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Thompson C, Gorey T, Lawler T, Watson G, Wells B, McVeigh JA. 'I can't relate to it': Exploring autistic and non-autistic adults' perceptions of the Australian Physical Activity and Sedentary Behaviour Guidelines. Health Promot J Austr 2025; 36:e944. [PMID: 39690441 DOI: 10.1002/hpja.944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 11/27/2024] [Accepted: 11/28/2024] [Indexed: 12/19/2024] Open
Abstract
BACKGROUND Despite sufficient physical activity (PA) being strongly associated with better health outcomes, half of the Australian population does not meet the Australian PA and Sedentary Behaviour Guidelines. This shortfall is more pronounced among autistic adults, who exhibit poorer health outcomes and lower PA levels than non-autistic adults. Despite these disparities, there is a limited understanding of how autistic and non-autistic individuals perceive and interpret the PA guidelines. METHODS This study investigated how autistic and non-autistic adults perceive and comprehend the Australian PA guidelines. This study used interpretative phenomenological analysis. RESULTS A total of 15 autistic and 20 non-autistic adults were interviewed, and 4 themes that were largely similar between both groups were identified: (1) Lack of Awareness and Engagement with the PA Guidelines, (2) Misinterpretation of Key Terms and Concepts, (3) Perceived lack of Relevance and Relatability of the PA Guidelines and (4) Lack of Inclusivity. CONCLUSION The findings underscore the importance of crafting health communication and promotion materials that are more visible, clear, inclusive and engaging for non-autistic and autistic individuals in Australia. SO WHAT?: This study highlights the potential for improving the number of people correctly understanding the PA guidelines by addressing dissemination methods, knowledge and interpretation of the guidelines as some components of the multifaceted process required to achieve behaviour change.
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Banerjee B, Thompson C, Nizet V, Bjånes E. Bactericidal efficacy of low dose gaseous ozone against clinically relevant multidrug-resistant bacteria. Front Microbiol 2024; 15:1480433. [PMID: 39723132 PMCID: PMC11668732 DOI: 10.3389/fmicb.2024.1480433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Accepted: 11/21/2024] [Indexed: 12/28/2024] Open
Abstract
Introduction Healthcare-associated infections (HAIs) pose a significant challenge in acute care hospitals, particularly in intensive care units, due to persistent environmental contamination despite existing disinfection protocols and manual cleaning methods. Current disinfection methods are labor-intensive and often ineffective against multidrug-resistant (MDR) pathogens, highlighting the need for new, automated, hands-free approaches. Methods This study evaluates the bactericidal efficacy of low concentrations of gaseous ozone (5 ppm) against clinically relevant and often MDR bacteria under various concentrations, contact times, temperatures, and environmental conditions. Results We observed a 3 log10-fold reduction in Escherichia coli and Salmonella Typhimurium and a 1-2 log10-fold reduction in group A Streptococcus and methicillin-resistant Staphylococcus aureus upon ozone exposure. The bactericidal effect was dose-dependent, with no significant difference between single and repeated exposures. Environmental conditions such as temperature and humidity had minimal impact on low-dose ozone efficacy, with slightly improved bacterial killing at colder temperatures and higher humidity levels. Gaseous ozone also showed significant bactericidal activity against the broad range of Gram-positive and -negative MDR clinical isolates. Discussion These findings highlight the potential of low-dose gaseous ozone as a versatile, effective, and hands-free disinfectant for healthcare and other settings. Further research is needed to establish long-term safety and efficacy guidelines for its use in occupied spaces and to explore potential synergy with other contemporary disinfection strategies.
