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Young S, Sanghvi T, Ragulojan R, Torkian P, Todatry S, D'Souza D, Flanagan S, Golzarian J. Local recurrence following a complete radiologic response in hepatocellular carcinoma patients: comparison of transarterial chemoembolisation and transarterial radioembolisation. Clin Radiol 2024; 79:371-377. [PMID: 38341344 DOI: 10.1016/j.crad.2024.01.014] [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] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 12/11/2023] [Accepted: 01/12/2024] [Indexed: 02/12/2024]
Abstract
AIM To evaluate and compare the rates of local recurrence in hepatocellular carcinoma (HCC) patients who undergo selective transarterial radioembolisation (TARE) or transarterial chemoembolisation (TACE) and achieve a complete response (CR) radiologically. MATERIALS AND METHODS All patients undergoing treatment with TARE or TACE at a single academic institution were reviewed retrospectively. Those who had been treated previously, presented with multifocal disease, had non-selective TARE or TACE, or did not achieve a complete response (CR) radiologically were excluded. RESULTS In total 110 patients were included (TACE n=60 [54.5%]; TARE n=50 [45.5%]). TARE patients were older (66.4 ± 9.4 versus 61.2 ± 5.6 years, p<0.001) and had larger tumours (4.4 ± 2.2 versus 3 ± 1.4 cm, p=0.002). TACE patients were significantly more likely to suffer a local recurrence (31/60, 51.7% versus 9/50, 18%, p<0.001) and had a significantly shorter time to recurrence (median 8.3 {interquartile range [IQR]}: 12 versus median 17.9 [IQR: 23.5] months, p=0.001). A local time to progression (TTP) Kaplan-Meier curve demonstrated TACE patients had a significantly shorter local TTP (hazard ratio [HR]: 7.2; 95% confidence interval [CI]: 3.64-14.24; p<0.001) and treatment modality (TACE or TARE; HR: 0.05; 95% CI: 0.005-0.5; p=0.01) was found to be associated with local recurrences on multivariate Cox proportional HR analysis. When overall TTP was evaluated, again TACE patients were found to have a significantly shorter TTP (HR: 2.13 [1.28-3.53], p=0.004). CONCLUSION In HCC patients undergoing selective treatment who achieve a CR radiologically, those treated with TARE may be less likely to suffer recurrence, either local or general, than those treated with TACE.
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Affiliation(s)
- S Young
- Department of Radiology, University of Arizona, Division of Interventional Radiology, 1501 N Campbell Ave, PO Box 245067, Tucson, AZ 85724, USA.
| | - T Sanghvi
- Minneapolis VA Hospital, 1 Veterans Dr, Minneapolis, MN 55417, USA
| | - R Ragulojan
- Department of Radiology, University of Minnesota, Division of Interventional Radiology, 420 Delaware St SE, MMC 292, MN 55455, USA
| | - P Torkian
- Department of Radiology, University of Minnesota, Division of Interventional Radiology, 420 Delaware St SE, MMC 292, MN 55455, USA
| | - S Todatry
- Department of Radiology, University of Minnesota, Division of Interventional Radiology, 420 Delaware St SE, MMC 292, MN 55455, USA
| | - D D'Souza
- Department of Radiology, University of Minnesota, Division of Interventional Radiology, 420 Delaware St SE, MMC 292, MN 55455, USA
| | - S Flanagan
- Department of Radiology, University of Minnesota, Division of Interventional Radiology, 420 Delaware St SE, MMC 292, MN 55455, USA
| | - J Golzarian
- Department of Radiology, University of Minnesota, Division of Interventional Radiology, 420 Delaware St SE, MMC 292, MN 55455, USA
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Payne ML, Young S, Heard J, Bernardy S, Duby JJ, Fine J, Wilson M, Louie E. Effect of dexmedetomidine on fluid resuscitation in burn-injured patients. J Burn Care Res 2024:irae038. [PMID: 38459902 DOI: 10.1093/jbcr/irae038] [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: 01/16/2024] [Indexed: 03/11/2024]
Abstract
Fluid creep occurs when resuscitation after extensive burn injury reaches volumes higher than predicted. Since this has been described in patients with high opioid requirements, continuous analgesics and sedatives, including dexmedetomidine, have been avoided during resuscitation. This study sought to describe the impact of dexmedetomidine on fluid resuscitation requirements. This retrospective cohort study included adult patients with burns greater than 20% total body surface area (TBSA) resuscitated between January 2017 and June 2022 at a regional burn center. Patients deceased within 48 hours of burn were excluded. Primary outcome was volume of fluid required in the first 24 and 48 hours post-burn. Secondary outcomes were the incidence of fluid-related adverse events within 7 days post-burn. A total of 170 patients were included: 55 in the dexmedetomidine cohort and 115 in the control cohort. After propensity matching for variables associated with fluid creep, the dexmedetomidine cohort required 4.2 ± 1.7 mL/kg/%TBSA in the first 24 hours compared to 3.6 ± 1.1 mL/kg/%TBSA in the control cohort (p=0.03). The difference was no longer significant at 48 hours (p=0.11). There were no differences in the incidence of acute respiratory distress syndrome, delayed escharotomy/fasciotomy, intraabdominal hypertension, or renal replacement therapy. Dexmedetomidine exposure during acute resuscitation resulted in increased fluid requirements in the first 24 hours, suggesting it is independently associated with fluid creep; however, this increase was not sustained at 48 hours. Clinical significance of this finding is unclear as there was no increase in adverse events related to excessive fluid resuscitation between cohorts.
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Affiliation(s)
- Michelle L Payne
- Rhode Island Hospital, Providence, Rhode Island, USA
- University of California, Davis Medical Center, Sacramento, California, USA
| | - Sierra Young
- University of California, Davis Medical Center, Sacramento, California, USA
| | - Jason Heard
- University of California, Davis Medical Center, Sacramento, California, USA
- Firefighters Burn Institute Regional Burn Center, Sacramento, California, USA
| | - Sarah Bernardy
- University of California, Davis Medical Center, Sacramento, California, USA
- Firefighters Burn Institute Regional Burn Center, Sacramento, California, USA
| | - Jeremiah J Duby
- University of California, Davis Medical Center, Sacramento, California, USA
| | - Jeffrey Fine
- University of California, Davis Health, Sacramento, California, USA
| | - Machelle Wilson
- University of California, Davis Health, Sacramento, California, USA
| | - Erin Louie
- University of California, Davis Medical Center, Sacramento, California, USA
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Schamschula J, Young S, Pridgeon S. Spontaneous renal tumour regression following an aortic dissection. Ann R Coll Surg Engl 2024; 106:96-98. [PMID: 36622223 PMCID: PMC10757886 DOI: 10.1308/rcsann.2022.0134] [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: 09/17/2022] [Indexed: 01/10/2023] Open
Abstract
Spontaneous tumour regression is a rare but well-documented phenomenon, especially for renal cell carcinomas. We describe the case of a 60-year-old male who presented with chest pain and shortness of breath. He was diagnosed with a large type A aortic dissection and an incidental right renal mass, highly suspicious of a renal cell carcinoma. Following repair of the dissection, subsequent imaging showed that the renal mass had largely resolved. Spontaneous tumour regression is commonly thought to occur through immunological mechanisms. A vascular cause of tumour regression through infarction is postulated in this case. Although angioembolisation is a well-recognised management option in the context of palliative treatment of symptomatic renal tumours, this case suggests an extended role for angioembolisation in the treatment of small renal masses.
