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Wadhavkar N, Nsubuga JP, Ibrahim N, Kumar P, Hsu A, Simmons S. Acute Liver Failure With Liver Enzymes >5,000 in Sickle Cell Disease. ACG Case Rep J 2024; 11:e01303. [PMID: 38511165 PMCID: PMC10954052 DOI: 10.14309/crj.0000000000001303] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/12/2024] [Indexed: 03/22/2024] Open
Abstract
Sickle cell disease is a hemoglobinopathy often complicated by painful vaso-occlusive episodes, acute chest syndrome, stroke, and myocardial infarction. Sickle cell intrahepatic cholestasis (SCIC) is a rare and potentially fatal complication of sickle cell disease. SCIC is thought to involve progressive hepatic injury due to sickling within sinusoids. We present the case of a young patient with SCIC and acute liver failure, requiring prompt treatment with exchange transfusion. Our case describes features that should raise suspicion for hepatic failure in SCIC and highlights exchange transfusion as a successful management approach in similar patients with an otherwise high risk of mortality.
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Affiliation(s)
- Neha Wadhavkar
- Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI
| | - John Paul Nsubuga
- Division of Gastroenterology, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Nouran Ibrahim
- The Warren Alpert Medical School of Brown University, Providence, RI
| | - Prasanna Kumar
- Department of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Andrew Hsu
- Division of Hematology Oncology, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Shannon Simmons
- Division of Gastroenterology, The Warren Alpert Medical School of Brown University, Providence, RI
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2
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Simmons S, Noble C, Arquette K, Thompson AD. Bridging the Gap: Impact of dedicated post-discharge services on readmission rates and emergency department visits for psychiatrically hospitalized youth. Clin Child Psychol Psychiatry 2023; 28:1257-1265. [PMID: 36075261 DOI: 10.1177/13591045221125634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND For psychiatrically hospitalized youth, discharge care coordination can reduce suicide risk and rehospitalization, but studies on effective interventions or programs are sparse. This study aimed to examine the impact of a dedicated post-discharge bridging service including case management and therapeutic supports on readmissions and emergency department presentations. METHODS This retrospective cohort study compared emergency department mental health visits (EDMH) and psychiatric hospitalizations in the 60 days before the hospitalization which included referral to the bridging service, and in the 60 days post-hospitalization. RESULTS This diagnostically heterogeneous group of 238 youth had a mean age of 14 years and were of similar racial and ethnic background as the broader inpatient population. There was a nominal decrease in hospitalizations (p = 0.251), and a significant decrease in EDMH (p < 0.001) in the 60 days following referral to this program compared to the 60 days prior. Further, the proportion of patients with at least one EDMH or hospitalization decreased significantly before and after linkage with this service from 42.4% to 27.3% (p < 0.001). CONCLUSION Dedicated post-discharge bridging services including family-centered, flexible case management and therapeutic supports can reduce EDMH visits and potentially lower readmission for children and adolescents.
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Affiliation(s)
- Shannon Simmons
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- Seattle Children's Hospital, Seattle, WA, USA
| | | | | | - Alysha D Thompson
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- Seattle Children's Hospital, Seattle, WA, USA
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3
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DeAbreu A, Bowness C, Alizadeh A, Chartrand C, Brunelle NA, MacQuarrie ER, Lee-Hone NR, Ruether M, Kazemi M, Kurkjian ATK, Roorda S, Abrosimov NV, Pohl HJ, Thewalt MLW, Higginbottom DB, Simmons S. Waveguide-integrated silicon T centres. Opt Express 2023; 31:15045-15057. [PMID: 37157355 DOI: 10.1364/oe.482008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The performance of modular, networked quantum technologies will be strongly dependent upon the quality of their quantum light-matter interconnects. Solid-state colour centres, and in particular T centres in silicon, offer competitive technological and commercial advantages as the basis for quantum networking technologies and distributed quantum computing. These newly rediscovered silicon defects offer direct telecommunications-band photonic emission, long-lived electron and nuclear spin qubits, and proven native integration into industry-standard, CMOS-compatible, silicon-on-insulator (SOI) photonic chips at scale. Here we demonstrate further levels of integration by characterizing T centre spin ensembles in single-mode waveguides in SOI. In addition to measuring long spin T1 times, we report on the integrated centres' optical properties. We find that the narrow homogeneous linewidth of these waveguide-integrated emitters is already sufficiently low to predict the future success of remote spin-entangling protocols with only modest cavity Purcell enhancements. We show that further improvements may still be possible by measuring nearly lifetime-limited homogeneous linewidths in isotopically pure bulk crystals. In each case the measured linewidths are more than an order of magnitude lower than previously reported and further support the view that high-performance, large-scale distributed quantum technologies based upon T centres in silicon may be attainable in the near term.
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Abstract
Mental health professionals routinely advise the public to call 911 in case of an acute mental health crisis to access emergent care and ensure safety. Although there is no national database collection process, available data shows that individuals experiencing an acute mental health crisis and Black youth are both at a significantly elevated risk of being harmed or killed by law enforcement during any encounter. This brief analytic essay explores whether advising the public to call 911 is truly the best practice recommendation for Black youth in a mental health crisis. An alternative to the traditional law enforcement response is a mobile unarmed crisis response program. The authors describe successful existing programs and advocate for more widespread adoption of such teams, which likely would provide safer, cost-effective, evidence-based alternatives during acute mental health crises.
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Affiliation(s)
- Ravi S Ramasamy
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
- Psychiatry and Behavioral Medicine Unit, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA.
| | - Alysha Thompson
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- Psychiatry and Behavioral Medicine Unit, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA
| | - Shannon Simmons
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- Psychiatry and Behavioral Medicine Unit, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA
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5
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Simmons S, Anzia J, Hsiao RCJ, Varley CK. Preparing Child and Adolescent Psychiatrists for the Future of our Field: in Defense of "Slow Tracking". Acad Psychiatry 2022; 46:82-84. [PMID: 35129811 DOI: 10.1007/s40596-022-01592-6] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 01/10/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Shannon Simmons
- University of Washington School of Medicine, Seattle, WA, USA.
| | - Joan Anzia
- Northwestern University, Chicago, IL, USA
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6
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Simmons S, McClellan J. Commentary: Getting kids what they need, where they are, when they need it: home-based services in a continuum of care - a commentary on Boege et al. (2021). Child Adolesc Ment Health 2021; 26:375-377. [PMID: 34519393 DOI: 10.1111/camh.12509] [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] [Accepted: 08/26/2021] [Indexed: 12/17/2022]
Abstract
In this edition of CAMH, Boege and colleague's 4-year follow-up study supports intensive home-based treatment as a viable alternative to inpatient hospitalization. Youth receiving home-based multimodal treatment fared just as well as those who remained hospitalized longer, with higher parental satisfaction. This study contributes to a sparse evidence base regarding longitudinal outcomes of psychiatric inpatient and intensive outpatient treatments for children and adolescents. Although mental illness is prevalent and increasing among youth, existing systems of care are often inadequate to provide flexible, effective, interdisciplinary team-based treatments, and supports for children and their families. Innovative approaches to providing evidence-based care and tracking outcomes are needed to strengthen the continuum of care.
