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Mirnezami AH, Drami I, Glyn T, Sutton PA, Tiernan J, Behrenbruch C, Guerra G, Waters PS, Woodward N, Applin S, Charles SJ, Rose SA, Denys A, Pape E, van Ramshorst GH, Baker D, Bignall E, Blair I, Davis P, Edwards T, Jackson K, Leendertse PG, Love-Mott E, MacKenzie L, Martens F, Meredith D, Nettleton SE, Trotman MP, van Hecke JJM, Weemaes AMJ, Abecasis N, Angenete E, Aziz O, Bacalbasa N, Barton D, Baseckas G, Beggs A, Brown K, Buchwald P, Burling D, Burns E, Caycedo-Marulanda A, Chang GJ, Coyne PE, Croner RS, Daniels IR, Denost QD, Drozdov E, Eglinton T, Espín-Basany E, Evans MD, Flatmark K, Folkesson J, Frizelle FA, Gallego MA, Gil-Moreno A, Goffredo P, Griffiths B, Gwenaël F, Harris DA, Iversen LH, Kandaswamy GV, Kazi M, Kelly ME, Kokelaar R, Kusters M, Langheinrich MC, Larach T, Lydrup ML, Lyons A, Mann C, McDermott FD, Monson JRT, Neeff H, Negoi I, Ng JL, Nicolaou M, Palmer G, Parnaby C, Pellino G, Peterson AC, Quyn A, Rogers A, Rothbarth J, Abu Saadeh F, Saklani A, Sammour T, Sayyed R, Smart NJ, Smith T, Sorrentino L, Steele SR, Stitzenberg K, Taylor C, Teras J, Thanapal MR, Thorgersen E, Vasquez-Jimenez W, Waller J, Weber K, Wolthuis A, Winter DC, Brangan G, Vimalachandran D, Aalbers AGJ, Abdul Aziz N, Abraham-Nordling M, Akiyoshi T, Alahmadi R, Alberda W, Albert M, Andric M, Angeles M, Antoniou A, Armitage J, Auer R, Austin KK, Aytac E, Baker RP, Bali M, Baransi S, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brunner M, Bui A, Burgess A, Burger JWA, Campain N, Carvalhal S, Castro L, Ceelen W, Chan KKL, Chew MH, Chok AK, Chong P, Christensen HK, Clouston H, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Damjanovic L, Davies M, Davies RJ, Delaney CP, de Wilt JHW, Deutsch C, Dietz D, Domingo S, Dozois EJ, Duff M, Egger E, Enrique-Navascues JM, Espín-Basany E, Eyjólfsdóttir B, Fahy M, Fearnhead NS, Fichtner-Feigl S, Fleming F, Flor B, Foskett K, Funder J, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Giner F, Ginther N, Glover T, Golda T, Gomez CM, Harris C, Hagemans JAW, Hanchanale V, Harji DP, Helbren C, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Holmström A, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Jenkins JT, Jourand K, Kaffenberger S, Kapur S, Kanemitsu Y, Kaufman M, Kelley SR, Keller DS, Kersting S, Ketelaers SHJ, Khan MS, Khaw J, Kim H, Kim HJ, Kiran R, Koh CE, Kok NFM, Kontovounisios C, Kose F, Koutra M, Kraft M, Kristensen HØ, Kumar S, Lago V, Lakkis Z, Lampe B, Larsen SG, Larson DW, Law WL, Laurberg S, Lee PJ, Limbert M, Loria A, Lynch AC, Mackintosh M, Mantyh C, Mathis KL, Margues CFS, Martinez A, Martling A, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, McArthur DR, McCormick JJ, McGrath JS, McPhee A, Maciel J, Malde S, Manfredelli S, Mikalauskas S, Modest D, Morton JR, Mullaney TG, Navarro AS, Neto JWM, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, O’Dwyer ST, Paarnio K, Pappou E, Park J, Patsouras D, Peacock O, Pfeffer F, Piqeur F, Pinson J, Poggioli G, Proud D, Quinn M, Oliver A, Radwan RW, Rajendran N, Rao C, Rasheed S, Rasmussen PC, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Seifert G, Selvasekar C, Shaban M, Shaikh I, Shida D, Simpson A, Skeie-Jensen T, Smart P, Smith JJ, Solbakken AM, Solomon MJ, Sørensen MM, Spasojevic M, Steffens D, Stocchi L, Stylianides NA, Swartling T, Sumrien H, Swartking T, Takala H, Tan EJ, Taylor D, Tejedor P, Tekin A, Tekkis PP, Thaysen HV, Thurairaja R, Toh EL, Tsarkov P, Tolenaar J, Tsukada Y, Tsukamoto S, Tuech JJ, Turner G, Turner WH, Tuynman JB, Valente M, van Rees J, van Zoggel D, Vásquez-Jiménez W, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Wakeman C, Warrier S, Wasmuth HH, Weiser MR, Westney OL, Wheeler JMD, Wild J, Wilson M, Yano H, Yip B, Yip J, Yoo RN, Zappa MA. The empty pelvis syndrome: a core data set from the PelvEx collaborative. Br J Surg 2024; 111:znae042. [PMID: 38456677 PMCID: PMC10921833 DOI: 10.1093/bjs/znae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/15/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Empty pelvis syndrome (EPS) is a significant source of morbidity following pelvic exenteration (PE), but is undefined. EPS outcome reporting and descriptors of radicality of PE are inconsistent; therefore, the best approaches for prevention are unknown. To facilitate future research into EPS, the aim of this study is to define a measurable core outcome set, core descriptor set and written definition for EPS. Consensus on strategies to mitigate EPS was also explored. METHOD Three-stage consensus methodology was used: longlisting with systematic review, healthcare professional event, patient engagement, and Delphi-piloting; shortlisting with two rounds of modified Delphi; and a confirmatory stage using a modified nominal group technique. This included a selection of measurement instruments, and iterative generation of a written EPS definition. RESULTS One hundred and three and 119 participants took part in the modified Delphi and consensus meetings, respectively. This encompassed international patient and healthcare professional representation with multidisciplinary input. Seventy statements were longlisted, seven core outcomes (bowel obstruction, enteroperineal fistula, chronic perineal sinus, infected pelvic collection, bowel obstruction, morbidity from reconstruction, re-intervention, and quality of life), and four core descriptors (magnitude of surgery, radiotherapy-induced damage, methods of reconstruction, and changes in volume of pelvic dead space) reached consensus-where applicable, measurement of these outcomes and descriptors was defined. A written definition for EPS was agreed. CONCLUSIONS EPS is an area of unmet research and clinical need. This study provides an agreed definition and core data set for EPS to facilitate further research.
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Chatelain LS, Kourilsky A, Lot G, Rogers A. Airo® navigation versus freehand fluoroscopy technique: A comparative study of accuracy and radiological exposure for thoracolumbar screws placement. Neurochirurgie 2023; 69:101437. [PMID: 36967084 DOI: 10.1016/j.neuchi.2023.101437] [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: 10/21/2022] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 04/14/2023]
Abstract
PURPOSE The aim was to compare the accuracy of freehand fluoroscopy and CT based navigation on thoracolumbar screws placement and their respective effects on radiological exposure to the patient. No previous study directly compared the Airo® navigation system to freehand technique. METHODS In this monocentric retrospective study, 156 consecutive patients who underwent thoracolumbar spine surgery were included. Epidemiological data and surgical indications were noted. Heary classification was used for thoracic screws and Gertzbein-Robbins classification for lumbar screws. Radiological exposure was collected for each surgery. RESULTS A total of 918 screws were implanted. We analyzed 725 lumbar screws (Airo® 287; freehand fluoroscopy 438) and 193 thoracic screws (Airo® 49; freehand fluoroscopy 144). Overall, lumbar screws accuracy (Gertzbein-Robbins grade A and B) was good in both groups (freehand fluoroscopy 91.3%; Airo® 97.6%; P<0.05). We found significantly less Grade B and C in the Airo® group. Thoracic accuracy was also good in both groups (Heary 1 and 2; freehand fluoroscopy 77.8%; Airo® 93.9%), without reaching statistical significance. Radiological exposure was significantly higher in the Airo® group with a mean effective dose of 9.69 mSv versus 0.71mSv for freehand fluoroscopy. CONCLUSION Our study confirmed that the use of Airo® navigation yielded good accuracy. It however exposed the patient to higher radiological exposure compared with freehand fluoroscopy technique. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
- L S Chatelain
- Fondation Rothschild, Department of Neurosurgery, 25-29, rue Manin, 75019 Paris, France.
| | - A Kourilsky
- Fondation Rothschild, Department of Neurosurgery, 25-29, rue Manin, 75019 Paris, France
| | - G Lot
- Fondation Rothschild, Department of Neurosurgery, 25-29, rue Manin, 75019 Paris, France
| | - A Rogers
- Fondation Rothschild, Department of Neurosurgery, 25-29, rue Manin, 75019 Paris, France; American Hospital of Paris, 55, boulevard du Château, 92200 Neuilly-sur-Seine, France
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3
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Brent DA, Grupp-Phelan J, O’Shea BA, Patel SJ, Mahabee-Gittens EM, Rogers A, Duffy SJ, Shenoi RP, Chernick LS, Casper TC, Webb MW, Nock MK, King CA. A comparison of self-reported risk and protective factors and the death implicit association test in the prediction of future suicide attempts in adolescent emergency department patients. Psychol Med 2023; 53:123-131. [PMID: 33947480 PMCID: PMC8568726 DOI: 10.1017/s0033291721001215] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Concerns have been raised about the utility of self-report assessments in predicting future suicide attempts. Clinicians in pediatric emergency departments (EDs) often are required to assess suicidal risk. The Death Implicit Association Test (IAT) is an alternative to self-report assessment of suicidal risk that may have utility in ED settings. METHODS A total of 1679 adolescents recruited from 13 pediatric emergency rooms in the Pediatric Emergency Care Applied Research Network were assessed using a self-report survey of risk and protective factors for a suicide attempt, and the IAT, and then followed up 3 months later to determine if an attempt had occurred. The accuracy of prediction was compared between self-reports and the IAT using the area under the curve (AUC) with respect to receiver operator characteristics. RESULTS A few self-report variables, namely, current and past suicide ideation, past suicidal behavior, total negative life events, and school or social connectedness, predicted an attempt at 3 months with an AUC of 0.87 [95% confidence interval (CI), 0.84-0.90] in the entire sample, and AUC = 0.91, (95% CI 0.85-0.95) for those who presented without reported suicidal ideation. The IAT did not add significantly to the predictive power of selected self-report variables. The IAT alone was modestly predictive of 3-month attempts in the overall sample ((AUC = 0.59, 95% CI 0.52-0.65) and was a better predictor in patients who were non-suicidal at baseline (AUC = 0.67, 95% CI 0.55-0.79). CONCLUSIONS In pediatric EDs, a small set of self-reported items predicted suicide attempts within 3 months more accurately than did the IAT.
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Affiliation(s)
- D. A. Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- UPMC Western Psychiatric Hospital, Pittsburgh, PA, USA
| | - J. Grupp-Phelan
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - B. A. O’Shea
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
- Department of Psychology, University of Amsterdam, Netherlands
| | - S. J. Patel
- Departments of Emergency Medicine and Trauma Services at the Children’s National Health System, USA
| | | | - A. Rogers
- Departments of Emergency Medicine and Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - S. J. Duffy
- Departments of Emergency Medicine and Pediatrics at the Alpert Medical School at Brown University, USA
| | - R. P. Shenoi
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - L. S. Chernick
- Department of Emergency Medicine, Columbia University, New York, NY, USA
| | - T. C. Casper
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - M. W. Webb
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - M. K. Nock
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
| | - C. A. King
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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Brooks CM, Ainley DG, Jacquet J, Chown SL, Pertierra LR, Francis E, Rogers A, Chavez-Molina V, Teh L, Sumaila UR. Protect global values of the Southern Ocean ecosystem. Science 2022; 378:477-479. [PMID: 36264826 DOI: 10.1126/science.add9480] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Climate change and fishing present dual threats.
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Affiliation(s)
- Cassandra M Brooks
- Department of Environmental Studies, University of Colorado Boulder, Boulder, CO, USA.
| | - David G Ainley
- H.T. Harvey & Associates Ecological Consultants, Los Gatos, CA, USA
| | - Jennifer Jacquet
- Department of Environmental Studies, New York University, New York, NY, USA
| | - Steven L Chown
- Securing Antarctica's Environmental Future, School of Biological Sciences, Monash University, Victoria, Australia
| | - Luis R Pertierra
- Department of Plant and Soil Sciences, University of Pretoria, Pretoria, South Africa
| | | | | | - Vasco Chavez-Molina
- Department of Environmental Studies, University of Colorado Boulder, Boulder, CO, USA.
| | - Louise Teh
- Institute for the Oceans and Fisheries and the School of Public Policy and Global Affairs, University of British Columbia, Vancouver, Canada
| | - U Rashid Sumaila
- Institute for the Oceans and Fisheries and the School of Public Policy and Global Affairs, University of British Columbia, Vancouver, Canada.,Institute for Environment and Development (LESTARI), National University of Malaysia, Selangor, Malaysia
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5
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Tuckey MR, Li Y, Neall AM, Chen PY, Dollard MF, McLinton SS, Rogers A, Mattiske J. Workplace bullying as an organizational problem: Spotlight on people management practices. J Occup Health Psychol 2022; 27:544-565. [PMID: 35951417 DOI: 10.1037/ocp0000335] [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: 11/08/2022]
Abstract
Though workplace bullying is conceptualized as an organizational problem, there remains a gap in understanding the contexts in which bullying manifests-knowledge vital for addressing bullying in practice. In three studies, we leverage the rich content contained within workplace bullying complaint records to explore this issue then, based on our discoveries, investigate people management practices linked to bullying. First, through content analysis of 342 official complaints lodged with a state health and safety regulator (over 5,500 pages), we discovered that the risk of bullying primarily arises from ineffective people management in 11 different contexts (e.g., managing underperformance, coordinating working hours, and entitlements). Next, we developed a behaviorally anchored rating scale to measure people management practices within a refined set of nine risk contexts. Effective and ineffective behavioral indicators were identified through content analysis of the complaints data and data from 44 critical incident interviews with subject matter experts; indicators were then sorted and rated by two independent samples to form a risk audit tool. Finally, data from a multilevel multisource study of 145 clinical healthcare staff nested in 25 hospital wards showed that the effectiveness of people management practices predicts concurrent exposure to workplace bullying at individual level beyond established organizational antecedents, and at the team level beyond leading indicator psychosocial safety climate. Overall, our findings highlight where the greatest risk of bullying lies within organizational systems and identifies effective ways of managing people within those contexts to reduce the risk, opening new avenues for bullying intervention research and practice. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | - Yiqiong Li
- University of Queensland Business School
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6
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Deb B, Selvalingam A, Alhusseini M, Rogers A, Ganesan P, Feng R, Clopton P, Ruiperez-Campillo S, Narayan S. Machine-learned physiological signatures from the ECG predict sudden death in ischemic cardiomyopathy. Europace 2022. [DOI: 10.1093/europace/euac053.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Health (NIH)
Background
Low left ventricular ejection fraction (LVEF) is an imperfect predictor of sudden cardiac death (SCD) in patients with ischemic cardiomyopathy. Novel features from the ECG might provide a readily available tool to better predict risk.
Purpose
We hypothesized that machine learning (ML) of the ECG can be used to predict SCD, and the ML-learned ECG features could be referenced to interpretable intracardiac signals (monophasic action potentials: MAP) to provide mechanistic insights.
Methods
We studied 5603 ECG Lead V1 beats in 41 patients (64±10 Y) with coronary disease and LVEF≤40% in steady-state pacing. Patients were randomly allocated to independent training and test cohorts in a 70:30 ratio, repeated K=10-fold. Support vector machines were trained to predict mortality at 3Y from the top 20 features derived from these beats. Patient-level predictions were made by computing an ECG score that indicates the proportion of test set beats in that patient computed by the beat-level model to predict death. Explainability analysis was performed using the arithmetic mean of MAP and ECG beats that predicted SCD versus those that predicted survival.
Results
Fig 1A. shows ECG lead V1 and MAP in a 79 Y man with LVEF 29%. Fig 1B shows the dataflow in the study. Predictive accuracies of ML models were 78 and 70% and optimal with 20 features for both ECG and MAP models respectively (Fig. 1C). Beat-level predictions in the validation (n=1678 Lead I beats) cohorts yielded c-statistics of 0.78 with the ECG (95% CI, 0.62–0.91) and 0.75 with MAPs (95% CI, 0.75-0.76) (data not shown). In multivariable patient-level models, c-statistic was 0.87 with ECGs (95% CI, 0.76-0.98) (Fig 1D) and 0.82 with MAPs. On explainability analysis, ECG beats that predicted SCD (Fig 2; red) had lower amplitude and more notched T-waves in lead V1 than beats that predicted no SCD (Fig 2; blue). MAP that predicted SCD had higher repolarization current at the same time points. Both QT duration (ECG) and action potential duration (MAP) did not differ (Fig 2).