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Affiliation(s)
| | | | - S Pridgeon
- James Cook University, Cairns, Australia
- Cairns Hospital, Australia
- Northern Urology, Cairns, Australia
- Australian Clinical Trials and Research, Cairns, Australia
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Young S, Parmar GS, Siriani-Ayoub N, Nguyen T. Continuing Professional Development for Radiation Oncologists: Where are the Gaps and Barriers? Int J Radiat Oncol Biol Phys 2023; 117:e558. [PMID: 37785711 DOI: 10.1016/j.ijrobp.2023.06.1872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Continuing professional development (CPD) involves continuing medical education (CME), as well as educational activities to enhance research, teaching and leadership skills. Although CPD has been well explored in other specialties, the literature pertaining to radiation oncology is lacking. We sought to evaluate current CPD practices of radiation oncologists (RO) and identify unmet needs and barriers. MATERIALS/METHODS An online survey on CPD was developed in English and French, approved by ethics board, and emailed to all RO departments across Canada. Respondents' current practices, preferences, barriers, and needs were explored across the CPD domains of CME, research, teaching and administrative skills. RESULTS One-hundred twenty-four radiation oncologists completed the survey with representation across all listed disease sites and provinces. Respondents had an average 13.6 years of experience as staff (6 months to 38 years) and 96% were affiliated with a university. ROs indicated the most helpful resources for CME were reading journal articles (27%), attending tumor boards (25%), conferences (19%), informal discussion with colleagues (11%), free online websites (e.g., NCCN) (4%) and Twitter (3.5%). Lack of time was unanimously regarded as a barrier for CME. Other barriers included growing clinical workloads, expanding literature, and a lack of renumeration for CME. The mean score was 3.5/5, between "neutral" and "satisfied" for "satisfaction that CME needs are met" on a 5-point Likert scale. Seventy-six percent of respondents are currently engaged in research, with 46% involved as a research supervisor. However, only 35% had protected time for research (ranging from 10-80% FTE). Time (89%), funding (63%) and human resources (63%) were cited as barriers. Respondents wanted to improve skills in statistical analysis, clinical trial design and grant writing. Most researchers (78%) were comfortable with quantitative methodologies. Conversely, only 35% were comfortable with qualitative methods. Nearly all respondents (98%) were involved with clinical teaching. While the majority of respondents were satisfied with their teaching ability, many wanted to improve skills in coaching, providing feedback and delivering lectures. The preferred learning formats for improving these skills were either workshops at conferences or online. Half of the respondents are currently in an administrative/leadership role, and of those that are not, only 30% were interested in pursuing future leadership positions. The main barriers cited were time and the experience required. CONCLUSION Overall satisfaction scores for current CME practices were mediocre amongst Canadian radiation oncologists - a group that is mostly in university-affiliated/academic practices with 98% involved in clinical teaching. There are notable barriers and unmet needs in research, teaching and administration - highlighting potential areas for future CPD initiatives in radiation oncology.
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Affiliation(s)
- S Young
- Western University, London, ON, Canada
| | - G S Parmar
- University of British Columbia, Vancouver, BC, Canada
| | | | - T Nguyen
- Western University, London, ON, Canada
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Corry J, Connell C, Wilson C, Young S, Lai K. Assessing the Compliance and Accuracy of a National Australian Head and Neck Cancer (HNC) Database. Int J Radiat Oncol Biol Phys 2023; 117:e574. [PMID: 37785749 DOI: 10.1016/j.ijrobp.2023.06.1908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Accurate cancer databases enable auditing of patient management, and this knowledge facilitates optimizing care. A multi-institutional organization, the largest single provider of radiation oncology services in Australia, has developed its own national database (ND). All patients are entered on the ND as a prerequisite for generating a radiotherapy prescription. A significant component of the ND is automated, but manual input from the treating radiation oncologist (RO) is also required. The purpose of this study was to assess the compliance and accuracy of the data entered on this ND for head and neck cancer (HNC) patients. MATERIALS/METHODS We included all HNC patients with either oral cavity cancer or oropharynx cancer (ICD-10 coding) treated between September 2021 and September 2022 to assess compliance. We randomly selected 25% of these cases and assigned them to 3 HNC ROs to manually review the accuracy of all clinical data points. RESULTS There were 166 HNC patients, 139 oropharynx and 27 oral cavity. Compliance in the 166 patients was excellent (94% or higher) for the majority of data points - age, gender, diagnosis ICD code, diagnosis date, laterality, TNM classification, radiotherapy dose, fractionation and technique and start and completion dates. Compliance was good (85% or more) for smoking history, use of chemotherapy, and p16 status (oropharynx). Compliance was poor (43%) for specific chemotherapy regimens. Accuracy was high (92% or higher) for diagnosis ICD code, smoking history, use of chemotherapy; good (87% or higher) for p16 status (oropharynx), laterality and histopathology; and poor for date of diagnosis (75%), TNM classification (62%) and specific chemotherapy regimens (29%). CONCLUSION The ND is a powerful tool for assessing patient care. Overall, compliance was very good. Accuracy was very good for most items, and we have highlighted areas where improvements can be made. This study shows that a compliant and accurate ND is achievable and supports the next goal of additional items to be included in the ND, specifically patient outcome data.
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Affiliation(s)
- J Corry
- Genesiscare St Vincent's Hospital, Fitzroy, VIC, Australia
| | - C Connell
- Adelaide Radiotherapy Centre, Adelaide, SA, Australia
| | | | - S Young
- Genesiscare, Sydney, NSW, Australia
| | - K Lai
- Genesiscare, Sydney, NSW, Australia
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Patel SV, Cance JD, Bonar EE, Carter PM, Dickerson DL, Fiellin LE, Fernandes CSF, Palimaru AI, Boomer TMP, Saldana L, Singh RR, Tinius E, Walton MA, Youn S, Young S, Philbrick S, Lambdin BH. Accelerating Solutions for the Overdose Crisis: an Effectiveness-Implementation Hybrid Protocol for the HEAL Prevention Cooperative. Prev Sci 2023; 24:40-49. [PMID: 36399222 PMCID: PMC9673891 DOI: 10.1007/s11121-022-01465-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2022] [Indexed: 11/19/2022]
Abstract
Given increasing opioid overdose mortality rates in the USA over the past 20 years, accelerating the implementation of prevention interventions found to be effective is critical. The Helping End Addiction Long-Term (HEAL) Prevention Cooperative (HPC) is a consortium of research projects funded to implement and test interventions designed to prevent the onset or escalation of opioid misuse among youth and young adults. The HPC offers a unique opportunity to synthesize and share lessons learned from participating research projects' varied implementation experiences, which can facilitate quicker integration of effective prevention interventions into practice. This protocol paper describes our hybrid approach to collecting and analyzing information about the implementation experiences of nine of the HPC research projects while they maintain their focus on assessing the effectiveness and cost-effectiveness of prevention interventions. To better understand implementation within this context, we will address five research questions: (1) What were the context and approach for implementing the prevention interventions, and how was the overall implementation experience? (2) How representative of the target population are the participants who were enrolled and retained in the research projects' effectiveness trials? (3) For what purposes and how were stakeholders engaged by the research projects? (4) What are the adaptable components of the prevention interventions? And finally, (5) how might implementation of the prevention interventions vary for non-trial implementation? This work will result in intervention-specific and general practical dissemination resources that can help potential adopters and deliverers of opioid misuse prevention make adoption decisions and prepare for successful implementation.