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Hassan S, Thompson C, Adams J, Chang M, Derbyshire D, Keeble M, Liu B, Mytton OT, Rahilly J, Savory B, Smith R, White M, Burgoine T, Cummins S. The adoption and implementation of local government planning policy to manage hot food takeaways near schools in England: A qualitative process evaluation. Soc Sci Med 2024; 362:117431. [PMID: 39447381 DOI: 10.1016/j.socscimed.2024.117431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 09/16/2024] [Accepted: 10/16/2024] [Indexed: 10/26/2024]
Abstract
INTRODUCTION Access to hot food takeaways, particularly near schools, is of growing concern for policymakers seeking to reduce childhood obesity globally. In England, United Kingdom (UK), local government jurisdictions are implementing planning policies to reduce access by restricting or denying planning permission for new takeaway outlets near schools. We used a qualitative approach to explore local government officers' perspectives on the barriers to and facilitators of the adoption, implementation, and perceived effectiveness of these policies. METHODS In 2021-2022, we conducted semi-structured interviews with 29 local planning ('planners') and public health government officers from 15 different local authorities across England who adopted a policy to restrict new takeaways. Data were analysed thematically. RESULTS Participants explained that they mostly thought the policies facilitated the refusal of applications for new takeaways near schools. However, participants speculated that businesses identified alternative opportunities to operate including functioning as 'restaurants' or within other locations. Effective working relationships between planners and public health officers were important for adoption and implementation, although planning and public health agendas did not always align and there were tensions between economic development and health improvement goals. The policy was adapted to suit local needs and priorities; in some cases, the policy was not used in areas where economic growth was prioritised. Clarity in policy wording and establishing a formal process for implementing policies including a designated individual responsible for checking and reviewing takeaway applications helped ensure consistency and confidence in policy implementation. CONCLUSION Although sometimes challenging, the policies were commonly described as feasible to implement. However, they may not completely prevent new takeaways opening, particularly where takeaways are relied upon to enhance local economies or where takeaway businesses find alternative ways to operate. Nevertheless, the policies can serve to shift the balance of power that currently favours commercial interests over public health priorities.
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Fong C, Patel B, Peckitt C, Bourmpaki E, Satchwell L, Cromarty S, Kidd S, von Loga K, Uhlik M, Begum R, Rana T, Waddell T, Darby S, Bradshaw A, Roques T, Morgan C, Rees C, Herbertson R, Das P, Thompson C, Hewish M, Petty R, Thistlethwaite F, Rao S, Starling N, Chau I, Cunningham D. Maintenance durvalumab after first-line chemotherapy in patients with HER2-negative advanced oesophago-gastric adenocarcinoma: results from the randomised PLATFORM study. ESMO Open 2024; 9:103622. [PMID: 39002179 PMCID: PMC11298822 DOI: 10.1016/j.esmoop.2024.103622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 05/26/2024] [Accepted: 05/31/2024] [Indexed: 07/15/2024] Open
Abstract
BACKGROUND PLAnning Treatment For Oesophago-gastric Cancer: a Randomised Maintenance Therapy Trial (PLATFORM) is an adaptive phase II study assessing the role of maintenance therapies in advanced oesophago-gastric (OG) adenocarcinoma. We evaluated the role of the anti-programmed death-ligand 1 (PD-L1) inhibitor durvalumab in these patients. PATIENTS AND METHODS Patients with human epidermal growth factor receptor 2-negative locally advanced or metastatic OG adenocarcinoma with disease control or response to 18 weeks of platinum-based first-line chemotherapy were randomised to active surveillance or maintenance durvalumab. The primary endpoint was progression-free survival (PFS). Safety was assessed in all patients who had commenced surveillance visits or received at least one dose of durvalumab. Exploratory survival analyses according to PD-L1 Combined Positive Score (CPS) and immune (biomarker-positive) or angiogenesis dominant (biomarker-negative) tumour microenvironment (TME) phenotypes were conducted. RESULTS Between March 2015 and April 2020, 205 patients were randomised to surveillance (n = 100) and durvalumab (n = 105). No significant differences were seen in PFS [hazard ratio (HR) 0.84, P = 0.13] and overall survival (OS; HR 0.98, P = 0.45) between surveillance and durvalumab. Five patients randomised to durvalumab demonstrated incremental radiological responses compared with none with surveillance. Treatment-related adverse events occurred in 77 (76.2%) durvalumab-assigned patients. A favourable effect in OS with durvalumab over surveillance in CPS ≥5 and immune biomarker-positive patients was observed compared with CPS <5 and biomarker-negative subgroups, respectively: CPS ≥5 versus <5: HR 0.63, 95% confidence interval (CI) 0.32-1.22 versus HR 0.93, 95% CI 0.44-1.96; biomarker-positive versus negative: HR 0.60, 95% CI 0.29-1.23 versus HR 0.84, 95% CI 0.42-1.65. CONCLUSION Maintenance durvalumab does not improve PFS in patients with OG adenocarcinoma who respond to first-line chemotherapy but induced incremental radiological responses in a subset of patients. TME characterisation could refine patient selection for anti-PD-L1 therapy above PD-L1 CPS alone.
