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Survival following lung volume reduction procedures: results from the UK Lung Volume Reduction (UKLVR) registry. BMJ Open Respir Res 2024; 11:e002092. [PMID: 38423954 PMCID: PMC10910650 DOI: 10.1136/bmjresp-2023-002092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/26/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION Lung volume reduction surgery (LVRS) and endobronchial valve (EBV) placement can produce substantial benefits in appropriately selected people with emphysema. The UK Lung Volume Reduction (UKLVR) registry is a national multicentre observational study set up to support quality standards and assess outcomes from LVR procedures at specialist centres across the UK. METHODS Data were analysed for all patients undergoing an LVR procedure (LVRS/EBV) who were recruited into the study at participating centres between January 2017 and June 2022, including; disease severity and risk assessment, compliance with guidelines for selection, procedural complications and survival to February 2023. RESULTS Data on 541 patients from 14 participating centres were analysed. Baseline disease severity was similar in patients who had surgery n=244 (44.9%), or EBV placement n=219 (40.9%), for example, forced expiratory volume in 1 s (FEV1) 32.1 (12.1)% vs 31.2 (11.6)%. 89% of cases had discussion at a multidisciplinary meeting recorded. Median (IQR) length of stay postprocedure for LVRS and EBVs was 12 (13) vs 4 (4) days(p=0.01). Increasing age, male gender and lower FEV1%predicted were associated with mortality risk, but survival did not differ between the two procedures, with 50 (10.8%) deaths during follow-up in the LVRS group vs 45 (9.7%) following EBVs (adjusted HR 1.10 (95% CI 0.72 to 1.67) p=0.661) CONCLUSION: Based on data entered in the UKLVR registry, LVRS and EBV procedures for emphysema are being performed in people with similar disease severity and long-term survival is similar in both groups.
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Initial progress of the magnetic diagnostics of the MAST-U tokamak. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2023; 94:073501. [PMID: 37404097 DOI: 10.1063/5.0156334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/15/2023] [Indexed: 07/06/2023]
Abstract
MAST Upgrade has just begun its third physics campaign in April of 2023. The set of magnetic probes used to diagnose the magnetic field and currents on MAST Upgrade are described, and their calibration procedures are outlined including calculation of uncertainties. The median uncertainty in the calibration factors of the flux loops and pickup coils are calculated as 1.7% and 6.3%. The arrays of installed instability diagnostics are described, and the detection and diagnosis of a specimen MHD mode are demonstrated. Plans for the improvement of the magnetics arrays are outlined.
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Can digital health apps provide patients with support to promote structured diabetes education and ongoing self-management? A real-world evaluation of myDiabetes usage. Digit Health 2023; 9:20552076221147109. [PMID: 36923369 PMCID: PMC10009031 DOI: 10.1177/20552076221147109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 12/06/2022] [Indexed: 03/16/2023] Open
Abstract
Objective Structured diabetes education has evidenced benefits yet reported uptake rates for those referred to traditional in-person programmes within 12 months of diagnosis were suboptimal. Digital health interventions provide a potential solution to improve diabetes education delivery at population scale, overcoming barriers identified with traditional approaches. myDiabetes is a cloud-based interactive digital health self-management app. This evaluation analysed usage data for people with type 2 diabetes focusing on digital structured diabetes education. Methods Descriptive quantitative analyses were conducted on existing anonymised user data over 12 months (November 2019-2020) to evaluate whether digital health can provide additional support to deliver diabetes education. Data was divided into two equal 6-month periods. As this overlapped the onset of COVID-19, analyses of its effect on usage were included as a secondary outcome. All data was reported via myDiabetes. Users were prescribed myDiabetes by National Health Service healthcare primary care teams. Those who registered for app use within the study period (n = 2783) were assessed for eligibility (n = 2512) and included if activated. Results Within the study period, n = 1245/2512 (49.6%) registered users activated myDiabetes. No statistically significant differences were observed between gender (p = 0.721), or age (p = 0.072) for those who activated (59.2 years, SD 12.93) and those who did not activate myDiabetes (57.6 years, SD 13.77). Activated users (n = 1119/1245 (89.8%)) viewed 11,572 education videos. No statistically significant differences were observed in education video views across age groups (p = 0.384), gender (p = 0.400), diabetes treatment type (p = 0.839) or smoking status (p = 0.655). Comparison of usage pre-COVID-19 and post-COVID-19 showed statistically significant increases in app activity (p ≤0.001). Conclusion Digital health is rapidly evolving in its role of supporting patients to self-manage. Since COVID-19 the benefits of digital technology have become increasingly recognised. There is potential for increasing diabetes education rates by offering patients a digital option in combination with traditional service delivery which should be substantiated through future research.