Conclusions
Machine learning of the ECG reveals novel predictors of SCD risk in patients with ischemic cardiomyopathy analogous to those identified in intracardiac signals. This approach can be used as a point-of-care ECG risk tool to improve risk stratification and allocation for ICD therapy beyond LVEF alone and may shed insights into the pathophysiology of ventricular arrhythmias.
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Affiliation(s)
- B Deb
- Stanford University School of Medicine, Cardiology, Palo Alto, United States of America
| | - A Selvalingam
- Stanford University School of Medicine, Cardiology, Palo Alto, United States of America
| | - M Alhusseini
- Stanford University School of Medicine, Cardiology, Palo Alto, United States of America
| | - A Rogers
- Stanford University School of Medicine, Cardiology, Palo Alto, United States of America
| | - P Ganesan
- Stanford University School of Medicine, Cardiology, Palo Alto, United States of America
| | - R Feng
- Stanford University School of Medicine, Cardiology, Palo Alto, United States of America
| | - P Clopton
- Stanford University School of Medicine, Cardiology, Palo Alto, United States of America
| | - S Ruiperez-Campillo
- Stanford University School of Medicine, Cardiology, Palo Alto, United States of America
| | - S Narayan
- Stanford University School of Medicine, Cardiology, Palo Alto, United States of America
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Mahajan R, Adams A, Allmond J, Alvarez Pol H, Argo E, Ayyad Y, Bardayan D, Bazin D, Budner T, Chen A, Chipps K, Davids B, Dopfer J, Friedman M, Fynbo H, Grzywacz R, Jose J, Liang J, Pain S, Perez-Loureiro D, Pollacco E, Psaltis A, Ravishankar S, Rogers A, Schaedig L, Sun LJ, Surbrook J, Wheeler T, Weghorn L, Wrede C. Measuring the 15O( α, γ) 19Ne Reaction in Type I X-ray Bursts using the GADGET II TPC: Software. EPJ Web Conf 2022. [DOI: 10.1051/epjconf/202226011034] [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: 11/14/2022] Open
Abstract
15O(α,γ)19Ne is regarded as one of the most important thermonuclear reactions in type I X-ray bursts. For studying the properties of the key resonance in this reaction using β decay, the existing Proton Detector component of the Gaseous Detector with Germanium Tagging (GADGET) assembly is being upgraded to operate as a time projection chamber (TPC) at FRIB. This upgrade includes the associated hardware as well as software and this paper mainly focusses on the software upgrade. The full detector set up is simulated using the ATTPCROOTv 2 data analysis framework for 20Mg and 241Am.
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8
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Wheeler T, Adams A, Allmond J, Alvarez Pol H, Argo E, Ayyad Y, Bardayan D, Bazin D, Budner T, Chen A, Chipps K, Davids B, Dopfer J, Friedman M, Fynbo H, Grzywacz R, Jose J, Liang J, Mahajan R, Pain S, Pérez-Loureiro D, Pollacco E, Psaltis A, Ravishankar S, Rogers A, Schaedig L, Sun LJ, Surbrook J, Weghorn L, Wrede C. Measuring the 15O(α, γ) 19Ne reaction in Type I X-ray bursts using the GADGET II TPC: Hardware. EPJ Web Conf 2022. [DOI: 10.1051/epjconf/202226011046] [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: 11/14/2022] Open
Abstract
Sensitivity studies have shown that the 15O(α, γ)19Ne reaction is the most important reaction rate uncertainty affecting the shape of light curves from Type I X-ray bursts. This reaction is dominated by the 4.03 MeV resonance in 19Ne. Previous measurements by our group have shown that this state is populated in the decay sequence of 20Mg. A single 20Mg(βp α)15O event through the key 15O(α, γ)19Ne resonance yields a characteristic signature: the emission of a proton and alpha particle. To achieve the granularity necessary for the identification of this signature, we have upgraded the Proton Detector of the Gaseous Detector with Germanium Tagging (GADGET) into a time projection chamber to form the GADGET II detection system. GADGET II has been fully constructed, and is entering the testing phase.
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9
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Geraghty R, Fowler W, Suntharasivam T, Thomas D, Rix D, Haslam P, Dorkin T, Williams R, Rogers A, Shaw M. Use of allium ureteral stents for managing iatrogenic ureteric injuries. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01046-6] [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: 11/04/2022]
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10
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Jenkins P, MacCormick A, Stokes J, Lyall F, Rogers A, Gafoor N. Learning from mistakes when reporting urgent and emergency vascular studies. Clin Radiol 2021; 77:159-166. [PMID: 34903386 DOI: 10.1016/j.crad.2021.10.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/13/2021] [Indexed: 02/07/2023]
Abstract
The majority of out-of-hours cases relate to neurological, chest, and gastrointestinal pathologies with acute vascular cases being encountered less commonly. Trainees and exposure of non-vascular/interventional radiology (IR) consultants to angiographic imaging is often limited in working hours and this may lead to reporting on-call cases outside of normal daytime practice. In a recent local review, a number on-call vascular studies were found to contain a number of vascular-related discrepancies. Vascular reporting is a complex subspecialty, which comprises many clear diagnoses (large vessel occlusions, large vessel aneurysms, or dissections); however, also several subtle and complex abnormalities. These more subtle abnormalities, at times, require dedicated vascular specialist review to ensure subtle findings are communicated appropriately to the clinical team. The recent increased complexity of endovascular treatments and their complications has also provided further challenge for the non-specialist reporter. Similarly, improved imaging techniques have allowed for non-obvious but significant findings that may require urgent management, such as small aneurysms and dissection flaps. We will review a range of key vascular findings that demonstrate learning opportunities, particularly within the acute and on-call settings. These will include gastrointestinal haemorrhage, subtle aortic pathologies, head and neck vascular emergencies, small to mid-sized vessel injuries and imaging of post-procedural complications. Educational hints and tips will be provided to enable learning from mistakes encountered by trainees and non-vascular specialist radiologists in the on-call or urgent reporting settings, and these will be reviewed with reference to the literature.
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Affiliation(s)
- P Jenkins
- Peninsula Radiology Academy, Plymouth, UK.
| | | | - J Stokes
- Department of Neuroradiology, University of Plymouth Hospitals NHS Trust, Plymouth, UK
| | - F Lyall
- Peninsula Radiology Academy, Plymouth, UK
| | - A Rogers
- Department of Radiology, Royal Cornwall NHS Trust, Cornwall, UK
| | - N Gafoor
- Department of Interventional Radiology, University of Plymouth Hospitals NHS Trust, Plymouth, UK
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11
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Jenkins B, Rogers A, Lawson S. Use of an electronic volume based feeding protocol to improve nutrition delivery in critical care. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.618] [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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12
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Wineski RE, Panico E, Karas A, Rosen P, Van Diver B, Norwood TG, Grayson JW, Beltran-Ale G, Dimmitt R, Kassel R, Rogers A, Leonard M, Chapman A, Boehm L, Wiatrak B, Harris WT, Smith N. Optimal timing and technique for endoscopic management of dysphagia in pediatric aerodigestive patients. Int J Pediatr Otorhinolaryngol 2021; 150:110874. [PMID: 34392101 DOI: 10.1016/j.ijporl.2021.110874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/27/2021] [Accepted: 08/05/2021] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The best strategy to manage an interarytenoid defect [Type 1 laryngeal cleft (LC-1) or deep interarytenoid groove (DIG)] in pediatric aerodigestive patients with dysphagia remains uncertain. This study compared benefit of interarytenoid augmentation (IAA) to suture repair or clinical observation alone in pediatric patients. METHODS A 3-year retrospective, single-center analysis of children with dysphagia undergoing endoscopic airway evaluation was performed. Physician preference guided treatment plan: suture repair with CO2 laser, IAA (carboxy methylcellulose or calcium hydroxyapatite), or observation. Primary outcome was improved post-operative diet. Significance was assumed at p < 0.05. RESULTS 449 patients underwent diagnostic endoscopy. Mean age (±SD) at procedure was 21 ± 13 months, with nearly one fourth (28 %) of children ≤ 12 months. Eighty (18 %) had either an LC-1 (n = 55) or DIG (n = 25). Of these, 35 (42 %) underwent suture repair, 22 (28 %) IAA, and 23 (30 %) observation only. Aspiration improved overall in the interventional groups compared to observational controls (58 % vs. 9 %, p < 0.05), with no change in benefit observed by age of intervention. IAA was as effective as suture repair (59 % vs 55 %, p = 0.46). In patients with only a DIG, IAA intervention alone significantly improved swallow function (66.6 % vs. 0 %, p < 0.05). CONCLUSION In pediatric aerodigestive patients with dysphagia, 18 % of children have an addressable lesion. IAA or suture repair similarly improves dietary advancement. IAA improves swallow function in patients with DIG. These findings support a novel protocol to intervene in dysphagia patients with LC-1 or DIG via IAA at the initial operative evaluation.
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Affiliation(s)
- R E Wineski
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.
| | - E Panico
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - A Karas
- Department of Otorhinolaryngology- Head and Neck Surgery, Rush University School of Medicine, Chicago, IL, USA
| | - P Rosen
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - B Van Diver
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - T G Norwood
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - J W Grayson
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - G Beltran-Ale
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA; Children's of Alabama Aerodigestive Program, Birmingham, AL, USA
| | - R Dimmitt
- Children's of Alabama Aerodigestive Program, Birmingham, AL, USA; Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - R Kassel
- Children's of Alabama Aerodigestive Program, Birmingham, AL, USA; Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - A Rogers
- Children's of Alabama Aerodigestive Program, Birmingham, AL, USA; The Charity League Hearing and Speech Center, Children's of Alabama, Birmingham, AL, USA
| | - M Leonard
- Children's of Alabama Aerodigestive Program, Birmingham, AL, USA; The Charity League Hearing and Speech Center, Children's of Alabama, Birmingham, AL, USA
| | - A Chapman
- Children's of Alabama Aerodigestive Program, Birmingham, AL, USA
| | - L Boehm
- Children's of Alabama Aerodigestive Program, Birmingham, AL, USA
| | - B Wiatrak
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA; Children's of Alabama Aerodigestive Program, Birmingham, AL, USA; Pediatric ENT Associates, Birmingham, AL, USA
| | - W T Harris
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA; Children's of Alabama Aerodigestive Program, Birmingham, AL, USA
| | - N Smith
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA; Children's of Alabama Aerodigestive Program, Birmingham, AL, USA; Pediatric ENT Associates, Birmingham, AL, USA
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13
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Sumaila UR, Skerritt DJ, Schuhbauer A, Villasante S, Cisneros-Montemayor AM, Sinan H, Burnside D, Abdallah PR, Abe K, Addo KA, Adelsheim J, Adewumi IJ, Adeyemo OK, Adger N, Adotey J, Advani S, Afrin Z, Aheto D, Akintola SL, Akpalu W, Alam L, Alava JJ, Allison EH, Amon DJ, Anderies JM, Anderson CM, Andrews E, Angelini R, Anna Z, Antweiler W, Arizi EK, Armitage D, Arthur RI, Asare N, Asche F, Asiedu B, Asuquo F, Badmus L, Bailey M, Ban N, Barbier EB, Barley S, Barnes C, Barrett S, Basurto X, Belhabib D, Bennett E, Bennett NJ, Benzaken D, Blasiak R, Bohorquez JJ, Bordehore C, Bornarel V, Boyd DR, Breitburg D, Brooks C, Brotz L, Campbell D, Cannon S, Cao L, Cardenas Campo JC, Carpenter S, Carpenter G, Carson RT, Carvalho AR, Castrejón M, Caveen AJ, Chabi MN, Chan KMA, Chapin FS, Charles T, Cheung W, Christensen V, Chuku EO, Church T, Clark C, Clarke TM, Cojocaru AL, Copeland B, Crawford B, Crépin AS, Crowder LB, Cury P, Cutting AN, Daily GC, Da-Rocha JM, Das A, de la Puente S, de Zeeuw A, Deikumah SKS, Deith M, Dewitte B, Doubleday N, Duarte CM, Dulvy NK, Eddy T, Efford M, Ehrlich PR, Elsler LG, Fakoya KA, Falaye AE, Fanzo J, Fitzsimmons C, Flaaten O, Florko KRN, Aviles MF, Folke C, Forrest A, Freeman P, Freire KMF, Froese R, Frölicher TL, Gallagher A, Garcon V, Gasalla MA, Gephart JA, Gibbons M, Gillespie K, Giron-Nava A, Gjerde K, Glaser S, Golden C, Gordon L, Govan H, Gryba R, Halpern BS, Hanich Q, Hara M, Harley CDG, Harper S, Harte M, Helm R, Hendrix C, Hicks CC, Hood L, Hoover C, Hopewell K, Horta E Costa BB, Houghton JDR, Iitembu JA, Isaacs M, Isahaku S, Ishimura G, Islam M, Issifu I, Jackson J, Jacquet J, Jensen OP, Ramon JJ, Jin X, Jonah A, Jouffray JB, Juniper SK, Jusoh S, Kadagi I, Kaeriyama M, Kaiser MJ, Kaiser BA, Kakujaha-Matundu O, Karuaihe ST, Karumba M, Kemmerly JD, Khan AS, Kimani P, Kleisner K, Knowlton N, Kotowicz D, Kurien J, Kwong LE, Lade S, Laffoley D, Lam ME, Lam VWL, Lange GM, Latif MT, Le Billon P, Le Brenne V, Le Manach F, Levin SA, Levin L, Limburg KE, List J, Lombard AT, Lopes PFM, Lotze HK, Mallory TG, Mangar RS, Marszalec D, Mattah P, Mayorga J, McAusland C, McCauley DJ, McLean J, McMullen K, Meere F, Mejaes A, Melnychuk M, Mendo J, Micheli F, Millage K, Miller D, Mohamed KS, Mohammed E, Mokhtar M, Morgan L, Muawanah U, Munro GR, Murray G, Mustafa S, Nayak P, Newell D, Nguyen T, Noack F, Nor AM, Nunoo FKE, Obura D, Okey T, Okyere I, Onyango P, Oostdijk M, Orlov P, Österblom H, Owens D, Owens T, Oyinlola M, Pacoureau N, Pakhomov E, Abrantes JP, Pascual U, Paulmier A, Pauly D, Pèlèbè ROE, Peñalosa D, Pennino MG, Peterson G, Pham TTT, Pinkerton E, Polasky S, Polunin NVC, Prah E, Ramírez J, Relano V, Reygondeau G, Robadue D, Roberts C, Rogers A, Roumbedakis K, Sala E, Scheffer M, Segerson K, Seijo JC, Seto KC, Shogren JF, Silver JJ, Singh G, Soszynski A, Splichalova DV, Spring M, Stage J, Stephenson F, Stewart BD, Sultan R, Suttle C, Tagliabue A, Tall A, Talloni-Álvarez N, Tavoni A, Taylor DRF, Teh LSL, Teh LCL, Thiebot JB, Thiele T, Thilsted SH, Thumbadoo RV, Tigchelaar M, Tol RSJ, Tortell P, Troell M, Uzmanoğlu MS, van Putten I, van Santen G, Villaseñor-Derbez JC, Wabnitz CCC, Walsh M, Walsh JP, Wambiji N, Weber EU, Westley F, Williams S, Wisz MS, Worm B, Xiao L, Yagi N, Yamazaki S, Yang H, Zeller D. WTO must ban harmful fisheries subsidies. Science 2021; 374:544. [PMID: 34709891 DOI: 10.1126/science.abm1680] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- U Rashid Sumaila
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.,School of Public Policy and Global Affairs, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Daniel J Skerritt
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Anna Schuhbauer
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Sebastian Villasante
- Cross-Research in Environmental Technologies, Department of Applied Economics, University of Santiago de Compostela, Santiago de Compostela, 15782, Spain
| | | | - Hussain Sinan
- Marine Affairs Program, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Duncan Burnside
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Patrízia Raggi Abdallah
- Instituto de Ciências Econômicas, Administrativas e Contábeis, Universidade Federal do Rio Grande, Rio Grande, RS, Brazil
| | - Keita Abe
- Centre for Applied Research at Norwegian School of Economics, Bergen, Norway
| | - Kwasi A Addo
- Institute for Environment and Sanitation Studies, University of Ghana, Accra, Ghana
| | - Julia Adelsheim
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Ibukun J Adewumi
- Global Ocean Accounts Partnership, University of New South Wales, Sydney, NSW, Australia.,African Marine Environment Sustainability Initiative, Lagos, Nigeria
| | - Olanike K Adeyemo
- Fish and Wildlife Unit, Department of Veterinary Public Health & Preventive Medicine, University of Ibadan, Ibadan, Nigeria
| | - Neil Adger
- Department of Geography, College of Life and Environmental Sciences, University of Exeter, EX44RJ, UK
| | - Joshua Adotey
- Centre for Coastal Management, Africa Centre of Excellence in Coastal Resilience, University of Cape Coast, Cape Coast, Ghana
| | - Sahir Advani
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.,Dakshin Foundation, Bengaluru, India
| | - Zahidah Afrin
- The World Maritime University-Sasakawa Global Ocean Institute, World Maritime University, Malmö, Sweden
| | - Denis Aheto
- Department of Fisheries and Aquatic Sciences, University of Cape Coast, Ghana
| | | | - Wisdom Akpalu
- School of Research and Graduate Studies, Ghana Institute of Management and Public Administration, Achimota-Accra, Ghana
| | - Lubna Alam
- Institute for Environment and Development, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Juan José Alava
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | | | | | - John M Anderies
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ 85287, USA.,School of Sustainability, Arizona State University, Tempe, AZ 85287, USA
| | - Christopher M Anderson
