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Schneider T, Farrell B, Karunananthan S, Afkham A, Keely E, Liddy C, McCarthy LM. Classification system for primary care provider eConsults about medications for older adults with frailty. BMC Prim Care 2024; 25:104. [PMID: 38565981 PMCID: PMC10985926 DOI: 10.1186/s12875-024-02340-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/12/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Providing primary care for people with frailty can be challenging due to an increased risk of adverse outcomes and use of potentially inappropriate medications which may exacerbate characteristics of frailty. eConsult is a service where primary care providers can receive timely specialist advice for their patients through a secure web-based application. We aimed to develop a classification system to characterize medication-focused eConsult questions for older adults with frailty and assess its usability. METHODS A classification system was developed and refined over three cycles of improvement through a cross-sectional study of 35 cases categorized as medication-focused from cases submitted in 2019 for patients aged 65 or older with frailty through the Champlain BASE eConsult service (Ontario, Canada). The final classification system was then applied to each case. RESULTS The classification system contains 5 sections: (1) case descriptives; (2) intent and type of question; (3) medication recommendations and additional information in the response; (4) medication classification; and (5) potentially inappropriate medications. Among the 35 medication-focused cases, the most common specialties consulted were endocrinology (9 cases, 26%) and cardiology (5 cases, 14%). Medication histories were available for 29 cases (83%). Many patients were prescribed potentially inappropriate medications based on explicit tools (AGS Beers Criteria®, STOPPFall, Anticholinergic Cognitive Burden Scale, ThinkCascades) yet few consults inquired about these medications. CONCLUSION A classification system to describe medication-related eConsult cases for patients experiencing frailty was developed and applied to 35 eConsult cases. It can be applied to more cases to identify professional development opportunities and enhancements for eConsult services.
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Affiliation(s)
- T Schneider
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - B Farrell
- Bruyère Research Institute, Ottawa, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Canada
- School of Pharmacy, University of Waterloo, Waterloo, Canada
| | - S Karunananthan
- Bruyère Research Institute, Ottawa, Canada
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - A Afkham
- Ontario Health East, Ottawa, Canada
| | - E Keely
- Department of Medicine, University of Ottawa, Ottawa, Canada
- Division of Endocrinology and Metabolism, The Ottawa Hospital, Ottawa, Canada
- Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Canada
| | - C Liddy
- Department of Family Medicine, University of Ottawa, Ottawa, Canada
- Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Canada
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada
| | - L M McCarthy
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.
- Bruyère Research Institute, Ottawa, Canada.
- School of Pharmacy, University of Waterloo, Waterloo, Canada.
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
- Institute for Better Health, Trillium Health Partners, Mississauga, Canada.
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McHugh MC, Fowler CA, Philbin S, Schneider T, Ballistrea LM, Klanchar SA, Smith BM, Benzinger RC, French DD, Saenger MS, Haun JN. Qualitative Evaluation Informs the Implementation of a Telehealth Program to Manage Chronic Pain. J Pain 2024:S1526-5900(24)00374-2. [PMID: 38336029 DOI: 10.1016/j.jpain.2024.02.007] [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] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/29/2024] [Accepted: 02/03/2024] [Indexed: 02/12/2024]
Abstract
In response to the opioid epidemic and high rates of chronic pain among the veteran population, the U.S. Department of Veterans Affairs implemented the TelePain-Empower Veterans Program (EVP), a nonpharmacological pain management program for veterans. Delivered virtually, TelePain-EVP incorporates integrated health components (Whole Health, Acceptance and Commitment Therapy, and Mindful Movement) through interdisciplinary personalized coaching. The objective of this quality improvement project was to evaluate the implementation of TelePain-EVP to identify determinants to implementation, benefits and challenges to participation, and recommendations for future direction. We used a qualitative descriptive design to conduct semistructured telephone interviews with TelePain-EVP leaders (n = 3), staff (n = 10), and veterans (n = 22). The interview guides aligned with the Consolidated Framework for Implementation Research (CFIR). Thematic content analysis organized and characterized findings. Several CFIR domains emerged as determinants relevant to program implementation, including innovation (eg, design); individuals (eg, deliverers, recipients); inner (eg, communications) and outer settings (eg, local conditions); and implementation process (eg, reflecting and evaluating). Identified determinants included facilitators (eg, virtual delivery) and barriers (eg, staff shortages). Participants reported improvements in pain management coping skills, interpersonal relationships, and sense of community, but no self-reported reductions in pain or medication use. Program improvement recommendations included using centralized staff to address vacancies, collecting electronic data, offering structured training, and providing course materials to veteran participants. Qualitative data can inform the sustained implementation of TelePain-EVP and other similar telehealth pain management programs. These descriptive data should be triangulated with quantitative data to objectively assess participant TelePain-EVP outcomes and associated participant characteristics. PERSPECTIVE: A qualitative evaluation of a telehealth program to manage chronic pain, guided by the CFIR framework, identified determinants of program implementation. Additionally, participants reported improvements in pain management coping skills, interpersonal relationships, and sense of community, but no self-reported reductions in pain or medication use.
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Affiliation(s)
- Megan C McHugh
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Department of Veterans Affairs, Hines, Illinois; Center for Health Services and Outcomes Research, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Christopher A Fowler
- Research and Development Service, James A. Haley Veterans' Hospital, Tampa, Florida; Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, Florida
| | - Sarah Philbin
- Center for Health Services and Outcomes Research, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Tali Schneider
- Research and Development Service, James A. Haley Veterans' Hospital, Tampa, Florida
| | - Lisa M Ballistrea
- Research and Development Service, James A. Haley Veterans' Hospital, Tampa, Florida
| | - S Angelina Klanchar
- Research and Development Service, James A. Haley Veterans' Hospital, Tampa, Florida
| | - Bridget M Smith
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Department of Veterans Affairs, Hines, Illinois
| | - Rachel C Benzinger
- Research and Development Service, James A. Haley Veterans' Hospital, Tampa, Florida
| | - Dustin D French
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Department of Veterans Affairs, Hines, Illinois; Center for Health Services and Outcomes Research, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Departments of Ophthalmology and Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Michael S Saenger
- Anesthesia Service Line, Atlanta Veterans Administration Health Care System, Decatur, Georgia; Division of Internal Medicine, School of Medicine, Emory University, Atlanta, Georgia
| | - Jolie N Haun
- Research and Development Service, James A. Haley Veterans' Hospital, Tampa, Florida; Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
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Haun JN, Schneider T, Ballistrea LM, McMahon-Grenz J, Melillo C, Benzinger R, Paykel JM. Veterans' lived experiences with the VA's Whole Health system and perceived impact on dimensions of wellness. Explore (NY) 2023:S1550-8307(23)00285-9. [PMID: 38184376 DOI: 10.1016/j.explore.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/12/2023] [Accepted: 12/20/2023] [Indexed: 01/08/2024]
Abstract
RESEARCH QUESTION What are the lived experiences and wellness related outcomes of veterans engaged in the Department of Veterans' Affairs (VA) Whole Health (WH) system of care? THEORETICAL FRAMEWORK This qualitative work was conducted with a pragmatic phenomenological approach to understand patients' lived experience within the WH system of care. Data were contextualized within a multi-dimensional wellness model. METHODOLOGY This descriptive quality improvement project used semi-structured telephone interviews. Interview script elicited veterans' WH participation experiences and perceived wellness related outcomes. CONTEXT Data were collected within a WH Service, at a large Veterans Health Administration Hospital in the Southeast United States. SAMPLE SELECTION Data were collected with a purposive sample of veterans that participated in at least 2 WH activities. DATA COLLECTION Patients were recruited by WH clinical team collaborators to participate in qualitative data collection. ANALYSIS AND INTERPRETATION Rapid content analysis and interpretation of results were conducted in alignment with dimensions of wellness constructs. MAIN RESULTS WH offers veterans' non-pharmacological tools to improve mental, physical, and social wellness. Participants (n = 50) represented the larger veteran population. Most veterans perceived a positive WH experience with improvement of three primary dimensions including mental and emotional, physical, and social wellness - impacts on other dimensions gleaned less perceived impact. Veterans reported adopting mindfulness and coping strategies, better mobility, pain management, and sleep quality, and enhanced social engagement. Even those who did benefit personally from all aspects of WH, felt the services are needed to support the larger veteran population. Reduced suicidal ideation and pain medication use emerged as a WH effect among approximately 10% of the sample.
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Affiliation(s)
- Jolie N Haun
- Research and Development Service, James A. Haley Veterans' Hospital, Research Service, 8900 Grand Oak Circle, Tampa, FL 33637, United States; Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT 84132, United States
| | - Tali Schneider
- Research and Development Service, James A. Haley Veterans' Hospital, Research Service, 8900 Grand Oak Circle, Tampa, FL 33637, United States
| | - Lisa M Ballistrea
- Research and Development Service, James A. Haley Veterans' Hospital, Research Service, 8900 Grand Oak Circle, Tampa, FL 33637, United States
| | - Julie McMahon-Grenz
- Research and Development Service, James A. Haley Veterans' Hospital, Research Service, 8900 Grand Oak Circle, Tampa, FL 33637, United States
| | - Christine Melillo
- Research and Development Service, James A. Haley Veterans' Hospital, Research Service, 8900 Grand Oak Circle, Tampa, FL 33637, United States
| | - Rachel Benzinger
- Research and Development Service, James A. Haley Veterans' Hospital, Research Service, 8900 Grand Oak Circle, Tampa, FL 33637, United States.
| | - Jacquelyn M Paykel
- Whole Health Service, James A. Haley Veterans Hospital, Tampa, FL 33637, United States
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Schneider T. Realization of the absorbed dose to water for 70 kV electronic brachytherapy sources for surface applications. Phys Med Biol 2023; 68:245022. [PMID: 37972409 DOI: 10.1088/1361-6560/ad0d41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/15/2023] [Indexed: 11/19/2023]
Abstract
Objective.The purpose of this work is to establish a primary standard for the absorbed dose to water for surface applications with 70 kV electronic brachytherapy sources and thereby to investigate several reference conditions with respect to applicability in metrology institutes, calibration labs and clinics.Approach.A primary standard for the absorbed dose to water for LDR-Seeds (ipFAC) was utilized. For this, the method of evaluation was modified to account for the different geometries in interstitial and surface brachytherapy and for the different energy distributions of the radiation fields, respectively. The correction factors required to determine the absorbed dose to water were evaluated using Monte Carlo (MC) simulations. MC-calculations were also used to estimate the uncertainties of this method.Main results.It could be shown that determining the absorbed dose to water in 1 cm depth below the surface of a water phantomDw(1 cm) is feasible with the ipFAC. Thereby the method to determineDw(1 cm) when the source is placed at 50 cm distance and the beam is collimated turns out to be more robust to variations in the directional emittance of the source than placing the source applicator assembly directly on the phantom.Significance.The first method features significantly lower uncertainties, 1.4% compared to 3.7% (both fork= 2), for the second one. However, a calibration based on a transfer chamber calibrated with the second method is more practical and easier to implement in clinical routine.
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Affiliation(s)
- T Schneider
- Dosimetry for Brachytherapy and Beta Radiation Protection, Physikalisch-Technische Bundesanstalt, Braunschweig, Germany
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Zölzer F, Schneider T, Ainsbury E, Goto A, Liutsko L, O'Reilly G, Lochard J. Ethical and societal aspects of radiological protection for offspring and next generations. Int J Radiat Biol 2023:1-11. [PMID: 37947483 DOI: 10.1080/09553002.2023.2281523] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/31/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE Over the last decade or so, ethical and societal aspects of radiological protection have received increasing attention. This is also reflected in the publications of the International Commission on Radiological Protection (ICRP). The current paper aims at identifying relevant ethical and societal topics which should receive attention in the context of radiological protection for offspring and next generations. MATERIALS AND METHODS We present a non-comprehensive review of the subject, based on presentation made at an ICRP workshop in Budapest in 2022. We first discuss the ethical values promoted by ICRP, and the application of these values in cases of (potential) pre-conceptual and prenatal radiation exposures. We then consider experience gained after the Fukushima accident indicating particular societal concerns about the health effects of such exposures. RESULTS AND CONCLUSIONS Beneficence/non-maleficence, prudence, justice and dignity, the "core values" of the system of radiological protection have special roles to play when heritable and/or in utero effects are to be considered. Prudence, in particular, must be taken account of in view of the fact that solid scientific data in humans are largely lacking in this area, and it is necessary to rely on insights from animal experiments as well as theoretical considerations. As regards societal considerations, the perception of risk among (potentially) affected populations needs to be taken seriously. Accountability, transparency, and inclusivity, the "procedural values" promoted by ICRP for the practical implementation of the system of radiological protection play a central role in overcoming skepticism and creating trust. Stakeholder involvement should emphasize cooperation and dialogue, which allows for the joint evaluation of an exposure situation by experts and affected people.
