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Sagin A, Balmer D, Rose S, Musheno R, Olenik JM, Dingfield L, Dine CJ, Bennett NL. Evaluation of a Palliative Care Longitudinal Curriculum for Medical Students Using the Context-Input-Process-Product Model. Am J Hosp Palliat Care 2024; 41:158-166. [PMID: 36945136 PMCID: PMC10751966 DOI: 10.1177/10499091231165504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Palliative care (PC) longitudinal curricula are increasingly being recognized as important in Undergraduate Medical Education (UME). They are however, not yet commonplace, and where they do exist may be implemented without a systematic, prospective approach to curriculum evaluation. This paper describes an implementation of a new longitudinal curriculum at the Perelman School of Medicine (PSOM) at the University of Pennsylvania. We used the Context Input Process Product (CIPP) model, a holistic evaluation model, to assess the local environment, design the curriculum, guide the improvement process, and evaluate outcomes. Comprehensive models such as CIPP provide a more robust approach to curriculum evaluation than outcomes-only models and may be of use to other programs who are implementing new curricula or improving upon existing programs.
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Affiliation(s)
- Alana Sagin
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Dorene Balmer
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Suzanne Rose
- Medicine/Academic Programs, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Rosie Musheno
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Jennifer M. Olenik
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Laura Dingfield
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - C. Jessica Dine
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Nadia L. Bennett
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Tsao S, Clancy C, Bennett N, Rose S, Kassutto S. Medical Education in the Metaverse: Integration of Virtual Learning Experiences Into Core Clerkships for Medical Students. Acad Med 2023; 98:S189-S190. [PMID: 37983434 DOI: 10.1097/acm.0000000000005386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Affiliation(s)
- Suzana Tsao
- Author affiliations: S. Tsao, N. Bennett, S. Rose, Perelman School of Medicine at the University of Pennsylvania; C. Clancy, S. Kassutto, Perelman School of Medicine at the University of Pennsylvania; Corporal Michael J. Crescenz VA Medical Center
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Muralidharan V, Burgart A, Daneshjou R, Rose S. Recommendations for the use of pediatric data in artificial intelligence and machine learning ACCEPT-AI. NPJ Digit Med 2023; 6:166. [PMID: 37673925 PMCID: PMC10482936 DOI: 10.1038/s41746-023-00898-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/03/2023] [Indexed: 09/08/2023] Open
Abstract
ACCEPT-AI is a framework of recommendations for the safe inclusion of pediatric data in artificial intelligence and machine learning (AI/ML) research. It has been built on fundamental ethical principles of pediatric and AI research and incorporates age, consent, assent, communication, equity, protection of data, and technological considerations. ACCEPT-AI has been designed to guide researchers, clinicians, regulators, and policymakers and can be utilized as an independent tool, or adjunctively to existing AI/ML guidelines.
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Affiliation(s)
- V Muralidharan
- Department of Dermatology, Stanford University, Stanford, USA.
| | - A Burgart
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, USA
| | - R Daneshjou
- Department of Dermatology, Stanford University, Stanford, USA
- Department of Biomedical Data Science, Stanford University, Stanford, USA
| | - S Rose
- Department of Health Policy, Stanford University, Stanford, USA
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Pirgozliev V, Whiting I, Mansbridge S, Abdullah J, Mirza W, Rose S. Feeding value of field bean (<i>Vicia faba</i> L. var. <i>minor</i>)
for laying hen pullets. J Anim Feed Sci 2023. [DOI: 10.22358/jafs/157501/2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Hamilton RH, Rose S, DeLisser HM. Defending Racial and Ethnic Diversity in Undergraduate and Medical School Admission Policies. JAMA 2023; 329:119-120. [PMID: 36477254 DOI: 10.1001/jama.2022.23124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This Viewpoint argues that reversing or restricting the use of race and ethnicity in academic admission policies could also threaten the diversity of medical schools, both directly by restricting race consciousness in medical school admission practices and indirectly by reducing the overall number of minoritized undergraduate students attending US colleges and universities who could apply to medical school.
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Affiliation(s)
- Roy H Hamilton
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Suzanne Rose
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Horace M DeLisser
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
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Azizi M, Mahfoud F, Weber MA, Sharp ASP, Schmieder RE, Lurz P, Lobo MD, Fisher NDL, Daemen J, Bloch MJ, Basile J, Sanghvi K, Saxena M, Gosse P, Jenkins JS, Levy T, Persu A, Kably B, Claude L, Reeve-Stoffer H, McClure C, Kirtane AJ, Mullin C, Thackeray L, Chertow G, Kahan T, Dauerman H, Ullery S, Abbott JD, Loening A, Zagoria R, Costello J, Krathan C, Lewis L, McElvarr A, Reilly J, Cash M, Williams S, Jarvis M, Fong P, Laffer C, Gainer J, Robbins M, Crook S, Maddel S, Hsi D, Martin S, Portnay E, Ducey M, Rose S, DelMastro E, Bangalore S, Williams S, Cabos S, Rodriguez Alvarez C, Todoran T, Powers E, Hodskins E, Paladugu V, Tecklenburg A, Devireddy C, Lea J, Wells B, Fiebach A, Merlin C, Rader F, Dohad S, Kim HM, Rashid M, Abraham J, Owan T, Abraham A, Lavasani I, Neilson H, Calhoun D, McElderry T, Maddox W, Oparil S, Kinder S, Radhakrishnan J, Batres C, Edwards S, Garasic J, Drachman D, Zusman R, Rosenfield K, Do D, Khuddus M, Zentko S, O'Meara J, Barb I, Foster A, Boyette A, Wang Y, Jay D, Skeik N, Schwartz R, Peterson R, Goldman JA, Goldman J, Ledley G, Katof N, Potluri S, Biedermann S, Ward J, White M, Mauri L, Sobieszczky P, Smith A, Aseltine L, Stouffer R, Hinderliter A, Pauley E, Wade T, Zidar D, Shishehbor M, Effron B, Costa M, Semenec T, Roongsritong C, Nelson P, Neumann B, Cohen D, Giri J, Neubauer R, Vo T, Chugh AR, Huang PH, Jose P, Flack J, Fishman R, Jones M, Adams T, Bajzer C, Mathur A, Jain A, Balawon A, Zongo O, Bent C, Beckett D, Lakeman N, Kennard S, D’Souza RJ, Statton S, Wilkes L, Anning C, Sayer J, Iyer SG, Robinson N, Sevillano A, Ocampo M, Gerber R, Faris M, Marshall AJ, Sinclair J, Pepper H, Davies J, Chapman N, Burak P, Carvelli P, Jadhav S, Quinn J, Rump LC, Stegbauer J, Schimmöller L, Potthoff S, Schmid C, Roeder S, Weil J, Hafer L, Agdirlioglu T, Köllner T, Böhm M, Ewen S, Kulenthiran S, Wachter A, Koch C, Fengler K, Rommel KP, Trautmann K, Petzold M, Ott C, Schmid A, Uder M, Heinritz U, Fröhlich-Endres K, Genth-Zotz S, Kämpfner D, Grawe A, Höhne J, Kaesberger B, von zur Mühlen C, Wolf D, Welzel M, Heinrichs G, Trabitzsch B, Cremer A, Trillaud H, Papadopoulos P, Maire F, Gaudissard J, Sapoval M, Livrozet M, Lorthioir A, Amar L, Paquet V, Pathak A, Honton B, Cottin M, Petit F, Lantelme P, Berge C, Courand PY, Langevin F, Delsart P, Longere B, Ledieu G, Pontana F, Sommeville C, Bertrand F, Feyz L, Zeijen V, Ruiter A, Huysken E, Blankestijn P, Voskuil M, Rittersma Z, Dolmans H, Kroon A, van Zwam W, Vranken J, de Haan. C, Renkin J, Maes F, Beauloye C, Lengelé JP, Huyberechts D, Bouvie A, Witkowski A, Januszewicz A, Kądziela J, Prejbisj A, Hering D, Ciecwierz D, Jaguszewski MJ, Owczuk R. Effects of Renal Denervation vs Sham in Resistant Hypertension After Medication Escalation: Prespecified Analysis at 6 Months of the RADIANCE-HTN TRIO Randomized Clinical Trial. JAMA Cardiol 2022; 7:1244-1252. [PMID: 36350593 PMCID: PMC9647563 DOI: 10.1001/jamacardio.2022.3904] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Importance Although early trials of endovascular renal denervation (RDN) for patients with resistant hypertension (RHTN) reported inconsistent results, ultrasound RDN (uRDN) was found to decrease blood pressure (BP) vs sham at 2 months in patients with RHTN taking stable background medications in the Study of the ReCor Medical Paradise System in Clinical Hypertension (RADIANCE-HTN TRIO) trial. Objectives To report the prespecified analysis of the persistence of the BP effects and safety of uRDN vs sham at 6 months in conjunction with escalating antihypertensive medications. Design, Setting, and Participants This randomized, sham-controlled, clinical trial with outcome assessors and patients blinded to treatment assignment, enrolled patients from March 11, 2016, to March 13, 2020. This was an international, multicenter study conducted in the US and Europe. Participants with daytime ambulatory BP of 135/85 mm Hg or higher after 4 weeks of single-pill triple-combination treatment (angiotensin-receptor blocker, calcium channel blocker, and thiazide diuretic) with estimated glomerular filtration rate (eGFR) of 40 mL/min/1.73 m2 or greater were randomly assigned to uRDN or sham with medications unchanged through 2 months. From 2 to 5 months, if monthly home BP was 135/85 mm Hg or higher, standardized stepped-care antihypertensive treatment starting with aldosterone antagonists was initiated under blinding to treatment assignment. Interventions uRDN vs sham procedure in conjunction with added medications to target BP control. Main Outcomes and Measures Six-month change in medications, change in daytime ambulatory systolic BP, change in home systolic BP adjusted for baseline BP and medications, and safety. Results A total of 65 of 69 participants in the uRDN group and 64 of 67 participants in the sham group (mean [SD] age, 52.4 [8.3] years; 104 male [80.6%]) with a mean (SD) eGFR of 81.5 (22.8) mL/min/1.73 m2 had 6-month daytime ambulatory BP measurements. Fewer medications were added in the uRDN group (mean [SD], 0.7 [1.0] medications) vs sham (mean [SD], 1.1 [1.1] medications; P = .045) and fewer patients in the uRDN group received aldosterone antagonists at 6 months (26 of 65 [40.0%] vs 39 of 64 [60.9%]; P = .02). Despite less intensive standardized stepped-care antihypertensive treatment, mean (SD) daytime ambulatory BP at 6 months was 138.3 (15.1) mm Hg with uRDN vs 139.0 (14.3) mm Hg with sham (additional decreases of -2.4 [16.6] vs -7.0 [16.7] mm Hg from month 2, respectively), whereas home SBP was lowered to a greater extent with uRDN by 4.3 mm Hg (95% CI, 0.5-8.1 mm Hg; P = .03) in a mixed model adjusting for baseline and number of medications. Adverse events were infrequent and similar between groups. Conclusions and Relevance In this study, in patients with RHTN initially randomly assigned to uRDN or a sham procedure and who had persistent elevation of BP at 2 months after the procedure, standardized stepped-care antihypertensive treatment escalation resulted in similar BP reduction in both groups at 6 months, with fewer additional medications required in the uRDN group. Trial Registration ClinicalTrials.gov Identifier: NCT02649426.