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Fission chamber data acquisition system for neutron flux measurements on the Mega-Amp Spherical Tokamak Upgrade. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2022; 93:093509. [PMID: 36182454 DOI: 10.1063/5.0106725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/15/2022] [Indexed: 06/16/2023]
Abstract
Neutron flux measurements are important in fusion devices for both safety requirements and physics studies. A new system has been built for the Mega-Amp Spherical Tokamak Upgrade (MAST Upgrade) that provides neutron count, DC, and Campbell mode measurements for a 1 µs period at 1 MHz. The acquisition system uses a Red Pitaya board to sample current from two fission chambers mounted on the side of the MAST-U vessel. The system-on-chip design of the Zynq-7020 on the Red Pitaya also allows a web server implementation using Flask for data retrieval and diagnostic configuration over the MAST Upgrade network.
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294 Implementation of Colorectal Robotic Assisted Surgical Programme During a Global Pandemic: Collaboration Between Territorial and National Waiting Times Centre. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
Golden Jubilee National Hospital (GJNH) established a thoracic Robotic Assisted Surgical (RAS) programme in 2018. In March 2021, GJNH invested in a new elective colorectal service and in response to the Scottish Government robotic investment established a collaboration with a territorial health board to host their robot and start a RAS colorectal programme. We provide an overview of barriers and facilitators leading to establishing this new collaboration.
Method
An observational review of RAS training timeline. Demographics, surgical operations, and hospital length of stay were documented. Surgeons, perioperative team, management, and industry (Intuitive) were interviewed to provide insights into implementation and training.
Results
Boards approved RAS business case in April 2021, robot on-site with GJNH governance approval in May. First cohort of colorectal surgeons completed proctored training July 2021. To date, 17 RAS resections performed (mean age 64, 9 males: 8 female). Mean length of stay 4.65 days. No anastomotic leaks and no mortality reported. Interviews revealed key facilitators: advantage of having an established RAS perioperative team and building on pre-existing industry links; developing and strengthening collaborative working between different health boards and surgeons. Barriers included: education of all team members to ensure patient safety for new specialty; multisite collaborative working.
Conclusions
This work provides a template model for future RAS collaborations between different sites and health boards. Collaborative working in a green-hospital setting may improve equity of access for patients whilst future-proofing surgery against further waves of the pandemic.
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A long‐term study of temporal variation in wing feather mite (Acari: Astigmata) infestations on robins,
Erithacus rubecula
, in Nottinghamshire, UK. J Zool (1987) 2022. [DOI: 10.1111/jzo.12954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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P52.07 Nodal Disease and Pneumonectomy: Always a Bad Combination? A Single High Volume Centre Experience of Long Term Outcomes. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Prediction of venous thromboembolism using clinical and serum biomarker data from a military cohort of trauma patients. BMJ Mil Health 2020; 167:402-407. [PMID: 32139417 DOI: 10.1136/bmjmilitary-2019-001393] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 12/20/2019] [Accepted: 12/23/2019] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Venous thromboembolism (VTE) is a frequent complication of trauma associated with high mortality and morbidity. Clinicians lack appropriate tools for stratifying trauma patients for VTE, thus have yet to be able to predict when to intervene. We aimed to compare random forest (RF) and logistic regression (LR) predictive modelling for VTE using (1) clinical measures alone, (2) serum biomarkers alone and (3) clinical measures plus serum biomarkers. METHODS Data were collected from 73 military casualties with at least one extremity wound and prospectively enrolled in an observational study between 2007 and 2012. Clinical and serum cytokine data were collected. Modelling was performed with RF and LR based on the presence or absence of deep vein thrombosis (DVT) and/or pulmonary embolism (PE). For comparison, LR was also performed on the final variables from the RF model. Sensitivity/specificity and area under the curve (AUC) were reported. RESULTS Of the 73 patients (median Injury Severity Score=16), nine (12.3%) developed VTE, four (5.5%) with DVT, four (5.5%) with PE, and one (1.4%) with both DVT and PE. In all sets of predictive models, RF outperformed LR. The best RF model generated with clinical and serum biomarkers included five variables (interleukin-15, monokine induced by gamma, vascular endothelial growth factor, total blood products at resuscitation and presence of soft tissue injury) and had an AUC of 0.946, sensitivity of 0.992 and specificity of 0.838. CONCLUSIONS VTE may be predicted by clinical and molecular biomarkers in trauma patients. This will allow the development of clinical decision support tools which can help inform the management of high-risk patients for VTE.