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Affiliation(s)
- F Zölzer
- Faculty of Health and Social Sciences, University of South Bohemia in České Budějovice, Czech Republic
| | - T Schneider
- Nuclear Protection Evaluation Centre (CEPN), Fontenay-aux-Roses, France
| | | | - A Goto
- Center for Integrated Science and Humanities, Fukushima Medical University, Fukushima, Japan
| | - L Liutsko
- Institute for Primary Health Care Research Jordi Gol i Gurina (IDIAP Jordi Gol) & ISGlobal, Barcelona, Spain
| | | | - J Lochard
- Institute of Atomic Bomb Diseases, Nagasaki University, Nagasaki, Japan
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Haun JN, Venkatachalam HH, Fowler CA, Alman AC, Ballistrea LM, Schneider T, Benzinger RC, Melillo C, Alexander NB, Klanchar SA, Lapcevic W, French DD. Mobile and Web-Based Partnered Intervention to Improve Remote Access to Pain and Posttraumatic Stress Disorder Symptom Management: Recruitment and Attrition in a Randomized Controlled Trial. J Med Internet Res 2023; 25:e49678. [PMID: 37788078 PMCID: PMC10582813 DOI: 10.2196/49678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/22/2023] [Accepted: 08/29/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Increasing access to nonpharmacological interventions to manage pain and posttraumatic stress disorder (PTSD) is essential for veterans. Complementary and integrative health (CIH) interventions can help individuals manage symptom burden with enhanced accessibility via remotely delivered health care. Mission Reconnect (MR) is a partnered, self-directed intervention that remotely teaches CIH skills. OBJECTIVE The purpose of this paper is to describe the recruitment, onboarding phase, and attrition of a fully remote randomized controlled trial (RCT) assessing the efficacy of a self-directed mobile and web-based intervention for veterans with comorbid chronic pain and PTSD and their partners. METHODS A total of 364 veteran-partner dyads were recruited to participate in a mixed methods multisite waitlist control RCT. Qualitative attrition interviews were conducted with 10 veterans with chronic pain and PTSD, and their self-elected partners (eg, spouse) who consented but did not begin the program. RESULTS At the point of completing onboarding and being randomized to the 2 treatment arms, of the 364 recruited dyads, 97 (26.6%) failed to complete onboarding activities. Reported reasons for failure to complete onboarding include loss of self-elected partner buy-in (n=8, 8%), difficulties with using remote data collection methods and interventions (n=30, 31%), and adverse health experiences unrelated to study activities (n=23, 24%). Enrolled veterans presented at baseline with significant PTSD symptom burden and moderate-to-severe pain severity, and represented a geographically and demographically diverse population. Attrition interviews (n=10) indicated that misunderstanding MR including the intent of the intervention or mistaking the surveys as the actual intervention was a reason for not completing the MR registration process. Another barrier to MR registration was that interviewees described the mailed study information and registration packets as too confusing and excessive. Competing personal circumstances including health concerns that required attention interfered with MR registration. Common reasons for attrition following successful MR registration included partner withdrawal, adverse health issues, and technological challenges relating to the MR and electronic data collection platform (Qualtrics). Participant recommendations for reducing attrition included switching to digital forms to reduce participant burden and increasing human interaction throughout the registration and baseline data collection processes. CONCLUSIONS Challenges, solutions, and lessons learned for study recruitment and intervention delivery inform best practices of delivering remote self-directed CIH interventions when addressing the unique needs of this medically complex population. Successful recruitment and enrollment of veterans with chronic pain and PTSD, and their partners, to remote CIH programs and research studies requires future examination of demographic and symptom-associated access barriers. Accommodating the unique needs of this medically complex population is essential for improving the effectiveness of CIH programs. Disseminating lessons learned and improving access to remotely delivered research studies and CIH programs is paramount in the post-COVID-19 climate. TRIAL REGISTRATION ClinicalTrials.gov NCT03593772; https://clinicaltrials.gov/ct2/show/NCT03593772.
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Affiliation(s)
- Jolie N Haun
- James A. Haley Veterans' Hospital, Research Service, Tampa, FL, United States
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States
| | | | - Christopher A Fowler
- James A. Haley Veterans' Hospital, Research Service, Tampa, FL, United States
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, United States
| | - Amy C Alman
- College of Public Health, University of South Florida, Tampa, FL, United States
| | - Lisa M Ballistrea
- James A. Haley Veterans' Hospital, Research Service, Tampa, FL, United States
| | - Tali Schneider
- James A. Haley Veterans' Hospital, Research Service, Tampa, FL, United States
| | - Rachel C Benzinger
- James A. Haley Veterans' Hospital, Research Service, Tampa, FL, United States
| | - Christine Melillo
- James A. Haley Veterans' Hospital, Research Service, Tampa, FL, United States
| | - Neil B Alexander
- VA Ann Arbor Healthcare System, Geriatric Research, Education, and Clinical Center, Ann Arbor, MI, United States
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, Ann Arbor, MI, United States
| | - S Angelina Klanchar
- James A. Haley Veterans' Hospital, Research Service, Tampa, FL, United States
| | - William Lapcevic
- James A. Haley Veterans' Hospital, Research Service, Tampa, FL, United States
| | - Dustin D French
- Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, IL, United States
- Center for Health Services and Outcomes Research, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Departments of Ophthalmology and Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Haun JN, Fowler CA, Venkatachalam HH, Saenger MS, Alman AC, Smith BM, Schneider T, Benzinger R, Stroupe K, French DD. Empower Veterans Program (EVP): a chronic pain management program demonstrates positive outcomes among veterans. BMC Health Serv Res 2023; 23:431. [PMID: 37138319 PMCID: PMC10155644 DOI: 10.1186/s12913-023-09327-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/22/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Chronic pain is a highly prevalent health condition among veterans. Traditional pharmacological interventions present unique challenges for chronic pain management including prescription opioid addiction and overdose. In alignment with the 2016 Comprehensive Addiction and Recovery Act and VA's Stepped Care Model to meet veterans' pain management needs, the Offices of Rural Health and Pain Management, Opioid Safety, and Prescription Drug Monitoring Program (PMOP) funded an enterprise-wide initiative to implement a Step 3 integrated tele-pain program: Empower Veterans Program (EVP). EVP provides veterans with chronic pain self-care skills using a whole health driven approach to pain management. OBJECTIVES The Comprehensive Addiction and Recovery Act prompted the strategic approach to offer non-pharmacological options to meet veterans' pain management needs. EVP, a 10-week interdisciplinary group medical appointment, leverages Acceptance and Commitment Therapy, Mindful Movement, and Whole Health to provide veterans with chronic pain self-care skills. This evaluation was conducted to describe participant characteristics, graduation, and satisfaction rates; and assess pre-post patient-reported outcomes (PRO) associated with EVP participation. METHODS A sample of 639 veterans enrolled in EVP between May, 2015 and December, 2017 provided data to conduct descriptive analyses to assess participant demographics, graduation, and satisfaction rates. PRO data were analyzed using a within-participants pre-post design, and linear mixed-effects models were used to examine pre-post changes in PRO. RESULTS Of 639 participants, 444 (69.48%) graduated EVP. Participant median program satisfaction rating was 8.41 (Interquartile Range: 8.20-9.20). Results indicate pre-post EVP improvements (Bonferroni-adjusted p < .003) in the three primary pain outcomes (intensity, interference, catastrophizing), and 12 of 17 secondary outcomes, including physical, psychological, health-related quality of life (HRQoL), acceptance, and mindfulness measures. DISCUSSION Data suggest that EVP has significant positive outcomes in pain, psychological, physical, HRQoL, acceptance, and mindfulness measures for veterans with chronic pain through non-pharmacological means. Future evaluations of intervention dosing effect and long-term effectiveness of the program is needed.
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Grants
- OMAT ID# 16403,16404, 16405, 16489, 16490 U.S. Department of Veterans Affairs
- OMAT ID# 16403,16404, 16405, 16489, 16490 U.S. Department of Veterans Affairs
- OMAT ID# 16403,16404, 16405, 16489, 16490 U.S. Department of Veterans Affairs
- OMAT ID# 16403,16404, 16405, 16489, 16490 U.S. Department of Veterans Affairs
- OMAT ID# 16403,16404, 16405, 16489, 16490 U.S. Department of Veterans Affairs
- OMAT ID# 16403,16404, 16405, 16489, 16490 U.S. Department of Veterans Affairs
- OMAT ID# 16403,16404, 16405, 16489, 16490 U.S. Department of Veterans Affairs
- OMAT ID# 16403,16404, 16405, 16489, 16490 U.S. Department of Veterans Affairs
- OMAT ID# 16403,16404, 16405, 16489, 16490 U.S. Department of Veterans Affairs
- OMAT ID# 16403,16404, 16405, 16489, 16490 U.S. Department of Veterans Affairs
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Affiliation(s)
- Jolie N Haun
- Research and Development Service, James A. Haley Veterans' Hospital, 8900 Grand Oak Circle, Tampa, FL, 33637, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84132, USA
| | - Christopher A Fowler
- Research and Development Service, James A. Haley Veterans' Hospital, 8900 Grand Oak Circle, Tampa, FL, 33637, USA.
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, 3515 E. Fletcher Ave, Tampa, FL, 33613, USA.
| | - Hari H Venkatachalam
- Research and Development Service, James A. Haley Veterans' Hospital, 8900 Grand Oak Circle, Tampa, FL, 33637, USA
| | - Michael S Saenger
- Anesthesia Service Line, Atlanta Veterans Administration Health Care System, 1670 Clairmont Rd, Decatur, GA, 30033, USA
- Division of Internal Medicine, School of Medicine, Emory University, 201 Dowman Dr, Atlanta, GA, 30322, USA
| | - Amy C Alman
- Research and Development Service, James A. Haley Veterans' Hospital, 8900 Grand Oak Circle, Tampa, FL, 33637, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84132, USA
| | - Bridget M Smith
- Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, 5000 South 5th Ave, Hines, IL, 60141, USA
| | - Tali Schneider
- Research and Development Service, James A. Haley Veterans' Hospital, 8900 Grand Oak Circle, Tampa, FL, 33637, USA
| | - Rachel Benzinger
- Research and Development Service, James A. Haley Veterans' Hospital, 8900 Grand Oak Circle, Tampa, FL, 33637, USA
| | - Kevin Stroupe
- Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, 5000 South 5th Ave, Hines, IL, 60141, USA
| | - Dustin D French
- Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, 5000 South 5th Ave, Hines, IL, 60141, USA
- Center for Health Services and Outcomes Research, Feinberg School of Medicine, Northwestern University, 633 N. St. Clair St. Suite 2000, Chicago, IL, 60611, USA
- Departments of Ophthalmology and Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 645 N. Michigan Ave. Suite 440, Chicago, IL, 60611, USA
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Rühm W, Cho K, Larsson CM, Wojcik A, Clement C, Applegate K, Bochud F, Bouffler S, Cool D, Hirth G, Kai M, Laurier D, Liu S, Romanov S, Schneider T. Vancouver call for action to strengthen expertise in radiological protection worldwide. Radiat Environ Biophys 2023; 62:175-180. [PMID: 37097458 DOI: 10.1007/s00411-023-01024-5] [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] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/25/2023] [Indexed: 05/18/2023]
Abstract
Ionising radiation has been used for over a century for peaceful purposes, revolutionising health care and promoting well-being through its application in industry, science, and medicine. For almost as long, the International Commission on Radiological Protection (ICRP) has promoted understanding of health and environmental risks of ionising radiation and developed a protection system that enables the safe use of ionising radiation in justified and beneficial practices, providing protection from all sources of radiation. However, we are concerned that a shortage of investment in training, education, research, and infrastructure seen in many sectors and countries may compromise society's ability to properly manage radiation risks, leading to unjustified exposure to or unwarranted fear of radiation, impacting the physical, mental, and social well-being of our peoples. This could unduly limit the potential for research and development in new radiation technologies (healthcare, energy, and the environment) for beneficial purposes. ICRP therefore calls for action to strengthen expertise in radiological protection worldwide through: (1) National governments and funding agencies strengthening resources for radiological protection research allocated by governments and international organisations, (2) National research laboratories and other institutions launching and sustaining long-term research programmes, (3) Universities developing undergraduate and graduate university programmes and making students aware of job opportunities in radiation-related fields, (4) Using plain language when interacting with the public and decision makers about radiological protection, and (5) Fostering general awareness of proper uses of radiation and radiological protection through education and training of information multipliers. The draft call was discussed with international organisations in formal relations with ICRP in October 2022 at the European Radiation Protection Week in Estoril, Portugal, and the final call announced at the 6th International Symposium on the System of Radiological Protection of ICRP in November 2022 in Vancouver, Canada.
