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McKeon M, McCoy N, Johnson C, Allen J, Altaye M, Amin M, Bayan S, Belafsky P, DeSilva B, Dion G, Ekbom D, Friedman A, Fritz M, Giliberto JP, Guardiani E, Kasperbauer J, Kim B, Krekeler BN, Kuhn M, Kwak P, Ma Y, Madden LL, Matrka L, Mayerhoff R, Piraka C, Rosen CA, Tabangin M, Wahab S, Wilson K, Wright C, Young VN, Postma G, Howell RJ. Postoperative Care of Zenker Diverticula: Contemporary Perspective from the Prospective OUtcomes Cricopharyngeaus Hypertonicity (POUCH) Collaborative. Laryngoscope 2024; 134:2678-2683. [PMID: 38146791 DOI: 10.1002/lary.31226] [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: 04/21/2023] [Revised: 11/02/2023] [Accepted: 11/27/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVES The aim of the study was to identify trends in postoperative management of persons undergoing surgery for Zenker diverticula (ZD) by evaluating length of stay (LOS), diet on discharge, and imaging with or without surgical complication. METHODS Prospectively enrolled adult patients with cricopharyngeal muscle dysfunction with diverticula undergoing surgery from August 1, 2017 to February 1, 2023 were included. Data were extracted from a multi-institutional REDCap database, summarizing means, medians, percentages, and frequencies. Fisher's exact or chi squared analyses were utilized, as appropriate, to compare subsets of data. Descriptive analysis assessed differences in clinical course and the relationship to postoperative management. RESULTS There were 298 patients with a mean (standard deviation) age of 71.8 (11.2) years and 60% male. Endoscopic surgery was performed in 79.5% (237/298) of patients versus 20.5% (61/298) open surgery. Sixty patients (20.1%) received postoperative imaging, with four leaks identified. Complications were identified in 9.4% of cases (n = 29 complications in 28 patients), more commonly in open surgery. Most (81.2%) patients were discharged within 23 h. About half of patients (49%) were discharged from the hospital on a pureed/liquid diet; 36% had been advanced to a soft diet. In patients without complications, LOS was significantly longer following open cases (p = 0.002); postoperative diet was not different between open and endoscopic (p = 0.26). CONCLUSIONS Overall, most patients are discharged within 23 h without imaging. However, LOS was affected by surgical approach. Postoperative complications are different in endoscopic versus open surgery. Complications with either approach were associated with prolonged LOS, need for imaging, and diet restriction. LEVEL OF EVIDENCE Level III Laryngoscope, 134:2678-2683, 2024.
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Affiliation(s)
- Mallory McKeon
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
| | - Nicole McCoy
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
| | - Christopher Johnson
- Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia at Augusta University Health, Augusta, Georgia, U.S.A
| | - Jacqui Allen
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Mekibib Altaye
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - Milan Amin
- Department of Otolaryngology-Head and Neck Surgery, New York University, New York, New York, U.S.A
| | - Semirra Bayan
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Peter Belafsky
- Department of Otolaryngology-Head and Neck Surgery, University of California - Davis, Davis, California, U.S.A
| | - Brad DeSilva
- Department of Otolaryngology-Head and Neck Surgery, Ohio State University, Columbus, Ohio, U.S.A
| | - Greg Dion
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
| | - Dale Ekbom
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Aaron Friedman
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
| | - Mark Fritz
- Department of Otolaryngology-Head and Neck Surgery, University of Kentucky, Lexington, Kentucky, U.S.A
| | - John Paul Giliberto
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A
| | - Elizabeth Guardiani
- Department of Otolaryngology-Head and Neck Surgery, University of Maryland, Baltimore, Maryland, U.S.A
| | - Jan Kasperbauer
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Brandon Kim
- Department of Otolaryngology-Head and Neck Surgery, Ohio State University, Columbus, Ohio, U.S.A
| | - Brittany N Krekeler
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
- Department of Communication Sciences and Disorders, College of Allied Health Sciences, University of Cincinnati, Cincinnati, Ohio, U.S.A
| | - Maggie Kuhn
- Department of Otolaryngology-Head and Neck Surgery, University of California - Davis, Davis, California, U.S.A
| | - Paul Kwak
- Department of Otolaryngology-Head and Neck Surgery, New York University, New York, New York, U.S.A
| | - Yue Ma
- Department of Otolaryngology-Head and Neck Surgery, University of California - San Francisco, San Francisco, California, U.S.A
| | - Lyndsay L Madden
- Department of Otolaryngology-Head and Neck Surgery, Wake Forest University, Winston-Salem, North Carolina, U.S.A
| | - Laura Matrka
- Department of Otolaryngology-Head and Neck Surgery, Ohio State University, Columbus, Ohio, U.S.A
| | - Ross Mayerhoff
- Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, U.S.A
| | - Cyrus Piraka
- Department of Gastroenterology/Hepatology, Henry Ford Health System, Detroit, Michigan, U.S.A
| | - Clark A Rosen
- Department of Otolaryngology-Head and Neck Surgery, University of California - San Francisco, San Francisco, California, U.S.A
| | - Meredith Tabangin
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - Shaun Wahab
- Department of Radiology, University of Cincinnati, Cincinnati, Ohio, U.S.A
| | - Keith Wilson
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
| | - Carter Wright
- Department of Otolaryngology-Head and Neck Surgery, Wake Forest University, Winston-Salem, North Carolina, U.S.A
| | - VyVy N Young
- Department of Otolaryngology-Head and Neck Surgery, University of California - San Francisco, San Francisco, California, U.S.A
| | - Gregory Postma
- Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia at Augusta University Health, Augusta, Georgia, U.S.A
| | - Rebecca J Howell
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
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Marshman C, Allen J, Ling D, Brand G. 'It's very values driven': A qualitative systematic review of the meaning of compassion according to healthcare professionals. J Clin Nurs 2024; 33:1647-1665. [PMID: 38240044 DOI: 10.1111/jocn.16998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/19/2023] [Accepted: 01/07/2024] [Indexed: 04/04/2024]
Abstract
AIMS AND OBJECTIVES To explore the meaning ascribed to the concept of compassion by healthcare professionals. BACKGROUND Compassion is universally regarded as the foundation of healthcare, a core value of healthcare organisations, and essential to the provision of quality care. Despite increasing research on compassion in healthcare, how healthcare professionals understand compassion remains unclear. DESIGN A systematic review of qualitative studies was conducted and is reported following PRISMA guidelines. METHOD Medline, Emcare, PsychINFO and CINAHL were searched to November 2021 for qualitative studies in English that explored healthcare professionals' understandings of compassion. Included studies were appraised for quality before data were extracted and thematically analysed. FINDINGS Seventeen papers met the inclusion criteria. An overarching theme, 'It's very values driven' underpins the four main themes identified: (1) 'It's about people and working with them': Compassion as being human, (2) 'There is this feeling': Compassion as being present, (3) 'If I don't understand them, I won't be able to help': Compassion as understanding, (4) 'Wanting to help in some way': Compassion as action. CONCLUSIONS Healthcare professional participants reported compassion as motivated by values and inherent to humanistic healthcare practice. The meanings healthcare professions described were varied and contextual. Qualitative research should further explore healthcare practitioners' experiences of compassion as part of their practice to inform health professions education, policy, and practice. RELEVANCE TO CLINICAL PRACTICE To practice with compassion, healthcare professionals require supportive and humanistic organisations that honour each person's humanity and encourage people to be human and compassionate to each other as well as to patients, their families and/or carers. Healthcare professionals need to reflect on what compassion means to them, how it is situated within their unique practice context, and how compassion can enhance clinical practice. NO PATIENT OR PUBLIC CONTRIBUTION This systematic review had no patient or public contribution.
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Affiliation(s)
- Cameron Marshman
- Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
- Peninsula Health, Frankston, Victoria, Australia
- The Australian College of Mental Health Nurses, Deakin, Australian Capital Territory, Australia
| | - Jacqui Allen
- Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Debbie Ling
- Department of Social Work, Monash University, Melbourne, Victoria, Australia
- Epworth HealthCare, Melbourne, Victoria, Australia
| | - Gabrielle Brand
- Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
- Monash Centre for Scholarship in Health Education (MCSHE), Monash University, Clayton, Victoria, Australia
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Rojo BL, Brown S, Barnes H, Allen J, Miles A. Home-based oral health program for adults with intellectual disabilities: An intervention study. Disabil Health J 2024; 17:101516. [PMID: 37648601 DOI: 10.1016/j.dhjo.2023.101516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Poor oral health is common in adults with intellectual disabilities leading to risk of mouth and lung infections. Yet, little is known about the benefits of preventative oral health programs. OBJECTIVE/HYPOTHESIS This prospective longitudinal experimental mixed methods study evaluated the efficacy of an oral health program aimed at improving knowledge and behaviours in adults with intellectual disabilities living in supported housing. METHODS A 90-min training session was provided to residents and their staff at 12 houses (56 residents; 67 staff). Follow-up training sessions (at 1 week, 1,2,3 months) were tailored to the learning abilities, behavioural/physical challenges, and independence of residents. Outcome measures were collected pre, 1, 2 and 3 months (n = 36): dental exam, plaque index, gingival signs, tongue coating index and behavioural rating scale. At 3 months, support workers (n = 10) and residents (n = 19) were interviewed. Residents' interviews were supported by Talking Mats®. RESULTS Most residents (94%) required support for oral cares; with 63% fully dependant on their support workers. 24 (63%) residents had significantly improved plaque scores at 3 months (p < .001). Resident interviews were restricted by communication competency but supported interviews indicated positive responses to 3-sided toothbrush 91%, interdental brush/flosser 60%, and mouthwash 100%. Support worker interviews revealed perceived health and social benefits including fresher breath and benefits of routines. CONCLUSIONS Oral health programs for adults with intellectual disabilities living in supported housing are well received by staff and residents, leading to changes in oral care routines and measurable changes in oral health.
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Affiliation(s)
| | - Sarah Brown
- Speech Science, The University of Auckland, New Zealand
| | | | - Jacqui Allen
- Surgery, The University of Auckland, New Zealand
| | - Anna Miles
- Speech Science, The University of Auckland, New Zealand.