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Filament identification in wide-angle high speed imaging of the mega amp spherical tokamak. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2019; 90:093502. [PMID: 31575268 DOI: 10.1063/1.5109470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 08/13/2019] [Indexed: 06/10/2023]
Abstract
A new tomographic inversion technique is presented for the identification of plasma filaments in wide-angle visible camera data. The technique works on the assumption that background subtracted images of filaments can be represented as a superposition of uniformly emitting magnetic equilibrium field lines. A large collection of equilibrium magnetic field lines is traced and projected onto the camera field of view and combined to form a geometry matrix describing the coordinate transformation from magnetic field aligned coordinates to image pixel coordinates. Inverting this matrix enables the reprojection of the emission in the camera images onto a field aligned basis, from which filaments are readily identifiable. The inversion is a poorly conditioned problem which is overcome using a least-squares approach with Laplacian regularization. Blobs are identified using the "watershed" algorithm and 2D Gaussians are fitted to get the positions, widths, and amplitudes of the filaments. A synthetic camera diagnostic generating images containing experimentally representative filaments is utilized to rigorously benchmark the accuracy and reliability of the technique. 74% of synthetic filaments above the detection amplitude threshold are successfully detected, with 98.8% of detected filaments being true positives. The accuracy with which filament properties and their probability density functions are recovered is discussed, along with sources of error and methods to minimize them.
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Abstract
A prospective study of fifty-two patients undergoing fibreoptic upper gastrointestinal endoscopy was carried out in order to determine whether bacteraemia was a significant risk. Aerobic and anaerobic blood cultures were performed before, during and after endoscopy. Cultures were also taken from lesions (if any found) in the oesophagus, stomach or duodenum. No significant bacteraemia was identified, and bacterial growth was found in only one upper gastrointestinal lesion.
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What is the Role of 3D CT in the Future of Rib Fracture Radiology? Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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A comparison of indigenous and non-indigenous patients referred to a rural and remote memory clinic in Western Canada. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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ELM divertor peak energy fluence scaling to ITER with data from JET, MAST and ASDEX upgrade. NUCLEAR MATERIALS AND ENERGY 2017. [DOI: 10.1016/j.nme.2017.04.014] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Comparing accelerometer, pedometer and a questionnaire for measuring physical activity in bronchiectasis: a validity and feasibility study? Respir Res 2017; 18:16. [PMID: 28088206 PMCID: PMC5237513 DOI: 10.1186/s12931-016-0497-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 12/21/2016] [Indexed: 11/21/2022] Open
Abstract
Background There are challenges for researchers and clinicians to select the most appropriate physical activity tool, and a balance between precision and feasibility is needed. Currently it is unclear which physical activity tool should be used to assess physical activity in Bronchiectasis. The aim of this research is to compare assessment methods (pedometer and IPAQ) to our criterion method (ActiGraph) for the measurement of physical activity dimensions in Bronchiectasis (BE), and to assess their feasibility and acceptability. Methods Patients in this analysis were enrolled in a cross-sectional study. The ActiGraph and pedometer were worn for seven consecutive days and the IPAQ was completed for the same period. Statistical analyses were performed using SPSS 20 (IBM). Descriptive statistics were used; the percentage agreement between ActiGraph and the other measures were calculated using limits of agreement. Feedback about the feasibility of the activity monitors and the IPAQ was obtained. Results There were 55 (22 male) data sets available. For step count there was no significant difference between the ActiGraph and Pedometer, however, total physical activity time (mins) as recorded by the ActiGraph was significantly higher than the pedometer (mean ± SD, 232 (75) vs. 63 (32)). Levels of agreement between the two devices was very good for step count (97% agreement); and variation in the levels of agreement were within accepted limits of ±2 standard deviations from the mean value. IPAQ reported more bouted- moderate - vigorous physical activity (MVPA) [mean, SD; 167(170) vs 6(9) mins/day], and significantly less sedentary time than ActiGraph [mean, SD; 362(115) vs 634(76) vmins/day]. There were low levels of agreement between the two tools (57% sedentary behaviour; 0% MVPA10+), with IPAQ under-reporting sedentary behaviour and over-reporting MVPA10+ compared to ActiGraph. The monitors were found to be feasible and acceptable by participants and researchers; while the IPAQ was accepta ble to use, most patients required assistance to complete it. Conclusions Accurate measurement of physical activity is feasible in BE and will be valuable for future trials of therapeutic interventions. ActiGraph or pedometer could be used to measure simple daily step counts, but ActiGraph was superior as it measured intensity of physical activity and was a more precise measure of time spent walking. The IPAQ does not appear to represent an accurate measure of physical activity in this population. Trial registration Clinical Trials Registration Number NCT01569009: Physical Activity in Bronchiectasis.