- School of Aquatic and Fishery Sciences, University of Washington, Seattle, WA 98195, USA
| | - Evan Andrews
- Ocean Frontier Institute, Memorial University of Newfoundland, St. John's, NL, A1B 3X5, Canada
| | - Ronaldo Angelini
- Civil Engineering Department, Federal University of Rio Grande do Norte, Campus Universitário Lagoa Nova, CP 1524, Natal/RN, Brazil
| | - Zuzy Anna
- Faculty of Fisheries and Marine Science, Universitas Padjadjaran, Bandung 40132, Indonesia.,SDGs Center, Universitas Padjadjaran, Bandung 40132, Indonesia
| | - Werner Antweiler
- Sauder School of Business, University of British Columbia, Vancouver, BC V6T 1Z2, Canada
| | - Evans K Arizi
- Centre for Coastal Management, Africa Centre of Excellence in Coastal Resilience, University of Cape Coast, Cape Coast, Ghana.,Department of Fisheries and Aquatic Sciences, University of Cape Coast, Ghana
| | - Derek Armitage
- School of Environment, Resources and Sustainability, University of Waterloo, Waterloo, ON, Canada
| | - Robert I Arthur
- Woodhill Solutions, Glyneath House, Longtown, Herefordshire, UK
| | - Noble Asare
- Department of Fisheries and Aquatic Sciences, Africa Centre of Excellence in Coastal Resilience, University of Cape Coast, Cape Coast, Ghana
| | - Frank Asche
- School of Forest, Fisheries, and Geomatics Sciences, University of Florida, Gainesville, FL 32603, USA.,Department of Industrial Economics, University of Stavanger, Stavanger, Norway
| | - Berchie Asiedu
- Department of Fisheries and Water Resources, School of Natural Resources, University of Energy and Natural Resources, Sunyani, Ghana
| | - Francis Asuquo
- Department of Oceanography, University of Calabar, Nigeria
| | - Lanre Badmus
- World Aquaculture Society, African Chapter West African Region, Ibadan, Nigeria
| | - Megan Bailey
- Marine Affairs Program, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Natalie Ban
- School of Environmental Studies, University of Victoria, Victoria, BC V8P 5C2, Canada
| | - Edward B Barbier
- Department of Economics, Colorado State University, Fort Collins, CO 80523-1771, USA
| | - Shanta Barley
- Minderoo Foundation, Broadway Nedlands, WA 6009, Australia
| | - Colin Barnes
- Centre for Environment, Energy and Natural Resource Governance, University of Cambridge, CB2 3QZ, UK
| | | | - Xavier Basurto
- Nicholas School of the Environment, Duke University, Beaufort, NC 28516, USA
| | | | - Elena Bennett
- Department of Natural Resource Sciences and Bieler School of Environment, McGill University, Montreal, QC H3A 0G4, Canada
| | - Nathan J Bennett
- The Peopled Seas Initiative, Vancouver, BC, Canada.,People and the Ocean Specialist Group, Commission on Environmental, Economic and Social Policy, International Union for Conservation of Nature, Gland, Switzerland
| | - Dominique Benzaken
- Australian National Centre for Ocean Resources and Security, Wollongong, NSW, Australia
| | - Robert Blasiak
- Stockholm Resilience Centre, Stockholm University, 10691, Stockholm, Sweden.,Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - John J Bohorquez
- School of Marine and Atmospheric Sciences, Stony Brook University, Stony Brook, NY 11794, USA
| | - Cesar Bordehore
- Department of Ecology, University of Alicante, 03690 Alicante, Spain
| | - Virginie Bornarel
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - David R Boyd
- School of Public Policy and Global Affairs, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | | | - Cassandra Brooks
- Environmental Studies, University of Colorado, Boulder, CO 80303-0397, USA
| | - Lucas Brotz
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Donovan Campbell
- Department of Geography and Geology, The University of the West Indies, Kingston, Jamaica
| | - Sara Cannon
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.,Department of Geography, University of British Columbia, Vancouver, BC, Canada
| | - Ling Cao
- School of Oceanography, Shanghai Jiao Tong University, Shanghai, China
| | | | - Steve Carpenter
- Center for Limnology, University of Wisconsin-Madison, Madison WI 53706, USA
| | | | - Richard T Carson
- Department of Economics, University of California, San Diego, La Jolla, CA 92093, USA
| | - Adriana R Carvalho
- Department of Ecology, Federal University of Rio Grande do Norte, Natal, 59078-970, Brazil
| | - Mauricio Castrejón
- Grupo de Investigación en Biodiversidad, Medio Ambiente y Salud, Universidad de Las Américas, Quito, Ecuador
| | - Alex J Caveen
- Biological and Marine Sciences, Hull University, Hull, HU6 7RX, UK
| | - M Nicole Chabi
- Hokkaido University, Institute for the Advancement of Higher Education, Hokkaido, Japan
| | - Kai M A Chan
- Institute for Resources, Environment, and Sustainability, The University of British Columbia, Vancouver, BC, Canada
| | - F Stuart Chapin
- Institute of Arctic Biology, University of Alaska, Fairbanks, AK 99775, USA
| | - Tony Charles
- School of the Environment, Saint Mary's University, Halifax, NS, B3H 3C3, Canada.,School of Business, Saint Mary's University, Halifax, NS, B3H 3C3, Canada
| | - William Cheung
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Villy Christensen
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Ernest O Chuku
- Centre for Coastal Management, Africa Centre of Excellence in Coastal Resilience, University of Cape Coast, Cape Coast, Ghana
| | - Trevor Church
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada
| | - Colin Clark
- Department of Mathematics, University of British Columbia, Vancouver, BC, Canada
| | - Tayler M Clarke
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Andreea L Cojocaru
- Department of Innovation, Management and Marketing, University of Stavanger Business School, University of Stavanger, 4036 Stavanger, Norway
| | - Brian Copeland
- Vancouver School of Economics, University of British Columbia, Vancouver, BC, Canada
| | - Brian Crawford
- Coastal Resources Center, Graduate School of Oceanography, University of Rhode Island, Narragansett, RI 02882, USA
| | - Anne-Sophie Crépin
- Stockholm Resilience Centre, Stockholm University, 10691, Stockholm, Sweden.,The Beijer Institute of Ecological Economics, The Royal Swedish Academy of Sciences, 10405, Stockholm, Sweden
| | - Larry B Crowder
- Hopkins Marine Station of Stanford University, Pacific Grove, CA 93950, USA
| | - Philippe Cury
- Institut de Recherche pour le Développement, Marseille, France
| | - Allison N Cutting
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Gretchen C Daily
- Natural Capital Project, Biology Department and Woods Institute for the Environment, Stanford University, Stanford, CA 94305, USA
| | - Jose Maria Da-Rocha
- Economics and Business Administration for Society, Universidade de Vigo, As Lagoas, Campus Universitario, 32004 Ourense, Spain.,Facultade de Ciencias Empresariais e Turismo, Universidade de Vigo, As Lagoas, Campus Universitario, 32004 Ourense, Spain
| | - Abhipsita Das
- Department of Applied Economics, Auburn University, College of Agriculture, Auburn, AL 36849, USA
| | - Santiago de la Puente
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Aart de Zeeuw
- Tilburg Sustainability Center and Department of Economics, Tilburg University, 5000 LE Tilburg, Netherlands
| | - Savior K S Deikumah
- Centre for Coastal Management, Africa Centre of Excellence in Coastal Resilience, University of Cape Coast, Cape Coast, Ghana
| | - Mairin Deith
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Boris Dewitte
- Center for Advanced Studies in Arid Zones, Campus Andrés Bello Universidad de La Serena, La Serena, Chile
| | - Nancy Doubleday
- Faculty of Humanities, McMaster University, Hamilton, ON, Canada
| | - Carlos M Duarte
- Red Sea Research Centre and Computational Bioscience Research Center, King Abdullah University of Science and Technology, Thuwal 23955, Saudi Arabia.,Biological and Environmental Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, 23955, Saudi Arabia
| | - Nicholas K Dulvy
- Earth to Ocean Research Group, Department of Biological Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Tyler Eddy
- Fisheries & Marine Institute, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Meaghan Efford
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Paul R Ehrlich
- Center for Conservation Biology, Department of Biology, Stanford University, Stanford, CA 94305, USA
| | - Laura G Elsler
- World Maritime University of the International Maritime Organization, a Specialized Agency of the United Nations, Malmö, Sweden
| | | | - A Eyiwunmi Falaye
- Department of Aquaculture and Fisheries Management, University of Ibadan, Ibadan, Nigeria
| | - Jessica Fanzo
- Berman Institute of Bioethics, Nitze School of Advanced International Studies, Baltimore, MD 21205, USA
| | - Clare Fitzsimmons
- School of Natural and Environmental Sciences, Newcastle University, Newcastle-upon-Tyne, UK
| | - Ola Flaaten
- The Norwegian College of Fishery Science, The Arctic University of Norway, Langnes, 9037, Tromsø, Norway
| | - Katie R N Florko
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Marta Flotats Aviles
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Carl Folke
- Stockholm Resilience Centre, Stockholm University, 10691, Stockholm, Sweden
| | | | - Peter Freeman
- Coastal Resources Center, Graduate School of Oceanography, University of Rhode Island, Narragansett, RI 02882, USA
| | - Kátia M F Freire
- Departamento de Engenharia de Pesca e Aquicultura, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil
| | - Rainer Froese
- Geomar-Helmholtz Centre for Ocean Research, 24105 Kiel, Germany
| | - Thomas L Frölicher
- Climate and Environmental Physics, Physics Institute, University of Bern, Bern, Switzerland.,Oeschger Centre for Climate Change Research, University of Bern, Bern, Switzerland
| | | | - Veronique Garcon
- Centre National de la Recherche Scientifique, Laboratory of Space Geophysical and Oceanographic Studies, Toulouse, France
| | - Maria A Gasalla
- University of Sao Paulo, Oceanographic Institute, Fisheries Ecosystems Laboratory, São Paulo, 05508-120, Brazil
| | - Jessica A Gephart
- Department of Environmental Science, American University, Washington, DC 20016, USA
| | - Mark Gibbons
- Biodiversity and Conservation Biology, University of the Western Cape, Belville, Western Cape, South Africa.,University of Western Cape, Cape Town, South Africa
| | - Kyle Gillespie
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Alfredo Giron-Nava
- Stanford Center for Ocean Solutions, Stanford University, Stanford, CA 94305, USA
| | - Kristina Gjerde
- IUCN Global Marine and Polar Programme, Cambridge, MA 02138, USA
| | - Sarah Glaser
- Secure Fisheries, a program of One Earth Future foundation, Broomfield, CO 80021, USA
| | - Christopher Golden
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Line Gordon
- Global Resilience Partnership, Stockholm, Sweden
| | - Hugh Govan
- School of Government, Development and International Affairs, University of the South Pacific, Suva, Fiji
| | - Rowenna Gryba
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.,Department of Statistics, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Benjamin S Halpern
- Bren School of Environmental Science and Management, University of California, Santa Barbara, CA 93117, USA.,National Center for Ecological Analysis and Synthesis, Santa Barbara, CA 93101, USA
| | - Quentin Hanich
- Australian National Centre for Ocean Resources and Security, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Mafaniso Hara
- Faculty of Economic and Management Sciences, University of the Western Cape, Bellville 7535, South Africa
| | - Christopher D G Harley
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.,Department of Zoology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Sarah Harper
- School of Environmental Studies, University of Victoria, Victoria, BC V8P 5C2, Canada
| | - Michael Harte
- College of Earth, Ocean, and Atmospheric Sciences, Oregon State University, Corvallis, OR 97331, USA
| | - Rebecca Helm
- University of North Carolina, Asheville, NC 28804, USA.,Smithsonian Institution National Museum of Natural History, Washington, DC 20560, USA
| | - Cullen Hendrix
- Josef Korbel School of International Studies, University of Denver, Denver, CO 80208, USA.,Peterson Institute for International Economics, Washington, DC 20036, USA
| | - Christina C Hicks
- Lancaster Environment Centre, Lancaster University, Lancaster LA1 4YQ, UK
| | - Lincoln Hood
- Marine Futures Laboratory and Sea Around Us - Indian Ocean, School of Biological Sciences, University of Western Australia, Crawley, WA, Australia
| | - Carie Hoover
- Marine Affairs Program, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Kristen Hopewell
- School of Public Policy and Global Affairs, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Bárbara B Horta E Costa
- Center of Marine Sciences, University of Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
| | - Jonathan D R Houghton
- School of Biological Sciences, Queen's University Belfast, Belfast, Co. Antrim, Northern Ireland
| | - Johannes A Iitembu
- Department of Fisheries and Ocean Sciences, Sam Nujoma Campus, University of Namibia, Henties Bay, Namibia
| | - Moenieba Isaacs
- Institute for Poverty, Land and Agrarian Studies, School of Government, Faculty of Economic and Management Sciences, University of the Western Cape, Cape Town, South Africa
| | - Sadique Isahaku
- General Education Academic and Career Pathway, Milwaukee Area Technical College, Milwaukee, WI 53233, USA
| | | | - Monirul Islam
- Department of Fisheries, University of Dhaka, Dhaka-1000, Bangladesh
| | - Ibrahim Issifu
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Jeremy Jackson
- Scripps Institution of Oceanography, University of California, San Diego, La Jolla, CA 92037, USA
| | | | - Olaf P Jensen
- Center for Limnology, University of Wisconsin-Madison, Madison, WI 53706, USA
| | | | - Xue Jin
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.,Ocean Development Research Institute, Major Research Base of Humanities and Social Sciences Ministry of Education, Ocean University of China, Qingdao 266100, China
| | - Alberta Jonah
- Centre for Coastal Management, Africa Centre of Excellence in Coastal Resilience, University of Cape Coast, Cape Coast, Ghana
| | | | - S Kim Juniper
- School of Earth and Ocean Sciences University of Victoria, Victoria, BC V8W 2Y2, Canada.,Department of Biology, University of Victoria, Victoria, BC V8W 2Y2, Canada
| | - Sufian Jusoh
- Institute of Malaysian and International Studies, Universiti Kebangsaan, Malaysia
| | | | - Masahide Kaeriyama
- Hokkaido University, Institute for the Advancement of Higher Education, Hokkaido, Japan
| | - Michel J Kaiser
- The Lyell Centre, Institute of Life and Earth Sciences, Heriot-Watt University, Edinburgh, EH14 4AP, UK
| | - Brooks Alexandra Kaiser
- Department of Sociology, Environmental and Business Economics, University of Southern Denmark, Degnevej 14, 6705 Esbjerg, Denmark
| | | | - Selma T Karuaihe
- Department of Agricultural Economics, Extension and Rural Development, University of Pretoria, Hatfield, Pretoria 0028, South Africa
| | | | | | - Ahmed S Khan
- Department of Agriculture and Agro-Industry, Agribusiness Division, African Development Bank, Abidjan, Côte d'Ivoire
| | - Patrick Kimani
- Coastal and Marine Resource Development, Bamburi, Mombasa, Kenya
| | | | | | - Dawn Kotowicz
- Coastal Resources Center, Graduate School of Oceanography, University of Rhode Island, Narragansett, RI 02882, USA
| | | | - Lian E Kwong
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.,Department of Earth, Ocean, and Atmospheric Sciences, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Steven Lade
- Stockholm Resilience Centre, Stockholm University, 10691, Stockholm, Sweden.,Fenner School of Environment and Society, The Australian National University, Canberra, ACT, Australia
| | - Dan Laffoley
- International Union for Conservation of Nature, World Commission on Protected Areas, Gland, Switzerland
| | - Mimi E Lam
- Centre for the Study of the Sciences and the Humanities, University of Bergen, 5007 Bergen, Norway
| | - Vicky W L Lam
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | | | - Mohd T Latif
- Department of Environmental Science and Natural Resources, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Philippe Le Billon
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | | | | | - Simon A Levin
- Department of Ecology and Evolutionary Biology, Princeton University, NJ 08544, USA.,High Meadows Environmental Institute, Princeton University, NJ 08544, USA
| | - Lisa Levin
- Center for Marine Biodiversity and Conservation, Scripps Institution of Oceanography, University of California, San Diego, La Jolla, CA 92093, USA
| | - Karin E Limburg
- State University of New York College of Environmental Science and Forestry, Syracuse, NY 13210, USA
| | - John List
- The Kenneth C. Griffin Department of Economics, The University of Chicago, Chicago, IL 60637, USA
| | - Amanda T Lombard
- Institute for Coastal and Marine Research, Nelson Mandela University, Gqeberha, South Africa
| | - Priscila F M Lopes
- Department of Ecology, Universidade Federal do Rio Grande do Norte, Brazil
| | - Heike K Lotze
- Department of Biology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Tabitha G Mallory
- China Ocean Institute, Seattle, WA 98122 USA.,University of Washington, Seattle, WA 98195, USA
| | - Roshni S Mangar
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Daniel Marszalec
- Department of Economics and Business, International Christian University, 3-10-2 Osawa, Mitaka-shi, Tokyo 181-8585, Japan
| | - Precious Mattah
- Centre for Coastal Management, Africa Centre of Excellence in Coastal Resilience, University of Cape Coast, Cape Coast, Ghana
| | - Juan Mayorga
- Environmental Market Solutions Lab, University of California Santa Barbara, Santa Barbara, CA 93106-5131, USA.,National Geographic Society, Pristine Seas, Washington, DC 20036, USA