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Affiliation(s)
- Shannon Simmons
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Jon McClellan
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
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Gallagher C, Rowett D, Nyfort-Hansen K, Simmons S, Bulto L, Middeldorp ME, Lau DH, Sanders P, Hendriks JM. Development and validation of a questionnaire to assess knowledge in patients with Atrial Fibrillation. Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
Centre for Heart Rhythm Disorders
Background
Education is critical to empower individuals to self-monitor and manage their condition. Significant variability exists in the provision of education for atrial fibrillation (AF), whilst individual patient factors including health literacy and education level attainment may impact on knowledge levels. Objective assessment of knowledge may help to target education to areas of need, and result in improved patient outcomes.
Objective
To describe the development and validation of a knowledge questionnaire for AF.
Methods
A multidisciplinary expert team of healthcare professionals developed the questionnaire, in conjunction with consumers, with question content based upon areas deemed most critical to AF and related self-management. The multiple choice questionnaire consists of 20 items, each worth 5 points, to give a total score out of 100. The questionnaire assesses five domains specific to AF: general knowledge, complications, medications, risk factors and action. The questionnaire was developed in English. The questionnaire was tested on 10 randomly selected patients with AF for face validity and 19 healthcare professionals for content validity. The final version was completed by 454 individuals with AF. Exploratory factor analysis was used to determine construct validity with factor loadings of 0.40 and above considered acceptable. Reliability was assessed using Cronbach’s alpha, with a value greater than 0.7 acceptable.
Results
Face and content validity were considered acceptable, after minor changes to wording. The cohort of 454 individuals with AF had a mean age of 66.9 ± 12 years and 43% were female. Mean (SD) total score was 57.7 ± 15.8. Exploratory factor analysis was undertaken using the principal components method. This resulted in a Kaiser–Meyer–Olkin Measure of Sampling Adequacy of .64 and a Bartlett"s Test of Sphericity being significant at 0.00. Seven factors were selected and analysed using principal component analysis with varimax rotation. All items loaded on one of the seven factors. Internal consistency demonstrated a Cronbach’s alpha of 0.65.
Conclusion
The Atrial Fibrillation Knowledge Questionnaire is a valid measure to assess knowledge in individuals with AF.
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Affiliation(s)
- C Gallagher
- University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - D Rowett
- University of South Australia, School of Pharmacy, Adelaide, Australia
| | - K Nyfort-Hansen
- University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - S Simmons
- University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - L Bulto
- University of Adelaide, School of Nursing, Adelaide, Australia
| | - ME Middeldorp
- University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - DH Lau
- University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - P Sanders
- University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - JM Hendriks
- Flinders University, College of Nursing and Health Sciences, Adelaide, Australia
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Gormley G, Ilyas S, Hiscock R, Simmons S. P.64 Assessing the compliance to an enhanced recovery after surgery for caesarean section program using protocol-determined factors. Int J Obstet Anesth 2021. [DOI: 10.1016/j.ijoa.2021.103062] [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: 10/21/2022]
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9
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Thompson A, Simmons S, Wolff J. Nowhere to Go: Providing Quality Services for Children With Extended Hospitalizations on Acute Inpatient Psychiatric Units. J Am Acad Child Adolesc Psychiatry 2021; 60:329-331. [PMID: 32976953 DOI: 10.1016/j.jaac.2020.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 08/22/2020] [Accepted: 09/16/2020] [Indexed: 10/23/2022]
Abstract
The US mental health system is in crisis because of inadequate treatment resources. The number of youths hospitalized for suicidality more than doubled during the last decade,1 and the suicide rate for 10- to 14-year-olds nearly tripled from 2007 to 2017.2 Although hospitalization is intended as a short-term stabilization setting reserved for the most acute and serious mental health problems, discharge is often delayed because of a lack of suitable step-down care such as outpatient, intensive outpatient (IOP), partial hospitalization programs (PHP), or residential psychiatric care. The availability of step-down care options differs vastly depending on region, insurance, and other factors, and the result is a subset of patients who remain hospitalized in acute inpatient units simply because of the absence of safe alternatives.
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Affiliation(s)
- Alysha Thompson
- Seattle Children's Hospital and University of Washington, Seattle.
| | - Shannon Simmons
- Seattle Children's Hospital and University of Washington, Seattle
| | - Jennifer Wolff
- Rhode Island Hospital, Bradley Hospital and Brown University, Providence
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10
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Simmons S, Russell D. Knowledge Gained in Journal Club. Acad Psychiatry 2020; 44:644-645. [PMID: 32578060 DOI: 10.1007/s40596-020-01262-5] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 06/11/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Shannon Simmons
- University of Washington School of Medicine, Seattle, WA, USA.
| | - Douglas Russell
- University of Washington School of Medicine, Seattle, WA, USA
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11
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Simmons S, Thompson A. Models of Interdisciplinary Education in the Inpatient Psychiatry Setting. Acad Psychiatry 2020; 44:504-505. [PMID: 32399834 DOI: 10.1007/s40596-020-01230-z] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/31/2020] [Indexed: 06/11/2023]
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12
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Connell SK, Rutman LE, Whitlock KB, Haviland MJ, Simmons S, Schloredt K, Ramos J, Brewer K, Augustine M, Lion KC. Health Care Reform, Length of Stay, and Readmissions for Child Mental Health Hospitalizations. Hosp Pediatr 2020; 10:238-245. [PMID: 32014883 DOI: 10.1542/hpeds.2019-0197] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Health care reform may impact inpatient mental health services by increasing access and changing insurer incentives. We examined whether implementation of the 2014 Affordable Care Act (ACA) was associated with changes in psychiatric length of stay (LOS) and 30-day readmissions for pediatric patients. METHODS We conducted an interrupted time-series analysis to evaluate LOS and 30-day readmissions during the 30 months before and 24 months after ACA implementation, with a 6-month wash-out period, on patients aged 4 to 17 years who were discharged from the psychiatry unit of a children's hospital. Differences by payer (Medicaid versus non-Medicaid) were examined in moderated interrupted time series. Logistic regression was used to examine the association between psychiatric LOS and 30-day readmissions. RESULTS There were 1874 encounters in the pre-ACA period and 2186 encounters in the post-ACA period. Compared with pre-ACA implementation, post-ACA implementation was associated with LOS that was significantly decreasing over time (pre-ACA versus post-ACA slope difference: -0.10 days per encounter per month [95% confidence interval -0.17 to -0.02]; P = .01), especially for Medicaid-insured patients (pre-ACA versus post-ACA slope difference: -0.14 days per encounter per month [95% confidence interval -0.26 to -0.01]; P = .03). The overall proportion of 30-day readmissions increased significantly (pre-ACA 6%, post-ACA 10%; P < .05 for the difference). We found no association between LOS and 30-day readmissions. CONCLUSIONS ACA implementation was associated with a decline in psychiatric inpatient LOS over time, especially for those on Medicaid, and an increase in 30-day readmissions. LOS was not associated with 30-day inpatient readmissions. Further investigation to understand the drivers of these patterns is warranted.