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Thompson C, González C, LLorca J. Additively-manufactured Mg wire-reinforced PLDL-matrix composites for biomedical applications. J Mech Behav Biomed Mater 2024; 153:106496. [PMID: 38460456 DOI: 10.1016/j.jmbbm.2024.106496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 03/11/2024]
Abstract
Coupons of a medical grade PLDL polymer matrix uniaxially reinforced with a 15% volume fraction of Mg wires have been manufactured by fused filament fabrication for the first time. Two different types of Mg wires, without and with a surface treatment by plasma electrolytic oxidation were used. Both composite materials were subjected to degradation in phosphate buffer solution over a 3-week period, and their degradation and deformation micromechanisms were analysed in detail. Additionally, the materials were subjected to extensive mechanical testing under various loading conditions, and the interface strength was also analysed. It was found that the presence of the Mg wires improves the mechanical behaviour and accelerates the corrosion rate of the composite with respect that of the polymer matrix and these properties can be further tailored through the surface-modification of Mg wires by plasma electrolytic oxidation. The additive manufacturing strategy presented opens the path to fabricate multimaterial implants and scaffolds with complex shape and tailored properties provided by biodegradable polymers reinforced with either Mg and Zn particles and/or wires.
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Lorenzo Polo A, Nix M, Thompson C, O'Hara C, Entwisle J, Murray L, Appelt A, Weistrand O, Svensson S. Improving hybrid image and structure-based deformable image registration for large internal deformations. Phys Med Biol 2024; 69:095011. [PMID: 38518382 DOI: 10.1088/1361-6560/ad3723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/22/2024] [Indexed: 03/24/2024]
Abstract
Objective.Deformable image registration (DIR) is a widely used technique in radiotherapy. Complex deformations, resulting from large anatomical changes, are a regular challenge. DIR algorithms generally seek a balance between capturing large deformations and preserving a smooth deformation vector field (DVF). We propose a novel structure-based term that can enhance the registration efficacy while ensuring a smooth DVF.Approach.The proposed novel similarity metric for controlling structures was introduced as a new term into a commercially available algorithm. Its performance was compared to the original algorithm using a dataset of 46 patients who received pelvic re-irradiation, many of which exhibited complex deformations.Main results.The mean Dice Similarity Coefficient (DSC) under the improved algorithm was 0.96, 0.94, 0.76, and 0.91 for bladder, rectum, colon, and bone respectively, compared to 0.69, 0.89, 0.62, and 0.88 for the original algorithm. The improvement was more pronounced for complex deformations.Significance.With this work, we have demonstrated that the proposed term is able to improve registration accuracy for complex cases while maintaining realistic deformations.
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Fenton R, Thompson C, Drake S, Foley L, Cook TM. Anaesthetic records: an evaluation of variation across England. Anaesth Rep 2024; 12:e12287. [PMID: 38533388 PMCID: PMC10963021 DOI: 10.1002/anr3.12287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2024] [Indexed: 03/28/2024] Open
Abstract
We collected blank non-specialist anaesthetic records from 71 National Health Service Trusts in England. A data set was established by collating all data items found in an initial tranche of 28 records. All 71 records were subsequently analysed for each data item in this data set. We found significant variation: the most populated record included 216 data items and the least included 38 data items: a greater than five-fold variation. There was significant variation in the inclusion of data items commonly considered important to patient safety; 42% of records omitted documentation of fasting status, 72% omitted documentation of a discussion around the risk of accidental awareness during general anaesthesia, 92% omitted documentation of quantitative neuromuscular blockade monitoring and 63% omitted documentation for 'Stop Before You Block' when performing regional anaesthesia. The study highlights significant variability in the composition of anaesthetic records across England which may impact on its value as a data repository, an action trigger, a medicolegal account, and a tool to facilitate safe handover. Standardisation of the anaesthetic record or the establishment of standards of recording would help to allay potential risks to patient safety and assist in guiding future procurement of electronic solutions for anaesthetic records.