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Affiliation(s)
- W Rühm
- Helmholtz Centre Munich, German Research Centre for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.
| | - K Cho
- Korea Institute of Nuclear Safety, Yuseong, 114, Daejeon, 34142, Korea
| | - C-M Larsson
- Australian Radiation Protection and Nuclear Safety Agency, 619 Lower Plenty Road, Yallambie, VIC, 3085, Australia
| | - A Wojcik
- Centre for Radiation Protection Research, Stockholm University, Svante Arrheniusväg 20C, 106 91, Stockholm, Sweden
- Institute of Biology, Jan Kochanoski University, 25-406, Kielce, Poland
| | - C Clement
- International Commission on Radiological Protection, 280 Slater Street, Ottawa, ON, K1P 5S9, Canada
| | - K Applegate
- University of Kentucky College Medicine, 800 Rose Street MN 150, Lexington, KY, 40506, USA
| | - F Bochud
- Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, Rue du Grand-Pré 1, 1007, Lausanne, Switzerland
| | - S Bouffler
- Radiation Protection Sciences Division, UK Health Security Agency, Didcot, OX11 0RQ, Oxon, UK
| | - D Cool
- International Commission on Radiological Protection, 280 Slater Street, Ottawa, ON, K1P 5S9, Canada
| | - G Hirth
- Australian Radiation Protection and Nuclear Safety Agency, 619 Lower Plenty Road, Yallambie, VIC, 3085, Australia
| | - M Kai
- Nippon Bunri University, 1727 Ichigi, Ōita, 870-0397, Japan
| | - D Laurier
- Institut de Radioprotection et de Sûreté Nucléaire, BP 17-92262 Fontenay-aux-Roses Cedex, 31 Avenue de la Division Leclerc , 92260, Fontenay-aux-Roses, Île-de-France, France
| | - S Liu
- China Institute of Atomic Energy, 275 (1), Beijing, 102413, People's Republic of China
| | - S Romanov
- Southern Urals Biophysics Institute, Ozyorsk, Chelyabinsk Region, Russian Federation
| | - T Schneider
- Nuclear Protection Evaluation Centre, 28, rue de la Redoute, 92260, Fontenay aux Roses, France
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Bönstrup M, Schneider T, Ader J, Bräuer A, Claßen J. P-18 Low-frequency brain oscillations in human motor control. Clin Neurophysiol 2023. [DOI: 10.1016/j.clinph.2023.02.035] [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: 03/08/2023]
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10
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Misselhorn J, Fiene M, Radecke J, Engel A, Schneider T. P-108 Using linear mixed modelling to reduce behavioral side-effects of tACS: Frontal alpha stimulation mimics attentional modulation of visual processing. Clin Neurophysiol 2023. [DOI: 10.1016/j.clinph.2023.02.125] [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: 03/08/2023]
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11
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Haun JN, Melillo C, Schneider T, Merzier MM, Klanchar SA, Fowler CA, Benzinger RC. User Testing of the Veteran Delegation Tool: Qualitative Inquiry. J Med Internet Res 2023; 25:e40634. [PMID: 36821364 PMCID: PMC9999259 DOI: 10.2196/40634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 12/05/2022] [Accepted: 12/31/2022] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Informal caregivers, or care partners, provide critical support to care recipients when managing health care. Veterans Health Administration (VHA) priorities identify care partners as vital in supporting veterans' care management. The Veteran Delegation Tool (VDT) is VHA's Health Insurance Portability and Accountability Act-compliant solution for care partners to comanage veterans' care through VHA's electronic health portal. Human-centered design approaches in VDT development are needed to inform enhancements aimed at promoting uptake and sustained use. OBJECTIVE The objective of this prospective descriptive quality improvement project was to use a human-centered design approach to examine VDT use perceptions and practical experiences. METHODS This project was conducted using a 4-phase approach: frame, discover, design, and deliver. The frame phase designed the protocol and prepared the VDT system for testing. This paper reports on the discover phase, which used semistructured and follow-up interviews and user testing to examine VDT's benefits, facilitators, and barriers. The discover phase data informed the design and deliver phases, which are underway. RESULTS Veterans (24/54, 44%), care partners (21/54, 39%), and individuals who represented dual roles (9/54, 17%)-namely veteran care partner (4/54, 7%), veteran clinical provider (2/54, 4%), and care partner provider (3/54, 6%)-participated in semistructured interviews in the discover phase. A subsample of these participants (3/54, 6%) participated in the follow-up interviews and user testing. Analysis of the semistructured interviews indicated convergence on the respondents' perceptions of VDT's benefits, facilitators, and barriers and recommendations for improving VDT. The perceived benefits were authorized access, comanagement of care needs on the web, communication with the clinical team, access to resources, and ease of burden. Perceived barriers were nonrecognition of the benefits of VDT, technical literacy access issues, increased stress in or burden on care partners, and personal health information security. Participant experiences across 4 VDT activity domains were upgrade to My HealtheVet Premium account, registration, sign-in, and use. User testing demonstrated users' challenges to register, navigate, and use VDT. Findings informed VDT development enhancements and recommendations. CONCLUSIONS Care partners need Health Insurance Portability and Accountability Act-compliant access to electronic health portals to assist with care management. VDT is VHA's solution, allowing communication among delegates, veterans, and clinical care teams. Users value VDT's potential use and benefits, while access and navigation improvements to ensure uptake and sustained use are needed. Future efforts need to iteratively evaluate the human-centered phases, design and deliver, of VDT to target audiences. Continued efforts to understand and respond to care partners' needs are warranted.
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Affiliation(s)
- Jolie N Haun
- James A Haley Veterans Hospital, Tampa, FL, United States.,College of Public Health, University of South Florida, Tampa, FL, United States
| | | | - Tali Schneider
- James A Haley Veterans Hospital, Tampa, FL, United States.,College of Public Health, University of South Florida, Tampa, FL, United States
| | | | | | - Christopher A Fowler
- James A Haley Veterans Hospital, Tampa, FL, United States.,Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
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12
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Haun JN, Nakase-Richardson R, Melillo C, Kean J, Benzinger RC, Schneider T, Pugh MJV. This is test MS2 5 Dec 2022 (Preprint). J Med Internet Res 2022; 12:e44776. [PMID: 37159250 DOI: 10.2196/44776] [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: 12/21/2022] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The traumatic brain injury (TBI) Intensive Evaluation and Treatment Program (IETP) is an innovative modality for delivering evidence-based treatments in a residential, inpatient format to special operational forces service members and veterans with mild TBI. IETPs provide bundled evidence-based assessment, treatment, referral, and case management in concordance with the existing guidelines for mild TBI and commonly co-occurring comorbidities. To date, there has been no formal characterization or evaluation of the IETP to understand the determinants of implementation across the system of care. The goal of our partnered evaluation initiative (PEI) with an operational partner, the Physical Medicine and Rehabilitation National Program Office, is to facilitate the full implementation of the IETP across all 5 Veterans Health Administration TBI-Centers of Excellence (TBI-COE) and to inform minimum standards while supporting the unique characteristics of each site. OBJECTIVE This IETP partnered evaluation will describe each of the 5 TBI-COE IETP services and state of implementation to identify opportunities for adaptation and scale, characterize the relationship between patient characteristics and clinical services received, evaluate the outcomes for participants in the IETP, and inform ongoing implementation and knowledge translation efforts to support IETP expansion. In alignment with the goals of the protocol, ineffective treatment components will be targeted for deimplementation. METHODS A 3-year concurrent mixed methods evaluation using a participatory approach in collaboration with the operational partner and TBI-COE site leadership will be conducted. Qualitative observations, semistructured focus groups, and interviewing methods will be used to describe IETP, stakeholder experiences and needs, and suggestions for IETP implementation. Quantitative methods will include primary data collection from patients in the IETP at each site to characterize long-term outcomes and patient satisfaction with treatment and secondary data collection to quantitatively characterize patient-level and care system-level data. Finally, data sets will be triangulated to share data findings with partners to inform ongoing implementation efforts. RESULTS Data collection began in December 2021 and is currently ongoing. The results and deliverables will inform IETP characterization, evaluation, implementation, and knowledge translation. CONCLUSIONS The results of this evaluation seek to provide an understanding of the determinants affecting the implementation of IETPs. Service member, staff, and stakeholder insights will inform the state of implementation at each site, and quantitative measures will provide options for standardized outcome measures. This evaluation is expected to inform national Physical Medicine and Rehabilitation Office policies and processes and knowledge translation efforts to improve and expand the IETP. Future work may include cost evaluations and rigorous research, such as randomized controlled trials. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44776.
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Affiliation(s)
- Jolie N Haun
- James A. Haley Veterans' Hospital, Research Service, Tampa, FL, United States
- College of Public Health, University of South Florida, Tampa, FL, United States
| | - Risa Nakase-Richardson
- James A. Haley Veterans' Hospital, Research Service, Tampa, FL, United States
- Pulmonary/Sleep Medicine Division, Department of Internal Medicine, University of South Florida, Tampa, FL, United States
| | - Christine Melillo
- James A. Haley Veterans' Hospital, Research Service, Tampa, FL, United States
| | - Jacob Kean
- VA Salt Lake City Health Care System, VA Informatics and Computing Infrastructure, Salt Lake City, UT, United States
| | - Rachel C Benzinger
- James A. Haley Veterans' Hospital, Research Service, Tampa, FL, United States
| | - Tali Schneider
- James A. Haley Veterans' Hospital, Research Service, Tampa, FL, United States
| | - Mary Jo V Pugh
- VA Salt Lake City Health Care System, Informatics, Decision-Enhancement and Analytic Sciences Center, Salt Lake City, UT, United States
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Haun J, Jean-Baptiste E, Schneider T, Ballistrea L, McMahon-Grenz J, Melillo C. “In every single way...we learn...to live”: Veterans’ Lived Experiences in the Whole Health Program. Arch Phys Med Rehabil 2022. [DOI: 10.1016/j.apmr.2022.08.758] [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: 12/05/2022]
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14
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Bourenkov G, Schneider T, Dakshinamoorthy U, Paknia E, Fogh R, Keller P, Flensburg C, Vonrhein C, Bricogne G, Schulze-Briese C, Chari A. Enabling high-energy large-unit-cell ultra-high-resolution X-ray crystallography on the P14 at PETRAIII beamline. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322096097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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15
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Shahsavar A, Stohler P, Bourenkov G, Zimmermann I, Siegrist M, Guba W, Pinard E, Sinning S, Seeger M, Schneider T, Dawson R, Nissen P. Structural insights into mechanism of glycine reuptake inhibition. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322096164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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16
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Schneider T, Wolgemuth JR, Bradley-Klug KL, Bryant CA, Ferron JM. Perceptions of School Life and Academic Success of Adolescents With Asthma. Journal of Adolescent Research 2022. [DOI: 10.1177/07435584221110632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adolescents spend approximately one-third of their day at school. With the growing prevalence of adolescent asthma, 1 in every 10 adolescents copes with asthma throughout the day, including in the school environment. Yet, little is known about the school experiences of adolescent students with asthma. Guided by the social-ecological model, this study aimed to explore the links between asthma and school experiences in middle and high school as perceived by students with asthma. In-depth interviews were conducted with 20 adolescents with asthma aged 12 to 17 who attended middle or high school around the mid-west area of Florida. Students shared insights on their school experiences and academic performance. Data were analyzed and interpreted using thematic analysis. Four overarching and intertwined themes shaped the school experiences of students with asthma: 1. Asthma control and management; 2. Social support; 3. Asthma knowledge and awareness; and 4. Accommodation of health and academic needs. Study findings suggest addressing the school disparities of adolescent students with asthma through a comprehensive, multi-level approach. Schools should create asthma education opportunities, improve the school system and environmental accommodations, enhance asthma control, and increase continuous social support by peers and school personnel.