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Affiliation(s)
- Michel Azizi
- Université Paris Cité, F-75006 Paris, France,Assistance Publique–Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Hypertension Department and DMU CARTE, F-75015 Paris, France,INSERM, CIC1418, F-75015 Paris, France
| | - Felix Mahfoud
- Klinik für Innere Medizin III, Saarland University Hospital, Homburg/Saar, Germany,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge
| | - Michael A. Weber
- Division of Cardiovascular Medicine, State University of New York, Downstate Medical Center, New York
| | - Andrew S. P. Sharp
- University Hospital of Wales, Cardiff and University of Exeter, Exeter, United Kingdom
| | - Roland E. Schmieder
- Nephrology and Hypertension, University Hospital Erlangen, Friedrich Alexander University, Erlangen, Germany
| | - Philipp Lurz
- Heart Center Leipzig, University of Leipzig, Leipzig, Germany
| | - Melvin D. Lobo
- Barts NIHR Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | | | - Joost Daemen
- Erasmus MC, University Medical Center Rotterdam, Department of Cardiology, Rotterdam, the Netherlands
| | - Michael J. Bloch
- Department of Medicine, University of Nevada School of Medicine, Vascular Care, Renown Institute of Heart and Vascular Health, Reno
| | - Jan Basile
- Division of Cardiovascular Medicine, Medical University of South Carolina, Ralph H. Johnson VA Medical Center, Charleston
| | | | - Manish Saxena
- Barts NIHR Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | | | | | - Terry Levy
- Royal Bournemouth Hospital, Dorset, United Kingdom
| | - Alexandre Persu
- Division of Cardiology, Cliniques Universitaires Saint-Luc and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Benjamin Kably
- Assistance Publique–Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Department of Pharmacology, Paris, France
| | | | | | | | - Ajay J. Kirtane
- Columbia University Medical Center/New York-Presbyterian Hospital and the Cardiovascular Research Foundation, New York
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- for the RADIANCE-HTN Investigators
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jay Giri
- for the RADIANCE-HTN Investigators
| | | | - Thu Vo
- for the RADIANCE-HTN Investigators
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Srinivas S, Yeluru A, Liau J, Ganesh A, Minocha J, Mcnamee C, Rose S, Fowler K, Berman Z. Abstract No. 194 Tumor response after ablative Y-90 transarterial radioembolization for hepatocellular carcinoma based on post-hoc voxel-based dosimetry. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.275] [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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Mongan A, Suri P, Artis DR, Cahir-McFarland E, Kroon HA, Andrews-Zwilling Y, Rose S, Keswani S, Dall’Era M, Yednock T. OP0232 HIGH PLASMA C4d/C4 IDENTIFIES LUPUS NEPHRITIS PATIENTS WITH DISEASE MEDIATED BY ACTIVATION OF THE CLASSICAL COMPLEMENT PATHWAY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundProliferative lupus nephritis (LN) involves immune complex deposition in the kidney that can severely impact normal renal clearance mechanisms. Immune complexes can activate C1q and the classical complement cascade, and along with pathogenic anti-C1q antibodies (PACAs), may amplify inflammation and disease progression. Martin et al reported that circulating C4d, a marker of complement activation downstream of the C1 complex, correlated well with C4d immunohistochemistry score in kidney tissue and could be a sensitive and specific biomarker for diagnosing active LN.1ObjectivesTo confirm and extend observations by Martin et al, and to extend a link between C4d, C1q activation, and PACA levels to identify patients most likely to have the classical complement pathway as a driving component of disease. Such patients would be potential candidates for anti-C1q therapy, such as ANX009, to dampen disease activity and slow disease progression (NCT04535752).MethodsPlasma samples were collected from a cohort of 40 LN patients (20 with disease flare and 20 without disease flare) from the California Lupus Epidemiology Study (CLUES), a multi-racial/ethnic cohort of individuals with physician-confirmed systemic lupus erythematosus, and 20 healthy controls (Table 1). A panel of complement factors, including 15 complement protein and relevant complexes, were measured using an enzyme-linked immunosorbent assay. Clinical disease activity was measured using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and proteinuria was evaluated by a random spot urine protein to creatinine ratio (UPCR).Table 1.Patient DemographicsCharacteristicsHealthy Control(n=20)LN Flare(n=20)LN Without Flare(n=20)Median age (years)*50 (31-60.8)28.5 (26-34.5)43.5 (33.5-52)Sex, n (%)Female18 (90)17 (85)18 (90)Demographics, n (%)Caucasian8 (40)1 (5)5 (25)Hispanic3 (15)9 (45)4 (20)African American1 (5)3 (15)3 (15)Asian8 (40)7 (35)8 (40)Median UPCR (mg/mg)*N/A1.8 (1.3-6.5)0.4 (0.2-0.6)Median SLEDAI*N/A12 (9-16)2 (2-4)*Reported as median (IQR).LN, lupus nephritis; N/A, not applicable; SLEDAI, Systemic Lupus Erythematosus Disease Activity Index; UPCR, urine protein:creatinine ratio.ResultsWe observed evidence of coordinated complement activation in LN patients relative to healthy controls. Specifically, levels of C4d and the C4d/C4 ratio were highly increased in LN patients with flare, while levels of C1q, C1s, and C4 were decreased, consistent with activation of the classical complement pathway (increased activation and component consumption). The C4d/C4 ratio also correlated with levels of PACA isotypes 1 and 3 that are known to activate the classical pathway. Improvements in C4 and C4d/C4 ratio were associated with improvements in proteinuria and SLEDAI following treatment for disease flare, indicating their potential value as biomarkers of treatment response.ConclusionA subset of LN patients exhibited high C4d/C4 ratio along with specific markers of classical pathway activation, indicating that the classical complement pathway may be a driving component of their disease. Reduction in this ratio appears to correlate with treatment response, but its levels are generally not normalized, suggesting an insufficient resolution of complement-mediated inflammation by currently available treatments. Our data support a clinical hypothesis that a subset of LN patients may benefit from a precision medicine approach targeting the classical complement pathway (Figure 1). This hypothesis will be evaluated in a forthcoming clinical trial testing the subcutaneously administered C1q inhibitor ANX009 in patients with active LN.References[1]Martin M, Trattner R, Nilsson SC, et al. Plasma C4d Correlates With C4d Deposition in Kidneys and With Treatment Response in Lupus Nephritis Patients. Front Immunol. 2020;11:582737.AcknowledgementsSupported by: Annexon BiosciencesDisclosure of InterestsAnn Mongan Employee of: Annexon Biosciences, Poojan Suri Employee of: Annexon Biosciences, Maze Therapeutics, Dean Richard Artis Shareholder of: Annexon Biosciences, Bristol Myer Squibb, Roche, Sanofi, BMS, J&J, Employee of: Annexon Biosciences, Ellen Cahir-McFarland Shareholder of: Annexon Biosciences, Employee of: Annexon Biosciences, Biogen, Henk-André Kroon Shareholder of: Annexon Biosciences, Employee of: Annexon Biosciences, Yaisa Andrews-Zwilling Employee of: Annexon Biosciences, Shawn Rose Employee of: Annexon, Johnson & Johnson, Sanjay Keswani Shareholder of: Annexon Biosciences, Nura Bio, Employee of: Annexon Biosciences, Nura Bio, Maria Dall’Era Consultant of: GSK, AstraZeneca, Biogen, Annexon Biosciences, Pfizer, Aurinia, Grant/research support from: Annexon Biosciences, GSK, Ted Yednock Shareholder of: Annexon Biosciences, Consultant of: Cortexyme, Employee of: Annexon Biosciences
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Dieny F, Rose S, Tsani A, Jauharany F, Fitranti D. Anthropometry indicators that are most related to metabolic profiles in female
college students. Food Res 2022. [DOI: 10.26656/fr.2017.6(3).250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Metabolic syndrome is not a disease but is a set of several disorders and causes an
increased risk of cardiovascular disease and diabetes mellitus complications. Several
studies have shown that non-invasive approaches such as anthropometric measurements
can be used for the early detection of metabolic syndrome. This study aimed to analyse the
anthropometric indicators related to metabolic syndrome in female college students. The
design of this research was cross sectional, with the number of subjects involved were as
many as 163 female college students aged 19 to 24 years old. Purposive sampling was
used in the sampling of this research. The independent variables in this study were the
Waist-to-Height Ratio (WHtR), Waist-Hip Ratio (WHR), Body Mass Index (BMI),
Sagittal Abdominal Diameter (SAD), and hip circumference. The dependent variable in
this study is the metabolic syndrome component that has been converted into a metabolic
syndrome score (cMetS). The analysis results showed that all anthropometric indicators,
namely WHtR, BMI, SAD, waist circumference, hip circumference and WHR have a
strong positive relationship with the metabolic syndrome score (p<0.001). BMI was the
anthropometric indicator that is most associated with the metabolic profiles, such as
systolic blood pressure (p<0.001), blood sugar (p<0.05), and HDL (p<0.001). Waist
circumference was the anthropometric indicator that is most associated with triglycerides
and metabolic syndrome score (p<0.001). Metabolic syndrome in female college students
can be identified using anthropometric measurements, one of which is BMI and WHR
which are very easy to measure and efficient. BMI and WHR have the strongest
relationship and can be used to detect early risk of metabolic syndrome in female college
students.
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Dieny F, Fitranti D, Jauharany F, Tsani A, Faradila U, Rose S. Anthropometric profile and its correlation to insulin resistance in female
students with obesity. Food Res 2022. [DOI: 10.26656/fr.2017.6(2).129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The prevalence of obesity in adolescent girls is increasing each year. Several
anthropometric measurements can be used to detect the incidence of insulin resistance.
This study was aimed to observe the correlation of anthropometric profiles with insulin
resistance in adolescent girls with obesity. This was an observational study with a total of
120 female students of Universitas Diponegoro (Undip), aged between 18 and 21 years
old, who have waist circumference >80 cm. They were chosen by a simple random
sampling technique. Anthropometric profile data taken has consisted of waist
circumference, hip circumference, waist-hip circumference ratio (WHR), waist-to-height
ratio (WHtR), neck circumference, waist circumference, thigh circumference, and 2D:4D
digit ratio. Insulin resistance data was determined using the Homeostasis Model
Assessment-Insulin Resistance (HOMA-IR.). Bivariate analysis was completed with the
Spearman rank test. There was 83.3% of subjects who experienced insulin resistance.
High WHtR was found in 98.3% of total subjects as many as 90.8% of subjects were at
risk based on WHR values. Based on 2D:4D ratio digits, neck circumference, wrist
circumference <50% of subjects were found as at risk. There was no correlation between
waist circumference, WHR, wrist circumference, 2D:4D digit ratio with HOMA-IR
(p>0.05). However, there was a positive correlation between WHtR, neck circumference,
and thigh circumference with HOMA-IR (p<0.05). Anthropometric profiles such as
WHtR, neck circumference, and thigh circumference were correlated with insulin
resistance in female adolescents with obesity.
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Pierre-Louis RE, Pannikodu K, Madhoun M, Hartnett J, Rose S. Implementing a Neurohospitalist Program Improves Stroke Care Metrics and Patient Satisfaction Scores. Neurohospitalist 2022; 12:241-248. [PMID: 35419152 PMCID: PMC8995615 DOI: 10.1177/19418744211069272] [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: 11/16/2022] Open
Abstract
Objective Compare the differences in health outcomes and patient satisfaction between a neurohospitalist model of care and a community-based neurologists model at a single community-based teaching hospital among in-patients diagnosed with a cerebrovascular accident (CVA). Methods Data was collected from the Stamford Hospital’s electronic medical records system. An assessment of patient health outcomes and satisfaction scores was conducted, comparing both discrete and continuous variables between the two time periods. An omnibus P-value of 0.05 ( P < 0.05) was considered statistically significant. Results The sample consisted of 341 patients between the two periods, pre-period n = 168 (49.3%) post-period n = 173 (50.7%). Door to lab and door to tPA times decreased significantly between pre- and post-periods ( P = 0.003 and P = 0.002, respectively) as did the number of MRIs ( P < 0.001). In addition, statistically significant increases were found between pre-period and post-period percentages, all increasing over time: stroke education ( P < 0.001), discharged on anticoagulant medication ( P < 0.001), and discharged on anti-thrombolytic medication ( P = 0.019). Patient satisfaction scores demonstrated mean gain across both periods for five of six items. Two items “Doctor’s Concern of my Questions/Worries” and “Skill of Doctors” demonstrated statistical significance ( P = 0.020 and P = 0.029, respectively). Conclusions The introduction of a neurohospitalist service at a community-based teaching hospital improved patient health outcomes on time to intervention, stroke education, discharge medications as well as patient satisfaction. Therefore, it may be beneficial for hospitals to implement a neurohospitalist model of care for their patients presenting with CVA.