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Steroid-Responsive Acute Rejection Should Not Be the End Point for Immunosuppressive Trials. Am J Transplant 2016; 16:3077-3078. [PMID: 27232598 DOI: 10.1111/ajt.13889] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 05/25/2016] [Accepted: 05/26/2016] [Indexed: 01/25/2023]
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Impact of school-based vegetable garden and physical activity coordinated health interventions on weight status and weight-related behaviors of ethnically diverse, low-income students: Study design and baseline data of the Texas, Grow! Eat! Go! (TGEG) cluster-randomized controlled trial. BMC Public Health 2016; 16:973. [PMID: 27624139 PMCID: PMC5022204 DOI: 10.1186/s12889-016-3453-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 08/05/2016] [Indexed: 11/21/2022] Open
Abstract
Background Coordinated, multi-component school-based interventions can improve health behaviors in children, as well as parents, and impact the weight status of students. By leveraging a unique collaboration between Texas AgriLife Extension (a federal, state and county funded educational outreach organization) and the University of Texas School of Public Health, the Texas Grow! Eat! Go! Study (TGEG) modeled the effectiveness of utilizing existing programs and volunteer infrastructure to disseminate an enhanced Coordinated School Health program. The five-year TGEG study was developed to assess the independent and combined impact of gardening, nutrition and physical activity intervention(s) on the prevalence of healthy eating, physical activity and weight status among low-income elementary students. The purpose of this paper is to report on study design, baseline characteristics, intervention approaches, data collection and baseline data. Methods The study design for the TGEG study consisted of a factorial group randomized controlled trial (RCT) in which 28 schools were randomly assigned to one of 4 treatment groups: (1) Coordinated Approach to Child Health (CATCH) only (Comparison), (2) CATCH plus school garden intervention [Learn, Grow, Eat & Go! (LGEG)], (3) CATCH plus physical activity intervention [Walk Across Texas (WAT)], and (4) CATCH plus LGEG plus WAT (Combined). The outcome variables include student’s weight status, vegetable and sugar sweetened beverage consumption, physical activity, and sedentary behavior. Parents were assessed for home environmental variables including availability of certain foods, social support of student health behaviors, parent engagement and behavior modeling. Results Descriptive data are presented for students (n = 1369) and parents (n = 1206) at baseline. The sample consisted primarily of Hispanic and African American (53 % and 18 %, respectively) and low-income (i.e., 78 % eligible for Free and Reduced Price School Meals program and 43 % food insecure) students. On average, students did not meet national guidelines for vegetable consumption or physical activity. At baseline, no statistical differences for demographic or key outcome variables among the 4 treatment groups were observed. Conclusions The TGEG study targets a population of students and parents at high risk of obesity and related chronic conditions, utilizing a novel and collaborative approach to program formulation and delivery, and a rigorous, randomized study design.
