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Perry S, Wu DJ, Abaied JL, Skinner-Dorkenoo AL, Sanchez S, Waters SF, Osnaya A. White parents' racial socialization during a guided discussion predicts declines in white children's pro-white biases. Dev Psychol 2024; 60:624-636. [PMID: 38386383 DOI: 10.1037/dev0001703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Although parent-child conversations about race are recommended to curb White U.S. children's racial biases, little work has tested their influence. We designed a guided racism discussion task for U.S. White parents and their 8-12-year-old White children. We explored whether children's and parents' (a) pro-White implicit biases changed pre to postconversation, (b) racial socialization messages (color conscious, external attributions for prejudiced behavior and colorblind racial ideology [CBRI]) predicted changes in each other's implicit biases, and (c) associations varied by the type of racism (subtle vs. blatant) discussed. Children's and parents' biases significantly declined, pre to postdiscussion. Parents' color conscious messages predicted greater declines and messages reflecting CBRI and external attributions predicted smaller declines in children's bias. These patterns were observed during discussions of subtle, but not blatant bias. Effects of children's messages on parents' bias were mixed. Our findings suggest that color conscious parent-child discussions may effectively reduce implicit pro-White bias in White children. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Sylvia Perry
- Department of Psychology, Institute for Policy Research, Northwestern University
| | - Deborah J Wu
- Department of Psychology, Northwestern University
| | - Jamie L Abaied
- Department of Psychological Science, University of Vermont
| | | | | | - Sara F Waters
- Department of Psychology, Washington State University
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2
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Lozano BA, Yankin I, Perry S, Rutter CR. Acid-base and electrolyte evaluation in dogs with upper GI obstruction: 115 dogs (2015-2021). J Small Anim Pract 2023; 64:696-703. [PMID: 37565533 DOI: 10.1111/jsap.13656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 06/10/2023] [Accepted: 06/29/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVES Metabolic alkalosis, although uncommon in small animals, has been previously associated with gastrointestinal obstructions. Depending on the population and disease process evaluated, previous prevalence of metabolic alkalosis is reported as ranging from 2% to 45% in canine patients. The objective of this study was to determine the prevalence of metabolic alkalosis and other acid-base and electrolyte disorders in a cohort of dogs with a confirmed upper gastrointestinal obstruction. MATERIALS AND METHODS Electronic medical records were reviewed to identify dogs who presented for vomiting with evidence of an upper gastrointestinal obstruction from January 2015 to October 2021. Patients were enrolled only if a preoperative venous blood gas was obtained and analysed in house. Traditional acid-base analysis was utilised to determine an acid-base status before relieving the obstruction. When available, post-operative venous acid-base status was determined within 24 hours after surgery, and compared to preoperative results. RESULTS A total of 115 dogs were included in the study. Twenty-five out of 115 (22%) dogs displayed either a simple metabolic alkalosis or a mixed acid-base disturbance before surgery. Twenty-seven out of 115 dogs (37%) had a normal acid-base status at entry. Seventy-one dogs had pre- and post-operative venous blood gas results available. Metabolic alkalosis was resolved in nearly all patients post-operatively, with no patients displaying a simple metabolic alkalosis. A mixed metabolic acidosis and respiratory alkalosis was the most common condition post-operatively, found in 25 of 71 (35%) dogs. Severe derangements of electrolytes were infrequent preoperatively (3/115; 2.6%). A majority of patients in this study exhibited hypokalaemia (64.4%), hypochloraemia (72.8%) and hyponatraemia (77.4%) on preoperative venous blood gases. Venous pH, Pv CO2 , bicarbonate and base excess were significantly higher preoperatively when compared to the post-operative results. CLINICAL SIGNIFICANCE This study found the prevalence of pre-operative metabolic alkalosis in dogs with a documented upper gastrointestinal obstruction to be lower than previously reported. Surgical or endoscopic alleviation of the upper gastrointestinal obstruction resulted in resolution of metabolic alkalosis in nearly all patients.
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Affiliation(s)
- B A Lozano
- Texas A&M University, Veterinary Medical Teaching Hospital, 408 Raymond Stotzer Pkwy, College Station, TX, 77845, USA
| | - I Yankin
- Texas A&M University, Veterinary Medical Teaching Hospital, 408 Raymond Stotzer Pkwy, College Station, TX, 77845, USA
| | - S Perry
- Texas A&M University, Veterinary Medical Teaching Hospital, 408 Raymond Stotzer Pkwy, College Station, TX, 77845, USA
| | - C R Rutter
- Texas A&M University, Veterinary Medical Teaching Hospital, 408 Raymond Stotzer Pkwy, College Station, TX, 77845, USA
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Lea J, Perry S, Mueller A. Assessing Advanced Practice Provider Well-Being in an Academic Medical Center. Nurs Clin North Am 2023; 58:257-270. [PMID: 37105659 DOI: 10.1016/j.cnur.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
In recent years, there has been a growing appreciation for the threat burnout has on clinician and patient safety, and in response, many stakeholders are advocating for solutions at the systems level. As a health-care organization, surveying clinicians is central to understanding burnout's prevalence and impact. This quality improvement project assessed well-being metrics among advanced practice providers (APPs) in a large academic medical center and found statistically significant relationships between burnout, professional fulfillment, and turnover. In collaboration with organizational leadership, the survey results were used in the development of system-wide initiatives to mitigate burnout and support professional fulfillment among APPs.
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Affiliation(s)
- Joshua Lea
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Bouvè College of Health Sciences, 360 Huntington Avenue, Northeastern University, Boston, MA 02115, USA.
| | - Sylvia Perry
- Avon Breast Center, Surgical Oncology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Ariel Mueller
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
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Turner NC, Swift C, Jenkins B, Kilburn L, Coakley M, Beaney M, Fox L, Goddard K, Garcia-Murillas I, Proszek P, Hall P, Harper-Wynne C, Hickish T, Kernaghan S, Macpherson IR, Okines AFC, Palmieri C, Perry S, Randle K, Snowdon C, Stobart H, Wardley AM, Wheatley D, Waters S, Winter MC, Hubank M, Allen SD, Bliss JM. Results of the c-TRAK TN trial: a clinical trial utilising ctDNA mutation tracking to detect molecular residual disease and trigger intervention in patients with moderate- and high-risk early-stage triple-negative breast cancer. Ann Oncol 2023; 34:200-211. [PMID: 36423745 DOI: 10.1016/j.annonc.2022.11.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Post-treatment detection of circulating tumour DNA (ctDNA) in early-stage triple-negative breast cancer (TNBC) patients predicts high risk of relapse. c-TRAK TN assessed the utility of prospective ctDNA surveillance in TNBC and the activity of pembrolizumab in patients with ctDNA detected [ctDNA positive (ctDNA+)]. PATIENTS AND METHODS c-TRAK TN, a multicentre phase II trial, with integrated prospective ctDNA surveillance by digital PCR, enrolled patients with early-stage TNBC and residual disease following neoadjuvant chemotherapy, or stage II/III with adjuvant chemotherapy. ctDNA surveillance comprised three-monthly blood sampling to 12 months (18 months if samples were missed due to coronavirus disease), and ctDNA+ patients were randomised 2 : 1 to intervention : observation. ctDNA results were blinded unless patients were allocated to intervention, when staging scans were done and those free of recurrence were offered pembrolizumab. A protocol amendment (16 September 2020) closed the observation group; all subsequent ctDNA+ patients were allocated to intervention. Co-primary endpoints were (i) ctDNA detection rate and (ii) sustained ctDNA clearance rate on pembrolizumab (NCT03145961). RESULTS Two hundred and eight patients registered between 30 January 2018 and 06 December 2019, 185 had tumour sequenced, 171 (92.4%) had trackable mutations, and 161 entered ctDNA surveillance. Rate of ctDNA detection by 12 months was 27.3% (44/161, 95% confidence interval 20.6% to 34.9%). Seven patients relapsed without prior ctDNA detection. Forty-five patients entered the therapeutic component (intervention n = 31; observation n = 14; one observation patient was re-allocated to intervention following protocol amendment). Of patients allocated to intervention, 72% (23/32) had metastases on staging at the time of ctDNA+, and 4 patients declined pembrolizumab. Of the five patients who commenced pembrolizumab, none achieved sustained ctDNA clearance. CONCLUSIONS c-TRAK TN is the first prospective study to assess whether ctDNA assays have clinical utility in guiding therapy in TNBC. Patients had a high rate of metastatic disease on ctDNA detection. Findings have implications for future trial design, emphasising the importance of commencing ctDNA testing early, with more sensitive and/or frequent ctDNA testing regimes.
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Affiliation(s)
- N C Turner
- Breast Cancer Now Research Centre, The Institute of Cancer Research, London, UK; Breast Unit, The Royal Marsden Hospital, London, UK.
| | - C Swift
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
| | - B Jenkins
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - L Kilburn
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - M Coakley
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
| | - M Beaney
- The Institute of Cancer Research, London, UK
| | - L Fox
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - K Goddard
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | | | - P Proszek
- NIHR Centre for Molecular Pathology, Royal Marsden Hospital, London, UK
| | - P Hall
- University of Edinburgh, Edinburgh, UK
| | - C Harper-Wynne
- Maidstone Hospital, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
| | - T Hickish
- University Hospitals Dorset NHS Foundation Trust, Bournemouth, UK
| | - S Kernaghan
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | | | - A F C Okines
- Breast Unit, The Royal Marsden Hospital, London, UK
| | - C Palmieri
- Clatterbridge Cancer Centre NHS Trust, Liverpool, Wirral, UK
| | - S Perry
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - K Randle
- Independent Cancer Patients' Voice, London, UK
| | - C Snowdon
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - H Stobart
- Independent Cancer Patients' Voice, London, UK
| | - A M Wardley
- Outreach Research & Innovation Group Ltd, Manchester, UK
| | - D Wheatley
- Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - S Waters
- Velindre Cancer Centre, Velindre University NHS Trust, Cardiff, UK
| | - M C Winter
- Sheffield Teaching Hospitals NHS Foundation Trust, Weston Park Hospital, Sheffield, UK
| | - M Hubank
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
| | - S D Allen
- The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
| | - J M Bliss
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
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Milsom WK, Kinkead R, Hedrick MS, Gilmour K, Perry S, Gargaglioni L, Wang T. Evolution of vertebrate respiratory central rhythm generators. Respir Physiol Neurobiol 2021; 295:103781. [PMID: 34481078 DOI: 10.1016/j.resp.2021.103781] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/03/2021] [Accepted: 08/29/2021] [Indexed: 12/01/2022]
Abstract
Tracing the evolution of the central rhythm generators associated with ventilation in vertebrates is hindered by a lack of information surrounding key transitions. To begin with, central rhythm generation has been studied in detail in only a few species from four vertebrate groups, lamprey, anuran amphibians, turtles, and mammals (primarily rodents). Secondly, there is a lack of information regarding the transition from water breathing fish to air breathing amniotes (reptiles, birds, and mammals). Specifically, the respiratory rhythm generators of fish appear to be single oscillators capable of generating both phases of the respiratory cycle (expansion and compression) and projecting to motoneurons in cranial nerves innervating bucco-pharyngeal muscles. In the amniotes we find oscillators capable of independently generating separate phases of the respiratory cycle (expiration and inspiration) and projecting to pre-motoneurons in the ventrolateral medulla that in turn project to spinal motoneurons innervating thoracic and abdominal muscles (reptiles, birds, and mammals). Studies of the one group of amphibians that lie at this transition (the anurans), raise intriguing possibilities but, for a variety of reasons that we explore, also raise unanswered questions. In this review we summarize what is known about the rhythm generating circuits associated with breathing that arise from the different rhombomeric segments in each of the different vertebrate classes. Assuming oscillating circuits form in every pair of rhombomeres in every vertebrate during development, we trace what appears to be the evolutionary fate of each and highlight the questions that remain to be answered to properly understand the evolutionary transitions in vertebrate central respiratory rhythm generation.