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Affiliation(s)
| | - Kelly Pannikodu
- Office of Research, Stamford Hospital, Stamford, Connecticut, USA
| | - Maher Madhoun
- Department of Medicine, Stamford Hospital, Stamford, CT, USA
| | - Josette Hartnett
- Office of Research, Stamford Hospital, Stamford, Connecticut, USA
| | - Suzanne Rose
- Office of Research, Stamford Hospital, Stamford, Connecticut, USA
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12
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Rose S, Hartnett J, Pillai S. A comprehensive dataset describing nurse's emotions, perceived stressors and coping mechanisms during the first surge of the COVID-19 pandemic. Data Brief 2022; 40:107814. [PMID: 35018296 PMCID: PMC8739366 DOI: 10.1016/j.dib.2022.107814] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/17/2021] [Accepted: 01/05/2022] [Indexed: 12/01/2022] Open
Abstract
A comprehensive and validated questionnaire modified from previous epidemics [1,2] was distributed to frontline HCWs at high risk for COVID-19 at our community-based teaching hospital, the epicenter of the pandemic in our state. Results of the full analysis were previously reported [3] indicating that our nursing staff were more likely to report feelings of stress, emotional exhaustion and fatigue compared to physicians and other health professionals. We highlight the pandemic's specific impact on nurses’ emotions, perceived stressors and effective coping mechanisms used during the first surge of COVID-19.
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Affiliation(s)
- Suzanne Rose
- Office of Research, Stamford Hospital, Stamford, CT, USA
| | | | - Seema Pillai
- Department of Nursing, Stamford Hospital, Stamford, CT, USA
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Li E, Williams C, Hitchner M, Lee KC, Ahmad H, Naik A, Jia L, Chen A, Ahmed F, Nijim S, Rose S. The Underrepresented, Low Income, and First Time (UpLIFT) Project: A Comprehensive, Open-Access Guide to Medical School Admissions Aimed to Increase Educational Equity for Underrepresented Premedical Students. Acad Med 2021; 96:S191-S192. [PMID: 34705691 DOI: 10.1097/acm.0000000000004299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Eric Li
- Author affiliations: E. Li, C. Williams, M. Hitchner, K.C. Lee, H. Ahmad, A. Naik, L. Jia, A. Chen, F. Ahmed, S. Nijim, S. Rose, Perelman School of Medicine at the University of Pennsylvania
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Shah BJ, Onken JE, Edgar L, Jou JH, Obstein KL, Pardi DS, Richter S, Reddy G, Rose S, Szyjkowski R, Fix OK. Development of Gastroenterology and Transplant Hepatology Milestones 2.0: A Guide For Programs, Faculty, and Fellows. Hepatology 2021; 74:2226-2232. [PMID: 34491583 DOI: 10.1002/hep.32097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 12/07/2022]
Affiliation(s)
- Brijen J Shah
- Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jane E Onken
- Division of Gastroenterology, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Laura Edgar
- Accreditation Council for Graduate Medical Education, Chicago, IL
| | - Janice H Jou
- Division of Gastroenterology and Hepatology, Oregon Health Science University, Portland, OR
| | - Keith L Obstein
- Division of Gastroenterology, Vanderbilt University Medical Center, Nashville, TN
| | - Darrell S Pardi
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
| | - Seth Richter
- Division of Gastroenterology, Albany Medical Center, Albany, NY
| | - Gautham Reddy
- Section of Gastroenterology, Hepatology and Nutrition, University of Chicago, Chicago, IL
| | - Suzanne Rose
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ronald Szyjkowski
- Division of Gastroenterology, SUNY Upstate Medical University, Syracuse, NY
| | - Oren K Fix
- Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC
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15
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Shah BJ, Onken JE, Edgar L, Jou JH, Obstein KL, Pardi DS, Richter S, Reddy G, Rose S, Szyjkowski R, Fix OK. Development of Gastroenterology and Transplant Hepatology Milestones 2.0: A Guide for Programs, Faculty, and Fellows. Gastroenterology 2021; 161:1318-1324. [PMID: 34507807 DOI: 10.1053/j.gastro.2021.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 04/23/2021] [Indexed: 12/02/2022]
Affiliation(s)
- Brijen J Shah
- Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jane E Onken
- Division of Gastroenterology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Laura Edgar
- Accreditation Council for Graduate Medical Education, Chicago, Illinois
| | - Janice H Jou
- Division of Gastroenterology and Hepatology, Oregon Health Science University, Portland, Oregon
| | - Keith L Obstein
- Division of Gastroenterology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Darrell S Pardi
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Seth Richter
- Division of Gastroenterology, Albany Medical Center, Albany, New York
| | - Gautham Reddy
- Section of Gastroenterology, Hepatology and Nutrition, University of Chicago, Chicago, Illinois
| | - Suzanne Rose
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ronald Szyjkowski
- Division of Gastroenterology, SUNY Upstate Medical University, Syracuse, New York
| | - Oren K Fix
- Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina
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Shah BJ, Onken JE, Edgar L, Jou JH, Obstein KL, Pardi DS, Richter S, Reddy G, Rose S, Szyjkowski R, Fix OK. Development of gastroenterology and transplant hepatology milestones 2.0: a guide for programs, faculty, and fellows. Gastrointest Endosc 2021; 94:665-670. [PMID: 34507806 DOI: 10.1016/j.gie.2021.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 04/23/2021] [Indexed: 12/11/2022]
Affiliation(s)
- Brijen J Shah
- Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jane E Onken
- Division of Gastroenterology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Laura Edgar
- Accreditation Council for Graduate Medical Education, Chicago, Illinois, USA
| | - Janice H Jou
- Division of Gastroenterology and Hepatology, Oregon Health Science University, Portland, Oregon, USA
| | - Keith L Obstein
- Division of Gastroenterology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Darrell S Pardi
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Seth Richter
- Division of Gastroenterology, Albany Medical Center, Albany, New York, USA
| | - Gautham Reddy
- Section of Gastroenterology, Hepatology and Nutrition, University of Chicago, Chicago, Illinois, USA
| | - Suzanne Rose
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ronald Szyjkowski
- Division of Gastroenterology, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Oren K Fix
- Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA
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17
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van Eijk L, Seidel M, Pannek K, George JM, Fiori S, Guzzetta A, Coulthard A, Bursle J, Ware RS, Bradford D, Rose S, Colditz PB, Boyd RN, Fripp J. Automating Quantitative Measures of an Established Conventional MRI Scoring System for Preterm-Born Infants Scanned between 29 and 47 Weeks' Postmenstrual Age. AJNR Am J Neuroradiol 2021; 42:1870-1877. [PMID: 34413061 DOI: 10.3174/ajnr.a7230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 05/03/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Conventional MR imaging scoring is a valuable tool for risk stratification and prognostication of outcomes, but manual scoring is time-consuming, operator-dependent, and requires high-level expertise. This study aimed to automate the regional measurements of an established brain MR imaging scoring system for preterm neonates scanned between 29 and 47 weeks' postmenstrual age. MATERIALS AND METHODS This study used T2WI from the longitudinal Prediction of PREterm Motor Outcomes cohort study and the developing Human Connectome Project. Measures of biparietal width, interhemispheric distance, callosal thickness, transcerebellar diameter, lateral ventricular diameter, and deep gray matter area were extracted manually (Prediction of PREterm Motor Outcomes study only) and automatically. Scans with poor quality, failure of automated analysis, or severe pathology were excluded. Agreement, reliability, and associations between manual and automated measures were assessed and compared against statistics for manual measures. Associations between measures with postmenstrual age, gestational age at birth, and birth weight were examined (Pearson correlation) in both cohorts. RESULTS A total of 652 MRIs (86%) were suitable for analysis. Automated measures showed good-to-excellent agreement and good reliability with manual measures, except for interhemispheric distance at early MR imaging (scanned between 29 and 35 weeks, postmenstrual age; in line with poor manual reliability) and callosal thickness measures. All measures were positively associated with postmenstrual age (r = 0.11-0.94; R2 = 0.01-0.89). Negative and positive associations were found with gestational age at birth (r = -0.26-0.71; R2 = 0.05-0.52) and birth weight (r = -0.25-0.75; R2 = 0.06-0.56). Automated measures were successfully extracted for 80%-99% of suitable scans. CONCLUSIONS Measures of brain injury and impaired brain growth can be automatically extracted from neonatal MR imaging, which could assist with clinical reporting.
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Affiliation(s)
- L van Eijk
- From The Australian e-Health Research Centre (L.v.E., M.S., K.P., D.B., S.R., J.F.), Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Australia.,Faculty of Medicine (L.V.E., M.S.), The University of Queensland, Brisbane, Australia
| | - M Seidel
- From The Australian e-Health Research Centre (L.v.E., M.S., K.P., D.B., S.R., J.F.), Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Australia.,Faculty of Medicine (L.V.E., M.S.), The University of Queensland, Brisbane, Australia
| | - K Pannek
- From The Australian e-Health Research Centre (L.v.E., M.S., K.P., D.B., S.R., J.F.), Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Australia
| | - J M George
- Queensland Cerebral Palsy and Rehabilitation Research Centre (J.M.G., R.N.B.), Centre for Children's Health Research, The University of Queensland, Brisbane, Australia
| | - S Fiori
- Department of Developmental Neuroscience (S.F., A.G.), Istituto di Ricovero e Cura a Carattere Scientifico Stella Maris, Pisa, Italy
| | - A Guzzetta
- Department of Developmental Neuroscience (S.F., A.G.), Istituto di Ricovero e Cura a Carattere Scientifico Stella Maris, Pisa, Italy.,Department of Clinical and Experimental Medicine (A.G.), University of Pisa, Pisa, Italy
| | - A Coulthard
- Department of Medical Imaging (A.C., J.B.), Royal Brisbane and Women's Hospital, Brisbane, Australia.,Discipline of Medical Imaging (A.C.), The University of Queensland, Brisbane, Australia
| | - J Bursle
- Department of Medical Imaging (A.C., J.B.), Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - R S Ware
- Menzies Health Institute Queensland (R.S.W.), Griffith University, Brisbane, Australia
| | - D Bradford
- From The Australian e-Health Research Centre (L.v.E., M.S., K.P., D.B., S.R., J.F.), Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Australia
| | - S Rose
- From The Australian e-Health Research Centre (L.v.E., M.S., K.P., D.B., S.R., J.F.), Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Australia
| | - P B Colditz
- Perinatal Research Centre (P.B.C.), University of Queenland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia.,Perinatal Research Centre, Brisbane and Women's Hospital (P.B.C.), Brisbane, Australia
| | - R N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre (J.M.G., R.N.B.), Centre for Children's Health Research, The University of Queensland, Brisbane, Australia
| | - J Fripp
- From The Australian e-Health Research Centre (L.v.E., M.S., K.P., D.B., S.R., J.F.), Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Australia
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18
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Rose S, Hartnett J, Pillai S. Healthcare worker's emotions, perceived stressors and coping mechanisms during the COVID-19 pandemic. PLoS One 2021; 16:e0254252. [PMID: 34242361 PMCID: PMC8270181 DOI: 10.1371/journal.pone.0254252] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/23/2021] [Indexed: 12/23/2022] Open
Abstract
Increasing cases, insufficient amount of personal protection equipment, extremely demanding workloads, and lack of adequate therapies to save lives can contribute to a psychological burden directly related to working during disease outbreaks. Healthcare workers (HCWs) are at a high risk of contracting COVID-19 due to its ability to spread efficiently through asymptomatic and symptomatic individuals. There are limited studies assessing the pandemic’s psychological impact on HCWs, specifically those in close proximity to hospitalized patients with COVID-19. Our study explored the emotions, perceived stressors, and coping strategies of front-line HCWs at high risk of exposure to COVID-19 during the first surge at our community-based teaching hospital, the epicenter of COVID-19 in Connecticut. A validated comprehensive questionnaire derived and modified from previous epidemics was used to inquire about staff feelings, factors that caused stress and factors that mitigated stress. Personal coping strategies and factors that can increase staff’s motivation to work during future events of similar nature were also asked. Emotional reactions, coping mechanisms, and stressors varied by healthcare role, while some experiences and reactions were similar among groups. Willingness to participate in a second wave of the pandemic or future outbreaks is strongly driven by adequate personal protective equipment, financial recognition, and recognition from management, similarly reported in previous disease outbreaks. All groups felt a reduction in stress due to a sense of camaraderie and teamwork, as well as when sharing jokes or humor with colleagues. Our HCWs at high risk of exposure experienced significant emotional distress during the first wave of the COVID-19 pandemic. By understanding the needs and experiences of our HCWs at highest risk, we can improve our psychological support using targeted interventions during future waves of this pandemic or similar devastating events.