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Rapamycin Interferes With Postdepletion Regulatory T Cell Homeostasis and Enhances DSA Formation Corrected by CTLA4-Ig. Am J Transplant 2016; 16:2612-23. [PMID: 26990829 DOI: 10.1111/ajt.13789] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 03/01/2016] [Accepted: 03/08/2016] [Indexed: 01/25/2023]
Abstract
Previously, we demonstrated that alemtuzumab induction with rapamycin as sole maintenance therapy is associated with an increased incidence of humoral rejection in human kidney transplant patients. To investigate the role of rapamycin in posttransplant humoral responses after T cell depletion, fully MHC mismatched hearts were transplanted into hCD52Tg mice, followed by alemtuzumab treatment with or without a short course of rapamycin. While untreated hCD52Tg recipients acutely rejected B6 hearts (n = 12), hCD52Tg recipients treated with alemtuzumab alone or in conjunction with rapamycin showed a lack of acute rejection (MST > 100). However, additional rapamycin showed a reduced beating quality over time and increased incidence of vasculopathy. Furthermore, rapamycin supplementation showed an increased serum donor-specific antibodies (DSA) level compared to alemtuzumab alone at postoperation days 50 and 100. Surprisingly, additional rapamycin treatment significantly reduced CD4(+) CD25(+) FoxP3(+) T reg cell numbers during treatment. On the contrary, ICOS(+) PD-1(+) CD4 follicular helper T cells in the lymph nodes were significantly increased. Interestingly, CTLA4-Ig supplementation in conjunction with rapamycin corrected rapamycin-induced accelerated posttransplant humoral response by directly modulating Tfh cells but not Treg cells. This suggests that rapamycin after T cell depletion could affect Treg cells leading to an increase of Tfh cells and DSA production that can be reversed by CTLA4-Ig.
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F-114FACTORS PROLONGING LENGTH OF STAY IN ENHANCED RECOVERY AFTER SURGERY FOR OPEN LUNG RESECTION SURGERY. Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cryobanked MSCs Have a Markedly Increased Susceptibility to T-cell Mediated Contact Cytolysis in Vitro Immediately Post Thaw and Shortened in Vivo Persistence Relative to Physiologically Fit Culture-rescued MSCs. Cytotherapy 2016. [DOI: 10.1016/j.jcyt.2016.03.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Perioperative BNP changes and functional capacity following lung resection. J Cardiothorac Vasc Anesth 2016. [DOI: 10.1053/j.jvca.2016.03.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Predictors of admission to long-term care in rural memory clinic patients. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Profile measurements in the plasma edge of mega amp spherical tokamak using a ball pen probe. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2015; 86:023510. [PMID: 25725845 DOI: 10.1063/1.4908572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The ball pen probe (BPP) technique is used successfully to make profile measurements of plasma potential, electron temperature, and radial electric field on the Mega Amp Spherical Tokamak. The potential profile measured by the BPP is shown to significantly differ from the floating potential both in polarity and profile shape. By combining the BPP potential and the floating potential, the electron temperature can be measured, which is compared with the Thomson scattering (TS) diagnostic. Excellent agreement between the two diagnostics is obtained when secondary electron emission is accounted for in the floating potential. From the BPP profile, an estimate of the radial electric field is extracted which is shown to be of the order ∼1 kV/m and increases with plasma current. Corrections to the BPP measurement, constrained by the TS comparison, introduce uncertainty into the ER measurements. The uncertainty is most significant in the electric field well inside the separatrix. The electric field is used to estimate toroidal and poloidal rotation velocities from E × B motion. This paper further demonstrates the ability of the ball pen probe to make valuable and important measurements in the boundary plasma of a tokamak.
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Type III procollagen as a biomarker of susceptibility to ARDS? Intensive Care Med 2015; 41:568-9. [DOI: 10.1007/s00134-015-3645-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2015] [Indexed: 11/30/2022]
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The new OPTN kidney allocation policy: potential for inequitable access among highly sensitized patients. Am J Transplant 2015; 15:284-5. [PMID: 25403877 DOI: 10.1111/ajt.13061] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 10/13/2014] [Indexed: 01/25/2023]
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In-circuit-measurement of parasitic elements in high gain high bandwidth low noise transimpedance amplifiers. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2014; 85:124703. [PMID: 25554310 DOI: 10.1063/1.4902854] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Parasitic elements play an important role in the development of every high performance circuit. In the case of high gain, high bandwidth transimpedance amplifiers, the most important parasitic elements are parasitic capacitances at the input and in the feedback path, which significantly influence the stability, the frequency response, and the noise of the amplifier. As these parasitic capacitances range from a few picofarads down to only a few femtofarads, it is nearly impossible to measure them accurately using traditional LCR meters. Unfortunately, they also cannot be easily determined from the transfer function of the transimpedance amplifier, as it contains several overlapping effects and its measurement is only possible when the circuit is already stable. Therefore, we developed an in-circuit measurement method utilizing minimal modifications to the input stage in order to measure its parasitic capacitances directly and with unconditional stability. Furthermore, using the data acquired with this measurement technique, we both proposed a model for the complicated frequency response of high value thick film resistors as they are used in high gain transimpedance amplifiers and optimized our transimpedance amplifier design.