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Affiliation(s)
- Tali Schneider
- James A. Haley Veterans Hospital, Tampa, FL, USA
- University of South Florida Tampa, USA
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17
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Kotmayer L, László T, Kiss R, Hegyi LL, Mikala G, Farkas P, Balogh A, Masszi T, Demeter J, Weisinger J, Alizadeh H, Gergely L, Sulák A, Egyed M, Plander M, Pettendi P, Lévai D, Schneider T, Pauker Z, Masszi A, Szász R, Bödör C, Alpár D. P615: BCL2 RESISTANCE MUTATIONS IN A REAL-WORLD COHORT OF PATIENTS WITH VENETOCLAX-TREATED CHRONIC LYMPHOCYTIC LEUKAEMIA. Hemasphere 2022. [DOI: 10.1097/01.hs9.0000845348.59055.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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18
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Rühm W, Clement C, Cool D, Laurier D, Bochud F, Applegate K, Schneider T, Bouffler S, Cho K, Hirth G, Kai M, Liu S, Romanov S, Wojcik A. Summary of the 2021 ICRP workshop on the future of radiological protection. J Radiol Prot 2022; 42:023002. [PMID: 35417898 DOI: 10.1088/1361-6498/ac670e] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/13/2022] [Indexed: 06/14/2023]
Abstract
The International Commission on Radiological Protection (ICRP) has embarked on a process to review and revise the current System of Radiological Protection ('the System'). To stimulate discussion, the ICRP published two open-access articles: one on aspects of the System that might require review, and another on research that might improve the scientific foundation of the System. Building on these articles, the ICRP organized a Workshop on the Future of Radiological Protection as an opportunity to engage in the review and revision of the System. This digital workshop took place from 14 October-3 November 2021 and included 20 live-streamed and 43 on-demand presentations. Approximately 1500 individuals from 100 countries participated. Based on the subjects covered by the presentations, this summary is organized into four broad areas: the scientific basis, concepts and application of the System; and the role of the ICRP. Some of the key topics that emerged included the following: classification of radiation-induced effects; adverse outcome pathway methodologies; better understanding of the dose-response relationship; holistic and reasonable approaches to optimization of protection; radiological protection of the environment; ethical basis of the System; clarity, consistency and communication of the System; application of the System in medicine and application of the principles of justification and optimization of protection.
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Affiliation(s)
- W Rühm
- Helmholtz Centre Munich, German Research Centre for Environmental Health, Ingolstaedter Landstraße 1, D-85764 Neuherberg, Germany
| | - C Clement
- International Commission on Radiological Protection, 280 Slater Street, Ottawa, Ontario K1P 5S9, Canada
| | - D Cool
- International Commission on Radiological Protection, 280 Slater Street, Ottawa, Ontario K1P 5S9, Canada
| | - D Laurier
- Institut de radioprotection et de Sûreté Nucléaire, BP 17-92262 Fontenay-aux-Roses Cedex, 31 avenue de la Division Leclerc, 92260 Fontenay-aux-Roses, Île-de-France, France
| | - F Bochud
- Lausanne University Hospital and University of Lausanne, Rue du Bugnon 21, CH-1011 Lausanne, Switzerland
| | - K Applegate
- University of Kentucky College Medicine, 800 Rose Street MN 150, Lexington, KY 40506, United States of America
| | - T Schneider
- Nuclear Protection Evaluation Centre, 28, rue de la Redoute, F-92260 Fontenay aux Roses, France
| | - S Bouffler
- Radiation Protection Science Division, UK Health Security Agency, Didcot, Oxon OX11 0RQ, United Kingdom
| | - K Cho
- Korea Institute of Nuclear Safety, PO Box 114, Yuseong, Daejeon 305-338, Republic of Korea
| | - G Hirth
- Australian Radiation Protection and Nuclear Safety Agency, PO Box 655, Miranda, NSW 1490, Australia
| | - M Kai
- Nippon Bunri University, 1727 Ichigi, Ōita 870-0397, Japan
| | - S Liu
- China Institute of Atomic Energy, PO Box 275 (1), Beijing CN-102413, People's Republic of China
| | - S Romanov
- Southern Urals Biophysics Institute, Ozyorsk, Chelyabinsk Region, Russia
| | - A Wojcik
- Centre for Radiation Protection Research, Stockholm University, Svante Arrheniusväg 20C, 106 91 Stockholm, Sweden
- Institute of Biology, Jan Kochanoski University, 25-406 Kielce, Poland
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Ban N, Boyd M, Coates R, Cool DA, Lecomte JF, Schneider T. Perspectives on tolerability and reasonableness. J Radiol Prot 2022; 42:020514. [PMID: 35472700 DOI: 10.1088/1361-6498/ac6a88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 04/26/2022] [Indexed: 06/14/2023]
Abstract
Judgements on tolerability and reasonableness are central to the optimisation of protection. There are currently several international developments regarding these key considerations which will contribute to the review and evolution of the system of radiological protection. The IRPA15 International Congress brought together the principal issues currently under discussion, and the outcome of these discussions is presented.
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Affiliation(s)
- N Ban
- Nuclear Regulation Authority, Tokyo, Japan
| | - M Boyd
- Former Chair CRPPH, NEA (Environmental Protection Agency, Washington, DC, United States of America
| | - R Coates
- Former IRPA President, Bouth, United Kingdom
| | - D A Cool
- Co-Chair, NCRP CC-1 (National Council on Radiation Protection and Measurements), Bethesda, MD, United States of America
| | - J-F Lecomte
- SFRP (French Society for Radiation Protection), IRSN (Institute for Radiological Protection and Nuclear Safety), Fontenay-aux-Roses, France
| | - T Schneider
- Chair ICRP TG114 Tolerability and Reasonableness, CEPN (Nuclear Protection Evaluation Centre), Fontenay-aux-Roses, France
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20
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Schneider T, Behrens R, Garcia-Yip F, Tanderup K, Kertzscher G, Johanson J, Georgi P, Blideanu V, Stien C, Plagnard J, Solc J, Sochor V, Pinto M, Sander T, Subiel A, Gouldstone C, de Prez L, Verhaegen F, Reniers B, Avilés Lucas P, Msimang Z, Eaton D, Weigand F, Rivard M. PO-1801 Primary standards and measurement methods for X-ray emitting electronic BT devices PRISM-eBT. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03764-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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21
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Garcia Yip F, Schneider T, Reginatto M, Behrens R, Buermann L, Grote F. OC-0123 Characterization of small active detectors for electronic brachytherapy dosimetry. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02499-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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22
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Schneider T, Solc J. OC-0118 Realization of the absorbed dose to water for the Intrabeam® - Electronic Brachytherapy X-ray source. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02494-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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23
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Schneider T, de Marzi L, Patriarca A, Prezado Y. Advancing proton minibeam radiation therapy through magnetic focussing. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00186-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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24
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Georgi P, Kertzscher G, Schneider T, Graversen Johansen J, Tanderup K, Nyvang L. PH-0325 Quality assurance of electronic brachytherapy treatment units with a plastic scintillation detector. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07298-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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25
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Langston T, Randazzo J, Kogel U, Hoeng J, Martin F, Titz B, Guedj E, Schneider T, Prabhakar B, Zhang J, Oldham M, Lee KM. Thirteen-week nose-only inhalation exposures of propylene glycol aerosols in Sprague Dawley rats with a lung systems toxicology analysis. Toxicology Research and Application 2021. [DOI: 10.1177/23978473211021072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objectives of this study were to increase PG exposure above concentrations tested by Suber et al. and use systems toxicology analysis of lung tissue to understand molecular events. Sprague Dawley rats were exposed to filtered air (sham), propylene glycol/water (PG/W; 90:10) or a propylene glycol/vegetable glycerin/water (PG/VG/W; 50:40:10) reference. The reference group was added at the high dose to observe any changes that might be associated with a carrier more in line with e-vapor products. Macroscopic examinations and terminal organ weights revealed no observations associated with exposure to PG/W or reference. Food consumption and body weights were unaffected by PG/W or reference when compared to sham. No exposure related alterations were observed in serum chemistry, hematology, coagulation, urinalysis or BALF cytology and clinical chemistry. Although clinical observations of dried red material around the nose in the high dose PG/W group were reported, histopathology showed no nasal hemorrhaging which was previously reported by Suber et al. Non-adverse PG/W and reference related findings of minimal mucous cell hyperplasia were noted in nasal cavity section II. No other exposure-related findings were noted in the primary or recovery necropsies. A systems toxicology analysis on lung tissue showed no statistically significant differentially expressed transcripts or proteins compared to the sham group. The endpoints measured from the PG/W high dose group did not differ significantly from those in the more common carrier PG/VG/W. As anticipated, exposure to PG aerosols was slightly irritating but well tolerated. Accordingly, the highest PG exposure (5 mg/L, 6 hrs/day) was regarded as the NOAEC, corresponding to a PG delivered dose of 1,152 mg/kg/day in rats.
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Affiliation(s)
- T Langston
- Altria Client Services LLC, Richmond, VA, USA
| | - J Randazzo
- Charles River Laboratories, Ashland, OH, USA
| | - U Kogel
- Phillip Morris International, Neuchatel CH, Switzerland
| | - J Hoeng
- Phillip Morris International, Neuchatel CH, Switzerland
| | - F Martin
- Phillip Morris International, Neuchatel CH, Switzerland
| | - B Titz
- Phillip Morris International, Neuchatel CH, Switzerland
| | - E Guedj
- Phillip Morris International, Neuchatel CH, Switzerland
| | - T Schneider
- Phillip Morris International, Neuchatel CH, Switzerland
| | - B Prabhakar
- Lancaster Laboratories, Inc., Lancaster, PA, USA
| | - J Zhang
- Altria Client Services LLC, Richmond, VA, USA
| | - M Oldham
- Oldham Associates LLC, Manakin Sabot, VA, USA
| | - KM Lee
- Altria Client Services LLC, Richmond, VA, USA
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Vidal M, Moignier C, Patriarca A, Sotiropoulos M, Schneider T, De Marzi L. Future technological developments in proton therapy - A predicted technological breakthrough. Cancer Radiother 2021; 25:554-564. [PMID: 34272182 DOI: 10.1016/j.canrad.2021.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 06/18/2021] [Indexed: 12/13/2022]
Abstract
In the current spectrum of cancer treatments, despite high costs, a lack of robust evidence based on clinical outcomes or technical and radiobiological uncertainties, particle therapy and in particular proton therapy (PT) is rapidly growing. Despite proton therapy being more than fifty years old (first proposed by Wilson in 1946) and more than 220,000 patients having been treated with in 2020, many technological challenges remain and numerous new technical developments that must be integrated into existing systems. This article presents an overview of on-going technical developments and innovations that we felt were most important today, as well as those that have the potential to significantly shape the future of proton therapy. Indeed, efforts have been done continuously to improve the efficiency of a PT system, in terms of cost, technology and delivery technics, and a number of different developments pursued in the accelerator field will first be presented. Significant developments are also underway in terms of transport and spatial resolution achievable with pencil beam scanning, or conformation of the dose to the target: we will therefore discuss beam focusing and collimation issues which are important parameters for the development of these techniques, as well as proton arc therapy. State of the art and alternative approaches to adaptive PT and the future of adaptive PT will finally be reviewed. Through these overviews, we will finally see how advances in these different areas will allow the potential for robust dose shaping in proton therapy to be maximised, probably foreshadowing a future era of maturity for the PT technique.