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Affiliation(s)
- S V Patel
- RTI International, Research Triangle Park, Durham, NC, USA.
| | - J D Cance
- RTI International, Research Triangle Park, Durham, NC, USA
| | - E E Bonar
- University of Michigan, Ann Arbor, MI, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
- Addiction Center, University of Michigan, Ann Arbor, MI, USA
| | - P M Carter
- University of Michigan, Ann Arbor, MI, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
| | - D L Dickerson
- Integrated Substance Abuse Programs (ISAP), University of California, Los Angeles, Los Angeles, CA, USA
| | | | | | | | | | - L Saldana
- Oregon Social Learning Center, Eugene, OR, USA
| | - R R Singh
- Oregon Social Learning Center, Eugene, OR, USA
| | - E Tinius
- Texas Christian University, Fort Worth, TX, USA
| | - M A Walton
- University of Michigan, Ann Arbor, MI, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
- Addiction Center, University of Michigan, Ann Arbor, MI, USA
| | - S Youn
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - S Young
- Texas Christian University, Fort Worth, TX, USA
| | - S Philbrick
- RTI International, Research Triangle Park, Durham, NC, USA
| | - B H Lambdin
- RTI International, Research Triangle Park, Durham, NC, USA
- University of Washington, Seattle, WA, USA
- University of California San Francisco, San Francisco, CA, USA
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Dullet N, Young S, Woodhead G, Goldberg D, Hannallah J. Abstract No. 596 Deep Venous Thrombosis Interventions: Change Over Time and Relative Percentage Performed by Interventional Radiologists. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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8
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Oslock A, Rosati LM, Bailey J, Young S, Kumar HJ, Molina AL. A resident-led quality improvement approach to addressing food insecurity. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00196-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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9
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Davidson AM, Nichols J, Boppana S, Young S, Wall K, Bliton K, O’Neil N, Mertens E. Congenital lobar emphysema: A challenging diagnosis. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00384-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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10
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Louie E, Young S, Virk M, Barsun A, Sen S. Topical Liposomal Amphotericin (Ambisome®) for the Treatment of Cutaneous Fusarium in a Burn-Injured Patient. J Burn Care Res 2023; 44:207-209. [PMID: 36227770 DOI: 10.1093/jbcr/irac152] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Indexed: 01/11/2023]
Abstract
Cutaneous Fusarium infections carry significant morbidity and mortality in burn-injured patients. Treatment involves surgical source control in combination of systemic and topical therapy. Given drug shortage constraints with conventional amphotericin deoxycholate, we describe the first case of successful treatment with adjunctive topical liposomal amphotericin in a critically ill burn-injured patient.
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Affiliation(s)
| | | | - Mehr Virk
- UC Davis Health, Sacramento, CA, USA
| | | | - Soman Sen
- UC Davis Health, Sacramento, CA, USA.,Shriners Hospital for Children, Sacramento, CA, USA
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Asherson P, Johansson L, Holland R, Bedding M, Forrester A, Giannulli L, Ginsberg Y, Howitt S, Kretzschmar I, Lawrie SM, Marsh C, Kelly C, Mansfield M, McCafferty C, Khan K, Muller-Sedgwick U, Strang J, Williamson G, Wilson L, Young S, Landau S, Thomson L. Randomised controlled trial of the short-term effects of osmotic-release oral system methylphenidate on symptoms and behavioural outcomes in young male prisoners with attention deficit hyperactivity disorder: CIAO-II study. Br J Psychiatry 2023; 222:7-17. [PMID: 35657651 PMCID: PMC7613969 DOI: 10.1192/bjp.2022.77] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Research has shown that 20-30% of prisoners meet the diagnostic criteria for attention-deficit hyperactivity disorder (ADHD). Methylphenidate reduces ADHD symptoms, but effects in prisoners are uncertain because of comorbid mental health and substance use disorders. AIMS To estimate the efficacy of an osmotic-release oral system methylphenidate (OROS-methylphenidate) in reducing ADHD symptoms in young adult prisoners with ADHD. METHOD We conducted an 8-week parallel-arm, double-blind, randomised placebo-controlled trial of OROS-methylphenidate versus placebo in male prisoners (aged 16-25 years) meeting the DSM-5 criteria for ADHD. Primary outcome was ADHD symptoms at 8 weeks, using the investigator-rated Connors Adult ADHD Rating Scale (CAARS-O). Thirteen secondary outcomes were measured, including emotional dysregulation, mind wandering, violent attitudes, mental health symptoms, and prison officer and educational staff ratings of behaviour and aggression. RESULTS In the OROS-methylphenidate arm, mean CAARS-O score at 8 weeks was estimated to be reduced by 0.57 points relative to the placebo arm (95% CI -2.41 to 3.56), and non-significant. The responder rate, defined as a 20% reduction in CAARS-O score, was 48.3% for the OROS-methylphenidate arm and 47.9% for the placebo arm. No statistically significant trial arm differences were detected for any of the secondary outcomes. Mean final titrated dose was 53.8 mg in the OROS-methylphenidate arm. CONCLUSIONS ADHD symptoms did not respond to OROS-methylphenidate in young adult prisoners. The findings do not support routine treatment with OROS-methylphenidate in this population. Further research is needed to evaluate effects of higher average dosing and adherence to treatment, multi-modal treatments and preventative interventions in the community.
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Desai B, Carrigan N, Wearn A, Blackman J, Ben Yehuda M, Young S, Koychev I, Coulthard E. Exploring the association between sleep and cognitive performance in a healthy and real-world cognitively impaired population. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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13
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Witteveen A, Young S, Cuijpers P, Ayuso-Mateos J, Barbui C, Bertolini F, Cabello M, Cadorin C, Downes N, Franzoi D, Gasior M, John A, Melchior M, McDaid D, Palantza C, Purgato M, Van der Waerden J, Wang S, Sijbrandij M. Remote mental health care interventions during the COVID-19 pandemic: An umbrella review. Behav Res Ther 2022; 159:104226. [PMID: 36410111 PMCID: PMC9661449 DOI: 10.1016/j.brat.2022.104226] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 10/13/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
Mitigating the COVID-19 related disruptions in mental health care services is crucial in a time of increased mental health disorders. Numerous reviews have been conducted on the process of implementing technology-based mental health care during the pandemic. The research question of this umbrella review was to examine what the impact of COVID-19 was on access and delivery of mental health services and how mental health services have changed during the pandemic. A systematic search for systematic reviews and meta-analyses was conducted up to August 12, 2022, and 38 systematic reviews were identified. Main disruptions during COVID-19 were reduced access to outpatient mental health care and reduced admissions and earlier discharge from inpatient care. In response, synchronous telemental health tools such as videoconferencing were used to provide remote care similar to pre-COVID care, and to a lesser extent asynchronous virtual mental health tools such as apps. Implementation of synchronous tools were facilitated by time-efficiency and flexibility during the pandemic but there was a lack of accessibility for specific vulnerable populations. Main barriers among practitioners and patients to use digital mental health tools were poor technological literacy, particularly when preexisting inequalities existed, and beliefs about reduced therapeutic alliance particularly in case of severe mental disorders. Absence of organizational support for technological implementation of digital mental health interventions due to inadequate IT infrastructure, lack of funding, as well as lack of privacy and safety, challenged implementation during COVID-19. Reviews were of low to moderate quality, covered heterogeneously designed primary studies and lacked findings of implementation in low- and middle-income countries. These gaps in the evidence were particularly prevalent in studies conducted early in the pandemic. This umbrella review shows that during the COVID-19 pandemic, practitioners and mental health care institutions mainly used synchronous telemental health tools, and to a lesser degree asynchronous tools to enable continued access to mental health care for patients. Numerous barriers to these tools were identified, and call for further improvements. In addition, more high quality research into comparative effectiveness and working mechanisms may improve scalability of mental health care in general and in future infectious disease outbreaks.