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Affiliation(s)
- W K Milsom
- Department of Zoology, University of British Columbia, Canada.
| | - R Kinkead
- Département de Pédiatrie, Université Laval, Canada
| | - M S Hedrick
- Department of Biological Sciences, California State University, Hayward, CA, USA
| | - K Gilmour
- Department of Biology, University of Ottawa, Canada
| | - S Perry
- Department of Biology, University of Ottawa, Canada
| | - L Gargaglioni
- Departamento de Morfologia e Fisiologia Animal, UNESP, Jaboticabal, Brazil
| | - T Wang
- Department of Zoophysiology, Aarhus University, Denmark
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Armstrong G, Portal C, Khot MI, West NP, Maisey T, Perry S, Tolan D, Jayne DG. O65: C-MET PROTEIN AS A COLORECTAL CANCER BIOMARKER FOR FLUORESCENCE IMAGE-GUIDED SURGERY. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.065] [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: 11/14/2022]
Abstract
Abstract
Introduction
The c-Met transmembrane protein is vital for cell differentiation and migration and is overexpressed in many gastrointestinal cancers. This study aimed to investigate a novel c-Met targeted peptide coupled to a fluorophore (EMI-137, Edinburgh Molecular Imaging Ltd.) for use in fluorescence image-guided colorectal cancer (CRC) surgery.
Method
A high c-Met expressing cell-line, HT29, was identified with temporary RNA suppression and used to develop a mouse xenograph CRC model. Tumours were allowed to grow to 10mm. EMI-137 was injected into the tail vein and biodistribution analysed using the IVIS system.
Nine patients undergoing elective surgery for colon cancer received a single IV dose EMI-137 1-3 hours before surgery. Tumour and LN fluorescence was assessed with a prototype Karl Storz laparoscope. Intraoperative fluorescence was correlated with radiological and pathological TNM stage and tissue c-Met expression using immunohistochemistry.
Result
The HT29 xenograph CRC model demonstrated selective EMI-137 uptake and fluorescence 1- 6 hours post administration. Nine participants aged 67-77 years received EMI-137 106 minutes (S.D±17) before surgery. Marked background fluorescence was observed in all patients. 4/9 (44%) patients showed mild increase in tumour fluorescence over background. 5/9 patients had histological LN disease, but no fluorescent nodes were detected intraoperatively. There was no correlation with T-stage. At histopathological assessment 8/9 participants showed moderate or high tumour c-Met expression. 8/8 malignant LNs demonstrated high c-Met expression.
Conclusion
EMI-137 is specific for human c-Met in 2D and xenograph CRC models. EMI-137 is safe for human use but its utility is limited by insufficient tumour-to-background ratios.
Take-home message
This first-in-man study of a novel fluorescent peptide targeted to the c-Met receptor, found EMI-137 lacked the sensitivity and specificity to accurately map the tumour margins and lymph node burden in laparoscopic colonic cancer resection surgery.
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Affiliation(s)
| | - C Portal
- Edinburgh Molecular Imaging Ltd, Edinburgh UK
| | - MI Khot
- University of Leeds, Leeds UK
| | - NP West
- University of Leeds, Leeds UK
- Leeds Teaching Hospital Trust
| | | | - S Perry
- University of Leeds, Leeds UK
| | - D Tolan
- Leeds Teaching Hospital Trust
| | - DG Jayne
- University of Leeds, Leeds UK
- Leeds Teaching Hospital Trust
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Clarke E, Levien AS, Bennett RA, Perry S, Daniel G. Clinical utility of liver biopsies in dogs undergoing splenectomy. J Small Anim Pract 2020; 61:684-688. [PMID: 33035380 DOI: 10.1111/jsap.13202] [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: 12/04/2019] [Revised: 05/25/2020] [Accepted: 06/22/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the prevalence of neoplasia detected on liver biopsy obtained at the time of splenectomy in dogs with splenic masses. MATERIALS AND METHODS Retrospective study of medical records of dogs with splenic masses from which liver biopsies were taken following splenectomy. RESULTS Malignant splenic neoplasia was detected in 50 of 113 (44.2%) of the dogs undergoing splenectomy. Neoplastic liver disease was detected on biopsy from 1 of 40 (2.5%) dogs with a grossly normal liver and from 20 of 69 (28.9%) dogs with a grossly abnormal liver. Dogs with a grossly abnormal liver had a ~ 16 times (95% CI: 2.5-170) higher chance of being diagnosed with liver neoplasia on biopsy. Haemoabdomen was also associated with an increased likelihood of liver neoplasia on biopsy at the time of splenectomy. CLINICAL SIGNIFICANCE A liver biopsy taken from grossly normal liver is a low-yield diagnostic test but liver biopsy is recommended following splenectomy if the liver appears abnormal at surgery.
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Affiliation(s)
- E Clarke
- Louisiana State University Veterinary Teaching Hospital, Skip Bertman Drive, Baton Rouge, LA, 70803, USA
| | - A S Levien
- The Animal Medical Center, 510 E 62nd St. New York, NY, 10065, USA.,Veterinary Specialists of Sydney, PO BOX 197, Padstow, NSW, 2211, Australia
| | - R A Bennett
- Louisiana State University Veterinary Teaching Hospital, Skip Bertman Drive, Baton Rouge, LA, 70803, USA.,The Animal Medical Center, 510 E 62nd St. New York, NY, 10065, USA
| | - S Perry
- Louisiana State University Veterinary Teaching Hospital, Skip Bertman Drive, Baton Rouge, LA, 70803, USA
| | - G Daniel
- The Animal Medical Center, 510 E 62nd St. New York, NY, 10065, USA.,Friendship Hospital for Animals, 4105 Brandywine St NW, Washington, DC, 20016, USA
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Abstract
Prior work has established that nonverbal signals that capitalize on existing cultural biases can shift attitudes toward members of familiar social groups (e.g., racial minority group members). This research is the first to examine whether nonverbal signals can influence adults’ attitudes toward unfamiliar individuals outside the context of existing cultural biases. In a series of studies, we examined whether seeing one individual receive more cold, unfriendly nonverbal signals than another individual would lead to biases in favor of the target of more positive nonverbal signals. Consistent with our preregistered hypotheses, exposure to nonverbal bias in favor of one individual over another led participants to develop nonverbal signal-consistent explicit biases. Moreover, a combined analysis of the data from all four samples indicated that participants also formed nonverbal signal-consistent implicit biases. Taken together, these findings suggest that nonverbal signals have the potential to create and spread attitudes toward others.
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Affiliation(s)
- Allison L. Skinner
- University of Washington, Seattle, USA
- Northwestern University, Evanston, IL, USA
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Nascimento MM, Alvarez AJ, Huang X, Hanway S, Perry S, Luce A, Richards VP, Burne RA. Arginine Metabolism in Supragingival Oral Biofilms as a Potential Predictor of Caries Risk. JDR Clin Trans Res 2019; 4:262-270. [PMID: 31039043 DOI: 10.1177/2380084419834234] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 11/15/2022] Open
Abstract
INTRODUCTION Ammonia production via the arginine deiminase system (ADS) of oral bacteria can function to reduce the cariogenicity of oral biofilms by neutralizing glycolytic acids that cause tooth demineralization. OBJECTIVES This cohort study investigated the relationship between ADS activity and bacterial profile changes of supragingival biofilms with caries experience among children over time. METHODS A total of 79 children aged 2 to 7 y at baseline were assessed every 6 mo for a period of 18 mo. Children were grouped as caries free (CF), caries active with enamel lesions (CAE), or caries active with dentin lesions (CA). Supragingival plaque samples were collected from caries-free surfaces (PF) and from enamel (PE) and dentin (PD) lesions. Plaque ADS activity was measured by monitoring citrulline production from arginine and compared with ribosomal 16S rRNA-derived taxonomic profiles for the same samples. RESULTS At baseline, 37% of the children were CF, 34% CAE, and 29% CA. At 18 mo, 26% were CF, 41% CAE, 23% CA, and 10% were caries experienced (new restorations but no caries activity). Throughout the study period, ADS activity was significantly higher in the CF group than the CA group (P < 0.0001), and ADS activity in the PF samples was significantly higher than in the PE and PD samples (P < 0.0001). Distance-based redundancy analysis showed that the bacterial communities could be differentiated when plaque samples are grouped into levels of high and low ADS activity. CONCLUSIONS There is a positive correlation between caries activity and low arginolytic capacity of the supragingival oral biofilms of children and tooth surfaces over time. Measurements of arginine metabolism via ADS may be useful to differentiate the caries risk of individuals and tooth surfaces. KNOWLEDGE TRANSFER STATEMENT Findings from this study support the development of new strategies for caries risk assessment and prevention based on modulation of the virulence of the oral microbiome through arginine metabolism in supragingival biofilms.