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Affiliation(s)
- M Vidal
- Centre Antoine-Lacassagne, Fédération Claude Lalanne, 227, avenue de la Lanterne, 06200 Nice, France
| | - C Moignier
- Centre François Baclesse, Department of Medical Physics, Centre de protonthérapie de Normandie, 14000 Caen, France
| | - A Patriarca
- Institut Curie, PSL Research University, Radiation oncology department, Centre de protonthérapie d'Orsay, Campus universitaire, bâtiment 101, 91898 Orsay, France
| | - M Sotiropoulos
- Institut Curie, Université PSL, CNRS UMR3347, Inserm U1021, Signalisation radiobiologie et cancer, 91400 Orsay, France
| | - T Schneider
- Institut Curie, Université PSL, CNRS UMR3347, Inserm U1021, Signalisation radiobiologie et cancer, 91400 Orsay, France
| | - L De Marzi
- Institut Curie, PSL Research University, Radiation oncology department, Centre de protonthérapie d'Orsay, Campus universitaire, bâtiment 101, 91898 Orsay, France; Institut Curie, PSL Research University, University Paris Saclay, Inserm LITO, Campus universitaire, 91898 Orsay, France.
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Haibel H, Vahldiek JL, Angermair S, Schumann M, Siegmund B, Poddubnyy D, Schneider T. POS1209 SUCCESSFUL TREATMENT OF SEVERE COVID-19 PNEUMONIA AND CYTOKINE RELEASE WITH SIMULTANEOUS TOCILIZUMAB AND ANAKINRA WITH ONE-MONTH FOLLOW-UP. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Severe and life threating COVID-19 pneumonia is often characterized by local and systemic immune-mediated hyperinflammation At the early disease stage activated monocytes are migrating to the lung and cause the typical opac infiltrates, which lead to an reduction of oxygen uptake. These pathophysiological observations and the fact that corticosteroids are so far the only drug, which has shown significant improvement, was the rationale use this combination anti-inflammatory drugs in severe Covid-19 disease. Interleukin (IL)-6 and IL-1 blockade alone, respectively showed contradictory results in severe COVID-19 pneumonia that might be related to the differences is patient populations (early vs. late stage) and to the fact that blockade of just one cytokine might be not sufficient against the cytokine storm.Objectives:Here we report results of an open-label treatment with a combination of an IL-6 receptor blocker tocilizumab and an IL-1 receptor antagonist anakinra in patients with early (up to 10 days since symptom onset) severe COVID-19 pneumonia with evidence of cytokine release.Methods:Adult patients with, according to World Health Organisation criteria, severe to critical COVID-19 infection associated pneumonia and cytokine release, requiring oxygen supplementation and evidence of rapid deterioration and decrease of oxygen saturation to ≤ 95% hospitalized between May 2020 and December 2020 were treated with tocilizumab 8 mg/ kg up to 800 mg intravenously and anakinra 100 to 300 mg for 3 to 5 days, starting at the same day. We excluded patients with a symptom duration of > 10 days, patients with evidence of bacterial infection, indicated by an elevated procalcitonin serum level, patients with severe pre-existing lung disease such as severe COPD or heart failure of > II according to the NYHA classification and patients > 80 years. Laboratory parameters and chest CT were performed on initial presentation and one month after treatment. A semi-quantitative CT score was calculated based on the extent of lobar pneumonia involvement (0:0%; 1, < 5%; 2:5-25%; 3:26-50%; 4:51-75%; 5, > 75%; range 0-5; global score 0-25) for each time point.Results:15 patients with severe to critical COVID-19 pneumonia and signs of cytokine release, mean age 55 (range 31-79) years, all male, with a mean symptom duration of 6 (range 4-10) days were treated. Mean oxygen saturation was 86% (range 76-95%) before initiating therapy. Mean ferritin was 1297 µg/l (range 347 – 2734), mean IL-6 112 ng/L (range 2.2 – 607.4) and CRP 82.4 mg/L (range 36.4 – 125). In all patients we were able to prevent them from intubation and mechanic ventilation, none of our patients died. Fife patients did not need to be referred to the intensive care unit at all, while 9 patients received noninvasive ventilation and high-flow nasal oxygen support. All patients showed typical imaging features of COVID-19 pneumonia at baseline (BL) according to the Radiological Society of North America (RSNA) chest CT classification system. The mean of the global chest CT severity score at BL was 13 (range 7-20) and decreased to 6 (range 0-16) within 1 month which corresponded to a mean reduction of 58%. Chronic fibrotic pulmonary changes were not seen in any patient at BL and after 1 month mild changes were observed in 6 patients. One patient experienced lower abdominal pain, urinary tract infection, gastrointestinal bleeding due to antrum ulcers Forrest III, in another patient atrial fibrillation, urinary tract infection and apoplexy were observed.Conclusion:In our case series, all patients treated with the combination tocilizumab and anakinra recovered fast and sustained without major infectious side effects, indicating that early interruption of cytocine release might be very effective and safe in preventing patients from mechanical ventilation, death and long-term damage.Image 1: Chest CT of a patient with active COVID-19 infection before and one month after treatment with a combination of tocilizumab and anakinraDisclosure of Interests:Hildrun Haibel Speakers bureau: Abbive, Novartis, Janssen, Pfizer, Roche, Consultant of: Janssen, Novartis, Roche, Janis Lucas Vahldiek: None declared, Stefan Angermair: None declared, Michael Schumann: None declared, Britta Siegmund Speakers bureau: Abbvie, CED Service GmbH, Falk, Ferring, Janssen, Novartis and Takeda as a representative of Charité – Universitätsmedizin Berlin, Consultant of: Abbvie, Arena, BMS, Boehringer, Celgene, Falk, Janssen, Lilly, Pfizer, Prometheus, Takeda representative of Charité – Universitätsmedizin Berlin, Grant/research support from: Pfizer, Denis Poddubnyy Speakers bureau: AbbVie, Bristol-Myers Squibb, Lilly, MSD, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Biocad, Gilead, GlaxoSmithKline, Eli Lilly, MSD, Novartis, Pfizer, Samsung Bioepis, and UCB, Grant/research support from: AbbVie, Eli Lilly, MSD, Novartis, and Pfizer, Thomas Schneider: None declared.
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Schneider T. SP-0008 Traceability of LDR and HDR source calibration. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06466-5] [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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Georgi P, Kertzscher G, Schneider T, Nyvang Jensen L, Tanderup K, Graversen Johansen J. PO-0218 Characterising a Papillon 50 electronic brachytherapy source using a plastic scintillation detector. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06377-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Blood safety is a non-negotiable issue worldwide, specifies the World Health Organization (WHO). Africa is both an entity and a multiplicity of situations within and cross-borders. Indeed, most African countries have recent borders and political organizations, after gaining independence in the 60's. Many such countries have maintained various types of links and cooperation programs with former European countries of influence, e.g. France and Belgium among others, which is the case for several countries from the francophone Central and West Africa. Besides, borders do not delineate ethnic groups as many of them migrate, with spread North to South and East to West across several countries, each having representations, ethnologically speaking. Transfusion is an essential supportive healthcare that requires medicine, technicity and logistics. Cooperation can be provided to Francophone Africa though at the expense of recruiting donors upon criteria that do not completely overlap with e.g. those put forward in France and other high-income countries, despite WHO claims for the universal model of Voluntary Non-Remunerated Blood Donation system. Next, the patient profile in intertropical Africa-of which the various francophone African countries-stringently differs from the profile now seen in France, with its younger (but strongly social network-connected) populations and the importance of anemia of all causes but frequently infectious in nature. The frequency of antigens defining blood groups also significantly differs from that in France and the rest of Europa. Last, the carriage of blood transmissible infectious pathogens in sick but also apparently healthy populations seriously complicates the build up of suitable blood component inventory. In the present review, we discuss the universality of blood donation, the specificities of inter-continent cooperation and report on experiences of such cooperation. The French Blood Establishment EFS has taken over earlier initiatives of regional blood services and provides technology and scientific transfer and support to many countries for several decades; the National Institute for Blood transfusion, an education and research institute, has set up collaborative research in several domains but mostly in the domain of blood transmissible infections. We next also present a theoretical view of support named ALEASE, that can be pursued, based on collaborative experiences carried out in the Mediterranean Northern and Eastern areas. ALEASE promotes benchmark between participants. If there is general agreement that cooperation between economically wealthy countries and low-income, developing, countries in the domain of blood and blood transfusion safety, promotion of blood donation, blood component manufacturing, transfusion technology, hemovigilance, etc., tools to achieve this goal can be periodically reviewed based on specific needs for countries and professionals. That also comprise of adapted, sometimes specific, education programs.
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Affiliation(s)
- O Garraud
- INSERM U_1059, Faculty of medicine, University of Lyon-Saint-Étienne, 69007 Saint-Étienne, France; Institut National de la Transfusion Sanguine, 75015 Paris, France.
| | - T Schneider
- Établissement Français du Sang, Direction des affaires internationales, 93218 La Plaine Saint-Denis, France
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McDaniel JT, McDermott RJ, Schneider T. A Fay-Herriot Model for Estimating Subjective Cognitive Decline among Military Veterans. J Prev Alzheimers Dis 2021; 8:457-461. [PMID: 34585220 DOI: 10.14283/jpad.2021.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Although studies have examined the geographic distribution of dementia among the general population in order to develop geographically targeted interventions, no studies have examined the geographic distribution of subjective cognitive decline (SCD) among military veterans specifically. OBJECTIVES To map the geographic distribution of subjective cognitive decline from 2011-2019 in the United States among military veterans. DESIGN Cross-sectional. SETTING United States. PARTICIPANTS Individuals reporting previous service in the United States Armed Forces. MEASUREMENTS Using 2011 Behavioral Risk Factor Surveillance System (BRFSS) data, which is last year for which geocoded SCD data is publicly available, we estimated the survey-weighted county-level prevalence of veteran SCD for counties with >30 veterans (43 counties in 7 states). We then developed a Fay-Herriot small area estimation linear model using auxiliary data from the Census, with county-level veteran-specific covariates including % >65 years old, % female, % college educated, and median income. Following model validation, we created beta-weighted predictions of veteran SCD for all USA counties for 2011-2019 using relevant time-specific Census auxiliary data. We provide choropleth maps of our predictions. RESULTS Results of our model on 43 counties showed that county-level rates of SCD were significantly associated with all auxiliary variables except annual income (F = 1.49, df = 4, 38). Direct survey-weighted rates were correlated with model-predicted rates in 43 counties (Pearson r = 0.32). Regarding predicted rates for the entire USA, the average county-level prevalence rate of veteran SCD in 2011 was 13.83% (SD = 7.35), but 29.13% in 2019 (SD = 14.71) - although variation in these rates were evident across counties. CONCLUSIONS SCD has increased since 2011 among veterans. Veterans Affairs hospitals should implement plans that include cognitive assessments, referral to resources, and monitoring patient progress, especially in rural areas.
