cases maintained or had an improved ASIA score post-operatively. Conclusion In all cases, the presence of concurrent laminar fractures resulted in an auto-decompression of the spinal canal, preserving neurological function.
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Affiliation(s)
- T Ó Doinn
- National Spinal Injuries Unit, Department of Trauma & Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - A J Hughes
- National Spinal Injuries Unit, Department of Trauma & Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - D P Ahern
- National Spinal Injuries Unit, Department of Trauma & Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - J McDonnell
- Royal College of Surgeons in Ireland, St. Stephen's Green, Dublin, Ireland
| | - E Kavanagh
- Radiology Department, Mater Misericordiae University Hospital, Dublin, Ireland
| | - S Morris
- National Spinal Injuries Unit, Department of Trauma & Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - J S Butler
- National Spinal Injuries Unit, Department of Trauma & Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
- School of Medicine and Medical Science, University College Dublin, Ireland
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Rivera G, Kamimoto K, Butka E, Kong W, Morris S. 829 Single-cell approaches to uncover adipocyte precursor heterogeneity and differentiation mechanisms in the skin. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Chappell A, Allison GT, Williams G, Gibson N, Morris S. The effect of a running training intervention on ankle power generation in children and adolescents with cerebral palsy: A randomized controlled trial. Clin Biomech (Bristol, Avon) 2020; 76:105024. [PMID: 32416406 DOI: 10.1016/j.clinbiomech.2020.105024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 04/09/2020] [Accepted: 04/28/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Children and adolescents with cerebral palsy who are classified as Gross Motor Function Classification Scale level I or II are usually able to run but lack ankle power generation for push-off. The aim of this study was to analyze the efficacy of a running training program in improving ankle power generation in children and adolescents with cerebral palsy. METHODS This randomized controlled trial compared kinematic and spatiotemporal data collected during running from 38 children and adolescents with unilateral or bilateral cerebral palsy before and after a 12-week running program. Normalized speed, stride length, cadence, foot strike pattern, peak ankle power generation, peak hip flexor power generation in swing and propulsion strategy were calculated. Linear mixed models were developed to analyze differences between groups. FINDINGS At follow-up the intervention group had increased normalized speed of running (t = -3.68 p < .01) while the control group got slower (t = 3.17 p < .01). In running, children in Gross Motor Function Classification Scale level II in the intervention group increased ankle power (t = 2.49 p = .01) while the control group did not change (t = 0.38 p = .71). In sprinting, children in Gross Motor Function Classification Scale levels I and II in the intervention group maintained ankle power (level I t = 0.32 p = .75; level II t = 1.56 p = .12) while those in the control group decreased ankle power (level I t = 4.69 p < .01; level II t = 2.52 p = .01). Most within-group differences did not result in significant between-group differences at follow-up. INTERPRETATION Power generation for running may be responsive to targeted intervention in children with cerebral palsy.
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Affiliation(s)
- A Chappell
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Western Australia, Australia; Ability Centre, Coolbinia, Western Australia, Australia.
| | - G T Allison
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Western Australia, Australia
| | - G Williams
- School of Health Sciences, University of Melbourne, Victoria, Australia; Epworth HealthCare, Victoria, Australia.
| | - N Gibson
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Western Australia, Australia; Ability Centre, Coolbinia, Western Australia, Australia; Perth Children's Hospital, Perth, Western Australia, Australia.
| | - S Morris
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Western Australia, Australia
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Khaykin Y, Alipour P, Azizi Z, Avoulov A, Jansen C, Donegan S, Morris S, Nath S, Tamjidi S, Varah N, Pantano A, Verma A, Weaver B, Hunter TD. P1409Effectiveness of atrial fibrillation ablation using a contact force stability module with contact force or non-contact force catheter. Europace 2020. [DOI: 10.1093/europace/euaa162.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
This study was funded by Biosense Webster, Inc.
Background
Catheter ablation is a mainstream treatment option for atrial fibrillation (AF). Recently, contact force (CF) enabled ablation catheters and a stability module were developed to allow for real-time CF sensing and improvement of catheter-tissue stability, which is important for achieving an optimal clinical outcome. We assessed the relative effectiveness of these new technologies, as well as the optimal CF stability parameters, in a real-world setting.