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Affiliation(s)
- M M Nascimento
- 1 Division of Operative Dentistry, Department of Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - A J Alvarez
- 2 Pediatric Dentistry Graduate Program, Department of Pediatric Dentistry, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - X Huang
- 3 Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL, USA
- 4 Current affiliation: Division of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - S Hanway
- 2 Pediatric Dentistry Graduate Program, Department of Pediatric Dentistry, College of Dentistry, University of Florida, Gainesville, FL, USA
- 5 Current affiliation: Pediatric dentist, private practice, Tallahassee, FL, USA
| | - S Perry
- 2 Pediatric Dentistry Graduate Program, Department of Pediatric Dentistry, College of Dentistry, University of Florida, Gainesville, FL, USA
- 6 Current affiliation: Pediatric dentist, private practice, St. Johns, FL, USA
| | - A Luce
- 2 Pediatric Dentistry Graduate Program, Department of Pediatric Dentistry, College of Dentistry, University of Florida, Gainesville, FL, USA
- 7 Current affiliation: Pediatric dentist, private practice, St. Petersburg, FL, USA
| | - V P Richards
- 8 Department of Biological Sciences, College of Sciences, Clemson University, Clemson, SC, USA
| | - R A Burne
- 3 Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL, USA
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Dowsett M, Jacobs S, Johnston S, Bliss J, Wheatley D, Holcombe C, Stein R, McIntosh S, Barry P, Dolling D, Snowdon C, Perry S, Batten L, Dodson A, Martins V, Modi A, Cornman C, Puhalla S, Wolmark N, Julian T, Pogue-Geile K, Robidoux A, Provencher L, Boileau JF, Shalaby I, Thirlwell M, Fisher K, Huang Bartlett C, Koehler M, Osborne K, Rimawi M. Abstract GS3-02: PALLET: A neoadjuvant study to compare the clinical and antiproliferative effects of letrozole with and without palbociclib. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-gs3-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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]
Abstract
Abstract
Background: CDK4/6 inhibitors, such as palbociclib, are used to treat ER+ metastatic breast cancer in combination with endocrine therapy with trials ongoing in patients with primary disease. No biomarkers exist to identify those who do/do not benefit from added CDK4/6 inhibition. PALLET is an investigator-initiated/led phase II randomized trial collaboration between UK and NSABP investigators evaluating the biological and clinical effects of palbociclib with letrozole combination as neoadjuvant therapy.
Methods: Postmenopausal women with ER+ primary breast cancer and tumors >2.0cm (ultrasound) were randomized to one of 4 treatment groups (3:2:2:2 ratio): Group A: letrozole (2.5mg/d) for 14 weeks; Group B: letrozole for 2 weeks followed by letrozole + palbociclib to 14 weeks; Group C: palbociclib for 2 weeks followed by letrozole + palbociclib to 14 weeks; Group D: letrozole + palbociclib for 14 weeks. Palbociclib was given 125mg/d PO on a 21 days on, 7 days off schedule. Post-14 week treatment was at the discretion of the treating clinician including letrozole until surgery. Core-cut biopsies were taken at baseline, 2 weeks and 14 weeks. Co-primary endpoints for letrozole alone vs palbociclib groups (Group A vs Groups B+C+D) were: (i) change in Ki67 (IHC) between baseline and 14 weeks (log-fold change, Mann-Whitney test); (ii) clinical response (ultrasound) after 14 weeks (4 group, ordinal, Mann-Whitney test). Complete cell-cycle arrest (CCCA) (Ki67≤2.7%) was analyzed using a logistic regression model adjusting for recruitment region. Pre-specified exploratory biomarkers included c-PARP (apoptosis).
Results: 307 patients were recruited between 27 Feb 2015 and 08 Mar 2018; 103 were randomized to letrozole alone and 204 to letrozole + palbociclib. 279 (90.9%) patients were evaluable for 14 week clinical response. Clinical response was not significantly different between letrozole vs letrozole + palbociclib groups [(p=0.20; CR+PR 49.5% (46/93) vs 54.3% (101/186) and PD 5.4% (5/93) vs 3.2% (6/186)] nor was the small proportion of patients with pathological CR (1/87, 1.1% vs 6/180, 3.3%; p=0.43). 190 (61.9%) patients were evaluable for 14 week change in Ki67. The median log-fold change in Ki67 was greater with letrozole + palbociclib vs letrozole alone (-4.1 vs -2.2; p<0.001) corresponding to a geometric mean change of -97.4% vs -88.5%. Similarly, a greater proportion of patients who received letrozole + palbociclib achieved CCCA (90% vs 59%, p<0.001). 146 (47.6%) patients were evaluable for c-PARP and the log-fold change (suppression) was greater with letrozole + palbociclib vs letrozole alone (-0.80 vs -0.42; p=0.003) corresponding to a geometric mean change of -56.8% vs -31.4%. Other biomarkers of response / resistance are being evaluated. A higher proportion of patients had a grade ≥3 toxicity on letrozole + palbociclib than letrozole alone (49.8% vs 17.0%; p<0.001) mainly due to asymptomatic neutropenia.
Conclusion: Adding palbociclib to letrozole markedly enhanced the suppression of malignant cell proliferation as assessed by Ki67 but did not substantially increase the clinical response of primary ER+ breast cancer over a 14-week period. Concurrent reductions in cell death may have reduced the speed of tumor shrinkage.
Citation Format: Dowsett M, Jacobs S, Johnston S, Bliss J, Wheatley D, Holcombe C, Stein R, McIntosh S, Barry P, Dolling D, Snowdon C, Perry S, Batten L, Dodson A, Martins V, Modi A, Cornman C, Puhalla S, Wolmark N, Julian T, Pogue-Geile K, Robidoux A, Provencher L, Boileau JF, Shalaby I, Thirlwell M, Fisher K, Huang Bartlett C, Koehler M, Osborne K, Rimawi M. PALLET: A neoadjuvant study to compare the clinical and antiproliferative effects of letrozole with and without palbociclib [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS3-02.
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Affiliation(s)
- M Dowsett
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - S Jacobs
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - S Johnston
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - J Bliss
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - D Wheatley
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - C Holcombe
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - R Stein
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - S McIntosh
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - P Barry
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - D Dolling
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - C Snowdon
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - S Perry
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - L Batten
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - A Dodson
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - V Martins
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - A Modi
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - C Cornman
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - S Puhalla
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - N Wolmark
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - T Julian
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - K Pogue-Geile
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - A Robidoux
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - L Provencher
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - JF Boileau
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - I Shalaby
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - M Thirlwell
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - K Fisher
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - C Huang Bartlett
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - M Koehler
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - K Osborne
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - M Rimawi
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
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Doshi RS, Gudzune KA, Dyrbye LN, Dovidio JF, Burke SE, White RO, Perry S, Yeazel M, van Ryn M, Phelan SM. Factors influencing medical student self-competence to provide weight management services. Clin Obes 2019; 9:e12288. [PMID: 30358159 PMCID: PMC6411289 DOI: 10.1111/cob.12288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Received: 07/30/2018] [Revised: 08/28/2018] [Accepted: 09/20/2018] [Indexed: 11/27/2022]
Abstract
This study aimed to identify factors associated with high obesity care self-competence among US medical students. The authors performed a cross-sectional analysis of 2014 survey data on fourth year medical students collected online as part of the Medical Student Cognitive Habits and Growth Evaluation Study (CHANGES). Independent variables included quality and quantity of interaction with patients and peers with obesity; hours of communication and partnership skills training; negative remarks against patients with obesity by supervising physicians, and witnessed discrimination against patients with obesity. The dependent variable was self-competence in providing obesity care. Of 5823 students invited to participate, 3689 (63%) responded and were included in our analyses. Most students were white (65%), half were women and 42% had high self-competence in caring for patients with obesity. Factors associated with high self-competence included increased interaction with peers with obesity (39% vs. 49%, P < 0.001) and increased partnership skills training (32% vs. 61%, P < 0.001). Increased partnership skills training and quantity of interactions with peers with obesity were associated with high student self-competence in providing obesity-related care to patients. Medical schools might consider increasing partnership skills training to improve students' preparedness and skill in performing obesity-related care.
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Affiliation(s)
- R S Doshi
- Duke University Medical Center, Department of Internal Medicine-Pediatrics, Duke University Hospital, Durham, North Carolina, USA
| | - K A Gudzune
- Department of General Internal Medicine, Johns Hopkins University School of Medicine and the Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - L N Dyrbye
- Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - J F Dovidio
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - S E Burke
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - R O White
- Division of Community Internal Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - S Perry
- Department of Psychology, Northwestern University, Evanston, Illinois, USA
| | - M Yeazel
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - M van Ryn
- Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - S M Phelan
- Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
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Castillo PR, MacIsaac C, Perry S, Veizer J. Marine Carbonates in the Mantle Source of Oceanic Basalts: Pb Isotopic Constraints. Sci Rep 2018; 8:14932. [PMID: 30297852 PMCID: PMC6175963 DOI: 10.1038/s41598-018-33178-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 09/24/2018] [Indexed: 11/08/2022] Open
Abstract
For almost fifty years, geochemists have been interpreting the clues from Pb isotopic ratios concerning mantle composition and evolution separately. The Pb isotopes of ocean island basalts (OIB) indicate that their mantle source is heterogeneous, most likely due to the presence of end-components derived from recycled crust and sediment. Some OIB have unusually high 206Pb/204Pb coming from one of the end-components with a long time-integrated high 238U/204Pb or μ (HIMU). Most OIB and many mid-ocean ridge basalts (MORB) also have high 206Pb/204Pb, indicating a HIMU-like source. Moreover, measured 232Th/238U (κ) for most MORB are lower than those deduced from their 208Pb/204Pb and 206Pb/204Pb. Such high μ and low κ features of oceanic basalts are inconsistent with the known geochemical behavior of U, Pb and Th and temporal evolution of the mantle; these have been respectively termed the 1st and 2nd Pb paradox. Here we show that subducted marine carbonates can be a source for HIMU and a solution to the Pb paradoxes. The results are consistent with the predictions of the marine carbonate recycling hypothesis that posits the Pb isotopes of oceanic basalts indicate a common origin and/or magma generation process.