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Sharma Y, Horwood C, Hakendorf P, Thompson C. Response to: Outcomes of admission for heart failure under general and cardiological medicine services. QJM 2023; 116:816-817. [PMID: 37267212 DOI: 10.1093/qjmed/hcad117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Indexed: 06/04/2023] Open
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Pillay L, Thompson C, Tabane C, Kirby J, Hendricks S, Swart J, van Rensburg DCJ, Zondi P, Rotunno A, Bayever D. South African Institute of Drug-Free Sport Position Statement on CBD (Cannabidiol) and THC (Tetrahydrocannabinol). SOUTH AFRICAN JOURNAL OF SPORTS MEDICINE 2023; 35:v35i1a16097. [PMID: 38249774 PMCID: PMC10798604 DOI: 10.17159/2078-516x/2023/v35i1a16097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024] Open
Abstract
Cannabidiol (CBD) and Tetrahydrocannabinol (THC) have become easily available to athletes over the years. Using these substances may inadvertently expose an athlete to the possibility of an adverse analytical finding (a "positive" test) and a sanction. Athletes need to understand the risk of an anti-doping rule violation or adverse analytical finding should these products be used, especially if no therapeutic use exemption exists. This position statement attempts to clarify the use of CBD and THC and their associated risks with Anti-Doping Rule Violations (ADRV) in the athletic population. The South African Sports Medicine Association supports this position statement.
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O'Brien S, Butticello M, Thompson C, Wilson B, Wyce A, Mahajan V, Kruger R, Mohammad H, Fedoriw A. Inhibiting PRMT5 induces DNA damage and increases anti-proliferative activity of Niraparib, a PARP inhibitor, in models of breast and ovarian cancer. BMC Cancer 2023; 23:775. [PMID: 37596538 PMCID: PMC10436459 DOI: 10.1186/s12885-023-11260-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/05/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Inhibitors of Poly (ADP-Ribose) Polymerases (PARP) provide clinical benefit to patients with breast and ovarian cancers, by compromising the DNA repair activity of cancer cells. Although these agents extend progression-free survival in many patients, responses can be short lived with many patients ultimately progressing. Identification of combination partners that increase dependence of cancer cells to the DNA repair activity of PARPs may represent a strategy to increase the utility of PARP inhibitors. Protein arginine methyltransferase 5 (PRMT5) regulates DNA damage response pathways through splicing and protein modification, and inhibitors of PRMT5 have recently entered clinical trials. METHODS The effect of PRMT5 inhibition on the levels of DNA damage and repair markers including γH2AX, RAD51, and 53BP1 was determined using high content immunofluorescent imaging. The anti-proliferative activity of the combination of PRMT5 and PARP inhibitors was evaluated using in vitro models of breast and ovarian cancers using both cell lines and ex vivo patient derived xenografts. Finally, the combinations of PRMT5 and PARP inhibitors were evaluated in cell line xenograft models in vivo. RESULTS Inhibition of PRMT5 by GSK3326595 led to increased levels of markers of DNA damage. The addition of GSK3326595 to the PARP inhibitor, niraparib, resulted in increased growth inhibition of breast and ovarian cancer cell lines and patient derived spheroids. In vivo, the combination improved the partial effects on tumor growth inhibition achieved by either single agent, producing complete tumor stasis and regression. CONCLUSION These data demonstrate that inhibition of PRMT5 induced signatures of DNA damage in models of breast and ovarian cancer. Furthermore, combination with the PARP inhibitor, Niraparib, resulted in increased anti-tumor activity in vitro and in vivo. Overall, these data suggest inhibition of PRMT5 as a mechanism to broaden and enhance the clinical application of PARP inhibitors.