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Affiliation(s)
- Sarah K Connell
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington;
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Lori E Rutman
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington
- Pediatric Emergency Medicine and
| | - Kathryn B Whitlock
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Miriam J Haviland
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Shannon Simmons
- Psychiatry and Behavioral Medicine, Seattle Children's Hospital, Seattle, Washington
| | - Kelly Schloredt
- Psychiatry and Behavioral Medicine, Seattle Children's Hospital, Seattle, Washington
| | - Jessica Ramos
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Kathy Brewer
- Psychiatry and Behavioral Medicine, Seattle Children's Hospital, Seattle, Washington
| | - Marie Augustine
- Psychiatry and Behavioral Medicine, Seattle Children's Hospital, Seattle, Washington
| | - K Casey Lion
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
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13
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Wang J, Dietrich M, Bell S, Maxwell C, Simmons S, Kripalani S. CHANGE IN VULNERABILITY AMONG OLDER CARDIAC ADULTS AFTER HOSPITAL DISCHARGE: ROLE OF POST-ACUTE HOME HEALTH. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - S Bell
- Department of Medicine, Vanderbilt University Medical Center
| | - C Maxwell
- Vanderbilt University, School of Nursing
| | - S Simmons
- Center for Quality Aging, Vanderbilt University Medical Center
| | - S Kripalani
- Department of Medicine, Vanderbilt University Medical Center
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14
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Shah A, Hollingsworth E, Narramore W, Simmons S, Vasilevskis E. MULTIPRONGED APPROACH TO OBTAIN A MEDICATION HISTORY FOR OLDER ADULTS IN THE ACUTE CARE SETTING. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Shah
- Center for Quality Aging, Vanderbilt University Medical Center
| | - E Hollingsworth
- Center for Quality Aging, Vanderbilt University Medical Center
| | | | - S Simmons
- Center for Quality Aging, Vanderbilt University Medical Center
| | - E Vasilevskis
- Center for Quality Aging, Vanderbilt University Medical Center
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15
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Hollingsworth E, Shah A, Vasilevskis E, Simmons S. DO DEPRESSIVE SYMPTOMS IMPROVE AS OLDER ADULTS TRANSITION FROM HOSPITAL TO POST-ACUTE CARE TO HOME? Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- E Hollingsworth
- Center for Quality Aging, Vanderbilt University Medical Center
| | - A Shah
- Center for Quality Aging, Vanderbilt University Medical Center
| | - E Vasilevskis
- Center for Quality Aging, Vanderbilt University Medical Center
| | - S Simmons
- Center for Quality Aging, Vanderbilt University Medical Center
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16
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Nguyen N, Alabaster A, Simmons S, Powell B. Salpingectomy for ovarian cancer prevention at the time of cesarean delivery: Comparison of outcomes of surgical technique. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Hiatt SM, Amaral MD, Bowling KM, Finnila CR, Thompson ML, Gray DE, Lawlor JMJ, Cochran JN, Bebin EM, Brothers KB, East KM, Kelley WV, Lamb NE, Levy SE, Lose EJ, Neu MB, Rich CA, Simmons S, Myers RM, Barsh GS, Cooper GM. Systematic reanalysis of genomic data improves quality of variant interpretation. Clin Genet 2018; 94:174-178. [PMID: 29652076 DOI: 10.1111/cge.13259] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 11/17/2017] [Revised: 03/22/2018] [Accepted: 03/28/2018] [Indexed: 12/30/2022]
Abstract
As genomic sequencing expands, so does our knowledge of the link between genetic variation and disease. Deeper catalogs of variant frequencies improve identification of benign variants, while sequencing affected individuals reveals disease-associated variation. Accumulation of human genetic data thus makes reanalysis a means to maximize the benefits of clinical sequencing. We implemented pipelines to systematically reassess sequencing data from 494 individuals with developmental disability. Reanalysis yielded pathogenic or likely pathogenic (P/LP) variants that were not initially reported in 23 individuals, 6 described here, comprising a 16% increase in P/LP yield. We also downgraded 3 LP and 6 variants of uncertain significance (VUS) due to updated population frequency data. The likelihood of identifying a new P/LP variant increased over time, as ~22% of individuals who did not receive a P/LP variant at their original analysis subsequently did after 3 years. We show here that reanalysis and data sharing increase the diagnostic yield and accuracy of clinical sequencing.
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Affiliation(s)
- S M Hiatt
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama
| | - M D Amaral
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama
| | - K M Bowling
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama
| | - C R Finnila
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama
| | - M L Thompson
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama
| | - D E Gray
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama
| | - J M J Lawlor
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama
| | - J N Cochran
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama
| | - E M Bebin
- University of Alabama at Birmingham, Birmingham, Alabama
| | | | - K M East
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama
| | - W V Kelley
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama
| | - N E Lamb
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama
| | - S E Levy
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama
| | - E J Lose
- University of Alabama at Birmingham, Birmingham, Alabama
| | - M B Neu
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama
| | - C A Rich
- University of Louisville, Louisville, Kentucky
| | - S Simmons
- University of Alabama at Birmingham, Birmingham, Alabama
| | - R M Myers
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama
| | - G S Barsh
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama
| | - G M Cooper
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama
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18
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Simmons S, Alabaster A, Martin M, Garcia C, McBride-Allen S, Littell R, Powell C. Complete Salpingectomy or Bilateral Tubal ligation: Change in Sterilization Practice in The United States. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.07.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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19
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Affiliation(s)
- S Simmons
- Mercy Hospital for Women, Heidelberg, Australia
| | - A M Cyna
- Women's and Children's Hospital, North Adelaide, Australia.,University of Adelaide, Australia
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Abstract
There is a strong, bidirectional link between substance abuse and traumatic experiences. Teens with cooccurring substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) have significant functional and psychosocial impairment. Common neurobiological foundations point to the reinforcing cycle of trauma symptoms, substance withdrawal, and substance use. Treatment of teens with these issues should include a systemic and integrated approach to both the SUD and the PTSD.