Purpose
To compare the clinical effectiveness of AF ablations performed with a CF catheter using location stability settings of 2.5 mm maximum distance for 12 s minimum (2.5/12) vs. a non-CF catheter with settings of 3 mm for 7 s (3/7).
Methods
Within 1/14–4/18, 176 de novo AF ablations using either a CF catheter with stability settings of 2.5/12 (n = 92, 5/16–4/18) or a non-CF catheter with stability settings of 3/7 (n = 84, 1/14–3/14) were performed by a single operator at a Canadian medical center. Patients routinely wore 48 hour Holter monitors every three months through the first year. The primary measures of effectiveness were Kaplan-Meier (KM) survival estimates of freedom from AF/atrial tachycardia (AT)/atrial flutter (AFL) recurrence after a 3-month blanking period and reablation.
Results
The CF group was 62.9 ± 10.0 years old, 57.6% male, and 66.3% paroxysmal (PAF). The non-CF group was 61.6 ± 9.9 years old, 63.1% male, and 76.2% PAF. Procedural complications consisted of a single vascular access complication in the non-CF group. The 12-month estimate of freedom from AF/AT/AFL recurrence was 79.4% in the CF group vs. 64.8% in the non-CF group (p = 0.058 for difference in survival over time). 12-month freedom from reablation was 90.4% in the CF group vs. 70.5% in the non-CF group (p = 0.002).
Conclusion
CF ablation with more stringent stability settings of 2.5/12 was more effective than non-CF ablation with stability settings of 3/7, likely attributable to the CF catheter enabling visualization of catheter-tissue contact and the stability module facilitating maintenance of CF stability during ablation.
Abstract Figure.
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Affiliation(s)
- Y Khaykin
- Southlake Regional Health Centre, Newmarket, Canada
| | - P Alipour
- Southlake Regional Health Centre, Newmarket, Canada
| | - Z Azizi
- Southlake Regional Health Centre, Newmarket, Canada
| | - A Avoulov
- Southlake Regional Health Centre, Newmarket, Canada
| | - C Jansen
- Southlake Regional Health Centre, Newmarket, Canada
| | - S Donegan
- Southlake Regional Health Centre, Newmarket, Canada
| | - S Morris
- Southlake Regional Health Centre, Newmarket, Canada
| | - S Nath
- Southlake Regional Health Centre, Newmarket, Canada
| | - S Tamjidi
- Southlake Regional Health Centre, Newmarket, Canada
| | - N Varah
- Southlake Regional Health Centre, Newmarket, Canada
| | - A Pantano
- Southlake Regional Health Centre, Newmarket, Canada
| | - A Verma
- Southlake Regional Health Centre, Newmarket, Canada
| | - B Weaver
- CTI Clinical Trial and Consulting Services, Real World Evidence, Covington, United States of America
| | - T D Hunter
- CTI Clinical Trial and Consulting Services, Real World Evidence, Covington, United States of America
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Rosenberg R, Babson K, Menno D, Morris S, Baladi M, Hyman D, Black J. 0751 Epworth Sleepiness Scale Test-Retest Reliability Analysis In Solriamfetol Studies. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.747] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The Epworth Sleepiness Scale (ESS) measures excessive daytime sleepiness. This analysis examined test-retest reliability of ESS scores in participants with narcolepsy or obstructive sleep apnea (OSA) in solriamfetol studies.
Methods
Intraclass correlation coefficient (ICC) estimates and 95% confidence intervals (CIs) for ESS scores from two 12-week, placebo-controlled trials (1 narcolepsy; 1 OSA), and one long-term open-label extension (OLE) trial (narcolepsy or OSA) were calculated separately for each trial, based on assessments (at time-point pairs) when scores were expected to be stable (at weeks 4 and 8, 8 and 12, and 4 and 12 in the 12-week trials, and weeks 14 and 26/27, 26/27 and 39/40, and 14 and 39/40 in the OLE). ICCs were analyzed for the overall population in each trial and by treatment and adherence to primary OSA therapy. An ICC >0.7 has been recommended as a quality criterion for acceptable test-retest reliability.