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4
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Howell R, Johnson C, Allen J, Altaye M, Amin M, Bayan S, Belafsky P, Cervenka B, Desilva B, Dion GR, Ekbom D, Friedman A, Fritz M, Giliberto JP, Guardiani E, Kasperbauer J, Kim B, Krekeler BN, Kuhn M, Kwak P, Ma Y, Madden LL, Matrka L, Mayerhoff R, McKeon M, Piraka C, Rosen CA, Tabangin M, Wahab SA, Wilson K, Wright C, Young VN, Postma G. Surgical Outcomes in Zenker Diverticula: A Multicenter, Prospective, Longitudinal Study. Laryngoscope 2024; 134:97-102. [PMID: 37191092 DOI: 10.1002/lary.30753] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 03/10/2023] [Revised: 04/19/2023] [Accepted: 05/03/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To compare improvement in patient-reported outcomes (PROM) in persons undergoing endoscopic and open surgical management of Zenker diverticula (ZD). METHODOLOGY Prospective, multicenter cohort study of all individuals enrolled in the Prospective OUtcomes of Cricopharyngeus Hypertonicity (POUCH) Collaborative who underwent surgery for ZD. Patient survey, radiography reports, and the 10-item Eating Assessment Tool (EAT-10) pre- and post-procedure were abstracted from a REDCap database, which summarized means, medians, percentages, and frequencies of. Outcome based on operative intervention (endoscopic vs. open) was compared using t-test, Wilcoxon rank sum test or chi-square test, as appropriate. RESULTS One hundred and forty-seven persons were prospectively followed. The mean age (SD) of the cohort was 68.7 (11.0). Overall, 66% of patients reported 100% improvement in EAT-10; 81% of patients had greater than 75% improvement; and 88% had greater than 50% improvement. Endoscopic was used for n = 109 patients, and open surgical intervention was used for n = 38. The median [interquartile range, IQR] EAT-10 percent improvement for endoscopic treatment was 93.3% [72, 100], and open was 100% [92.3, 100] (p = 0.05). The incidence of intraoperative complications was 3.7% for endoscopic and 7.9% for open surgical management. The median [IQR] in follow-up was 86 and 97.5 days, respectively. CONCLUSION Both endoscopic and open surgical management of ZD provide significant improvement in patient-reported outcomes. The data suggest that open diverticulectomy may provide a modest advantage in symptomatic improvement compared to endoscopic management. The data suggest that the postoperative complication rate is higher in the open surgical group. LEVEL OF EVIDENCE 3 Laryngoscope, 134:97-102, 2024.
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Affiliation(s)
- Rebecca Howell
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
| | - Christopher Johnson
- Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia at Augusta University, Augusta, Georgia, U.S.A
| | - Jacqui Allen
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Mekibib Altaye
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - Milan Amin
- Department of Otolaryngology-Head and Neck Surgery, New York University Grossman School of Medicine, New York, New York, U.S.A
| | - Semirra Bayan
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Peter Belafsky
- Department of Otolaryngology-Head and Neck Surgery, University of California-Davis, Davis, California, U.S.A
| | - Brian Cervenka
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
| | - Brad Desilva
- Department of Otolaryngology-Head and Neck Surgery, Ohio State University, Columbus, Ohio, U.S.A
| | - Gregory R Dion
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
| | - Dale Ekbom
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Aaron Friedman
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
| | - Mark Fritz
- Department of Otolaryngology-Head and Neck Surgery, University of Kentucky, Lexington, Kentucky, U.S.A
| | - John Paul Giliberto
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A
| | - Elizabeth Guardiani
- Department of Otolaryngology-Head and Neck Surgery, University of Maryland, Baltimore, Maryland, U.S.A
| | - Jan Kasperbauer
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Brandon Kim
- Department of Otolaryngology-Head and Neck Surgery, Ohio State University, Columbus, Ohio, U.S.A
| | - Brittany N Krekeler
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
- Department of Communication Sciences and Disorders, University of Cincinnati College of Allied Health Sciences, Cincinnati, Ohio, U.S.A
| | - Maggie Kuhn
- Department of Otolaryngology-Head and Neck Surgery, University of California-Davis, Davis, California, U.S.A
| | - Paul Kwak
- Department of Otolaryngology-Head and Neck Surgery, New York University Grossman School of Medicine, New York, New York, U.S.A
| | - Yue Ma
- Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, U.S.A
| | - Lyndsay L Madden
- Department of Otolaryngology-Head and Neck Surgery, Wake Forest University, Winston-Salem, North Carolina, U.S.A
| | - Laura Matrka
- Department of Otolaryngology-Head and Neck Surgery, Ohio State University, Columbus, Ohio, U.S.A
| | - Ross Mayerhoff
- Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, U.S.A
| | - Mallory McKeon
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
| | - Cyrus Piraka
- Department of Gastroenterology/Hepatology, Henry Ford Health System, Detroit, Michigan, U.S.A
| | - Clark A Rosen
- Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, U.S.A
| | - Meredith Tabangin
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - Shaun A Wahab
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
| | - Keith Wilson
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
| | - Carter Wright
- Department of Otolaryngology-Head and Neck Surgery, Wake Forest University, Winston-Salem, North Carolina, U.S.A
| | - VyVy N Young
- Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, U.S.A
| | - Gregory Postma
- Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia at Augusta University, Augusta, Georgia, U.S.A
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Vega DM, Yee LM, McShane LM, Williams PM, Chen L, Vilimas T, Fabrizio D, Funari V, Newberg J, Bruce LK, Chen SJ, Baden J, Carl Barrett J, Beer P, Butler M, Cheng JH, Conroy J, Cyanam D, Eyring K, Garcia E, Green G, Gregersen VR, Hellmann MD, Keefer LA, Lasiter L, Lazar AJ, Li MC, MacConaill LE, Meier K, Mellert H, Pabla S, Pallavajjalla A, Pestano G, Salgado R, Samara R, Sokol ES, Stafford P, Budczies J, Stenzinger A, Tom W, Valkenburg KC, Wang XZ, Weigman V, Xie M, Xie Q, Zehir A, Zhao C, Zhao Y, Stewart MD, Allen J. Erratum to "Aligning tumor mutational burden (TMB) quantification across diagnostic platforms: phase II of the Friends of Cancer Research TMB Harmonization Project": [Annals of Oncology 32 (2021) 1626-1636]. Ann Oncol 2024; 35:145. [PMID: 37558578 DOI: 10.1016/j.annonc.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Affiliation(s)
- D M Vega
- Friends of Cancer Research, Washington
| | - L M Yee
- National Cancer Institute, Bethesda
| | | | - P M Williams
- Molecular Characterization Laboratory, Frederick National Lab for Cancer Research, Leidos Biomedical Research Inc., Frederick
| | - L Chen
- Molecular Characterization Laboratory, Frederick National Lab for Cancer Research, Leidos Biomedical Research Inc., Frederick
| | - T Vilimas
- Molecular Characterization Laboratory, Frederick National Lab for Cancer Research, Leidos Biomedical Research Inc., Frederick
| | | | - V Funari
- NeoGenomics Laboratories, Aliso Viejo, USA
| | | | - L K Bruce
- NeoGenomics Laboratories, Aliso Viejo, USA
| | | | - J Baden
- Bristol Myers Squibb Co., Princeton
| | | | - P Beer
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - M Butler
- LGC Clinical Diagnostics, Gaithersburg
| | | | | | - D Cyanam
- Clinical Sequencing Division, Thermo Fisher Scientific, Ann Arbor
| | - K Eyring
- Intermountain Precision Genomics, St. George
| | - E Garcia
- Brigham and Women's Hospital, Boston, USA
| | - G Green
- Bristol Myers Squibb Co., Princeton
| | | | - M D Hellmann
- Memorial Sloan Kettering Cancer Center, New York
| | | | - L Lasiter
- Friends of Cancer Research, Washington
| | - A J Lazar
- The University of Texas MD Anderson Cancer Center, Houston
| | - M-C Li
- National Cancer Institute, Bethesda
| | | | - K Meier
- Illumina Inc, Clinical Genomics, San Diego
| | | | | | | | | | - R Salgado
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | | | | | - P Stafford
- Caris Life Sciences Inc, Phoenix, Arizona, USA
| | - J Budczies
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - A Stenzinger
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - W Tom
- Clinical Sequencing Division, Thermo Fisher Scientific, Ann Arbor
| | | | - X Z Wang
- EMD Serono Research and Development Institute, Inc., Billerica
| | | | - M Xie
- AstraZeneca Pharmaceuticals LP, Waltham, USA
| | - Q Xie
- General Dynamics Information Technology, Inc., Columbia, USA
| | - A Zehir
- Memorial Sloan Kettering Cancer Center, New York
| | - C Zhao
- Illumina Inc, Clinical Genomics, San Diego
| | - Y Zhao
- National Cancer Institute, Bethesda
| | | | - J Allen
- Friends of Cancer Research, Washington
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6
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Allen J. Spare a thought for swallowing. Curr Opin Otolaryngol Head Neck Surg 2023; 31:341-342. [PMID: 37916903 DOI: 10.1097/moo.0000000000000923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Affiliation(s)
- Jacqui Allen
- University of Auckland, Department of Surgery, New Zealand
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7
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Kerrison G, Miles A, Allen J, Heron M. Impact of Quantitative Videofluoroscopic Swallowing Measures on Clinical Interpretation and Recommendations by Speech-Language Pathologists. Dysphagia 2023; 38:1528-1536. [PMID: 37126110 PMCID: PMC10611843 DOI: 10.1007/s00455-023-10580-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 04/11/2023] [Indexed: 05/02/2023]
Abstract
Quantitative measures are available for adult videofluoroscopic swallow study (VFSS) analysis but are yet to be seen routinely in clinical practice. This study explores agreement between traditional observational analysis and quantitative analysis, and the impact of analytical approaches on subsequent diagnosis and recommendations. One hundred adults referred for VFSSs with swallowing concerns were administered a standardised VFSS protocol. All VFSSs were analysed using three approaches: (1) a traditional observational analysis typically used by treating speech-language pathologists (SLPs), (2) quantitative analysis by two independent raters, and (3) binary subjective analysis by 11 independent raters. Three metrics were focussed on; pharyngeal constriction (PC), hyoid displacement (Hmax) and pharyngoesophageal segment opening (PESmax). All raters were blinded to others' ratings. Treating SLPs using traditional observational analysis were provided with no instructions. Quantitative analysis used published Leonard and Kendall digital displacement measures. Binary subjective analysis involved rating each VFSS as normal versus impaired for the three metrics above. Treating SLPs using traditional observational analysis and quantitative analysis raters independently provided diagnostics and treatment plans. PC, Hmax and PESmax achieved fair agreement (Kappa = 0.33-0.36) between binary subjective analysis compared to substantial agreement (ICC = 0.77-0.94) for quantitative analysis. Reports of impairment were significantly lower in the traditional observational and binary subjective analyses compared with studies rated using the quantitative analysis (p < 0.05). Consequently, this resulted in significantly less rehabilitation recommendations when traditional observational analysis was used in comparison to the quantitative analysis. Quantitative measures to analyse VFSSs can be used in clinical practice producing increased inter-rater agreement and supporting more targeted rehabilitation recommendations than using a traditional observational VFSS analysis alone.