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Hyde RL, Gallagher J, Donnelly K, Thompson C, Macfarlane C. Community children's nursing: developing a bespoke model of post-registration education. Nurs Child Young People 2023; 35:16-21. [PMID: 36184935 DOI: 10.7748/ncyp.2022.e1449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2022] [Indexed: 05/05/2023]
Abstract
Community children's nurses provide a vital service between the hospital and home environment, supporting children, young people and families with their health needs. In the UK, the number of educational pathways providing a specialist practitioner qualification in community children's nursing has declined significantly in recent years. This has left many community children's nursing services with little or no access to educational programmes, despite the rising demand. The four UK governments, together with regulatory bodies such as the Nursing and Midwifery Council, have embarked on ambitious transformation of post-registration career frameworks and standards, the long-term impact of which is uncertain. This article discusses an approach that one community children's nursing service in Scotland took to address these challenges by liaising with a local university and accessing a bespoke advanced practice programme.
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Katich JM, Apel EC, Bourgeois I, Brock CA, Bui TP, Campuzano-Jost P, Commane R, Daube B, Dollner M, Fromm M, Froyd KD, Hills AJ, Hornbrook RS, Jimenez JL, Kupc A, Lamb KD, McKain K, Moore F, Murphy DM, Nault BA, Peischl J, Perring AE, Peterson DA, Ray EA, Rosenlof KH, Ryerson T, Schill GP, Schroder JC, Weinzierl B, Thompson C, Williamson CJ, Wofsy SC, Yu P, Schwarz JP. Pyrocumulonimbus affect average stratospheric aerosol composition. Science 2023; 379:815-820. [PMID: 36821693 DOI: 10.1126/science.add3101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Pyrocumulonimbus (pyroCb) are wildfire-generated convective clouds that can inject smoke directly into the stratosphere. PyroCb have been tracked for years, yet their apparent rarity and episodic nature lead to highly uncertain climate impacts. In situ measurements of pyroCb smoke reveal its distinctive and exceptionally stable aerosol properties and define the long-term influence of pyroCb activity on the stratospheric aerosol budget. Analysis of 13 years of airborne observations shows that pyroCb are responsible for 10 to 25% of the black carbon and organic aerosols in the "present-day" lower stratosphere, with similar impacts in both the North and South Hemispheres. These results suggest that, should pyroCb increase in frequency and/or magnitude in future climates, they could generate dominant trends in stratospheric aerosol.
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Deshaies-Rugama AS, Blais H, Sekerovic Z, Massicotte M, Carrier J, Thompson C, Nigam M, Desautels A, Montplaisir J, Gosselin N. Sleep architecture in idiopathic hypersomnia. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.290] [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: 11/28/2022]
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Sharma Y, Horwood C, Hakendorf P, Thompson C. Characteristics and outcomes of patients with heart failure discharged from different speciality units in Australia: an observational study. QJM 2022; 115:727-734. [PMID: 35176164 DOI: 10.1093/qjmed/hcac051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/02/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Previous studies have reported differing clinical outcomes among hospitalized heart failure (HF) patients admitted under cardiology and general medicine (GM) without consideration of patients' frailty. AIMS To explore outcomes in patients admitted under the two specialities after taking into account their frailty and other characteristics. METHODS This retrospective study included all HF patients ≥18 years admitted between 1 January 2013 and 31 December 2019 at two Australian tertiary hospitals. Frailty was determined by use of the Hospital Frailty Risk Score (HFRS) and patients with HFRS ≥ 5 were classified as frail. Propensity score matching (PSM) was used to match 11 variables between the two specialities. The primary outcomes included the days-alive-and-out-of-hospital (DAOH90) at 90 days of discharge, 30-day mortality and readmissions. RESULTS Of 4913 HF patients, mean age 76.2 (14.1) years, 51% males, 2653 (54%) were admitted under cardiology compared to 2260 (46%) under GM. Patients admitted under GM were more likely to be older females, with a higher Charlson index and poor renal function than those admitted under cardiology. Overall, 23.8% patients were frail and frail patients were more likely to be admitted under GM than cardiology (33.6% vs. 15.3%, P < 0.001). PSM created 1532 well-matched patients in each group. After PSM, the DAOH90 was not significantly different among patients admitted in GM when compared to cardiology (coefficient -5.36, 95% confidence interval -11.73 to 1.01, P = 0.099). Other clinical outcomes were also similar between the two specialities. CONCLUSIONS Clinical characteristics of HF patients differ between GM and cardiology; however, clinical outcomes were not significantly different after taking into account frailty and other variables.