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Affiliation(s)
- A.B. Witteveen
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands,Corresponding author
| | - S. Young
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - P. Cuijpers
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - J.L. Ayuso-Mateos
- Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - C. Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - F. Bertolini
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - M. Cabello
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - C. Cadorin
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - N. Downes
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, Paris, France
| | - D. Franzoi
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - M. Gasior
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - A. John
- Health Data Science, Swansea University Medical School, Swansea, UK
| | - M. Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, Paris, France
| | - D. McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - C. Palantza
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - M. Purgato
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - J. Van der Waerden
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, Paris, France
| | - S. Wang
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - M. Sijbrandij
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
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Ponce SB, Young S, Harris M, Walker D, Sona M, Jones N, Kwartang J, Jankowski C, Griggs J, Berendt M, Cuevas C, Rendon AD, Beyer K. Perceptions of Radiation Therapy amongst Black Female Breast Cancer Survivors in Urban Communities. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Young S. Hysteroscopic Resection of Early Pregnancy Loss. J Minim Invasive Gynecol 2022. [DOI: 10.1016/j.jmig.2022.09.133] [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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Bamford T, Easter C, Montgomery S, Smith R, Coomarasamy A, Smith RD, Young S, Anna B, Iasonos R, Louise B, Gina A, Wachter A, Corcoran S, Amy B, Alison C. A morphokinetic ploidy prediction model built and validated on over 8000 blastocysts. Reprod Biomed Online 2022. [DOI: 10.1016/j.rbmo.2022.08.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Foster S, Rickman R, Nichols A, Collins S, Miller J, Onono M, Wekesa P, Young S, Widen E. Dietary Diversity in Infancy Is Associated with Linear Growth in The Second Year of Life. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.08.097] [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: 10/14/2022]
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Pleasance E, Bohm A, Williamson LM, Nelson JMT, Shen Y, Bonakdar M, Titmuss E, Csizmok V, Wee K, Hosseinzadeh S, Grisdale CJ, Reisle C, Taylor GA, Lewis E, Jones MR, Bleile D, Sadeghi S, Zhang W, Davies A, Pellegrini B, Wong T, Bowlby R, Chan SK, Mungall KL, Chuah E, Mungall AJ, Moore RA, Zhao Y, Deol B, Fisic A, Fok A, Regier DA, Weymann D, Schaeffer DF, Young S, Yip S, Schrader K, Levasseur N, Taylor SK, Feng X, Tinker A, Savage KJ, Chia S, Gelmon K, Sun S, Lim H, Renouf DJ, Jones SJM, Marra MA, Laskin J. Whole genome and transcriptome analysis enhances precision cancer treatment options. Ann Oncol 2022; 33:939-949. [PMID: 35691590 DOI: 10.1016/j.annonc.2022.05.522] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 05/03/2022] [Accepted: 05/31/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Recent advances are enabling delivery of precision genomic medicine to cancer clinics. While the majority of approaches profile panels of selected genes or hotspot regions, comprehensive data provided by whole genome and transcriptome sequencing and analysis (WGTA) presents an opportunity to align a much larger proportion of patients to therapies. PATIENTS AND METHODS Samples from 570 patients with advanced or metastatic cancer of diverse types enrolled in the Personalized OncoGenomics (POG) program underwent WGTA. DNA-based data, including mutations, copy number, and mutation signatures, were combined with RNA-based data, including gene expression and fusions, to generate comprehensive WGTA profiles. A multidisciplinary molecular tumour board used WGTA profiles to identify and prioritize clinically actionable alterations and inform therapy. Patient responses to WGTA-informed therapies were collected. RESULTS Clinically actionable targets were identified for 83% of patients, 37% of whom received WGTA-informed treatments. RNA expression data were particularly informative, contributing to 67% of WGTA-informed treatments; 25% of treatments were informed by RNA expression alone. Of a total 248 WGTA-informed treatments, 46% resulted in clinical benefit. RNA expression data were comparable to DNA-based mutation and copy number data in aligning to clinically beneficial treatments. Genome signatures also guided therapeutics including platinum, PARP inhibitors, and immunotherapies. Patients accessed WGTA-informed treatments through clinical trials (19%), off-label use (35%), and as standard therapies (46%) including those which would not otherwise have been the next choice of therapy, demonstrating the utility of genomic information to direct use of chemotherapies as well as targeted therapies. CONCLUSIONS Integrating RNA expression and genome data illuminated treatment options that resulted in 46% of treated patients experiencing positive clinical benefit, supporting the use of comprehensive WGTA profiling in clinical cancer care. CLINICAL TRIAL NUMBER NCT02155621.
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Affiliation(s)
- E Pleasance
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - A Bohm
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver; Department of Medicine, University of British Columbia, Vancouver
| | - L M Williamson
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - J M T Nelson
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - Y Shen
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - M Bonakdar
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - E Titmuss
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - V Csizmok
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - K Wee
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - S Hosseinzadeh
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver; Department of Medicine, University of British Columbia, Vancouver
| | - C J Grisdale
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - C Reisle
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - G A Taylor
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - E Lewis
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - M R Jones
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - D Bleile
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - S Sadeghi
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - W Zhang
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - A Davies
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - B Pellegrini
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - T Wong
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - R Bowlby
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - S K Chan
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - K L Mungall
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - E Chuah
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - A J Mungall
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - R A Moore
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - Y Zhao
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - B Deol
- Department of Medical Oncology, BC Cancer, Vancouver
| | - A Fisic
- Department of Medical Oncology, BC Cancer, Vancouver
| | - A Fok
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver
| | - D A Regier
- Canadian Centre for Applied Research in Cancer Control, Cancer Control Research, BC Cancer, Vancouver
| | - D Weymann
- Canadian Centre for Applied Research in Cancer Control, Cancer Control Research, BC Cancer, Vancouver
| | - D F Schaeffer
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver; Pancreas Centre BC, Vancouver
| | - S Young
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver
| | - S Yip
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver
| | - K Schrader
- Hereditary Cancer Program, BC Cancer, Vancouver; Department of Medical Genetics, University of British Columbia, Vancouver
| | - N Levasseur
- Department of Medical Oncology, BC Cancer, Vancouver
| | - S K Taylor
- Department of Medical Oncology, BC Cancer, Kelowna
| | - X Feng
- Department of Medical Oncology, BC Cancer, Victoria
| | - A Tinker
- Department of Medical Oncology, BC Cancer, Vancouver
| | - K J Savage
- Department of Medical Oncology, BC Cancer, Vancouver
| | - S Chia
- Department of Medical Oncology, BC Cancer, Vancouver
| | - K Gelmon
- Department of Medical Oncology, BC Cancer, Vancouver
| | - S Sun
- Department of Medical Oncology, BC Cancer, Vancouver
| | - H Lim
- Department of Medical Oncology, BC Cancer, Vancouver
| | - D J Renouf
- Department of Medical Oncology, BC Cancer, Vancouver; Pancreas Centre BC, Vancouver
| | - S J M Jones
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver; Department of Medical Genetics, University of British Columbia, Vancouver; Department of Molecular Biology and Biochemistry, Simon Fraser University, Vancouver, Canada
| | - M A Marra
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver; Department of Medical Genetics, University of British Columbia, Vancouver
| | - J Laskin
- Department of Medical Oncology, BC Cancer, Vancouver.
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Ince O, Önder H, Gencturk M, Cebeci H, Golzarian J, Young S. Abstract No. 27 Radiomics with machine learning in selective internal radiation therapy: prediction of radiologic response. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.108] [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] Open
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Flanagan S, Young S. Abstract No. 584 Recanalization of chronically occluded portal and mesenteric veins: a non-transplant pediatric cohort. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.566] [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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Young S, Sanghvi T, Ragulojan R, Torkian P, Todarty S, D’Souza D, Flanagan S, Golzarian J. Abstract No. 30 Local recurrence following complete radiologic response: a comparison of transarterial radioembolization and transarterial chemoembolization. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.111] [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] Open
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Ince O, Önder H, Gencturk M, Golzarian J, Young S. Abstract No. 220 Machine learning and refractory ascites: ability to predict those who will respond to TIPS placement. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.301] [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] Open
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Torkian P, Young S, Jahangiri Y, Rosenberg M, Shrestha P, Golzarian J, Talaie R. Abstract No. 534 Effects of lumbar spine construct and movements in May-Thurner syndrome using a detailed Finite Element Model (FEM). J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.516] [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] Open
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Young S, Ragulojan R, Torkian P, Todarty S, Sanghvi T, D’Souza D, Golzarian J, Flanagan S. Abstract No. 559 Planar vs 3D: comparison of two lung shunt fraction calculation methods utilized for radioembolization. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.541] [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] Open
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Evans F, Deslandes R, Deslandes P, Young S. Opinions of stakeholders about integrating pharmacists into Community Mental Health Teams. International Journal of Pharmacy Practice 2022. [DOI: 10.1093/ijpp/riac019.060] [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
Pharmacists are routinely involved in optimising medicines for mental health patients during inpatient admissions through attending ward rounds and providing a clinical pharmacy service. (1) Despite literature demonstrating the benefits, specialist pharmacists are not routinely integrated in Community Mental Health Teams (CMHTs) (2) and there is little research to identify the barriers to pharmacists’ integration. The opinions of stakeholder who influence the design of community mental health services, are key to understanding these issues.