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Affiliation(s)
- Suzanne Rose
- Office of Research and Clinical Trials, Stamford Hospital, Stamford, Connecticut, United States of America
- * E-mail:
| | - Josette Hartnett
- Office of Research and Clinical Trials, Stamford Hospital, Stamford, Connecticut, United States of America
| | - Seema Pillai
- Department of Nursing, Stamford Hospital, Stamford, Connecticut, United States of America
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Chen L, Vavrenyuk A, Ren JH, Desai P, Bahgat J, Bernstein MA, Ebright MI, Gowda M, Rose S, Fallahi A, Stainken B, Hsi DH. Prognostic Value of Coronary Artery Calcification Identified by the Semi-quantitative Weston Method in the Emergency Room or Other Hospitalized Patients. Front Cardiovasc Med 2021; 8:684292. [PMID: 34222379 PMCID: PMC8248783 DOI: 10.3389/fcvm.2021.684292] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/13/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Coronary artery calcification (CAC) may provide insight to the patients' coronary artery disease (CAD) risks and influence early intervention. With increasing use of non-gated CT scans in clinical practice, the visual coronary artery scoring system (Weston Method) could quickly provide clinicians with important information of CAC for patient triage and management. Methods: We retrospectively studied the available CT imaging data and estimated CAC burden using the Weston method in 493 emergency room or other hospitalized patients. The Weston scores were calculated by the sum of the score for each vessel including the left main, left anterior descending, left circumflex artery and right coronary artery (range 0–12). The primary endpoint was a composite of the major adverse cardiac events (MACEs), including cardiac death, myocardial infarction, stroke, and coronary revascularization. Results: During a median follow-up of 85 months, a total of 25 (5.1%) MACE were recorded and 57 (11.2%) patients died from any causes. Detectable CAC was most common (96%) in the left anterior descending coronary arteries. Multivariable analysis showed that CAC total scores were independent predictors for MACE and all-cause mortality. Receiver operating characteristic analysis showed that CAC total score ≥5 was the optimal cutoff value for predicting MACEs. Conclusions: In the emergency room and hospitalized patients, the semi-quantitation of CAC burden using the Weston score system was related to the long-term cardiovascular outcomes including mortality. Clinicians and radiologists should maximize the value of non-contrast chest CT images by reporting CAC details.
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Affiliation(s)
- Lu Chen
- Department of Ultrasound, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.,Heart and Vascular Institute, Stamford Hospital, Stamford, CT, United States
| | - Andrey Vavrenyuk
- Department of Medicine, Stamford Hospital, Stamford, CT, United States
| | - Jun Hong Ren
- Heart and Vascular Institute, Stamford Hospital, Stamford, CT, United States
| | - Pankil Desai
- Heart and Vascular Institute, Stamford Hospital, Stamford, CT, United States
| | - Joseph Bahgat
- Heart and Vascular Institute, Stamford Hospital, Stamford, CT, United States
| | - Michael A Bernstein
- Division of Pulmonary Medicine and Critical Care, Stamford Hospital, Stamford, CT, United States
| | - Michael I Ebright
- Division of Thoracic Surgery, Stamford Hospital, Stamford, CT, United States
| | - Mamatha Gowda
- Department of Radiology, Stamford Hospital, Stamford, CT, United States
| | - Suzanne Rose
- Office of Research, Stamford Hospital, Stamford, CT, United States
| | - Arzhang Fallahi
- Heart and Vascular Institute, Stamford Hospital, Stamford, CT, United States
| | - Brian Stainken
- Division of Thoracic Surgery, Stamford Hospital, Stamford, CT, United States
| | - David H Hsi
- Heart and Vascular Institute, Stamford Hospital, Stamford, CT, United States
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Osorio Capitan M, Rose S, Novo Sukia I, Herrero de la Parte B, Ruiz Montesinos I, Garcia-Alonso I. ENHANCERS OF LIVER REGENERATION IN ONCOLOGICAL SURGERY. Br J Surg 2021. [DOI: 10.1093/bjs/znab160.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
INTRODUCTION
Chemotherapy hinders liver function and probably its regenerating capacity, forcing to delay it after surgery. Our objective has been to verify this effect in an experimental model and to see if a hepatotrophic agent can prevent it.
MATERIAL AND METHODS
Four groups of 6 WAG/RijHsd rats (males, 3-4 months) were submitted to ligation of the portal branch to the left lateral and left paramedian lobes. They were sacrificed 36 h later to quantify the percentage of liver corresponding to the ligated lobes (weight), the number of hepatocyte’s nuclei (nº/100 µm2) and their mean size (µm2). One group received no treatment (control); another folic acid (2.5 mg/kg ip, during surgery); other 5-Fluorouracil (5-FU 50 mg/kg ip 48 h before); and the fourth received folic&5-FU.
RESULTS
The animals treated with folic acid showed a greater number of hepatocyte’s nuclei (24.4 ± 2.77 vs 15.2 ± 1.51) and their mean size was also greater (121 ± 2.34 vs 111 ± 1.8). However, the reduction in weight of the ligated parenchyma was less than in control group (33.4 ± 1.08 vs 29.5 ± 1.08). 5-FU did not modify the number of nuclei (15.6 ± 18.4), although they were smaller in size (104 ± 1.7). The addition of folic acid to 5-FU increased the number of nuclei (21.7 ± 2.8) and normalized their size (111 ± 3.2).
CONCLUSIONS
5-FU exerts a depressant effect on livers regeneration, and folic acid overcomes it. Thus, folic acid could allow early application of chemotherapy without affecting liver regeneration.
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Affiliation(s)
| | - S Rose
- Sº de Cirugía General, Hospital de Bidasoa
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Xue C, Minocha J, Rose S, Sicklick J, Fanta P, Berman Z. Abstract No. 184 Radioembolization for metastatic succinate dehydrogenase–deficient gastrointestinal stromal tumors. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.190] [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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Kraatz S, Rose S, Cosh M, Torbick N, Huang X, Siqueira P. Performance Evaluation of UAVSAR and Simulated NISAR Data for Crop/Noncrop Classification Over Stoneville, MS. Earth Space Sci 2021; 8:e2020EA001363. [PMID: 33681415 PMCID: PMC7900998 DOI: 10.1029/2020ea001363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/26/2020] [Accepted: 11/12/2020] [Indexed: 06/12/2023]
Abstract
Synthetic Aperture Radar (SAR) data are well-suited for change detection over agricultural fields, owing to high spatiotemporal resolution and sensitivity to soil and vegetation. The goal of this work is to evaluate the science algorithm for the NASA ISRO SAR (NISAR) Cropland Area product using data collected by NASA's airborne Uninhabited Aerial Vehicle SAR (UAVSAR) platform and the simulated NISAR data derived from it. This study uses mode 129, which is to be used for global-scale mapping. The mode consists of an upper (129A) and lower band (129B), respectively having bandwidths of 20 and 5 MHz. This work uses 129A data because it has a four times finer range resolution compared to 129B. The NISAR algorithm uses the coefficient of variation (CV) to perform crop/noncrop classification at 100 m. We evaluate classifications using three accuracy metrics (overall accuracy, J-statistic, Cohen's Kappa) and spatial resolutions (10, 30, and 100 m) for crop/noncrop delineating CV thresholds (CVthr) ranging from 0 to 1 in 0.01 increments. All but the 10 m 129A product exceeded NISAR's mission accuracy requirement of 80%. The UAVSAR 10 m data performed best, achieving maximum overall accuracy, J-statistic, and Kappa values of 85%, 0.62, and 0.60. The same metrics for the 129A product respectively are: 77%, 0.40, 0.36 at 10 m; 81%, 0.55, 0.49 at 30 m; 80%, 0.58, 0.50 at 100 m. We found that using a literature recommended CVthr value of 0.5 yielded suboptimal accuracy (65%) at this site and that optimal CVthr values monotonically decreased with decreasing spatial resolution.
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Affiliation(s)
- S. Kraatz
- Department of Electrical and Computer EngineeringUniversity of MassachusettsAmherstMAUSA
| | - S. Rose
- Department of Electrical and Computer EngineeringUniversity of MassachusettsAmherstMAUSA
| | - M.H. Cosh
- USDA ARS Hydrology and Remote Sensing LaboratoryBeltsvilleMDUSA
| | | | | | - P. Siqueira
- Department of Electrical and Computer EngineeringUniversity of MassachusettsAmherstMAUSA
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Vetter M, Smrz S, Gehrig P, Peng K, Matsuo K, Davidson B, Cisa M, Lees B, Brunette L, Tucker K, Stuart Staley A, Gotlieb W, Holloway R, Essel K, Holman L, Goldfeld E, Olawaiye A, Rose S, Uppal S, Bixel K. Pathologic and clinical tumor size discordance in early-stage cervical cancer: Does it matter? Gynecol Oncol 2020; 159:354-358. [DOI: 10.1016/j.ygyno.2020.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/05/2020] [Indexed: 02/07/2023]
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Rose S, Kogan JR, Bennett NL, Dlugos DJ, Delaney A, Schorr R, Shea JA. Perelman School of Medicine at the University of Pennsylvania. Acad Med 2020; 95:S439-S443. [PMID: 33626739 DOI: 10.1097/acm.0000000000003317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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Bailey EG, Greenall RF, Baek DM, Morris C, Nelson N, Quirante TM, Rice NS, Rose S, Williams KR. Female In-Class Participation and Performance Increase with More Female Peers and/or a Female Instructor in Life Sciences Courses. CBE Life Sci Educ 2020; 19:ar30. [PMID: 32644001 PMCID: PMC8711806 DOI: 10.1187/cbe.19-12-0266] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
As we strive to make science education more inclusive, more research is needed to fully understand gender gaps in academic performance and in-class participation in the life sciences. Studies suggest that male voices dominate introductory biology courses, but no studies have been done on upper-level courses. Results on achievement gender gaps in biology vary and often conflict, and no studies have been done on the correlation between participation and academic performance gaps. We observed 34 life sciences courses at all levels at a large private university. Overall, males were more likely to participate than their female peers, but these gender gaps varied from class to class. Females participated more in classes in which the instructor called on most hands that were raised or in classes with more females in attendance. Performance gender gaps also varied by classroom, but female final course grades were as much as 0.2 SD higher in classes with a female instructor and/or a female student majority. Gender gaps in participation and final course grades were positively correlated, but this could be solely because female students are more likely to both participate more and earn higher grades in classes with many females in attendance.
