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van der Boor CF, Taban D, Ismail K, Simon J, Roberts B, Fuhr D, Tol WA, Greco G. Measuring refugees' capabilities: translation, adaptation, and valuation of the OxCAP-MH into Juba Arabic for use among South Sudanese male refugees in Uganda. J Patient Rep Outcomes 2024; 8:40. [PMID: 38564035 PMCID: PMC10987405 DOI: 10.1186/s41687-024-00720-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 03/24/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Forcibly displaced populations are highly vulnerable to psychosocial distress and mental disorders, including alcohol misuse. In an ongoing trial that seeks to develop a transdiagnostic intervention addressing psychological distress and alcohol use disorders among conflict-affected populations, we will carry out a cost-effectiveness evaluation using a capability-based Oxford Capabilities Mental Health (OxCAP-MH) measure. The OxCAP-MH is a 16-item questionnaire developed from the Capability Approach, that covers multiple domains of functioning and welfare. The aim of the current paper is to present the results of the translation, cultural adaptation and valuation of the OxCAP-MH into Juba Arabic for South Sudanese refugees living in Uganda. We adhered to the official Translation and Linguistic Validation process of the OxCAP-MH. To carry out the translation, the Concept Elaboration document, official English version of the OxCAP-MH, and the Back-Translation Review Template were used. Four independent translators were used for forward and back translations. The reconciled translated version was then piloted in two focus group discussions (N = 16) in Rhino refugee settlement. A most important to least important valuation of the sixteen capability domains covered in the OxCAP-MH was also done. RESULTS The Juba Arabic version of the OxCAP-MH was finalized following a systematic iterative process. The content of the Juba Arabic version remained unchanged, but key concepts were adapted to ensure cultural acceptability, feasibility, and comprehension of the measure in the local context of Rhino refugee settlement. Most participants had low levels of literacy and required support with filling in the tool. Participants suggested an additional capability that is currently not reflected in the OxCAP-MH, namely access to food. Furthermore, discussions around the valuation exercise of the sixteen domains led to two separate importance scales, which showed relevant differences. CONCLUSIONS In this context, the OxCAP-MH was considered culturally acceptable. The valuation exercise proved cognitively demanding. Participants voiced confusion over how to answer the questions on the OxCAP-MH instrument due to low levels of literacy. These concerns invite consideration for future research to consider how measures such as the OxCAP-MH can be made more accessible to individuals with low literacy rates in resource poor settings.
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Affiliation(s)
- C F van der Boor
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - D Taban
- HealthRight International, Plot 855, Mawanda Road -Kamwokya, Kampala, Uganda
| | - K Ismail
- HealthRight International, Plot 855, Mawanda Road -Kamwokya, Kampala, Uganda
| | - J Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna, 1090, Austria
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
| | - B Roberts
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - D Fuhr
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, Achterstraße, 30D-28359, Bremen, Germany
- Health Sciences, University of Bremen, Bremen, Germany
| | - W A Tol
- Department of Public Health, University of Copenhagen, Bartholinsgade 4, bg. 9, 1356 København K, CSS, bg. 9, Building: 9.2.16, Copenhagen, Denmark
- Athena Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - G Greco
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
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Kowalski C, Sibert NT, Hammerer P, Wesselmann S, Feick G, Carl EG, Klotz T, Apel H, Dieng S, Nyarangi-Dix J, Knoll T, Reike MJ, Duwe G, Bartolf E, Steiner T, Borowitz R, Lümmen G, Seitz AK, Pfitzenmaier J, Aziz A, Brock M, Berger FP, Kaftan BT, Grube C, Häfner T, Hamza A, Schmelz H, Haas J, Lenart S, Lafita A, Sippel C, Winter A, Kedia G, Hadaschik B, Varga Z, Buse S, Richter M, Distler F, Simon J, Wiegel T, Baltes S, Janitzky A, Sommer JP, Hijazi S, Fülkell P, Harke NN, Bolenz C, Khalil C, Breidenbach C, Tennstedt P, Burchardt M. [Urinary incontinence after radical prostatectomy for prostate cancer-data from 17,149 patients from 125 certified centers]. Urologie 2024; 63:67-74. [PMID: 37747493 DOI: 10.1007/s00120-023-02197-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND In addition to erectile dysfunction, urinary incontinence is the most common functional limitation after radical prostatectomy (RPE) for prostate cancer (PCa). The German S3 guideline recommends informing patients about possible effects of the therapy options, including incontinence. However, only little data on continence from routine care in German-speaking countries after RPE are currently available, which makes it difficult to inform patients. OBJECTIVE The aim of this work is to present data on the frequency and severity of urinary incontinence after RPE from routine care. MATERIALS AND METHODS Information from the PCO (Prostate Cancer Outcomes) study is used, which was collected between 2016 and 2022 in 125 German Cancer Society (DKG)-certified prostate cancer centers in 17,149 patients using the Expanded Prostate Cancer Index Composite Short Form (EPIC-26). Changes in the "incontinence" score before (T0) and 12 months after RPE (T1) and the proportion of patients who used pads, stratified by age and risk group, are reported. RESULTS The average score for urinary incontinence (value range: 0-worst possible to 100-best possible) was 93 points at T0 and 73 points 12 months later. At T0, 97% of the patients did not use a pad, compared to 56% at T1. 43% of the patients who did not use a pad before surgery used at least one pad a day 12 months later, while 13% use two or more. The proportion of patients using pads differs by age and risk classification. CONCLUSION The results provide a comprehensive insight into functional outcome 12 months after RPE and can be taken into account when informing patients.
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Affiliation(s)
- Christoph Kowalski
- Deutsche Krebsgesellschaft, Berlin, Kuno-Fischer-Str. 8, 14057, Berlin, Deutschland.
| | - Nora Tabea Sibert
- Deutsche Krebsgesellschaft, Berlin, Kuno-Fischer-Str. 8, 14057, Berlin, Deutschland
| | - Peter Hammerer
- Städtisches Klinikum Braunschweig, Braunschweig, Deutschland
| | - Simone Wesselmann
- Deutsche Krebsgesellschaft, Berlin, Kuno-Fischer-Str. 8, 14057, Berlin, Deutschland
| | - Günter Feick
- Bundesverband Prostatakrebs Selbsthilfe, Bonn, Deutschland
| | | | | | | | | | | | - Thomas Knoll
- Klinikum Sindelfingen-Böblingen, Sindelfingen, Deutschland
| | | | - Gregor Duwe
- Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | | | | | | | - Gerd Lümmen
- GFO Kliniken Troisdorf, Troisdorf, Deutschland
| | - Anna Katharina Seitz
- Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Jesco Pfitzenmaier
- Ev. Klinikum Bethel, Universitätsklinikum OWL d, Universität Bielefeld, Bielefeld, Deutschland
| | | | - Marko Brock
- Stiftungsklinikum PROSELIS Recklinghausen, Recklinghausen, Deutschland
| | | | | | | | - Tim Häfner
- Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - Amir Hamza
- Klinikum St. Georg Leipzig, Leipzig, Deutschland
| | - Hans Schmelz
- BundeswehrZentralkrankenhaus Koblenz, Koblenz, Deutschland
| | - Jürgen Haas
- Klinikum am Steinenberg, Reutlingen, Deutschland
| | | | | | | | - Alexander Winter
- Universitätsklinik für Urologie, Klinikum Oldenburg, Department für Humanmedizin, Fakultät für Medizin und Gesundheitswissenschaften, Carl von Ossietzky Universität Oldenburg, Oldenburg, Deutschland
| | - George Kedia
- DIAKOVERE Friederikenstift, Hannover, Deutschland
| | | | - Zoltan Varga
- SRH Kliniken Landkreis Sigmaringen, Sigmaringen, Deutschland
| | | | - Matthias Richter
- Kliniken Maria Hilf Mönchengladbach, Mönchengladbach, Deutschland
| | - Florian Distler
- Universitätsklinik der Paracelsus, Privatuniversität am Klinikum Nürnberg, Nürnberg, Deutschland
| | - Jörg Simon
- Ortenau-Klinikum Offenburg, Offenburg, Deutschland
| | | | | | | | | | | | | | - Nina N Harke
- Medizinische Hochschule Hannover, Hannover, Deutschland
| | | | | | | | - Pierre Tennstedt
- Martini Klinik am Universitätsklinikum Hamburg-Eppendorf, Hamburg-Eppendorf, Deutschland
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Hau JL, Schleicher L, Herdan S, Simon J, Seifert J, Fritz G, Steuber J. Functionality of the Na +-translocating NADH:quinone oxidoreductase and quinol:fumarate reductase from Prevotella bryantii inferred from homology modeling. Arch Microbiol 2023; 206:32. [PMID: 38127130 PMCID: PMC10739449 DOI: 10.1007/s00203-023-03769-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023]
Abstract
Members of the family Prevotellaceae are Gram-negative, obligate anaerobic bacteria found in animal and human microbiota. In Prevotella bryantii, the Na+-translocating NADH:quinone oxidoreductase (NQR) and quinol:fumarate reductase (QFR) interact using menaquinone as electron carrier, catalyzing NADH:fumarate oxidoreduction. P. bryantii NQR establishes a sodium-motive force, whereas P. bryantii QFR does not contribute to membrane energization. To elucidate the possible mode of function, we present 3D structural models of NQR and QFR from P. bryantii to predict cofactor-binding sites, electron transfer routes and interaction with substrates. Molecular docking reveals the proposed mode of menaquinone binding to the quinone site of subunit NqrB of P. bryantii NQR. A comparison of the 3D model of P. bryantii QFR with experimentally determined structures suggests alternative pathways for transmembrane proton transport in this type of QFR. Our findings are relevant for NADH-dependent succinate formation in anaerobic bacteria which operate both NQR and QFR.
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Affiliation(s)
- Jann-Louis Hau
- Institute of Biology, University of Hohenheim, Garbenstraße 30, 70599, Stuttgart, Germany
| | - Lena Schleicher
- Institute of Biology, University of Hohenheim, Garbenstraße 30, 70599, Stuttgart, Germany
- HoLMiR-Hohenheim Center for Livestock Microbiome Research, University of Hohenheim, Leonore-Blosser-Reisen-Weg 3, 70599, Stuttgart, Germany
| | - Sebastian Herdan
- Institute of Biology, University of Hohenheim, Garbenstraße 30, 70599, Stuttgart, Germany
- HoLMiR-Hohenheim Center for Livestock Microbiome Research, University of Hohenheim, Leonore-Blosser-Reisen-Weg 3, 70599, Stuttgart, Germany
| | - Jörg Simon
- Microbial Energy Conservation and Biotechnology, Department of Biology, Technical University of Darmstadt, Schnittspahnstraße 10, 64287, Darmstadt, Germany
| | - Jana Seifert
- HoLMiR-Hohenheim Center for Livestock Microbiome Research, University of Hohenheim, Leonore-Blosser-Reisen-Weg 3, 70599, Stuttgart, Germany
- Institute of Animal Science, University of Hohenheim, Emil-Wolff-Straße 8, 70599, Stuttgart, Germany
| | - Günter Fritz
- Institute of Biology, University of Hohenheim, Garbenstraße 30, 70599, Stuttgart, Germany
| | - Julia Steuber
- Institute of Biology, University of Hohenheim, Garbenstraße 30, 70599, Stuttgart, Germany.