Aim
To explore the views of relevant stakeholders in one health board (HB) in Wales, regarding integration of pharmacists into CMHTs, and to make recommendations to overcome identified barriers to integration.
Methods
Semi-structured interviews using open questions with key stakeholders within two CMHTs and the HB’s adult mental health clinical board. Participants were selected purposively to allow recruitment of individuals who would provide insight into the proposed question(s). Written, informed consent was obtained. A deductive approach was used to define interview questions. Interviews were transcribed and analysed thematically using an inductive approach to explore the data without any pre-conceived ideas and identify additional key themes. The study was registered with the HB.
Results
Interviews (3 pharmacists, 2 consultant psychiatrists, 1 integrated manager, 2 clinical nurse leads and 2 general managers) lasted between 30-45 minutes. Analysis revealed five main themes; relationship with the pharmacist, including previous experiences and individual pharmacist’s personal attributes; CMHT workload relevant to pharmacists’ skills; workforce and financial pressures; the need for ongoing support for and from pharmacists; and pharmacists’ expertise including non-medical prescribing. Previous experience of working with specialist mental health pharmacist influenced participants’ views, those with limited experience were less clear about what a pharmacist’s role would be in CMHTs“…we haven’t had specialist pharmacist linked to us ………“Always can get in touch with pharmacy by e-mail or phone. Can see advantage of a pharmacist in the building, the medics would really like that it wouldn’t need to be every week maybe a morning every two weeks. We know where pharmacy are, not a dire need. Others identified a clear role for pharmacists, “running clinic for us especially when we have referrals from GP purely asking for medication reviews having [pharmacist] here the benefit surpasses most of the options we can offer through medic”. Participants believed pharmacists needed training in risk assessment and consultation skills and they should be prescribers to contribute effectively. Nine participants had worked previously with pharmacists, all advocated their integration into CMHTs.
Conclusion
This small-scale study suggests there is a desire to integrate pharmacists into CMHTs with a strong emphasis on their role in addressing medicine-related workload pressures. Positive relationships formed from prior experience of working with pharmacists strongly influenced support for integration. There are potential roles for pharmacists that would improve timeliness and quality of care for people supported by CMHTs. Resource constraints such as lack of funding and availability of appropriately trained pharmacists need to be resolved. Further work is necessary to investigate how these barriers can be addressed and to evaluate the cost-effectiveness of any pharmacy service delivered.
References
(1) Royal Pharmaceutical Society England (2018). No health without mental health: How can pharmacy support people with mental health problems? London. Royal Pharmaceutical Society England
(2) Robinson, J. (2017). Challenging the Stigma. The Pharmaceutical Journal, November 2017, Vol 299, No 7907, [online] | DOI: 10.1211/PJ.2017.20203915 [Accessed 1 Mar. 2019]
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Affiliation(s)
- F Evans
- Pharmacy Department, Cardiff and Vale University Health Board, Cardiff, Wales
| | - R Deslandes
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, Wales
| | - P Deslandes
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, Wales
| | - S Young
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, Wales
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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, Castel P, Derouineau J, Kousignan P, Eliazevitch M, Pierre I, Collias L, Viard JP, Gilquin J, Sobel A, Slama L, Ghosn J, Hadacek B, Thu-Huyn N, Nait-Ighil L, Cros A, Maignan A, Duvivier C, Consigny PH, Lanternier F, Shoai-Tehrani M, Touam F, Jerbi S, Bodard L, Jung C, Goujard C, Quertainmont Y, Duracinsky M, Segeral O, Blanc A, Peretti D, Cheret A, Chantalat C, Dulucq MJ, Levy Y, Lelievre JD, Lascaux AS, Dumont C, Boue F, Chambrin V, Abgrall S, Kansau I, Raho-Moussa M, De Truchis P, Dinh A, Davido B, Marigot D, Berthe H, Devidas A, Chevojon P, Chabrol A, Agher N, Lemercier Y, Chaix F, Turpault I, Bouchaud O, Honore P, Rouveix E, Reimann E, Belan AG, Godin Collet C, Souak S, Mortier E, Bloch M, Simonpoli AM, Manceron V, Cahitte I, Hiraux E, Lafon E, Cordonnier F, Zeng AF, Zucman D, Majerholc C, Bornarel D, Uludag A, Gellen-Dautremer J, Lefort A, Bazin C, Daneluzzi V, Gerbe J, Jeantils V, Coupard M, Patey O, Bantsimba J, Delllion S, Paz PC, Cazenave B, Richier L, Garrait V, Delacroix I, Elharrar B, Vittecoq D, Bolliot C, Lepretre A, Genet P, Masse V, Perrone V, Boussard JL, Chardon P, Froguel E, Simon P, Tassi S, Avettand Fenoel V, Barin F, Bourgeois C, Cardon F, Chaix ML, Delfraissy JF, Essat A, Fischer H, Lecuroux C, Meyer L, Petrov-Sanchez V, Rouzioux C, Saez-Cirion A, Seng R, Kuldanek K, Mullaney S, Young C, Zucchetti A, Bevan MA, McKernan S, Wandolo E, Richardson C, Youssef E, Green P, Faulkner S, Faville R, Herman S, Care C, Blackman H, Bellenger K, Fairbrother K, Phillips A, Babiker A, Delpech V, Fidler S, Clarke M, Fox J, Gilson R, Goldberg D, Hawkins D, Johnson A, Johnson M, McLean K, Nastouli E, Post F, Kennedy N, Pritchard J, Andrady U, Rajda N, Donnelly C, McKernan S, Drake S, Gilleran G, White D, Ross J, Harding J, Faville R, Sweeney J, Flegg P, Toomer S, Wilding H, Woodward R, Dean G, Richardson C, Perry N, Gompels M, Jennings L, Bansaal D, Browing M, Connolly L, Stanley B, Estreich S, Magdy A, O'Mahony C, Fraser P, Jebakumar SPR, David L, Mette R, 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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Abstract
Abstract
Disseminated infection caused by non-tuberculous mycobacteria (NTM) is very rare, with an incidence of 1.0 to 1.8 cases per 100,000 persons, and typically only occurs in severely immunocompromised hosts. Burn patients suffer loss of the natural cutaneous barrier as well as injury-induced immune dysfunction, and as a result, commonly develop infections, especially with multidrug-resistant organisms. However, very few NTM infections in burn patients have been reported in the literature. Disseminated NTM infection, in particular, can be a challenge to diagnose in burn patients due to burn related physiology such as hyperpyrexia and widespread skin injury. We present a case of disseminated infection leading to bacteremia caused by Mycobacterium abscessus in a critically ill burn patient with a 74% total body surface area burn. M. abscessus belongs to the subgroup of NTM known as rapidly growing mycobacteria (RGM), which are notable for their ability to form colonies in a matter of days, rather than weeks, and because they are often highly drug-resistant, which complicates antimicrobial therapy. This is the third reported case of bacteremia caused by NTM in a burn patient and the second case that was successfully transitioned from intravenous antimicrobials to an oral regimen.