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Affiliation(s)
- J T McDaniel
- Justin T McDaniel, Southern Illinois University Carbondale, USA,
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Poussin C, Van Der Toorn M, Scheuner S, Piault R, Kondylis A, Savioz R, Dulize R, Peric D, Guedj E, Maranzano F, Merg C, Morelli M, Egesipe AL, Johne S, Majeed S, Pak C, Schneider T, Schlage W, Ivanov N, Peitsch M, Hoeng J. Systems toxicology revealed reduced impact of ths 2.2 aerosol relative to 3R4F smoke on aortic smooth muscle cell aging and exacerbation effects in aged cells in vitro. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Solanky BS, John NA, DeAngelis F, Stutters J, Prados F, Schneider T, Parker RA, Weir CJ, Monteverdi A, Plantone D, Doshi A, MacManus D, Marshall I, Barkhof F, Gandini Wheeler-Kingshott CAM, Chataway J. NAA is a Marker of Disability in Secondary-Progressive MS: A Proton MR Spectroscopic Imaging Study. AJNR Am J Neuroradiol 2020; 41:2209-2218. [PMID: 33154071 DOI: 10.3174/ajnr.a6809] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/24/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE The secondary progressive phase of multiple sclerosis is characterised by disability progression due to processes that lead to neurodegeneration. Surrogate markers such as those derived from MRI are beneficial in understanding the pathophysiology that drives disease progression and its relationship to clinical disability. We undertook a 1H-MRS imaging study in a large secondary progressive MS (SPMS) cohort, to examine whether metabolic markers of brain injury are associated with measures of disability, both physical and cognitive. MATERIALS AND METHODS A cross-sectional analysis of individuals with secondary-progressive MS was performed in 119 participants. They underwent 1H-MR spectroscopy to obtain estimated concentrations and ratios to total Cr for total NAA, mIns, Glx, and total Cho in normal-appearing WM and GM. Clinical outcome measures chosen were the following: Paced Auditory Serial Addition Test, Symbol Digit Modalities Test, Nine-Hole Peg Test, Timed 25-foot Walk Test, and the Expanded Disability Status Scale. The relationship between these neurometabolites and clinical disability measures was initially examined using Spearman rank correlations. Significant associations were then further analyzed in multiple regression models adjusting for age, sex, disease duration, T2 lesion load, normalized brain volume, and occurrence of relapses in 2 years preceding study entry. RESULTS Significant associations, which were then confirmed by multiple linear regression, were found in normal-appearing WM for total NAA (tNAA)/total Cr (tCr) and the Nine-Hole Peg Test (ρ = 0.23; 95% CI, 0.06-0.40); tNAA and tNAA/tCr and the Paced Auditory Serial Addition Test (ρ = 0.21; 95% CI, 0.03-0.38) (ρ = 0.19; 95% CI, 0.01-0.36); mIns/tCr and the Paced Auditory Serial Addition Test, (ρ = -0.23; 95% CI, -0.39 to -0.05); and in GM for tCho and the Paced Auditory Serial Addition Test (ρ = -0.24; 95% CI, -0.40 to -0.06). No other GM or normal-appearing WM relationships were found with any metabolite, with associations found during initial correlation testing losing significance after multiple linear regression analysis. CONCLUSIONS This study suggests that metabolic markers of neuroaxonal integrity and astrogliosis in normal-appearing WM and membrane turnover in GM may act as markers of disability in secondary-progressive MS.
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Affiliation(s)
- B S Solanky
- From the Department of Neuroinflammation (B.S.S., N.A.J., F.D., J.S., F.P., D.P., A.D., D.M., C.A.M.G.W.-K., J.C.), Faculty of Brain Sciences, Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology
| | - N A John
- From the Department of Neuroinflammation (B.S.S., N.A.J., F.D., J.S., F.P., D.P., A.D., D.M., C.A.M.G.W.-K., J.C.), Faculty of Brain Sciences, Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology
| | - F DeAngelis
- From the Department of Neuroinflammation (B.S.S., N.A.J., F.D., J.S., F.P., D.P., A.D., D.M., C.A.M.G.W.-K., J.C.), Faculty of Brain Sciences, Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology
| | - J Stutters
- From the Department of Neuroinflammation (B.S.S., N.A.J., F.D., J.S., F.P., D.P., A.D., D.M., C.A.M.G.W.-K., J.C.), Faculty of Brain Sciences, Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology
| | - F Prados
- From the Department of Neuroinflammation (B.S.S., N.A.J., F.D., J.S., F.P., D.P., A.D., D.M., C.A.M.G.W.-K., J.C.), Faculty of Brain Sciences, Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology
- Centre for Medical Image Computing (F.P., F.B.), Department of Medical Physics and Biomedical Engineering, University College London, London, UK
- Universitat Oberta de Catalunya (F.P.), Barcelona, Spain
| | | | - R A Parker
- Edinburgh Clinical Trials Unit (R.A.P., C.J.W.), Usher Institute
| | - C J Weir
- Edinburgh Clinical Trials Unit (R.A.P., C.J.W.), Usher Institute
| | - A Monteverdi
- Department of Brain and Behavioural Sciences (A.M., C.A.M.G.W.-K.), University of Pavia, Pavia, Italy
| | - D Plantone
- From the Department of Neuroinflammation (B.S.S., N.A.J., F.D., J.S., F.P., D.P., A.D., D.M., C.A.M.G.W.-K., J.C.), Faculty of Brain Sciences, Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology
| | - A Doshi
- From the Department of Neuroinflammation (B.S.S., N.A.J., F.D., J.S., F.P., D.P., A.D., D.M., C.A.M.G.W.-K., J.C.), Faculty of Brain Sciences, Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology
| | - D MacManus
- From the Department of Neuroinflammation (B.S.S., N.A.J., F.D., J.S., F.P., D.P., A.D., D.M., C.A.M.G.W.-K., J.C.), Faculty of Brain Sciences, Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology
| | - I Marshall
- Centre for Clinical Brain Sciences (I.M.), University of Edinburgh, Edinburgh, UK
| | - F Barkhof
- Centre for Medical Image Computing (F.P., F.B.), Department of Medical Physics and Biomedical Engineering, University College London, London, UK
- National Institute for Health Research (F.B.), University College London Hospitals Biomedical Research Centre, London, UK
- Department of Radiology and Nuclear Medicine (F.B., J.C.), MS Center Amsterdam, Amsterdam, the Netherlands
| | - C A M Gandini Wheeler-Kingshott
- From the Department of Neuroinflammation (B.S.S., N.A.J., F.D., J.S., F.P., D.P., A.D., D.M., C.A.M.G.W.-K., J.C.), Faculty of Brain Sciences, Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology
- Brain MRI 3T Research Center (C.A.M.G.W.-K.), Scientific Institute for Research, Hospitalization and Healthcare Mondino National Neurological Institute Foundation, Pavia, Italy
- Department of Brain and Behavioural Sciences (A.M., C.A.M.G.W.-K.), University of Pavia, Pavia, Italy
| | - J Chataway
- From the Department of Neuroinflammation (B.S.S., N.A.J., F.D., J.S., F.P., D.P., A.D., D.M., C.A.M.G.W.-K., J.C.), Faculty of Brain Sciences, Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology
- Department of Radiology and Nuclear Medicine (F.B., J.C.), MS Center Amsterdam, Amsterdam, the Netherlands
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Kai M, Homma T, Lochard J, Schneider T, Lecomte JF, Nisbet A, Shinkarev S, Averin V, Lazo T. ICRP Publication 146: Radiological Protection of People and the Environment in the Event of a Large Nuclear Accident : Update of ICRP PUBLICATIONS 109 AND 111. Ann ICRP 2020; 49:11-135. [PMID: 33291942 DOI: 10.1177/0146645320952659] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Danda C, Pandey V, Schneider T, Norman R, Maia JM. Enhanced Dispersion and Mechanical Behavior of Polypropylene Composites Compounded Using Extension-Dominated Extrusion. INT POLYM PROC 2020. [DOI: 10.3139/217.3899] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
The process of dispersing filler in polymer matrix is vital to the behavior of polymer composites. The current study involves understanding the extent of dispersion of filler by only varying the nature of mixing during the process. Identical polymer composite materials are processed via two different kinds of mixing sections on the screw in a twin-screw extruder, differing in the type and amount of stress they impose on the filler agglomerate. An aggressive (900) Kneading Block (KB) mixing section is compared with recently developed Extensional Mixing Elements (EMEs), which impart extension dominated mixing while KB imparts shear dominated mixing. Various EME geometries of different levels of aggressiveness were computationally studied and validated. Composites obtained from KB are compared with composites processed using five different EME geometries. Three composites of Polypropylene (PP) filled with carbon black, graphene nano platelets and carbon nanotubes were studied independently. Composites processed through EMEs display about an order of magnitude better dispersion of filler agglomerate over the composites processed through KB. In addition, enhanced modulus and yield stress is observed for composites processed through EMEs. An improvement of 63% to 266% in the strain achieved for EME processed composites is seen under biaxial film stretching.
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Affiliation(s)
- C. Danda
- Department of Macromolecular Science and Engineering , Case Western Reserve University, Cleveland, OH , USA
| | - V. Pandey
- Department of Macromolecular Science and Engineering , Case Western Reserve University, Cleveland, OH , USA
| | - T. Schneider
- Department of Macromolecular Science and Engineering , Case Western Reserve University, Cleveland, OH , USA
| | - R. Norman
- Department of Macromolecular Science and Engineering , Case Western Reserve University, Cleveland, OH , USA
| | - J. M. Maia
- Department of Macromolecular Science and Engineering , Case Western Reserve University, Cleveland, OH , USA
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Schneider T, Neumaier F, Hescheler J, Alpdogan S. Cav2.3 R-type calcium channels: from its discovery to pathogenic de novo CACNA1E variants: a historical perspective. Pflugers Arch 2020; 472:811-816. [PMID: 32529299 PMCID: PMC7351833 DOI: 10.1007/s00424-020-02395-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 12/31/2022]
Abstract
So-called pharmacoresistant (R-type) voltage-gated Ca2+ channels are structurally only partially characterized. Most of them are encoded by the CACNA1E gene and are expressed as different Cav2.3 splice variants (variant Cav2.3a to Cav2.3e or f) as the ion conducting subunit. So far, no inherited disease is known for the CACNA1E gene but recently spontaneous mutations leading to early death were identified, which will be brought into focus. In addition, a short historical overview may highlight the development to understand that upregulation during aging, easier activation by spontaneous mutations or lack of bioavailable inorganic cations (Zn2+ and Cu2+) may lead to similar pathologies caused by cellular overexcitation.
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Affiliation(s)
| | - F Neumaier
- Universitat zu Koln, 50931, Köln, Germany
| | | | - S Alpdogan
- Universitat zu Koln, 50931, Köln, Germany
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Schneider T. Asthma and Academic Performance Among Children and Youth in North America: A Systematic Review. J Sch Health 2020; 90:319-342. [PMID: 31998975 DOI: 10.1111/josh.12877] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 10/18/2019] [Accepted: 10/22/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The increasing prevalence of asthma among adolescents and the limited studies exploring the educational outcomes for youth coping with asthma makes the inquiry in this field of special interest. This paper reviews the literature on empirical studies exploring the relationship between asthma and academic performance among adolescents. METHODS Five databases (CINAHL, PubMed, ERIC EBSCO, Web of Science, and PsycINFO) were searched for peer-reviewed empirical studies exploring the link between asthma and academic performance utilized. Studies were reviewed, logged, and assessed studies for their research design, methods, and findings. Data synthesis incorporated strengths, limitations, and recommendations for future research and practice. RESULTS Twenty studies met the inclusion criteria. Of these, 13 employed a survey design and 7 evaluated school-based interventions implementing an experimental design. Whereas researchers applied quantitative methods in all the studies, qualitative and mixed-method designs were infrequently used. Studies showed a link between school absenteeism and asthma; other academic indicators (eg, graduation and test-scores) showed inconsistent correlation. CONCLUSIONS Future research should deploy more variable research designs and methods to improve understanding of the factors contributing to the relationship between adolescent asthma and academic performance. Additional topic-specific inquiry is needed to inform school practices and policies.