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P224 Lymph Node Assessment In Surgical Resection Of Non-small Cell Lung Cancer (nsclc): Are We Hitting The Target? Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Teachers’ perceptions on supporting participation in physical education at school in students with Type 1 diabetes. J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
Background: The prevalence of systemic lupus erythematous (SLE) patients requiring renal replacement therapy (RRT) is increasing but data on clinical outcomes are scarce. Interestingly, data on technique failure and peritoneal-dialysis (PD)-related infections are rarer, despite SLE patients being considered at high risk for infections. The aim of our study is to compare clinical outcomes of SLE patients on PD in a large PD cohort. Methods: We conducted a nationwide prospective observational study from the BRAZPD II cohort. For this study we identified all patients on PD for greater than 90 days. Within that subset, all those with SLE as primary renal disease were matched with PD patients without SLE for comparison of clinical outcomes, namely: patient mortality, technique survival and time to first peritonitis, then were analyzed taking into account the presence of competing risks. Results: Out of a total of 9907 patients, we identified 102 SLE patients incident in PD and with more than 90 days on PD. After matching the groups consisted of 92 patients with SLE and 340 matched controls. Mean age was 46.9 ± 16.8 years, 77.3% were females and 58.1% were Caucasians. After adjustments SLE sub-hazard distribution ratio for mortality was 1.06 (CI 95% 0.55–2.05), for technique failure was 1.01 (CI 95% 0.54–1.91) and for time to first peritonitis episode was 1.40 (CI 95% 0.92–2.11). The probability for occurrence of competing risks in all three outcomes was similar between groups. Conclusion: PD therapy was shown to be a safe and equally successful therapy for SLE patients compared to matched non-SLE patients.
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Test performance of PET-CT for mediastinal lymph node staging of pulmonary carcinoid tumours. Thorax 2014; 70:379-81. [DOI: 10.1136/thoraxjnl-2014-205899] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Measurement of T Cell Homeostatic Activation and Proliferation Following T Cell Depletion With Alemtuzumab. Transplantation 2014. [DOI: 10.1097/00007890-201407151-01947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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HLA and MICA Alloantibody Profiling in Pediatric Renal Transplant Recipients: Report From The Clinical Trials in Organ Transplantation in Children (CTOTC-02). Transplantation 2014. [DOI: 10.1097/00007890-201407151-00034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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F-093 * THE ROLE OF HAEMATOLOGICAL MARKERS IN PATIENTS UNDERGOING THYMECTOMY: A MULTICENTRE STUDY FROM THE UNITED KINGDOM. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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The use of technology to promote physical activity in Type 2 diabetes management: a systematic review. Diabet Med 2013; 30:1420-32. [PMID: 23870009 DOI: 10.1111/dme.12289] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 06/13/2013] [Accepted: 07/15/2013] [Indexed: 12/25/2022]
Abstract
INTRODUCTION With increasing evidence available on the importance of physical activity in the management of Type 2 diabetes, there has been an increase in technology-based interventions. This review provides a systematic and descriptive assessment of the effectiveness of technology to promote physical activity in people with Type 2 diabetes. For this review, technology included mobile phones and text messages, websites, CD-ROMs and computer-learning-based technology, and excluded telephone calls. METHODS A systematic literature search was conducted to retrieve articles from January 2001 to March 2013 using the following databases: the Cochrane Library, EMBASE, MEDLINE, PsycINFO and PubMed. Articles had to describe an intervention that used technology to promote physical activity in people with Type 2 diabetes. A methodological quality assessment of the studies was conducted and data synthesis was performed. RESULTS In total, 15 articles were eligible for review: web-based (9), mobile phone (3), CD-ROM (2) and computer based (1). All studies found an increase in physical activity but only nine were significant. The use of a personal coach, logbooks and reinforcement strategies such as phone calls and email counselling were found to be effective components for behaviour change. No studies were ranked as low in terms of methodological quality. CONCLUSIONS Technology-based interventions to promote physical activity are effective; using further methods to promote participant adherence is associated with greater benefit. Further research should look into strategies to enhance adherence and sustainability in order to increase the effectiveness of technology-based physical activity intervention in diabetes care.