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Affiliation(s)
- P R Castillo
- Scripps Institution of Oceanography, UCSD, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
| | - C MacIsaac
- Scripps Institution of Oceanography, UCSD, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - S Perry
- Scripps Institution of Oceanography, UCSD, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - J Veizer
- Department of Earth and Environmental Sciences, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
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Henry L, Perry S. Nutritional outcomes in dementia and non-dementia patients. Clin Nutr ESPEN 2017. [DOI: 10.1016/j.clnesp.2017.07.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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14
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Perry S, Burrow MF, Leung WK, Bridges SM. Simulation and curriculum design: a global survey in dental education. Aust Dent J 2017; 62:453-463. [DOI: 10.1111/adj.12522] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2017] [Indexed: 11/28/2022]
Affiliation(s)
- S Perry
- Faculty of Education; The University of Hong Kong; Hong Kong China
| | - MF Burrow
- Melbourne Dental School; The University of Melbourne; Melbourne Victoria Australia
| | - WK Leung
- Faculty of Dentistry; University of Hong Kong; Hong Kong China
| | - SM Bridges
- Faculty of Education/ Centre for the Enhancement of Teaching and Learning; The University of Hong Kong; Hong Kong China
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Banerjee S, Kilburn L, Bowen R, Tovey H, Hall M, Kaye S, Rustin G, Gore M, McLachlan J, Attygalle A, Tunariu N, Lima J, Chatfield P, Jeffs L, Folkerd E, Hills M, Perry S, Attard G, Dowsett M, Bliss J. Principal results of the cancer of the ovary abiraterone trial (CORAL): A phase II study of abiraterone in patients with recurrent epithelial ovarian cancer (CRUKE/12/052). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw435.27] [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: 11/14/2022] Open
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16
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Hardeman RR, Przedworski JM, Burke S, Burgess DJ, Perry S, Phelan S, Dovidio JF, van Ryn M. Association Between Perceived Medical School Diversity Climate and Change in Depressive Symptoms Among Medical Students: A Report from the Medical Student CHANGE Study. J Natl Med Assoc 2016; 108:225-235. [PMID: 27979008 PMCID: PMC5171227 DOI: 10.1016/j.jnma.2016.08.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 08/08/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE To determine whether perceptions of the medical school diversity climate are associated with depression symptoms among medical students. METHODS Longitudinal web-based survey conducted in the fall of 2010 and spring of 2014 administered to a national sample of medical students enrolled in 49 schools across the U.S. (n = 3756). Negative diversity climate measured by perceptions of the institution's racial climate; exposure to negative role modeling by medical educators; frequency of witnessing discrimination in medical school. Depression symptoms measured by the PROMIS Emotional Distress-Depression Short-Form. RESULTS 64% of students reported a negative racial climate; 81% reported witnessing discrimination toward other students at least once, and 94% reported witnessing negative role modeling. Negative racial climate, witnessed discrimination, and negative role modeling were independently and significantly associated with an increase in depression symptoms between baseline and follow-up. Adjusting for students' personal experiences of mistreatment, associations between depressive symptoms and negative racial climate and negative role modeling, remained significant (.72 [.51-.93]; .33 [.12-.54], respectively). CONCLUSIONS Among medical students, greater exposure to a negative medical school diversity climate was associated with an increase in self-reported depressive symptoms.
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Affiliation(s)
- Rachel R Hardeman
- Division of Health Policy and Management, University of Minnesota, 420 Delaware St SE, Minneapolis, MN 55455, USA.
| | - Julia M Przedworski
- University of Minnesota, School of Public Health, Division of Health Policy and Management, Minneapolis, MN, USA
| | - Sara Burke
- Yale University, Department of Psychology, New Haven, CT, USA
| | - Diana J Burgess
- Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USA; University of Minnesota Medical School, Department of Medicine, Minneapolis, MN, USA
| | - Sylvia Perry
- Northwestern University, Department of Psychology, Evanston, IL 60208, USA
| | - Sean Phelan
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA
| | - John F Dovidio
- Yale University, Department of Psychology, New Haven, CT, USA
| | - Michelle van Ryn
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA
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Perl G, Nordheimer S, Lando S, Benedict C, Brenner B, Perry S, Shmoisman G, Purim O, Amit L, Stemmer SM, Ben-Aharon I. Young patients and gastrointestinal (GI) tract malignancies - are we addressing the unmet needs? BMC Cancer 2016; 16:630. [PMID: 27519697 PMCID: PMC4983017 DOI: 10.1186/s12885-016-2676-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 08/04/2016] [Indexed: 01/11/2023] Open
Abstract
Background Recent epidemiological studies indicate the rate of gastrointestinal (GI) malignancies among younger patients is increasing, mainly due to colorectal cancer. There is a paucity of data regarding the magnitude of treatment-related symptoms, psychosocial issues and potential unmet needs in this population. We aimed to characterize the needs of this population to evaluate whether unmet needs could be targeted by potential intervention. Methods Female and male patients diagnosed with cancer of the gastrointestinal tract <40y retrospectively completed a questionnaire to evaluate symptoms, daily function and unmet needs at pre-treatment, during and post-treatment. Comparisons were made by gender, disease stage and treatment modality. Multiple linear regression models evaluated effects of demographics, symptoms and needs on multiple domains of health-related-quality-of-life (using Short-Form Health Survey-12 and CARES). Results Fifty patients were enrolled (52 % female) to a pilot study. Median age at diagnosis was 35.5y (range, 21-40y). The symptoms that significantly increased from baseline to during and post-treatment were: diarrhea (37 %), sleeping disorder (32 %) and sexual dysfunction (40 %). Patients also reported significant deterioration in occupational activities and coping with children compared with baseline. Female patients reported significant unmet need for nutritional counseling and psychosocial support compared to male patients (p < 0.05). Patients treated with multimodality-treatment presented higher rates of unmet needs (p = 0.03). Conclusions Young patients with GI cancers represent a group with unique characteristics and needs compared with published evidence on other young-onset malignancies. The distinctive symptoms and areas of treatment-related functional impairments indicate there are unmet needs, especially in the area of psychosocial support and nutritional counseling.
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Affiliation(s)
- G Perl
- Institute of Oncology, Davidoff Center, Rabin Medical Center, Kaplan St, Petah-Tiqva, 49100, Israel
| | - S Nordheimer
- Institute of Oncology, Davidoff Center, Rabin Medical Center, Kaplan St, Petah-Tiqva, 49100, Israel
| | - S Lando
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - C Benedict
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - B Brenner
- Institute of Oncology, Davidoff Center, Rabin Medical Center, Kaplan St, Petah-Tiqva, 49100, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - S Perry
- Institute of Oncology, Davidoff Center, Rabin Medical Center, Kaplan St, Petah-Tiqva, 49100, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - G Shmoisman
- Institute of Oncology, Davidoff Center, Rabin Medical Center, Kaplan St, Petah-Tiqva, 49100, Israel
| | - O Purim
- Institute of Oncology, Davidoff Center, Rabin Medical Center, Kaplan St, Petah-Tiqva, 49100, Israel
| | - L Amit
- Institute of Oncology, Davidoff Center, Rabin Medical Center, Kaplan St, Petah-Tiqva, 49100, Israel
| | - S M Stemmer
- Institute of Oncology, Davidoff Center, Rabin Medical Center, Kaplan St, Petah-Tiqva, 49100, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - I Ben-Aharon
- Institute of Oncology, Davidoff Center, Rabin Medical Center, Kaplan St, Petah-Tiqva, 49100, Israel. .,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
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van Ryn M, Hardeman R, Phelan SM, Burgess DJ, Dovidio JF, Herrin J, Burke SE, Nelson DB, Perry S, Yeazel M, Przedworski JM. Medical School Experiences Associated with Change in Implicit Racial Bias Among 3547 Students: A Medical Student CHANGES Study Report. J Gen Intern Med 2015; 30:1748-56. [PMID: 26129779 PMCID: PMC4636581 DOI: 10.1007/s11606-015-3447-7] [Citation(s) in RCA: 182] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 05/18/2015] [Accepted: 06/02/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Physician implicit (unconscious, automatic) bias has been shown to contribute to racial disparities in medical care. The impact of medical education on implicit racial bias is unknown. OBJECTIVE To examine the association between change in student implicit racial bias towards African Americans and student reports on their experiences with 1) formal curricula related to disparities in health and health care, cultural competence, and/or minority health; 2) informal curricula including racial climate and role model behavior; and 3) the amount and favorability of interracial contact during school. DESIGN Prospective observational study involving Web-based questionnaires administered during first (2010) and last (2014) semesters of medical school. PARTICIPANTS A total of 3547 students from a stratified random sample of 49 U.S. medical schools. MAIN OUTCOME(S) AND MEASURE(S) Change in implicit racial attitudes as assessed by the Black-White Implicit Association Test administered during the first semester and again during the last semester of medical school. KEY RESULTS In multivariable modeling, having completed the Black-White Implicit Association Test during medical school remained a statistically significant predictor of decreased implicit racial bias (-5.34, p ≤ 0.001: mixed effects regression with random intercept across schools). Students' self-assessed skills regarding providing care to African American patients had a borderline association with decreased implicit racial bias (-2.18, p = 0.056). Having heard negative comments from attending physicians or residents about African American patients (3.17, p = 0.026) and having had unfavorable vs. very favorable contact with African American physicians (18.79, p = 0.003) were statistically significant predictors of increased implicit racial bias. CONCLUSIONS Medical school experiences in all three domains were independently associated with change in student implicit racial attitudes. These findings are notable given that even small differences in implicit racial attitudes have been shown to affect behavior and that implicit attitudes are developed over a long period of repeated exposure and are difficult to change.
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Affiliation(s)
| | | | | | - Diana J Burgess
- University of Minnesota, Minneapolis, MN, USA.,Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USA
| | | | | | | | - David B Nelson
- Mayo Clinic College of Medicine, Rochester, MN, USA.,Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USA
| | | | - Mark Yeazel
- University of Minnesota, Minneapolis, MN, USA
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Phelan SM, Puhl RM, Burke SE, Hardeman R, Dovidio JF, Nelson DB, Przedworski J, Burgess DJ, Perry S, Yeazel MW, van Ryn M. The mixed impact of medical school on medical students' implicit and explicit weight bias. Med Educ 2015; 49:983-92. [PMID: 26383070 PMCID: PMC4755318 DOI: 10.1111/medu.12770] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 03/13/2015] [Accepted: 04/21/2015] [Indexed: 05/07/2023]
Abstract
CONTEXT Health care trainees demonstrate implicit (automatic, unconscious) and explicit (conscious) bias against people from stigmatised and marginalised social groups, which can negatively influence communication and decision making. Medical schools are well positioned to intervene and reduce bias in new physicians. OBJECTIVES This study was designed to assess medical school factors that influence change in implicit and explicit bias against individuals from one stigmatised group: people with obesity. METHODS This was a prospective cohort study of medical students enrolled at 49 US medical schools randomly selected from all US medical schools within the strata of public and private schools and region. Participants were 1795 medical students surveyed at the beginning of their first year and end of their fourth year. Web-based surveys included measures of weight bias, and medical school experiences and climate. Bias change was compared with changes in bias in the general public over the same period. Linear mixed models were used to assess the impact of curriculum, contact with people with obesity, and faculty role modelling on weight bias change. RESULTS Increased implicit and explicit biases were associated with less positive contact with patients with obesity and more exposure to faculty role modelling of discriminatory behaviour or negative comments about patients with obesity. Increased implicit bias was associated with training in how to deal with difficult patients. On average, implicit weight bias decreased and explicit bias increased during medical school, over a period of time in which implicit weight bias in the general public increased and explicit bias remained stable. CONCLUSIONS Medical schools may reduce students' weight biases by increasing positive contact between students and patients with obesity, eliminating unprofessional role modelling by faculty members and residents, and altering curricula focused on treating difficult patients.