| | - Carol McAusland
- Department of Food and Resource Economics, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Douglas J McCauley
- Marine Science Institute, University of California Santa Barbara, Santa Barbara, CA 93106, USA
| | - Jeffrey McLean
- Global Health Graduate Programs, McMaster University, Hamilton, ON, Canada
| | - Karly McMullen
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Frank Meere
- Sustainable Fisheries Management, Calwell, ACT 2905, Australia
| | - Annie Mejaes
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Michael Melnychuk
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.,School of Aquatic and Fishery Sciences, University of Washington, Seattle, WA 98105, USA
| | - Jaime Mendo
- Universidad Nacional Agraria La Molina, Lima, Peru
| | - Fiorenza Micheli
- Hopkins Marine Station, Pacific Grove, CA 93950, USA.,Stanford Center for Ocean Solutions, Pacific Grove, CA 94305, USA
| | - Katherine Millage
- Bren School of Environmental Science and Management, University of California, Santa Barbara, CA 93117, USA
| | | | | | | | - Mazlin Mokhtar
- Institute for Environment and Development, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Lance Morgan
- Marine Conservation Institute, Glen Ellen CA 95442, USA
| | - Umi Muawanah
- The Agency for Research and Human Development on Marine Affairs and Fisheries, Ministry of Marine Affairs and Fisheries, Indonesia
| | - Gordon R Munro
- Vancouver School of Economics, University of British Columbia, Vancouver, BC, Canada
| | - Grant Murray
- Nicholas School of the Environment, Duke University, Beaufort, NC 28516, USA
| | - Saleem Mustafa
- Institute for Environment and Development, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | | | - Dianne Newell
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Tu Nguyen
- Department of Applied Economics, Oregon State University, Corvallis, OR 97331, USA
| | - Frederik Noack
- Department of Food and Resource Economics, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Adibi M Nor
- International Institute of Public Policy and Management, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Francis K E Nunoo
- Department of Marine and Fisheries Sciences, University of Ghana, Legon, Accra, Ghana
| | - David Obura
- Coastal Oceans Research and Development - Indian Ocean (CORDIO) East Africa, Mombasa 80101, Kenya
| | - Tom Okey
- School of Environmental Studies, University of Victoria, Victoria, BC V8P 5C2, Canada
| | - Isaac Okyere
- Department of Fisheries and Aquatic Sciences, Africa Centre of Excellence in Coastal Resilience, University of Cape Coast, Cape Coast, Ghana
| | - Paul Onyango
- University of Dar es Salaam, Department of Aquatic Sciences and Fisheries, Dar es Salaam, Tanzania
| | - Maartje Oostdijk
- World Maritime University of the International Maritime Organization, a Specialized Agency of the United Nations, Malmö, Sweden
| | - Polina Orlov
- Department of Earth, Ocean, and Atmospheric Sciences, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Henrik Österblom
- Stockholm Resilience Centre, Stockholm University, 10691, Stockholm, Sweden
| | - Dwight Owens
- Ocean Networks, Canada University of Victoria, Victoria, BC, Canada
| | - Tessa Owens
- School of International and Public Affairs, Columbia University, New York, NY 10027, USA.,The Earth Institute, Columbia University, New York, NY 10025, USA
| | - Mohammed Oyinlola
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Nathan Pacoureau
- Earth to Ocean Research Group, Department of Biological Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Evgeny Pakhomov
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.,Department of Earth, Ocean, and Atmospheric Sciences, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | | | | | - Aurélien Paulmier
- Laboratoire d'Etudes en Géophysique et Océanographie Spatiales, Université de Toulouse, Toulouse, France
| | - Daniel Pauly
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Rodrigue Orobiyi Edéya Pèlèbè
- Centre for Coastal Management, Africa Centre of Excellence in Coastal Resilience, University of Cape Coast, Cape Coast, Ghana.,Research Laboratory in Aquaculture and Aquatic Ecotoxicology, Faculty of Agronomy, University of Parakou, Benin
| | | | - Maria G Pennino
- Instituto Español de Oceanografía, Centro Oceanográfico de Vigo, 36390 Vigo, Spain
| | - Garry Peterson
- Stockholm Resilience Centre, Stockholm University, 10691, Stockholm, Sweden
| | - Thuy T T Pham
- The Norwegian College of Fishery Science, The Arctic University of Norway, Langnes, 9037, Tromsø, Norway
| | - Evelyn Pinkerton
- School of Resource and Environmental Management, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Stephen Polasky
- Department of Applied Economics, University of Minnesota, St. Paul, MN 55108, USA
| | - Nicholas V C Polunin
- School of Natural and Environmental Sciences, Newcastle University, Newcastle-upon-Tyne, UK
| | - Ekow Prah
- Centre for Coastal Management, Africa Centre of Excellence in Coastal Resilience, University of Cape Coast, Cape Coast, Ghana
| | - Jorge Ramírez
- Charles Darwin Foundation, Puerto Ayora, Galápagos, Ecuador
| | - Veronica Relano
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Gabriel Reygondeau
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Don Robadue
- Coastal Resources Center, Graduate School of Oceanography, University of Rhode Island, Narragansett, RI 02882, USA
| | - Callum Roberts
- Centre for Ecology and Conservation, University of Exeter, Penryn, Cornwall, UK
| | | | - Katina Roumbedakis
- Cross-Research in Environmental Technologies, Department of Applied Economics, University of Santiago de Compostela, Santiago de Compostela, 15782, Spain
| | - Enric Sala
- National Geographic, Pristine Seas, Washington, DC 20036, USA
| | | | - Kathleen Segerson
- Department of Economics, University of Connecticut, Storrs, CT 06269, USA
| | - Juan Carlos Seijo
- School of Natural Resources, Universidad Marista de Mérida, Mérida, Yucatán, México
| | - Karen C Seto
- School of the Environment, Yale University, New Haven, CT 06511, USA
| | - Jason F Shogren
- Department of Economics, University of Wyoming, Laramie, WY 82071, USA
| | | | - Gerald Singh
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.,Department of Geography, Memorial University of Newfoundland, St. John's, NL A1B 3X5, Canada
| | - Ambre Soszynski
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Dacotah-Victoria Splichalova
- Institute for Resources, Environment, and Sustainability, The University of British Columbia, Vancouver, BC, Canada
| | | | - Jesper Stage
- Department of Social Sciences, Technology and Arts, Luleå University of Technology, 971 87 Luleå, Sweden
| | - Fabrice Stephenson
- National Institute of Water and Atmospheric Research, Hamilton, New Zealand
| | - Bryce D Stewart
- Department of Environment and Geography, University of York, York, YO10 5NG, UK
| | - Riad Sultan
- Department of Economics and Statistics, University of Mauritius, Reduit, Mauritius
| | - Curtis Suttle
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.,Department of Botany, University of British Columbia, Vancouver, BC, Canada
| | | | - Amadou Tall
- The Economic Community of West African States (ECOWAS), Wuse, Abuja, Nigeria
| | - Nicolás Talloni-Álvarez
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Alessandro Tavoni
- Department of Economics, Universita di Bologna, 40126 Bologna, Italy.,Grantham Research Institute on Climate Change and the Environment, London School of Economics, London WC2A 2AE, UK
| | - D R Fraser Taylor
- Geomatics and Cartographic Research Centre, Carleton University, Ottawa, ON, Canada
| | - Louise S L Teh
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Lydia C L Teh
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Jean-Baptiste Thiebot
- National Institute of Polar Research, 10-3, Midori-cho, Tachikawa, Tokyo 190-8518, Japan
| | - Torsten Thiele
- Institute for Advanced Sustainability Studies, Potsdam, Germany
| | | | - Romola V Thumbadoo
- Geography and Environmental Studies, Carleton University, Ottawa, ON K1S 5B6, Canada
| | | | - Richard S J Tol
- Department of Economics, University of Sussex, Falmer, Brighton, BN1 9SL, UK.,Institute for Environmental Studies and Department of Spatial Economics, Vrije Universiteit, Amsterdam, Netherlands
| | - Philippe Tortell
- Department of Earth, Ocean, and Atmospheric Sciences, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Max Troell
- The Beijer Institute of Ecological Economics, The Royal Swedish Academy of Sciences, 10405, Stockholm, Sweden
| | - M Selçuk Uzmanoğlu
- Department of Fisheries, Institute of Pure and Applied Sciences, Marmara University, İstanbul, Turkey
| | - Ingrid van Putten
- Commonwealth Scientific and Industrial Research Organisation, Oceans and Atmosphere, Hobart, Tasmania, Australia.,Centre for Marine Socioecology, University of Tasmania, Hobart, Tasmania, Australia
| | | | | | - Colette C C Wabnitz
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.,Stanford Center for Ocean Solutions, Stanford University, Stanford, CA 94305, USA
| | - Melissa Walsh
- Marine Conservation Finance Consulting and Ocean Finance Initiative, Asian Development Bank, Metro Manila, Philippines
| | - J P Walsh
- Graduate School of Oceanography, The University of Rhode Island, Bay Campus, Narragansett, RI 02882, USA
| | - Nina Wambiji
- Kenya Marine and Fisheries Research Institute, Mombasa, Kenya
| | - Elke U Weber
- Andlinger Center for Energy and Environment, Princeton University, Princeton, NJ 08540, USA
| | | | | | - Mary S Wisz
- World Maritime University of the International Maritime Organization, a Specialized Agency of the United Nations, Malmö, Sweden
| | - Boris Worm
- Department of Biology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Lan Xiao
- Hokkaido University, Institute for the Advancement of Higher Education, Hokkaido, Japan
| | - Nobuyuki Yagi
- Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi Bunkyo-ku Tokyo, Japan
| | - Satoshi Yamazaki
- Tasmanian School of Business and Economics, University of Tasmania, Sandy Bay, TAS 7005, Australia
| | - Hong Yang
- Department of Geography and Environmental Science, University of Reading, UK, RG6 6AB, UK
| | - Dirk Zeller
- School of Biological Sciences & Oceans Institute, University of Western Australia, Crawley, WA 6009, Australia
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14
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Al Awadhi A, Benichi S, Lot G, Rogers A. A case of intramuscular lumbar myxoma: Uncertainty in the preoperative diagnosis of a spinal soft tissue tumour. Neurochirurgie 2021; 68:530-534. [PMID: 34537211 DOI: 10.1016/j.neuchi.2021.08.007] [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: 06/20/2021] [Revised: 08/29/2021] [Accepted: 08/31/2021] [Indexed: 11/15/2022]
Abstract
We report an uncommon case of a 76-year-old woman who presented with lower back pain, an intermittent L5 radiculopathy and a right palpable paraspinal mass. Imaging studies revealed a 7-cm lumbar paraspinal pseudo-cystic soft tissue tumour developed in the paravertebral musculature, without a clear radiological diagnosis. Gross total surgical resection was performed, resulting in complete resolution of pain. Histopathological studies revealed an intramuscular (IM) myxoma. With a low positive predictive value of radiological work-up and a poor yield of percutaneous biopsies, surgery remains the mainstay treatment for these rare soft tissue tumours of the lumbar spine. Intramuscular myxomas show excellent postoperative results.
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Affiliation(s)
- A Al Awadhi
- Hôpital Fondation Ophtalmologique Adolphe de Rothschild, Service de Neurochirurgie, 29, rue Manin, 75019 Paris, France.
| | - S Benichi
- Hôpital Fondation Ophtalmologique Adolphe de Rothschild, Service de Neurochirurgie, 29, rue Manin, 75019 Paris, France
| | - G Lot
- Hôpital Fondation Ophtalmologique Adolphe de Rothschild, Service de Neurochirurgie, 29, rue Manin, 75019 Paris, France
| | - A Rogers
- Hôpital Fondation Ophtalmologique Adolphe de Rothschild, Service de Neurochirurgie, 29, rue Manin, 75019 Paris, France
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15
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Rogers A, Alatsatianos A, Clark A, Lim A, Chakravarty D, Townsley R. P-29 Patient factors that influence stage of presentation in oropharyngeal squamous cell carcinoma in the West of Scotland. Oral Oncol 2021. [DOI: 10.1016/s1368-8375(21)00318-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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16
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Veeratterapillay R, Gravestock P, Rogers A, Harding C, Keltie K, Cognigni P, Sims A. Infective complications following ureteroscopy for stone disease: An analysis of nhs hospital episode statistics in England. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00680-1] [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: 11/30/2022]
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17
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Veeratterapillay R, Geraghty R, Pandian R, Roy C, Stenhouse G, Soomro N, Paez E, Rogers A, Page T, Rix D, Thomas D, Rai B. Ten-year oncological outcomes of diagnostic ureteroscopy prior to nephroureterectomy for upper tract urothelial carcinoma. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01153-2] [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: 11/26/2022]
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18
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Rogers A, Fowler W, Williams R, Haslam P, Rix D, Suntharisavam T, Thomas D, Dorkin T, Shaw M. The use of allium metal ureteric stents in the treatment of ureteric obstruction or injury. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01273-2] [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: 11/17/2022]
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19
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Geraghty R, Wilson I, Olinger E, Cook P, Troup S, Kennedy D, Rogers A, Shaw M, Somani B, Dhayat N, Fuster D, Sayer J. Routine urinary biochemistry does not accurately predict stone type nor recurrence in kidney stone formers: A multi-centre, multi-model, externally validated machine-learning study. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00625-4] [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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20
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Rizvi I, Abroaf A, Veeratterapillay R, Rogers A, Shaw M, Fitzpatrick J. Management of acute ureteric colic in a large tertiary centre during the initial COVID-19 pandemic - How did our practice change? Eur Urol 2021. [PMCID: PMC8263123 DOI: 10.1016/s0302-2838(21)00636-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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21
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Rogers A, Fraser L, Geary T. 684 Use of Overnight Pulse Oximetry and STBUR Questionnaire for Paediatric OSA In A District General Setting. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.469] [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: 11/12/2022]
Abstract
Abstract
Introduction
Overnight pulse oximetry (OPO) is often used to support the diagnosis of obstructive sleep apnoea (OSA) and stratify risk of peri-operative breathing difficulties in children undergoing adenotonsillectomy for OSA. Our objective was to audit our indications for OPO and the impact on subsequent ENT management. We sought to assess the correlation of STBUR (Snoring, Troubled-breathing, Unrefreshed Questionnaire) score with OPO values in these patients.
Method
Retrospective review of 32 OPO reports over a 7-month period. Data collected included age, weight, indication, mean spO2, number of dips >4%, outcome and STBUR score.
Results
The commonest indication (19) for OPO was to assess severity of OSA in children <3 or those with significant comorbidity to determine best setting for surgery; 50% were ultimately managed in a tertiary centre. 10 children underwent OPO due to diagnostic uncertainty but significant parental concern; all studies normal and parents reassured. STBUR score correlated poorly with number of dips >4% (R = 0.0109) and mean nadir >4% (R = 0.0031) Weight poorly recorded (19%).
Conclusions
Referrals were generally appropriate and influenced management in all cases. STBUR scores insufficiently sensitive to stratify severity of OSA. New protocol developed.
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Affiliation(s)
- A Rogers
- University Hospital Crosshouse, Kilmarnock, United Kingdom
| | - L Fraser
- University Hospital Crosshouse, Kilmarnock, United Kingdom
| | - T Geary
- University Hospital Crosshouse, Kilmarnock, United Kingdom
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22
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Rogers A, Ramasubbu R, Ramasubbu B. 345 A Novel Study Exploring the Hidden Cost of Insufficient Investment in Computer Technology in a District General Hospital. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.009] [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: 11/12/2022]
Abstract
Abstract
Introduction
The NHS’ move towards increasing digitisation is limited by inadequate resourcing. It is estimated 70% of a junior doctor’s time is spent completing computer-based administrative work. Aging and insufficient equipment leads to inefficiency. The objective of this study is to investigate the hidden cost of insufficient and poorly performing computer technology.
Method
Surveys were disseminated to doctors and data was collected regarding designation, ward, salary and estimated ‘minutes-waiting’ for computers to become free (CF) and to load (CL).