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Affiliation(s)
- Emily H Hsu
- UC Davis Health, Department of Pharmacy, Sacramento, CA, USA
| | - Sierra Young
- UC Davis Health, Department of Pharmacy, Sacramento, CA, USA
| | - Nicola Clayton
- UC Davis Health, Department of Pharmacy, Sacramento, CA, USA
| | - Jin Lee
- UC Davis Health, Department of Pharmacy, Sacramento, CA, USA
| | - Naomi Hauser
- UC Davis Health, Division of Infectious Diseases, Department of Medicine, Sacramento, CA, USA
| | - Bennett Penn
- UC Davis Health, Division of Infectious Diseases, Department of Medicine, Sacramento, CA, USA
| | - Soman Sen
- UC Davis Health, Division of Burn Surgery, Department of Surgery, Sacramento, CA, USA
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Pandey P, Young S. Design Considerations for In-Field Measurement of Plant Architecture Traits Using Ground-Based Platforms. Methods Mol Biol 2022; 2539:171-190. [PMID: 35895204 DOI: 10.1007/978-1-0716-2537-8_15] [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] [Indexed: 06/15/2023]
Abstract
This work provides a high-level overview of system design considerations for measuring plant architecture traits in row crops using ground-based, mobile platforms. High-throughput phenotyping technologies are commonly deployed in isolated growth chambers or greenhouses; however, there is a need for field-based systems to measure large quantities of plants exposed to natural climates throughout a growing season. High-throughput methods using ground-based mobile systems collect valuable phenotypic information at higher temporal resolutions compared to manual methods (e.g., handheld calipers and measuring sticks). Additionally, the close proximity to plants when using ground-based systems compared to aerial platforms enables plant phenotyping at the organ level. While there is no single best platform for obtaining ground-based plant measurements across crop varieties with different planting configurations, there are a wide range of off-the-shelf systems and sensors that can be integrated to accommodate varying row widths, plant spacing, plant heights, and plot sizes, in addition to emerging commercially available platforms. This chapter will provide an overview of sensor types suitable for phenotyping plant size and shape, as well as provide guidance for deployment with ground-based systems, including push carts or buggies, modified tractors, and robotic platforms.
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Affiliation(s)
- Piyush Pandey
- Department of Biological and Agricultural Engineering, North Carolina State University, Raleigh, NC, USA
| | - Sierra Young
- Department of Civil and Environmental Engineering, Utah State University, Logan, UT, USA.
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Young S, McDonald K, Woode R, Ford J, Newberry R, Clarke L. 367: Goblet cell-associated antigen passages and tolerogenic dendritic cells are increased in the intestinal-specific CFTR KO mouse intestine. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01791-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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31
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Abner V, Holt JP, Knauer M, Young S. 506 Late-Breaking: Rapid Weight Assessment of Finishing Pigs. J Anim Sci 2021. [DOI: 10.1093/jas/skab235.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Accurate pig body weight assessment is an important factor in managing swine herds and imperative when determining acceptable market weights. Pigs marketed outside the desired weight range established by the packer can lead to severe economic loss to the producer. This study’s objective was to validate new weight measurement technologies and determine their usefulness on swine farms. Accuracy of three methods were evaluated: human observation, a walk-across platform scale (CIMA; Correggio, Italy), and PigVision mounted cameras (Asimetrix Inc; Durham, NC). Weights were validated with a calibrated livestock scale in all three studies. In the first study, a trained individual selected pigs estimated to be market weight at two sites. Site one had 468 pigs and an accuracy of 84.4%, site two had 522 pigs and an 82.5% accuracy. A 16-week study was then conducted to determine PigVision camera accuracy over time from placement to market. Cameras were mounted above 12 pens. Weights were validated every two weeks. The accuracy for pigs that weighed 32.7 kg (87.7%) was lower (P < 0.05) than the accuracy for pigs that weighed 117.5 kg (97.6%) or 125.7 kg (96.6%). The overall accuracy from placement to market was 94.1%. A final study at market compared human observation, the walk-across scale, and PigVision. A total of 91 pigs were weighed with each method. The accuracy for the walk-across scale was 98.2%. The walk-across scale did not register a weight for six pigs. Final accuracies were 88.2% for human observation, and 96.6% for PigVision. Human observation is the chosen method in many operations today yet offers the lowest accuracy. The walk-across scale is easy to operate but requires tactical animal movement. PigVision is the least arduous option, provides constant data, but does require maintenance. This work was funded by the National Pork Board.
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Miller M, Strazdins E, Young S, Kalish N, Congreve K. A retrospective single-site data-linkage study comparing manual to electronic data abstraction for routine post-operative nausea and vomiting audit. Int J Qual Health Care 2021; 33:6345452. [PMID: 34363667 DOI: 10.1093/intqhc/mzab116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/09/2021] [Accepted: 08/06/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Post-operative nausea and vomiting (PONV) is a common cause of patient dissatisfaction following anaesthesia. Audit of adherence to PONV prevention guidelines is resource intensive when performed by manual chart extraction. Electronic audit can require costly anaesthetic and medical records. OBJECTIVE In our single-site study we sought to compare manual and electronic PONV audits by utilizing existing non-anaesthetic electronic medical records to avoid expensive additional software. METHODS The audits were performed from 13 January 2020 to 1 February 2020 for surgical inpatients. Two PONV periods were captured-the post-anaesthetic recovery unit and on the ward (to 24 h). Electronic PONV was defined as the administration of an anti-emetic medication. A 6-month electronic PONV rate was also calculated. RESULTS Manual audit captured 142 patients and electronic audit captured 294 patients, over the same time period. The manual PONV rate was 10% (95% confidence interval (CI) 5-16%) in the post-anaesthetic recovery unit and 20% (95% CI 14-28%) the next day. The electronic rate was 5% (95% CI 3-8%) in the post-anaesthetic recovery unit and 15% (11-19%) in a 24-h period. The 6-month electronic audit found 3510 patients, with a post-anaesthetic recovery unit and 24-h PONV rates of 5% (4-6%) and 14% (13-16%), respectively. Electronic audit did not identify 5.8% of PONV patients in the manual audit. CONCLUSION Electronic audit enrolled more patients and identified a lower PONV rate than manual audit, likely from less enrolment bias. Electronic audit was easily repeated over a 6-month period. While electronic PONV audit is possible without additional software, an electronic anaesthetic chart would greatly improve audit quality.