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Affiliation(s)
- Sean M Phelan
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Rebecca M Puhl
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, Connecticut, USA
| | - Sara E Burke
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Rachel Hardeman
- Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA
| | - John F Dovidio
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - David B Nelson
- Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Julia Przedworski
- Division of Health Policy and Management, University of Minnesota, Minneapolis, Minnesota, USA
| | - Diana J Burgess
- Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sylvia Perry
- Department of Psychological Science, University of Vermont, Burlington, Vermont, USA
| | - Mark W Yeazel
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Michelle van Ryn
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota, USA
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20
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Phelan SM, Burgess DJ, Puhl R, Dyrbye LN, Dovidio JF, Yeazel M, Ridgeway JL, Nelson D, Perry S, Przedworski JM, Burke SE, Hardeman RR, van Ryn M. The Adverse Effect of Weight Stigma on the Well-Being of Medical Students with Overweight or Obesity: Findings from a National Survey. J Gen Intern Med 2015; 30:1251-8. [PMID: 26173517 PMCID: PMC4539327 DOI: 10.1007/s11606-015-3266-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The stigma of obesity is a common and overt social bias. Negative attitudes and derogatory humor about overweight/obese individuals are commonplace among health care providers and medical students. As such, medical school may be particularly threatening for students who are overweight or obese. OBJECTIVE The purpose of our study was to assess the frequency that obese/overweight students report being stigmatized, the degree to which stigma is internalized, and the impact of these factors on their well-being. DESIGN We performed cross-sectional analysis of data from the Medical Student Cognitive Habits and Growth Evaluation Study (CHANGES) survey. PARTICIPANTS A total of 4,687 first-year medical students (1,146 overweight/obese) from a stratified random sample of 49 medical schools participated in the study. MAIN MEASURES Implicit and explicit self-stigma were measured with the Implicit Association Test and Anti-Fat Attitudes Questionnaire. Overall health, anxiety, depression, fatigue, self-esteem, sense of mastery, social support, loneliness, and use of alcohol/drugs to cope with stress were measured using previously validated scales. KEY RESULTS Among obese and overweight students, perceived stigma was associated with each measured component of well-being, including anxiety (beta coefficient [b] = 0.18; standard error [SE] = 0.03; p < 0.001) and depression (b = 0.20; SE = 0.03; p < 0.001). Among the subscales of the explicit self-stigma measure, dislike of obese people was associated with several factors, including depression (b = 0.07; SE = .01; p < 0.001), a lower sense of mastery (b = -0.10; SE = 0.02; p < 0.001), and greater likelihood of using drugs or alcohol to cope with stress (b = .05; SE = 0.01; p < 0.001). Fear of becoming fat was associated with each measured component of well-being, including lower body esteem (b = -0.25; SE = 0.01; p < 0.001) and less social support (b = -0.06; SE = 0.01; p < 0.001). Implicit self-stigma was not consistently associated with well-being factors. Compared to normal-weight/underweight peers, overweight/obese medical students had worse overall health (b = -0.33; SE = 0.03; p < 0.001) and body esteem (b = -0.70; SE = 0.02; p < 0.001), and overweight/obese female students reported less social support (b = -0.12; SE = 0.03; p < 0.001) and more loneliness (b = 0.22; SE = 0.04; p < 0.001). CONCLUSIONS Perceived and internalized weight stigma may contribute to worse well-being among overweight/obese medical students.
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Affiliation(s)
- Sean M Phelan
- College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA,
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Romney W, Salbach N, Perry S, Deutsch J. Evidence based practice confidence upon entry to physical therapy school is related to previous research-related experience. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Phelan SM, Dovidio JF, Puhl RM, Burgess DJ, Nelson DB, Yeazel MW, Hardeman R, Perry S, van Ryn M. Implicit and explicit weight bias in a national sample of 4,732 medical students: the medical student CHANGES study. Obesity (Silver Spring) 2014; 22:1201-8. [PMID: 24375989 PMCID: PMC3968216 DOI: 10.1002/oby.20687] [Citation(s) in RCA: 148] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 12/14/2013] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine the magnitude of explicit and implicit weight biases compared to biases against other groups; and identify student factors predicting bias in a large national sample of medical students. METHODS A web-based survey was completed by 4,732 1st year medical students from 49 medical schools as part of a longitudinal study of medical education. The survey included a validated measure of implicit weight bias, the implicit association test, and 2 measures of explicit bias: a feeling thermometer and the anti-fat attitudes test. RESULTS A majority of students exhibited implicit (74%) and explicit (67%) weight bias. Implicit weight bias scores were comparable to reported bias against racial minorities. Explicit attitudes were more negative toward obese people than toward racial minorities, gays, lesbians, and poor people. In multivariate regression models, implicit and explicit weight bias was predicted by lower BMI, male sex, and non-Black race. Either implicit or explicit bias was also predicted by age, SES, country of birth, and specialty choice. CONCLUSIONS Implicit and explicit weight bias is common among 1st year medical students, and varies across student factors. Future research should assess implications of biases and test interventions to reduce their impact.
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Affiliation(s)
- Sean M Phelan
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota, USA
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Nascimento MM, Liu Y, Kalra R, Perry S, Adewumi A, Xu X, Primosch RE, Burne RA. Oral arginine metabolism may decrease the risk for dental caries in children. J Dent Res 2013; 92:604-8. [PMID: 23640952 DOI: 10.1177/0022034513487907] [Citation(s) in RCA: 56] [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] [Indexed: 11/15/2022] Open
Abstract
Arginine metabolism by oral bacteria via the arginine deiminase system (ADS) increases the local pH, which can neutralize the effects of acidification from sugar metabolism and reduce the cariogenicity of oral biofilms. To explore the relationship between oral arginine metabolism and dental caries experience in children, we measured ADS activity in oral samples from 100 children and correlated it with their caries status and type of dentition. Supragingival dental plaque was collected from tooth surfaces that were caries-lesion-free (PF) and from dentinal (PD) and enamel (PE) caries lesions. Regardless of children's caries status or type of dentition, PF (378.6) had significantly higher ADS activity compared with PD (208.4; p < .001) and PE (194.8; p = .005). There was no significant difference in the salivary arginolytic activity among children with different caries status. Mixed-model analysis showed that plaque caries status is significantly associated with ADS activity despite children's age, caries status, and dentition (p < .001), with healthy plaque predicting higher ADS activity compared with diseased plaque. Plaque arginine metabolism varies greatly among children and tooth sites, which may affect their susceptibility to caries.
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Affiliation(s)
- M M Nascimento
- Department of Restorative Dental Sciences, Division of Operative Dentistry, University of Florida, Gainesville, FL, USA.
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de Mey C, Sechaud R, Sudershan M, Perry S, Hara H, Drollmann A, Karan R, Di Scala L, Biswal S, Pattersson B, Kasie G. Effiziente Deposition und anhaltende Lungenkonzentration nach Inhalation von NVA237 via Breezhaler® beim Menschen. Pneumologie 2013. [DOI: 10.1055/s-0033-1334763] [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: 10/27/2022]
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Le Blackadder-Coward JCQ, Perry S. Chronic fatigue syndrome in the UK armed forces. J R Nav Med Serv 2013; 99:121-126. [PMID: 24511794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Chronic Fatigue Syndrome (CFS) is a debilitating condition that can have a significant impact on the lives of patients and those who care for them. In the UK Armed Forces this condition can also have a marked impact on a patient's career and their ability to function in the deployed environment. In this article the recognition and management of CFS will be discussed, as well as the occupational considerations within the UK Armed Forces.