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Mathematical model for radial expansion and conflation of intratumoral infectious centers predicts curative oncolytic virotherapy parameters. PLoS One 2013; 8:e73759. [PMID: 24040057 PMCID: PMC3770695 DOI: 10.1371/journal.pone.0073759] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 07/21/2013] [Indexed: 01/24/2023] Open
Abstract
Simple, inductive mathematical models of oncolytic virotherapy are needed to guide protocol design and improve treatment outcomes. Analysis of plasmacytomas regressing after a single intravenous dose of oncolytic vesicular stomatitis virus in myeloma animal models revealed that intratumoral virus spread was spatially constrained, occurring almost exclusively through radial expansion of randomly distributed infectious centers. From these experimental observations we developed a simple model to calculate the probability of survival for any cell within a treated tumor. The model predicted that small changes to the density of initially infected cells or to the average maximum radius of infected centers would have a major impact on treatment outcome, and this was confirmed experimentally. The new model provides a useful and flexible tool for virotherapy protocol optimization.
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Agreement between the IPAQ-long weekday sitting item and the activPAL™ activity monitor in Scottish adults. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Staff and participant insights of group-based physical activity interventions for Type 2 Diabetes in a clinical practice setting. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Effect of a person centred consultation intervention to reduce the sedentary behaviour of working Scottish adults. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Development of an online tool to determine appropriateness for an epilepsy surgery evaluation. Neurology 2012; 79:1084-93. [DOI: 10.1212/wnl.0b013e3182698c4c] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Observation of lobes near the X point in resonant magnetic perturbation experiments on MAST. PHYSICAL REVIEW LETTERS 2012; 108:255003. [PMID: 23004608 DOI: 10.1103/physrevlett.108.255003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Indexed: 06/01/2023]
Abstract
The application of nonaxisymmetric resonant magnetic perturbations (RMPs) with a toroidal mode number n = 6 in the MAST tokamak produces a significant reduction in plasma energy loss associated with type-I edge localized modes (ELMs), the first such observation with n > 3. During the ELM mitigated stage clear lobe structures are observed in visible-light imaging of the X-point region. These lobes or manifold structures, that were predicted previously, have been observed for the first time in a range of discharges and their appearance is correlated with the effect of RMPs on the plasma; i.e., they only appear above a threshold when a density pump out is observed or when the ELM frequency is increased. They appear to be correlated with the RMPs penetrating the plasma and may be important in explaining why the ELM frequency increases. The number and location of the structures observed can be well described using vacuum modeling. Differences in radial extent and poloidal width from vacuum modeling are likely to be due to a combination of transport effects and plasma screening.
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Predictors of Severity of Cognitive Impairment in Rural Patients Presenting to a Memory Clinic (P01.089). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p01.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Kinetic instabilities that limit β in the edge of a tokamak plasma: a picture of an H-mode pedestal. PHYSICAL REVIEW LETTERS 2012; 108:135002. [PMID: 22540707 DOI: 10.1103/physrevlett.108.135002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Indexed: 05/31/2023]
Abstract
Plasma equilibria reconstructed from the Mega-Amp Spherical Tokamak have sufficient resolution to capture plasma evolution during the short period between edge-localized modes (ELMs). Immediately after the ELM, steep gradients in pressure, P, and density, n(e), form pedestals close to the separatrix, and they then expand into the core. Local gyrokinetic analysis over the ELM cycle reveals the dominant microinstabilities at perpendicular wavelengths of the order of the ion Larmor radius. These are kinetic ballooning modes in the pedestal and microtearing modes in the core close to the pedestal top. The evolving growth rate spectra, supported by gyrokinetic analysis using artificial local equilibrium scans, suggest a new physical picture for the formation and arrest of this pedestal.