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Affiliation(s)
- E. G. Bailey
- Department of Biology, Brigham Young University, Provo, UT 84602
- *Address correspondence to: E. G. Bailey ()
| | - R. F. Greenall
- Department of Biology, Brigham Young University, Provo, UT 84602
| | - D. M. Baek
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, UT 84602
| | - C. Morris
- Department of Spanish and Portuguese, Brigham Young University, Provo, UT 84602
| | - N. Nelson
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, UT 84602
| | - T. M. Quirante
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, UT 84602
| | - N. S. Rice
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, UT 84602
| | - S. Rose
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, UT 84602
| | - K. R. Williams
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT 84602
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Affiliation(s)
- Suzanne Rose
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
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Seridi L, Cesaroni M, Loza MJ, Schreiter J, Sweet K, Orlovsky Y, Baribaud I, Orillion A, Lipsky P, Vollenhoven RV, Hahn BH, Tsokos G, Chevrier M, Rose S, Baribaud F, Jordan J. OP0161 ASSOCIATION OF BASELINE CYTOTOXIC GENE EXPRESSION WITH USTEKINUMAB RESPONSE IN SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Systemic Lupus Erythematous (SLE) is a clinically and biologically diverse disease, for which only one new therapy has been approved in the past 60 years. In a phase 2 trial on patients with mild-to-moderate SLE, ustekinumab (UST) improved clinical and laboratory measures of disease activity compared with placebo (PBO).1Objectives:We previously reported an association of IFN-γ reduction with response to UST,2suggesting an impact on the IL12/Th1 axis. To extend these findings, we performed unbiased transcriptomic analysis from baseline whole blood samples to identify genes that discriminate UST responders (UST-R) from non-responders (UST-NR) using the primary endpoint of Systemic Lupus Erythematosus Responder Index (SRI)-4 at week 24 to define response.Methods:UST was studied in a Ph2 PBO-controlled study of 102 patients with seropositive SLE and active disease despite standard therapy. Patients were randomized 3:2 to receive IV UST 6 mg/kg or placebo followed by subcutaneous injections of UST 90 mg or PBO every 8 weeks. Whole blood gene expression at baseline was measured via microarray using RNA samples from 100 patients, as samples from 2 patients failed quality control. An unbiased approach was used to identify gene signatures present at baseline that associate with UST response. Recombinant IL-12 or IL-23 was incubatedin vitrowith whole blood from 6 healthy donors for 24h and RNA-Seq was performed to determine the effect of these treatments on representative genes comprising the UST response signature.Results:A non-biased machine learning algorithm identified a 9-gene whole blood signature composed primarily of cytotoxic cell-associated transcripts (PRF1, KLRD1, GZMH, NKG7, GNLY, FGFBP2, TRGC2, TARP, TRGV2) that was enriched at baseline in UST-R vs UST-NR. By Gene Set Variation Analysis, the cytotoxic signature enrichment in UST-NR was less at baseline than both UST-R and a healthy control cohort (P=0.0087, P=0.056, respectively), whereas UST-R cytotoxic gene enrichment was similar to healthy controls (P=0.31). No significant difference in cytotoxic signature enrichment was observed at baseline between PBO responders and PBO non-responders or healthy controls (Figure). Enrichment levels of the cytotoxic gene signature remained stable over time in PBO and UST-NR groups while a trend of decreased cytotoxic signature was observed in UST-R, although never reaching levels seen in UST-NR. To begin to understand the relationship between IL-12 and IL-23, the targets of UST, and the cytotoxic signature, whole blood was stimulated with these cytokinesin vitro. Recombinant IL-12, but not IL-23, resulted in increased expression of representative members of this cytotoxic gene signature.Conclusion:We identified a novel cytotoxic signature in baseline blood samples that associated with UST response in SLE. The observation that IL-12 can increase this signaturein vitroand that IL-12 is a robust inducer of cytotoxic cell activity3as well as IFN-γ3suggests an important role of IL-12 blockade in the mechanism of action of UST in SLE.References:[1]van Vollenhoven RF. Lancet. 2018;392:1330-39[2]Jordan. ACR 2018 Abstract # 2951[3]G. Trinchieri. Nat Rev Immunol. 2003;3:133-46Figure.Disclosure of Interests:Loqmane Seridi Employee of: Janssen Research & Development, LLC, Matteo Cesaroni Employee of: Janssen Research & Development, LLC, Matthew J Loza Employee of: Janssen Research & Development, LLC, Jessica Schreiter Employee of: Janssen Research & Development, LLC, Kristen Sweet Employee of: Janssen Research & Development, LLC, Yevgeniya Orlovsky Employee of: Janssen Research & Development, LLC, Spring House, PA, United States of America, Isabelle Baribaud Employee of: Janssen Research & Development, LLC, Ashley Orillion Employee of: Janssen Research & Development, LLC, Peter Lipsky Consultant of: Horizon Therapeutics, Ronald van Vollenhoven Grant/research support from: AbbVie, Amgen, Arthrogen, Bristol-Myers Squibb, GlaxoSmithKline (GSK), Janssen Research & Development, LLC, Lilly, Pfizer, Roche, and UCB, Consultant of: AbbVie, AstraZeneca, Biotest, Bristol-Myers Squibb, Celgene, Crescendo Bioscience, GSK, Janssen, Lilly, Medac, Merck, Novartis, Pfizer, Roche, UCB and Vertex, Speakers bureau: AbbVie, AstraZeneca, Biotest, Bristol-Myers Squibb, Celgene, Crescendo Bioscience, GlaxoSmithKline, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, UCB, Vertex, Bevra H. Hahn Grant/research support from: Janssen Research & Development, LLC, George Tsokos Grant/research support from: Janssen Research & Development, LLC, Marc Chevrier Employee of: Janssen Research & Development, LLC, Shawn Rose Employee of: Janssen Research & Development, LLC, Frederic Baribaud Shareholder of: Janssen Research & Development, LLC, Employee of: Janssen Research & Development, LLC, Jarrat Jordan Employee of: Janssen Research & Development, LLC
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Werth V, Hahn BH, Tsokos G, Rose S, Fei K, Gregan YI, Gordon R, Lo KH, Vollenhoven RV. AB0850 CUTANEOUS LUPUS ERYTHEMATOSUS DISEASE AREA & SEVERITY INDEX (CLASI) DEMONSTRATES THRESHOLDS FOR DETECTION OF TREATMENT RESPONSE IN A PHASE 2, PLACEBO-CONTROLLED TRIAL OF USTEKINUMAB IN SLE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:In a Phase 2 study, Ustekinumab (UST) showed improvement at week (wk) 24 in the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) response (≥4-point improvement from baseline [BL]) vs placebo (PBO).1Post hoc analysis revealed that more patients (pts) on UST vs PBO achieved ≥50% improvement in total CLASI activity score.Objectives:To examine the relationships of CLASI activity responses to SLEDAI-2K (S2K) mucocutaneous disease responses.Methods:Adults with SLE (S2K ≥6, ≥1 BILAG A and/or ≥2 BILAG B scores) despite standard of care (SOC) therapy were enrolled. Pts (n=102) were randomized (3:2) to UST ~6 mg/kg IV or PBO at wk 0, followed by UST 90 mg SC or PBO every 8 wks beginning at wk 8 + SOC. S2K index measures complete improvement from BL; S2K Responder Index-50 (S2K RI-50) evaluates partial improvement (≥50%) in S2K rash. CLASI rash: sum of erythema and scale/hypertrophy score. In post hoc analysis, improvement in CLASI activity score at wk 24 was calculated using increasing thresholds of BL disease activity and various cut points of improvement to define treatment response.Results:Complete improvement from BL in rash was concordant between CLASI and S2K (correlation coefficients [r] ≥0.997, Table 1). There was less agreement between CLASI and S2K RI-50 for assessing partial improvement in rash. Treatment difference (UST vs PBO) in % pts achieving partial improvement in rash was observed for CLASI (60% vs 38.5%), but not S2K RI-50 (51.1% vs 50%). Complete improvement from BL in mucosal ulceration was congruent between CLASI and S2K (r=1). Both instruments demonstrated greater proportions of responders to UST vs PBO. Treatment differences between UST and PBO in achieving ≥20%, ≥35%, and ≥50% improvement from BL in total CLASI activity score were noteworthy at various thresholds of disease activity (Table 2).Table 1.CLASI Activity Scores vs SLEDAI-2K Activity24-Week ImprovementTreatmentActivity Measure% (n/N*)r**CLASI RashSLEDAI-2K Rash100%PBO30.8 (8/26)30.8 (8/26)1.0000UST28.9 (13/45)31.1 (14/45)0.9997≥50%PBO38.5 (10/26)50.0 (13/26)0.9996UST60.0 (27/45)51.1 (23/45)0.8693CLASIMucosal UlcerSLEDAI-2KMucosal Ulcer100%PBO66.7 (8/12)69.2 (9/13)1.0000UST89.5 (17/19)89.5 (17/19)1.0000*N=Evaluated pts with BL SLEDAI rash present, total CLASI activity score >0, and CLASI rash or mucosal ulcer activity scores >0 in analyses of subcomponents; **Calculated using tetrachoric correlation.Table 2.Differences in Partial Improvement in Total CLASI Activity Score at Various BL Disease Activity ThresholdsCLASI Total Activity ScoreImprovementThreshold (%)PBO% (n/N*)UST% (n/N*)Difference % (UST vs PBO)BL >0≥2054.8 (17/31)74.5 (38/51)19.7≥3541.9 (13/31)60.8 (31/51)18.9≥5041.9 (13/31)54.9 (28/51)13.0BL ≥4≥2058.8 (10/17)71.9 (23/32)13.1≥3535.3 (6/17)62.5 (20/32)27.2≥5035.3 (6/17)53.1 (17/32)17.8BL ≥6≥2053.8 (7/13)72.0 (18/25)18.2≥3530.8 (4/13)60.0 (15/25)29.2≥5030.8 (4/13)52.0 (13/25)21.2BL ≥8≥2058.3 (7/12)70.6 (12/17)12.3≥3533.3 (4/12)58.8 (10/17)25.5≥5033.3 (4/12)47.1 (8/17)13.8*N=Evaluated pts with BL total CLASI activity score >0, ≥4, ≥6, ≥8 based on post hoc analysesConclusion:CLASI demonstrated partial improvement in active mucocutaneous disease that was not captured by S2K RI-50. Treatment effect favoring UST vs PBO was observed across range of thresholds of BL CLASI activity and cut points used to define improvement, which have previously been shown to be clinically meaningful.2Findings are based on a limited sample size and treatment duration; results will be confirmed in an ongoing Phase 3 UST trial (NCT03517722).References:[1]Van Vollenhoven R.Lancet. 2018;392:1330[2]Chakka S.JID.2019;139: S101 (#587)Disclosure of Interests:Victoria Werth Grant/research support from: Biogen, Celgene, Gilead, Janssen, Viela, Consultant of: Biogen, Gilead, Janssen, Abbvie, GSK, Resolve, AstraZeneca, Amgen, Eli Lilly, EMD Serono, BMS, Viela, Kyowa Kirin, Bevra H. Hahn Grant/research support from: Janssen Research & Development, LLC, George Tsokos Grant/research support from: Janssen Research & Development, LLC, Shawn Rose Employee of: Janssen Research & Development, LLC, Kaiyin Fei Employee of: Janssen Research & Development, LLC, Y Irene Gregan Employee of: Janssen Research & Development, LLC, Robert Gordon Employee of: Janssen Research & Development, LLC, Kim Hung Lo Employee of: Janssen Research & Development, LLC, Ronald van Vollenhoven Grant/research support from: AbbVie, Amgen, Arthrogen, Bristol-Myers Squibb, GlaxoSmithKline (GSK), Janssen Research & Development, LLC, Lilly, Pfizer, Roche, and UCB, Consultant of: AbbVie, AstraZeneca, Biotest, Bristol-Myers Squibb, Celgene, Crescendo Bioscience, GSK, Janssen, Lilly, Medac, Merck, Novartis, Pfizer, Roche, UCB and Vertex, Speakers bureau: AbbVie, AstraZeneca, Biotest, Bristol-Myers Squibb, Celgene, Crescendo Bioscience, GlaxoSmithKline, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, UCB, Vertex
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Berman Z, Fischman A, Young L, Flanagan S, Katz M, Diiulio M, Kuban J, Golzarian J, Rose S. Abstract No. 390 Feasibility, safety, and efficacy of in-line balloon occlusion assisted delivery of ethylene-vinyl alcohol copolymer (Onyx) for peripheral arterial applications: a multicenter case series. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.451] [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: 11/16/2022] Open
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Affiliation(s)
- Marilyn A Katz
- University of Connecticut School of Medicine Farmington Connecticut USA
| | - Suzanne Rose
- Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania USA
| | - Nicole M Deiorio
- Virginia Commonwealth University School of Medicine Richmond Virginia USA
| | - Sally A Santen
- Virginia Commonwealth University School of Medicine Richmond Virginia USA
- Consultant, Accelerating Change in Medical Education American Medical Association Chicago Illinois USA
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Van Horn L, Lenders CM, Pratt CA, Beech B, Carney PA, Dietz W, DiMaria-Ghalili R, Harlan T, Hash R, Kohlmeier M, Kolasa K, Krebs NF, Kushner RF, Lieh-Lai M, Lindsley J, Meacham S, Nicastro H, Nowson C, Palmer C, Paniagua M, Philips E, Ray S, Rose S, Salive M, Schofield M, Thompson K, Trilk JL, Twillman G, White JD, Zappalà G, Vargas A, Lynch C. Advancing Nutrition Education, Training, and Research for Medical Students, Residents, Fellows, Attending Physicians, and Other Clinicians: Building Competencies and Interdisciplinary Coordination. Adv Nutr 2019; 10:1181-1200. [PMID: 31728505 PMCID: PMC6855992 DOI: 10.1093/advances/nmz083] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/13/2019] [Accepted: 07/15/2019] [Indexed: 01/15/2023] Open
Abstract
Nutrition plays an important role in health promotion and disease prevention and treatment across the lifespan. Physicians and other healthcare professionals are expected to counsel patients about nutrition, but recent surveys report minimal to no improvements in medical nutrition education in US medical schools. A workshop sponsored by the National Heart, Lung, and Blood Institute addressed this gap in knowledge by convening experts in clinical and academic health professional schools. Representatives from the National Board of Medical Examiners, the Accreditation Council for Graduate Medical Education, the Liaison Committee on Medical Education, and the American Society for Nutrition provided relevant presentations. Reported is an overview of lessons learned from nutrition education efforts in medical schools and health professional schools including interprofessional domains and competency-based nutrition education. Proposed is a framework for coordinating activities of various entities using a public-private partnership platform. Recommendations for nutrition research and accreditation are provided.