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Affiliation(s)
- Tali Schneider
- Deputy Director, , Florida Prevention Research Center, University of South Florida, Tampa, FL, 33613
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Jaubert O, Cruz G, Bustin A, Schneider T, Koken P, Doneva M, Rueckert D, Botnar RM, Prieto C. Free-running cardiac magnetic resonance fingerprinting: Joint T1/T2 map and Cine imaging. Magn Reson Imaging 2020; 68:173-182. [PMID: 32061964 PMCID: PMC7677167 DOI: 10.1016/j.mri.2020.02.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/21/2020] [Accepted: 02/09/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE To develop and evaluate a novel non-ECG triggered 2D magnetic resonance fingerprinting (MRF) sequence allowing for simultaneous myocardial T1 and T2 mapping and cardiac Cine imaging. METHODS Cardiac MRF (cMRF) has been recently proposed to provide joint T1/T2 myocardial mapping by triggering the acquisition to mid-diastole and relying on a subject-dependent dictionary of MR signal evolutions to generate the maps. In this work, we propose a novel "free-running" (non-ECG triggered) cMRF framework for simultaneous myocardial T1 and T2 mapping and cardiac Cine imaging in a single scan. Free-running cMRF is based on a transient state bSSFP acquisition with tiny golden angle radial readouts, varying flip angle and multiple adiabatic inversion pulses. The acquired data is retrospectively gated into several cardiac phases, which are reconstructed with an approach that combines parallel imaging, low rank modelling and patch-based high-order tensor regularization. Free-running cMRF was evaluated in a standardized phantom and ten healthy subjects. Comparison with reference spin-echo, MOLLI, SASHA, T2-GRASE and Cine was performed. RESULTS T1 and T2 values obtained with the proposed approach were in good agreement with reference phantom values (ICC(A,1) > 0.99). Reported values for myocardium septum T1 were 1043 ± 48 ms, 1150 ± 100 ms and 1160 ± 79 ms for MOLLI, SASHA and free-running cMRF respectively and for T2 of 51.7 ± 4.1 ms and 44.6 ± 4.1 ms for T2-GRASE and free-running cMRF respectively. Good agreement was observed between free-running cMRF and conventional Cine 2D ejection fraction (bias = -0.83%). CONCLUSION The proposed free-running cardiac MRF approach allows for simultaneous assessment of myocardial T1 and T2 and Cine imaging in a single scan.
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Affiliation(s)
- O Jaubert
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.
| | - G Cruz
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - A Bustin
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - T Schneider
- Philips Healthcare, Guilford, United Kingdom
| | - P Koken
- Philips Research Europe, Hamburg, Germany
| | - M Doneva
- Philips Research Europe, Hamburg, Germany
| | - D Rueckert
- Department of Computing, Imperial College London, London, United Kingdom
| | - R M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - C Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom; Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
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Boersma P, Borboroglu PG, Gownaris N, Bost C, Chiaradia A, Ellis S, Schneider T, Seddon P, Simeone A, Trathan P, Waller L, Wienecke B. Applying science to pressing conservation needs for penguins. Conserv Biol 2020; 34:103-112. [PMID: 31257646 PMCID: PMC7027562 DOI: 10.1111/cobi.13378] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 06/25/2019] [Accepted: 06/25/2019] [Indexed: 05/29/2023]
Abstract
More than half of the world's 18 penguin species are declining. We, the Steering Committee of the International Union for Conservation of Nature Species Survival Commission Penguin Specialist Group, determined that the penguin species in most critical need of conservation action are African penguin (Spheniscus demersus), Galápagos penguin (Spheniscus mendiculus), and Yellow-eyed penguin (Megadyptes antipodes). Due to small or rapidly declining populations, these species require immediate scientific collaboration and policy intervention. We also used a pairwise-ranking approach to prioritize research and conservation needs for all penguins. Among the 12 cross-taxa research areas we identified, we ranked quantifying population trends, estimating demographic rates, forecasting environmental patterns of change, and improving the knowledge of fisheries interactions as the highest priorities. The highest ranked conservation needs were to enhance marine spatial planning, improve stakeholder engagement, and develop disaster-management and species-specific action plans. We concurred that, to improve the translation of science into effective conservation for penguins, the scientific community and funding bodies must recognize the importance of and support long-term research; research on and conservation of penguins must expand its focus to include the nonbreeding season and juvenile stage; marine reserves must be designed at ecologically appropriate spatial and temporal scales; and communication between scientists and decision makers must be improved with the help of individual scientists and interdisciplinary working groups.
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Affiliation(s)
- P.D. Boersma
- Center for Ecosystem Sentinels and Department of BiologyUniversity of WashingtonSeattleWA98103U.S.A.
- Global Penguin SocietyPuerto Madryn9120Argentina
| | - P. García Borboroglu
- Center for Ecosystem Sentinels and Department of BiologyUniversity of WashingtonSeattleWA98103U.S.A.
- Global Penguin SocietyPuerto Madryn9120Argentina
- CESIMAR CCT Cenpat‐CONICET9120Puerto MadrynChubutArgentina
| | - N.J. Gownaris
- Center for Ecosystem Sentinels and Department of BiologyUniversity of WashingtonSeattleWA98103U.S.A.
| | - C.A. Bost
- Centre d'Etudes Biologiques de Chizé79360Villiers‐en‐BoisFrance
| | - A. Chiaradia
- Conservation DepartmentPhillip Island Nature ParksCowesVIC3922Australia
| | - S. Ellis
- International Rhino FoundationStrasburgVA22657U.S.A.
| | - T. Schneider
- Detroit Zoological SocietyRoyal OakMI48067U.S.A.
| | - P.J. Seddon
- Department of ZoologyUniversity of OtagoDunedin9016New Zealand
| | - A. Simeone
- Facultad de Ciencias de la VidaUniversidad Andres BelloSantiago8370146Chile
| | | | - L.J. Waller
- Southern African Foundation for the Conservation of Coastal Birds (SANCCOB)Cape Town7441South Africa
- Department of Biodiversity and Conservation BiologyUniversity of the Western CapeBellvilleCape Town7535South Africa
| | - B. Wienecke
- Australian Antarctic DivisionKingstonTAS7050Australia
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De Marzi L, Nauraye C, Lansonneur P, Pouzoulet F, Patriarca A, Schneider T, Guardiola C, Mammar H, Dendale R, Prezado Y. Spatial fractionation of the dose in proton therapy: Proton minibeam radiation therapy. Cancer Radiother 2019; 23:677-681. [DOI: 10.1016/j.canrad.2019.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 08/01/2019] [Indexed: 10/26/2022]
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Abstract
During the recording of whole cell currents from stably transfected HEK-293 cells, the decline of currents carried by the recombinant human Cav2.3+β3 channel subunits is related to adenosine triphosphate (ATP) depletion after rupture of the cells. It reduces the number of functional channels and leads to a progressive shift of voltage-dependent gating to more negative potentials (Neumaier F., et al., 2018). Both effects can be counteracted by hydrolysable ATP, whose protective action is almost completely prevented by inhibition of serine/threonine but not tyrosine or lipid kinases. These findings indicate that ATP promotes phosphorylation of either the channel or an associated protein, whereas dephosphorylation during cell dialysis results in run-down. Protein phosphorylation is required for Cav2.3 channel function and could directly influence the normal features of current carried by these channels. Therefore, results from in vitro and in vivo phosphorylation of Cav2.3 are summarized to come closer to a functional analysis of structural variations in Cav2.3 splice variants.
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Affiliation(s)
- T Schneider
- a Center of Physiology and Pathophysiology , Institute of Neurophysiology , Cologne , Germany
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Okosun J, Bödör C, Batlevi C, Nagy N, Michot J, Schneider T, Alizadeh H, Simon Z, Vose J, Younes A, Ribrag V, Fitzgibbon J, Yang J, Agarwal S, Newberry K, Michaud N. EZH2 GAIN-OF-FUNCTION MUTATIONS ARE NOT ASSOCIATED WITH MORE FAVORABLE PROGNOSIS IN RELAPSED/REFRACTORY FOLLICULAR LYMPHOMA (FL): A PRELIMINARY ANALYSIS ON 590 PATIENTS. Hematol Oncol 2019. [DOI: 10.1002/hon.6_2630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- J. Okosun
- Hematology, Barts Cancer Institute; Queen Mary University of London; London United Kingdom
| | - C. Bödör
- Hematology; Semmelweis University; Budapest Hungary
| | - C. Batlevi
- Medical Oncology; Memorial Sloan Kettering Cancer Center; New York United States
| | - N. Nagy
- Cancer Research; Semmelweis University; Budapest Hungary
| | - J. Michot
- Hematology and Innovative Drugs; Gustave Roussy; Villejuif France
| | - T. Schneider
- Medical Oncology and Hematology; National Institute of Oncology; Budapest Hungary
| | - H. Alizadeh
- Internal Medicine; University of Pecs; Pecs Hungary
| | - Z. Simon
- Biochemistry and Molecular Biology; University of Debrecen; Debrecen Hungary
| | - J. Vose
- Oncology & Hematology; University of Nebraska Medical Center; Omaha United States
| | - A. Younes
- Medical Oncology; Memorial Sloan Kettering Cancer Center; New York United States
| | - V. Ribrag
- DITEP; Gustave Roussy; Villejuif France
| | - J. Fitzgibbon
- Hematology, Barts Cancer Institute; Queen Mary University of London; London United Kingdom
| | - J. Yang
- Biostatistics; Epizyme; Cambridge United States
| | - S. Agarwal
- Chief Medical Officer; Epizyme; Cambridge United States
| | | | - N.R. Michaud
- Translational Medicine; Epizyme; Cambridge United States
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Young BR, Gwede CK, Thomas B, Vázquez-Otero C, Ewing A, Best AL, Aguado Loi CX, Martinez-Tyson D, Schneider T, Meade CD, Baldwin JA, Bryant C. A Systematic Review of U.S.-Based Colorectal Cancer Screening Uptake Intervention Systematic Reviews: Available Evidence and Lessons Learned for Research and Practice. Front Public Health 2019; 7:145. [PMID: 31245345 PMCID: PMC6579825 DOI: 10.3389/fpubh.2019.00145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 05/21/2019] [Indexed: 01/08/2023] Open
Abstract
Background: We examined colorectal cancer screening (CRCS) intervention effectiveness, through the effect sizes associated with: (1) screening modality, (2) intervention level (e.g., client-directed), and (3) intervention component (e.g. client reminders) within published CRCS intervention systematic reviews (SRs). Methods: A search of peer-reviewed CRCS SRs that were written in English was employed utilizing five databases: CINAHL, Cochrane Library, rTIPS, PubMed, and PsycINFO EBSCOHOST. SRs that included CRCS interventions with a randomized controlled trial, quasi-experimental, or single arm design were eligible. Data on effect sizes by screening modality, intervention level, and intervention component were extracted and synthesized. Results: There were 16 eligible CRCS intervention SRs that included 116 studies published between 1986 and 2013. Reviews organized data by CRCS screening modality, or intervention component. Effect size reporting varied by format (i.e., ranges, medians of multiple studies, or effect size per study), and groupings of modalities and components. Overall, the largest effect sizes were for studies that utilized a combination of colonoscopy, fecal occult blood test (FOBT), and sigmoidoscopy as screening options (16–45 percentage point difference). Conclusions: Evidence suggests that CRCS interventions which include a combination of screening modalities may be most effective. This is the first SR to examine effect sizes of published CRCS SRs. However, because some SRs did not report effect sizes and there were tremendous variability reporting formats among those that did, a standard reporting format is warranted. Synthesizing findings can contribute to improved knowledge of evidence-based best-practices, direct translation of findings into policy and practice, and guide further research in CRCS.