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Assessment of Familial Hypercholesterolaemia in a Regional Community in Western Australia: Comparison Between Primary Care and Specialist Centre. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Deconvolution of Thomson scattering temperature profiles. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2011; 82:053501. [PMID: 21639498 DOI: 10.1063/1.3581230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Deconvolution of Thomson scattering (TS) profiles is required when the gradient length of the electron temperature (T(e)) or density (n(e)) are comparable to the instrument function length (Δ(R)). The most correct method for deconvolution to obtain underlying T(e) and n(e) profiles is by consideration of scattered signals. However, deconvolution at the scattered signal level is complex since it requires knowledge of all spectral and absolute calibration data. In this paper a simple technique is presented where only knowledge of the instrument function I(r) and the measured profiles, T(e, observed)(r) and n(e, observed)(r), are required to obtain underlying T(e)(r) and n(e)(r). This method is appropriate for most TS systems and is particularly important where high spatial sampling is obtained relative to Δ(R).
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P23 Effect of omalizumab on oral corticosteroid requirements of young children with severe asthma; results of a UK survey. Thorax 2010. [DOI: 10.1136/thx.2010.150961.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Laser beam combiner for Thomson scattering core LIDAR. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2010; 81:10D534. [PMID: 21033888 DOI: 10.1063/1.3485081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The light detection and ranging Thomson scattering (TS) diagnostic is advantageous since it only requires a single view port into the tokamak. This technique requires a short pulse laser at high energy, usually showing a limited repetition rate. Having multiple lasers will increase the repetition rate. This paper presents a scanning mirror as a laser beam combiner. Measurements of the position accuracy and jitter show that the pointing stability of the laser beam is within ±25 μrad for over tens of seconds. A control feedback loop is implemented to demonstrate the long term stability. Such a system could be applied for ITER and JET.
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Tracking of physical activity behaviours during childhood, adolescence and young adulthood: a systematic review. J Epidemiol Community Health 2009. [DOI: 10.1136/jech.2009.096701i] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
Interferon-beta (IFN-beta) is a type I interferon used in the management of multiple sclerosis. Therapy with IFN-beta has rarely been associated with the development of autoimmune disorders. We present the cases of two female patients diagnosed with relapsing-remitting multiple sclerosis (RRMS) who developed inflammatory musculoskeletal manifestations, following IFN-beta therapy. The first patient developed a monoarthritis 2 weeks after initiation of IFN-beta, which persisted during the 14 months of therapy and resolved with discontinuation of the medication. The second patient developed both autoimmune thyroid disease and a refractory pre-patellar bursitis after 50 months of IFN-beta therapy. Our literature review revealed an additional six cases of onset of inflammatory arthritis in MS patients receiving IFN-beta. We review these reports with comparison to our two cases. The role of IFN-beta in inflammatory musculoskeletal disease is unclear. The potential autoimmune complications of this therapeutic agent should be comprehended when monitoring patients receiving such treatment.
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A randomized trial investigating the 12-month changes in physical activity and health outcomes following a physical activity consultation delivered by a person or in written form in Type 2 diabetes: Time2Act. Diabet Med 2009; 26:293-301. [PMID: 19317825 DOI: 10.1111/j.1464-5491.2009.02675.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Physical activity is a cornerstone of Type 2 diabetes management but is underutilized. Physical activity consultations increase physical activity in people with Type 2 diabetes but resources are often limited. Time2Act is a randomized control trial to study the 12-month effectiveness of a physical activity consultation delivered by a person or in written form, in contrast to standard care, for people with Type 2 diabetes. METHODS A total of 134 inactive people with Type 2 diabetes in a contemplation or preparation stage were randomized to either intervention or standard care. Objective (accelerometer) and subjective (7-day recall) physical activity levels were measured over 1 week, along with physiological [blood pressure, body mass index (BMI), waist circumference] and biochemical [glycated haemoglobin (HbA(1c)), total and high-density lipoprotein (HDL) cholesterol] measures at baseline, 6 and 12 months. RESULTS Neither a physical activity consultation delivered by a person nor in written form was better than standard care at increasing physical activity levels or improving health outcomes in the full study cohort. Total and HDL cholesterol, waist circumference and both systolic and diastolic blood pressure improved over 12 months in all groups, whilst HbA(1c) improved over 6 months. In a subgroup (baseline pedometer steps < 5000/day), the physical activity consultation delivered by a person significantly increased physical activity over 12 months and the standard care group significantly decreased. CONCLUSIONS More research is needed which not only investigates the most economical and effective methods to promote physical activity, but also the best setting to conduct physical activity consultations and the participant factors affecting uptake of physical activity in Type 2 diabetes.
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