Results
33 surveys were completed. The hospital-wide average CF and CL were 25 minutes and 31.06 minutes respectively, with a corresponding average daily cost per doctor of £10.16 (CF) and £12.63 (CL), totalling £22.79/doctor/day. In the highest-expense ward, CF (31.66 minutes) and CL (38.33 minutes) equated to £30.28/doctor/day. Following acquisition of new hardware and re-audit, CL was significantly reduced to 20.4 minutes (p = 0.0142).
Conclusions
This study highlights the hidden cost of insufficient, poorly performing hardware. Every day the total cost of time-wasted greatly surpasses the cost of a single computer unit, illustrating the false economy of reduced capital investment in computer technology.
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Affiliation(s)
- A Rogers
- Inverclyde Royal Hospital, Greenock, United Kingdom
| | - R Ramasubbu
- University of Glasgow, Glasgow, United Kingdom
| | - B Ramasubbu
- Inverclyde Royal Hospital, Greenock, United Kingdom
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23
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Horan J, M Sahebally S, Rogers A, Winter D. O38: TACKING VERSUS NO TACKING IN LAPAROSCOPIC TOTALLY EXTRAPERITONEAL REPAIR OF PRIMARY INGUINAL HERNIA - A SYSTEMATIC REVIEW AND META-ANALYSIS. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
The necessity of mesh fixation in laparoscopic totally extraperitoneal (TEP) inguinal hernia repair remains controversial. We performed a systematic review and meta-analysis to compare the effectiveness of mesh tacking versus no tacking in laparoscopic TEP repair for primary inguinal hernia.
Materials and Methods
PubMed, EMBASE and Cochrane databases were searched for relevant articles from inception until November 2019. All studies that compared tacking versus no tacking in TEP repairs for inguinal herniae were included. Recurrent and femoral herniae were excluded from the current analysis. The primary outcome measure was recurrence, while secondary outcomes included postoperative pain scores at discharge and at 1 month, mean operative time, length of stay and seroma rates. Random effects models were used to calculate pooled effect size estimates.
Result
Eight randomised controlled trials were included capturing 557 patients and 715 inguinal herniae. On random effects analysis, there were no significant differences between tacking and no tacking in terms of recurrence (OR 0.94, 95% CI=0.10 to 9.28, p=0.96), postoperative pain scores on discharge (Mean difference 0.82, 95% CI=-0.35 to 2.00, p=0.17) or at 1 month (Mean difference 0.53, 95% CI=-0.75 to 1.82, p=0.41), mean operative time (Mean difference 1.58 mins, 95% CI=-0.22 to 3.37, p=0.09), seroma (OR=0.70, 95% CI=0.28 to 1.74, p=0.44) or length of stay (Mean difference 0.11 days, 95% CI=-0.04 to 0.25, p=0.14).
Conclusion
Mesh tacking in laparoscopic TEP repair for primary inguinal herniae does not translate into improved postoperative outcomes and may be omitted.
Take-home message
Mesh tacking in laparoscopic TEP repair for primary inguinal herniae does not translate into improved postoperative outcomes and may be omitted.
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Affiliation(s)
- J Horan
- Department of Colorectal Surgery, St Vincent's University Hospital, Ballsbridge, Dublin 4
| | - S M Sahebally
- Department of Colorectal Surgery, St Vincent's University Hospital, Ballsbridge, Dublin 4
| | - A Rogers
- Department of Colorectal Surgery, St Vincent's University Hospital, Ballsbridge, Dublin 4
| | - D Winter
- Department of Colorectal Surgery, St Vincent's University Hospital, Ballsbridge, Dublin 4
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24
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Geldsetzer P, Mukama T, Jawad N, Riffe T, Rogers A, Sudharsanan N. Sex differences in the mortality rate for coronavirus disease 2019 compared to other causes of death. medRxiv 2021. [PMID: 33655277 DOI: 10.1101/2021.02.23.21252314] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Men are more likely than women to die due to coronavirus disease 2019 (COVID-19). This paper sets out to examine whether the magnitude of the sex differences in the COVID-19 mortality rate are unusual when compared to other common causes of death. In doing so, we aim to provide evidence as to whether the causal pathways for the sex differences in the mortality rate of COVID-19 likely differ from those for other causes of death. We found that sex differences in the age-standardized COVID-19 mortality rate were substantially larger than for the age-standardized all-cause mortality rate and most other common causes of death. These differences were especially large in the oldest age groups. One Sentence Summary The sex difference in the mortality rate of coronavirus disease 2019 is substantially larger than for other common causes of death.
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Caudron Y, Le Guerinel C, Boissonnet H, Rogers A. Idiopathic biventricular hydrocephalus: A clinical case report. Neurochirurgie 2021; 67:628-629. [PMID: 33529692 DOI: 10.1016/j.neuchi.2021.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/10/2021] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Y Caudron
- Fondation ophtalmologique Adolphe de Rothschild, Department of Neurosurgery, 29 Rue Manin, 75019, Paris, France.
| | - C Le Guerinel
- Fondation ophtalmologique Adolphe de Rothschild, Department of Neurosurgery, 29 Rue Manin, 75019, Paris, France
| | - H Boissonnet
- Fondation ophtalmologique Adolphe de Rothschild, Department of Neurosurgery, 29 Rue Manin, 75019, Paris, France
| | - A Rogers
- Fondation ophtalmologique Adolphe de Rothschild, Department of Neurosurgery, 29 Rue Manin, 75019, Paris, France
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Thomas KS, Batchelor JM, Akram P, Chalmers JR, Haines RH, Meakin GD, Duley L, Ravenscroft JC, Rogers A, Sach TH, Santer M, Tan W, White J, Whitton ME, Williams HC, Cheung ST, Hamad H, Wright A, Ingram JR, Levell NJ, Goulding JMR, Makrygeorgou A, Bewley A, Ogboli M, Stainforth J, Ferguson A, Laguda B, Wahie S, Ellis R, Azad J, Rajasekaran A, Eleftheriadou V, Montgomery AA. Randomized controlled trial of topical corticosteroid and home-based narrowband ultraviolet B for active and limited vitiligo: results of the HI-Light Vitiligo Trial. Br J Dermatol 2020; 184:828-839. [PMID: 33006767 DOI: 10.1111/bjd.19592] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Evidence for the effectiveness of vitiligo treatments is limited. OBJECTIVES To determine the effectiveness of (i) handheld narrowband UVB (NB-UVB) and (ii) a combination of potent topical corticosteroid (TCS) and NB-UVB, compared with TCS alone, for localized vitiligo. METHODS A pragmatic, three-arm, placebo-controlled randomized controlled trial (9-month treatment, 12-month follow-up). Adults and children, recruited from secondary care and the community, aged ≥ 5 years and with active vitiligo affecting < 10% of skin, were randomized 1 : 1 : 1 to receive TCS (mometasone furoate 0·1% ointment + dummy NB-UVB), NB-UVB (NB-UVB + placebo TCS) or a combination (TCS + NB-UVB). TCS was applied once daily on alternating weeks; NB-UVB was administered on alternate days in escalating doses, adjusted for erythema. The primary outcome was treatment success at 9 months at a target patch assessed using the participant-reported Vitiligo Noticeability Scale, with multiple imputation for missing data. The trial was registered with number ISRCTN17160087 on 8 January 2015. RESULTS In total 517 participants were randomized to TCS (n = 173), NB-UVB (n = 169) and combination (n = 175). Primary outcome data were available for 370 (72%) participants. The proportions with target patch treatment success were 17% (TCS), 22% (NB-UVB) and 27% (combination). Combination treatment was superior to TCS: adjusted between-group difference 10·9% (95% confidence interval 1·0%-20·9%; P = 0·032; number needed to treat = 10). NB-UVB alone was not superior to TCS: adjusted between-group difference 5·2% (95% CI - 4·4% to 14·9%; P = 0·29; number needed to treat = 19). Participants using interventions with ≥ 75% expected adherence were more likely to achieve treatment success, but the effects were lost once treatment stopped. Localized grade 3 or 4 erythema was reported in 62 (12%) participants (including three with dummy light). Skin thinning was reported in 13 (2·5%) participants (including one with placebo ointment). CONCLUSIONS Combination treatment with home-based handheld NB-UVB plus TCS is likely to be superior to TCS alone for treatment of localized vitiligo. Combination treatment was relatively safe and well tolerated but was successful in only around one-quarter of participants.
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Affiliation(s)
- K S Thomas
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - J M Batchelor
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - P Akram
- Department of Medical Physics and Clinical Engineering, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - J R Chalmers
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - R H Haines
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - G D Meakin
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - L Duley
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - J C Ravenscroft
- Department of Paediatric Dermatology, Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - A Rogers
- Department of Medical Physics and Clinical Engineering, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - T H Sach
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - M Santer
- Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | - W Tan
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - J White
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - M E Whitton
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - H C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - S T Cheung
- Cannock Chase Hospital and New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - H Hamad
- Cannock Chase Hospital and New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - A Wright
- St Luke's Hospital, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - J R Ingram
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - N J Levell
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - J M R Goulding
- Solihull Hospital, University Hospitals of Birmingham NHS Foundation Trust, Birmingham, UK
| | - A Makrygeorgou
- West Glasgow Ambulatory Care Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - A Bewley
- Barts Health NHS Trust and Queen Mary University London, London, UK
| | - M Ogboli
- Birmingham Children's Hospital, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - J Stainforth
- York Hospital, York Teaching Hospital NHS Foundation Trust, York, UK
| | - A Ferguson
- Royal Derby Hospital and the London Road Community Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - B Laguda
- Chelsea and Westminster Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - S Wahie
- University Hospital of North Durham, County Durham and Darlington NHS Foundation Trust, Durham, UK
| | - R Ellis
- The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - J Azad
- The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - A Rajasekaran
- Birmingham City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | | | - A A Montgomery
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
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Rogers A, Akram P, Batchelor JM, Crutchley J, Grocki M, Haines RH, Meakin G, O'Dowd K, Ravenscroft J, Thomas KS. Quality assurance and characterization of narrowband ultraviolet B devices for use at home: lessons from the HI-Light Vitiligo Trial. Br J Dermatol 2020; 184:954-955. [PMID: 33107975 PMCID: PMC8246568 DOI: 10.1111/bjd.19630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 10/08/2020] [Accepted: 10/25/2020] [Indexed: 11/30/2022]
Affiliation(s)
- A Rogers
- Department of Medical Physics and Clinical Engineering, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK
| | - P Akram
- Department of Medical Physics and Clinical Engineering, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK
| | - J M Batchelor
- Centre of Evidence Based Dermatology, King's Meadow Campus, Lenton Lane, Nottingham, NG7 2NR, UK
| | - J Crutchley
- Department of Medical Physics and Clinical Engineering, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK
| | - M Grocki
- Department of Medical Physics and Clinical Engineering, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK
| | - R H Haines
- Nottingham Clinical Trials Unit, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - G Meakin
- Nottingham Clinical Trials Unit, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - K O'Dowd
- Department of Medical Physics and Clinical Engineering, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK
| | - J Ravenscroft
- Department of Dermatology, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK
| | - K S Thomas
- Centre of Evidence Based Dermatology, King's Meadow Campus, Lenton Lane, Nottingham, NG7 2NR, UK
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Sach TH, Thomas KS, Batchelor JM, Perways A, Chalmers JR, Haines RH, Meakin GD, Duley L, Ravenscroft JC, Rogers A, Santer M, Tan W, White J, Whitton ME, Williams HC, Cheung ST, Hamad H, Wright A, Ingram JR, Levell N, Goulding JMR, Makrygeorgou A, Bewley A, Ogboli M, Stainforth J, Ferguson A, Laguda B, Wahie S, Ellis R, Azad J, Rajasekaran A, Eleftheriadou V, Montgomery AA. An economic evaluation of the randomized controlled trial of topical corticosteroid and home-based narrowband ultraviolet B for active and limited vitiligo (the HI-Light Vitiligo Trial). Br J Dermatol 2020; 184:840-848. [PMID: 32920824 DOI: 10.1111/bjd.19554] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Economic evidence for vitiligo treatments is absent. OBJECTIVES To determine the cost-effectiveness of (i) handheld narrowband ultraviolet B (NB-UVB) and (ii) a combination of topical corticosteroid (TCS) and NB-UVB compared with TCS alone for localized vitiligo. METHODS Cost-effectiveness analysis alongside a pragmatic, three-arm, placebo-controlled randomized controlled trial with 9 months' treatment. In total 517 adults and children (aged ≥ 5 years) with active vitiligo affecting < 10% of skin were recruited from secondary care and the community and were randomized 1: 1: 1 to receive TCS, NB-UVB or both. Cost per successful treatment (measured on the Vitiligo Noticeability Scale) was estimated. Secondary cost-utility analyses measured quality-adjusted life-years using the EuroQol 5 Dimensions 5 Levels for those aged ≥ 11 years and the Child Health Utility 9D for those aged 5 to < 18 years. The trial was registered with number ISRCTN17160087 on 8 January 2015. RESULTS The mean ± SD cost per participant was £775 ± 83·7 for NB-UVB, £813 ± 111.4 for combination treatment and £600 ± 96·2 for TCS. In analyses adjusted for age and target patch location, the incremental difference in cost for combination treatment compared with TCS was £211 (95% confidence interval 188-235), corresponding to a risk difference of 10·9% (number needed to treat = 9). The incremental cost was £1932 per successful treatment. The incremental difference in cost for NB-UVB compared with TCS was £173 (95% confidence interval 151-196), with a risk difference of 5·2% (number needed to treat = 19). The incremental cost was £3336 per successful treatment. CONCLUSIONS Combination treatment, compared with TCS alone, has a lower incremental cost per additional successful treatment than NB-UVB only. Combination treatment would be considered cost-effective if decision makers are willing to pay £1932 per additional treatment success.
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Affiliation(s)
- T H Sach
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - K S Thomas
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - J M Batchelor
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - A Perways
- Department of Medical Physics and Clinical Engineering, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - J R Chalmers
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - R H Haines
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - G D Meakin
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - L Duley
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - J C Ravenscroft
- Department of Paediatric Dermatology, Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - A Rogers
- Department of Medical Physics and Clinical Engineering, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - M Santer
- Primary Care, Population Sciences & Medical Education, University of Southampton, Southampton, UK
| | - W Tan
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - J White
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - M E Whitton
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - H C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - S T Cheung
- Cannock Chase Hospital and New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - H Hamad
- Cannock Chase Hospital and New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - A Wright
- St Luke's Hospital, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - J R Ingram
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - N Levell
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - J M R Goulding
- Solihull Hospital, University Hospitals of Birmingham NHS Foundation Trust, Birmingham, UK
| | - A Makrygeorgou
- West Glasgow Ambulatory Care Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - A Bewley
- Whipps Cross Hospital and The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - M Ogboli
- Birmingham Children's Hospital, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - J Stainforth
- York Hospital, York Teaching Hospital NHS Foundation Trust, York, UK
| | - A Ferguson
- Royal Derby Hospital and the London Road Community Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - B Laguda
- Chelsea and Westminster Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - S Wahie
- University Hospital of North Durham, County Durham and Darlington NHS Foundation Trust, Durham, UK
| | - R Ellis
- The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - J Azad
- The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - A Rajasekaran
- Birmingham City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | | | - A A Montgomery
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
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Rogers A, Tung J, Tooley J, Bhatia N, Kang G, Alhusseini M, Baykaner T, Wang P, Perez M, Clifford G, Tereshchenko L, Narayan S. Deep neural network trained on surface ECG improves diagnostic accuracy of prior myocardial infarction over Q wave analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Detection of prior myocardial infarction (MI) may inform arrhythmia treatment and prognosis, yet cardiac imaging is resource intensive. ECG Q-wave analysis is quick and inexpensive but has poor accuracy for assessing prior MI.
Purpose
To evaluate the ability of a deep neural network (DNN) trained on the surface ECG to identify patients with prior MI.
Methods
We assessed 608 well-characterized patients (61.4±14.5 years, 31.2% female) at 2 academic centers. From one 12-lead ECG, median beats were calculated in 3 orthogonal planes (X, Y, Z; Fig. 1A) and used to train a DNN to identify a history of prior MI. Accuracy was compared to manual assessment of pathologic Q waves, defined as a deflection >25% of the subsequent R wave, >40ms in width, and >0.2mV amplitude in 1 of 3 ECG planes.
Results
Of 608 patients, 175 had history of MI (28.7%). The DNN outperformed the accuracy of pathologic Q waves. In training, DNN converged to >98% accuracy and in testing, its accuracy was 71±5% (Fig. 1B) (k=5-fold cross validation). This outperformed the 62% accuracy of pathologic Q waves in this study (red dotted line, Fig. 1B). In the validation cohort, DNN provided an area under the receiver operating characteristics curve of 0.730 (Fig. 1C).
Conclusion
Deep learning of a 12-lead ECG can identify features of prior myocardial injury more accurately than Q-wave analysis. In attempting to improve these results further, studies should explain what inputs weighted DNN decisions, and identify those that reflect abnormalities detectable clinically or on imaging.