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Affiliation(s)
- Gwen Kerrison
- The University of Auckland - Waipapa Taumata Rau, 22 Symonds Street, Auckland, 1010, New Zealand
- Te Whatu Ora - Hauora a Toi Bay of Plenty, 829 Cameron Road, Tauranga, 3112, New Zealand
- Te Whatu Ora - Waikato, Pembroke Street, Hamilton, 3204, New Zealand
| | - Anna Miles
- School of Psychology, The University of Auckland- Waipapa Taumata Rau, Grafton Campus, Park Road, Private Bag 92019, Auckland, New Zealand.
| | - Jacqui Allen
- Auckland ENT Group, 242 Great South Road, Greenlane, Auckland, New Zealand
| | - Michael Heron
- Te Whatu Ora - Te Matau a Māui Hawkes Bay, Corner Omahu Road and McLeod Street, Private Bag 9014, Hastings, 4156, New Zealand
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8
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Howell R, Tang A, Allen J, Altaye M, Amin M, Bayan S, Belafsky P, Cervenka B, deSilva B, Dion G, Ekbom D, Friedman A, Fritz M, Giliberto JP, Guardiani E, Harmon J, Kasperbauer JL, Khosla S, Kim B, Kuhn M, Kwak P, Ma Y, Madden L, Matrka L, Mayerhoff R, Piraka C, Rosen C, Tabangin ME, Wahab SA, Wilson K, Wright SC, Young V, Yuen S, Postma GN. Killian Jamieson Diverticulum, the Great Mimicker: A Case Series and Contemporary Review. Laryngoscope 2023; 133:2110-2115. [PMID: 36453465 DOI: 10.1002/lary.30508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To assess barium esophagram (BAS) as a diagnostic marker for patients with Killian Jamieson diverticula (KJD). METHODS Prospective, multicenter cohort study of individuals enrolled in the Prospective OUtcomes of Cricopharyngeus Hypertonicity (POUCH) Collaborative. Patient demographics, comorbidities, radiographic imaging reports, laryngoscopy findings, patient-reported outcome measures (PROM), and operative reporting were abstracted from a REDCap database and summarized using means, medians, percentages, frequencies. Paired t-tests and Wilcoxon Signed Rank test were used to test pre- to post-operative differences in RSI, EAT-10, and VHI-10 scores. Diagnostic test evaluation including sensitivity, specificity, positive, and negative predictive value with 95% confidence intervals were calculated comparing BAS findings to operative report. RESULTS A total of 287 persons were enrolled; 13 (4%) patients were identified with confirmed KJD on operative reports. 100% underwent open transcervical excision. BAS has a 46.2% (95% confidence interval [CI]: 23.2, 70.9) sensitivity and 97.8% (95% CI: 95.3, 99.0) specificity in detecting a KJD and 50% (95% CI: 25.4, 74.6) positive predictive value but 97.4% (95%CI: 94.8, 98.7) negative predictive value. Preoperatively, patients reported mean (SD) RSI and EAT-10 of 19.4 (9) and 8.3 (7.5) accordingly. Postoperatively, patients reported mean (SD) RSI and EAT-10 as 5.4 (6.2) and 2.3 (3.3). Both changes in RSI and EAT-10 were statistically significant (p = 0.008, p = 0.03). CONCLUSION KJD are rare and represent <5% of hypopharyngeal diverticula undergoing surgical intervention. Open transcervical surgery significantly improves symptoms of dysphagia. BAS has high specificity but low sensitivity in detecting KJD. LEVEL OF EVIDENCE 4 Laryngoscope, 133:2110-2115, 2023.
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Affiliation(s)
- Rebecca Howell
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - Alice Tang
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jacqui Allen
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Mekibib Altaye
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Milan Amin
- Department of Otolaryngology-Head and Neck Surgery, New York University, New York, New York, USA
| | - Semirra Bayan
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Peter Belafsky
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Davis, California, USA
| | - Brian Cervenka
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - Brad deSilva
- Department of Otolaryngology-Head and Neck Surgery, Ohio State University, Columbus, Ohio, USA
| | - Greg Dion
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - Dale Ekbom
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Aaron Friedman
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - Mark Fritz
- Department of Otolaryngology-Head and Neck Surgery, University of Kentucky, Lexington, Kentucky, USA
| | - John Paul Giliberto
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
| | - Elizabeth Guardiani
- Department of Otolaryngology-Head and Neck Surgery, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Jeffrey Harmon
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jan L Kasperbauer
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Sid Khosla
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - Brandon Kim
- Department of Otolaryngology-Head and Neck Surgery, Ohio State University, Columbus, Ohio, USA
| | - Maggie Kuhn
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Davis, California, USA
| | - Paul Kwak
- Department of Otolaryngology-Head and Neck Surgery, New York University, New York, New York, USA
| | - Yue Ma
- Department of Otolaryngology-Head and Neck Surgery, University of California - San Francisco, San Francisco, California, USA
| | - Lyndsay Madden
- Department of Otolaryngology-Head and Neck Surgery, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Laura Matrka
- Department of Otolaryngology-Head and Neck Surgery, Ohio State University, Columbus, Ohio, USA
| | - Ross Mayerhoff
- Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, USA
| | - Cyrus Piraka
- Department of Gastroenterology/Hepatology, Henry Ford Health System, Detroit, Michigan, USA
| | - Clark Rosen
- Department of Otolaryngology-Head and Neck Surgery, University of California - San Francisco, San Francisco, California, USA
| | - Meredith E Tabangin
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Shaun A Wahab
- Department of Radiology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Keith Wilson
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - S Carter Wright
- Department of Otolaryngology-Head and Neck Surgery, Wake Forest University, Winston-Salem, North Carolina, USA
- Department of Otolaryngology-Head and Neck Surgery, University of Maryland, Baltimore, Maryland, USA
| | - Vyvy Young
- Department of Otolaryngology-Head and Neck Surgery, University of California - San Francisco, San Francisco, California, USA
| | - Sonia Yuen
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - Gregory N Postma
- Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia at Augusta University Health, Augusta, Georgia, USA
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Barlow A, Haroz EE, O’Keefe VM, Brockie T, Manson SM, Allen J, Wexler L, Buchwald D, Rasmus S, Goklish N, Ivanich J, Stifter M, Cwik M. New Collaborative Research on Suicide Prevention, Practice, and Policy With American Indian and Alaska Native Communities Holds Promise for All Peoples. Health Promot Pract 2023; 24:841-851. [PMID: 36863761 PMCID: PMC10474247 DOI: 10.1177/15248399221116630] [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] [Indexed: 03/04/2023]
Abstract
Youth suicide is increasing in the United States, with deaths among younger people of color driving this upward trend. For more than four decades, American Indian and Alaska Native (AIAN) communities have suffered disproportionate rates of youth suicide and years of productive life lost compared to other U.S. Races. The National Institute of Mental Health (NIMH) recently funded three regional Collaborative Hubs to carry out suicide prevention research, practice, and policy development with AIAN communities in Alaska and rural and urban areas of the Southwestern United States. The Hub partnerships are supporting a diverse array of tribally-driven studies, approaches, and policies with immediate value for increasing empirically driven public health strategies to address youth suicide. We discuss unique features of the cross-Hub work, including: (a) long-standing Community-Based Participatory Research processes that led to the Hubs' innovative designs and novel approaches to suicide prevention and evaluation, (b) comprehensive ecological theoretical approaches that contextualize individual risk and protective factors in multilevel social contexts; (c) unique task-shifting and systems of care approaches to increase reach and impact on youth suicide in low-resource settings; and (d) prioritization of strengths-based approaches. The work of the Collaborative Hubs for AIAN youth suicide prevention is generating specific and substantive implications for practice, policy, and research presented in this article at a time when youth suicide prevention is a dire national priority. Approaches also have relevance for historically marginalized communities worldwide.
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Affiliation(s)
- A. Barlow
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - E. E. Haroz
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - V. M. O’Keefe
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - T. Brockie
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - S. M. Manson
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - J. Allen
- University of Minnesota Medical School, Duluth, MN, USA
| | - L. Wexler
- University of Michigan, Ann Arbor, MI, USA
| | - D. Buchwald
- Washington State University, Spokane, WA, USA
| | - S. Rasmus
- University of Alaska Fairbanks, Fairbanks, AK, USA
| | - N. Goklish
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- White Mountain Apache Tribe, Whiteriver, AZ, USA
| | - J. Ivanich
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - M. Stifter
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - M. Cwik
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Allen J, Balasubramanian B, Donoghue AM, Upadhyaya I, Luo Y, Upadhyay A. Effect of trans-cinnamaldehyde nanoemulsion wash on chicken embryo development in fertilized eggs. Poult Sci 2023; 102:102812. [PMID: 37302329 PMCID: PMC10404770 DOI: 10.1016/j.psj.2023.102812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/21/2023] [Accepted: 05/23/2023] [Indexed: 06/13/2023] Open
Abstract
Cleanliness of eggs is critical in successful hatching egg operations. The objective of this study was to investigate the effect of trans-cinnamaldehyde nanoemulsion (TCNE) wash treatments, as a sanitation strategy, on embryonic development in fertilized eggs. Trans-cinnamaldehyde is a generally recognized as safe status phytochemical obtained from cinnamon bark. TCNE were prepared with emulsifiers Tween 80 (Tw.80) or gum Arabic and lecithin (GAL) by sonication. Day-old fertilized eggs were subjected to TCNE wash treatments at 34°C for 5 min, followed by 18 d of incubation at 37.7°C. Washing of fertilized eggs with TCNE-Tw.80 or GAL at 0.48% concentration did not significantly alter the egg weight at d 18 of incubation, as compared to baseline and control (P > 0.05). The egg weight loss (calculated as percentage) did not differ significantly between eggs subjected to nanoemulsion wash treatments and control eggs (P > 0.05). In case of embryo fertility and mortality, for baseline and control, ∼ 95% fertility rate was achieved, with combined early and midterm mortality at 16%. Likewise, TCNE-Tw.80 or TCNE-GAL resulted in 95% fertility (P > 0.05), with 11% and 17% combined early and midterm mortality, respectively. Furthermore, TCNE wash treatments did not differ significantly in yolk sac and embryo weight (as compared to control) and did not affect the length of the d 18 embryo (P > 0.05). Moreover, TCNE wash treatments did not alter tibia weight and length (P > 0.05). Results suggest that TCNE could potentially be used as a natural antimicrobial for fertilized egg sanitation. Further studies in industry settings are warranted.