- HoLMiR-Hohenheim Center for Livestock Microbiome Research, University of Hohenheim, Leonore-Blosser-Reisen-Weg 3, 70599, Stuttgart, Germany.
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Kushner P, Anderson JE, Simon J, Boye KS, Ranta K, Torcello-Gómez A, Levine JA. Efficacy and Safety of Tirzepatide in Adults With Type 2 Diabetes: A Perspective for Primary Care Providers. Clin Diabetes 2023; 41:258-272. [PMID: 37092144 PMCID: PMC10115620 DOI: 10.2337/cd22-0029] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This article reviews the efficacy and safety data of tirzepatide, a once-weekly, novel glucose-dependent insulinotropic polypeptide and glucagon-like peptide 1 (GLP-1) receptor agonist approved in the United States, the European Union, and other regions for the treatment of type 2 diabetes. All doses of tirzepatide demonstrated superiority in reducing A1C and body weight from baseline versus placebo or active comparators. The safety profile of tirzepatide was consistent with that of the GLP-1 receptor agonist class, with mild to moderate and transient gastrointestinal side effects being the most common adverse events. With clinically and statistically significant reductions in A1C and body weight without increased risk of hypoglycemia in various populations, tirzepatide has demonstrated potential as a first-in-class treatment option for many people with type 2 diabetes.
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Affiliation(s)
- Pamela Kushner
- Family Medicine, University of California School of Medicine, Irvine, CA
- Kushner Wellness Center, Los Angeles, CA
| | | | - Jörg Simon
- Medizinisches Versorgungszentrum im Altstadt-Carree Fulda GmbH, Fulda, Germany
| | | | - Kari Ranta
- Eli Lilly and Company, Helsinki, Finland
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Wilkens D, Simon J. Biosynthesis and function of microbial methylmenaquinones. Adv Microb Physiol 2023; 83:1-58. [PMID: 37507157 DOI: 10.1016/bs.ampbs.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
The membranous quinone/quinol pool is essential for the majority of life forms and its composition has been widely used as a biomarker in microbial taxonomy. The most abundant quinone is menaquinone (MK), which serves as an essential redox mediator in various electron transport chains of aerobic and anaerobic respiration. Several methylated derivatives of MK, designated methylmenaquinones (MMKs), have been reported to be present in members of various microbial phyla possessing either the classical MK biosynthesis pathway (Men) or the futalosine pathway (Mqn). Due to their low redox midpoint potentials, MMKs have been proposed to be specifically involved in appropriate electron transport chains of anaerobic respiration. The class C radical SAM methyltransferases MqnK, MenK and MenK2 have recently been shown to catalyse specific MK methylation reactions at position C-8 (MqnK/MenK) or C-7 (MenK2) to synthesise 8-MMK, 7-MMK and 7,8-dimethylmenaquinone (DMMK). MqnK, MenK and MenK2 from organisms such as Wolinella succinogenes, Adlercreutzia equolifaciens, Collinsella tanakaei, Ferrimonas marina and Syntrophus aciditrophicus have been functionally produced in Escherichia coli, enabling extensive quinone/quinol pool engineering of the native MK and 2-demethylmenaquinone (DMK). Cluster and phylogenetic analyses of available MK and MMK methyltransferase sequences revealed signature motifs that allowed the discrimination of MenK/MqnK/MenK2 family enzymes from other radical SAM enzymes and the identification of C-7-specific menaquinone methyltransferases of the MenK2 subfamily. It is envisaged that this knowledge will help to predict the methylation status of the menaquinone/menaquinol pool of any microbial species (or even a microbial community) from its (meta)genome.
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Affiliation(s)
- Dennis Wilkens
- Microbial Energy Conversion and Biotechnology, Department of Biology, Technical University of Darmstadt, Schnittspahnstraße 10, Darmstadt, Germany
| | - Jörg Simon
- Microbial Energy Conversion and Biotechnology, Department of Biology, Technical University of Darmstadt, Schnittspahnstraße 10, Darmstadt, Germany; Centre for Synthetic Biology, Technical University of Darmstadt, Darmstadt, Germany.
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6
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Janssen LMM, Pokhilenko I, Drost RMWA, Paulus ATG, Thorn J, Hollingworth W, Noble S, Berger M, Simon J, Evers SMAA. Methods for think-aloud interviews in health-related resource-use research: the PECUNIA RUM instrument. Expert Rev Pharmacoecon Outcomes Res 2023; 23:383-389. [PMID: 36880336 DOI: 10.1080/14737167.2023.2187379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
BACKGROUND The think-aloud (TA) approach is a qualitative research method that allows for gaining insight into thoughts and cognitive processes. It can be used to incorporate a respondent's perspective when developing resource-use measurement (RUM) instruments. Currently, the application of TA methods in RUM research is limited, and so is the guidance on how to use them. Transparent publication of TA methods for RUM in health economics studies, which is the aim of this paper, can contribute to reducing the aforementioned gap. METHODS Methods for conducting TA interviews were iteratively developed by a multi-national working group of health economists and additional qualitative research expertise was sought. TA interviews were conducted in four countries to support this process. A ten-step process was outlined in three parts: Part A 'before the interview' (including translation, recruitment, training), Part B 'during the interview' (including setting, opening, completing the instrument, open-ended questions, closing), and part C 'after the interview' (including transcription and data analysis, trustworthiness). CONCLUSIONS This manuscript describes the step-by-step approach for conducting multi-national TA interviews with potential respondents of the PECUNIA RUM instrument. It increases the methodological transparency in RUM development and reduces the knowledge gap of using qualitative research methods in health economics.
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Affiliation(s)
- L M M Janssen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | - I Pokhilenko
- Institute of Applied Health Research Edgbaston, Centre for Economics of Obesity, University of Birmingham, Birmingham, The United Kingdom
| | - R M W A Drost
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | - A T G Paulus
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | - J Thorn
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, the United Kingdom
| | - W Hollingworth
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, the United Kingdom
| | - S Noble
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, the United Kingdom
| | - M Berger
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria.,Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, the United Kingdom
| | - J Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - S M A A Evers
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.,Trimbos Institute National Institute of Mental Health and Addiction, Utrecht, The Netherlands
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Fischer F, Kowalski C, Simon J, Graefen M, Rose M, Beyer B. [The interoperability of IIEF-5 with EPIC-26 : Sexual function after radical prostatectomy]. Urologie 2023:10.1007/s00120-023-02027-2. [PMID: 36877230 DOI: 10.1007/s00120-023-02027-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/02/2022] [Indexed: 03/07/2023]
Abstract
BACKGROUND In the past, the IIEF‑5 (International Index of Erectile Function 5 ) was predominantly used to measure erectile function in prostate cancer patients. Following international developments, the domain "sexuality" of the EPIC-26 (Expanded Prostate Cancer Index Composite 26) is increasingly used in Germany. OBJECTIVE The aim of this work is to create a practicable comparison of the domain "sexuality" of the EPIC-26 with the IIEF‑5 for treatment in Germany. This is particularly necessary for the evaluation of historical patient collectives. MATERIALS AND METHODS For the evaluation, 2123 patients with prostate cancer confirmed by biopsy from 2014-2017 who completed both the IIEF‑5 and the EPIC-26 were considered. Linear regression analyses are calculated to convert IIEF‑5 sum scores to EPIC-26 sexuality domain scores. RESULTS The correlation between IIEF‑5 and the EPIC-26 domain score "sexuality" was 0.74, suggesting a high degree of content convergence between the constructs measured. While the standard error of the predicted values is relatively small, the prediction intervals are very wide. For example, for the critical IIEF‑5 value of 22, the predicted value is 78.88 with a 95% prediction interval of 55.09 to 102.66. CONCLUSION IIEF‑5 and the Sexuality scale of the EPIC-26 measure a similar construct. The analysis shows that conversion of individual values is associated with great uncertainty. However, at the group level, the observed EPIC-26 "sexuality" score could be predicted quite accurately. This opens up the possibility of comparing the erectile function of cohorts of patients/test persons, even if this was collected with different measuring instruments.
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Affiliation(s)
- F Fischer
- Medizinische Klinik mit Schwerpunkt Psychosomatik, Charité - Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin und Berlin Institute of Health, Berlin, Deutschland
| | - C Kowalski
- Deutsche Krebsgesellschaft, Berlin, Deutschland
| | - J Simon
- Medizinische Klinik mit Schwerpunkt Psychosomatik, Charité - Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin und Berlin Institute of Health, Berlin, Deutschland
| | - M Graefen
- Prostatakarzinomzentrum, Martini-Klinik am UKE GmbH, Martinistraße 52, 20246, Hamburg, Deutschland
| | - M Rose
- Medizinische Klinik mit Schwerpunkt Psychosomatik, Charité - Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin und Berlin Institute of Health, Berlin, Deutschland.,Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, USA
| | - B Beyer
- Prostatakarzinomzentrum, Martini-Klinik am UKE GmbH, Martinistraße 52, 20246, Hamburg, Deutschland. .,Klinik Wildetal, Kliniken Hartenstein, Bad Wildungen, Deutschland.
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Menzen M, Berentzen TL, Catarig AM, Pieperhoff S, Simon J, Jacob S. Real-World Use of Once-Weekly Semaglutide in Type 2 Diabetes: Results from SemaglUtide Real-world Evidence (SURE) Germany. Exp Clin Endocrinol Diabetes 2023; 131:205-215. [PMID: 36599459 PMCID: PMC10101737 DOI: 10.1055/a-2007-2061] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 01/06/2023]
Abstract
CONTEXT Efficacy and safety of once-weekly semaglutide in type 2 diabetes were established in the phase 3 SUSTAIN trials, which included patients across the continuum of type 2 diabetes care. It is useful to complement these findings with real-world evidence. OBJECTIVE SURE Germany evaluated once-weekly semaglutide in a real-world type 2 diabetes patient population. DESIGN/SETTING The prospective observational study was conducted at 93 clinical practices in adults with+≥ 1 documented glycated haemoglobin value ≤12 weeks before initiation of semaglutide. INTERVENTION Once-weekly semaglutide was prescribed at the physicians' discretion. MAIN OUTCOMES The primary endpoint was change in glycated haemoglobin from baseline to end-of-study (~30 weeks). Secondary endpoints included changes in body weight and patient-reported outcomes. All adverse events were systematically collected and reported, including patient-reported documented and/or severe hypoglycaemia. RESULTS Of 779 patients in the full analysis set, 669 (85.9%) completed the study on treatment with semaglutide, comprising the effectiveness analysis set. In this data set, estimated mean changes in glycated haemoglobin and body weight from baseline to end-of-study were -1.0%point (-10.9 mmol/mol; P<0.0001) and -4.5 kg (-4.2%; P<0.0001). Sensitivity analyses supported the primary analysis. Improvements were observed in other secondary endpoints, including patient-reported outcomes. No new safety concerns were identified. CONCLUSIONS In a real-world population in Germany, patients with type 2 diabetes treated with once-weekly semaglutide experienced clinically significant improvements in glycaemic control and body weight. These results support the use of once-weekly semaglutide in routine clinical practice in adult patients with type 2 diabetes in Germany.