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Affiliation(s)
| | - S Perry
- Department of Community Mental Health, Sunny Walk PP6, HMNB Portsmouth. PO1 3LT
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Jovanovic I, Giga V, Tesic M, Paunovic I, Kostic J, Dobric M, Dikic M, Stepanovic J, Belesiln B, Djordjevic-Dikic A, Lindqvist P, Henein M, Soderberg S, Gonzalez M, Tossavainen E, Djordjevic-Dikic A, Tesic M, Stepanovic J, Giga V, Kostic J, Trifunovic D, Jovanovic I, Paunovic I, Stanic S, Beleslin B, Koutsogiannis N, Moulias A, Xanthopoulou I, Mavronasiou E, Kakkavas A, Davlouros P, Alexopoulos D, Barbier P, Cefalu' C, Gripari P, Pontone G, Andreini D, Pepi M, Duncan AM, Snow T, Barker S, Davies S, Di Mario C, Moat N, Serra W, Chetta A, Marangio E, Reverberi C, Cattabiani MA, Ardissino D, Sahlen A, Hakansson F, Shahgaldi K, Manouras A, Norman M, Winter R, Johnson J, Fawzi S, Rafla SM, El Atroush H, Farouk K, Wilson C, Hilde J, Skjoerten I, Melsom M, Humerfelt S, Hansteen V, Hisdal J, Steine K, Rees P, Hutchings S, Magnino C, Omede' P, Avenatti E, Chiarlo M, Presutti D, Bucca C, Moretti C, Gaita F, Veglio F, Milan A, Kostic J, Tesic M, Stepanovic J, Giga V, Paunovic I, Marinkovic A, Jovanovic I, Beleslin B, Ostojic M, Djordjevic Dikic A, Najjar E, Winter R, Gunyeli E, Shahgaldi K, Manouras A, Rodriguez Munoz DA, Moya Mur J, Baguda JDJ, Lazaro Rivera C, Navas Tejedor P, Jimenez Nacher J, Castillo Orive M, Fernandez-Golfin C, Zamorano Gomez J, Satendra M, Sargento L, Sousa C, Lousada N, Palma Reis R, Said K, Shehata A, Ashour Z, El-Tobgi S, Li Kam Wa M, Pabari P, Perry S, Kyriacou A, Manisty C, Francis D, Kusmierczyk-Droszcz B, Kowalik E, Niewiadomska J, Lech A, Hoffman P, Patrianakos A, Kalogerakis A, Zacharaki A, Nyktari E, Psathakis E, Parthenakis F, Vardas P, Stefani L, Milicia M, Bartolini A, Gori N, Tempesti G, Toncelli L, Vono M, Di Tante V, Pedri S, Galanti G, Zhong L, Huang F, Le T, Chen Q, Gao F, Tan R, Anwar A, Nosir Y, Alasnig M, Llemit M, Alhagoly A, Chamsi-Pasha H, Trifunovic D, Ostojic M, Stankovic S, Vujisic-Tesic B, Petrovic M, Nedeljkovic I, Beleslin B, Djordjevic-Dikic A, Banovic M, Tesic M, Orii M, Hirata K, Tanimoto T, Ishibashi K, Yamano T, Ino Y, Yamaguchi T, Kubo T, Imanishi T, Akasaka T, Giesecke A, Ripsweden J, Shahgaldi K, Guyeli E, Winter R, Hristova K, Vasilev D, Pavlov P, Katova T, Simova I, Kostova V, Wada T, Hirata KH, Kubo T, Shiono Y, Ishibashi K, Tanimoto T, Ino Y, Yamaguchi T, Imanishi TI, Akasaka T, Martirosyan M, Adamyan K, Chilingaryan A, Negrea S, Alexandrescu C, Civaia F, Bourlon F, Dreyfus G, Malev E, Kim G, Omelchenko M, Mitrofanova L, Zemtsovsky E, Santoro A, Costantino F, Dores E, Tarsia G, Di Natale M, Innelli P, Schiano Lomoriello V, De Stefano F, Galderisi M, Lee SP, Ahn H, Hwang H, Kim H, Kim Y, Kim K, Kim K, Sohn D, Ahn H, Calin A, Popescu B, Rosca M, Beladan C, Enache R, Gurzun M, Calinescu C, Calin C, Ginghina C, Rafla S, Hamdy S, Lotfi M, Elneklawy M, Mordi I, Spratt J, Sonecki P, Stanton T, Mcculloch A, Goodfield N, Tzemos N, Ghulam Ali S, Fusini L, Tamborini G, Celeste F, Gripari P, Muratori M, Maffessanti F, Mirea O, Alamanni F, Pepi M, Demirkan B, Guray Y, Guray U, Ege M, Kisacik H, Sasmaz H, Korkmaz S, Petrovic-Nagorni S, Zdravkovic-Ciric S, Nagorni A, Stanojevic D, Jankovic-Tomasevic R, Atanaskovic V, Mitic V, Szymanski C, Magne J, Rusinaru D, Fournier A, Mezghani S, Peltier M, Touati G, Tribouilloy C, Huttin O, Khachab H, Voilliot D, Schwartz J, Zinzius P, Lemoine S, Carillo S, Popovic B, Juilliere Y, Selton-Suty C, Kimura K, Takenaka K, Ebihara A, Uno K, Morita H, Nakajima T, Motoyoshi Y, Komori T, Yatomi Y, Nagai R, Mihaila S, Mincu R, Rimbas R, Badiu C, Vinereanu D, Igual Munoz B, Maceira Gonzalez A, Domingo Valero D, Estornell Erill J, Giner Blasco J, Arnau Vives M, Molina Aguilar P, Navarro Manchon J, Zorio Grima E, Miglioranza M, Sant'anna R, Rover M, Mantovani A, Lessa J, Haertel J, Salgado Filho P, Kalil R, Leiria T, Risum N, Sogaard P, Fritz Hansen T, Bruun N, Kisslo J, Velazquez E, Jons C, Olsen N, Azevedo O, Lourenco M, Machado I, Pereira V, Medeiros R, Pereira A, Quelhas I, Lourenco A, Rangel I, Goncalves A, Sousa C, Correia A, Pinho T, Madureira A, Martins E, Silva-Cardoso J, Macedo F, Maciel M, Kinova E, Zlatareva N, Goudev A, Rogge B, Cramariuc D, Lonnebakken M, Rieck A, Gohlke-Baerwolf C, Chambers J, Boman K, Gerdts E, Florescu M, Mihalcea D, Enescu O, Suran B, Mincu R, Patrascu N, Magda L, Cinteza M, Vinereanu D, Bruno R, Cogo A, Bartesaghi M, Thapa K, Duo E, Basnyat B, Ghiadoni L, Picano E, Sicari R, Pratali L, Jensen-Urstad K, Nordin A, Bjornadal L, Svenungsson E, King GJ, Murphy R, Almuntaser I, Mc Loughlin B, Livingston A, Nevin S, Clarke J, De Sousa CC, Rangel I, Martins E, Correia A, Nadais G, Silveira F, Silva Cardoso J, Goncalves A, Macedo F, Maciel M, Lindqvist P, Henein M, Hornsten R, Rasmunsson J, Hedstrom M, Alm C, Filali T, Jedaida B, Lahidheb D, Gommidh M, Mahfoudhi H, Hajlaoui N, Dahmani R, Fehri W, Haouala H, Shin SH, Woo S, Kim D, Park K, Kwan J, Brambila CA, Gabrielli L, Bijnens B, Marin J, Sitges I, Grazioli G, Pare C, Mont L, Brugada J, Sitges M, Pica S, Ghio S, Raineri C, Camporotondo R, Rordorf R, Previtali M, Landolina M, Valentini A, Turco A, Visconti L, Stuart B, Santos A, Cruz I, Caldeira D, Cotrim C, Fazendas P, Joao I, Almeida A, Pereira H, Goncalves A, Pinho T, Sousa C, Rangel I, Correia A, Madureira A, Macedo F, Zamorano JL, Maciel M, Driessen M, Kort E, Leiner T, Cramer M, Sieswerda G, Chamuleau S, Kim D, Choi Y, Park H, Kim H, Shin J, Song J, Kang D, Song J, Parisi V, Galasso G, Festa G, Piccolo R, Rengo G, De Rosa R, Pagano G, Iacotucci P, Leosco D, Piscione F, Bellsham-Revell H, Nedjati-Gilani S, Yao C, Pushparajah K, Penney G, Simpson J, Lopez Melgar B, Sanchez Sanchez V, Rodriguez Garcia J, Coma Samartin R, Martin Asenjo R, Fernandez Casares S, Lopez-Guarch CJ, Diaz Anton B, Mayordomo Gomez S, Lombera Romero F, Yamada S, Okada K, Iwano H, Nishino H, Nakabachi M, Yokoyama S, Kaga S, Mikami T, Tsutsui H, Stoebe S, Tarr A, Pfeiffer D, Hagendorff A, Klitsie L, Roest A, Kuipers I, Van Der Hulst A, Hazekamp M, Blom N, Ten Harkel A, Hagendorff A, Stoebe S, Tarr A, Gelbrich G, Loeffler M, Pfeiffer D, Badran H, Elnoamany M, Soltan G, Ezat M, Elsedi M, Abdelfatah R, Yacoub M, Kydd A, Khan F, Mccormick L, Gopalan D, Virdee M, Dutka D, Ruiz Ortiz M, Mesa D, Delgado M, Romo E, Morenate M, Baeza F, Castillo F, Lopez Granados A, Del Prado JA, De Lezo JS, Kilickiran Avci B, Yurdakul S, Sahin S, Ermis E, Dilekci B, Aytekin S, Turhan S, Gerede D, Hural R, Ozcan O, Candemir B, Erol C, Saha SK, Kiotsekoglou A, Gopal A, Govind S, Lindqvist P, Soderberg S, Kawata T, Daimon M, Sekita G, Miyazaki S, Ichikawa R, Maruyama M, Suzuki H, Daida H, Persic V, Lovric D, Jurin H, Pehar Pejcinovic V, Baricevic Z, Pezo Nikolic B, Ivanac Vranesic I, Separovic Hanzevacki J, Ahn H, Cho G, Lee S, Kim H, Kim Y, Sohn D, Igual Munoz B, Estornell Erill J, Gonzalez AM, Bel Minguez A, Perez Guillen M, Donate Bertolin L, Monmeneu Menadas J, Lopez Lereu P, La Huerta AA, Argudo AM, Igual Munoz B, Gonzalez AM, Valero DD, La Huerta AA, Fernandez PA, Ferrer JM, Rueda Soriano J, Buendia Sanchez F, Estornell Erill J, Carrasco J, Carvalho MS, De Araujo Goncalves P, Sousa P, Dores H, Marques H, Pereira Machado F, Gaspar A, Aleixo A, Mota Carmo M, Roquette J, Vassiliadis IV, Despotopoulos E, Kaitozis O, Tekedis C, Al-Mallah M, Nour K, Tomaszewski A, Kutarski A, Brzozowski W, Tomaszewski M, Oleszczak K, Tong J, Bian Y, Yang F, Li P, Chen L, Shen X, Xu Y, Yan L, Kilickiran Avci B, Yurdakul S, Sahin S, Ermis E, Dilekci B, Aytekin S, Hristova K, Marinov R, Georgiev S, Kaneva A, Lasarov S, Mitev P, Katova T, Pilosoff V, Ikonomidis I, Tzortzis S, Triantafyllidi H, Paraskevaidis I, Trivilou P, Papadakis I, Papadopoulos C, Pavlidis G, Anastasiou-Nana M, Lekakis J. Poster session: Aortic stenosis. Eur Heart J Cardiovasc Imaging 2012. [DOI: 10.1093/ehjci/jes264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Veenhof C, Perry S, Lucas C. The influence of sport participation on physical function in patients with osteoarthritis during and after exercise therapy. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.434] [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: 10/27/2022]
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Belletrutti M, Black K, Perry S, Shepherd J, Venner M, Romanick M. Removal of Codeine in Pediatric Oncology: A Qualitative Evaluation of Sucess and Attitudes. Paediatr Child Health 2012. [DOI: 10.1093/pch/17.suppl_a.16ab] [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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Meunier H, Molina-Vila P, Perry S. Participation in group defence: proximate factors affecting male behaviour in wild white-faced capuchins. Anim Behav 2012. [DOI: 10.1016/j.anbehav.2011.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Abstract
More than one-third of the world's population, or over 2 billion people, are infected with Mycobacterium tuberculosis, the causative pathogen of tuberculosis in humans. Why only 10% of those infected develop active disease while the remainder harbor latent infection remains one of the greatest scientific and public health mysteries. Bacterial persistence is characterized by a dynamic state of immunological tolerance between pathogen and host. The critical role of CD4(+) T cells in defense against intracellular pathogens became evident during epidemiological studies of HIV-1 infection, which showed a clear inverse relationship between CD4(+) T-cell count in peripheral blood and increased risk of infection with M. tuberculosis, pneumocystis and Toxoplasma gondii. There is also growing evidence of a common mucosal immune system, whereby immune cells activated at one mucosal site may disseminate to remote effector sites. In this commentary, we review emerging evidence from human studies that the outcome of M. tuberculosis infection is influenced by concurrent mucosal infections, using Helicobacter pylori and geohelminths as examples. Understanding how the complexity of microbial exposures influences host immunity may have important implications for vaccine development and therapeutic interventions.