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Affiliation(s)
- J Allen
- Department of Animal Science, University of Connecticut, Storrs, CT 06269, USA
| | - B Balasubramanian
- Department of Animal Science, University of Connecticut, Storrs, CT 06269, USA
| | - A M Donoghue
- USDA-ARS, Poultry Production and Product Safety Research, Fayetteville, AR 72701, USA
| | - I Upadhyaya
- Department of Extension, University of Connecticut, Storrs, CT 06269, USA
| | - Y Luo
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - A Upadhyay
- Department of Animal Science, University of Connecticut, Storrs, CT 06269, USA.
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Browne J, Chipps KA, Schmidt K, Schatz H, Ahn S, Pain SD, Montes F, Ong WJ, Greife U, Allen J, Bardayan DW, Blackmon JC, Blankstein D, Cha S, Chae KY, Febbraro M, Hall MR, Jones KL, Kontos A, Meisel Z, O'Malley PD, Schmitt KT, Smith K, Smith MS, Thompson P, Toomey R, Vostinar M, Walter D. First Direct Measurement Constraining the ^{34}Ar(α,p)^{37}K Reaction Cross Section for Mixed Hydrogen and Helium Burning in Accreting Neutron Stars. Phys Rev Lett 2023; 130:212701. [PMID: 37295108 DOI: 10.1103/physrevlett.130.212701] [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] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/19/2022] [Accepted: 05/02/2023] [Indexed: 06/12/2023]
Abstract
The rate of the final step in the astrophysical αp process, the ^{34}Ar(α,p)^{37}K reaction, suffers from large uncertainties due to a lack of experimental data, despite having a considerable impact on the observable light curves of x-ray bursts and the composition of the ashes of hydrogen and helium burning on accreting neutron stars. We present the first direct measurement constraining the ^{34}Ar(α,p)^{37}K reaction cross section, using the Jet Experiments in Nuclear Structure and Astrophysics gas jet target. The combined cross section for the ^{34}Ar,Cl(α,p)^{37}K,Ar reaction is found to agree well with Hauser-Feshbach predictions. The ^{34}Ar(α,2p)^{36}Ar cross section, which can be exclusively attributed to the ^{34}Ar beam component, also agrees to within the typical uncertainties quoted for statistical models. This indicates the applicability of the statistical model for predicting astrophysical (α,p) reaction rates in this part of the αp process, in contrast to earlier findings from indirect reaction studies indicating orders-of-magnitude discrepancies. This removes a significant uncertainty in models of hydrogen and helium burning on accreting neutron stars.
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Affiliation(s)
- J Browne
- Department of Physics and Astronomy and National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824
- Joint Institute for Nuclear Astrophysics (JINA-CEE), Michigan State University, East Lansing, Michigan 48824
| | - K A Chipps
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996
| | - Konrad Schmidt
- Department of Physics and Astronomy and National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824
- Joint Institute for Nuclear Astrophysics (JINA-CEE), Michigan State University, East Lansing, Michigan 48824
- Institute of Radiation Physics, Helmholtz-Zentrum Dresden-Rossendorf, Bautzner Landstrasse 400, 01328 Dresden, Germany
| | - H Schatz
- Department of Physics and Astronomy and National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824
- Joint Institute for Nuclear Astrophysics (JINA-CEE), Michigan State University, East Lansing, Michigan 48824
| | - S Ahn
- Department of Physics and Astronomy and National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824
- Joint Institute for Nuclear Astrophysics (JINA-CEE), Michigan State University, East Lansing, Michigan 48824
| | - S D Pain
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996
| | - F Montes
- Department of Physics and Astronomy and National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824
- Joint Institute for Nuclear Astrophysics (JINA-CEE), Michigan State University, East Lansing, Michigan 48824
| | - W J Ong
- Department of Physics and Astronomy and National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824
- Joint Institute for Nuclear Astrophysics (JINA-CEE), Michigan State University, East Lansing, Michigan 48824
| | - U Greife
- Physics Department, Colorado School of Mines, Golden, Colorado 80401
| | - J Allen
- Department of Physics and Astronomy, University of Notre Dame, Notre Dame, Indiana 46556
| | - D W Bardayan
- Joint Institute for Nuclear Astrophysics (JINA-CEE), Michigan State University, East Lansing, Michigan 48824
- Department of Physics and Astronomy, University of Notre Dame, Notre Dame, Indiana 46556
| | - J C Blackmon
- Department of Physics and Astronomy, Louisiana State University, Baton Rouge, Louisiana 70803
| | - D Blankstein
- Department of Physics and Astronomy, University of Notre Dame, Notre Dame, Indiana 46556
| | - S Cha
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - K Y Chae
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - M Febbraro
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831
| | - M R Hall
- Department of Physics and Astronomy, University of Notre Dame, Notre Dame, Indiana 46556
| | - K L Jones
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996
| | - A Kontos
- Department of Physics and Astronomy and National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824
- Joint Institute for Nuclear Astrophysics (JINA-CEE), Michigan State University, East Lansing, Michigan 48824
| | - Z Meisel
- Department of Physics and Astronomy and National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824
- Joint Institute for Nuclear Astrophysics (JINA-CEE), Michigan State University, East Lansing, Michigan 48824
| | - P D O'Malley
- Department of Physics and Astronomy, University of Notre Dame, Notre Dame, Indiana 46556
| | - K T Schmitt
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831
| | - K Smith
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996
| | - M S Smith
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831
| | - P Thompson
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996
| | - R Toomey
- Department of Physics and Astronomy, Rutgers University, Piscataway, New Jersey 08854
| | - M Vostinar
- Department of Physics and Astronomy, Rutgers University, Piscataway, New Jersey 08854
| | - D Walter
- Department of Physics and Astronomy, Rutgers University, Piscataway, New Jersey 08854
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Yamamoto H, Allen J, Wilson G, Akhter A, Zuzarte P, Simpson J, Keshavjee S, Yeung J. Generation of Personalized Donor-Specific Snv Maps from Cfdna in Ex Vivo Lung Perfusate Using Nanopore Sequencing. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1418] [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: 04/05/2023] Open
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Allen J, Balasubramanian B, Rankin K, Shah T, Donoghue AM, Upadhyaya I, Sartini B, Luo Y, Upadhyay A. Erratum to "Trans-cinnamaldehyde nanoemulsion wash inactivates Salmonella Enteritidis on shelled eggs without affecting egg color" [Poult. Sci. 102 (4) (2023) 102523. Poult Sci 2023; 102:102649. [PMID: 36935343 PMCID: PMC10102489 DOI: 10.1016/j.psj.2023.102649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
Affiliation(s)
- J Allen
- Department of Animal Science, University of Connecticut, Storrs, CT 06269, USA
| | - B Balasubramanian
- Department of Animal Science, University of Connecticut, Storrs, CT 06269, USA
| | - K Rankin
- Department of Animal Science, University of Connecticut, Storrs, CT 06269, USA
| | - T Shah
- Department of Animal Science, University of Connecticut, Storrs, CT 06269, USA
| | - A M Donoghue
- USDA-ARS, Poultry Production and Product Safety Research, Fayetteville, AR 72701, USA
| | - I Upadhyaya
- Department of Extension, University of Connecticut, Storrs, CT 06269, USA
| | - B Sartini
- Department of Fisheries, Animal & Veterinary Science, University of Rhode Island, Kingston, RI 02881, USA
| | - Y Luo
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - A Upadhyay
- Department of Animal Science, University of Connecticut, Storrs, CT 06269, USA.
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Allen J, Balasubramanian B, Rankin K, Shah T, Donoghue AM, Upadhyaya I, Sartini B, Luo Y, Upadhyay A. Trans-cinnamaldehyde nanoemulsion wash inactivates Salmonella Enteritidis on shelled eggs without affecting egg color. Poult Sci 2023; 102:102523. [PMID: 36796244 PMCID: PMC9958492 DOI: 10.1016/j.psj.2023.102523] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/14/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023] Open
Abstract
Salmonella Enteritidis is a major foodborne pathogen that causes enteric illnesses in humans, primarily through the consumption of contaminated poultry meat and eggs. Despite implementation of traditional disinfection approaches to reduce S. Enteritidis contamination, egg-borne outbreaks continue to occur, raising public health concerns and adversely affecting the popularity and profitability for the poultry industry. Generally Recognized as Safe (GRAS) status phytochemicals such as Trans-cinnamaldehyde (TC) have previously shown to exhibit anti-Salmonella efficacy, however, the low solubility of TC is a major hurdle in its adoption as an egg wash treatment. Therefore, the present study investigated the efficacy of Trans-cinnamaldehyde nanoemulsions (TCNE) prepared with emulsifiers Tween 80 (Tw.80) or Gum Arabic and lecithin (GAL) as dip treatments, at 34°C, for reducing S. Enteritidis on shelled eggs in presence or absence of 5% chicken litter. In addition, the efficacy of TCNE dip treatments in reducing trans-shell migration of S. Enteritidis across shell barrier was investigated. The effect of wash treatments on shell color were evaluated on d 0, 1, 7, and 14 of refrigerated storage. TCNE-Tw.80 or GAL treatments (0.06, 0.12, 0.24, 0.48%) were effective in inactivating S. Enteritidis by at least 2 to 2.5 log cfu/egg as early as 1 min of washing time (P < 0.05). In presence of organic matter, nanoemulsions (0.48%) reduced S. Enteritidis counts by ∼ 2 to 2.5 log cfu/egg as early as 1 min, (P < 0.05). Nanoemulsion wash also inhibited trans-shell migration of S. Enteritidis, as compared to control (P < 0.05). The nanoemulsion wash treatments did not affect shell color (P > 0.05). Results suggest that TCNE could potentially be used as an antimicrobial wash to reduce S. Enteritidis on shelled eggs, although further studies investigating the effect of TCNE wash treatments on organoleptic properties of eggs are necessary.