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Affiliation(s)
- M Miller
- Department of Anaesthesia and Pain Medicine, St George Hospital, Gray St, Kogarah, Sydney, NSW 2217, Australia.,St George and Sutherland Clinical Schools, UNSW, Gray St, Kogarah, Sydney, NSW 2217, Australia
| | - E Strazdins
- Department of Anaesthesia, Canberra Hospital, Yamba Drive, Garran Australian Capital Territory, Canberra, ACT 2605, Australia
| | - S Young
- Department of Anaesthesia and Pain Medicine, St George Hospital, Gray St, Kogarah, Sydney, NSW 2217, Australia
| | - N Kalish
- Department of Anaesthesia and Pain Medicine, St George Hospital, Gray St, Kogarah, Sydney, NSW 2217, Australia
| | - K Congreve
- Department of Anaesthesia and Pain Medicine, St George Hospital, Gray St, Kogarah, Sydney, NSW 2217, Australia
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Wongjarupong N, Young S, Lake J, Lim N. Abstract No. 28 Sustained improvement in hepatic function following transjugular intrahepatic portosystemic shunt for Budd-Chiari syndrome. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Moran P, Young S, Pontolillo J, Chen T, Sharma P, Owen J, Golzarian J, Flanagan S, D’Souza D, Sanghvi T. Abstract No. 153 Neutrophil-to-lymphocyte ratio may predict survival and radiologic response in those undergoing radioembolization for hepatocellular carcinoma. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Pontolillo J, Young S, Sharma P, Chen T, Moran P, Owen J, Golzarian J, D’Souza D, Flanagan S, Sanghvi T. Abstract No. 168 Platelet-to-lymphocyte ratio: utility in metastatic colorectal patients undergoing radioembolization. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Young S, Flanagan S, D’Souza D, Golzarian J, Pontolillo J, Chen T, Sharma P, Owen J, Moran P, Sanghvi T. Abstract No. 445 Dose distribution in radioembolization: a comparison between glass and resin microspheres. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Sharma P, Young S, Chen T, Pontolillo J, Moran P, Owen J, Golzarian J, D’Souza D, Flanagan S, Sanghvi T. Abstract No. 38 Novel composite score of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and aspartate-aminotransferase-lymphocyte ratio predicts overall survival in metastatic colorectal patients undergoing radioembolization. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.454] [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] Open
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38
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Sharma P, Young S, Pontolillo J, Chen T, Moran P, Owen J, D’Souza D, Golzarian J, Flanagan S, Sanghvi T. Abstract No. 35 Platelet-to-lymphocyte ratio: evaluation of relevancy in hepatocellular carcinoma patients undergoing radioembolization. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.451] [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: 11/27/2022] Open
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39
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Spano A, Young S, Flanagan S. Abstract No. 523 Pre-operative Botox injection for ventral hernia repair: early experience at a single institution. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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40
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Owen J, Young S, Sharma P, Pontolillo J, Chen T, Moran P, Golzarian J, Flanagan S, D’Souza D, Sanghvi T. Abstract No. 152 Aspartate aminotransferase-lymphocyte ratio: utility in hepatocellular carcinoma patients undergoing radioembolization. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.158] [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] Open
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Williams K, Selwyn C, Elkins C, Young S, Pancione K, Baker M, Getch Y. An integrated addictions nursing subspecialty to expand the opioid use disorder and substance use disorder workforce. Eur Psychiatry 2021. [PMCID: PMC9480147 DOI: 10.1192/j.eurpsy.2021.1521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction In the U.S. approximately11.4 million misused prescription pain relievers; 2.1 million had an OUD in 2017. The Addictions Nursing Subspecialty was created to address this epidemic by expanding a workforce trained in OUD/SUD screening, treatment, and prevention. A curriculum was developed that included integrated/telehealth health care settings in medical and mental health provider shortage areas during their last nine months of training. Courses were developed and taught by aninterprofessional team of university faculty and informed by evidence-based guidelines/clinical competencies for effective OUD/SUD screening/prevention, assessment, treatment, and recovery. Courses were also offered as electives for nursing, clinical-counseling, social work, and other health science disciplines emphasizing an interdisciplinary approach to healthcare. Objectives Expand the OUD/SUD trained workforce in areas with high OUD/SUD mortality rates and high mental health provider shortages emphasizing team-based integrated care and telehealth settings. Methods Program curriculum was informed by evidence-based guidelines/clinical competencies for effective OUD/SUD screening/prevention, assessment, treatment, and recovery using integrated care. Competencies included: Core Competencies for Integrated Behavioral Health and Primary Care that have been set forth by the Center for Integrated Health Solutions, telehealth competencies outlined in the recommended competencies by the National Organization of Nurse Practitioner Faculties (NONPF), and Core Competencies for Addictions Medicine by the American Board of Addictions Medicine. Results Approximately 11 students enrolled in courses received additions integrated/telehealth health care settings. Students responded positively to evaluations regarding timely feedback, unique approach (i.e. intrative content, short videos and discussions). Conclusions The Addictions Nursing subspecialty will continue to be offered allowing enrollment for nurses twice a year.
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Kilic O, Young S. Presentation and outcomes of attention deficit and hyperactivity disorder in females and males. Eur Psychiatry 2021. [PMCID: PMC9471393 DOI: 10.1192/j.eurpsy.2021.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Abstract BodyAttention deficit and hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children. Its primary clinical features include symptoms of inattention and hyperactivity/impulsivity, although young people often present with emotional dysregulation, excessive mind-wandering and executive dysfunction. Symptoms of ADHD often persist into adulthood together with high rates of comorbidity and significant psychosocial impairment across the lifespan. Berry, Shaywitz and Shaywitz proposed over 30 years ago that girls with ADHD form a ‘silent minority’ with greater internalized behavior which leads them to be under-identified. Even when referred for clinical assessment, their ADHD symptoms are missed or misdiagnosed for other conditions such as anxiety, depression and personality disorder. This means they will not receive the treatment they need. Compared with controls, they may be especially vulnerable to childhood adversities and health problems and they may cope with these difficulties with dysfunctional strategies (eg. with substance misuse and/or deliberate self-harming behaviours). If we are to enhance long-term outcomes in girls and women with ADHD, healthcare practitioners need to better understand the presentation of ADHD in females, improve detection and assessment of ADHD in order that they may access appropriate treatment. This workshop will focus on the differences in presentation and outcomes between males and females with ADHD.DisclosureNo significant relationships.
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Young S, Larson L, Bermudez J, Mohei H, Rostambeigi N, Golzarian J, Mahgoub A. Evaluation of the frequency and factors predictive of hernia incarceration following transjugular intrahepatic portosystemic shunt placement. Clin Radiol 2021; 76:287-293. [PMID: 33549300 DOI: 10.1016/j.crad.2020.12.014] [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: 05/05/2020] [Accepted: 12/30/2020] [Indexed: 02/07/2023]
Abstract
AIM To examine the frequency and predictive factors for bowel incarceration following transjugular intrahepatic portosystemic shunts (TIPS) placement to treat refractory cirrhosis-induced ascites. MATERIALS AND METHODS Ninety-nine patients with known hernias at the time of TIPS placement were identified. Their electronic medical records were reviewed and pertinent pre-procedural, procedural, and outcome variables were recorded. Patients were divided between those that suffered incarceration (study group) and a control group of those with a hernia who did not suffer incarceration. RESULTS Twelve of the 99 patients (12.1%) suffered hernia incarceration, of which seven (7.1%) suffered incarceration in the first 90 days. One patient who suffered incarceration ultimately died from complications of the incarceration. When comparing all patients who suffered incarceration to controls, incarceration patients were found to have significantly higher albumin levels (mean 3.13 versus 2.73, p=0.02). When just considering those who had incarcerations in the first 90 days to controls, incarceration patients were less likely to have improvement in their ascites (p=0.04). CONCLUSIONS Incarcerated hernias occur frequently after TIPS placement and can lead to significant morbidity and mortality. Clinicians should be aware of this complication and counsel patients on presenting symptoms prior to placement.
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Affiliation(s)
- S Young
- Department of Radiology, Division of Interventional Radiology, University of Minnesota, 420 Delaware ST SE, Minneapolis, MN 55455, USA.