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Affiliation(s)
- S Perry
- Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, USA
| | - R Hussain
- Department of Molecular Biology, Aga Khan University, Karachi, Pakistan
| | - J Parsonnet
- Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, USA
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Herrera V, Perry S, Parsonnet J, Banaei N. Clinical Application and Limitations of Interferon- Release Assays for the Diagnosis of Latent Tuberculosis Infection. Clin Infect Dis 2011; 52:1031-7. [DOI: 10.1093/cid/cir068] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [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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van Ryn M, Burgess DJ, Dovidio JF, Phelan SM, Saha S, Malat J, Griffin JM, Fu SS, Perry S. THE IMPACT OF RACISM ON CLINICIAN COGNITION, BEHAVIOR, AND CLINICAL DECISION MAKING. Du Bois Rev 2011; 8:199-218. [PMID: 24761152 PMCID: PMC3993983 DOI: 10.1017/s1742058x11000191] [Citation(s) in RCA: 189] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Over the past two decades, thousands of studies have demonstrated that Blacks receive lower quality medical care than Whites, independent of disease status, setting, insurance, and other clinically relevant factors. Despite this, there has been little progress towards eradicating these inequities. Almost a decade ago we proposed a conceptual model identifying mechanisms through which clinicians' behavior, cognition, and decision making might be influenced by implicit racial biases and explicit racial stereotypes, and thereby contribute to racial inequities in care. Empirical evidence has supported many of these hypothesized mechanisms, demonstrating that White medical care clinicians: (1) hold negative implicit racial biases and explicit racial stereotypes, (2) have implicit racial biases that persist independently of and in contrast to their explicit (conscious) racial attitudes, and (3) can be influenced by racial bias in their clinical decision making and behavior during encounters with Black patients. This paper applies evidence from several disciplines to further specify our original model and elaborate on the ways racism can interact with cognitive biases to affect clinicians' behavior and decisions and in turn, patient behavior and decisions. We then highlight avenues for intervention and make specific recommendations to medical care and grant-making organizations.
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Affiliation(s)
- Michelle van Ryn
- Department of Family Medicine and Community Health, University of Minnesota
| | - Diana J Burgess
- Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center and Department of Medicine, University of Minnesota
| | | | - Sean M Phelan
- Department of Family Medicine and Community Health, University of Minnesota
| | - Somnath Saha
- Section of General Internal Medicine, Portland VA Medical Center and Division of General Internal Medicine and Geriatrics, Oregon Health and Science University
| | | | - Joan M Griffin
- Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center and Department of Medicine, University of Minnesota
| | - Steven S Fu
- Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center and Department of Medicine, University of Minnesota
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Giannoudis PV, Tan HB, Perry S, Tzioupis C, Kanakaris NK. The systemic inflammatory response following femoral canal reaming using the reamer-irrigator-aspirator (RIA) device. Injury 2010; 41 Suppl 2:S57-61. [PMID: 21144930 DOI: 10.1016/s0020-1383(10)70011-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [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: 02/02/2023]
Abstract
We evaluated the peripheral release of inflammatory mediators after femoral fracture and subsequent intramedullary reaming using the RIA reamers. IL-6 was elevated after trauma, and reaming with RIA induced a measurable second hit response. However, despite a higher ISS, the levels of IL-6 in the RIA group were similar to the levels measured in a group of patients where reaming of the femoral canal was performed using conventional reamers. There was one death related to fat embolism syndrome in the conventional reamers group. However, the overall incidence of complications was low and similar between the 2 groups of studied patients. In polytrauma patients, large scale studies are desirable to evaluate further the immuno-inflammatory response using the RIA reamers prior to the instrumentation of the femoral canal.
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Affiliation(s)
- P V Giannoudis
- Academic Department of Trauma and Orthopaedics, Leeds Teaching Hospitals NHS Trust, School of Medicine, University of Leeds, UK.
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Goldzweig G, Andritsch E, Hubert A, Brenner B, Walach N, Perry S, Baider L. Psychological distress among male patients and male spouses: what do oncologists need to know? Ann Oncol 2009; 21:877-883. [PMID: 19822532 DOI: 10.1093/annonc/mdp398] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The aim of the current study was to strengthen the knowledge of oncologists concerning psychological distress and social support among married and unmarried male cancer patients and healthy male spouses of female cancer patients. PATIENTS AND METHODS Three groups of men were recruited from three major cancer centers in Israel: 185 married colon and rectal cancer patients, 54 single (unmarried) colon and rectal cancer patients, and 153 male spouses of female cancer patients. Participants were evaluated on four standardized instruments measuring psychological distress, coping, and social support. RESULTS About 42.6% of the participants reported on a clinical level of psychological distress, with the highest rates (61.1%) among the single (unmarried) patients. Distress was negatively correlated to Karnofsky score and coping variables among all study groups. Distress was significantly and negatively correlated to social support variables among the spouses and married patients but not among the single patient groups. CONCLUSIONS Social support received by male cancer patients from friends and family may be mediated by spouse support. As a result, single male patients are at higher risk for psychological distress. Male spouses were also found to have high rates of distress. These two groups need special attention by oncologists.
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Affiliation(s)
- G Goldzweig
- Clinical Psychology Section, The School of Behavioral Sciences, The Academic College of Tel-Aviv-Yafo, Tel Aviv, Israel
| | - E Andritsch
- The Institute of Internal Medicine and Oncology, Graz University Hospital, Graz, Austria
| | - A Hubert
- Digestive Tract Tumors Unit, Sharett Institute of Oncology, Hadassah University Hospital, Jerusalem, Israel
| | - B Brenner
- The GI Oncology Unit, The Institute of Oncology, Rabin Medical Center, Beilinson Hospital, Petach-Tivka, Israel
| | - N Walach
- Oncology Unit, The Institute of Oncology, Assaf Harofeh Medical Center, Zerifin, Israel
| | - S Perry
- The Institute of Oncology, Rabin Medical Center, Beilinson Hospital, Petach-Tivka, Israel
| | - L Baider
- Department of Psycho-Oncology, Sharett Institute of Oncology, Hadassah University Hospital, Jerusalem, Israel.
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Peters K, Desjardins A, Reardon DA, Perry S, Herndon JE, Bailey L, Friedman AH, Friedman HS, Bigner DD, Vredenburgh JJ. Temozolomide (TMZ) and bevacizumab (BV) as initial treatment for unresectable or multifocal glioblastoma multiforme (GBM). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e13025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13025 Background: GBMs are vascular tumors and inherently resistant to therapy. The prognosis for patients is poor with a median survival of 9–15 months. Patients with unresectable or multifocal GBMs have an even poorer prognosis, with a median survival of 6–8 months. Given the angiogenic phenotype of GBM, we conducted a phase II trial of upfront BV and 5-day TMZ in newly diagnosed unresectable or multifocal GBMs. Methods: Patients had histologically documented newly diagnosed GBMs that were unresectable or multifocal. Patients received up to 4 cycles of temozolomide at 200 mg/m2/d days 1–5 and BV at 10 mg/kg on days 1 and 14 in a 28 day cycle. An MRI was performed after every cycle and patients continued on therapy as long as there was no tumor progression, grade 4 non-hematologic toxicity or recurrent grade 4 hematologic toxicity after a dose reduction to 150 mg/m2/d. The primary endpoint was tumor response using the modified MacDonald criteria plus FLAIR and T2 sequences to evaluate non-enhancing tumor. Results were evaluated by two independent reviewers. Results: 41 patients were enrolled between October 2007 and September 2008 and 31 patients were analyzed after completion of cycle 2. As the best response, there were 8 (25.8%) partial responses, 19 (61.3 %) patients with stable disease, and 4(12.9 %) had disease progression. 19 of the 41 patients enrolled completed four cycles without tumor progression. The regimen was tolerable, with 3 grade 4 hematologic toxicities including neutropenia and thrombocytopenia. There were 2 grade 4 non-hematologic toxicities, including pulmonary embolism. There were two CNS hemorrhages. The median PFS was 3.6 months (2.9 months, 4.4 months) and the median OS was 4.5 months (3.7 months, 5.3 months). Conclusions: Upfront temozolomide and bevacizumab was well tolerated, but synergistic chemotherapy or growth factor inhibitors need to be added to produce meaningful clinical benefit, particularly for unresectable or multifocal GBM. No significant financial relationships to disclose.
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Affiliation(s)
- K. Peters
- Duke University Medical Center, Durham, NC
| | | | | | - S. Perry
- Duke University Medical Center, Durham, NC
| | | | - L. Bailey
- Duke University Medical Center, Durham, NC
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Weed M, Bryant R, Perry S. Cognitive development in macaques: Attentional set-shifting in juvenile and adult rhesus monkeys. Neuroscience 2008; 157:22-8. [PMID: 18805462 DOI: 10.1016/j.neuroscience.2008.08.047] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Revised: 07/31/2008] [Accepted: 08/12/2008] [Indexed: 11/28/2022]
Abstract
In humans and nonhuman primates, the structure and function of frontal cortical regions of the brain are not completely developed until early adulthood. How this cortical development affects cognitive function continues to be elucidated. To that end, this experiment tested the ability of juvenile and adult rhesus monkeys to perform a cognitive task that is dependent upon intact frontal cortical function for optimal performance. Twenty-four juvenile (mean age 2.3 years) and 16 adult (mean age 10.3 years) rhesus monkeys were tested on the Cambridge Neuropsychological Test Automated Battery intradimensional/extradimensional set-shifting (ID/ED) task. Performance on the ID/ED task has been shown to be dependent upon frontal cortical function in both humans and nonhuman primates. Compared with adults, juveniles were impaired on the reversal of simple discrimination, intradimensional shift, reversal of intradimensional shift, and the extradimensional shift stages of the task. These results indicate juveniles committed more perseverative errors and more errors on the set-formation and set-shifting components of the ID/ED task. The developmental stage of the juvenile monkeys corresponds to roughly 5 to 6-year-old children, and these results are consistent with performance of human children and adults on similar ID/ED tests and on several other tests of attentional set-shifting or attentional flexibility. Furthermore, these results are consistent with the ongoing development of frontal cortical structures relating to ongoing cognitive development in nonhuman primates.