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Affiliation(s)
- Belinda-Rose Young
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Prevention Research Center, College of Public Health, University of South Florida, Tampa, FL, United States
| | - Clement K Gwede
- Prevention Research Center, College of Public Health, University of South Florida, Tampa, FL, United States.,Moffitt Cancer Center & Research Institute and Morsani, College of Medicine, University of South Florida, Tampa, FL, United States
| | - Bria Thomas
- Prevention Research Center, College of Public Health, University of South Florida, Tampa, FL, United States
| | - Coralia Vázquez-Otero
- Prevention Research Center, College of Public Health, University of South Florida, Tampa, FL, United States
| | - Aldenise Ewing
- Prevention Research Center, College of Public Health, University of South Florida, Tampa, FL, United States
| | - Alicia L Best
- Prevention Research Center, College of Public Health, University of South Florida, Tampa, FL, United States
| | - Claudia X Aguado Loi
- Prevention Research Center, College of Public Health, University of South Florida, Tampa, FL, United States.,Health Sciences and Human Performance Department, University of Tampa, Tampa, FL, United States
| | - Dinorah Martinez-Tyson
- Prevention Research Center, College of Public Health, University of South Florida, Tampa, FL, United States
| | - Tali Schneider
- Prevention Research Center, College of Public Health, University of South Florida, Tampa, FL, United States
| | - Cathy D Meade
- Prevention Research Center, College of Public Health, University of South Florida, Tampa, FL, United States.,Moffitt Cancer Center & Research Institute and Morsani, College of Medicine, University of South Florida, Tampa, FL, United States
| | - Julie A Baldwin
- Prevention Research Center, College of Public Health, University of South Florida, Tampa, FL, United States.,Health Sciences Department, Northern Arizona University, Flagstaff, AZ, United States
| | - Carol Bryant
- Prevention Research Center, College of Public Health, University of South Florida, Tampa, FL, United States
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Schneider T. OC-0079 Expanding Calibration Service for LDR Brachytherapy Seeds by Photon Fluence Determination. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30499-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Schneider T, De Marzi L, Patriarca A, Prezado Y. PO-1017 Towards magnetically focused proton minibeams: investigating the limits of a clinical PBS nozzle. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31437-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fiene M, Schwab B, Misselhorn J, Herrmann C, Schneider T, Engel A. Phase-specific aftereffects of transcranial alternating current stimulation on visual processing. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Misselhorn J, Schwab B, Schneider T, Engel A. Bifocal high-definition tACS over early sensory regions modulates crossmodal matching: Combined evidence from EEG and tACS/behavioral studies. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.439] [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] Open
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Klement RJ, Abbasi-Senger N, Adebahr S, Alheid H, Allgaeuer M, Becker G, Blanck O, Boda-Heggemann J, Brunner T, Duma M, Eble MJ, Ernst I, Gerum S, Habermehl D, Hass P, Henkenberens C, Hildebrandt G, Imhoff D, Kahl H, Klass ND, Krempien R, Lewitzki V, Lohaus F, Ostheimer C, Papachristofilou A, Petersen C, Rieber J, Schneider T, Schrade E, Semrau R, Wachter S, Wittig A, Guckenberger M, Andratschke N. The impact of local control on overall survival after stereotactic body radiotherapy for liver and lung metastases from colorectal cancer: a combined analysis of 388 patients with 500 metastases. BMC Cancer 2019; 19:173. [PMID: 30808323 PMCID: PMC6390357 DOI: 10.1186/s12885-019-5362-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [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: 06/10/2018] [Accepted: 02/11/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The aim of this analysis was to model the effect of local control (LC) on overall survival (OS) in patients treated with stereotactic body radiotherapy (SBRT) for liver or lung metastases from colorectal cancer. METHODS The analysis is based on pooled data from two retrospective SBRT databases for pulmonary and hepatic metastases from 27 centers from Germany and Switzerland. Only patients with metastases from colorectal cancer were considered to avoid histology as a confounding factor. An illness-death model was employed to model the relationship between LC and OS. RESULTS Three hundred eighty-eight patients with 500 metastatic lesions (lung n = 209, liver n = 291) were included and analyzed. Median follow-up time for local recurrence assessment was 12.1 months. Ninety-nine patients with 112 lesions experienced local failure. Seventy-one of these patients died after local failure. Median survival time was 27.9 months in all patients and 25.4 months versus 30.6 months in patients with and without local failure after SBRT. The baseline risk of death after local failure exceeds the baseline risk of death without local failure at 10 months indicating better survival with LC. CONCLUSION In CRC patients with lung or liver metastases, our findings suggest improved long-term OS by achieving metastatic disease control using SBRT in patients with a projected OS estimate of > 12 months.
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Affiliation(s)
- Rainer J Klement
- Department of Radiation Oncology, Leopoldina Hospital Schweinfurt, Schweinfurt, Germany
| | - N Abbasi-Senger
- Department of Radiation Oncology, University Hospital Jena, Jena, Germany
| | - S Adebahr
- Department of Radiation Oncology, University Hospital Freiburg, Freiburg, Germany
| | - H Alheid
- Strahlentherapie Bautzen, Bautzen, Germany
| | - M Allgaeuer
- Department of Radiation Oncology, Hospital Barmherzige Brueder, Regensburg, Germany
| | - G Becker
- RadioChirurgicum CyberKnife Suedwest, Goeppingen, Germany
| | - O Blanck
- Department of Radiation Oncology Universitaetsklinikum Schleswig-Holstein, Luebeck, Germany
| | - J Boda-Heggemann
- Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - T Brunner
- Department of Radiation Oncology, University Hospital Freiburg, Freiburg, Germany
| | - M Duma
- Department of Radiation Oncology, Klinikum rechts der Isar- Technische Universitaet Muenchen, Munich, Germany
| | - M J Eble
- Department of Radiation Oncology, University Hospital Aachen, Aachen, Germany
| | - I Ernst
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - S Gerum
- Department of Radiation Oncology, Ludwig Maximilians University Munich, Munich, Germany
| | - D Habermehl
- Department of Radiation Oncology, Klinikum rechts der Isar- Technische Universitaet Muenchen, Munich, Germany.,Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | - P Hass
- Department of Radiation Oncology, University Hospital Magdeburg, Magdeburg, Germany
| | - C Henkenberens
- Department of Radiotherapy and Special Oncology, Medical School Hannover, Hanover, Germany
| | - G Hildebrandt
- Department of Radiation Oncology, University of Rostock, Rostock, Germany
| | - D Imhoff
- Department of Radiation Oncology, University Hospital Frankfurt, Frankfurt, Germany
| | - H Kahl
- Department of Radiation Oncology, Hospital Augsburg, Augsburg, Germany
| | - N D Klass
- Department of Radiation Oncology, University Hospital Bern, Bern, Switzerland
| | - R Krempien
- Department of Radiation Oncology, Helios Klinikum Berlin Buch, Berlin, Germany
| | - V Lewitzki
- Department of Radiation Oncology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - F Lohaus
- Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - C Ostheimer
- Department of Radiation Oncology, University Hospital Halle, Halle, Germany
| | - A Papachristofilou
- Department of Radiation Oncology, University Hospital Hamburg, Hamburg, Germany
| | - C Petersen
- Department of Radiation Oncology, University Hospital Basel, Basel, Switzerland
| | - J Rieber
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | | | - E Schrade
- Department of Radiation Oncology, Hospital Heidenheim, Heidenheim, Germany
| | - R Semrau
- Department of Radiation Oncology, University Hospital of Cologne, Cologne, Germany
| | - S Wachter
- Department of Radiation Oncology, Klinikum Passau, Passau, Germany
| | - A Wittig
- Department of Radiation Oncology, University Hospital Jena, Jena, Germany.,Department of Radiotherapy and Radiation Oncology, Philipps-University Marburg, University Hospital Giessen and Marburg, Marburg, Germany
| | - M Guckenberger
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - N Andratschke
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
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Gallardo RA, Cortés-Ortuño D, Schneider T, Roldán-Molina A, Ma F, Troncoso RE, Lenz K, Fangohr H, Lindner J, Landeros P. Flat Bands, Indirect Gaps, and Unconventional Spin-Wave Behavior Induced by a Periodic Dzyaloshinskii-Moriya Interaction. Phys Rev Lett 2019; 122:067204. [PMID: 30822086 DOI: 10.1103/physrevlett.122.067204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 10/26/2018] [Indexed: 06/09/2023]
Abstract
Periodically patterned metamaterials are known for exhibiting wave properties similar to the ones observed in electronic band structures in crystal lattices. In particular, periodic ferromagnetic materials are characterized by the presence of bands and band gaps in their spin-wave spectrum at tunable GHz frequencies. Recently, the fabrication of magnets hosting Dzyaloshinskii-Moriya interactions has been pursued with high interest since properties, such as the stabilization of chiral spin textures and nonreciprocal spin-wave propagation, emerge from this antisymmetric exchange coupling. In this context, to further engineer the magnon band structure, we propose the implementation of magnonic crystals with periodic Dzyaloshinskii-Moriya interactions, which can be obtained, for instance, via patterning of periodic arrays of heavy metal wires on top of an ultrathin magnetic film. We demonstrate through theoretical calculations and micromagnetic simulations that such systems show an unusual evolution of the standing spin waves around the gaps. We also predict the emergence of indirect gaps and flat bands, effects that depend on the strength of the Dzyaloshinskii-Moriya interaction. Such phenomena, which have been previously observed in different systems, are observed here simultaneously, opening new routes towards engineered metamaterials for spin-wave-based devices.
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Affiliation(s)
- R A Gallardo
- Departamento de Física, Universidad Técnica Federico Santa María, Avenida España 1680, Valparaíso, Chile
- Center for the Development of Nanoscience and Nanotechnology (CEDENNA), 917-0124 Santiago, Chile
| | - D Cortés-Ortuño
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton SO17 1BJ, United Kingdom
| | - T Schneider
- Helmholtz-Zentrum Dresden-Rossendorf, Institut of Ion Beam Physics and Materials Research, Bautzner Landstr. 400, 01328 Dresden, Germany
- Department of Physics, Technische Universität Chemnitz, Reichenhainer Str. 70, 09126 Chemnitz, Germany
| | - A Roldán-Molina
- Universidad de Aysén, Calle Obispo Vielmo 62, Coyhaique, Chile
| | - Fusheng Ma
- Jiangsu Key Lab on Opto-Electronic Technology, Center for Quantum Transport and Thermal Energy Science, School of Physics and Technology, Nanjing Normal University, Nanjing 210023, China
| | - R E Troncoso
- Departamento de Física, Universidad Técnica Federico Santa María, Avenida España 1680, Valparaíso, Chile
- Center for Quantum Spintronics, Department of Physics, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway
| | - K Lenz
- Helmholtz-Zentrum Dresden-Rossendorf, Institut of Ion Beam Physics and Materials Research, Bautzner Landstr. 400, 01328 Dresden, Germany
| | - H Fangohr
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton SO17 1BJ, United Kingdom
- European XFEL GmbH, Holzkoppel 4, 22869 Schenefeld, Germany
| | - J Lindner
- Helmholtz-Zentrum Dresden-Rossendorf, Institut of Ion Beam Physics and Materials Research, Bautzner Landstr. 400, 01328 Dresden, Germany
| | - P Landeros
- Departamento de Física, Universidad Técnica Federico Santa María, Avenida España 1680, Valparaíso, Chile
- Center for the Development of Nanoscience and Nanotechnology (CEDENNA), 917-0124 Santiago, Chile
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Schneider T, Baum L, Amy A, Marisa C. I have most of my asthma under control and I know how my asthma acts: Users' perceptions of asthma self-management mobile app tailored for adolescents. Health Informatics J 2019; 26:342-353. [PMID: 30732520 DOI: 10.1177/1460458218824734] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Asthma continues to be the leading chronic condition among US adolescents. Despite medical advances, many adolescents face uncontrolled asthma mainly due to insufficient self-management skills. Mobile apps pose a promising adjunct to in-clinic asthma care. However, little is known about the usability and effectiveness of such technology. In all, 20 adolescents participated in a 3-month trial to test an asthma app tailored to their age. Qualitative data on adolescents' experience with the app were inquired. Overall, participants thought the app was functional and user-friendly. The majority expressed that the app assisted them with asthma self-management through tracking of asthma status and text reminders to test their peak flow regularly. They indicated external factors that limited app use and suggested improvements to make the app more engaging and appealing to adolescents. The tested app provides a feasible means to assist adolescent in developing self-management skills, tracking disease status, and communicating with healthcare providers.
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