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Affiliation(s)
- Shannon Simmons
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle Children's Hospital, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA.
| | - Liza Suárez
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, 1747 West Roosevelt Road #192, Chicago, IL 60612, USA
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21
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Rosenberg S, Nikolov N, Dybdahl M, Simmons S, Crofton K, Watt E, Friedmann KP, Judson R, Wedebye E. Development of a QSAR Model for thyroperoxidase inhibition and screening of 72,526 REACH substances. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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22
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Hendriks J, Gallagher C, Mahajan R, Nyfort-Hansen K, Simmons S, Rowet D, Middeldorp M, Lau D, Sanders P. Seasonal Variation in Hospital Presentations for Atrial Fibrillation in Australia. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.316] [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: 11/25/2022]
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23
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Durre B, Simmons S. Comparison Of Interrater Reliabililty Between Lower Quarter Y Balance Test And The Single Leg Squat. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000466016.98861.45] [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: 11/21/2022]
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Muhonen JT, Laucht A, Simmons S, Dehollain JP, Kalra R, Hudson FE, Freer S, Itoh KM, Jamieson DN, McCallum JC, Dzurak AS, Morello A. Quantifying the quantum gate fidelity of single-atom spin qubits in silicon by randomized benchmarking. J Phys Condens Matter 2015; 27:154205. [PMID: 25783435 DOI: 10.1088/0953-8984/27/15/154205] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Building upon the demonstration of coherent control and single-shot readout of the electron and nuclear spins of individual (31)P atoms in silicon, we present here a systematic experimental estimate of quantum gate fidelities using randomized benchmarking of 1-qubit gates in the Clifford group. We apply this analysis to the electron and the ionized (31)P nucleus of a single P donor in isotopically purified (28)Si. We find average gate fidelities of 99.95% for the electron and 99.99% for the nuclear spin. These values are above certain error correction thresholds and demonstrate the potential of donor-based quantum computing in silicon. By studying the influence of the shape and power of the control pulses, we find evidence that the present limitation to the gate fidelity is mostly related to the external hardware and not the intrinsic behaviour of the qubit.
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Affiliation(s)
- J T Muhonen
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, UNSW Australia, Sydney, NSW 2052, Australia
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Carey R, Simmons S, Malherbe M, Jansen van Rensburg BJ, Joubert G. Clinical features of patients with systemic lupus erythematosus (SLE) attending the SLE outpatient clinic at Universitas Hospital in Bloemfontein, South Africa. S Afr Fam Pract (2004) 2014. [DOI: 10.1080/20786204.2008.10873674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Sharp B, Maier P, Juneja N, Fowler J, Hornacek B, Simmons S. Emergency Medicine Patient Satisfaction With Email Follow-Up Reminders. Ann Emerg Med 2013. [DOI: 10.1016/j.annemergmed.2013.07.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pollock W, Simmons S, Phillips L, McDonald S. Pattern and rate of massive transfusion for obstetric haemorrhage. Aust Crit Care 2013. [DOI: 10.1016/j.aucc.2013.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Simmons S, Pollock WE, Phillips L, McDonald S. Massive blood transfusion for obstetric haemorrhage. Crit Care 2013. [PMCID: PMC3642736 DOI: 10.1186/cc12308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Silver HJ, Wall R, Hollingsworth E, Pruitt A, Shotwell M, Simmons S. Simple kcal/kg formula is comparable to prediction equations for estimating resting energy expenditure in older cognitively impaired long term care residents. J Nutr Health Aging 2013; 17:39-44. [PMID: 23299377 PMCID: PMC4957543 DOI: 10.1007/s12603-012-0387-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Assessment of energy needs is a critical step in developing the nutrition care plan, especially for individuals unable to modulate their own energy intakes. The purpose of this study was to assess precision and accuracy of commonly used prediction equations in comparison to measured resting energy expenditure in a sample of "oldest old" adults residing in long term care (LTC). SUBJECTS AND DESIGN Resting energy expenditure (mREE) was measured by indirect calorimetry in 45 residents aged 86.1 ± 7.3 years, and compared to frequently used prediction equations (pREE): Mifflin St.Jeor, Harris Benedict, World Health Organization and Owen. Precision and accuracy were determined by concordance correlation coefficients and number of individuals within ± 10% of mREE. Bland Altman plots with linear dependence trends were constructed to visualize agreement. To complete analyses, the common 25 kcal/kg formula was assessed and alternative formulas were determined for best fit by regressing adjusted mREE on body weight. RESULTS mREE averaged 976.2 ± 190.3 kcal/day for females and 1260.0 ± 275.9 kcal/d for males. The strength of the relationships between pREE and mREE were only moderate (r = 0.41 - 0.72). In examining linear trends in the Bland Altman plots, significant systematic deviation from mREE was detected for all pREE. Two kcal/kg formulas were generated: 20.6 kcal/kg for females and 22.7 kcal/kg for males, which were not significantly different. CONCLUSION None of the prediction equations adequately estimated energy needs in this sample of the "oldest old." A simple formula using 21-23 kcal/kg may be a more practical and reliable method to determine energy needs in the LTC setting.
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Affiliation(s)
- H J Silver
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
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Abstract
BACKGROUND An increased prevalence of overweight and obesity for adults on government-funded nutrition assistance, such as the Supplemental Nutrition Assistance Program (SNAP), has been observed; however, this association among preschool-aged children is not well understood. Longitudinal research designs tracking changes in body mass index-for-age (BMI) in children of low-income households may provide a clearer picture of the association between SNAP participation and overweight and obesity among this age group. To determine if there is a relationship between SNAP participation and overweight and obesity prevalence in low-income, preschool children, we conducted a cross-sectional analysis of children in a Head Start program, and a longitudinal analysis of those children who were enrolled for 2 years. METHODS Height and weight data and SNAP participation of 386 students (207 male, 179 female, 4.2 ± 0.5 years) enrolled in a Head Start program were analyzed; data for 2 years were available for 167 of the students. Height and weight measures were used to determine BMI percentile per Centers for Disease Control and Prevention guidelines. SNAP participation was obtained through a nutritional questionnaire given to parents at time of Head Start Program enrollment. RESULTS No significant differences were found between SNAP and non-SNAP participants for BMI percentile in either the cross-sectional or longitudinal analysis. BMI percentile increased for both groups over time, but failed to reach significance (p = .13). CONCLUSION Future studies are warranted with an inclusion of a larger and more geographically diverse sample to further determine the association between SNAP participation and overweight and obesity in preschool-aged children.
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Affiliation(s)
- Shannon Simmons
- Department of Human Performance, Corban University, 5000 Deer Park Dr SE, Salem, OR 97317, USA.