| | - L Larson
- Department of Medicine, Division of Gastroenterology, University of Minnesota, 420 Delaware ST SE, Minneapolis, MN 55455, USA
| | - J Bermudez
- Department of Radiology, Division of Interventional Radiology, University of Minnesota, 420 Delaware ST SE, Minneapolis, MN 55455, USA
| | - H Mohei
- Department of Medicine, Division of Gastroenterology, University of Minnesota, 420 Delaware ST SE, Minneapolis, MN 55455, USA
| | - N Rostambeigi
- Department of Radiology, Division of Interventional Radiology, Washington University, 5110 S Kingshighway Blvd, St Louis, MO 63110, USA
| | - J Golzarian
- Department of Radiology, Division of Interventional Radiology, University of Minnesota, 420 Delaware ST SE, Minneapolis, MN 55455, USA
| | - A Mahgoub
- Department of Medicine, Division of Gastroenterology, Baylor Scott and White, 3410 Worth St, Ste 860, Dallas, TX 75246, USA
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Lu Y, Young S, Linder E, Whipker B, Suchoff D. Hyperspectral Imaging With Machine Learning to Differentiate Cultivars, Growth Stages, Flowers, and Leaves of Industrial Hemp ( Cannabis sativa L.). Front Plant Sci 2021; 12:810113. [PMID: 35185960 PMCID: PMC8847227 DOI: 10.3389/fpls.2021.810113] [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] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 12/27/2021] [Indexed: 05/04/2023]
Abstract
As an emerging cash crop, industrial hemp (Cannabis sativa L.) grown for cannabidiol (CBD) has spurred a surge of interest in the United States. Cultivar selection and harvest timing are important to produce CBD hemp profitably and avoid economic loss resulting from the tetrahydrocannabinol (THC) concentration in the crop exceeding regulatory limits. Hence there is a need for differentiating CBD hemp cultivars and growth stages to aid in cultivar and genotype selection and optimization of harvest timing. Current methods that rely on visual assessment of plant phenotypes and chemical procedures are limited because of its subjective and destructive nature. In this study, hyperspectral imaging was proposed as a novel, objective, and non-destructive method for differentiating hemp cultivars, growth stages as well as plant organs (leaves and flowers). Five cultivars of CBD hemp were grown greenhouse conditions and leaves and flowers were sampled at five growth stages 2-10 weeks in 2-week intervals after flower initiation and scanned by a benchtop hyperspectral imaging system in the spectral range of 400-1000 nm. The acquired images were subjected to image processing procedures to extract the spectra of hemp samples. The spectral profiles and scatter plots of principal component analysis of the spectral data revealed a certain degree of separation between hemp cultivars, growth stages, and plant organs. Machine learning based on regularized linear discriminant analysis achieved the accuracy of up to 99.6% in differentiating the five hemp cultivars. Plant organ and growth stage need to be factored into model development for hemp cultivar classification. The classification models achieved 100% accuracy in differentiating the five growth stages and two plant organs. This study demonstrates the effectiveness of hyperspectral imaging for differentiating cultivars, growth stages and plant organs of CBD hemp, which is a potentially useful tool for growers and breeders of CBD hemp.
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Affiliation(s)
- Yuzhen Lu
- Department of Agricultural and Biological Engineering, Mississippi State University, Starkville, MS, United States
- *Correspondence: Yuzhen Lu,
| | - Sierra Young
- Department of Biological and Agricultural Engineering, North Carolina State University, Raleigh, NC, United States
- Sierra Young,
| | - Eric Linder
- Department of Crop and Soil Sciences, North Carolina State University, Raleigh, NC, United States
| | - Brian Whipker
- Department of Horticultural Science, North Carolina State University, Raleigh, NC, United States
| | - David Suchoff
- Department of Crop and Soil Sciences, North Carolina State University, Raleigh, NC, United States
- David Suchoff,
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Lawson K, Gauthier KS, Piovesan D, Fournier J, Rosen B, Maliyan A, Beatty J, Jin L, Leleti M, Ginn E, Udyavar A, Ada C, Au J, Meleza C, Zhao S, Young S, Walters M, Powers J. Discovery and characterization of novel, potent, and selective hypoxiainducible factor (HIF)-2α inhibitors. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)31106-0] [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: 10/23/2022]
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Abstract
Haemoglobin SC (HbSC) disease accounts for 30% of cases of sickle cell disease in the United Kingdom and the United States. Unlike other sickle cell carriers, who are relatively asymptomatic, people with HbSC disease have a combination of genotypes with the potential to cause considerable morbidity due to intracellular water loss. Patients can present with acute pain, acute chest syndrome, proliferative retinopathy, splenic and renal complications, or stroke. We present a young man with HbSC disease who developed acute compartment syndrome. This is only the second report of this syndrome in a patient with HbSC disease. This is a very rare complication in HbSC disease, but it can have serious implications.
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Affiliation(s)
- E Cochrane
- Bradford Teaching Hospitals NHS Foundation Trust, UK
| | - S Young
- Bradford Teaching Hospitals NHS Foundation Trust, UK
| | - Z Shariff
- Bradford Teaching Hospitals NHS Foundation Trust, UK
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Young S, Sanghvi T, Lake JJ, Rubin N, Golzarian J. Predicting post-transarterial chemoembolization outcomes: A comparison of direct and total bilirubin serums levels. Diagn Interv Imaging 2020; 101:355-364. [PMID: 31948887 PMCID: PMC7772772 DOI: 10.1016/j.diii.2019.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/05/2019] [Accepted: 12/09/2019] [Indexed: 12/29/2022]
Abstract
PURPOSE To retrospectively review the ability of direct bilirubin serum level to predict mortality and complications in patients undergoing transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) and compare it to the predictive value of the currently utilized total bilirubin serum level. MATERIALS AND METHODS A total of 219 patients who underwent TACE for 353 hepatocelluar carcinomas (HCC) at a single institution were included. There were 165 men and 54 women, with a mean age of 61.4±7.6 (SD) [range: 27-86 years]. The patients' electronic medical records were evaluated and they were divided into cohorts based on total bilirubin (<2, 2-3, and >3mg/dL) as well as direct bilirubin (<1 and 1-2mg/dL). RESULTS Direct bilirubin serum level was significantly greater in the cohort of patients who did not survive as compared to those who survived 6 months ([0.58±0.46 (SD) mg/dL; range: <0.1-1.8mg/dL] vs. [0.40±0.31 (SD) mg/dL; range: <0.1-1.6mg/dL], respectively) (P=0.04) and 12 months ([0.49±0.38 (SD) mg/dL; range: <0.1-1.8mg/dL] vs. [0.38±0.32 (SD) mg/dL; range: <0.1-1.6mg/dL], respectively) (P=0.03). While total bilirubin serum level was not significantly different in those who did not and did survive 6 months ([1.54±0.99 (SD) mg/dL; range: 0.3-3.9mg/dL] vs. [1.27±0.70 (SD) mg/dL; range: 0.3-3.75mg/dL], respectively) (P=0.16), it was significantly different when evaluating 12 months survival ([1.46±0.87 (SD)mg/dL; range: 0.3-3.9mg/dL] vs. [1.22±0.65 (SD) mg/dL; range: 0.3-3.9mg/dL]) (P=0.03). Akaike information criterion (AIC) analysis revealed that direct bilirubin level more accurately predicted overall survival (AIC=941.19 vs. 1000.51) and complications (AIC=352.22 vs. 357.42) than total bilirubin serum levels. CONCLUSION Direct bilirubin serum level appears to outperform total bilirubin concentration for predicting complications and overall survival in patients undergoing TACE. Patients with relatively maintained direct bilirubin levels should be considered for TACE, particularly in the setting of bridging to transplant.
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Affiliation(s)
- S Young
- Department of Radiology, University of Minnesota, Minneapolis, MN 55455 , USA.
| | - T Sanghvi
- Minneapolis Veterans Affairs Healthcare System, Minneapolis, MN 55471 , USA
| | - J J Lake
- Department of Medicine, Division of Hepatology, University of Minnesota, Minneapolis, MN 55471 , USA
| | - N Rubin
- Department of Radiology, University of Minnesota, Minneapolis, MN 55455 , USA
| | - J Golzarian
- Department of Radiology, University of Minnesota, Minneapolis, MN 55455 , USA
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Young S, Rivard M, Kimyon R, Sanghvi T. Accuracy of liver ablation zone prediction in a single 2450 MHz 100 Watt generator model microwave ablation system: An in human study. Diagn Interv Imaging 2020; 101:225-233. [DOI: 10.1016/j.diii.2019.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/11/2019] [Accepted: 10/15/2019] [Indexed: 12/18/2022]
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Leach D, Muñoz N, Dupuis C, Williams M, Dixon K, Young S, Sheth R, Hartgerink J. Abstract No. 430 Self-assembling hydrogel platform improves intratumoral drug delivery and retention. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.491] [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: 10/25/2022] Open
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Young S, Phillips J, Griego-Fullbright C, Wagner A, Jim P, Chaudhuri S, Tang S, Sickler J. Molecular Point-of-care Testing for Influenza A/B and Respiratory Syncytial Virus: Workflow Parameters for the ID Now™ and cobas® Liat® Systems. J Infect Public Health 2020. [DOI: 10.1016/j.jiph.2020.01.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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