Results
In the 12-week narcolepsy trial, ICCs (95% CI) were 0.83 (0.79, 0.87) for weeks 4 and 8 (n=199), 0.87 (0.83, 0.90) for weeks 8 and 12 (n=196), and 0.81 (0.76, 0.85) for weeks 4 and 12 (n=196). In the 12-week OSA trial, ICCs (95% CI) were 0.74 (0.69, 0.78) for weeks 4 and 8 (n=416), 0.80 (0.76, 0.83) for weeks 8 and 12 (n=405), and 0.74 (0.69, 0.78) for weeks 4 and 12 (n=405). In the OLE trial, ICCs (95% CI) were 0.82 (0.79, 0.85) for weeks 14 and 27/26 (n=495), 0.85 (0.82, 0.87) for weeks 27/26 and 40/39 (n=463), and 0.78 (0.74, 0.81) for weeks 14 and 40/39 (n=463). Treatment (solriamfetol combined/placebo) or adherence to primary OSA therapy did not impact reliability.
Conclusion
In 3 large clinical trials of participants with narcolepsy or OSA, the ESS demonstrated an acceptable level of test-retest reliability.
Support
Jazz Pharmaceuticals
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Affiliation(s)
| | - K Babson
- Jazz Pharmaceuticals, Palo Alto, CA
| | - D Menno
- Jazz Pharmaceuticals, Palo Alto, CA
| | - S Morris
- Jazz Pharmaceuticals, Palo Alto, CA
| | - M Baladi
- Jazz Pharmaceuticals, Palo Alto, CA
| | - D Hyman
- Jazz Pharmaceuticals, Palo Alto, CA
| | - J Black
- Stanford Center for Sleep Sciences and Medicine, Palo Alto, CA
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Evans R, Taylor S, Kalasthry J, Sakai N, Miles A, Aboagye A, Agoramoorthy L, Ahmed S, Amadi A, Anand G, Atkin G, Austria A, Ball S, Bazari F, Beable R, Beare S, Beedham H, Beeston T, Bharwani N, Bhatnagar G, Bhowmik A, Blakeway L, Blunt D, Boavida P, Boisfer D, Breen D, Bridgewater J, Burke S, Butawan R, Campbell Y, Chang E, Chao D, Chukundah S, Clarke C, Collins B, Collins C, Conteh V, Couture J, Crosbie J, Curtis H, Daniel A, Davis L, Desai K, Duggan M, Ellis S, Elton C, Engledow A, Everitt C, Ferdous S, Frow A, Furneaux M, Gibbons N, Glynne-Jones R, Gogbashian A, Goh V, Gourtsoyianni S, Green A, Green L, Green L, Groves A, Guthrie A, Hadley E, Halligan S, Hameeduddin A, Hanid G, Hans S, Hans B, Higginson A, Honeyfield L, Hughes H, Hughes J, Hurl L, Isaac E, Jackson M, Jalloh A, Janes S, Jannapureddy R, Jayme A, Johnson A, Johnson E, Julka P, Kalasthry J, Karapanagiotou E, Karp S, Kay C, Kellaway J, Khan S, Koh D, Light T, Limbu P, Lock S, Locke I, Loke T, Lowe A, Lucas N, Maheswaran S, Mallett S, Marwood E, McGowan J, Mckirdy F, Mills-Baldock T, Moon T, Morgan V, Morris S, Morton A, Nasseri S, Navani N, Nichols P, Norman C, Ntala E, Nunes A, Obichere A, O'Donohue J, Olaleye I, Oliver A, Onajobi A, O'Shaughnessy T, Padhani A, Pardoe H, Partridge W, Patel U, Perry K, Piga W, Prezzi D, Prior K, Punwani S, Pyers J, Rafiee H, Rahman F, Rajanpandian I, Ramesh S, Raouf S, Reczko K, Reinhardt A, Robinson D, Rockall A, Russell P, Sargus K, Scurr E, Shahabuddin K, Sharp A, Shepherd B, Shiu K, Sidhu H, Simcock I, Simeon C, Smith A, Smith D, Snell D, Spence J, Srirajaskanthan R, Stachini V, Stegner S, Stirling J, Strickland N, Tarver K, Teague J, Thaha M, Train M, Tulmuntaha S, Tunariu N, van Ree K, Verjee A, Wanstall C, Weir S, Wijeyekoon S, Wilson J, Wilson S, Win T, Woodrow L, Yu D. Patient deprivation and perceived scan burden negatively impact the quality of whole-body MRI. Clin Radiol 2020; 75:308-315. [PMID: 31836179 DOI: 10.1016/j.crad.2019.10.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/30/2019] [Indexed: 01/26/2023]
Abstract