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Dennis A, Arhanghelschi I, Simmons S, Royse C. Prospective observational study of serial cardiac output by transthoracic echocardiography in healthy pregnant women undergoing elective caesarean delivery. Int J Obstet Anesth 2010; 19:142-8. [DOI: 10.1016/j.ijoa.2009.06.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2009] [Revised: 04/28/2009] [Accepted: 06/25/2009] [Indexed: 11/15/2022]
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Bentzen SM, Agrawal RK, Aird EGA, Barrett JM, Barrett-Lee PJ, Bentzen SM, Bliss JM, Brown J, Dewar JA, Dobbs HJ, Haviland JS, Hoskin PJ, Hopwood P, Lawton PA, Magee BJ, Mills J, Morgan DAL, Owen JR, Simmons S, Sumo G, Sydenham MA, Venables K, Yarnold JR. The UK Standardisation of Breast Radiotherapy (START) Trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet 2008; 371:1098-107. [PMID: 18355913 PMCID: PMC2277488 DOI: 10.1016/s0140-6736(08)60348-7] [Citation(s) in RCA: 760] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The international standard radiotherapy schedule for early breast cancer delivers 50 Gy in 25 fractions of 2.0 Gy over 5 weeks, but there is a long history of non-standard regimens delivering a lower total dose using fewer, larger fractions (hypofractionation). We aimed to test the benefits of radiotherapy schedules using fraction sizes larger than 2.0 Gy in terms of local-regional tumour control, normal tissue responses, quality of life, and economic consequences in women prescribed post-operative radiotherapy. METHODS Between 1999 and 2001, 2215 women with early breast cancer (pT1-3a pN0-1 M0) at 23 centres in the UK were randomly assigned after primary surgery to receive 50 Gy in 25 fractions of 2.0 Gy over 5 weeks or 40 Gy in 15 fractions of 2.67 Gy over 3 weeks. Women were eligible for the trial if they were aged over 18 years, did not have an immediate reconstruction, and were available for follow-up. Randomisation method was computer generated and was not blinded. The protocol-specified principal endpoints were local-regional tumour relapse, defined as reappearance of cancer at irradiated sites, late normal tissue effects, and quality of life. Analysis was by intention to treat. This study is registered as an International Standard Randomised Controlled Trial, number ISRCTN59368779. FINDINGS 1105 women were assigned to the 50 Gy group and 1110 to the 40 Gy group. After a median follow up of 6.0 years (IQR 5.0-6.2) the rate of local-regional tumour relapse at 5 years was 2.2% (95% CI 1.3-3.1) in the 40 Gy group and 3.3% (95% CI 2.2 to 4.5) in the 50 Gy group, representing an absolute difference of -0.7% (95% CI -1.7% to 0.9%)--ie, the absolute difference in local-regional relapse could be up to 1.7% better and at most 1% worse after 40 Gy than after 50 Gy. Photographic and patient self-assessments indicated lower rates of late adverse effects after 40 Gy than after 50 Gy. INTERPRETATION A radiation schedule delivering 40 Gy in 15 fractions seems to offer rates of local-regional tumour relapse and late adverse effects at least as favourable as the standard schedule of 50 Gy in 25 fractions.
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Bentzen SM, Agrawal RK, Aird EGA, Barrett JM, Barrett-Lee PJ, Bliss JM, Brown J, Dewar JA, Dobbs HJ, Haviland JS, Hoskin PJ, Hopwood P, Lawton PA, Magee BJ, Mills J, Morgan DAL, Owen JR, Simmons S, Sumo G, Sydenham MA, Venables K, Yarnold JR. The UK Standardisation of Breast Radiotherapy (START) Trial A of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet Oncol 2008; 9:331-41. [PMID: 18356109 PMCID: PMC2323709 DOI: 10.1016/s1470-2045(08)70077-9] [Citation(s) in RCA: 712] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background The international standard radiotherapy schedule for breast cancer treatment delivers a high total dose in 25 small daily doses (fractions). However, a lower total dose delivered in fewer, larger fractions (hypofractionation) is hypothesised to be at least as safe and effective as the standard treatment. We tested two dose levels of a 13-fraction schedule against the standard regimen with the aim of measuring the sensitivity of normal and malignant tissues to fraction size. Methods Between 1998 and 2002, 2236 women with early breast cancer (pT1-3a pN0-1 M0) at 17 centres in the UK were randomly assigned after primary surgery to receive 50 Gy in 25 fractions of 2·0 Gy versus 41·6 Gy or 39 Gy in 13 fractions of 3·2 Gy or 3·0 Gy over 5 weeks. Women were eligible if they were aged over 18 years, did not have an immediate surgical reconstruction, and were available for follow-up. Randomisation method was computer generated and was not blinded. The protocol-specified principal endpoints were local-regional tumour relapse, defined as reappearance of cancer at irradiated sites, late normal tissue effects, and quality of life. Analysis was by intention to treat. This study is registered as an International Standard Randomised Controlled Trial, number ISRCTN59368779. Findings 749 women were assigned to the 50 Gy group, 750 to the 41·6 Gy group, and 737 to the 39 Gy group. After a median follow up of 5·1 years (IQR 4·4–6·0) the rate of local-regional tumour relapse at 5 years was 3·6% (95% CI 2·2–5·1) after 50 Gy, 3·5% (95% CI 2·1–4·3) after 41·6 Gy, and 5·2% (95% CI 3·5–6·9) after 39 Gy. The estimated absolute differences in 5-year local-regional relapse rates compared with 50 Gy were 0·2% (95% CI −1·3% to 2·6%) after 41·6 Gy and 0·9% (95% CI −0·8% to 3·7%) after 39 Gy. Photographic and patient self-assessments suggested lower rates of late adverse effects after 39 Gy than with 50 Gy, with an HR for late change in breast appearance (photographic) of 0·69 (95% CI 0·52–0·91, p=0·01). From a planned meta-analysis with the pilot trial, the adjusted estimates of α/β value for tumour control was 4·6 Gy (95% CI 1·1–8·1) and for late change in breast appearance (photographic) was 3·4 Gy (95% CI 2·3–4·5). Interpretation The data are consistent with the hypothesis that breast cancer and the dose-limiting normal tissues respond similarly to change in radiotherapy fraction size. 41·6 Gy in 13 fractions was similar to the control regimen of 50 Gy in 25 fractions in terms of local-regional tumour control and late normal tissue effects, a result consistent with the result of START Trial B. A lower total dose in a smaller number of fractions could offer similar rates of tumour control and normal tissue damage as the international standard fractionation schedule of 50 Gy in 25 fractions.