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Affiliation(s)
- J Allen
- University of Connecticut, Department of Animal Science, Storrs, CT 06269, USA
| | - B Balasubramanian
- University of Connecticut, Department of Animal Science, Storrs, CT 06269, USA
| | - K Rankin
- University of Connecticut, Department of Animal Science, Storrs, CT 06269, USA
| | - T Shah
- University of Connecticut, Department of Animal Science, Storrs, CT 06269, USA
| | - A M Donoghue
- USDA-ARS, Poultry Production and Product Safety Research, Fayetteville, AR 72701, USA
| | - I Upadhyaya
- University of Connecticut, Department of Extension, Storrs, CT 06269, USA
| | - B Sartini
- University of Rhode Island, Department of Fisheries, Animal & Veterinary Science, Kingston, RI 02881, USA
| | - Y Luo
- University of Connecticut, Department of Nutritional Sciences, Storrs, CT 06269, USA
| | - A Upadhyay
- University of Connecticut, Department of Animal Science, Storrs, CT 06269, USA.
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Leonard R, Miles A, Allen J. Bolus Clearance Ratio Elevated in Patients With Neurogenic Dysphagia Compared With Healthy Adults: A Measure of Pharyngeal Efficiency. Am J Speech Lang Pathol 2023; 32:107-114. [PMID: 36378903 DOI: 10.1044/2022_ajslp-22-00199] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE Postswallow pharyngeal residue is a risk factor for aspiration, implies swallowing inefficiency, and increases the work of eating. The Bolus Clearance Ratio (BCR) is a derived metric that relates quantities of bolus material observed in the pharynx at two different points: before and after a swallow. The ratio provides a percentage estimate of bolus clearance. In healthy adults, mean BCR is < .05; that is, less than 5% of an ingested bolus is retained in the pharynx. The aim of this study was to compare BCR measures from patients referred for videofluoroscopic swallow studies with concerns related to stroke (n = 100) or other neurological conditions (n = 131, including Parkinson's disease and dementia) with BCRs for 139 healthy adults across the age range. METHOD BCR for a 20 ml of thin liquid barium bolus was measured. Additional metrics included age, penetration-aspiration scale (PAS) score, and quantitative measures of timing and displacement. Correlations were explored between BCR and pharyngeal constriction ratio (PCR), pharyngoesophageal segment opening (PESmax), maximum hyoid displacement (HMax), and total pharyngeal transit time (TPT). RESULTS BCR values for patients with stroke (Mdn = 9%, interquartile range [IQR]: 19%, range: 0%-73%) and other neurological conditions (Mdn = 9%, IQR: 16%, range: 0%-96%) were significantly higher than in healthy norms (Mdn = 2%, IQR: 4%, range: 0%-16%, p < .001). BCR was significantly correlated with age (R s = .23, p < .01), TPT (R s = .20, p < .01), PCR (R s = .55, p < .01), PESmax (R s = -.17, p < .01), HMax (R s = -.16, p < .01), and PAS (R s = .38, p < .01). CONCLUSIONS BCR was elevated in patients with neurogenic dysphagia in comparison with healthy norms and was significantly associated with increased aspiration severity (i.e., PAS). BCR was also correlated with pharyngeal timing and displacement parameters, with the strongest correlation with pharyngeal constriction-a measure of pharyngeal strength. The BCR offers clinicians a simple, quantitative measure of bolus residue and, therefore, pharyngeal efficiency and may be used to assess change in patients over time and with treatment.
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Affiliation(s)
| | - Anna Miles
- Speech Science, School of Psychology, The University of Auckland, New Zealand
| | - Jacqui Allen
- Speech Science, School of Psychology, The University of Auckland, New Zealand
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Maoz A, Allen J, Vaccaro K, Velarde J, Weiskopf K. 189P IL-10 enhances macrophage phagocytosis of cancer cells in response to CD47 blockade and opsonizing antibodies. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Kußmaul C, Schaffrath Rosario A, Allen J, Lange M, Koschollek C, Haller S, Schlaud M. Waning of SARS-CoV-2 IgG antibodies after vaccination: first results from the CoMoLo follow-up 2021. Eur J Public Health 2022. [PMCID: PMC9593459 DOI: 10.1093/eurpub/ckac129.048] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background In 2020, the study “Corona-Monitoring Lokal” (CoMoLo) assessed seroprevalences of SARS-CoV-2 IgG antibodies in four study locations that were particularly affected by outbreaks in the early stages of the pandemic in Germany. One of the objectives of the 2021 follow-up was to examine the development of immunological parameters over time, including the extent of IgG antibody waning after vaccination. Methods Venous blood specimens were collected from a sample of initial study participants over a 2-week period between May and October 2021, with an oversampling of seropositive or previously infected individuals. Levels of IgG antibodies to the SARS-CoV-2 spike protein were measured from serum using Anti-SARS-CoV-2-QuantiVac-ELISA (IgG) tests by Euroimmun. Information on SARS-CoV-2 vaccinations or known infections was collected via online questionnaires or telephone interviews. Results A total of 3328 participants (74% response) gave blood specimens for this follow-up study, with questionnaire information available for 2843 (85%) of these. Preliminary analyses suggest that in participants who had received two doses of a vaccine more than 3 weeks before giving blood (n = 1583), IgG levels decreased exponentially by about 9.8% (95%CI 9.1% - 10.4%) with each additional week since the last dose, when controlling for age, sex, and type of vaccine. There was evidence of this waning effect differing by vaccine type. Antibody levels also appear to decline with increasing age, according to preliminary results. Final results of the linear model used to assess the dynamics and predictive factors of antibody levels will be reported. Conclusions This follow-up study will add evidence to an improved understanding of antibody waning after SARS-CoV-2 vaccination. Preliminary results are in line with international studies and may be helpful for discussions on potential benefits of further vaccinations in Germany. Key messages • Antibodies induced by COVID-19 vaccination wane over time. The magnitude of this effect differs by vaccine type. Antibodies also decreased with increasing age. • Our results may be helpful for discussions on potential benefits of further COVID-19 vaccinations in Germany.
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Affiliation(s)
- C Kußmaul
- Department of Epidemiology and Health Monitoring, Robert Koch Institute , Berlin, Germany
| | - A Schaffrath Rosario
- Department of Epidemiology and Health Monitoring, Robert Koch Institute , Berlin, Germany
| | - J Allen
- Department of Epidemiology and Health Monitoring, Robert Koch Institute , Berlin, Germany
| | - M Lange
- Department of Epidemiology and Health Monitoring, Robert Koch Institute , Berlin, Germany
| | - C Koschollek
- Department of Epidemiology and Health Monitoring, Robert Koch Institute , Berlin, Germany
| | - S Haller
- Department of Infectious Disease Epidemiology, Robert Koch Institute , Berlin, Germany
| | - M Schlaud
- Department of Epidemiology and Health Monitoring, Robert Koch Institute , Berlin, Germany
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18
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Instone A, Stielke A, Allen J, Cotter-Roberts A, Bainham B, Couzens L, Beynon C, Dyakova M, Green L. International Horizon Scanning the impact of Covid-19 on increasing the health gap and vulnerability. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.005] [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
The COVID-19 pandemic has caused unprecedented challenges for populations, health systems and governments worldwide, which have resulted in lasting economic, social and health impacts. The results of such have been felt disproportionately throughout society and existing vulnerabilities have been highlighted and heightened. A clear understanding of the extent of these vulnerabilities is needed in order to fully address the problem. The World Health Organization Collaborating Centre on Investment for Health and Well-being (WHOCC), Public Health Wales has developed a summary report focusing on the existing and emerging inequalities resulting from the pandemic, as identified through international evidence and learning from the International Horizon Scanning Reports. These reports, undertaken between May 2020 - August 2021, are based upon rapid evidence synthesis reviews of international literature. The summary report focuses on global learning and best practices in order to better understand and address the unequal impacts of the pandemic. The information has been categorised according to the five essential conditions required to enable a healthy life as presented within the WHO health equity conditions framework. The report provides evidence on groups most vulnerable to both direct and indirect impacts of the pandemic as well as promising practice to address the resulting inequity. Inequalities and related factors explored within the report include but are not limited to, level of deprivation and education. Taking a global perspective, this report summarises international evidence to support inclusive, sustainable, and equitable solutions, such as protecting economic well-being and taking an intergenerational lens in both response and recovery. To address and mitigate the impact of the pandemic upon vulnerable groups, collating and sharing international evidence and best practice has proven to support equitable long-term socio-economic and environmental recovery.
Key messages
• International learning provides vital insights to support recovery in Wales and beyond.
• Responses to the pandemic should address the needs of the vulnerable to reduce existing health gaps.