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Affiliation(s)
- Linda Van Horn
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA,Address correspondence to LVH (e-mail: )
| | - Carine M Lenders
- Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA
| | - Charlotte A Pratt
- Division of Cardiovascular Sciences, National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Bettina Beech
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, MS, USA
| | - Patricia A Carney
- Department of Family Medicine; of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - William Dietz
- Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Rose DiMaria-Ghalili
- College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Timothy Harlan
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Robert Hash
- American Medical Association, Chicago, IL, USA
| | - Martin Kohlmeier
- Department of Nutrition, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Kathryn Kolasa
- Department of Family Medicine; of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA
| | - Nancy F Krebs
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Robert F Kushner
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Mary Lieh-Lai
- Accreditation Council for Graduate Medical Education, Chicago, IL, USA
| | - Janet Lindsley
- Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Susan Meacham
- Division of Cardiovascular Sciences, National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Holly Nicastro
- Division of Cardiovascular Sciences, National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Caryl Nowson
- Department of Nutrition and Ageing, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Carole Palmer
- Division of Nutrition & Oral Health, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Miguel Paniagua
- Test Materials Development, National Board of Medical Examiners, Philadelphia, PA, USA
| | - Edward Philips
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
| | - Sumantra Ray
- Global Center for Nutrition and Health, University of Cambridge, Cambridge, United Kingdom
| | - Suzanne Rose
- Department of Medicine, School of Health, University of Connecticut, Farmington, CT, USA
| | - Marcel Salive
- Division of Geriatrics & Clinical Gerontology, National Institutes of Health, National Institute on Aging, Bethesda, MD, USA
| | - Marsha Schofield
- Nutrition Services Coverage, Academy of Nutrition and Dietetics, Chicago, IL, USA
| | - Kathryn Thompson
- Department of Biomedical Sciences, College of Osteopathic Medicine, University of New England, Biddeford, ME, USA
| | - Jennifer L Trilk
- Department of Biomedical Sciences, University of South Carolina School of Medicine, Greenville, SC, USA
| | - Gwen Twillman
- Department of Education & Development, American Society for Nutrition, Rockville, MD, USA
| | - Jeffrey D White
- Division of Cancer Treatment and Diagnosis, National Institutes of Health, National Cancer Institute, Bethesda, MD, USA
| | - Giovanna Zappalà
- Division of Geriatrics and Clinical Gerontology and Head of the Office of Nutrition, National Institutes of Health, National Institute on Aging, Bethesda, MD, USA
| | - Ashley Vargas
- Office of Disease Prevention, National Institutes of Health, Rockville, MD, USA
| | - Christopher Lynch
- Office of Nutrition Research, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
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Ladwa R, Pattison D, Smith J, Goodman S, Burge M, Rose S, Dowson N, Wyld D. The impact of tumour absorbed dosimetry with survival outcomes after peptide receptor radionuclide therapy in metastatic neuroendocrine tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz256.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Marsh CL, Kurian SM, Rice JC, Whisenant TC, David J, Rose S, Schieve C, Lee D, Case J, Barrick B, Peddi VR, Mannon RB, Knight R, Maluf D, Mandelbrot D, Patel A, Friedewald JJ, Abecassis MM, First MR. Application of TruGraf v1: A Novel Molecular Biomarker for Managing Kidney Transplant Recipients With Stable Renal Function. Transplant Proc 2019; 51:722-728. [PMID: 30979456 DOI: 10.1016/j.transproceed.2019.01.054] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/10/2018] [Accepted: 01/17/2019] [Indexed: 01/22/2023]
Abstract
TruGraf v1 is a laboratory-developed DNA microarray-based gene expression blood test to enable proactive noninvasive serial assessment of kidney transplant recipients with stable renal function. It has been previously validated in patients identified as Transplant eXcellence (TX: stable serum creatinine, normal biopsy results, indicative of immune quiescence), and not-TX (renal dysfunction and/or rejection on biopsy results). TruGraf v1 is intended for use in subjects with stable renal function to measure the immune status as an alternative to invasive, expensive, and risky surveillance biopsies. MATERIALS AND METHODS In this study, simultaneous blood tests and clinical assessments were performed in 192 patients from 7 transplant centers to evaluate TruGraf v1. The molecular testing laboratory was blinded to renal function and biopsy results. RESULTS Overall, TruGraf v1 accuracy (concordance between TruGraf v1 result and clinical and/or histologic assessment) was 74% (142/192), and a result of TX was accurate in 116 of 125 (93%). The negative predictive value for TruGraf v1 was 90%, with a sensitivity 74% and specificity of 73%. Results did not significantly differ in patients with a biopsy-confirmed diagnosis vs those without a biopsy. CONCLUSIONS TruGraf v1 can potentially support a clinical decision enabling unnecessary surveillance biopsies with high confidence, making it an invaluable addition to the transplant physician's tool kit for managing patients. TruGraf v1 testing can potentially avoid painful and risky invasive biopsies, reduce health care costs, and enable frequent assessment of patients with stable renal function to confirm the presence of immune quiescence in the peripheral blood.
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Affiliation(s)
- C L Marsh
- Scripps Center for Organ Transplantation, La Jolla, California, United States; Scripps Clinic Bio-Repository and Transplantation Research, La Jolla, California, United States.
| | - S M Kurian
- Scripps Clinic Bio-Repository and Transplantation Research, La Jolla, California, United States
| | - J C Rice
- Scripps Center for Organ Transplantation, La Jolla, California, United States
| | - T C Whisenant
- University of California, San Diego, School of Medicine, Center for Computational Biology and Bioinformatics, La Jolla, California, United States
| | - J David
- Transplant Genomics Inc, Mansfield, Massachusetts, United States
| | - S Rose
- Transplant Genomics Inc, Mansfield, Massachusetts, United States
| | - C Schieve
- Transplant Genomics Inc, Mansfield, Massachusetts, United States
| | - D Lee
- Transplant Genomics Inc, Mansfield, Massachusetts, United States
| | - J Case
- Scripps Clinic Bio-Repository and Transplantation Research, La Jolla, California, United States
| | - B Barrick
- Scripps Clinic Bio-Repository and Transplantation Research, La Jolla, California, United States
| | - V R Peddi
- California Pacific Medical Center, San Francisco, California, United States
| | - R B Mannon
- University of Alabama School of Medicine, Birmingham, Alabama, United States
| | - R Knight
- Houston Methodist Hospital, Houston, Texas, United States
| | - D Maluf
- University of Virginia, Charlottesville, Virginia, United States
| | - D Mandelbrot
- University of Wisconsin, Madison, Wisconsin, United States
| | - A Patel
- Henry Ford Hospital, Detroit, Michigan, United States
| | - J J Friedewald
- Comprehensive Transplant Center, Northwestern University, Chicago, Illionis, United States
| | - M M Abecassis
- Comprehensive Transplant Center, Northwestern University, Chicago, Illionis, United States
| | - M R First
- Transplant Genomics Inc, Mansfield, Massachusetts, United States; Comprehensive Transplant Center, Northwestern University, Chicago, Illionis, United States
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First MR, Peddi VR, Mannon R, Knight R, Marsh CL, Kurian SM, Rice JC, Maluf D, Mandelbrot D, Patel A, David J, Schieve C, Lee D, Lewis P, Friedewald JJ, Abecassis MM, Rose S. Investigator Assessment of the Utility of the TruGraf Molecular Diagnostic Test in Clinical Practice. Transplant Proc 2018; 51:729-733. [PMID: 30979457 DOI: 10.1016/j.transproceed.2018.10.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 09/14/2018] [Accepted: 10/30/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND TruGraf v1 is a well-validated DNA microarray-based test that analyzes blood gene expression profiles as an indicator of immune status in kidney transplant recipients with stable renal function. METHODS In this study, investigators assessed clinical utility of the TruGraf test in patient management. In a retrospective study, simultaneous blood tests and clinical assessments were performed in 192 patients at 7 transplant centers, and in a prospective observational study they were performed in 45 subjects at 5 transplant centers. RESULTS When queried regarding whether or not the TruGraf test result impacted their decision regarding patient management, in 168 of 192 (87.5%) cases the investigator responded affirmatively. The prospective study indicated that TruGraf results supported physicians' decisions on patient management 87% (39/45) of the time, and in 93% of cases physicians indicated that they would use serial TruGraf testing in future patient management. A total of 21 of 39 (54%) reported results confirmed their decision that no intervention was needed, and 17 of 39 (44%) reported that results specifically informed them that a decision not to perform a surveillance biopsy was correct. CONCLUSIONS TruGraf is the first and only noninvasive test to be evaluated for clinical utility in determining rejection status of patients with stable renal function and shows promise of providing support for clinical decisions to avoid unnecessary surveillance biopsies with a high degree of confidence. TruGraf is an invaluable addition to the transplant physician's tool kit for managing patient health by avoiding painful and invasive biopsies, reducing health care costs, and enabling frequent assessment of patients with stable renal function to confirm immune quiescence.