AIM To evaluate the association between the image quality of cancer staging whole-body magnetic resonance imaging (WB-MRI) and patient demographics, distress, and perceived scan burden. MATERIALS AND METHODS A sample of patients recruited prospectively to multicentre trials comparing WB-MRI with standard scans for staging lung and colorectal cancer were invited to complete two questionnaires. The baseline questionnaire, administered at recruitment, collated data on demographics, distress and co-morbidity. The follow-up questionnaire, completed after staging investigations, measured perceived WB-MRI scan burden (scored 1 low to 7 high). WB-MRI anatomical coverage, and technical quality was graded by a radiographic technician and grading combined to categorise the scan as "optimal", "sub-optimal" or "degraded". A radiologist categorised 30 scans to test interobserver agreement. Data were analysed using the chi-square, Fisher's exact, t-tests, and multinomial regression. RESULTS One hundred and fourteen patients were included in the study (53 lung, 61 colorectal; average age 65.3 years, SD=11.8; 66 men [57.9%]). Overall, 45.6% (n=52), scans were classified as "optimal" quality, 39.5% (n=45) "sub-optimal", and 14.9% (n=17) as "degraded". In adjusted analyses, greater deprivation level and higher patient-reported scan burden were both associated with a higher likelihood of having a sub-optimal versus an optimal scan (odds ratio [OR]: 4.465, 95% confidence interval [CI]: 1.454 to 13.709, p=0.009; OR: 1.987, CI: 1.153 to 3.425, p=0.013, respectively). None of the variables predicted the likelihood of having a degraded scan. CONCLUSIONS Deprivation and patients' perceived experience of the WB-MRI are related to image quality. Tailored protocols and individualised patient management before and during WB-MRI may improve image quality.
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Kent S, Morris S, Ananth S. Systematic review of thromboprophylaxis in patients having orthognathic surgery. Br J Oral Maxillofac Surg 2020; 58:396-403. [PMID: 32192762 DOI: 10.1016/j.bjoms.2020.01.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 01/13/2020] [Indexed: 11/25/2022]
Abstract
Orthognathic surgery is an elective procedure that is done in healthy individuals so complications such as thromboembolic events are rare. Pharmacological thromboprophylaxis, which reduces the risk of these events, may also increase blood loss and potentially the risk of life-threatening haemorrhage, so a state of clinical equipoise exists about whether it should be given routinely. We systematically reviewed published papers to identify the incidence of venous thromboembolism and haemorrhage in patients treated by orthognathic surgery who were, and were not, given pharmacological thromboprophylaxis. The pooled incidence of thromboembolic events was 0% in those who were, and 0.19% in those who were not. Return to theatre to control bleeding was required in 2.72% of the patients treated at centres where it was given, and in 0.55% at those where it was not. Small sample sizes, the heterogeneity of treatment protocols, and incomplete reporting made further statistical analysis impossible. The incidence of venous thromboembolism in patients who have orthognathic surgery is low when compared with the rest of the hospital population. Although pharmacological thromboprophylaxis may further reduce this, it can also increase blood loss, and uncertainty therefore remains over the best protocol for its routine use. The risk stratification of individual patients, and large randomised controlled trials are now required to establish the best treatment.
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Affiliation(s)
- S Kent
- Department of Oral and Maxillofacial Surgery, Morriston Hospital, Swansea.
| | - S Morris
- Department of Oral and Maxillofacial Surgery, Morriston Hospital, Swansea
| | - S Ananth
- Department of Oral and Maxillofacial Surgery, Morriston Hospital, Swansea
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