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Simmons S. Book Review: Analgesia, Anaesthesia and Pregnancy: A Practical Guide. Second Edition. Anaesth Intensive Care 2008. [DOI: 10.1177/0310057x0803600124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Simmons S, Cheng J, Ashburn J, Awan S, Meigooni A. SU-FF-T-272: Investigation of Small IMRT Beamlets with a Wellhöfer CC01 “Pinpoint” Chamber. Med Phys 2007. [DOI: 10.1118/1.2760933] [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: 11/07/2022] Open
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Dzietko M, Sifringer M, Boos V, Genz K, Simmons S, Gerstner B, Bührer C, Ikonomidou H, Obladen M, Felderhoff-Mueser U. 17-Beta Östrogen schütz das unreife Gehirn der Ratte vor Sauerstoff induziertem Zelltod. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Washburn NJ, Simmons S, Sommer V, Adkins B, Gerken P, Rogers M, Wilson B, Lang B, Hickman B, Barnhart C, Ethirajan S. Outcome of interventions to identify family history and risk management for women with breast cancer in the ambulatory setting. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.6121] [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: 11/20/2022] Open
Abstract
6121 Background: In 2002, Kansas City Cancer Center (KCCC) performed a quality improvement (QI) project to evaluate how breast cancer patients were being assessed for family history and cancer risk management. A self-administered family history questionnaire was developed to improve the thoroughness of family history collected and education of clinicians was completed to improve the recognition of risk factors based on ASCO guidelines. Methods: Chart audits on 210 women with breast cancer at KCCC, were completed in the second quarter of 2005. All patients were under the age of 65, not undergoing chemotherapy. A risk management tool was developed. Scoring criteria for 2002 was replicated in 2005 as listed in the table . Results: In 2002, 171 pts (89%) had level 1 or 2 family history assessed compared to 207 pts (99%) in 2005, p<0.0001. In 2002, 47% had 3 generations assessed compared to 84% in 2005, p<0.0001. In 2002 and 2005, some risk factor management occurred in both groups, and was equal, 78% and 80% respectively (p=ns). Of those that had risk management 33% had level 1 in 2002 compared to 3% in 2005 (p<0.0001) a 91% reduction in identifying risk without subsequent management. In 2002, 58% had level 2, compared to 71% in 2005 (p=0.02) a 23% improvement in identification & management of risk. In 2002, 9% had level 3 compared to 26% in 2005 (p<0.0001) a 183% improvement in patients with a detailed risk assessment and/or genetic referral. Conclusions: By improving the assessment of family history and education of providers, women with breast cancer are receiving more information to reduce their risk for recurrence and complications. Patients who were identified as high risk for BRCA1 or BRCA2 mutations were referred to either a nurse practitioner or genetic counselor. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- N. J. Washburn
- Kansas City Cancer Center, Kansas City, MO; Kansas City Cancer Center, Kansas City, KS; Kansas City Cancer Center, Lee’s Summit, MO; Kansas City Cancer Center, Overland Park, KS
| | - S. Simmons
- Kansas City Cancer Center, Kansas City, MO; Kansas City Cancer Center, Kansas City, KS; Kansas City Cancer Center, Lee’s Summit, MO; Kansas City Cancer Center, Overland Park, KS
| | - V. Sommer
- Kansas City Cancer Center, Kansas City, MO; Kansas City Cancer Center, Kansas City, KS; Kansas City Cancer Center, Lee’s Summit, MO; Kansas City Cancer Center, Overland Park, KS
| | - B. Adkins
- Kansas City Cancer Center, Kansas City, MO; Kansas City Cancer Center, Kansas City, KS; Kansas City Cancer Center, Lee’s Summit, MO; Kansas City Cancer Center, Overland Park, KS
| | - P. Gerken
- Kansas City Cancer Center, Kansas City, MO; Kansas City Cancer Center, Kansas City, KS; Kansas City Cancer Center, Lee’s Summit, MO; Kansas City Cancer Center, Overland Park, KS
| | - M. Rogers
- Kansas City Cancer Center, Kansas City, MO; Kansas City Cancer Center, Kansas City, KS; Kansas City Cancer Center, Lee’s Summit, MO; Kansas City Cancer Center, Overland Park, KS
| | - B. Wilson
- Kansas City Cancer Center, Kansas City, MO; Kansas City Cancer Center, Kansas City, KS; Kansas City Cancer Center, Lee’s Summit, MO; Kansas City Cancer Center, Overland Park, KS
| | - B. Lang
- Kansas City Cancer Center, Kansas City, MO; Kansas City Cancer Center, Kansas City, KS; Kansas City Cancer Center, Lee’s Summit, MO; Kansas City Cancer Center, Overland Park, KS
| | - B. Hickman
- Kansas City Cancer Center, Kansas City, MO; Kansas City Cancer Center, Kansas City, KS; Kansas City Cancer Center, Lee’s Summit, MO; Kansas City Cancer Center, Overland Park, KS
| | - C. Barnhart
- Kansas City Cancer Center, Kansas City, MO; Kansas City Cancer Center, Kansas City, KS; Kansas City Cancer Center, Lee’s Summit, MO; Kansas City Cancer Center, Overland Park, KS
| | - S. Ethirajan
- Kansas City Cancer Center, Kansas City, MO; Kansas City Cancer Center, Kansas City, KS; Kansas City Cancer Center, Lee’s Summit, MO; Kansas City Cancer Center, Overland Park, KS
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Dzietko M, Sifringer M, Boos V, Genz K, Simmons S, Gerstner B, Bührer C, Ikonomidou H, Obladen M, Felderhoff-Mueser U. 17-Beta Östrogen schütz das unreife Gehirn der Ratte vor Sauerstoff induziertem Zelltod. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-943160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Adkins BW, Washburn N, Simmons S, Gerken P, Sommer V, Rogers B, LaNoue K, Wilson B. Recognizing depression in outpatient oncology patient population: A quality improvement project. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.8102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- B. W. Adkins
- Kansas City Cancer Ctr, Overland Prk, MO; Kansas City Cancer Ctr, Kansas City, MO; Kansas City Cancer Ctr, Kansas City, MO; Kansas City Cancer Ctr, Lee’s Summit, MO
| | - N. Washburn
- Kansas City Cancer Ctr, Overland Prk, MO; Kansas City Cancer Ctr, Kansas City, MO; Kansas City Cancer Ctr, Kansas City, MO; Kansas City Cancer Ctr, Lee’s Summit, MO
| | - S. Simmons
- Kansas City Cancer Ctr, Overland Prk, MO; Kansas City Cancer Ctr, Kansas City, MO; Kansas City Cancer Ctr, Kansas City, MO; Kansas City Cancer Ctr, Lee’s Summit, MO
| | - P. Gerken
- Kansas City Cancer Ctr, Overland Prk, MO; Kansas City Cancer Ctr, Kansas City, MO; Kansas City Cancer Ctr, Kansas City, MO; Kansas City Cancer Ctr, Lee’s Summit, MO
| | - V. Sommer
- Kansas City Cancer Ctr, Overland Prk, MO; Kansas City Cancer Ctr, Kansas City, MO; Kansas City Cancer Ctr, Kansas City, MO; Kansas City Cancer Ctr, Lee’s Summit, MO
| | - B. Rogers
- Kansas City Cancer Ctr, Overland Prk, MO; Kansas City Cancer Ctr, Kansas City, MO; Kansas City Cancer Ctr, Kansas City, MO; Kansas City Cancer Ctr, Lee’s Summit, MO
| | - K. LaNoue
- Kansas City Cancer Ctr, Overland Prk, MO; Kansas City Cancer Ctr, Kansas City, MO; Kansas City Cancer Ctr, Kansas City, MO; Kansas City Cancer Ctr, Lee’s Summit, MO