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Affiliation(s)
- A Instone
- WHO Collaborating Center on Investment for Health and Well-being, Public Health Wales , Cardiff, UK
| | - A Stielke
- WHO Collaborating Center on Investment for Health and Well-being, Public Health Wales , Cardiff, UK
| | - J Allen
- WHO Collaborating Center on Investment for Health and Well-being, Public Health Wales , Cardiff, UK
| | - A Cotter-Roberts
- WHO Collaborating Center on Investment for Health and Well-being, Public Health Wales , Cardiff, UK
| | - B Bainham
- WHO Collaborating Center on Investment for Health and Well-being, Public Health Wales , Cardiff, UK
- Health Improvement, Public Health Wales , Cardiff, UK
| | - L Couzens
- WHO Collaborating Center on Investment for Health and Well-being, Public Health Wales , Cardiff, UK
| | - C Beynon
- WHO Collaborating Center on Investment for Health and Well-being, Public Health Wales , Cardiff, UK
| | - M Dyakova
- WHO Collaborating Center on Investment for Health and Well-being, Public Health Wales , Cardiff, UK
| | - L Green
- WHO Collaborating Center on Investment for Health and Well-being, Public Health Wales , Cardiff, UK
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19
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Tschorn M, Neuperdt L, Blume M, Flerlage N, Allen J, Loss J. Von welchen Eindämmungsmaßnahmen in der
SARS-CoV-2-Pandemie sind Kinder und Jugendlichen betroffen? – Ergebnisse
der KIDA-Studie des Robert Koch-Instituts. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753980] [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: 12/12/2022]
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20
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Tschorn M, Loss J, Allen J, Blume M, Scheidt-Nave C, Thamm R, Poethko-Müller C, Neuperdt L, Hölling H, Mauz E, Waldhauer J, Mueters S, Hövener C, Flerlage N, Krug S. Wie steht es um die Gesundheit von Kindern und Jugendlichen in der
SARS-CoV-2-Pandemie im Jahr 2022? – Ergebnisse der KIDA-Studie des
Robert Koch-Instituts. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753975] [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: 12/12/2022]
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21
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Corcoran R, Tian J, Chen J, Chao S, Pelka K, Baiev I, Sindurakar P, Allen J, Meyerhardt J, Enzinger A, Enzinger P, McCleary N, Klempner S, Yurgelun M, Abrams T, Clark J, Ryan D, Giannakis M, Parikh A, Hacohen N. SO-38 Clinical efficacy and single-cell analysis of combined BRAF, MEK, and PD-1 inhibition in BRAFV600E colorectal cancer patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.436] [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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22
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Miles A, Dharmarathna I, Fuller L, Jardine M, Allen J. Developing a Protocol for Quantitative Analysis of Liquid Swallowing in Children. Am J Speech Lang Pathol 2022; 31:1244-1263. [PMID: 35302872 DOI: 10.1044/2021_ajslp-20-00337] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Objective measures in videofluoroscopic swallow studies (VFSSs) can quantify swallow biomechanics. There are a wide array of validated measures studied in infants, children, and adults. There is a need for a pediatric VFSS protocol that consists of a small number of vital, time efficient, and clinically relevant measures. In this study, we aimed to establish a standard protocol for quantitative VFSS analysis in children. METHOD Protocol development began with a systematic literature review, which identified 22 quantitative and eight descriptive measures available in the literature. A pediatric VFSS database of 553 children was collected using a standardized VFSS protocol. Studies were evaluated using the 30 previously reported measures covering displacement and timing parameters as well as penetration-aspiration and residue. Measures were tested for rater reliability and internal consistency. Measures meeting acceptable values for protocol inclusion were included in the final protocol (Cronbach's alpha > .53). RESULTS Interrater and intrarater reliability of 17 measures met acceptable reliability levels. During internal consistency testing, we removed six further measures based on Cronbach's alpha levels indicating that two or more measures were equivalent in measuring the same aspect of swallow biomechanics in children. A VFSS protocol of reliable, valid, and obtainable objective quantitative (n = 6) and descriptive measures (n = 3) with separate protocols for young infants (≤ 9 months) and older children was established. CONCLUSIONS A standardized quantitative VFSS protocol for children has been developed to suit two age groups (≤ 9 and > 9 months old). Consistent VFSS administration and reporting support assessment over time and across disease groups. Future research should focus on how this information can be used by clinicians to produce individualized treatment plans for children with swallowing impairment.
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Affiliation(s)
- Anna Miles
- Speech Science, School of Psychology, Faculty of Science, The University of Auckland, New Zealand
| | - Isuru Dharmarathna
- Speech Science, School of Psychology, Faculty of Science, The University of Auckland, New Zealand
- Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Colombo, Sri Lanka
| | - Laura Fuller
- Speech Science, School of Psychology, Faculty of Science, The University of Auckland, New Zealand
| | - Marie Jardine
- Speech Science, School of Psychology, Faculty of Science, The University of Auckland, New Zealand
| | - Jacqui Allen
- Department of Surgery, The University of Auckland, New Zealand
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23
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Pai V, Talukder S, Martinez L, Kydd A, Bhagra S, Lewis C, Parameshwar J, Messer S, Osman M, Virdi A, Cacciottolo P, Kaul P, Rafiq M, Allen J, Large S, Tsui S, Jenkins D, Pettit S, Berman M. Outcomes of Mechanical Circulatory Support for Severe Primary Graft Dysfunction After DBD versus DCD Heart Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.109] [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] Open
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24
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Yamamoto H, Sage A, Wilson G, Allen J, Anwar Z, Keshavjee S, Yeung J. cfDNA Levels in Ex Vivo Lung Perfusate Are Associated with the Prognosis of Donor Lungs. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.026] [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] Open
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25
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Berra G, Allen J, Duong A, Levy L, Kawashima M, Renaud-Picard B, Ghany R, McInnis M, Keshavjee S, Yeung J, Juvet S, Martinu T. Transcriptional Landscape of Chronic Lung Allograft Rejection in Humans. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1592] [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] Open
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26
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Narayan S, Pietrusz A, Allen J, Docherty K, Emery N, Ennis M, Flesher R, Foo W, Freebody J, Gallagher E, Grose N, Harris D, Hewamadduma C, Holmes S, James M, Maidment L, Mayhew A, Moat D, Moorcroft N, Muni-Lofra R, Nevin K, Quinlivan R, Sodhi J, Stuart D, White N, Yvonne J. Adult North Star Network (ANSN): Consensus Document for Therapists Working with Adults with Duchenne Muscular Dystrophy (DMD) - Therapy Guidelines. J Neuromuscul Dis 2022; 9:365-381. [PMID: 35124658 DOI: 10.3233/jnd-210707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- S Narayan
- University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - A Pietrusz
- UCL Queen Square Institute of Neurology, MRC Centre for Neuromuscular Diseases, UK
| | - J Allen
- Neuromuscular Complex Care Centre (NMCCC), National Hospital for Neurology and Neurosurgery, UK
| | - K Docherty
- University Hospitals Dorset NHS Foundation Trust, UK
| | - N Emery
- The Robert Jones and Agnes Hunt Orthopaedic Hospital, UK
| | - M Ennis
- The Walton Centre NHS Foundation Trust, UK
| | - R Flesher
- The Walton Centre NHS Foundation Trust, UK
| | - W Foo
- Manchester University NHS Foundation Trust, UK
| | - J Freebody
- John Radcliffe Hospital -OxfordUniversity Hospitals NHS Foundation Trust, UK
| | | | - N Grose
- North Bristol NHS Foundation Trust, The South West Neuromuscular Operational Delivery Network (SWNODN), UK
| | - D Harris
- West Midlands Rehabilitation Centre, Birmingham Community Healthcare NHS Foundation Trust, UK
| | - C Hewamadduma
- Sheffield Teaching Hospitals NHS Foundation Trust, UK.,Sheffield Institute for Translational Neurosciences (SITRAN), University of Sheffield, UK
| | - S Holmes
- MRC Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, UK
| | - M James
- The John Walton Muscular Dystrophy Research Centre, Newcastle, UK
| | - L Maidment
- Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - A Mayhew
- The John Walton Muscular Dystrophy Research Centre, Newcastle, UK
| | - D Moat
- The John Walton Muscular Dystrophy Research Centre, Newcastle, UK
| | - N Moorcroft
- West Midlands Rehabilitation Centre, Birmingham Community Healthcare NHS Foundation Trust, UK
| | - R Muni-Lofra
- The John Walton Muscular Dystrophy Research Centre, Newcastle, UK
| | - K Nevin
- Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - R Quinlivan
- UCL Queen Square Institute of Neurology, MRC Centre for Neuromuscular Diseases, UK
| | - J Sodhi
- The John Walton Muscular Dystrophy Research Centre, Newcastle, UK
| | | | - N White
- The Robert Jones and Agnes Hunt Orthopaedic Hospital, UK
| | - J Yvonne
- University Hospitals of Leicester Emergency and Specialist Medicine, UK
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27
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WANG Y, Lim C, Allen J, Chan C, Kwek J, Coffman T, Bee Y, Jafar T. POS-317 GENDER DISPARITIES BY AGE AND KIDNEY FUNCTION ON RISKS OF ALL-CAUSE MORTALITY AND CARDIOVASCULAR MORTALITY AMONG PATIENTS WITH TYPE 2 DIABETES. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.337] [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: 10/19/2022] Open
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28
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Fuller L, Miles A, Dharmarathna I, Allen J. Variability in Swallowing Biomechanics in Infants with Feeding Difficulties: A Videofluoroscopic Analysis. Dysphagia 2022; 37:1740-1747. [PMID: 35298686 PMCID: PMC9643272 DOI: 10.1007/s00455-022-10436-2] [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: 07/05/2021] [Accepted: 03/04/2022] [Indexed: 12/16/2022]
Abstract
Clinicians performing feeding evaluations in infants often report swallow variability or inconsistency as concerning. However, little is known about whether this represents pathological incoordination or normal physiologic variance in a developing child. Our retrospective study explored quantitative videofluoroscopic measures in 50 bottle-fed infants (0-9 months) referred with feeding concerns. Our research questions were as follows: Is it possible to assess swallow to swallow variability in an infant with feeding concerns, is there variability in pharyngeal timing and displacement in infants referred for videofluoroscopy, and is variability associated with aspiration risk? Measures were taken from a mid-feed, 20-s loop recorded at 30 frames per second. Each swallow within the 20-s loop (n = 349 swallows) was analysed using quantitative digital measures of timing, displacement and coordination (Swallowtail™). Two blinded raters measured all swallows with strong inter-rater reliability (ICC .78). Swallow frequency, suck-swallow ratio, residue and aspiration were also rated. Variability in timing and displacement was identified across all infants but did not correlate with aspiration (p > .05). Sixteen infants (32%) aspirated. Across the cohort, swallow frequency varied from 1 to 15 within the 20-s loops; suck-swallow ratios varied from 1:1 to 6:1. Within-infant variability in suck-swallow ratios was associated with higher penetration-aspiration scores (p < .001). In conclusion, pharyngeal timing and displacement variability is present in infants referred with feeding difficulties but does not correlate with aspiration. Suck-swallow ratio variability, however, is an important risk factor for aspiration that can be observed at bedside without radiation. These objective measures provide insight into infant swallowing biomechanics and deserve further exploration for their clinical applicability.