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Sulava E, Thompson C, Lesko J, Treager C, Friedrich E, Stuart S. 268 Axillary Use of Three Junctional Tourniquet Devices in Human Volunteers. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Thompson C, Margo T, Yu FB, Lehmann CU. Developing a Pediatric EHR Testing & Certification Program in the USA: Initial Phase. Stud Health Technol Inform 2022; 290:1020-1021. [PMID: 35673185 DOI: 10.3233/shti220247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In 2016, the 21st Century Cures Act included ONC's 10 functionality recommendations for voluntary testing and certification of pediatric EHRs. Since 2019, Drummond has been developing a new pediatric EHR testing and certification program with pediatric and industry experts. The testing criteria are based upon AAP's 47 requirements that include ONC's 10 recommendations. It is anticipated the program will be operationalized and ready for EHR vendors in 1Q2022.
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Eccles J, Thompson C, Thompson B, Amato M, Themelis K, Critchley H, Harrison N, Davies K. AB1209 MECHANISTIC FACTORS CONTRIBUTING TO PAIN AND FATIGUE IN FIBROMYALGIA AND ME/CFS: AUTONOMIC AND INFLAMMATORY INSIGHTS FROM AN EXPERIMENTAL MEDICINE STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundFibromyalgia and ME/CFS are multifaceted conditions with overlapping symptoms(1); the pathoaetiological mechanisms are complex and debated(2), however there is a strong association with features of hereditary disorders of connective tissue (hypermobility) and autonomic and inflammatory abnormalities (1,2).ObjectivesTo determine potential autonomic and inflammatory mechanisms of pain and fatigue in fibromyalgia and ME/CFSMethodsAfter excluding participants with WCC higher than 10 (suggesting acute infection) baseline markers of inflammation (CRP and ESR) were available for 60 patients with confirmed diagnoses of Fibromyalgia and/ or ME/CFS and 23 matched controls. Participants then underwent full research diagnostic evaluation including a hypermobility assessment(1) and autonomic challenge (60 degree head up tilt, ISRCTN78820481). Subjective pain and fatigue were assessed before and after challenge (VAS). Linear regression models were used to explore predictors, with adjustment for confounders as appropriate. Mediation analyses (looking for mechanistic effects) were conducted according to the method of Hayes (3) and mediation considered significant if bootstrapped confidence intervals of the estimated indirect effect did not cross zero. In these mediation analyses predictor variable was group membership (patient or control), outcome variable was change in 1)pain and 2)fatigue induced by challenge and mediatiors 1)no of connective tissue features in hypermobility diagnostic criteria endorsed by participant; 2)baseline inflammatory markers.ResultsESR and CRP were significantly higher in patients rather than controls, even after correcting for BMI, age and sex (B=5.15, t=2.05, p=0.044; B=1.77, t=2.15, p=0.044 respectively). Adjusted ESR and CRP correlated with both subjective fatigue (B=0.44, t=2.09, p=0.04; B=1.63, t=2.60, p=0.011) and pain severity (B=0.13, t=2.51, p=0.014; B=0.45, t=3.01, p=0.004) at baseline. Autonomic challenge amplified pain (B=14.20, t=2.87, p=0.005) and fatigue (B=31.48, t=5.95, p=<0.001) in patients to a significantly greater degree than controls, controlling for baseline levels. Baseline ESR and CRP also predicted