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Affiliation(s)
- Markus Menzen
- Gemeinschaftskrankenhaus Bonn, Innere Medizin - Diabetologie und Endokrinologie, Bonn, Germany
| | | | | | | | - Jörg Simon
- MVZ im Altstadt-Carree Fulda GmbH, Fulda, Germany
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Samu F, Szita É, Botos E, Simon J, Gallé-Szpisjak N, Gallé R. Agricultural spider decline: long-term trends under constant management conditions. Sci Rep 2023; 13:2305. [PMID: 36759542 PMCID: PMC9911793 DOI: 10.1038/s41598-023-29003-2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 01/27/2023] [Indexed: 02/11/2023] Open
Abstract
There is widespread evidence for a worldwide trend of insect decline, but we have much fewer data about recent temporal trends in other arthropod groups, including spiders. Spiders can be hypothesised to similarly decline because of trophic dependence on insects and being equally sensitive to local and global environmental changes. Background trends in arthropod populations can be verified if we decouple large-scale environmental transitions, such as climate change, from local factors. To provide a case study on baseline spider community trends, we observed changes in the spider community of an unsprayed alfalfa field and its margin 23 years apart under largely unchanged local conditions. We aimed to determine whether there are changes in spider abundance, species richness and mean species characteristics. Spider abundance per unit effort decreased dramatically, by 45% in alfalfa and by 59% in the margin, but species richness and most characteristics remained unchanged. Community composition in both habitats shifted and became more similar by the current study period. The population decline was especially marked in certain farmland species. We propose that in the absence of local causative factors, spider abundance decline in our study indicates a reduction of spider populations at landscape and regional scales.
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Affiliation(s)
- F Samu
- Plant Protection Institute, Centre of Agricultural Research, ELKH, Herman Ottó Street 15, 1022, Budapest, Hungary
| | - É Szita
- Plant Protection Institute, Centre of Agricultural Research, ELKH, Herman Ottó Street 15, 1022, Budapest, Hungary.
| | - E Botos
- Plant Protection Institute, Centre of Agricultural Research, ELKH, Herman Ottó Street 15, 1022, Budapest, Hungary
| | - J Simon
- Plant Protection Institute, Centre of Agricultural Research, ELKH, Herman Ottó Street 15, 1022, Budapest, Hungary
| | - N Gallé-Szpisjak
- 'Lendület' Landscape and Conservation Ecology, Institute of Ecology and Botany, Centre for Ecological Research, 2163, Vácrátót, Hungary
| | - R Gallé
- 'Lendület' Landscape and Conservation Ecology, Institute of Ecology and Botany, Centre for Ecological Research, 2163, Vácrátót, Hungary.,MTA-SZTE 'Momentum' Applied Ecology Research Group, Közép Fasor 52, 6726, Szeged, Hungary
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10
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Lam C, Ray A, Maresh G, Zhang X, Baer H, Haupt C, Simon J, Green H, Paruch J, Li L. Evaluating the effect of checkpoint inhibitors in microsatellite instability high and microsatellite stable colorectal cancer using a humanized murine model. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00568-2] [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: 01/28/2023]
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11
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Hankins JS, Potter MB, Fernandez ME, Melvin C, DiMartino L, Jacobs SR, Bosworth HB, King AA, Simon J, Glassberg JA, Kutlar A, Gordeuk VR, Shah N, Baumann AA, Klesges LM. Evaluating the implementation of a multi-level mHealth study to improve hydroxyurea utilization in sickle cell disease. Front Health Serv 2023; 2:1024541. [PMID: 36925803 PMCID: PMC10012741 DOI: 10.3389/frhs.2022.1024541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 12/09/2022] [Indexed: 01/22/2023]
Abstract
Background Sickle Cell Disease (SCD) is a progressive genetic disease that causes organ damage and reduces longevity. Hydroxyurea is an underutilized evidence-based medication that reduces complications and improves survival in SCD. In a multi-site clinical trial, part of the NIH-funded Sickle Cell Disease Implementation Consortium (SCDIC), we evaluate the implementation of a multi-level and multi-component mobile health (mHealth) patient and provider intervention to target the determinants and context of low hydroxyurea use. Given the complexity of the intervention and contextual variability in its implementation, we combined different behavioral and implementation theories, models, and frameworks to facilitate the evaluation of the intervention implementation. In this report, we describe engagement with stakeholders, planning of the implementation process, and final analytical plan to evaluate the implementation outcomes. Methods During 19 meetings, a 16-member multidisciplinary SCDIC implementation team created, conceived, and implemented a project that utilized Intervention Mapping to guide designing an intervention and its evaluation plan. The process included five steps: (1) needs assessment of low hydroxyurea utilization, (2) conceptual framework development, (3) intervention design process, (4) selection of models and frameworks, and (5) designing evaluation of the intervention implementation. Results Behavioral theories guided the needs assessment and the design of the multi-level mHealth intervention. In designing the evaluation approach, we combined two implementation frameworks to best account for the contextual complexity at the organizational, provider, and patient levels: (1) the Consolidated Framework for Implementation Research (CFIR) that details barriers and facilitators to implementing the mHealth intervention at multiple levels (users, organization, intervention characteristics, broader community), and (2) the Technology Acceptance Model (TAM), a conceptual model specific for explaining the intent to use new information technology (including mHealth). The Reach Effectiveness Adoption Implementation and Maintenance (RE-AIM) framework was used to measure the outcomes. Discussion Our research project can serve as a case study of a potential approach to combining different models/frameworks to help organize and plan the evaluation of interventions to increase medication adherence. The description of our process may serve as a blueprint for future studies developing and testing new strategies to foster evidence-based treatments for individuals living with SCD.
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Affiliation(s)
- J. S Hankins
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - M. B Potter
- Department of Family and Community Medicine, University of California San Francisco School of Medicine, San Francisco, CA, United States
- Clinical, Family, and Community Medicine, University of California San Francisco, CA, United States
| | - M. E Fernandez
- Health Promotion and Behavioral Sciences, University of Texas Health Science Center, School of Public Health at Houston, Houston, TX, United States
| | - C Melvin
- The Medical University of South Carolina, Charleston, SC, United States
| | - L DiMartino
- RTI International, Research triangle park, NC, United States
| | - S. R Jacobs
- RTI International, Research triangle park, NC, United States
| | - H. B Bosworth
- Department of Population Health Studies, Duke University, Durham, NC, United States
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Medical Center, Durham, NC, United States
| | - A. A King
- Department of Pediatrics, Washington University, Saint louis, MO, United States
| | - J Simon
- Department of Emergency Medicine, Ichan School of Medicine at Mount Sinai, New York, NY, United States
| | - J. A Glassberg
- Department of Emergency Medicine, Ichan School of Medicine at Mount Sinai, New York, NY, United States
| | - A Kutlar
- Augusta University, Augusta, GA, United States
| | - V. R Gordeuk
- Department of Medicine, the University of Illinois at Chicago, Chicago, IL, United States
| | - N Shah
- Department of Pediatric Hematology and Oncology, Duke University, Durham, NC, United States
| | - A. A Baumann
- Division of Public Health Sciences, Department of Surgery, Washington University, Saint louis, MO, United States
| | - L. M Klesges
- Division of Public Health Sciences, Department of Surgery, Washington University, Saint louis, MO, United States
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12
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Pokhilenko I, Kast T, Janssen LMM, Evers SMAA, Paulus ATG, Simon J, Mayer S, Berger M, Konnopka A, Muntendorf L, Brodszky V, García-Pérez L, Park A, Salvador-Carulla L, Drost RMWA. International comparability of reference unit costs of education services: when harmonizing methodology is not enough (PECUNIA project). Expert Rev Pharmacoecon Outcomes Res 2023; 23:135-141. [PMID: 36472303 DOI: 10.1080/14737167.2023.2152331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Health problems can lead to costs in the education sector. However, these costs are rarely incorporated in health economic evaluations due to the lack of reference unit costs (RUCs), cost per unit of service, of education services and of validated methods to obtain them. In this study, a standardized unit cost calculation tool developed in the PECUNIA project, the PECUNIA RUC Template for services, was applied to calculate the RUCs of selected education services in five European countries. METHODS The RUCs of special education services and of educational therapy were calculated using the information collected via an exploratory gray literature search and contact with service providers. RESULTS The RUCs of special education services ranged from €55 to €189 per school day. The RUCs of educational therapy ranged from €6 to €25 per contact and from €5 to €35 per day. Variation was observed in the type of input data and measurement unit, among other. DISCUSSION The tool helped reduce variability in the RUCs related to costing methodology and gain insights into other aspects that contribute to the variability (e.g. data availability). Further research and efforts to generate high quality input data are required to reduce the variability of the RUCs.
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Affiliation(s)
- I Pokhilenko
- Centre for Economics of Obesity, Health Economics Unit, Institute of Applied Health Research, College of Dental and Medical Sciences, University of Birmingham, Birmingham, The United Kingdom
| | - T Kast
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | - L M M Janssen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | - S M A A Evers
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.,Centre of Economic Evaluation & Machine Learning, Trimbos Institute, National Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - A T G Paulus
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.,School of Health Professions Education, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - J Simon
- Department of Health Economics, Centre for Public Health, Medical University of Vienna, Vienna, Austria.,Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - S Mayer
- Department of Health Economics, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | - M Berger
- Department of Health Economics, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | - A Konnopka
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L Muntendorf
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - L García-Pérez
- Servicio de Evaluación, Servicio Canario de la Salud (SESCS), Santa Cruz de Tenerife, Spain
| | - A Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - L Salvador-Carulla
- Mental Health Policy Unit, Health Research Institute, University of Canberra, Canberra, Australia
| | - R M W A Drost
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
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Burgos S, Jefferys S, Peterson J, Parker J, Manickam A, Simon J, Margolis D, Browne E. PP 3.11 – 00171 The chromatin insulator CTCF inhibits HIV gene expression. J Virus Erad 2022. [DOI: 10.1016/j.jve.2022.100191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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14
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Schroeder L, Whitmarsh A, Brenner N, Thomas S, Simon J, Waterboer T, Ness A, Pring M. P06 HPV antibodies as a diagnostic and prognostic biomarker in head and neck cancers outside of the oropharynx: Insights from the Head and Neck 5000 study. Oral Oncol 2022. [DOI: 10.1016/j.oraloncology.2022.106145] [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: 11/11/2022]
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15
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Simon J. Methodological advancements in costing methods for (public) health economic evaluations: results from the European PECUNIA project. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.238] [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
(Public) health economic evaluations face significant problems regarding the standardization and comparability of their methods. In addition, at least a quarter of the total direct cost impact of healthcare interventions affects other economic sectors. International methods and tools are lacking for the rigorous and comparable assessment of the costs and outcomes of (public) health care from a societal perspective. The H2020 PECUNIA project (grant No 779292) brought together ten partners from six countries (AT/DE/ES/HU/NL/UK) between 2018 and 2021 aiming to improve the comparability and feasibility of multi-sectoral, multi-national health economic evaluations in Europe. A multi-step, mixed methods approach was used following a new harmonized costing concept to develop new methods and tools for the standardised identification, definition, measurement and valuation of costs in multiple sectors (health care, social care, (criminal) justice, education, employment and productivity, and patient, family and informal care), and for the broader, harmonised, supra-national assessment of outcomes using selected mental disorders as illustrative examples. This presentation will summarise the relevant advances in costing methods, give an overview of the developed tools that are now publicly available (www.pecunia-project.eu/tools), and discuss the lessons learned regarding how far it is possible to harmonize costing evidence with standardised tools in Europe, and what the necessary future research directions may be.