Figure 1
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): NIH NRSA F32
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Affiliation(s)
- A Rogers
- Stanford University, Palo Alto, United States of America
| | - J.S Tung
- Stanford University, Palo Alto, United States of America
| | - J Tooley
- Stanford University, Palo Alto, United States of America
| | - N.K Bhatia
- Stanford University, Palo Alto, United States of America
| | - G Kang
- Stanford University, Palo Alto, United States of America
| | - M.I Alhusseini
- Stanford University, Palo Alto, United States of America
| | - T Baykaner
- Stanford University, Palo Alto, United States of America
| | - P.J Wang
- Stanford University, Palo Alto, United States of America
| | - M Perez
- Stanford University, Palo Alto, United States of America
| | - G Clifford
- Emory University School of Medicine, Atlanta, United States of America
| | - L Tereshchenko
- Oregon Health and Science University, Portland, United States of America
| | - S.M Narayan
- Stanford University, Palo Alto, United States of America
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Rogers A, Ravi N, Bhatia N, Shah R, Pong T, Tung J, Purewal S, Baykaner T, Rappel W, Brodt C, Wang P, Lee A, Narayan S. Complete transmural epicardial ablation reduces organized areas in atrial fibrillation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The surgical maze is suggested to be effective in persistent atrial fibrillation (AF) by reducing the area for fibrillatory wavelets. However, the mechanism for recurrence and next treatment steps are unclear.
Purpose
We set out to evaluate the impact of complete transmural epicardial maze lesion sets on the extent atrial organization using novel analyses of wide-area recordings of AF.
Methods
19 patients (age 50.9±12.0, 78% male) underwent maze followed by endocardial mapping of AF with a 64-pole basket catheter. Block across roof, floor, and pulmonary vein lesions sets was assessed by high-density voltage mapping and organized zones of AF were assessed by panoramic recordings. Total organized area and mean area of the dominant site were evaluated using automated custom scripts.
Results
Patients had 3.2±0.9 organized regions in 1 minute of LA recordings. A 54 yo F showed residual conduction to the posterior wall from the roof (purple, Fig. 1A) and a figure-of-8 propagation pattern during AF (arrows, fig B) which terminated with localized ablation (yellow lesions, Fig. 1A, red X, Fig. 1B). Overall, patients with complete block on epicardial lesion set had smaller areas of organization (13.7±8% vs. 45.7±32% of mapped areas, p=0.029) vs. those with gaps. The average size of the dominant area was smaller with complete transmural lines than with gaps (5.7±3% vs. 15.9±10%, p=0.033) (Fig. 1C).
Conclusion
These results show that complete transmural lesion sets constrain the critical mass available for AF, with smaller resulting organized zones. Future studies that quantify how partitioning the atrial surface affects AF may help personalize lesion sets after maze.
Figure 1
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): NIH NRSA F32 United States
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Affiliation(s)
- A Rogers
- Stanford University, Palo Alto, United States of America
| | - N Ravi
- Stanford University, Palo Alto, United States of America
| | - N.K Bhatia
- Stanford University, Palo Alto, United States of America
| | - R.L Shah
- Stanford University, Palo Alto, United States of America
| | - T Pong
- Stanford University, Palo Alto, United States of America
| | - J.S Tung
- Stanford University, Palo Alto, United States of America
| | - S Purewal
- Stanford University, Palo Alto, United States of America
| | - T Baykaner
- Stanford University, Palo Alto, United States of America
| | - W.J Rappel
- University of San Diego, Physics, La Jolla, United States of America
| | - C.R Brodt
- Stanford University, Palo Alto, United States of America
| | - P.J Wang
- Stanford University, Palo Alto, United States of America
| | - A Lee
- Stanford University, Palo Alto, United States of America
| | - S.M Narayan
- Stanford University, Palo Alto, United States of America
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Ellis J, Vassilev I, James E, Rogers A. Implementing a social network intervention: can the context for its workability be created? A quasi-ethnographic study. Implement Sci Commun 2020; 1:93. [PMID: 33123686 PMCID: PMC7590694 DOI: 10.1186/s43058-020-00087-5] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 10/15/2020] [Indexed: 11/10/2022] Open
Abstract
Background Policy makers and researchers recognise the challenges of implementing evidence-based interventions into routine practice. The process of implementation is particularly complex in local community environments. In such settings, the dynamic nature of the wider contextual factors needs to be considered in addition to capturing interactions between the type of intervention and the site of implementation throughout the process. This study sought to examine how networks and network formation influence the implementation of a self-management support intervention in a community setting. Methods An ethnographically informed approach was taken. Data collection involved obtaining and analysing documents relevant to implementation (i.e. business plan and health reports), observations of meetings and engagement events over a 28-month period and 1:1 interviews with implementation-network members. Data analysis utilised the adaptive theory approach and drew upon the Consolidated Framework for Implementation Research. The paper presents the implementation events in chronological order to illustrate the evolution of the implementation process. Results The implementation-network was configured from the provider-network and commissioning-network. The configuration of the implementation-network was influenced by both the alignment between the political landscape and the intervention, and also the intervention having a robust evidence base. At the outset of implementation, the network achieved stability as members were agreed on roles and responsibilities. The stability of the implementation-network was threatened as progress slowed. However, with a period of reflection and evaluation, and with a flexible and resilient network, implementation was able to progress. Conclusions Resilience and creativity of all involved in the implementation in community settings is required to engage with a process which is complex, dynamic, and fraught with obstacles. An implementation-network is required to be resilient and flexible in order to adapt to the dynamic nature of community contexts. Of particular importance is understanding the demands of the various network elements, and there is a requirement to pause for "reflection and evaluation" in order to modify the implementation process as a result of learning.
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Affiliation(s)
- J Ellis
- NIHR CLAHRC Wessex, School of Health Sciences, University of Southampton, University Road, Building 67, Southampton, SO17 1BJ UK
| | - I Vassilev
- NIHR CLAHRC Wessex, School of Health Sciences, University of Southampton, University Road, Building 67, Southampton, SO17 1BJ UK
| | - E James
- NIHR CLAHRC Wessex, School of Health Sciences, University of Southampton, University Road, Building 67, Southampton, SO17 1BJ UK
| | - A Rogers
- NIHR CLAHRC Wessex, School of Health Sciences, University of Southampton, University Road, Building 67, Southampton, SO17 1BJ UK
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Yu JS, Rink T, Yu SM, Liu K, Carver K, Lather JD, Payne J, Rogers A, Erdal BS. The broken circle method: a novel technique that enhances detection of Hill-Sachs lesions on internal rotation shoulder radiographs. Clin Radiol 2020; 76:158.e1-158.e12. [PMID: 33008621 DOI: 10.1016/j.crad.2020.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 09/02/2020] [Indexed: 11/18/2022]
Abstract
AIM To describe and test a new method that increases the conspicuity of a Hill-Sachs lesion on internal rotation (IR) radiographs. MATERIALS AND METHODS This study had institutional review board approval. A retrospective search for patients with a prior shoulder dislocation and a Hill-Sachs lesion documented on magnetic resonance imaging (MRI) was performed over a 10-year period identifying 256 test patients. In Part 1, the IR radiographs from test cases were randomised with controls, and three readers scored them independently for the defect. The readers were then taught the Broken Circle (BC) method and re-scored the radiographs. In Part 2, 15 cases of Hill-Sachs lesions that were missed by all readers in Part 1 were randomised with controls, and were shown to 25 radiology residents before (pre-test) and after (post-test) learning the BC method. A paired t-test was used to compare the differences in sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV). RESULTS In Part 1, the sensitivity increased 19.7% (54.1%-73.8%; p<0.05) and NPV increased 10.8% (62.5%-73.3%; p<0.01). In Part 2, post-test sensitivity for residents increased 16.3% (55.2%-71.5%; p<0.0001), accuracy increased 13.4% (64%-77.4%; p<0.0001), and NPV increased 13.3% (40.8%-54.1%; p<0.0001) independent of the level of training. The change in accuracy was also statistically significant for every individual class. CONCLUSION The BC method was an effective technique that facilitated detection of a Hill-Sachs lesion at all levels of training, and was useful as a teaching tool.
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Affiliation(s)
- J S Yu
- Department of Radiology, The Ohio State University Wexner Medical Center, 452 Doan Tower, 395 West 12th Avenue, Columbus, OH 43210, USA.
| | - T Rink
- Department of Radiology, The Ohio State University Wexner Medical Center, 452 Doan Tower, 395 West 12th Avenue, Columbus, OH 43210, USA
| | - S M Yu
- Department of Radiology, The Ohio State University Wexner Medical Center, 452 Doan Tower, 395 West 12th Avenue, Columbus, OH 43210, USA
| | - K Liu
- Department of Radiology, The Ohio State University Wexner Medical Center, 452 Doan Tower, 395 West 12th Avenue, Columbus, OH 43210, USA
| | - K Carver
- Department of Radiology, The Ohio State University Wexner Medical Center, 452 Doan Tower, 395 West 12th Avenue, Columbus, OH 43210, USA
| | - J D Lather
- Department of Radiology, The Ohio State University Wexner Medical Center, 452 Doan Tower, 395 West 12th Avenue, Columbus, OH 43210, USA
| | - J Payne
- Department of Radiology, The Ohio State University Wexner Medical Center, 452 Doan Tower, 395 West 12th Avenue, Columbus, OH 43210, USA
| | - A Rogers
- Department of Radiology, The Ohio State University Wexner Medical Center, 452 Doan Tower, 395 West 12th Avenue, Columbus, OH 43210, USA
| | - B S Erdal
- Department of Radiology, The Ohio State University Wexner Medical Center, 452 Doan Tower, 395 West 12th Avenue, Columbus, OH 43210, USA
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Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Rogers A, Morrison SC, Gorst T, Paton J, Freeman J, Marsden J, Cramp MC. Repeatability of plantar pressure assessment during barefoot walking in people with stroke. J Foot Ankle Res 2020; 13:39. [PMID: 32600388 PMCID: PMC7325079 DOI: 10.1186/s13047-020-00407-x] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/16/2020] [Indexed: 11/10/2022] Open
Abstract
Purpose Stroke-related changes in foot structure and function affect balance and mobility and quantifying foot function following stroke could offer clinically useful information to inform rehabilitation. The aim of this work was to explore the feasibility of undertaking plantar pressure assessment during barefoot walking in people with stroke, and evaluate the repeatability of the assessment protocol and regional footprint analysis as a measure of dynamic foot characteristics. Materials & methods Plantar pressure analysis was undertaken using a pressure platform (Tekscan HR Mat) on two test sessions, approximately two weeks apart (mean = 15.64 ± 11.64 days). Peak plantar pressure (kPa) and contact area (cm2) for foot regions were extracted and repeatability analysis undertaken. Descriptive evaluation of field notes and experiences of the participants was undertaken to inform the feasibility of the data collection protocol. Results Twenty-one participants (61.8 ± 9.2 years; 11 male, 10 female; 8 right-sided, 13 left-sided stroke) were recruited and 18 returned for retesting. Full data capture was achieved from 14 participants. Peak pressure and contact area demonstrated moderate to good repeatability for at the toes (ICC 0.76 and 0.58 respectively) and good to excellent repeatability for the other foot regions (ICC ≥ 0.82). Conclusion The protocol adopted in this study was feasible and yielded good to excellent repeatability for the foot regions, except the toes. The challenges with data collection in our study cohort could help inform future studies adopting similar protocols. This work also has relevance for use of pressure technology in clinical practice for assessing and monitoring foot function following stroke.
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Affiliation(s)
- A Rogers
- School of Health and Rehabilitation Sciences, Keele University, Keele, UK
| | - S C Morrison
- School of Health Sciences, University of Brighton, Darley Road, Eastbourne, BN20 7UR, UK.
| | - T Gorst
- School of Health Professions, University of Plymouth, Plymouth, UK
| | - J Paton
- School of Health Professions, University of Plymouth, Plymouth, UK
| | - J Freeman
- School of Health Professions, University of Plymouth, Plymouth, UK
| | - J Marsden
- School of Health Professions, University of Plymouth, Plymouth, UK
| | - M C Cramp
- School of Allied Health Professions, University of the West of England, Bristol, UK
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Seixas A, Jin P, Liu M, Nunes J, Grandner M, Rogers A, McFarlane S, Jean-Louis G. 1062 The Role of Sleep in Sex and Racial/Ethnic Differences in 10-Year CVD Risk in the Sleep Heart Health Study: The Use of Machine-Learnt and Precision Insights to Understand Racial/Ethnic and Sex Differences in Sleep-CVD Disparity. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The current study investigated whether insufficient sleep (<7 hrs.) explains differences in 10-year CVD risk, using Framingham risk (FRS) and Reynolds risk (RRS) scores, between blacks and whites and characterized risk and protective CVD risk profiles.
Methods
Using the Sleep Heart Health Study (SHHS) (N=6,441) data, we investigated the independent role of insufficient sleep in explaining differences in 10-years CVD between blacks and whites via a proportional odds model of four 10-year CVD risk groups: low (<5%), low-medium (5% to <10%), medium-high (10% to <20%) and high (≥20%), adjusting for age, sex, and apnea-hypopnea index (AHI). We performed two levels of cluster analyses; via hierarchical cluster algorithm with entire sample (Level 1), and latent profiles in the low (protective profiles) and high (risk profiles) CVD risk groups (Level 2) to determine overall CVD risk, and risk and protective CVD profiles.
Results
Blacks had a higher prevalence of smoking behavior, diabetes, mean systolic blood pressure, body mass index, total cholesterol compared to whites. Conversely, whites had a higher mean HDL cholesterol, sleep hours, and sleep efficiency compared to blacks. Men had higher 10-year CVD risk than women. AHI and race/ethnicity-sleep interaction were positively associated, while sleep was negatively associated with FRS and RRS. Across all CVD risk groups, whites who slept less than 5.5 hrs. had a higher CVD risk and those who slept more than 6.5 hrs. had a lower CVD risk compared to blacks. In Level 1 cluster analyses, we found two clusters: Cluster 1 (n= 3233): 6.17 sleep hours, apnea-index 11.84, age 59, SBP 125.43, total cholesterol 209, HDL 51.39, BMI 29.03, and slightly more than 50% female; and Cluster 2 (n=1657): 5.61 sleep hours, apnea-index 13.41, age 74, SBP 131, total cholesterol 204, HDL 50.30, BMI 26.45, and slightly less than 50% female. In Level 2 cluster analyses, we found two profiles within the low and high CVD risk groups.
Conclusion
These findings suggest that blacks may not receive full protection from long-term CVD risk with longer sleep duration, as their white counterparts.
Support
K01HL135452, R01MD007716, R01HL142066, K07AG052685
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Affiliation(s)
- A Seixas
- NYU Grossman School of Medicine, New York, NY
| | - P Jin
- NYU Grossman School of Medicine, New York, NY
| | - M Liu
- NYU Grossman School of Medicine, New York, NY
| | - J Nunes
- City University of New York School of Medicine, New York, NY
| | - M Grandner
- University of Arizona College of Medicine, Tuscon, AZ
| | - A Rogers
- St. John’s University, Queens, NY
| | - S McFarlane
- State University of New York, Downstate Health Science University, New York, NY
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Williams S, Seixas A, Avirappattu G, Robbins R, Lough L, Rogers A, Beaugris L, Bernard M, Jean-Louis G. 1058 Modeling Self-reported Sleep Duration And Hypertension Using Deep Learning Network: Analysis Of The National Health And Nutrition Examination Survey Data. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Epidemiologic data show strong associations between self-reported sleep duration and hypertension (HTN). Modeling these associations is suboptimal when utilizing traditional logistic regressions. In this study, we modeled the associations of sleep duration and HTN using Deep Learning Network.
Methods
Data were extracted from participants (n=38,540) in the National Health and Nutrition Examination Survey (2006-2016), a nationally representative study of the US civilian non-institutionalized population. Self-reported demographic, medical history and sleep duration were determined from household interview questions. HTN was determined as SBP ≥ 130 mmHg and DBP ≥ 80 mmHg. We used a deep neural network architecture with three hidden layers with two input features and one binary output to model associations of sleep duration with HTN. The input features are the hours of sleep (limited to between 4 and 10 hours) and its square; and the output variable HTN. Probability predictions were generated 100 times from resampled (with replacement) data and averaged.
Results
Participants ranged from 18 to 85 years old; 51% Female, 41% white, 22% black, 26% Hispanic, 46% married, and 25% < high school. The model showed that sleeping 7 hours habitually was associated with the least observed HTN probabilities (P=0.023%). HTN probabilities increased as sleep duration decreased (6hrs=0.05%; 5hrs=0.110%; 4hrs=0.16%); HTN probabilities for long sleepers were: (8hrs=0.027; 9hrs=0.024; 10hrs=0.022). Whites showed sleeping 7hrs or 9hrs was associated with lowest HTN probabilities (0.008 vs. 0.005); blacks showed the lowest HTN probabilities associated with sleeping 8hrs (0.07), and Hispanics showed the lowest HTN probabilities sleeping 7hrs (0.04).
Conclusion
We found that sleeping 7 hours habitually confers the least amount of risk for HTN. Probability of HTN varies as a function of individual’s sex and race/ethnicity. Likewise, the finding that blacks experience the lowest HTN probability when they sleep habitually 8 hours is of great public health importance.