| | - B. Wilson
- Kansas City Cancer Ctr, Overland Prk, MO; Kansas City Cancer Ctr, Kansas City, MO; Kansas City Cancer Ctr, Kansas City, MO; Kansas City Cancer Ctr, Lee’s Summit, MO
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Ethirajan S, Adkins B, Spencer S, Gerken P, Washburn N, Simmons S, Sommer V, Rogers M, Strauss Tranin A. Genetic risk assessment in women with breast cancer in the outpatient setting: Establishing the standard of practice for ambulatory care clinics. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.1039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S. Ethirajan
- Kansas City Cancer Centers, Overland Park, KS; Kansas City Cancer Centers, Kansas City, MO; Kansas City Cancer Centers, Kansas City, KS; Kansas City Cancer Centers, Lee's Summit, MO; Cancer Genetic Counseling, Overland Park, KS
| | - B. Adkins
- Kansas City Cancer Centers, Overland Park, KS; Kansas City Cancer Centers, Kansas City, MO; Kansas City Cancer Centers, Kansas City, KS; Kansas City Cancer Centers, Lee's Summit, MO; Cancer Genetic Counseling, Overland Park, KS
| | - S. Spencer
- Kansas City Cancer Centers, Overland Park, KS; Kansas City Cancer Centers, Kansas City, MO; Kansas City Cancer Centers, Kansas City, KS; Kansas City Cancer Centers, Lee's Summit, MO; Cancer Genetic Counseling, Overland Park, KS
| | - P. Gerken
- Kansas City Cancer Centers, Overland Park, KS; Kansas City Cancer Centers, Kansas City, MO; Kansas City Cancer Centers, Kansas City, KS; Kansas City Cancer Centers, Lee's Summit, MO; Cancer Genetic Counseling, Overland Park, KS
| | - N. Washburn
- Kansas City Cancer Centers, Overland Park, KS; Kansas City Cancer Centers, Kansas City, MO; Kansas City Cancer Centers, Kansas City, KS; Kansas City Cancer Centers, Lee's Summit, MO; Cancer Genetic Counseling, Overland Park, KS
| | - S. Simmons
- Kansas City Cancer Centers, Overland Park, KS; Kansas City Cancer Centers, Kansas City, MO; Kansas City Cancer Centers, Kansas City, KS; Kansas City Cancer Centers, Lee's Summit, MO; Cancer Genetic Counseling, Overland Park, KS
| | - V. Sommer
- Kansas City Cancer Centers, Overland Park, KS; Kansas City Cancer Centers, Kansas City, MO; Kansas City Cancer Centers, Kansas City, KS; Kansas City Cancer Centers, Lee's Summit, MO; Cancer Genetic Counseling, Overland Park, KS
| | - M. Rogers
- Kansas City Cancer Centers, Overland Park, KS; Kansas City Cancer Centers, Kansas City, MO; Kansas City Cancer Centers, Kansas City, KS; Kansas City Cancer Centers, Lee's Summit, MO; Cancer Genetic Counseling, Overland Park, KS
| | - A. Strauss Tranin
- Kansas City Cancer Centers, Overland Park, KS; Kansas City Cancer Centers, Kansas City, MO; Kansas City Cancer Centers, Kansas City, KS; Kansas City Cancer Centers, Lee's Summit, MO; Cancer Genetic Counseling, Overland Park, KS
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Arcury TA, Quandt SA, Simmons S. Farmer health beliefs about an occupational illness that affects farmworkers: the case of green tobacco sickness. J Agric Saf Health 2003; 9:33-45. [PMID: 12673914 DOI: 10.13031/2013.12348] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Latino migrant and seasonal farmworkers, like all agricultural workers, experience high rates of occupational illness and injury. Interventions to reduce occupational injury among farmworkers must attend to the health beliefs of agricultural employers as well as employees, as employers control many aspects of the work environment. Occupational safety programs for Latino migrant and seasonal farmworkers must also be conceptually based in health behavior change and health disparities theories. We examine health beliefs of tobacco farmers about green tobacco sickness (GTS) to show the importance of delineating employer beliefs in agricultural safety. GTS is a highly prevalent occupational illness among tobacco workers that results from nicotine poisoning through dermal absorption of nicotine during cultivation and harvesting. We use qualitative methods structured by the Explanatory Models of Illness approach to identify farmer beliefs about the etiology, onset, pathophysiology, course, and treatment of GTS. Data were collected through semi-structured in-depth interviews with 15 North Carolina tobacco farmers. A computer-assisted, systematic qualitative analysis framework was applied to the interview transcripts. While tobacco farmers were generally knowledgeable about GTS, their explanatory models for this occupational illness often mis-identified its causes (heat and bending rather than nicotine) and minimized its seriousness. These models included methods of prevention that are not proven (e.g., use of anti-nausea drugs) or are more harmful than GTS (smoking cigarettes). The need for medical treatment was also discounted. Addressing each of these beliefs is important in any program to prevent GTS among farmworkers. Documenting and understanding the beliefs and knowledge of agricultural employers is an important undertaking in our efforts to reduce occupational injury and illness among farmworkers.
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Affiliation(s)
- T A Arcury
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1084, USA.
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Cyna A, Simmons S. Call for an alternative coupling system for regional equipment. Anaesthesia 2002. [DOI: 10.1046/j.0003-2409.2002.02520.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Cyna A, Simmons S, Osborn K, Andrew M. Fatal epidural infusion-call for a system-wide change. Anaesth Intensive Care 2002; 30:99-100. [PMID: 11939453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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McHenry T, Simmons S, Alitz C, Holcomb J. Forward surgical stabilization of penetrating lower extremity fractures: circular casting versus external fixation. Mil Med 2001; 166:791-5. [PMID: 11569443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
OBJECTIVE There are two choices for the stabilization of penetrating lower extremity fractures in the forward surgical environment: bivalved circular casting and external fixation. The material and equipment requirements of these methods are of paramount importance in the austere forward surgical environment. METHODS Casualties from the Battle of the Black Sea in Somalia 1993 were examined. Penetrating lower extremity fractures requiring immobilization were identified. The relative packing volume and weight for each method of immobilization were analyzed. Finally, the current literature concerning the treatment of penetrating lower extremity fractures sustained in combat was reviewed. RESULTS The consumable material requirements of cast immobilization are 22.9 times greater by weight and 3.16 times greater by packing volume. Cast immobilization also has a greater durable equipment requirement. External fixation has multiple clinical advantages but is considerably more expensive. CONCLUSION Based on these variables, the authors determined that external fixation is the treatment of choice for penetrating lower extremity fractures in the forward surgical environment.