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Affiliation(s)
- J Simon
- Department of Health Economics, Center for Public Health, Medical University , Vienna, Austria
- Department of Psychiatry, University of Oxford , Oxford, UK
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Simon J, Oalmann C, Stern P, Senter R, Chien M, Graf R, Bessede A, Campbell A. A novel gut-restricted small molecule TLR2 agonist enhances immune checkpoint inhibitor efficacy in a preclinical mouse fibrosarcoma tumor model. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01139-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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17
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King S, Ahmed S, Shirt L, Slobogian V, Vig C, Barbera L, Kurien E, Santana M, Pabani A, Biondo P, Sinnarajah A, Simon J, Hao D. EP10.01-008 Examining Social Determinants of Health Among Newly Diagnosed Lung Cancer Patients Contacted for Early Specialist Palliative Care Consultation. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.885] [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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Varey A, El Sharouni MA, Simon J, Gershenwald J, Long G, Scolyer R, Thompson J, Lo S. 805P Predicting recurrence-free survival for patients with stage II melanoma: A validated tool to guide selection for adjuvant systemic therapy. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.931] [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] Open
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19
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Simon J, Ibrahim Y, Adeyemo D, Garba N, Asuku A, Bello S, Ibikunle I. Radiological consequence analysis for hypothetical accidental release from Nigerian Research Reactor-1. Appl Radiat Isot 2022; 186:110308. [DOI: 10.1016/j.apradiso.2022.110308] [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] [Received: 10/14/2021] [Revised: 05/12/2022] [Accepted: 05/27/2022] [Indexed: 11/02/2022]
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20
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Gagyi R, Szegedi N, Simon J, Wijchers S, Bhagwandien R, Kong M, Ruppersberg P, Szili-Torok T. Left atrial anatomical variations correlate with atrial fibrillation sources near the left atrial ridge. Europace 2022. [DOI: 10.1093/europace/euac053.192] [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: None.
Background
Anatomical variations and characteristics of the left atrium (LA) may have a previously undescribed effect on source locations in atrial fibrillation (AF). Electrographic flow (EGF) mapping is a novel method used to estimate cardiac action potential flow in the atria that can detect AF sources in patients with persistent AF. The EGF technology offers a revolutionary mapping possibility for AF, however, it is not commercially available yet.
Purpose
This is the first study aiming to investigate the relationship between anatomical characteristics of the LA and non-PV sources detected by EGF in patients with persistent AF.
Methods
We collected cardiac computed tomography (CT) and EGF data from patients who underwent radiofrequency catheter ablation (CA) for persistent AF. EGF mapping creates a spatial and temporal reconstruction of electric potentials derived from endocardial unipolar electrograms. By analyzing EGF maps obtained during CA procedures, we localized non-PV sources in the LA. Patients with individual stable sources with a source activity above threshold (leading source present in more than > 26% of the time) were classified as having an S-Type EGF signature with source-dependent AF. Patients with no stable active source pattern and no leading source with a source activity above threshold were characterized as having a C-Type EGF signature consistent with source-independent AF. We assessed LA anatomical characteristics including size, LAA length, LAA ostial diameter, trajectory of the left superior pulmonary vein (LSPV) and its relation to the LAA on cardiac CT scans. Abutting LAA-LSPV was defined as cases when the LSPV touched the posterior aspect of LAA, and the maximal distance between the two structures was less than 2 mm. Those cases where the distance between LAA and LSPV was more than 2 mm were defined as non-abutting LAA-LSPV.
Results
Thirty patients were included in this study (mean age 62.4±6.8 years):23 patients had an S-Type EGF signature (77%), and 7 patients had a C-Type EGF signature (23%). We identified 10 patients with AF sources near the LA ridge, while twenty patients had no leading source near the LA ridge. LA anatomical characteristics, LAA length and ostial diameter showed no correlation with the presence of a leading source near the ridge. We described 19 patients with abutting LAA-LSPV, and 11 patients with non-abutting LAA-LSPV. Three out of 19 patients presented with a leading source near ridge in the abutting LAA-LSPV group, while 7 out of 11 patients presented with a leading source near ridge in the non-abutting LAA-LSPV group (p=0.01).
Conclusion
Our data suggests that non-abutting LAA-LSPV is associated with the presence of AF sources near the LA ridge.
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Affiliation(s)
- R Gagyi
- Erasmus University Medical Centre, Rotterdam, Netherlands (The)
| | - N Szegedi
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - J Simon
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - S Wijchers
- Erasmus University Medical Centre, Rotterdam, Netherlands (The)
| | - R Bhagwandien
- Erasmus University Medical Centre, Rotterdam, Netherlands (The)
| | - M Kong
- Ablacon Inc., Austin, United States of America
| | | | - T Szili-Torok
- Erasmus University Medical Centre, Rotterdam, Netherlands (The)
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21
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Tews D, Gouveri E, Simon J, Marck C. A Smartphone-Based Application to Assist Insulin Titration in Patients Undergoing Basal Insulin-Supported Oral Antidiabetic Treatment. J Diabetes Sci Technol 2022:19322968221090521. [PMID: 35491554 DOI: 10.1177/19322968221090521] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION INSULIA is an insulin-titration app developed for patients with type 2 diabetes treated with basal insulin as part of a basal insulin-supported oral therapy (BOT). The app uses patient-logged fasting blood glucose (FBG) values and a titration plan defined by the treating physician to provide basal insulin dosing recommendations. Physicians use the web portal to monitor their patients' therapy progress and, if necessary, adjust therapy. The aim of this study was to assess the app, specifically its features, handling and impact on diabetes treatment and self-management in Germany. METHODS This German retrospective pilot study included physicians (diabetologists, general practitioners, and internists) and patients with type 2 diabetes who either receive or start BOT using the app. Both groups completed group-specific questionnaires between December 2018 and June 2019. RESULTS Overall, 10 physicians and 34 patients with type 2 diabetes completed their respective questionnaires. Physicians perceived their app-using patients to be more involved and more confident in managing their insulin therapy than patients not using the app. The majority of patients considered the app as a tool that assists with safer insulin treatment. The physicians perceived that due to the app use, FBG and HbA1c target values were achieved more often than patients not using the app and the number and severity of hypoglycemic episodes was reduced. CONCLUSION The titration app seems to have a positive impact on BOT patients' FBG and HbA1c target achievement and was highly appreciated by both physicians and patients alike.
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Affiliation(s)
| | | | - Jörg Simon
- MVZ im Altstadt-Carree Fulda GmbH, Fulda, Germany
| | - Cornelia Marck
- Centrum für Diabetologie und Allgemeinmedizin, Pohlheim, Germany
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22
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Simon J, Shapiro M, Larkin L, Kim N, Patel S, Kingsberg S. Onset of Flibanserin Treatment Effect in Postmenopausal Women Assessed by Subdomain Scores of the Female Sexual Function Index (FSFI). J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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23
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Sibert NT, Pfaff H, Breidenbach C, Wesselmann S, Roth R, Feick G, Carl G, Dieng S, Gaber AA, Blana A, Darr C, Distler F, Kunath F, Bedke J, Erdmann J, Minner J, Simon J, Kwiatkowski M, Burchardt M, Harz N, Conrad S, Höfner T, Knoll T, Beyer B, Hammerer P, Kowalski C. Variation across operating sites in urinary and sexual outcomes after radical prostatectomy in localized and locally advanced prostate cancer. World J Urol 2022; 40:1437-1446. [PMID: 35347412 DOI: 10.1007/s00345-022-03985-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/07/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The extent of variation in urinary and sexual functional outcomes after radical prostatectomy (RPE) between prostate cancer (PC) operating sites remains unknown. Therefore, this analysis aims to compare casemix-adjusted functional outcomes (EPIC-26 scores incontinence, irritative/obstructive function and sexual function) between operating sites 12 months after RPE. MATERIALS AND METHODS Analysis of a cohort of 7065 men treated with RPE at 88 operating sites (prostate cancer centers, "PCCs") between 2016 and 2019. Patients completed EPIC-26 and sociodemographic information surveys at baseline and 12 months after RPE. Survey data were linked to clinical data. EPIC-26 domain scores at 12 months after RPE were adjusted for relevant confounders (including baseline domain score, clinical and sociodemographic information) using regression analysis. Differences between sites were described using minimal important differences (MIDs) and interquartile ranges (IQR). The effects of casemix adjustment on the score results were described using Cohen's d and MIDs. RESULTS Adjusted domain scores at 12 months varied between sites, with IQRs of 66-78 (incontinence), 89-92 (irritative/obstructive function), and 20-29 (sexual function). Changes in domain scores after casemix adjustment for sites ≥ 1 MID were noted for the incontinence domain (six sites). Cohen's d ranged between - 0.07 (incontinence) and - 0.2 (sexual function), indicating a small to medium effect of casemix adjustment. CONCLUSIONS Variation between sites was greatest in the incontinence and sexual function domains for RPE patients. Future research will need to identify the factors contributing to this variation. TRIAL REGISTRY The study is registered at the German Clinical Trial Registry ( https://www.drks.de/drks_web/ ) with the following ID: DRKS00010774.
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Affiliation(s)
- Nora Tabea Sibert
- German Cancer Society, Kuno-Fischer-Straße 8, 14057, Berlin, Germany.