Support
This study was supported by funding from the NIH: R01MD007716, R01HL142066, R01AG056531, T32HL129953, K01HL135452, and K07AG052685.
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Affiliation(s)
- S Williams
- NYU Grossman School of Medicine, New York, NY
| | - A Seixas
- NYU Grossman School of Medicine, New York, NY
| | | | | | - L Lough
- NYU Grossman School of Medicine, New York, NY
| | - A Rogers
- St. John’s University, Queens, NY
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Garcia J, Moore J, Payano L, Rogers A, Poke P, Casimir G, Jean-Louis G, Seixas A. 1102 Relationship Between Emotional Distress And Sleep Duration Among Hispanics Using The 2018 National Health Interview Survey Dataset. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Although Hispanics experience a high level of shorter sleep duration (< 7 hrs./24 period), a clear mechanism or cause is lacking. Previous research indicate that emotional distress may explain the burden of shorter sleep among blacks. Applying these findings to Hispanics, we investigated whether emotional distress explains the burden of short sleep duration (< 7 hrs.) among Hispanics and if this relationship varies by sex
Methods
We used data from the 2018 National Health Interview Survey (NHIS) dataset, a nationally representative sample, in which only Hispanic ethnicity participants (N=3,091) were analyzed. Average sleep duration was self-reported and measured in hours. Emotional distress was measured using Kessler 6, which measures how an individual felt over the past 30 days: nervous, hopeless, restless/fidgety, depressed, effortful and worthless. To assess the association between short sleep duration and emotional distress, we performed Pearson correlation, hierarchical regression analyses, and stratified this relationship by sex to determine if this relationship differed between males and females, adjusting for covariates.
Results
Of the total sample of 3,091 Hispanics, 1,762 were female, and 1,329 were male. Sleep duration and emotional distress were negatively correlated among females (r = -.27, p <.001) and males (r=-.18, p <.001). Among Hispanic females, sleep duration significantly predicted emotional distress, β = -.27, t = -11.60, p <.001, and explained a significant portion of variance in emotional distress, R2 = .07, F= 134.63, p <.001. While, among Hispanic males, sleep significantly predicted emotional distress (β = -.18, t =-6.5, p <.001) and explained a significant portion of the variance in emotional distress (R2 = .03, F= 42.37, p <.001).
Conclusion
Our findings indicate that a negative sleep-ED relationship, suggesting that shorter sleep was predictive of higher levels of emotional distress among Hispanics and that this relationship is greater among Hispanic females, compared males.
Support
K01HL135452, R01MD007716, R01HL142066, and K07AG052685
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Affiliation(s)
- J Garcia
- NYU Grossman School of Medicine, New York, NY
| | - J Moore
- NYU Grossman School of Medicine, New York, NY
| | - L Payano
- NYU Grossman School of Medicine, New York, NY
| | - A Rogers
- St. John’s University, Queens, NY
| | - P Poke
- NYU Grossman School of Medicine, New York, NY
| | - G Casimir
- SUNY Downstate Medical Center, Brooklyn, NY
| | | | - A Seixas
- NYU Grossman School of Medicine, New York, NY
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Rogers A, Seixas A, Moore J, Zizi F, Williams S, Gyamfi L, Pichardo Y, Jean-Louis G. 0621 Utilization of the Ares to Predict OSA Among Blacks Using Home-Based Watchpat Recording. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
In two waves of data we collected in Brooklyn New York, we observed blacks were at high risk for obstructive sleep apnea (OSA). In the NIH-funded study ‘Metabolic Syndrome Outcome Study (MetSO), blacks enrolled from primary-care settings had a 59% risk of OSA. Similarly, blacks surveyed in churches and barbershops had a 43% risk of OSA. While these studies showed higher than expected risk as noted in the general population (29%), it remains uncertain how many of those blacks would be diagnosed with OSA in that population. The purpose of this study was to explore the rate of OSA using the WatchPat device in a community-based setting.
Methods
Data were collected from an NIH-funded study ‘Peer-Enhanced Education to Reduce Sleep Ethnic Disparities, designed to navigate blacks at risk of OSA to receive timely diagnosis and treatment using peer-delivered linguistically and culturally tailored sleep health education. Blacks were screened for OSA using the Apnea Risk Evaluation System (ARES) Questionnaire; a score ≥6 denoted moderate-high OSA risk. Individuals were asked to wear the WatchPAT 200 for one night during a week-long sleep assessment. WatchPat 200 measures SaO2 to determine respiratory-related arousals, defined as an Apnea-Hypopnea Index (AHI) ≥5, which is used to identify and diagnose OSA. We used SPSS 25.0 to perform logical regression analysis to assess associations between ARES and WatchPat AHI.
Results
A sample of 111 blacks provided valid ARES and WatchPat data for the present analyses. Of the sample, the mean age was 62.26 (SD=13.52 years; female = 55%); 49% reported annual income >20K and 79.5% reported a high school education. Moreover, 27% reported high blood pressure, 13%, diabetes, and 65% were overweight/obese. Multivariate-adjusted logical regression analyses indicated that blacks at risk for OSA were 66% more likely to receive an OSA diagnosis based on WatchPat AHI data (OR = 1.662, p < 0.01). The model adjusted for age, sex, income, and education.
Conclusion
The present study demonstrated that blacks at risk for OSA at the community level have a significant likelihood of receiving an OSA diagnosis using home-based recordings.
Support
NIH Support (T32HL129953, RO1MD007716, K01HL135452 and K07AG052685).
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Affiliation(s)
- A Rogers
- St. John’s University, Queens, NY
| | - A Seixas
- NYU Grossman School of Medicine, New York, NY
| | - J Moore
- NYU Grossman School of Medicine, New York, NY
| | - F Zizi
- NYU Grossman School of Medicine, New York, NY
| | - S Williams
- NYU Grossman School of Medicine, New York, NY
| | - L Gyamfi
- NYU Grossman School of Medicine, New York, NY
| | - Y Pichardo
- NYU Grossman School of Medicine, New York, NY
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Lough L, Seixas A, Avirappattu G, Robbins R, Rogers A, Williams S, Jean-Louis G. 1046 Assessing Sleep-Related Hypertension Risks Using JNC 8 Guidelines: Analysis Of The National Health And Nutrition Examination Survey Data. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Associations between self-reported sleep duration and risk of hypertension (HTN) are well established. The level of sleep-related HTN risk based on the new JNC 8 classification guidelines requires further research. In this study, we modeled the associations of insufficient sleep with HTN using the National Health and Nutrition Examination Survey (NHANES).
Methods
Data were extracted from the 2006-2016 NHANES (n=38,540), a nationally representative study of the US civilian population. Self-reported demographic and sleep duration were determined from household interview questions. Insufficient sleep was categorized as sleeping <7hrs. Using 2017 ACC/AHA guidelines, HTN was classified as elevated (SBP:120-129mmHg and DBP <80mmHg, Stage I (SBP:130-139mmHg and DBP:80-89mmHg), or Stage II (SBP ≥140mmHg and DBP ≥90mmHg). Logistic regression modeling was performed using R.
Results
Participants’ ages ranged from 18-85 years. Of the sample, 51% were female, 41% white, 22% black, 26% Hispanic, 8% others; 46% were married, and 25% completed <high school. The model showed strong age and BMI-adjusted associations of insufficient sleep with HTN at all levels: (elevated: OR=1.079, CI=1.03-1.13; Stage I: OR=1.127, CI=1.07-1.18, and Stage II: OR=1.334, CI=1.17-1.52). Important sex and race/ethnicity differences in sleep-related HTN risks were observed: males (elevated: OR=1.024, CI=0.95-1.10; Stage I: OR=1.077, CI=1.01-1.15, and Stage II: OR=1.254, CI=1.06-1.48); females (elevated: OR=1.125, CI=1.05-1.21; Stage I: OR=1.170, CI=1.08-1.26, and Stage II: OR=1.445, CI=1.17-1.79); whites (elevated: OR=1.007, CI=0.93-1.08; Stage I: OR=1.030, CI=0.95-1.12, and Stage II: OR=1.131, CI=0.90-1.43); blacks (elevated: OR=1.047, CI=0.94-1.16; Stage I: OR=1.080, CI=0.97-1.20, and Stage II: OR=1.179, CI=0.95-1.46); and Hispanics (elevated: OR=1.066, CI=0.94-1.21; State I: OR=1.089, CI=0.96-1.24, and Stage II: OR=1.337, CI=0.92-1.92).
Conclusion
Our analyses showed that sleep-related HTN risks vary as a function of individual’s sex and race/ethnicity. Increasing sleep duration at all HTN severity level is important and males and Hispanics at Stage II HTN might benefit the most.
Support
This study was supported by funding from the NIH: R01MD007716,R01HL142066, R01AG056531, T32HL129953, K01HL135452 and K07AG052685
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Affiliation(s)
- L Lough
- NYU Grossman School of Medicine, New York, NY
| | - A Seixas
- NYU Grossman School of Medicine, New York, NY
| | | | | | - A Rogers
- St. John’s University, Queens, NY
| | - S Williams
- NYU Grossman School of Medicine, New York, NY
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Ellis J, Band R, Kinsella K, Cheetham-Blake T, James E, Ewings S, Rogers A. Optimising and profiling pre-implementation contexts to create and implement a public health network intervention for tackling loneliness. Implement Sci 2020; 15:35. [PMID: 32429961 PMCID: PMC7238736 DOI: 10.1186/s13012-020-00997-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 05/03/2020] [Indexed: 01/14/2023] Open
Abstract
Background The implementation of complex interventions experiences challenges that affect the extent to which they become embedded and scaled-up. Implementation at scale in complex environments like community settings defies universal replication. Planning for implementation in such environments requires knowledge of organisational capacity and structure. Pre-implementation work is an important element of the early phase of preparing the setting for the introduction of an intervention, and the factors contributing towards the creation of an optimal pre-implementation community context are under-acknowledged. Methods To explore the factors contributing towards the creation of an optimal pre-implementation context, a quasi-ethnographic approach was taken. The implementation of a social network intervention designed to tackle loneliness in a community setting acts as the case in example. Observations (of meetings), interviews (with community partners) and documentary analysis (national and local policy documents and intervention resources) were conducted. Layder’s adaptive theory approach was taken to data analysis, with the Consolidated Framework for Implementation Research (CFIR) and a typology of third-sector organisations used to interpret the findings. Results Community settings were found to sit along a continuum with three broad categories defined as Fully Professionalised Organisations; Aspirational Community, Voluntary and Social Enterprises; and Non-Professionalised Community-Based Groups. The nature of an optimal pre-implementation context varied across these settings. Using the CFIR, the results illustrate that some settings were more influenced by political landscape (Fully professional and Aspirational setting) and others more influenced by their founding values and ethos (Non-Professionalised Community-Based settings). Readiness was achieved at different speeds across the categories with those settings with more resource availability more able to achieve readiness (Fully Professional settings), and others requiring flexibility in the intervention to help overcome limited resource availability (Aspirational and Non-Professionalised Community-Based settings). Conclusions The CFIR is useful in highlighting the multiple facets at play in creating the optimal pre-implementation context, and where flex is required to achieve this. The CFIR illuminates the similarities and differences between and across settings, highlighting the complexity of open system settings and the important need for pre-implementation work. Trial registration ISRCTN19193075
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Affiliation(s)
- J Ellis
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Building 67, University Road, Southampton, SO17 1BJ, UK.
| | - R Band
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Building 67, University Road, Southampton, SO17 1BJ, UK
| | - K Kinsella
- Public Health Institute, Liverpool John Moores University, 3rd Floor Exchange Station, Tithebarn Street, Liverpool, L2 2QP, UK
| | - T Cheetham-Blake
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Building 67, University Road, Southampton, SO17 1BJ, UK
| | - E James
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Building 67, University Road, Southampton, SO17 1BJ, UK
| | - S Ewings
- School of Health Sciences, University of Southampton, Building 67, University Road, Southampton, SO17 1BJ, UK
| | - A Rogers
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Building 67, University Road, Southampton, SO17 1BJ, UK
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Chamberlain JM, Kapur J, Shinnar S, Elm J, Holsti M, Babcock L, Rogers A, Barsan W, Cloyd J, Lowenstein D, Bleck TP, Conwit R, Meinzer C, Cock H, Fountain NB, Underwood E, Connor JT, Silbergleit R. Efficacy of levetiracetam, fosphenytoin, and valproate for established status epilepticus by age group (ESETT): a double-blind, responsive-adaptive, randomised controlled trial. Lancet 2020; 395:1217-1224. [PMID: 32203691 PMCID: PMC7241415 DOI: 10.1016/s0140-6736(20)30611-5] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/03/2020] [Accepted: 03/05/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Benzodiazepine-refractory, or established, status epilepticus is thought to be of similar pathophysiology in children and adults, but differences in underlying aetiology and pharmacodynamics might differentially affect response to therapy. In the Established Status Epilepticus Treatment Trial (ESETT) we compared the efficacy and safety of levetiracetam, fosphenytoin, and valproate in established status epilepticus, and here we describe our results after extending enrolment in children to compare outcomes in three age groups. METHODS In this multicentre, double-blind, response-adaptive, randomised controlled trial, we recruited patients from 58 hospital emergency departments across the USA. Patients were eligible for inclusion if they were aged 2 years or older, had been treated for a generalised convulsive seizure of longer than 5 min duration with adequate doses of benzodiazepines, and continued to have persistent or recurrent convulsions in the emergency department for at least 5 min and no more than 30 min after the last dose of benzodiazepine. Patients were randomly assigned in a response-adaptive manner, using Bayesian methods and stratified by age group (<18 years, 18-65 years, and >65 years), to levetiracetam, fosphenytoin, or valproate. All patients, investigators, study staff, and pharmacists were masked to treatment allocation. The primary outcome was absence of clinically apparent seizures with improved consciousness and without additional antiseizure medication at 1 h from start of drug infusion. The primary safety outcome was life-threatening hypotension or cardiac arrhythmia. The efficacy and safety outcomes were analysed by intention to treat. This study is registered in ClinicalTrials.gov, NCT01960075. FINDINGS Between Nov 3, 2015, and Dec 29, 2018, we enrolled 478 patients and 462 unique patients were included: 225 children (aged <18 years), 186 adults (18-65 years), and 51 older adults (>65 years). 175 (38%) patients were randomly assigned to levetiracetam, 142 (31%) to fosphenyltoin, and 145 (31%) were to valproate. Baseline characteristics were balanced across treatments within age groups. The primary efficacy outcome was met in those treated with levetiracetam for 52% (95% credible interval 41-62) of children, 44% (33-55) of adults, and 37% (19-59) of older adults; with fosphenytoin in 49% (38-61) of children, 46% (34-59) of adults, and 35% (17-59) of older adults; and with valproate in 52% (41-63) of children, 46% (34-58) of adults, and 47% (25-70) of older adults. No differences were detected in efficacy or primary safety outcome by drug within each age group. With the exception of endotracheal intubation in children, secondary safety outcomes did not significantly differ by drug within each age group. INTERPRETATION Children, adults, and older adults with established status epilepticus respond similarly to levetiracetam, fosphenytoin, and valproate, with treatment success in approximately half of patients. Any of the three drugs can be considered as a potential first-choice, second-line drug for benzodiazepine-refractory status epilepticus. FUNDING National Institute of Neurological Disorders and Stroke, National Institutes of Health.
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Affiliation(s)
- James M Chamberlain
- Division of Emergency Medicine Children's National Hospital, Washington, DC, USA
| | - Jaideep Kapur
- Department of Neurology, University of Virginia Health Sciences Center, Charlottesville, VA, USA
| | - Shlomo Shinnar
- Neurology, Pediatrics and Epidemiology and Population Health Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jordan Elm
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Maija Holsti
- Division of Pediatric Emergency Medicine, University of Utah, Salt Lake City, UT, USA
| | - Lynn Babcock
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | - Alex Rogers
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA; Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - William Barsan
- Department of Emergency Medicine, Neuro Emergencies Research, University of Michigan, Ann Arbor, MI, USA
| | - James Cloyd
- Center for Orphan Drug Research, College of Pharmacy, University of Minnesota, Minneapolis, MN, USA
| | - Daniel Lowenstein
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Thomas P Bleck
- Division of Stroke and Neurocritical Care, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Robin Conwit
- National Institute of Neurological Disorders and Stroke, National Institutes of Health Neuroscience Center, Bethesda, MD, USA
| | - Caitlyn Meinzer
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Hannah Cock
- Institute of Molecular and Clinical Sciences, St George's University of London, London, UK
| | - Nathan B Fountain
- Department of Neurology, University of Virginia Health Sciences Center, Charlottesville, VA, USA
| | - Ellen Underwood
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Jason T Connor
- ConfluenceStat LLC and University of Central Florida College of Medicine, Cooper City, FL, USA
| | - Robert Silbergleit
- Department of Emergency Medicine, Neuro Emergencies Research, University of Michigan, Ann Arbor, MI, USA.