challenge-induced increase in fatigue (B=0.78, t=370, p=<0.001; B=1.91, t=3.36, p=<0.001) and ESR challenge-induced increases in pain (B=0.46, t=2.35, p=0.021).Mediation analysis demonstrated that number of connective tissue features expressed in hypermobility criteria mediated the degree to which subjective pain was increased by the autonomic challenge (Bootstraped 95% CI of indirect effect do not cross zero, 0.1572 – 6.8171). ESR mediated the degree to which subjective fatigue was increased by the autonomic challenge (Bootstraped 95% CI of indirect effect do not cross zero,0.7541 – 7.3888).ConclusionTo our knowledge this is the first study to directly explore autonomic and inflammatory mechanisms of pain and fatigue in a combined population of Fibromyalgia and ME/CFS. This study this adds to the evidence-base of baseline inflammatory abnormalities in fibromyalgia and ME/CFS. It highlights their potential role in predicting symptom severity and their potential mechanistic role in autonomic induced pain and fatigue, suggesting future treatment strategies.References[1]Eccles JA, Thompson B, Themelis K, Amato ML, Stocks R, Pound A, et al. Beyond bones: The relevance of variants of connective tissue (hypermobility) to fibromyalgia, ME/CFS and controversies surrounding diagnostic classification: an observational study. Clin Med (Lond). 2021;21(1):53-8.[2]Eccles JA, Davies KA. The challenges of chronic pain and fatigue. Clin Med (Lond). 2021;21(1):19-27.[3]Hayes AF. Partial, conditional, and moderated moderated mediation: Quantification, inference, and interpretation. Commun Monogr. 2018;85(1):4-40.Disclosure of InterestsJessica Eccles: None declared, Charlotte Thompson: None declared, Beth Thompson: None declared, Marisa Amato: None declared, Kristy Themelis: None declared, Hugo Critchley: None declared, Neil Harrison Grant/research support from: speakers bureau, Kevin Davies: None declared
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Pascual-González C, de la Vega J, Thompson C, Fernández-Blázquez JP, Herráez-Molinero D, Biurrun N, Lizarralde I, Del Río JS, González C, LLorca J. Processing and mechanical properties of novel biodegradable poly-lactic acid/Zn 3D printed scaffolds for application in tissue regeneration. J Mech Behav Biomed Mater 2022; 132:105290. [PMID: 35671668 DOI: 10.1016/j.jmbbm.2022.105290] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 12/15/2022]
Abstract
The feasibility to manufacture scaffolds of poly-lactic acid reinforced with Zn particles by fused filament fabrication is demonstrated for the first time. Filaments of 2.85 mm in diameter of PLA reinforced with different weight fractions of μm-sized Zn - 1 wt.% Mg alloy particles (in the range 3.5 to 17.5 wt.%) were manufactured by a double extrusion method in which standard extrusion is followed by precision extrusion in a filament-maker machine. Filaments with constant diameter, negligible porosity and a homogeneous reinforcement distribution were obtained for Zn weight fractions of up to 10.5%. It was found that the presence of Zn particles led to limited changes in the physico-chemical properties of the PLA that did not affect the window temperature for 3D printing nor the melt flow index. Thus, porous scaffolds could be manufactured by fused filament fabrication at 190 °C with poly-lactic acid/Zn composites containing 3.5 and 7 wt.% of Zn and at 170 °C when the Zn content was 10.5 wt.% with excellent dimensional accuracy and mechanical properties.