| | - Holger Pfaff
- Faculty of Human Sciences, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, University of Cologne, Eupener Str. 129, 50933, Cologne, Germany
| | - Clara Breidenbach
- German Cancer Society, Kuno-Fischer-Straße 8, 14057, Berlin, Germany
| | - Simone Wesselmann
- German Cancer Society, Kuno-Fischer-Straße 8, 14057, Berlin, Germany
| | - Rebecca Roth
- Faculty of Medicine and University Hospital Cologne, Institute of Medical Statistics and Computational Biology, University of Cologne, Robert-Koch-Str. 10, 50931, Cologne, Germany
| | - Günther Feick
- Federal Association of German Prostate Cancer Patient Support Groups, Bonn, Germany
| | - Günter Carl
- Federal Association of German Prostate Cancer Patient Support Groups, Bonn, Germany
| | | | - Amr A Gaber
- Urologische Klinik, Carl-Thiem-Klinikum Cottbus, Thiemstr. 111, 03048, Cottbus, Germany
| | - Andreas Blana
- Klinik für Urologie und Kinderurologie, Klinikum Fürth, Jakob-Henle-Strasse 1, 90766, Fürth, Germany
| | - Christopher Darr
- Klinik für Urologie, Universitätsklinikum Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - Florian Distler
- Klinik für Urologie, Universitätsklinik der Paracelsus Medizinischen Privatuniversität, Standort Klinikum Nürnberg, Prof.-Ernst-Nathan-Straße 1 (Haus 22), 90419, Nuremberg, Germany
| | - Frank Kunath
- Department of Urology and Pediatric Urology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Krankenhausstrasse 12, 91054, Erlangen, Germany
| | - Jens Bedke
- Klinik für Urologie, Universität Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Jörg Erdmann
- Prostatakarzinomzentrum Tauber-Franken, Uhlandstr. 7, 97980, Bad Mergentheim, Germany
| | - Jörg Minner
- Hegau-Bodensee-Klinikum GmbH, Virchowstraße 10, 78224, Singen, Germany
| | - Jörg Simon
- Klinik für Urologie und Kinderurologie, Ortenau Klinikum, Ebertplatz 12, 77654, Offenburg, Germany
| | - Maciej Kwiatkowski
- Kantonsspital Aarau AG, Onkologiezentrum Mittelland, Tellstrasse 25, 5001, Aarau, Switzerland
| | - Martin Burchardt
- Klinik und Poliklinik für Urologie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - Nino Harz
- Klinikum Dortmund, Münsterstraße 240, 44145, Dortmund, Germany
| | - Stefan Conrad
- DIAKOVERE Friederikenstift, Humboldtstraße 5, 30169, Hannover, Germany
| | - Thomas Höfner
- Klinik und Poliklinik für Urologie und Kinderurologie, UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Thomas Knoll
- Kliniken Sindelfingen, Arthur-Gruber-Str. 70, 71065, Sindelfingen, Germany
| | - Burkhard Beyer
- Martini-Klinik Prostate Cancer Center Hamburg, Martinistraße 52, 20246, Hamburg, Germany
| | - Peter Hammerer
- Städtisches Klinikum Braunschweig, Freisestraße 9/10, 38118, Braunschweig, Germany
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Lucas M, Merchant M, O'Connor M, Smith S, Trombino A, Zhang WY, Simon J, Eathiraj S, Waters N, Buck E. 27MO BDTX-1535, a CNS penetrant, irreversible inhibitor of intrinsic and acquired resistance EGFR mutations, demonstrates preclinical efficacy in NSCLC and GBM PDX models. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.01.036] [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: 11/01/2022] Open
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25
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Simon J, Ibrahim Y, Adeyemo D, Garba N, Asuku A. Comparative analysis of core life-time for the NIRR-1 HEU and LEU cores. Progress in Nuclear Energy 2021. [DOI: 10.1016/j.pnucene.2021.103970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Simon J, Fung K, Raisi-Estabragh Z, Aung N, Khanji MY, Kolossvary M, Merkely B, Munroe PB, Harvey NC, Piechnik SK, Neubauer S, Petersen SE, Maurovich-Horvat P. Association of daily coffee consumption with cardiovascular health – results from the UK Biobank. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2416] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
There are conflicting reports on the association of coffee consumption with cardiovascular (CV) health. The UK Biobank is a prospective cohort study including data for half a million middle-aged individuals.
Purpose
We studied the association of daily coffee consumption with all-cause and CV mortality, and incidence of the major CV diseases in the UK Biobank. In a subgroup of participants who underwent cardiovascular magnetic resonance (CMR), we evaluated the association between regular coffee intake and cardiac structure and function parameters.
Methods
UK Biobank cohort of participants without clinically manifested heart disease at the time of recruitment were included. Regular coffee intake was categorized into 3 groups: zero, light-to-moderate (0.5–3 cups/day) and high (>3 cups/day) coffee drinkers. We estimated association of daily coffee consumption with incident outcomes using multivariable Cox-regression models (median follow-up of 11 years) and, in the subset with CMR data, with left and right ventricular (LV, RV) end-systolic and end-diastolic volumes, LV mass, and LV/RV stroke volume using multivariable linear regression. Models were adjusted for potential confounders and mediators, including: age, sex, non-European ethnicities, body mass index, smoking, physical activity, Townsend deprivation index, alcohol, meat, fruit and vegetable intake, hypertension, diabetes mellitus, and cholesterol level.
Results
We included 468,629 individuals (mean age 56.2±8.1 years, 44.2% male). Among them, 22.1% did not consume coffee on a regular basis, 58.4% had 0.5–3 cups per day and 19.5% had >3 cups per day. After adjustment for potential confounders and mediators, compared to non-coffee drinkers, light-to-moderate coffee drinking was associated with lower risk of all-cause mortality (HR=0.88, p<0.001), CV mortality (HR=0.83, p=0.006), and incident stroke (HR=0.79; p=0.037). CMR data were available in 30,650 participants. In multivariable analysis, compared to non-coffee drinkers, both the light-to-moderate and high coffee consuming categories, were associated with significantly increased LV and RV ventricular end-systolic (β=0.91 and 1.64 for LV and 1.10 and 1.72 for RV), end-diastolic (β=2.21 and 3.28 for LV and 2.24 and 3.35 for RV) and stroke volumes (β=1.31 and 1.64 for LV and 1.15 and 1.63 for RV), as well as greater LV mass (β=0.78 and 1.64; all p<0.001).
Conclusion
In this large study of the UK Biobank population, regular coffee consumption of up to 3 cups per day was associated with favorable cardiovascular outcomes, in particular, decreased all-cause and CV mortality and stroke incidence. Regular coffee consumption was also associated with a pattern of CMR metrics in keeping with the reverse of age-related cardiac alterations.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Simon
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - K Fung
- Queen Mary University of London, 2William Harvey Research Institute, NIHR Barts Biomedical Research Centre, London, United Kingdom
| | - Z Raisi-Estabragh
- Queen Mary University of London, 2William Harvey Research Institute, NIHR Barts Biomedical Research Centre, London, United Kingdom
| | - N Aung
- Queen Mary University of London, 2William Harvey Research Institute, NIHR Barts Biomedical Research Centre, London, United Kingdom
| | - M Y Khanji
- Queen Mary University of London, 2William Harvey Research Institute, NIHR Barts Biomedical Research Centre, London, United Kingdom
| | - M Kolossvary
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - B Merkely
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - P B Munroe
- Queen Mary University of London, 2William Harvey Research Institute, NIHR Barts Biomedical Research Centre, London, United Kingdom
| | - N C Harvey
- University of Southampton, MRC Lifecourse Epidemiology Unit, Southampton, United Kingdom
| | - S K Piechnik
- University of Oxford, National Institute for Health Research, Oxford Biomedical Research Centre, Division of Cardiovascul, Oxford, United Kingdom
| | - S Neubauer
- University of Oxford, National Institute for Health Research, Oxford Biomedical Research Centre, Division of Cardiovascul, Oxford, United Kingdom
| | - S E Petersen
- Queen Mary University of London, 2William Harvey Research Institute, NIHR Barts Biomedical Research Centre, London, United Kingdom
| | - P Maurovich-Horvat
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
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Simon J, Mahdiui ME, Smit JM, Szaraz L, Herczeg SZ, Van Rosendael AR, Zsarnoczay E, Nagy AI, Kolossvary M, Szilveszter B, Szegedi N, Geller L, Bax JJ, Maurovich-Horvat P, Merkely B. Left atrial appendage size is a marker of atrial fibrillation recurrence after radiofrequency catheter ablation in patients with persistent atrial fibrillation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0384] [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: 11/14/2022] Open
Abstract
Abstract
Background
Catheter ablation is an established therapy for rhythm control in patients with drug-refractory atrial fibrillation (AF), however, recurrence is frequent particularly in persistent AF. There are no consistently confirmed predictors of AF recurrence after catheter ablation. The left atrial appendage (LAA) potentially plays an important role in AF recurrence, although the exact mechanism and pathophysiology are still unclear.
Purpose
We aimed to study whether LAA volume (LAAV) and function influence the long-term recurrence of AF after point-by-point radiofrequency catheter ablation, depending on AF type.
Methods
AF patients who underwent point-by-point radiofrequency catheter ablation after preprocedural cardiac computed tomography (CT) and transthoracic and transesophageal echocardiography (TEE) were included in this retrospective analysis. LAAV and LAA orifice area were measured by CT and LAA flow velocity assessed by TEE and was used as a surrogate marker of LAA function. Uni- and multivariable Cox proportional hazard regression models were performed to determine the predictors of AF recurrence.
Results
In total, 561 AF patients (61.9±10.2 years, 34.9% females) were included in the study. Recurrence of AF was detected in 40.8% of the cases (34.6% in patients with paroxysmal and 53.5% in those with persistent AF) with a median recurrence-free time of 22.7 [9.3–43.1] months. Patients with AF recurrence had significantly higher body surface area-indexed left atrial volume (iLAV), LAAV and LAA orifice area, as compared to those without recurrence. Moreover, patients with persistent AF had significantly higher iLAV, LAAV, LAA orifice area and lower LAA flow velocity, than those with paroxysmal AF. After adjustment for the main cardiovascular risk factors and comorbidities left ventricular ejection fraction (LVEF) <50% (HR=2.17; 95% CI=1.38–3.43; p<0.001) and LAAV (HR=1.06; 95% CI=1.01–1.12; p=0.029) were independently associated with AF recurrence in persistent AF, while no independent predictors could be identified in paroxysmal AF.
Conclusions
The current study demonstrates that beyond left ventricular systolic dysfunction, LAA enlargement is associated with higher rate of AF recurrence after catheter ablation in persistent AF, but not in patients with paroxysmal AF. Our results suggest that preprocedural assessment of LVEF and LAAV might contribute to optimal patient selection and aid to improve long-term results of ablation procedures in patients with persistent AF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Simon
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - M E Mahdiui
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - J M Smit
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - L Szaraz
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - S Z Herczeg
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | | | - E Zsarnoczay
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - A I Nagy
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - M Kolossvary
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - B Szilveszter
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - N Szegedi
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - L Geller
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - J J Bax
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - P Maurovich-Horvat
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - B Merkely
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
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28
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Simon J, Hahn V, Jermendy GY, Kolossvary M, Kardos A, Szilveszter B, Boussoussou M, Vattay B, Merkely B, Maurovich-Horvat P. Adverse coronary plaque characteristics are more common in patients with diabetes. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2632] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Diabetes mellitus (DM) is associated with increased cardiovascular morbidity and mortality. However, there is a lack of data about the prevalence of adverse coronary artery plaques characteristics in patients with DM.
Purpose
In our study we aimed to compare the prevalence of adverse atherosclerotic coronary artery plaque characteristics between patients with and without DM.
Methods
We have analyzed the data of patients who underwent coronary computed tomography angiography (CCTA) between October 2012 and December 2020. Our exclusion criteria were coronary anomaly, congenital or other structural heart disease, previous revascularization or heart transplantation, non-diagnostic image quality and no available data on the presence of DM. Patients were divided into two groups based on the presence of DM.
Results
In total, 11,357 patients were included in our study. Prevalence of DM was 14.5%. There were significant differences in age (63.2±9.5 vs 58.1±12.2 years, p<0.001) and major cardiovascular risk factors such as hypertension, dyslipidemia and smoking between the two groups (all p<0.05). We have measured higher coronary artery calcium score in patients with DM vs. without DM (424.3±744.0 vs 174.2±794.6, p<0.001). Obstructive coronary artery disease (stenosis >70%) was more frequent in the DM group (24.6% vs 10.5%, p<0.001). While 29.6% of patients without DM had at least one plaque with adverse characteristics, this rate was 38.9% in those with DM (positive remodeling: 19.6% vs 26.1%, low attenuation: 7.6% vs 10.2%, spotty calcium: 16.9% vs 21.6%, napkin-ring sign: 1.7% vs 2.6%, all p<0.05).