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Lefevre E, Rogers A. Carotid artery vein-pouch bifurcation aneurysm in rats: An experimental model for microneurosurgical training. Neurochirurgie 2020; 66:183-188. [PMID: 32277998 DOI: 10.1016/j.neuchi.2020.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/12/2020] [Accepted: 02/18/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND In the era of endovascular treatment of intracranial aneurysms, surgical clipping is still a relevant treatment method in some cases. However, it has become harder to teach this skill, as the number of surgical cases has decreased over the past years. We therefore decided to use a previously described experimental aneurysm model for surgical training. MATERIAL AND METHODS We operated on 8 rats and constructed a vein-pouch aneurysm at a surgically created carotid bifurcation. Survivors were kept alive for 1 month and operated on to clip the aneurysm. RESULTS Only 3 rats had survived at 1 month. All the carotid arteries were permeable. Only 2 aneurysms were circulating at 1 month, as 1 had thrombosed. They were successfully clipped at 1 month. CONCLUSIONS These preliminary results enabled our junior surgeon to clip two circulating aneurysms, under an operative microscope reproducing surgical conditions. Although the efficacy of the model could be improved, we believe it could be used as a first step in training neurosurgical residents in the basics of aneurysm clipping and microsurgical techniques in a realistic setting.
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Affiliation(s)
- E Lefevre
- Department of Neurosurgery, hôpital universitaire Pitié Salpêtrière, Paris, France.
| | - A Rogers
- Department of Neurosurgery, fondation ophtalmologique Adolphe-de-Rothschild, Paris, France.
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Reidy C, Foster C, Rogers A. A novel exploration of the support needs of people initiating insulin pump therapy using a social network approach: a longitudinal mixed-methods study. Diabet Med 2020; 37:298-310. [PMID: 31618464 PMCID: PMC7003843 DOI: 10.1111/dme.14155] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/14/2019] [Indexed: 12/14/2022]
Abstract
AIMS To establish what practical and emotional means of support are required on initiation of insulin pump therapy and how needs change over time, using GENIE, a social network intervention. METHODS The study's longitudinal design used semi-structured interviews, surveys (PAID, CLARKE) and HbA1c values at time of pump initiation, and at 3 and 6 months. Interviews used GENIE to capture participants' expectations and experiences of pump therapy and associated support and resources. Thematic analysis was used with sequential, time-ordered matrices. RESULTS A total of 16 adults undertook 47 interviews. A total of 94 services, resources and activities were acquired, while tally, frequency and value of network members increased over time. The novelty of pump therapy impacted on participants' self-management needs. Key themes included: 1) the independent nature of managing diabetes; 2) overcoming the challenges and illness burden associated with pump use; 3) the need for responsive and tailored emotional and practical support; and 4) useful resources when incorporating pump therapy. GENIE was thought to be novel and beneficial. CONCLUSIONS A social network approach determined what resources and support people with diabetes require when incorporating a new health technology. Visualisation of support networks using concentric circles enabled people to consider and mobilise support and engage in new activities as their needs changed. The novelty of pump therapy creates new illness-related work, but mobilisation of personally valued flexible, tailored support can improve the process of adaptation.
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Affiliation(s)
- C. Reidy
- National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Wessex School of Health SciencesFaculty of Environmental and Life Sciences, University of Southampton
| | - C. Foster
- Macmillan Survivorship Research GroupSchool of Health Sciences, Faculty of Environmental and Life Sciences, University of SouthamptonSouthamptonUK
| | - A. Rogers
- National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Wessex School of Health SciencesFaculty of Environmental and Life Sciences, University of Southampton
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Bakewell L, Bradley J, Doe J, Parker H, Stellwegan A, White S, Worsfold A, Akbar T, Rogers A, Smith T. The case for electronic nutrition screening tools. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2019.12.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Maleki S, Rahwan T, Ghosh S, Malibari A, Alghazzawi D, Rogers A, Beigy H, Jennings NR. The Shapley value for a fair division of group discounts for coordinating cooling loads. PLoS One 2020; 15:e0227049. [PMID: 31923244 PMCID: PMC6953874 DOI: 10.1371/journal.pone.0227049] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 12/11/2019] [Indexed: 11/18/2022] Open
Abstract
We consider a demand response program in which a block of apartments receive a discount from their electricity supplier if they ensure that their aggregate load from air conditioning does not exceed a predetermined threshold. The goal of the participants is to obtain the discount, while ensuring that their individual temperature preferences are also satisfied. As such, the apartments need to collectively optimise their use of air conditioning so as to satisfy these constraints and minimise their costs. Given an optimal cooling profile that secures the discount, the problem that the apartments face then is to divide the total discounted cost in a fair way. To achieve this, we take a coalitional game approach and propose the use of the Shapley value from cooperative game theory, which is the normative payoff division mechanism that offers a unique set of desirable fairness properties. However, applying the Shapley value in this setting presents a novel computational challenge. This is because its calculation requires, as input, the cost of every subset of apartments, which means solving an exponential number of collective optimisations, each of which is a computationally intensive problem. To address this, we propose solving the optimisation problem of each subset suboptimally, to allow for acceptable solutions that require less computation. We show that, due to the linearity property of the Shapley value, if suboptimal costs are used rather than optimal ones, the division of the discount will be fair in the following sense: each apartment is fairly “rewarded” for its contribution to the optimal cost and, at the same time, is fairly “penalised” for its contribution to the discrepancy between the suboptimal and the optimal costs. Importantly, this is achieved without requiring the optimal solutions.
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Affiliation(s)
- Sasan Maleki
- Department of Computer Engineering, Sharif University of Technology, Tehran, Iran
- * E-mail:
| | - Talal Rahwan
- Computer Science, New York University Abu Dhabi, Abu Dhabi, UAE
| | - Siddhartha Ghosh
- Electronics and Computer Science, University of Southampton, Southampton, United Kingdom
| | - Areej Malibari
- Computer Science Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Daniyal Alghazzawi
- Information Systems Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Alex Rogers
- Department of Computer Science, Oxford University, Oxford, United Kingdom
| | - Hamid Beigy
- Department of Computer Engineering, Sharif University of Technology, Tehran, Iran
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McMahon G, Rogers A, Woulfe Z, Tuthill E, Doyle M, Burke G, Imcha M. Women's Opinions on Cardiotocograph Monitoring and Staff Communication During Labour. Ir Med J 2019; 112:1022. [PMID: 32311252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- G McMahon
- Dept. of Obstetrics and Gynaecology, University Maternity Hospital Limerick, Ireland
| | - A Rogers
- Labour Ward, University Maternity Hospital Limerick, Ireland
| | - Z Woulfe
- Labour Ward, University Maternity Hospital Limerick, Ireland
| | - E Tuthill
- Dept. of Obstetrics and Gynaecology, University Maternity Hospital Limerick, Ireland
| | - M Doyle
- Labour Ward, University Maternity Hospital Limerick, Ireland
| | - G Burke
- Dept. of Obstetrics and Gynaecology, University Maternity Hospital Limerick, Ireland
| | - M Imcha
- Dept. of Obstetrics and Gynaecology, University Maternity Hospital Limerick, Ireland
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Mozola MA, Peng X, Wendorf M, Alles S, Artiga L, Buchholz T, Camacho A, Charveron N, Clayborn J, Decker C, Deibel C, Donohue T, Draughon A, Ewings J, Feldworth M, Gane P, Goodwin J, Gunter T, Gutierrez M, Hovland R, Jechorek R, Jones W, Keskinen L, Lamproe B, Larson E, Manwarren H, Merkling A, Osing C, Pangloli P, Remes A, Richter E, Rogers A, Rose B, Ryser E, Secraw S, Slupik M, Wessinger A, Westmoreland R, Yan Z, Zahoor T, Zhang L. Evaluation of the GeneQuence® DNA Hybridization Method in Conjunction with 24-Hour Enrichment Protocols for Detection of Salmonella spp. in Select Foods: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/90.3.738] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A multilaboratory study was conducted to compare performance of the GeneQuence® DNA hybridization (DNAH) method incorporating new 24 h enrichment protocols and reference culture procedures for detection of Salmonella spp. in select foods. Six food types (raw ground turkey, raw ground beef, dried whole egg, milk chocolate, walnuts, and dry pet food) were tested by the DNAH method and by the culture methods of either the U.S. Department of Agriculture-Food Safety and Inspection Service (USDA-FSIS) or the U.S. Food and Drug Administration's Bacteriological Analytical Manual (FDA/BAM). Fifteen laboratories participated in the study. Four of the foods tested (raw ground turkey, dried whole egg, milk chocolate, and dry pet food), showed no statistically significant differences in performance between the DNAH method and the reference procedure as determined by Chi square analysis. Sensitivity rates for the DNAH method ranged from 92 to 100. The DNAH method, with the specific enrichment protocol evaluated, was found to be ineffective for detection of Salmonella spp. in walnuts. For raw ground beef, results from one trial showed a statistically significant difference in performance, with more positives obtained by the reference method. However, evidence suggests that the difference in the number of positives was likely due to lack of homogeneity of the test samples rather than to DNAH method performance.
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Affiliation(s)
| | - Xuan Peng
- Neogen Corp., 620 Lesher Pl, Lansing, MI 48912
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Richards A, Rogers A. Interdisciplinary Event with Undergraduate Dietetic and Nursing Students Increases Positive Attitudes Towards Team Based Practice. J Acad Nutr Diet 2019. [DOI: 10.1016/j.jand.2019.08.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lahoz-Monfort JJ, Chadès I, Davies A, Fegraus E, Game E, Guillera-Arroita G, Harcourt R, Indraswari K, McGowan J, Oliver JL, Refisch J, Rhodes J, Roe P, Rogers A, Ward A, Watson DM, Watson JEM, Wintle BA, Joppa L. A Call for International Leadership and Coordination to Realize the Potential of Conservation Technology. Bioscience 2019. [DOI: 10.1093/biosci/biz090] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
AbstractAdvancing technology represents an unprecedented opportunity to enhance our capacity to conserve the Earth's biodiversity. However, this great potential is failing to materialize and rarely endures. We contend that unleashing the power of technology for conservation requires an internationally coordinated strategy that connects the conservation community and policy-makers with technologists. We argue an international conservation technology entity could (1) provide vision and leadership, (2) coordinate and deliver key services necessary to ensure translation from innovation to effective deployment and use of technology for on-the-ground conservation across the planet, and (3) help integrate innovation into biodiversity conservation policy from local to global scales, providing tools to monitor outcomes of conservation action and progress towards national and international biodiversity targets. This proposed entity could take the shape of an international alliance of conservation institutions or a formal intergovernmental institution. Active and targeted uptake of emerging technology can help society achieve biodiversity conservation goals.
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Affiliation(s)
- José J Lahoz-Monfort
- School of BioSciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | | | - Alasdair Davies
- Zoological Society of London, Regent's Park, London, NW1 4RY, United Kingdom
| | - Eric Fegraus
- 2011 Crystal Drive, Suite 600, Arlington, VA 22202 United Kingdom
| | - Edward Game
- The Nature Conservancy, South Brisbane, QLD 4101, Australia
| | | | - Robert Harcourt
- Department of Biological Sciences, Macquarie University, North Ryde, NSW, 2109, Australia
| | - Karlina Indraswari
- School of Electrical Engineering and Computer Science, Queensland University of Technology, Brisbane, QLD, 4066, Australia
| | - Jennifer McGowan
- The Nature Conservancy, South Brisbane, QLD 4101, Australia
- Department of Biological Sciences, Macquarie University, North Ryde, NSW, 2109, Australia
- Centre of Excellence for Environmental Decisions, School of Biological Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Jessica L Oliver
- School of Electrical Engineering and Computer Science, Queensland University of Technology, Brisbane, QLD, 4066, Australia
| | - Johannes Refisch
- School of BioSciences, The University of Melbourne, Parkville, VIC 3010, Australia
- Centre of Excellence for Environmental Decisions, School of Biological Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
- Great Apes Survival Partnership, UN Environment, P.O. Box 30552, 00100 Nairobi, Kenya
| | - Jonathan Rhodes
- School of Earth and Environmental Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Paul Roe
- School of Electrical Engineering and Computer Science, Queensland University of Technology, Brisbane, QLD, 4066, Australia
| | - Alex Rogers
- Department of Computer Science, University of Oxford, Oxford, United Kingdom
| | - Adrian Ward
- Wentworth Group of Concerned Scientists, 95 Pitt St, Sydney NSW 2000, Australia
| | - David M Watson
- Institute for Land, Water and Society, Charles Sturt University, Albury, NSW, Australia
| | - James E M Watson
- School of BioSciences, The University of Melbourne, Parkville, VIC 3010, Australia
- School of Earth and Environmental Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
- Wildlife Conservation Society, Global Conservation Program, Bronx NY 10460, United States
| | - Brendan A Wintle
- School of BioSciences, The University of Melbourne, Parkville, VIC 3010, Australia
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Hodgson H, Davidson D, Duncan A, Guthrie J, Henderson E, MacDiarmid M, McGown K, Pollard V, Potter R, Rodgers A, Wilson A, Horner J, Doran M, Simm S, Taylor R, Rogers A, Rippon MG, Colgrave M. A multicentre, clinical evaluation of a hydro-responsive wound dressing: the Glasgow experience. J Wound Care 2019; 26:642-650. [PMID: 29131748 DOI: 10.12968/jowc.2017.26.11.642] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Our aim was to assess the effectiveness of hydro-responsive wound dressing (HRWD) in debridement and wound bed preparation of a variety of acute and chronic wounds that presented with devitalised tissue needing removal so that healing may proceed. METHOD This was a non-comparative evaluation of acute and chronic wounds that required debridement as part of their normal treatment regimen. Clinicians recorded wound changes including a subjective assessment level of devitalised tissue and wound bed preparation, presence of pain, wound status (e.g., wound size) and periwound skin condition. Data was also collected from clinicians and patients to provide information on clinical performance of the dressing. RESULTS We recruited 100 patients with a variety of wound types into the study. Over 90% of the clinicians reported removal of devitalised tissue to enable a healing response in both chronic and acute wounds. Specifically, over the course of the evaluation period, levels of devitalised tissue (necrosis and slough) reduced from 85.5% to 26.3%, and this was accompanied by an increase in wound bed granulation from 12.0% to 33.7%. Correspondingly, there was a 40% reduction in wound area, hence a clinically relevant healing response was seen upon treatment with HRWD. It is also noteworthy that this patient population included a significant proportion of chronic wounds (51.4%) that showed no signs of wound progression within <4 weeks before study inclusion. Of these chronic wounds, 93% demonstrated wound progression upon treatment with HRWD. Despite reported pain levels being low pre- and post-dressing change, overall wound pain improved (reduced) in 48% of patients. Periwound skin condition showed a tendency towards improvement, and the fluid management capabilities of the HRWD was reported as good to excellent in the majority of cases. Wound infections were reduced by at least 60% over the evaluation period. A simple cost-effective analysis demonstrated significant savings using HRWD (£6.33) over current standard practice regimens of a four-step debridement process (£8.05), larval therapy (£306.39) and mechanical pad debridement (£11.46). CONCLUSION HRWD was well tolerated and was demonstrated to be an efficient debridement tool providing rapid, effective and pain free debridement in a variety of wound types.
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Affiliation(s)
- H Hodgson
- Lead Investigator, Lead Nurse Tissue Viability, Tissue Viability Acute and Partnerships, Glasgow
| | - D Davidson
- Vascular Nurse Specialist, Inverclyde Royal Hospital, Greenock
| | - A Duncan
- Vascular Nurse Specialist, Queen Elizabeth University Hospital, Glasgow
| | - J Guthrie
- Tissue Viability Specialist Nurse, Tissue Viability Acute and Partnerships, Glasgow
| | - E Henderson
- Tissue Viability Nurse Specialist, Glasgow Royal Infirmary, Glasgow
| | - M MacDiarmid
- Tissue Viability Clinical Nurse Specialist, Queen Elizabeth University Hospital, Glasgow
| | - K McGown
- Tissue Viability Nurse, Queen Elizabeth University Hospital, Glasgow
| | - V Pollard
- Tissue Viability Nurse, Inverclyde Royal Hospital, Greenock
| | - R Potter
- Tissue Viability Clinical Nurse Specialist, Tissue Viability Specialist Nurses (Partnerships Glasgow)
| | - A Rodgers
- Paediatric Tissue Viability Nurse, Royal Hospital for Children, Glasgow
| | - A Wilson
- Tissue Viability Nurse Specialist, Royal Alexandra Hospital, Paisley
| | - J Horner
- Tissue Viability Personal Assistant, Tissue Viability Acute and Partnerships, Glasgow
| | - M Doran
- Tissue Viability Personal Assistant, Tissue Viability Acute and Partnerships, Glasgow
| | - S Simm
- Clinical Development Manager, Hartmann Wound Care, Haywood, Lancashire
| | - R Taylor
- Nurse Advisor (North), Hartmann Wound Care, Haywood, Lancashire
| | - A Rogers
- Medical Communications, Flintshire, North Wales
| | - M G Rippon
- Visiting Clinical Research Fellow, Huddersfield University, Queensgate, Huddesfield
| | - M Colgrave
- Freelance Medical Writer, Molecular Cell Research, Lincoln
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