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Affiliation(s)
- M R First
- Transplant Genomics Inc, Mansfield, MA; Comprehensive Transplant Center, Northwestern University, Chicago, IL.
| | - V R Peddi
- California Pacific Medical Center, San Francisco, CA
| | - R Mannon
- University of Alabama at Birmingham, Birmingham, AL
| | - R Knight
- Houston Methodist Hospital, Houston, TX
| | - C L Marsh
- Scripps Center for Organ Transplantation, La Jolla, CA
| | - S M Kurian
- Scripps Center for Organ Transplantation, La Jolla, CA
| | - J C Rice
- Scripps Center for Organ Transplantation, La Jolla, CA
| | - D Maluf
- University of Virginia, Charlottesville, VA
| | | | - A Patel
- Henry Ford Hospital, Detroit, MI
| | - J David
- Transplant Genomics Inc, Mansfield, MA
| | - C Schieve
- Transplant Genomics Inc, Mansfield, MA
| | - D Lee
- Transplant Genomics Inc, Mansfield, MA
| | - P Lewis
- Transplant Genomics Inc, Mansfield, MA
| | - J J Friedewald
- Comprehensive Transplant Center, Northwestern University, Chicago, IL
| | - M M Abecassis
- Comprehensive Transplant Center, Northwestern University, Chicago, IL
| | - S Rose
- Transplant Genomics Inc, Mansfield, MA
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Dellero Y, Cagnac O, Rose S, Seddiki K, Cussac M, Morabito C, Lupette J, Aiese Cigliano R, Sanseverino W, Kuntz M, Jouhet J, Maréchal E, Rébeillé F, Amato A. Proposal of a new thraustochytrid genus Hondaea gen. nov. and comparison of its lipid dynamics with the closely related pseudo-cryptic genus Aurantiochytrium. ALGAL RES 2018. [DOI: 10.1016/j.algal.2018.08.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Dellero Y, Rose S, Metton C, Morabito C, Lupette J, Jouhet J, Maréchal E, Rébeillé F, Amato A. Ecophysiology and lipid dynamics of a eukaryotic mangrove decomposer. Environ Microbiol 2018; 20:3057-3068. [DOI: 10.1111/1462-2920.14346] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 06/27/2018] [Accepted: 06/28/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Younès Dellero
- Laboratoire de Physiologie Cellulaire et Végétale; Université Grenoble Alpes, CNRS, CEA, INRA; Grenoble Cedex 9 France
| | - Suzanne Rose
- Laboratoire de Physiologie Cellulaire et Végétale; Université Grenoble Alpes, CNRS, CEA, INRA; Grenoble Cedex 9 France
| | - Coralie Metton
- Laboratoire de Physiologie Cellulaire et Végétale; Université Grenoble Alpes, CNRS, CEA, INRA; Grenoble Cedex 9 France
| | - Christian Morabito
- Laboratoire de Physiologie Cellulaire et Végétale; Université Grenoble Alpes, CNRS, CEA, INRA; Grenoble Cedex 9 France
| | - Josselin Lupette
- Laboratoire de Physiologie Cellulaire et Végétale; Université Grenoble Alpes, CNRS, CEA, INRA; Grenoble Cedex 9 France
| | - Juliette Jouhet
- Laboratoire de Physiologie Cellulaire et Végétale; Université Grenoble Alpes, CNRS, CEA, INRA; Grenoble Cedex 9 France
| | - Eric Maréchal
- Laboratoire de Physiologie Cellulaire et Végétale; Université Grenoble Alpes, CNRS, CEA, INRA; Grenoble Cedex 9 France
| | - Fabrice Rébeillé
- Laboratoire de Physiologie Cellulaire et Végétale; Université Grenoble Alpes, CNRS, CEA, INRA; Grenoble Cedex 9 France
| | - Alberto Amato
- Laboratoire de Physiologie Cellulaire et Végétale; Université Grenoble Alpes, CNRS, CEA, INRA; Grenoble Cedex 9 France
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Gerull B, Rose S, Ritchie D, Martens K, Maxey C, Jagers J, Parboosingh J, Sheldon R. 5049Genetic association study suggests involvement of sex-specific serotonin signaling in vasovagal syncope. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B Gerull
- Comprehensive Heart Failure Center (CHFC), Internal Medicine, Wurzburg, Germany
| | - S Rose
- Libin Cardiovascular Institute of Alberta - University of Calgary, Calgary, Canada
| | - D Ritchie
- Libin Cardiovascular Institute of Alberta - University of Calgary, Calgary, Canada
| | - K Martens
- Libin Cardiovascular Institute of Alberta - University of Calgary, Calgary, Canada
| | - C Maxey
- Libin Cardiovascular Institute of Alberta - University of Calgary, Calgary, Canada
| | - J Jagers
- Libin Cardiovascular Institute of Alberta - University of Calgary, Calgary, Canada
| | | | - R Sheldon
- Libin Cardiovascular Institute of Alberta - University of Calgary, Calgary, Canada
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Bailey EG, Baek D, Meiling J, Morris C, Nelson N, Rice NS, Rose S, Stockdale P. Learning Gains from a Recurring "Teach and Question" Homework Assignment in a General Biology Course: Using Reciprocal Peer Tutoring Outside Class. CBE Life Sci Educ 2018; 17:ar23. [PMID: 29749838 PMCID: PMC5998311 DOI: 10.1187/cbe.17-12-0259] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 01/23/2018] [Accepted: 01/24/2018] [Indexed: 06/08/2023]
Abstract
Providing students with one-on-one interaction with instructors is a big challenge in large courses. One solution is to have students interact with their peers during class. Reciprocal peer tutoring (RPT) is a more involved interaction that requires peers to alternate the roles of "teacher" and "student." Theoretically, advantages for peer tutoring include the verbalization and questioning of information and the scaffolded exploration of material through social and cognitive interaction. Studies on RPT vary in their execution, but most require elaborate planning and take up valuable class time. We tested the effectiveness of a "teach and question" (TQ) assignment that required student pairs to engage in RPT regularly outside class. A quasi-experimental design was implemented: one section of a general biology course completed TQ assignments, while another section completed a substitute assignment requiring individuals to review course material. The TQ section outperformed the other section by ∼6% on exams. Session recordings were coded to investigate correlation between TQ quality and student performance. Asking more questions was the characteristic that best predicted exam performance, and this was more predictive than most aspects of the course. We propose the TQ as an easy assignment to implement with large performance gains.
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Affiliation(s)
- E. G. Bailey
- Department of Biology, Brigham Young University, Provo, UT 84602
| | - D. Baek
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, UT 84602
| | - J. Meiling
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, UT 84602
| | - C. Morris
- Department of Spanish and Portuguese, Brigham Young University, Provo, UT 84602
| | - N. Nelson
- Department of Biology, Brigham Young University, Provo, UT 84602
| | - N. S. Rice
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, UT 84602
| | - S. Rose
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, UT 84602
| | - P. Stockdale
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, UT 84602
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Kapoor B, Contreras F, Katz M, Arepally A, Fischman A, Rose S, Kim A, Ferraro J. 3:18 PM Abstract No. 133 Surefire Infusion System (SIS) hepatocellular carcinoma registry study interim results: a multicenter study of the safety, feasibility, and outcomes of the SIS expandable-tip microcatheter in DEB-TACE. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.151] [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: 10/17/2022] Open
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Robison D, Rajasekaran S, Berman N, Auerbach L, Henderson D, Rose S, Mazzurco L, Matson C. "It Feels Like Being a Real Doctor:" The Virtual Family Approach in Medical Education. MedEdPublish (2016) 2017; 6:187. [PMID: 38406477 PMCID: PMC10885308 DOI: 10.15694/mep.2017.000187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
This article was migrated. The article was marked as recommended. The majority of health outcomes are determined by social determinants of health (SDOH) while medical care is responsible for as little as 20% of health outcomes. This article is an introduction to the Virtual Family (VF) approach to case based instruction; a novel strategy for addressing SDOH in medical school. The VF theoretical framework is presented and practical considerations and challenges for implementation of the VF approach at three different medical schools are offered. VFs are defined as representations of families or social groups that are not real. "Virtual," in this instance, refers to people or things that do not physically exist. The VF approach allows students and educators to adjust the "lens" of a case's focus to view the relevant determinants. The VF approach is presented as an extension of the virtual patient approach. Theoretical support for the VF approach is argued drawing on principles from modeling and simulation, effective story design, establishing a sense of human presence, serious gaming, visual design, identity leveraging, and flow theory. Challenges and benefits of the approach are described. Measures of efficacy designed to match learning goals are proposed. The VF approach is presented as practical, accessible, economical, and potentially powerful.
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Sheldon R, Talajic M, Becker G, Essebag V, Sultan O, Ritchie D, Rose S, Morillo C, Krahn A, Brignole M, Maxey C. SYNCOPE: PACING VERSUS RECORDING IN THE LATER YEARS. A RANDOMIZED PRAGMATIC CLINICAL TRIAL OF STRATEGIES OF PERMANENT PACEMAKER VERSUS IMPLANTABLE CARDIAC MONITOR IN OLDER PATIENTS WITH SYNCOPE. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Kurian S, Velazquez E, Thompson R, Whisenant T, Rose S, Riley N, Harrison F, Gelbart T, Friedewald J, charrette J, Brietigam S, Peysakhovich J, First M, Abecassis M, Salomon D. Orthogonal Comparison of Molecular Signatures of Kidney Transplants With Subclinical and Clinical Acute Rejection: Equivalent Performance Is Agnostic to Both Technology and Platform. Am J Transplant 2017; 17:2103-2116. [PMID: 28188669 PMCID: PMC5519433 DOI: 10.1111/ajt.14224] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/06/2017] [Accepted: 01/20/2017] [Indexed: 01/25/2023]
Abstract
We performed orthogonal technology comparisons of concurrent peripheral blood and biopsy tissue samples from 69 kidney transplant recipients who underwent comprehensive algorithm-driven clinical phenotyping. The sample cohort included patients with normal protocol biopsies and stable transplant (sTx) function (n = 25), subclinical acute rejection (subAR, n = 23), and clinical acute rejection (cAR, n = 21). Comparisons between microarray and RNA sequencing (RNA-seq) signatures were performed and demonstrated a strong correlation between the blood and tissue compartments for both technology platforms. A number of shared differentially expressed genes and pathways between subAR and cAR in both platforms strongly suggest that these two clinical phenotypes form a continuum of alloimmune activation. SubAR is associated with fewer or less expressed genes than cAR in blood, whereas in biopsy tissues, this clinical phenotype demonstrates a more robust molecular signature for both platforms. The discovery work done in this study confirms a clear ability to detect gene expression profiles for sTx, subAR, and cAR in both blood and biopsy tissue, yielding equivalent predictive performance that is agnostic to both technology and platform. Our data also provide strong biological insights into the molecular mechanisms underlying these signatures, underscoring their logistical potential as molecular diagnostics to improve clinical outcomes following kidney transplantation.
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Affiliation(s)
- S.M. Kurian
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA
| | - E. Velazquez
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA
| | - R. Thompson
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA
| | - T. Whisenant
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA
| | - S. Rose
- Transplant Genomics Inc., Mansfield, MA
| | - N. Riley
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA
| | - F. Harrison
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA
| | - T. Gelbart
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA
| | - J.J. Friedewald
- Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - j. charrette
- Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - S. Brietigam
- Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - J. Peysakhovich
- Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - M.R. First
- Transplant Genomics Inc., Mansfield, MA,Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - M.M. Abecassis
- Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - D.R. Salomon
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA
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D’Ambrosio J, Faul A, Rose S, Reinhart J. THE THRIVE CENTER, AN INNOVATION HUB DESIGNED TO CARE FOR THE GLOBAL AGING POPULATION. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J.G. D’Ambrosio
- School of Medicine, University of Louisville, Louisville, Kentucky,
| | - A. Faul
- School of Medicine, University of Louisville, Louisville, Kentucky,
| | - S. Rose
- The Thrive Center, Louisville, Kentucky
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Rumble ME, Dickson D, Rose S, Nelson A, White K, Benca R, Costanzo E. 1011 INSOMNIA AND ACTIGRAPHIC REST-ACTIVITY INDICES PREDICT QUALITY OF LIFE FOLLOWING SURGERY FOR ENDOMETRIAL CANCER. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.1010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rose S, Hall E, Etienne V, Dieudonne F, Romela B, Tondereau M, Armony M, Baltzell K. Continuing Education and Job Satisfaction in a Rural Haitian
Hospital. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.301] [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: 10/19/2022] Open
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Jenewein T, Beckmann BM, Rose S, Osterhues HH, Schmidt U, Wolpert C, Miny P, Marschall C, Alders M, Bezzina CR, Wilde AAM, Kääb S, Kauferstein S. Genotype-phenotype dilemma in a case of sudden cardiac death with the E1053K mutation and a deletion in the SCN5A gene. Forensic Sci Int 2017; 275:187-194. [PMID: 28391114 DOI: 10.1016/j.forsciint.2017.02.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 10/26/2016] [Revised: 01/13/2017] [Accepted: 02/23/2017] [Indexed: 12/19/2022]
Abstract
Mutations in the cardiac sodium channel gene SCN5A may result in various arrhythmia syndromes such as long QT syndrome type 3 (LQTS), Brugada syndrome (BrS), sick sinus syndrome (SSS), cardiac conduction diseases (CCD) and possibly dilated cardiomyopathy (DCM). In most of these inherited cardiac arrhythmia syndromes the phenotypical expression may range from asymptomatic phenotypes to sudden cardiac death (SCD). A 16-year-old female died during sleep. Autopsy did not reveal any explanation for her death and a genetic analysis was performed. A variant in the SCN5A gene (E1053K) that was previously described as disease causing was detected. Family members are carriers of the same E1053K variant, some even in a homozygous state, but surprisingly did not exhibit any pathological cardiac phenotype. Due to the lack of genotype-phenotype correlation further genetic studies were performed. A novel deletion in the promoter region of SCN5A was identified in the sudden death victim but was absent in other family members. These findings demonstrate the difficulties in interpreting the results of a family-based genetic screening and underline the phenotypic variability of SCN5A mutations.