Conclusions
The prevalence of severe coronary artery stenosis and coronary plaques with adverse characteristics was higher in patients with DM. Multivariate analysis is needed to further explore this association.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Simon
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - V Hahn
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | | | - M Kolossvary
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - A Kardos
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - B Szilveszter
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - M Boussoussou
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - B Vattay
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - B Merkely
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - P Maurovich-Horvat
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
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Ahmed S, Simon J, Biondo P, Hao D, Sinnarajah A. OA05.02 Acceptability of Automatic Referrals to Supportive and Palliative Care, by Patients Living with Advanced Lung Cancer: A Co-Design Process. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.048] [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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30
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Hahn V, Simon J, Kolossvary M, Szilveszter B, Kardos AS, Boussoussou M, Vattay B, Merkely B, Maurovich Horvat P. The presence of adverse atherosclerotic coronary plaque features is associated with diabetes. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab111.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [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): The grant was given to the Bioimaging field of Semmelweis University by the Excellence Program of the Ministry of Innovation and Technology in Hungary.
On Behalf of
Cardiovascular Imaging Research Group (CIRG)
Introduction
Diabetes mellitus (DM) is associated with increased cardiovascular morbidity and mortality. However, there is a lack of data about the prevalence of high-risk coronary artery plaques in patients with DM.
Purpose
In our study we aimed to compare the prevalence of adverse atherosclerotic coronary artery plaque features between patients with and without DM.
Methods
We have analyzed the data of patients who underwent coronary computed tomography angiography (CCTA) between October 2012 and December 2020. Our exclusion criteria were coronary anomaly, congenital or other structural heart disease, previous revascularization or heart transplantation, non-diagnostic image quality and no available data on the presence of DM. Patients were divided into two groups based on the presence of DM.
Results
In total, 11357 patients (47.6% men) were included in our study. Prevalence of DM was 14.5%. There were significant differences in age (63.2 ± 9.5 vs 58.1 ± 12.2 years, p < 0.001) and major cardiovascular risk factors such as hypertension, dyslipidemia and smoking between the two groups (all p < 0.05). We have measured higher coronary artery calcium score in patients with DM vs. without DM (424.3 ± 744.0 vs 174.2 ± 794.6, p < 0.001). Luminal stenosis >70% was more frequent in the DM group (24.6% vs 10.5%, p < 0.001). While 29.6% of patients without DM had at least one high risk plaque, this rate was 38.9% in those with DM (positive remodeling: 19.6% vs 26.1%, low attenuation: 7.6% vs 10.2%, spotty calcium: 16.9% vs 21.6%, napkin-ring sign: 1.7% vs 2.6%, all p < 0.05).
Conclusions
The prevalence of severe coronary artery stenosis and coronary plaques with adverse characteristics was higher in patients with DM.
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Affiliation(s)
- V Hahn
- Semmelweis University, Budapest, Hungary
| | - J Simon
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - M Kolossvary
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - B Szilveszter
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - AS Kardos
- Semmelweis University, Budapest, Hungary
| | - M Boussoussou
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - B Vattay
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - B Merkely
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
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31
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Vecsey-Nagy M, Szegedi N, Simon J, Szilveszter B, Kolossvary M, Boussoussou M, Vattay B, Delgado V, Jeroen B, Maurovich-Horvat P, Merkely B, Geller L. Orientation of the right superior pulmonary vein affects outcome after pulmonary vein isolation. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab111] [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: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Aims
Controversial results have been published regarding the influence of pulmonary vein (PV) anatomical variations on outcomes after pulmonary vein isolation (PVI). However, no data is available on the impact of PV orientation on the long-term success rates of point-by-point PVI. We sought to determine the impact of PV anatomy and orientation on atrial fibrillation (AF)-free survival in patients undergoing PVI using the radiofrequency point-by-point technique.
Methods and results
We retrospectively included 448 patients who underwent initial point-by-point radiofrequency ablation for AF at our department. Left atrial CT-angiography (CTA) was performed before each procedure. PV anatomical variations, ostial parameters (area, effective diameter and eccentricity), orientation and their associations with 24-month AF-free survival were analyzed. PV anatomical variations and ostial parameters were not predictive for AF-free survival (all p > 0.05). Univariate analysis showed that female sex (p = 0.025) was associated with higher rates of AF recurrence, ventral-caudal (p = 0.002), dorsal-cranial (p = 0.034) and dorsal-caudal (p = 0.042) orientation of the right superior PV (RSPV), on the other hand, showed an association with lower rates of AF recurrence, as compared to the reference ventral-cranial orientation. On multivariate analysis, both female sex [odds ratio(OR) 1.83, 95% CI 1.15-2.93, p = 0.011] and ventral-caudal RSPV orientation, compared with ventral-cranial orientation, proved to be independent predictors of 24-month AF recurrence (OR 0.37, 95% CI 0.19-0.71, p = 0.003).
Conclusion
Female sex and ventral-caudal RSPV orientation have an impact on long-term arrhythmia-free survival. Assessment of PV orientation may be a useful tool in predicting AF-free survival and may contribute to a more personalized management of AF.
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Affiliation(s)
| | - N Szegedi
- Semmelweis University, Budapest, Hungary
| | - J Simon
- Semmelweis University, Budapest, Hungary
| | | | | | | | - B Vattay
- Semmelweis University, Budapest, Hungary
| | - V Delgado
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - B Jeroen
- Leiden University Medical Center, Leiden, Netherlands (The)
| | | | - B Merkely
- Semmelweis University, Budapest, Hungary
| | - L Geller
- Semmelweis University, Budapest, Hungary
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32
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Szegedi N, Simon J, Szilveszter B, Sallo Z, Herczeg S, Nagy VK, Szeplaki G, Tahin T, Merkely B, Geller L. Abutting left atrial appendage and left superior pulmonary vein predicts recurrence of atrial fibrillation after point-by-point pulmonary vein isolation. Europace 2021. [DOI: 10.1093/europace/euab116.188] [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: 11/15/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Catheter ablation is the cornerstone for rhythm control in patients with drug-refractory atrial fibrillation (AF). Baseline predictors of AF recurrence after catheter ablation are well established, such as female gender and left atrial enlargement. The role of the spatial relationship between the left superior pulmonary vein (LSPV) and left atrial appendage (LAA) is unknown.
Purpose
We sought to evaluate whether juxtaposed LSPV and LAA plays a role in AF recurrence after catheter ablation for paroxysmal AF.
Methods
Consecutive patients, who underwent point-by-point radiofrequency catheter ablation for paroxysmal AF at our hospital between January of 2014 and December of 2017, were enrolled in the study. All patients underwent pre-procedural cardiac CT-angiography (CTA) for the assessment of left atrial (LA) and pulmonary vein (PV) anatomy. Abutting LAA-LSPV was defined as cases when LSPV touched the posterior aspect of LAA (distance less than 2 mm).
Results
We included 428 patients (60.7 ± 10.8 years, 35.5% female). AF recurrence rate was 33.4% with a median recurrence-free time of 21.2 (IQR = 8.8-43.0) months. In the univariate analysis, female sex (HR = 1.45; 95%CI = 1.04-2.01; p = 0.028), LA volume (HR = 1.01; 95%CI = 1.00-1.01; p = 0.042), and cases when LSPV touched the posterior wall of LAA (HR = 1.53; 95%CI = 1.09-2.14; p = 0.013) were associated with AF recurrence. In the multivariate analysis, female sex (adjusted HR = 1.55; 95%CI = 1.06-2.28; p = 0.024), LA volume (adjusted HR = 1.01; 95%CI = 1.00-1.02; p = 0.028), and abutting LAA-LSPV (adjusted HR = 1.60; 95%CI = 1.13-2.50; p = 0.008) remained significant predictors of AF recurrence.
Conclusion
Female gender, higher LA volume, and abutting LSPV and LAA predispose patients to have a higher chance for arrhythmia recurrence after catheter ablation for paroxysmal AF.
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Affiliation(s)
- N Szegedi
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - J Simon
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - B Szilveszter
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - Z Sallo
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - S Herczeg
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - VK Nagy
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - G Szeplaki
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - T Tahin
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - B Merkely
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - L Geller
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
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Danne T, Axel Schweitzer M, Keuthage W, Kipper S, Kretzschmar Y, Simon J, Wiedenmann T, Ziegler R. Impact of Fast-Acting Insulin Aspart on Glycemic Control in Patients with Type 1 Diabetes Using Intermittent-Scanning Continuous Glucose Monitoring Within a Real-World Setting: The GoBolus Study. Diabetes Technol Ther 2021; 23:203-212. [PMID: 32924568 PMCID: PMC7906866 DOI: 10.1089/dia.2020.0360] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: The GoBolus study investigated the real-world effectiveness of faster aspart in patients with type 1 diabetes (T1D) using intermittent-scanning continuous glucose monitoring (iscCGM) systems. Methods: This 24-week, multicenter, single-arm, noninterventional study investigated adults with T1D (HbA1c, 7.5%-9.5%) receiving multiple daily injections (MDI) of insulin and using iscCGM within local healthcare settings for ≥6 months before switching to faster aspart at study start (week 0; baseline). Primary endpoint was HbA1c change from baseline to week 24. Exploratory endpoint was change in iscCGM metrics from baseline to week 24. Results: Overall, 243 patients were included (55.6% male), with mean age/diabetes duration, 49.9/18.8 years; mean HbA1c, 8.1%. By week 24, HbA1c had decreased by 0.19% (-2.1 mmol/mol, P < 0.0001) with no mean change in insulin doses or basal/bolus insulin ratios. For patients with sufficient available iscCGM data (n = 92): "time in range" (TIR; 3.9-10.0 mmol/L) increased from 46.9% to 50.1% (P = 0.01), corresponding to an increase of 46.1 min/day; time in hyperglycemia decreased from 49.1% to 46.1% (>10.0 mmol/L, P = 0.026) and 20.4% to 17.9% (>13.9 mmol/L, P = 0.013), corresponding to 43.5 (P = 0.024) and 35.6 (P = 0.015) fewer minutes per day on average spent in these ranges, respectively; no change for time in hypoglycemia (<3.9 and <3.0 mmol/L). Mean interstitial and postprandial glucose improved from 10.4 to 10.1 mmol/L (P = 0.035) and 11.9 to 11.0 mmol/L (P = 0.002), respectively. Conclusion: Real-world switching to faster aspart in adults with T1D on MDI improved HbA1c, increased TIR, and decreased time in hyperglycemia without affecting time in hypoglycemia. The GoBolus study: NCT03450863.