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Grosell M, Genz J, Perry S, Gilmour K, Taylor J. Apical proton pump activity and CAIV act to control luminal osmotic pressure and enhance intestinal water absorption by seawater acclimated rainbow trout (RBT). Comp Biochem Physiol A Mol Integr Physiol 2008. [DOI: 10.1016/j.cbpa.2008.04.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Grosell M, Gilmour K, Perry S, Genz J, Taylor J. Intestinal water absorption, anion exchange, proton transport and epithelial metabolic rate in marine teleost fish. Comp Biochem Physiol A Mol Integr Physiol 2007. [DOI: 10.1016/j.cbpa.2007.01.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Steele S, Li V, Lo A, Cheng H, Perry S. The role of the M2 muscarinic receptor in the development of hypoxic bradycardia in zebrafish (Danio rerio) larvae. Comp Biochem Physiol A Mol Integr Physiol 2007. [DOI: 10.1016/j.cbpa.2007.01.393] [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: 11/15/2022]
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Currie S, Gilmour K, McConnell T, McGinn P, Perry S, Reddin K. β-Adrenergic stimulation enhances the heat shock response in fish. Comp Biochem Physiol A Mol Integr Physiol 2007. [DOI: 10.1016/j.cbpa.2007.01.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Chang WY, Khosrowshahian F, Wolanski M, Marshall R, McCormick W, Perry S, Crawford MJ. Conservation of Pitx1 expression during amphibian limb morphogenesis. Biochem Cell Biol 2006; 84:257-62. [PMID: 16609707 DOI: 10.1139/o06-036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In contrast to the pattern of limb emergence in mammals, chicks, and the newt N. viridescens, embryos such as Xenopus laevis and Eleutherodactylus coqui initiate pelvic limb buds before they develop pectoral ones. We studied the expression of Pitx1 in X. laevis and E. coqui to determine if this paired-like homeodomain transcription factor directs differentiation specifically of the hindlimb, or if it directs the second pair of limbs to form, namely the forelimbs. We also undertook to determine if embryonic expression patterns were recapitulated during the regeneration of an amputated limb bud. Pitx1 is expressed in hindlimbs in both X. laevis and E. coqui, and expression is similar in both developing and regenerating limb buds. Expression in hindlimbs is restricted to regions of proliferating mesenchyme.
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Affiliation(s)
- W Y Chang
- Department of Biological Sciences, University of Windsor, Canada
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Witt WP, Pickard S, Kuzel T, McDade T, Perry S, Hung S, Zagory J, Lin H, Costello S, Colella K, Bennett CL. Relationship between biological and self-reported measures of stress among informal caregivers of patients with prostate cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.18506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
18506 Background: Informal caregivers of prostate cancer patients often experience chronic psychological stress that may adversely impact their physical and mental health, and their ability to care for their families and the patient. This study aims to determine the association between perceived and biological stress among informal caregivers of prostate cancer patients. Methods: A total of 24 informal caregivers of prostate cancer patients were recruited from both the Jesse Brown VA Center (Lakeside and Westside, Chicago) and the Robert H. Lurie Comprehensive Cancer Center at Northwestern University. Caregivers completed self-reported measures of stress, somatization, life events, burden, health status (SF-36) and mental health. Capillary blood spot samples from caregivers were used to examine two measures of biological stress, Epstein-Barr virus antibody titer and C-reactive protein. Results: Informal caregivers had a mean age of 63 years and were mostly female and spouses of patients with prostate cancer. Many had preexisting co-morbidities, including 45.8% with hypertension, 45.8% with arthritis, and 33.3% with diabetes. Nearly 30% had been hospitalized in the last 12 months. 33.3% of caregivers experienced at least one major life event in the last year and 62.5% had symptoms of somatization illness. Caregivers with symptoms of somatization illness had higher mean Epstein-Barr antibody titers as compared with those without symptoms (Mean EBV antibody titer: 198.3 versus 141.8, respectively (p < 0.05)). Caregiver-reported measures were not correlated with C-reactive protein levels. Caregivers with higher levels of strain perceived more stress in their lives (p < 0.05), but showed relatively high self-esteem (mean = 30.6, SD = 2.8, on a 7–35 scale). Conclusions: These preliminary findings suggest that informal caregivers who report symptoms of somatization illness exhibit signs of relative suppression of the cell-mediated immune processes as a result of the reactivation of the Epstein-Barr virus. Final analyses will be conducted that control for potential confounders and will further elucidate if caregiver stress is associated with suppression of the immune system. No significant financial relationships to disclose.
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Affiliation(s)
- W. P. Witt
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - S. Pickard
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - T. Kuzel
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - T. McDade
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - S. Perry
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - S. Hung
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - J. Zagory
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - H. Lin
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - S. Costello
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - K. Colella
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - C. L. Bennett
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
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Chin C, Bernstein D, Shek J, Gamberg P, Perry S. 408. J Heart Lung Transplant 2006. [DOI: 10.1016/j.healun.2005.11.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
OBJECTIVES To assess insecticide-treated nets (ITNs) use, other malaria prevention measures, knowledge of malaria and diffusion of information about ITNs by the National Malaria Control Programme (NMCP) in Mali. DESIGN A descriptive cross-sectional study. SETTING Four villages in Mopti region, Mali that had participated in the Mopti Regional Malaria Control Program (MRMCP) ITN Education Programme five years prior. PARTICIPANTS Three hundred thirty nine randomly-selected households. Within each household, mothers of children one to nine years of age were interviewed regarding knowledge of malaria and prevention practices. RESULTS Overall, 11% of households used ITNs, with 97% of these in two villages. Ninety eight percent of households used bednets, 22% used insecticide sprays and 39% used mosquito coils. Significant predictors of ITNs use were: head of household literacy, larger family size, Bambara ethnicity, hearing about the NMCP and hearing about ITNs from health agents. Reasons why ITNs were not used included not knowing anything about ITNs, cost and not having net impregnation services readily available in the village. Levels of knowledge concerning malaria disease, transmission and prevention varied amongst the four villages. ITN households had significantly higher levels of knowledge about malaria and its prevention. CONCLUSION Five years after the implementation of the MRMCP, ITNs use was low and diffusion of malaria prevention information was unequal among villages. Future efforts in improving the programme must recognise these differences in knowledge and ITNs utilisation and make village-specific changes that are acceptable for each village.
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Affiliation(s)
- M Rhee
- Health Research and Policy Department, Stanford Medical School, Stanford University, Stanford, CA 94305, USA
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Kanaujia GV, Lam PK, Perry S, Brusasca PN, Catanzaro A, Gennaro ML. Integration of microscopy and serodiagnostic tests to screen for active tuberculosis. Int J Tuberc Lung Dis 2005; 9:1120-6. [PMID: 16229223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
SETTING University of California San Diego Medical Center, USA. OBJECTIVE To create a simple screening strategy for tuberculosis (TB) that includes antibody detection assays to improve the accuracy of microscopic examination of sputum for acid-fast bacilli (AFB smear). METHODS Serum samples were obtained from 190 patients suspected of having active TB. TB diagnosis was established by Mycobacterium tuberculosis culture. HIV status was determined by commercial serologic tests. IgG antibody levels were measured by ELISA using purified M. tuberculosis antigens. Data from 130 randomly selected patients were used to develop a screening strategy; data from the remaining 60 patients were used for validation. RESULTS AFB smear had 70% sensitivity and 88% specificity. In algorithms integrating single or multi-antigen ELISA with AFB smear and HIV results, the sensitivity improved over each test alone. The algorithm that included a four-antigen ELISA (38 kDa antigen, lipoarabinomannan, MPT-64 and glutamine synthase) had a sensitivity of 93% and a specificity of 76%. Compared to AFB smear, the sensitivity of the algorithm was significantly higher, while the specificity was not statistically different. CONCLUSION This study demonstrates that a screening strategy can be created by integrating multi-antigen ELISA with AFB smear and HIV testing.
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Affiliation(s)
- G V Kanaujia
- Public Health Research Institute, Newark, New Jersey, USA
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Nguyen M, Perry S, Parsonnet J. QuantiFERON-TB predicts tuberculin skin test boosting in U.S. foreign-born. Int J Tuberc Lung Dis 2005; 9:985-91. [PMID: 16158890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
SETTING Santa Clara County, Northern California. OBJECTIVE To characterize agreement of tuberculin skin test (TST) and QuantiFERON-TB (QFT) with repeated testing. DESIGN Fifty-two subjects participating in an ongoing prospective study of infectious disease transmission were tested by TST and QFT at two home visits 3 months apart. Boosting was defined as reclassification of TST from negative to positive. Agreement and reproducibility of TST and QFT were assessed using kappa and McNemar statistics. RESULTS Of 48 individuals completing all tests, 75% were foreign-born (92% Latin America) and 58% were BCG-vaccinated. Initial TST and QFT were positive in 13 (27%) and 21 (44%), respectively, with an overall agreement of 67% (K = 0.29). Ten (29%) of 35 initial TST-negative reactions boosted, nine of whom were BCG-vaccinated subjects. Boosting occurred in eight (67%) of 12 subjects who were initially QFT-positive/TST-negative. Compared to the second TST, initial QFT had a relative post-test probability of 76% (95% CI 0.58-0.95); boosting accounted for 8/16 (50%) of initial testing discordances. CONCLUSION Positive QFT in the setting of negative TST frequently anticipates a TST boost. This finding helps explain discordance between the two tests and may provide an alternative to serial TST testing.
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Affiliation(s)
- M Nguyen
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California 94305, USA
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Watt R, McGlone P, Evans D, Boulton S, Jacobs J, Graham S, Appleton T, Perry S, Sheiham A. The facilitating factors and barriers influencing change in dental practice in a sample of English general dental practitioners. Br Dent J 2004; 197:485-9; discussion 475. [PMID: 15547609 DOI: 10.1038/sj.bdj.4811748] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2003] [Accepted: 11/11/2003] [Indexed: 01/22/2023]
Abstract
AIM The objective of this study was to investigate the barriers and facilitators to change in dental practices among a sample of general dental practitioners (GDPs) from three regions of England. METHOD In-depth face-to-face interviews with 60 GDPs were undertaken. The sample was selected from a group of 317 GDPs who had completed a questionnaire in the first phase of this study. The participants were selected to reflect diversity regarding the number and extent of self-reported changes reported in the questionnaire, and personal and practice characteristics. Of the 92 attempted contacts, 60 (65%) of the interviews were successfully completed. The interview schedule formed the basis of the interview. All the interviews and notes were transferred on to NUD*IST QSR version 4, a qualitative analysis package. RESULTS No single factor was identified as being more important than another in facilitating change. The main facilitators for change were: financial factors, regular patient attendance, particularly a core patient group, staff loyalty, having regular staff meetings and open communication and having access to peer support. The main barriers to change were the reverse of the facilitators plus not having a financial stakehold in the practice. CONCLUSIONS A range of factors were identified as influencing change in general dental practice. These include GDPs' attitudes and experience of change, patient factors, organisational issues, contact with peers and access to appropriate training courses.
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Affiliation(s)
- R Watt
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK.
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