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Affiliation(s)
- T McHenry
- Joint Trauma Training Center, Ben Taub General Hospital, 1504 Taub Loop, Houston, TX 77030, USA
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Abstract
The objective of this retrospective study was to identify risk factors for screw migration after triple pelvic osteotomy (TPO) in clinical patients. The medical records, radiographs made immediately after surgery, and follow-up radiographs documenting a healed osteotomy were reviewed for 52 dogs treated with unilateral TPO and 38 dogs treated with bilateral TPO. Signalment, surgeon expertise, length of surgery, sequence of surgery in dogs treated bilaterally, use of ischial or ilial wires or both, screw depth in the sacrum, and screw migration were documented for each of the 128 pelvic osteotomies. Screws placed in the first and second plate hole, securing the cranial portion of the plate, loosened most frequently. Factors associated with decreased screw migration included use of an ischial hemicerclage wire and increased depth of sacral purchase with the first and second cranial screws.
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Affiliation(s)
- S Simmons
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana 61802, USA
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Nurnberger JI, Gershon ES, Simmons S, Ebert M, Kessler LR, Dibble ED, Jimerson SS, Brown GM, Gold P, Jimerson DC, Guroff JJ, Storch FI. Behavioral, biochemical and neuroendocrine responses to amphetamine in normal twins and 'well-state' bipolar patients. Psychoneuroendocrinology 2001; 7:163-76. [PMID: 6891082 DOI: 10.1016/0306-4530(82)90009-9] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
An i.v. injection of dextroamphetamine (0.3 mgm/kg) was given to 13 pairs of normal monozygotic twins, three pairs of normal dizygotic twins and 11 patients with bipolar affective disorder in remission and off medications. Behavioral excitation in response to amphetamine was highly correlated in monozygotic twins; it was predicted by the baseline variables of high plasma MHPG, low serum prolactin and low pulse; it correlated with a rise in cortisol; and it was not correlated with plasma amphetamine level. Pre-infusion baseline MHPG and growth hormone and prolactin responses to amphetamine also were concordant in twins. Plasma amphetamine level, pulse and blood pressure and cortisol responses were not concordant, suggesting significant environmental influences. Haloperidol pretreatment in one pair of twins abolished the excitation response but did not reduce increases in cortisol and growth hormone. This suggests a role for dopamine in the excitation response but predominant serotonergic and noradrenergic mediation of the hormonal responses. None of the responses or baseline measures distinguished patients from controls. Thus, no consistently altered sensitivity to monoaminergic stimulation by amphetamine in bipolar affective disorder was demonstrated in this study. This is one of the first reports of familial (possibly genetic) variation in a psychostimulant drug response in man. The responses identified as concordant may be useful in characterizing other pathologic conditions.
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Singh LP, Gennerette D, Simmons S, Crook ED. Glucose-induced insulin resistance of phosphatidylinositol 3'-OH kinase and AKT/PKB is mediated by the hexosamine biosynthesis pathway. J Diabetes Complications 2001; 15:88-96. [PMID: 11274905 DOI: 10.1016/s1056-8727(00)00140-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [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] [Indexed: 12/20/2022]
Abstract
Hyperglycemia is responsible for many of the vascular complications and metabolic derangements seen in diabetes. One potential regulator of the effects of glucose is the hexosamine biosynthesis pathway (HBP). Glutamine: fructose-6-phosphate amidotransferase (GFA), the first and rate-limiting enzyme in this pathway, catalyzes the transfer of an amino group from glutamine to fructose-6-phosphate to form glucosamine-6-phosphate. Overexpression of GFA in rat-1 fibroblasts results in insulin resistance for glycogen synthase (GS) activity, and renders these cells more sensitive to the effects of glucose. Using rat-1 cells, we examine further the mechanisms whereby hexosamines lead to insulin resistance. Insulin stimulated GS activity was found to occur via a PI-3 kinase (PI-3K)-dependent pathway as wortmannin, an inhibitor of PI-3K, blocked insulin's ability to stimulate GS activity. Subsequently, we examined the effects of hexosamines on PI-3K and Akt/PKB activity. Cells were cultured in 1 mM glucose (low glucose, LG), 20 mM glucose (high glucose, HG), or 1 mM glucose plus 3 mM glucosamine (GlcN) for 16--20 h. After treatment with insulin (100 nM) for 5 min, cell extracts were assayed for IRS-1 associated and total PI-3K activity. At LG, insulin increased PI-3K activity by 43%. There was no insulin stimulation of PI-3K activity in cells cultured in HG or GlcN. There was a trend for IRS-1 protein levels to decrease in HG but not GlcN. PI-3K protein levels were not altered by HG or GlcN. Finally PKB activity was assayed. At LG, insulin stimulated PKB activity. Again, both HG and GlcN significantly reduced insulin's ability to stimulate PKB activity. We conclude that the hexosamine-mediated insulin resistance of GS activity seen in rat-1 cells is mediated by hexosamine regulation of PI-3K and PKB.
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Affiliation(s)
- L P Singh
- Division of Nephrology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA
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Nunes LW, Simmons S, Hallowell MJ, Kinback R, Trooskin S, Kozar R. Diagnostic performance of trauma US in identifying abdominal or pelvic free fluid and serious abdominal or pelvic injury. Acad Radiol 2001; 8:128-36. [PMID: 11227641 DOI: 10.1016/s1076-6332(01)90057-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RATIONALE AND OBJECTIVES This study assessed the ability of a six-point trauma ultrasound (US) evaluation (a) to identify the presence of free fluid in the abdomen or pelvis, with computed tomography (CT) and laparotomy used as diagnostic standards and (b) to predict the presence of abdominal or pelvic injury, particularly injury requiring surgical intervention. MATERIALS AND METHODS Of 156 patients who underwent US evaluation for free fluid after sustaining blunt and penetrating trauma, 147 were entered into the prospective study and underwent follow-up CT and/or laparotomy (n = 79), in-hospital observation, or outpatient examination. RESULTS The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of US for identifying abdominal or pelvic free fluid were 69%, 100%, 100%, 95%, and 95%, respectively. The corresponding values for predicting abdominal and pelvic injury on the basis of free fluid status alone were 57%, 99%, 80%, 96%, and 95%, respectively. Performing repeated US examinations in patients with deteriorating clinical status decreased the false-negative rate by 50%, increasing the sensitivity for free fluid detection to 85% and the negative predictive value to 97%. Similarly, the sensitivity and negative predictive value for detection of injury increased to 71% and 97%, respectively. A learning curve was also observed, with 67% of the false-negative findings occurring in the first 3 months of the 19-month study. CONCLUSION A six-point trauma US evaluation can reliably identify abdominal and pelvic free fluid, which can be a reliable indicator of abdominal or pelvic injury. Scanning conditions must be optimized, and the approach to clinical management must be cautious.
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Affiliation(s)
- L W Nunes
- Department of Radiologic Sciences, MCP Hahnemann University, Hahnemann University Hospital, Philadelphia, PA 19102, USA
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