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Affiliation(s)
- Thomas Danne
- Diabetes Center for Children and Adolescents, Children's Hospital on the Bult, Hanover Medical School, Hanover, Germany
- Address correspondence to: Thomas Danne, MD, Diabetes Center for Children and Adolescents, Kinder- und Jugendkrankenhaus AUF DER BULT, Hanover Medical School, Janusz-Korczak-Allee 12, Hannover 30173, Germany
| | | | - Winfried Keuthage
- Schwerpunktpraxis für Diabetes und Ernährungsmedizin, Muenster, Germany
| | | | | | - Jörg Simon
- Medizinisches Versorgungszentrum im Altstadt-Carree Fulda GmbH, Fulda, Germany
| | | | - Ralph Ziegler
- Diabetes Clinic for Children and Adolescents, Muenster, Germany
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Costa J, Vanhove P, George E, Simon J, Horrer I, Metz D. High furosemide doses and survival in heart failure patients: A propensity score study. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.114] [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: 10/22/2022]
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Wilkens D, Meusinger R, Hein S, Simon J. Sequence analysis and specificity of distinct types of menaquinone methyltransferases indicate the widespread potential of methylmenaquinone production in bacteria and archaea. Environ Microbiol 2020; 23:1407-1421. [PMID: 33264482 DOI: 10.1111/1462-2920.15344] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/30/2020] [Indexed: 01/06/2023]
Abstract
Menaquinone (MK) serves as an essential membranous redox mediator in various electron transport chains of aerobic and anaerobic respiration. In addition, the composition of the quinone/quinol pool has been widely used as a biomarker in microbial taxonomy. The HemN-like class C radical SAM methyltransferases (RSMTs) MqnK, MenK and MenK2 have recently been shown to facilitate specific menaquinone methylation reactions at position C-8 (MqnK/MenK) or C-7 (MenK2) to synthesize 8-methylmenaquinone, 7-methylmenaquinone and 7,8-dimethylmenaquinone. However, the vast majority of protein sequences from the MqnK/MenK/MenK2 family belong to organisms, whose capacity to produce methylated menaquinones has not been investigated biochemically. Here, representative putative menK and menK2 genes from Collinsella tanakaei and Ferrimonas marina were individually expressed in Escherichia coli (wild-type or ubiE deletion mutant) and the corresponding cells were found to produce methylated derivatives of the endogenous MK and 2-demethylmenaquinone. Cluster and phylogenetic analyses of 828 (methyl)menaquinone methyltransferase sequences revealed signature motifs that allowed to discriminate enzymes of the MqnK/MenK/MenK2 family from other radical SAM enzymes and to identify C-7-specific menaquinone methyltransferases of the MenK2 subfamily. This study will help to predict the methylation status of the quinone/quinol pool of a microbial species (or even a microbial community) from its (meta)genome and contribute to the future design of microbial quinone/quinol pools in a Synthetic Biology approach.
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Affiliation(s)
- Dennis Wilkens
- Microbial Energy Conversion and Biotechnology, Department of Biology, Technical University of Darmstadt, Schnittspahnstraße 10, Darmstadt, 64287, Germany
| | - Reinhard Meusinger
- Department of Chemistry, Macromolecular Chemistry, Technical University of Darmstadt, Alarich-Weiss-Str. 4, Darmstadt, 64287, Germany
| | - Sascha Hein
- Microbial Energy Conversion and Biotechnology, Department of Biology, Technical University of Darmstadt, Schnittspahnstraße 10, Darmstadt, 64287, Germany
| | - Jörg Simon
- Microbial Energy Conversion and Biotechnology, Department of Biology, Technical University of Darmstadt, Schnittspahnstraße 10, Darmstadt, 64287, Germany.,Centre for Synthetic Biology, Technical University of Darmstadt, Darmstadt, 64283, Germany
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Jacob J, Ribeiro M, Benadjaoud M, Jenny C, Feuvret L, Simon J, Bernier M, Antoni D, Hoang-Xuan K, Psimaras D, Carpentier A, Ricard D, Maingon P. OC-0696: Development of dose constraints to the brain areas implied in cognition: a prospective study. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00718-0] [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: 10/22/2022]
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Simon J, Konnopka A, Brodszky V, Evers S, Hakkaart-van Roijen L, Serrano-Pérez P, vador-Carulla LSAL, Park AL, Hollingworth W. (Pharmaco)economic evaluations for mental health related services: the PECUNIA project. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Mental health disorders affect large proportions of the general public resulting in serious cost consequences even beyond the health care sector. The PECUNIA project (EU H2020 grant agreement No 779292) aims to establish standardised costing and outcome assessment measures for optimised healthcare provision in the EU for multi-sectoral, multi-national and multi-person (pharmaco)economic evaluations using selected mental health disorders as illustrative examples.
Methods
Harmonised Identification, Definition, Measurement and Valuation of service costs in multiple sectors (health care, social care, criminal justice, education, productivity, patient, family). Reviews and surveys of mental health related services and other resource use in six European countries (AT, DE, ES, HU, NL, UK) to develop a new harmonised costing concept and related tools.
Results
We identified many taxonomical and conceptual discrepancies which currently hinder harmonized costing efforts and comparability of economic evaluations/HTAs across countries and sectors. The 'PECUNIA care atom', a new multi-sectoral costing concept forms the basis of resource item classification and international coding of mental health related services using the DESDE-PECUNIA system. Linked, harmonized tools such as the PECUNIA-European Resource Use Measurement instrument and the PECUNIA-European Reference Unit Costing Templates have been developed and are currently deployed in six countries to establish a PECUNIA-European Unit Cost Compendium alongside pan-European outcome evaluation methods.
Conclusions
The PECUNIA tools will lead to better understanding of the variations in costs and outcomes of mental health services/interventions within and across countries, and improve the feasibility, quality, comparability and transferability of (pharmaco)economic evaluations and HTAs in Europe. They also allow the harmonized measurement of broader economic and societal impacts of mental health services.
Key messages
The PECUNIA project developed compatible European multi-sectoral, multi-national and multi-person costing and outcome assessment tools. Methods & tools allow the harmonised measurement of broader economic & societal impacts of mental health related services, and improve the transferability & comparability of economic evaluations/HTAs.
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Affiliation(s)
- J Simon
- Department of Health Economics, Medical University of Vienna, Vienna, Austria
| | - A Konnopka
- Zentrum für Psychosoziale Medizin, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - S Evers
- Department of Health Services Research, Maastricht University, Maastricht, Netherlands
| | - L Hakkaart-van Roijen
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - P Serrano-Pérez
- Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - L S a l vador-Carulla
- Centre for Mental Health Research, Australian National University, ANU College of Health and Medicine, Sydeny, Australia
| | - A L Park
- Department of Health Policy, London School of Economics, London, UK
| | - W Hollingworth
- Department of Population Health Sciences, University of Bristol, Bristol, UK
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Ruf CG, Krampe S, Matthies C, Anheuser P, Nestler T, Simon J, Isbarn H, Dieckmann KP. Major complications of post-chemotherapy retroperitoneal lymph node dissection in a contemporary cohort of patients with testicular cancer and a review of the literature. World J Surg Oncol 2020; 18:253. [PMID: 32972425 PMCID: PMC7517823 DOI: 10.1186/s12957-020-02032-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 09/18/2020] [Indexed: 11/17/2022] Open
Abstract
Background Post-chemotherapy retroperitoneal lymph node dissection (pc-RPLND) is one cornerstone in the clinical management of patients with nonseminomatous testicular germ cell tumours (GCT). A wide range of complication rates in this type of surgery is reported so far. We retrospectively evaluated the frequency of major complications by using the Clavien-Dindo classification and analysed the influence of various clinical factors on complication rates in pc-RPLND. Methods We retrospectively analysed 146 GCT patients undergoing pc-RPLND. Complications of grade III–V according to the Clavien-Dindo classification occurring within 30 days after surgery were registered along with the following clinical factors: age, body mass index (BMI), duration of surgery, number of anatomic fields resected, side of primary tumour, histology of surgical specimen, histology of primary tumour, and total dose of cisplatin applied prior to surgery. For comparison, we also evaluated 35 chemotherapy-naïve patients with primary RPLND and 19 with laparoscopic RPLND. We analysed types and frequencies of the various complications as well as associations with clinical factors using descriptive statistical methods. Results A total of 14.4% grade III–IV complications were observed in pc-RPLND, and 8.6% and 5.3% in primary and in laparoscopic RPLND, respectively. There was no perioperative mortality. Lymphocele was the most frequent adverse event (16% of grade III–IV complications). Operation time > 270 min (p = 0.001) and vital cancer in the resected specimen (p = 0.02) were significantly associated with higher complication rates. Left-sided resection fields involved two-fold higher complication rates, barely missing statistical significance (p = 0.06). Conclusions Pc-RPLND involves a grade III–V complication rate of 14.4%. Prolonged operation time and vital cancer in the residual mass are significantly associated with higher complication rates. The Clavien-Dindo classification system may allow inter-observer variation in rating complication grades, which may represent one reason for the wide range of reported RPLND complication rates. RPLND represents major surgery and surgeons active in this field must be competent to manage adverse events.
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Affiliation(s)
- Christian Guido Ruf
- Department of Urology, Bundeswehrkrankenhaus Hamburg, Lesserstraße 180, 22049, Hamburg, Germany.,Department of Urology, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany
| | - Simon Krampe
- Department of Urology, Bundeswehrkrankenhaus Hamburg, Lesserstraße 180, 22049, Hamburg, Germany
| | - Cord Matthies
- Department of Urology, Bundeswehrkrankenhaus Hamburg, Lesserstraße 180, 22049, Hamburg, Germany
| | - Petra Anheuser
- Department of Urology, Albertinen Krankenhaus Hamburg, Suentelstrasse 11a, 22457, Hamburg, Germany
| | - Tim Nestler
- Department of Urology, Bundeswehrzentralkrankenhaus Koblenz, Rübenacher Str. 170, 56072, Koblenz, Germany
| | - Jörg Simon
- Department of Urology, Ortenau-Klinikum, Ebertplatz 12, 77654, Offenburg, Germany
| | - Hendrik Isbarn
- Martini Klinik, Universitätsklinikum Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Klaus Peter Dieckmann
- Department of Urology, Albertinen Krankenhaus Hamburg, Suentelstrasse 11a, 22457, Hamburg, Germany. .,Department of Urology, Asklepios Klinik Altona, Paul Ehrlich Strasse 1, 22763, Hamburg, Germany.
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Perić N, Ullmann T, Hofmarcher MM, Or Z, Simon J. Is the EU ready for a generic set of indicators for health system performance? A qualitative study. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.498] [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
Background
As part of the EU funded BRIDGE Health project, 23 headline indicators for assessing and comparing the performance of public health systems were proposed. They were shortlisted out of the currently existing and often overlapping pool of over 2000 health system performance assessment (HSPA) indicators. In this qualitative study, we explored their validity and perceived national-level utility for policy making and factors affecting the potential uptake of an indicator hierarchy (headline, operational & explanatory levels) at Member States' and EU levels.
Methods
Semi-structured interviews with a purposive sample of 24 policy makers and senior policy advisors from 15 EU Member States and one candidate country were performed between July and November 2018. All interviews were transcribed and coded using summative and directed content analysis to generate thematic categories in MAXQDA.
Results
Preliminary results suggest that experts positively perceived the overall balance of the shortlist across performance domains reflecting most of the important policy areas. However, some further amendments to the generic set of indicators were recommended to increase their policy relevance and measurement validity while keeping the size manageable. The concept and usage of headline HSPA indicators is mostly viewed as a communication tool whereas more granular information at explanatory levels is perceived to be more appropriate for data driven policymaking and cross-country learning.
Conclusions
Interviews showed a considerable heterogeneity in the feasibility of applying a generic HSPA framework in an EU-wide health strategy as a compass for improvement through comparisons of health systems. Factors such as flexibility in adaptation to the national context, improvement in building knowledge capacity, potential misinterpretation in the 'European Semester' context, as well as lack of appropriately defined benchmarks were recurrent themes in hindering its uptake.