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Affiliation(s)
- T Jenewein
- Institute of Legal Medicine, University of Frankfurt, Frankfurt am Main, Germany
| | - B M Beckmann
- University Hospital Munich, Department of Medicine I, Ludwig Maximilians University, Munich, Germany; German Cardiovascular Research Center (DZHK), Partner Site: Munich Heart Alliance, Munich, Germany
| | - S Rose
- Institute of Legal Medicine, University of Frankfurt, Frankfurt am Main, Germany
| | - H H Osterhues
- District Hospital Loerrach, Medical Clinic, Loerrach, Germany
| | - U Schmidt
- Institute of Legal Medicine, University Hospital of Freiburg, Freiburg, Germany
| | - C Wolpert
- Klinik für Innere Medizin, Cardiology Klinikum Ludwigsburg, Ludwigsburg, Germany
| | - P Miny
- Medical Genetics, University Hospital Basel, Basel, Switzerland
| | - C Marschall
- Center of Human Genetics and Laboratory Diagnostics, Martinsried, Germany
| | - M Alders
- Department of Clinical Genetics, Amsterdam Medical Center, Amsterdam, The Netherlands
| | - C R Bezzina
- Heart Centre, Department of Clinical and Experimental Cardiology, Amsterdam Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - A A M Wilde
- Heart Centre, Department of Clinical and Experimental Cardiology, Amsterdam Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders, Jeddah, Kingdom of Saudi Arabia
| | - S Kääb
- University Hospital Munich, Department of Medicine I, Ludwig Maximilians University, Munich, Germany; German Cardiovascular Research Center (DZHK), Partner Site: Munich Heart Alliance, Munich, Germany
| | - S Kauferstein
- Institute of Legal Medicine, University of Frankfurt, Frankfurt am Main, Germany.
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Frye RE, Wynne R, Rose S, Slattery J, Delhey L, Tippett M, Kahler SG, Bennuri SC, Melnyk S, Sequeira JM, Quadros EV. Thyroid dysfunction in children with autism spectrum disorder is associated with folate receptor α autoimmune disorder. J Neuroendocrinol 2017; 29. [PMID: 28199771 DOI: 10.1111/jne.12461] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 02/07/2017] [Accepted: 02/09/2017] [Indexed: 12/11/2022]
Abstract
Folate receptor α (FRα) autoantibodies (FRAAs) are prevalent in autism spectrum disorder (ASD). FRAAs disrupt folate transport across the blood-brain barrier by binding to the FRα. Thyroid dysfunction is frequently found in children with ASD. We measured blocking and binding FRAAs and thyroid-stimulating hormone (TSH), free thyroxine (T4) (FT4), total triiodothyronine (T3) (TT3), reverse T3 (rT3), thyroid-releasing hormone (TRH) and other metabolites in 87 children with ASD, 84 of whom also underwent behaviour and cognition testing and in 42 of whom FRAAs, TSH and FT4 were measured at two time points. To better understand the significance of the FRα in relation to thyroid development, we examined FRα expression on prenatal and postnatal thyroid. TSH, TT3 and rT3 were above the normal range in 7%, 33% and 51% of the participants and TRH was below the normal range in 13% of the participants. FT4 was rarely outside the normal range. TSH concentration was positively and the FT4/TSH, TT3/TSH and rT3/TSH ratios were inversely related to blocking FRAA titres. On repeated measurements, changes in TSH and FT4/TSH ratio were found to correspond to changes in blocking FRAA titres. TSH and the FT4/TSH, TT3/TSH and rT3/TSH ratios were related to irritability on the Aberrant Behavior Checklist and several scales of the Social Responsiveness Scale (SRS), whereas TT3 was associated with SRS subscales and TRH was related to Vineland Adaptive Behavior Scale subscales. The thyroid showed significant FRα expression during the early prenatal period, although expression decreased significantly in later gestation and postnatal thyroid tissue. The results of the present study suggest that thyroid dysfunction in ASD may be related to blocking FRAA. The high expression of FRα in the early foetal thyroid suggests that foetal and neonatal exposure to maternal FRAAs could affect the development of the thyroid and may contribute to the pathology in ASD.
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Affiliation(s)
- R E Frye
- Department of Pediatrics, Arkansas Children's Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - R Wynne
- Department of Pediatrics, Arkansas Children's Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - S Rose
- Department of Pediatrics, Arkansas Children's Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - J Slattery
- Department of Pediatrics, Arkansas Children's Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - L Delhey
- Department of Pediatrics, Arkansas Children's Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - M Tippett
- Department of Pediatrics, Arkansas Children's Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - S G Kahler
- Department of Pediatrics, Arkansas Children's Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - S C Bennuri
- Department of Pediatrics, Arkansas Children's Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - S Melnyk
- Department of Pediatrics, Arkansas Children's Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - J M Sequeira
- Department of Medicine, State University of New York - Downstate Medical Center, Brooklyn, NY, USA
| | - E V Quadros
- Department of Medicine, State University of New York - Downstate Medical Center, Brooklyn, NY, USA
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Rose S, Halstead G, Newton I, Narsinh K. Proof of concept: pressure-directed embolization of hepatic arteries in a porcine model using a temporary occlusion balloon microcatheter. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Conti E, Mitra J, Calderoni S, Pannek K, Shen KK, Pagnozzi A, Rose S, Mazzotti S, Scelfo D, Tosetti M, Muratori F, Cioni G, Guzzetta A. Network over-connectivity differentiates autism spectrum disorder from other developmental disorders in toddlers: A diffusion MRI study. Hum Brain Mapp 2017; 38:2333-2344. [PMID: 28094463 DOI: 10.1002/hbm.23520] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 11/29/2016] [Accepted: 01/06/2017] [Indexed: 11/09/2022] Open
Abstract
Advanced connectivity studies in toddlers with Autism Spectrum Disorder (ASD) are increasing and consistently reporting a disruption of brain connectivity. However, most of these studies compare ASD and typically developing subjects, thus providing little information on the specificity of the abnormalities detected in comparison with other developmental disorders (other-DD). We recruited subjects aged below 36 months who received a clinical diagnosis of Neurodevelopmental Disorder (32 ASD and 16 other-DD including intellectual disability and language disorder) according to DSM-IV TR. Structural and diffusion MRI were acquired to perform whole brain probabilistic and anatomically constrained tractography. Network connectivity matrices were built encoding the number of streamlines (DNUM ) and the tract-averaged fractional anisotropy (DFA ) values connecting each pair of cortical and subcortical regions. Network Based Statistics (NBS) was finally applied on the connectivity matrices to evaluate the network differences between the ASD and other-DD groups. The network differences resulted in an over-connectivity pattern (i.e., higher DNUM and DFA values) in the ASD group with a significance of P < 0.05. No contra-comparison results were found. The over-connectivity pattern in ASD occurred in networks primarily involving the fronto-temporal nodes, known to be crucial for social-skill development and basal ganglia, related to restricted and repetitive behaviours in ASD. To our knowledge, this is the first network-based diffusion study comparing toddlers with ASD and those with other-DD. Results indicate the detection of different connectivity patterns in ASD and other-DD at an age when clinical differential diagnosis is often challenging. Hum Brain Mapp 38:2333-2344, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- E Conti
- Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy
| | - J Mitra
- The Australian eHealth Research Centre, CSIRO, Brisbane, Queensland, Australia
| | - S Calderoni
- Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy
| | - K Pannek
- The Australian eHealth Research Centre, CSIRO, Brisbane, Queensland, Australia
| | - K K Shen
- The Australian eHealth Research Centre, CSIRO, Brisbane, Queensland, Australia
| | - A Pagnozzi
- The Australian eHealth Research Centre, CSIRO, Brisbane, Queensland, Australia
| | - S Rose
- The Australian eHealth Research Centre, CSIRO, Brisbane, Queensland, Australia
| | - S Mazzotti
- Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy
| | - D Scelfo
- Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy
| | - M Tosetti
- Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy
| | - F Muratori
- Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - G Cioni
- Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - A Guzzetta
- Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Steel C, Hardy A, Smith B, Wykes T, Rose S, Enright S, Hardcastle M, Landau S, Baksh MF, Gottlieb JD, Rose D, Mueser KT. Cognitive-behaviour therapy for post-traumatic stress in schizophrenia. A randomized controlled trial. Psychol Med 2017; 47:43-51. [PMID: 27650432 DOI: 10.1017/s0033291716002117] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is limited evidence for effective interventions in the treatment of post-traumatic stress symptoms within individuals diagnosed with schizophrenia. Clinicians have concerns about using exposure treatments with this patient group. The current trial was designed to evaluate a 16-session cognitive restructuring programme, without direct exposure, for the treatment of post-traumatic stress symptoms specifically within individuals diagnosed with schizophrenia. METHOD A multicentre randomized controlled single-blinded trial with assessments at 0 months, 6 months (post-treatment) and 12 months (follow-up) was conducted. A total of 61 participants diagnosed with schizophrenia and exhibiting post-traumatic stress symptoms were recruited. Those randomized to treatment were offered up to 16 sessions of cognitive-behaviour therapy (CBT, including psychoeducation, breathing training and cognitive restructuring) over a 6-month period, with the control group offered routine clinical services. The main outcome was blind rating of post-traumatic stress symptoms using the Clinician Administered PTSD Scale for Schizophrenia. Secondary outcomes were psychotic symptoms as measured by the Positive and Negative Symptom Scale and the Psychotic Symptom Rating Scale. RESULTS Both the treatment and control groups experienced a significant decrease in post-traumatic stress symptoms over time but there was no effect of the addition of CBT on either the primary or secondary outcomes. CONCLUSIONS The current trial did not demonstrate any effect in favour of CBT. Cognitive restructuring programmes may require further adaptation to promote emotional processing of traumatic memories within people diagnosed with a psychotic disorder.
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Affiliation(s)
- C Steel
- School of Psychology and Clinical Language Sciences, University of Reading,Reading,UK
| | - A Hardy
- Department of Psychology,Institute of Psychiatry, Psychology & Neuroscience, King's College London,London,UK
| | - B Smith
- North East London NHS Foundation Trust,UK
| | - T Wykes
- Department of Psychology,Institute of Psychiatry, Psychology & Neuroscience, King's College London,London,UK
| | - S Rose
- Berkshire Healthcare NHS Foundation Trust,UK
| | - S Enright
- Berkshire Healthcare NHS Foundation Trust,UK
| | | | - S Landau
- Department of Biostatistics,Institute of Psychiatry, Psychology & Neuroscience, King's College London,London,UK
| | - M F Baksh
- Department of Mathematics and Statistics,University of Reading,Reading,UK
| | - J D Gottlieb
- Center for Psychiatric Rehabilitation, Boston University,Boston, MA,USA
| | - D Rose
- Health Services Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London,London,UK
| | - K T Mueser
- Department of Mathematics and Statistics,University of Reading,Reading,UK
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