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Charters PFP, Rossdale J, Brown W, Burnett TA, Komber HMEI, Thompson C, Robinson G, MacKenzie Ross R, Suntharalingam J, Rodrigues JCL. Diagnostic accuracy of an automated artificial intelligence derived right ventricular to left ventricular diameter ratio tool on CT pulmonary angiography to predict pulmonary hypertension at right heart catheterisation. Clin Radiol 2022; 77:e500-e508. [PMID: 35487778 DOI: 10.1016/j.crad.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/09/2022] [Indexed: 11/25/2022]
Abstract
AIM To determine the diagnostic accuracy of an automated artificial intelligence derived right ventricle/left ventricle diameter ratio (RV/LV) computed tomography pulmonary angiography (CTPA) analysis tool to detect pulmonary hypertension (PH) in patients with suspected PH referred to a specialist centre. MATERIALS AND METHODS The present study was a retrospective analysis of a prospectively maintained database of 202 consecutive patients with suspected PH, who underwent CTPA within 12 months of right heart catheterisation (RHC). Automated ventricular segmentation and RV/LV calculation (Imbio LLC, Minneapolis, MN, USA) was undertaken on the CTPA images. PH diagnosis was made using the RHC reference standard. RESULTS The automated RV/LV correlated more strongly with RHC metrics than main pulmonary artery (MPA) diameter and MPA to ascending aorta diameter ratio (MPA/AA) measured manually (mean pulmonary arterial pressure [mPAP] r=0.535, R2 = 0.287 p<0.001; pulmonary vascular resistance [PVR] r=0.607, R2 = 0.369 p<0.001). In the derivation cohort (n=100), the area under the receiver-operating curve for automated RV/LV discriminating PH was 0.752 (95% confidence interval [CI] 0.677-0.827, p<0.001). Using an optimised Youden's Index of ≥1.12 classified from derivation, automated RV/LV ratio analysis was more sensitive for the detection of PH with higher positive predictive value (PPV) when compared with manual MPA and MPA/AA in the validation cohort (n=102). Automated RV/LV compromise (1.12) and specific (1.335) thresholds were strongly predictive of mortality (log-rank 7.401, p=0.007 and log-rank 16.075, p<0.001 respectively). CONCLUSION In suspected PH, automated RV/LV diameter thresholds have high sensitivity for PH, outperform manual MPA and MPA/AA and can predict survival.
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Arditto C, Thompson C, Millington P, Richardson Z, Carus C. Developing and implementing MSK first contact practitioners in West Yorkshire and Harrogate. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sharma Y, Horwood C, Hakendorf P, Thompson C. Benefits of Heart Failure Specific Pharmacotherapy in Frail Hospitalised Heart Failure Patients: An Observational Study. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Combat Trauma Research Group, Getz C, Thompson C, Barbour B, Verga J, Treager C, Lopachin T, Boboc M, Bohan M, Friedrich E, Stuart S. 75 Impact of Lighting Conditions of Procedural Competence With Emergency Cricothyrotomy. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Thompson C, Milbourn B, Taylor JL, Falkmer T, Bölte S, Evans K, Girdler S. Experiences of Parents of Specialist Peer Mentored Autistic University Students. Dev Neurorehabil 2021; 24:368-378. [PMID: 33588672 DOI: 10.1080/17518423.2021.1886190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
ABSTRCTBackground: Parents continue to support to autistic university students, and consequently, experience considerable stress.Aim: To explore the experiences of parents of specialist peer mentored university students and to examine these using the ICF as a theoretical framework.Method: Thirteen semi-structured interviews were completed and analyzed using thematic analysis. Directive content analysis linked the data to the ICF core set for autism spectrum disorders (ASD).Results: Five interrelated themes emerged: The mentoring relationship is a facilitator, Developing skills for university, Mentoring changes lives, Mentoring is not a substitute for other supports, and University is an emotional rollercoaster. Specialist peer mentoring was linked to Activity and Participation (44%) and Environmental factors (32%) of the ICF core set for ASD.Conclusion: These results add to the specialist peer mentoring evidence-base, and indicate perceived benefits for autistic university students and their parents. An unintended consequence was that parents broadened their participation in activities.
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Denys P, Giannantoni A, Thompson C, Volteau M, Vilain C, Kennelly M. Significant reduction of urinary incontinence episodes in patients with neurogenic detrusor overactivity treated with abobotulinumtoxinA (aboBoNT-A): Pooled results of the phase III CONTENT program. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00418-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Desai SH, Mwangi R, Maurer M, King R, Cerhan J, Feldman A, Habermann T, Farooq U, Thompson C, Wang Y, Ansell SM, Witzig TE, Nowakowski GN. DO CELL‐OF‐ORIGIN, DOUBLE EXPRESSER, AND DOUBLE HIT STATUS AFFECT OUTCOMES IN RELAPSED/REFRACTORY DIFFUSE LARGE B CELL LYMPHOMA (R/R DLBCL)? A PROSPECTIVE OBSERVATIONAL STUDY. Hematol Oncol 2021. [DOI: 10.1002/hon.66_2879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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