Key messages
Policy makers assess explanatory level indicators to be more actionable than headline level indicators. To facilitate the use of headline indicators at EU-level as a navigation tool for health systems, the list has to be stable to create trends and sufficiently flexible in adapting to new priorities.
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Affiliation(s)
- N Perić
- Department of Health Economics, Medical University of Vienna, Centre for Public Health, Department of Health Economics, Vienna, Austria
| | - T Ullmann
- Department of Health Economics, Medical University of Vienna, Centre for Public Health, Department of Health Economics, Vienna, Austria
| | | | - Z Or
- Institut de Recherche et Documentation en Economie de la Santé – IRDES, Paris, France
| | - J Simon
- Department of Health Economics, Medical University of Vienna, Centre for Public Health, Department of Health Economics, Vienna, Austria
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Karim S, Lupichuk S, Tan A, Sinnarajah A, Simon J. 1516P Real world implementation of Serious Illness Care Program (SICP) in cancer care. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.142] [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: 11/15/2022] Open
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Moick S, Hiesmayr M, Mouhieddine M, Kiss N, Bauer P, Sulz I, Singer P, Simon J. Reducing the knowledge to action gap in hospital nutrition care - Developing and implementing nutritionDay 2.0. Clin Nutr 2020; 40:936-945. [PMID: 32747205 DOI: 10.1016/j.clnu.2020.06.021] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 06/16/2020] [Accepted: 06/18/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND & AIMS In hospital nutrition care the difficulty of translating knowledge to action often leads to inadequate management of patients with malnutrition. nutritionDay, an annual cross-sectional survey has been assessing nutrition care in healthcare institutions in 66 countries since 2006. While initial efforts led to increased awareness of malnutrition, specific local remedial actions rarely followed. Thus, reducing the Knowledge-to-action (KTA) gap in nutrition care requires more robust and focused strategies. This study describes the strategy, methods, instruments and experience of developing and implementing nutritionDay 2.0, an audit and feedback intervention that uses quality and economic indicators, feedback, benchmarking and self-defined action strategies to reduce the KTA gap in hospital nutrition care. METHODS We used an evidence based multi-professional mixed-methods approach to develop and implement nutritionDay 2.0 This audit and feedback intervention is driven by a Knowledge-to-Action framework complemented with robust stakeholder analysis. Further evidence was synthesized from the literature, online surveys, a pilot study, World Cafés and individual expert feedback involving international health care professionals, nutrition care scientists and patients. RESULTS The process of developing and implementing nutritionDay 2.0 over three years resulted in a new audit questionnaire based on 36 nutrition care quality and economic indicators at hospital, unit and patient levels, a new action-oriented feedback and benchmarking report and a unit-level personalizable action plan template. The evaluation of nutritionDay 2.0 is ongoing and will include satisfaction and utility of nutritionDay 2.0 tools and short-, mid- and long-term effects on the KTA gap. CONCLUSION In clinical practice, nutritionDay 2.0 has the potential to promote behavioural and practice changes and improve hospital nutrition care outcomes. In research, the data generated advances knowledge about institutional malnutrition and quality of hospital nutrition care. The ongoing evaluation of the initiative will reveal how far the KTA gap in hospital nutrition care was addressed and facilitate the understanding of the mechanisms needed for successful audit and feedback. TRIAL REGISTRATION Registration in clinicaltrials.gov: Identifier: NCT02820246.
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Affiliation(s)
- S Moick
- nutritionDay worldwide, Höfergasse 13/5, Vienna, 1090, Austria.
| | - M Hiesmayr
- Department Cardiac-, Thoracic-, Vascular Anaesthesia and Intensive Care and CEMSIIS, Medical University Vienna, Vienna, A-1090, Austria.
| | - M Mouhieddine
- Department Cardiac-, Thoracic-, Vascular Anaesthesia and Intensive Care, Medical University Vienna, Vienna, A-1090, Austria.
| | - N Kiss
- Department of Health Economics, Medical University Vienna, Vienna, A-1090, Austria.
| | - P Bauer
- Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, Vienna, A-1090, Austria.
| | - I Sulz
- Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, Vienna, A-1090, Austria.
| | - P Singer
- Department of General Intensive Care, Rabin Medical Center, Petah Tikva and Sackler School of Medicine, Tel Aviv University, Israel.
| | - J Simon
- Department of Health Economics, Medical University Vienna, Vienna, A-1090, Austria.
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Simon J, Clayton A, Kingsberg S, Portman D, Jordan R, Lucas J, Williams L, Krop J. 038 Effect Size of Bremelanotide Treatment in the Phase 3 RECONNECT Studies. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Simon J, Száraz L, Szilveszter B, Merkely B, Maurovich-Horvat P, Kolossváry M. Coronary Artery Calcium Score May Select Patients In Whom Coronary Ct Angiography Is Discouraged Due To The Need For Downstream Testing. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Vattay B, Borzsák S, Kolossváry M, Ruzsa Z, Boussoussou M, Simon J, Merkely B, Maurovich-Horvat P, Szilveszter B. The Impact Of Iterative Reconstrustion Algorhitms On Dynamic Computed Tomography Myocardial Perfusion Parameters. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Simon J, Millheiser L, Clayton A, Kingsberg S, Kim N. 084 Improvements in Female Sexual Function Index (FSFI) Domains Over Time after Flibanserin Treatment in Premenopausal Women with Hypoactive Sexual Desire Disorder (HSDD). J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.389] [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: 10/23/2022]
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Szilveszter B, Vattay B, Boussoussou M, Simon J, Merkely B, Maurovich-Horvat P, Kolossváry M. Characteristics, Predictors And Prognostic Value Of Coronary Artery Plaque Progression Using Serial Computer Tomography Imaging. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chapel A, Semont A, Linard C, Mathieu N, Demarquay C, Squiban C, Voswinkel J, Rouard H, Gorin N, Lataillade J, Benderitter M, Simon J, Mothy M. Clinical trial evaluating the efficacy of systemic mesenchymal stromal cell injections for the treatment of severe and chronic radiotherapy-induced abdomino-pelvic complications refractory to standard therapy. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Simon J, Anderson R, Craig S. Early Post-Operative Atrial Fibrillation after Lung Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.697] [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: 10/24/2022] Open
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49
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Kardos P, Geiss F, Simon J, Franken C, Butt U, Worth H. Duplicate Prescriptions of Inhaled Medications for Obstructive Lung Diseases. Pneumologie 2020; 74:149-158. [PMID: 32143230 DOI: 10.1055/a-1083-7961] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Inhalative treatments with metered dose aerosols and dry powder inhalers are the backbone of the pharmacotherapy for asthma and COPD. In the last decade many new and generic inhalative bronchodilators were launched at the German market, both monotherapies and fixed dose double bronchodilator (LABA/LAMA, beta adrenergic and antimuscarinic) or LABA and inhaled corticosteroid (ICS) and triple (LABA/LAMA/ICS) combinations. According to two surveys in 2015 among respiratory physicians we expected a high proportion of patients receiving duplicate prescriptions, e. g. a fixed dose new LABA/LAMA combination in addition to an existing ICS/LABA fixed dose combination. METHODOLOGY We searched the database of a large mail order pharmacy (DocMorris) to identify duplicate prescriptions of inhalative drugs for a patient by the same or by two or more different physicians during a 3 months period. RESULTS Unexpectedly, we found as little as around 1 % duplicate prescriptions for the same patient. Duplicate prescriptions involving combination products were found to be much more common than duplicate prescriptions of different mono-products. Irrespective the low percentage number of all prescriptions we saw in just one large mail order pharmacy several thousands of erroneous prescriptions. CONCLUSION At least in the setting of this mail order pharmacy duplicate (i. e. contraindicated and potentially dangerous) prescriptions are relatively rare. Prescribers and pharmacists should be aware of the issue of duplicates - especially when prescribing or filling prescriptions with combination products.
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Affiliation(s)
- P Kardos
- Group Practice and Center for Allergy, Respiratory and Sleep Medicine at Red Cross Maingau Hospital Frankfurt am Main, Germany
| | - F Geiss
- Mail Order Pharmacy DocMorris N. V., Heerlen, Netherlands
| | - J Simon
- Mail Order Pharmacy DocMorris N. V., Heerlen, Netherlands
| | - C Franken
- Mail Order Pharmacy DocMorris N. V., Heerlen, Netherlands
| | - U Butt
- German Airways League Bad Lippspringe, Germany
| | - H Worth
- Facharztforum Fürth, Germany
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Partridge JSL, Rogerson A, Joughin AL, Walker D, Simon J, Swart M, Dhesi JK. The emerging specialty of perioperative medicine: a UK survey of the attitudes and behaviours of anaesthetists. Perioper Med (Lond) 2020; 9:3. [PMID: 31988744 PMCID: PMC6971857 DOI: 10.1186/s13741-019-0132-0] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 11/25/2019] [Indexed: 12/02/2022] Open
Abstract
Background In 2014, the Royal College of Anaesthetists (RCoA) launched the Perioperative Medicine Programme to facilitate the delivery of best preoperative, intraoperative and postoperative care through implementation of evidence-based medicine to reduce variation and improve postoperative outcomes. However, variation exists in the establishment of perioperative medicine services in the UK. This survey explored attitudes and behaviours of anaesthetists towards perioperative medicine, described current anaesthetic-led perioperative medicine services across the UK and explored barriers to anaesthetic involvement in perioperative medicine. Methods Survey content based on the RCoA vision document was refined and validated using an expert panel. An anonymous electronic survey was then sent by email to the members of the RCoA. Results Seven hundred fifty-eight UK anaesthetists (4.5% of the RCoA mailing list) responded to the survey. Of these, 64% considered themselves a perioperative doctor, with 65% having changed local services in response to the RCoA vision. Barriers to developing perioperative medicine included insufficient time (75%) and inadequate training (51%). Three quarters of respondents advocate anaesthetists leading the development of perioperative medicine. Conclusions Despite evidence of emerging services, this survey describes barriers to ongoing development of perioperative medicine. Facilitators may include increased clinical exposure, targeted education and training and collaborative working with other specialties.
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Affiliation(s)
- J S L Partridge
- 1Perioperative Medicine for Older People Undergoing Surgery (POPS), Older Persons Assessment Unit, Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London, SE1 9RT UK.,2Division of Primary Care and Public Health Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - A Rogerson
- 3Perioperative Medicine for Older People Undergoing Surgery (POPS), Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A L Joughin
- 4Department of Medicine for the Elderly, Great Western Hospital, Marlborough Road, Swindon, UK
| | - D Walker
- 5Anaesthesia and Critical Care Medicine, University College London Hospitals, London, UK
| | - J Simon
- 6Imperial College Healthcare NHS Trust, London, UK
| | - M Swart
- 7Anaesthesia and Perioperative Medicine, Torbay Hospital, Torquay, Devon TQ2 7AA UK.,8National Clinical Lead for the Perioperative Medicine Programme, Royal College of Anaesthetists, London, UK
| | - J K Dhesi
- 1Perioperative Medicine for Older People Undergoing Surgery (POPS), Older Persons Assessment Unit, Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London, SE1 9RT UK.,9Division of Primary Care and Public Health Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
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