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Affiliation(s)
- Laura Fuller
- Speech Science, School of Psychology, The University of Auckland, Grafton Campus, Private Bag 92019, Auckland, New Zealand ,Counties Manukau District Health Board, Auckland, New Zealand
| | - Anna Miles
- Speech Science, School of Psychology, The University of Auckland, Grafton Campus, Private Bag 92019, Auckland, New Zealand
| | - Isuru Dharmarathna
- Speech Science, School of Psychology, The University of Auckland, Grafton Campus, Private Bag 92019, Auckland, New Zealand
| | - Jacqui Allen
- Speech Science, School of Psychology, The University of Auckland, Grafton Campus, Private Bag 92019, Auckland, New Zealand
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29
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Vega DM, Yee LM, McShane LM, Williams PM, Chen L, Vilimas T, Fabrizio D, Funari V, Newberg J, Bruce LK, Chen SJ, Baden J, Carl Barrett J, Beer P, Butler M, Cheng JH, Conroy J, Cyanam D, Eyring K, Garcia E, Green G, Gregersen VR, Hellmann MD, Keefer LA, Lasiter L, Lazar AJ, Li MC, MacConaill LE, Meier K, Mellert H, Pabla S, Pallavajjalla A, Pestano G, Salgado R, Samara R, Sokol ES, Stafford P, Budczies J, Stenzinger A, Tom W, Valkenburg KC, Wang XZ, Weigman V, Xie M, Xie Q, Zehir A, Zhao C, Zhao Y, Stewart MD, Allen J. Aligning tumor mutational burden (TMB) quantification across diagnostic platforms: phase II of the Friends of Cancer Research TMB Harmonization Project. Ann Oncol 2021; 32:1626-1636. [PMID: 34606929 DOI: 10.1016/j.annonc.2021.09.016] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 09/21/2021] [Accepted: 09/26/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Tumor mutational burden (TMB) measurements aid in identifying patients who are likely to benefit from immunotherapy; however, there is empirical variability across panel assays and factors contributing to this variability have not been comprehensively investigated. Identifying sources of variability can help facilitate comparability across different panel assays, which may aid in broader adoption of panel assays and development of clinical applications. MATERIALS AND METHODS Twenty-nine tumor samples and 10 human-derived cell lines were processed and distributed to 16 laboratories; each used their own bioinformatics pipelines to calculate TMB and compare to whole exome results. Additionally, theoretical positive percent agreement (PPA) and negative percent agreement (NPA) of TMB were estimated. The impact of filtering pathogenic and germline variants on TMB estimates was assessed. Calibration curves specific to each panel assay were developed to facilitate translation of panel TMB values to whole exome sequencing (WES) TMB values. RESULTS Panel sizes >667 Kb are necessary to maintain adequate PPA and NPA for calling TMB high versus TMB low across the range of cut-offs used in practice. Failure to filter out pathogenic variants when estimating panel TMB resulted in overestimating TMB relative to WES for all assays. Filtering out potential germline variants at >0% population minor allele frequency resulted in the strongest correlation to WES TMB. Application of a calibration approach derived from The Cancer Genome Atlas data, tailored to each panel assay, reduced the spread of panel TMB values around the WES TMB as reflected in lower root mean squared error (RMSE) for 26/29 (90%) of the clinical samples. CONCLUSIONS Estimation of TMB varies across different panels, with panel size, gene content, and bioinformatics pipelines contributing to empirical variability. Statistical calibration can achieve more consistent results across panels and allows for comparison of TMB values across various panel assays. To promote reproducibility and comparability across assays, a software tool was developed and made publicly available.
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Affiliation(s)
- D M Vega
- Friends of Cancer Research, Washington, USA
| | - L M Yee
- National Cancer Institute, Bethesda, USA
| | | | - P M Williams
- Molecular Characterization Laboratory, Frederick National Lab for Cancer Research, Leidos Biomedical Research Inc., Frederick, USA
| | - L Chen
- Molecular Characterization Laboratory, Frederick National Lab for Cancer Research, Leidos Biomedical Research Inc., Frederick, USA
| | - T Vilimas
- Molecular Characterization Laboratory, Frederick National Lab for Cancer Research, Leidos Biomedical Research Inc., Frederick, USA
| | - D Fabrizio
- Foundation Medicine Inc., Cambridge, USA
| | - V Funari
- NeoGenomics Laboratories, Aliso Viejo, USA
| | - J Newberg
- Foundation Medicine Inc., Cambridge, USA
| | - L K Bruce
- NeoGenomics Laboratories, Aliso Viejo, USA
| | | | - J Baden
- Bristol Myers Squibb Co., Princeton, USA
| | | | - P Beer
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - M Butler
- LGC Clinical Diagnostics, Gaithersburg, USA
| | | | | | - D Cyanam
- Clinical Sequencing Division, Thermo Fisher Scientific, Ann Arbor, USA
| | - K Eyring
- Intermountain Precision Genomics, St. George, USA
| | - E Garcia
- Brigham and Women's Hospital, Boston, USA
| | - G Green
- Bristol Myers Squibb Co., Princeton, USA
| | | | - M D Hellmann
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - L A Keefer
- Personal Genome Diagnostics, Baltimore, USA
| | - L Lasiter
- Friends of Cancer Research, Washington, USA
| | - A J Lazar
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - M-C Li
- National Cancer Institute, Bethesda, USA
| | | | - K Meier
- Illumina Inc, Clinical Genomics, San Diego, USA
| | | | | | | | | | - R Salgado
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | | | - E S Sokol
- Foundation Medicine Inc., Cambridge, USA
| | | | - J Budczies
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - A Stenzinger
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - W Tom
- Clinical Sequencing Division, Thermo Fisher Scientific, Ann Arbor, USA
| | | | - X Z Wang
- EMD Serono Research and Development Institute, Inc., Billerica, USA
| | | | - M Xie
- AstraZeneca Pharmaceuticals LP, Waltham, USA
| | - Q Xie
- General Dynamics Information Technology, Inc., Columbia, USA
| | - A Zehir
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - C Zhao
- Illumina Inc, Clinical Genomics, San Diego, USA
| | - Y Zhao
- National Cancer Institute, Bethesda, USA
| | - M D Stewart
- Friends of Cancer Research, Washington, USA.
| | - J Allen
- Friends of Cancer Research, Washington, USA
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30
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Haroz E, Wexler L, Manson S, Cwik M, O’Keefe V, Allen J, Rasmus S, Buchwald D, Barlow A. Sustaining suicide prevention programs in American Indian and Alaska Native communities and Tribal health centers. Implementation Research and Practice 2021; 2. [PMID: 35821881 PMCID: PMC9273109 DOI: 10.1177/26334895211057042] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Research on sustaining community-based interventions is limited. This is particularly true for suicide prevention programs and in American Indian and Alaska Native (AIAN) settings. Aiming to inform research in this area, this paper sought to identify factors and strategies that are key to sustain suicide prevention efforts in AIAN communities. Methods: We used a modified Nominal Group Technique with a purposeful sample of N = 35 suicide prevention research experts, program implementors and AIAN community leaders to develop a list of prioritized factors and sustainability strategies. We then compared this list with the Public Health Program Capacity for Sustainability Framework (PHPCSF) to examine the extent the factors identified aligned with the existing literature. Results: Major factors identified included cultural fit of intervention approaches, buy in from local communities, importance of leadership and policy making, and demonstrated program success. Strategies to promote these factors included partnership building, continuous growth of leadership, policy development, and ongoing strategic planning and advocacy. All domains of the PHPCF were representative, but additional factors and strategies were identified that emerged as important in AIAN settings. Conclusions: Sustaining effective and culturally informed suicide prevention efforts is of paramount importance to prevent suicide and save lives. Future research will focus on generating empirical evidence of these strategies and their effectiveness at promoting program sustainability in AIAN communities.
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Affiliation(s)
- E.E. Haroz
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - L. Wexler
- University of Michigan, School of Social Work and the Research Center for Group Dynamics, Institute for Social Research, Ann Arbor, MI
| | - S.M. Manson
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - M. Cwik
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - V.M. O’Keefe
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - J. Allen
- Department of Family Medicine & Biobehavioral Health, University of Minnesota Medical School, Duluth Campus, Duluth, MN
| | - S.M. Rasmus
- Center for Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska, Fairbanks, AK
| | - D. Buchwald
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA
| | - A. Barlow
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Frappaz D, Dhall G, Murray MJ, Goldman S, Faure Conter C, Allen J, Kortmann R, Haas-Kogen D, Morana G, Finlay J, Nicholson JC, Bartels U, Souweidane M, Schöenberger S, Vasiljevic A, Robertson P, Albanese A, Alapetite C, Czech T, Lau CC, Wen P, Schiff D, Shaw D, Calaminus G, Bouffet E. Intracranial germ cell tumors in Adolescents and Young Adults: European and North American consensus review, current management and future development. Neuro Oncol 2021; 24:516-527. [PMID: 34724065 PMCID: PMC8972311 DOI: 10.1093/neuonc/noab252] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [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] [Indexed: 11/14/2022] Open
Abstract
The incidence of intracranial germ cell tumors (iGCT) is much lower in European and North American (E&NA) than in Asian population. However, E&NA cooperative groups have simultaneously developed with success treatment strategies with specific attention paid to long-term sequelae. Neurological sequelae may be reduced by establishing a diagnosis with an endoscopic biopsy and/or cerebrospinal fluid (CSF) and/or serum analysis, deferring the need to perform a radical surgery. Depending on markers and/or histological characteristics, patients are treated as either germinoma or non-germinomatous germ cell tumors (NGGCT). Metastatic disease is defined by a positive CSF cytology and/or distant drops in craniospinal MRI. The combination of surgery and/or chemotherapy and radiation therapy is tailored according to grouping and staging. With more than 90% 5-year event-free survival (EFS), localized germinomas can be managed without aggressive surgery, and benefit from chemotherapy followed by whole ventricular irradiation with local boost. Bifocal germinomas are treated as non-metastatic entities. Metastatic germinomas may be cured with craniospinal irradiation. With a 5-year EFS over 70%, NGGCT benefit from chemotherapy followed by delayed surgery in case of residual disease, and some form of radiotherapy. Future strategies will aim at decreasing long-term side effects while preserving high cure rates.
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Affiliation(s)
- D Frappaz
- Institut d'Hématologie Oncologie Pédiatrique, Lyon, France
| | - G Dhall
- University of Alabama at Birmingham (UAB), Birmingham, USA
| | - M J Murray
- Department of Pathology, University of Cambridge, Cambridge, UK.,Department of Paediatric Haematology and Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - S Goldman
- Phoenix Children's Hospital University of Arizona, USA
| | - C Faure Conter
- Institut d'Hématologie Oncologie Pédiatrique, Lyon, France
| | - J Allen
- NYU Grossman School, New York, USA
| | - R Kortmann
- University of Leipzig Medical Center; Leipzig, Germany
| | | | | | - J Finlay
- Nationwide Children's Hospital, Colombus, USA
| | - J C Nicholson
- Department of Paediatric Haematology and Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Ute Bartels
- The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - M Souweidane
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - S Schöenberger
- Department of Pediatric Hematology and Oncology, University Hospital Essen, Essen, Germany
| | - A Vasiljevic
- Centre de Pathologie et Neuropathologie Est, Hospices Civils de Lyon, France
| | | | | | | | - T Czech
- Medical University of Vienna, Austria
| | - C C Lau
- Connecticut Children's Medical Center, USA
| | - P Wen
- University of Leipzig Medical Center; Leipzig, Germany
| | - D Schiff
- University of Virginia School of Medicine, Charlottesville, USA
| | - D Shaw
- Seattle Children's Hospital and University of Washington, Seattle USA
| | | | - E Bouffet
- The Hospital for Sick Children, University of Toronto, Toronto, Canada
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Mills K, Creedy DK, Sunderland N, Allen J, Corporal S. A critique of measures of emotion and empathy in First Peoples' cultural safety in nursing education: A systematic literature review. Contemp Nurse 2021; 57:338-355. [PMID: 34693881 DOI: 10.1080/10376178.2021.1991413] [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: 10/20/2022]
Abstract
BACKGROUND In Australia, undertaking cultural safety education often evokes strong emotional responses by health students. Despite the potential for emotion to drive transformative learning in this space, measures of emotion are uncommon. AIM To review existing tools that intend to measure emotional components of learning in relation to cultural safety education. METHODS Articles published in English from January 2005 to January 2020; reported studies from Australia, New Zealand, Canada and United States of America; and measured an emotional construct/s after an education intervention offered to university students enrolled in a health programme were included. Studies were assessed for quality according to the Critical Appraisals Skills Programme criteria. RESULTS Eight articles were reviewed; five conducted in the United States of America, and three in Australia. Intervention type, measures, methodological rigour and outcomes varied. Studies predominately measured empathy, guilt and/or fear. CONCLUSIONS Although students' emotional responses were measured, processes for students to reflect upon these reactions were not incorporated in the classroom. The review has implications for future research and curricula through developments in measuring and acting upon emotion in cultural safety education for nursing students in Australia.
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Affiliation(s)
- Kyly Mills
- School of Health Services and Social Work, Griffith University, Meadowbrook, Australia
| | - D K Creedy
- School of Nursing and Midwifery, Griffith University, Meadowbrook, Australia
| | - N Sunderland
- School of Health Services and Social Work, Griffith University, Meadowbrook, Australia
| | - J Allen
- School of Nursing and Midwifery, Griffith University, Meadowbrook, Australia
| | - S Corporal
- School of Health Services and Social Work, Griffith University, Meadowbrook, Australia
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Kadel R, Allen J, Dyakova M, Bellis M. Forecasting the economic consequences of COVID-19 on longstanding illnesses in Wales. Eur J Public Health 2021. [PMCID: PMC8574772 DOI: 10.1093/eurpub/ckab165.066] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The unemployment rate following the COVID-19 pandemic in Wales is increasing and there is a positive link between unemployment and longstanding illnesses. This study aimed to project the percentage of adults with longstanding illnesses and chronic health conditions following COVID-19 associated with the economic consequences.
Methods
We retrieved historical data on the unemployment rates and status of longstanding illnesses among adults from the Office for National Statistics (ONS) and National Survey for Wales (NSW), and used time-series models to project the unemployment rates and percentage of adults with longstanding illnesses and chronic health conditions over a three year period (2020/21 - 2022/23).
Results
Without reparative interventions, the unemployment rate is expected to increase sharply from 3.8% in 2019 to about 7% in 2020 following COVID-19 and then gradually increase over the projected period. With increased unemployment, longstanding illness (LSI) would be expected to increase gradually following COVID-19, with an estimated increase of around or exceeding 4% over three years depending on the LSI measure. There would be a higher increment in the percentage of adults with limiting LSI compared with adults with any LSI, suggesting implications for wider health and social care services. With current unemployment predictions, the percentage of adults with chronic health conditions is projected to increase following the COVID-19 pandemic over the projected period, with a higher increment for mental health and endocrine/metabolic conditions
Conclusions
The longstanding illnesses and chronic health conditions are expected to increase in the coming years following COVID-19 pandemic. Therefore, preventative measures for longstanding illnesses and chronic health conditions should be a priority for a sustainable recovery from the COVID-19.
Key messages
Without reparative interventions, the unemployment rate is expected to increase following the COVID-19 pandemic. The projected prevalence of limiting longstanding illness in adults following COVID-19 suggests implications for wider health and social care services.
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Affiliation(s)
- R Kadel
- WHO CC on Investment for Health & Well-being, Public Health Wales, Cardiff, UK
| | - J Allen
- WHO CC on Investment for Health & Well-being, Public Health Wales, Cardiff, UK
| | - M Dyakova
- WHO CC on Investment for Health & Well-being, Public Health Wales, Cardiff, UK
| | - M Bellis
- WHO CC on Investment for Health & Well-being, Public Health Wales, Cardiff, UK
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Allen J, Cotter-Roberts A, Kadel R, Hughes K, Dyakova M. COVID-19 impact on financial security: evidence from the National Public Engagement Survey in Wales. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.324] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
A nationally representative COVID-19 Public Engagement Survey for Wales, led by the World Health Organization Collaborating Centre on Investment for Health and Well-being at Public Health Wales, has been ongoing from April 2020, helping to inform a sustainable recovery from the COVID-19 pandemic. A data analysis was performed as part of the Welsh Health Equity Status Report initiative focusing on income and job security, which influences living conditions and lifestyle behaviours.
Methods
A Generalized Linear Model was used to calculate the predicted probability of response for variables of interest, e.g. whether an individual reported being in a worse financial situation due to the pandemic, across the life course, socio-economic gradient and sex. Data collected via telephone between 03 April - 25 July 2020 produced a sample ranging between approx. 2,500 - 7,500 participants. The sample was weighted according to deprivation quintile (using the Welsh Index of Multiple Deprivation), age group and sex.
Results
A significantly higher proportion of survey respondents (18 - 24 years of age) reported being worried about losing their job or not being able to find one, than any other age group. A significantly higher proportion of survey respondents in the most deprived population fifth (33.7%) reported being in a worse financial situation as a result of the restrictions, compared to the least deprived fifth (21.7%).
Conclusions
COVID-19 has had a major impact on people's lives and livelihoods in Wales, hitting the most deprived and vulnerable the most. It has increased job insecurity, especially among younger/working age people. The government has taken unprecedented financial and other measures to address inequities; nevertheless, most are temporary and not specifically targeted to support specific (vulnerable) groups. Measures to promote sustainable economic recovery, job security and safeguarding due to the COVID-19 pandemic need continuity and consistency
Key messages
COVID-19 has had a significant impact on income and job security in Wales, disproportionately affecting the most deprived. To mitigate COVID-19 harms, a continuous and consistent focus on equity is essential to promote sustainable economic recovery.
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Affiliation(s)
- J Allen
- WHO CC on Investment for Health & Well-being, Public Health Wales, Cardiff, UK
| | - A Cotter-Roberts
- WHO CC on Investment for Health & Well-being, Public Health Wales, Cardiff, UK
| | - R Kadel
- WHO CC on Investment for Health & Well-being, Public Health Wales, Cardiff, UK
| | - K Hughes
- WHO CC on Investment for Health & Well-being, Public Health Wales, Cardiff, UK
| | - M Dyakova
- WHO CC on Investment for Health & Well-being, Public Health Wales, Cardiff, UK
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Stielke A, Bowles C, Couzens L, Cotter-Roberts A, Allen J, Van Eimeren M, Bainham B, Dyakova M. COVID-19 International Horizon Scanning – informing a response and recovery in Wales and beyond. Eur J Public Health 2021. [PMCID: PMC8574609 DOI: 10.1093/eurpub/ckab165.271] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Issue The rapidly evolving nature and uncertainties of the COVID-19 pandemic have led to unprecedented challenges for health systems, as well as to wellbeing, social and economic impacts for individuals and communities across the globe. Effective, dynamic, innovative and evidence-based solutions are needed to address these challenges. Description of Problem The World Health Organization (WHO) Collaborating Centre on Investment for Health and Well-being, Public Health Wales, has initiated and continues to perform International Horizon Scanning work to inform the evolving COVID-19 public health response and recovery plans in Wales by learning from best practices from other countries. The learning and intelligence is systematically synthesized in rapid regular reports published every week/two weeks. The focus and scope vary, depending on the COVID-19 situation and public health and policy needs. Results The work stream has provided Welsh Government, the National Health Service (NHS), Public Health Wales and other key stakeholders with continuous and timely learning from the experience of other countries along with emerging evidence and guidance, provided by key international organisations. This includes international evidence, epidemiological data, experience, measures and recovery approaches, to understand and explore solutions. Reports have given a consistent overview of approaches across countries such as a comparative analysis of the vaccine roll-out or a systematic overview of the R-value and measures implemented accordingly. Lessons To understand, mitigate and address the impacts of the pandemic in Wales and beyond, a timely, dynamic and evidence-informed actionable intelligence has proven to be essential to inform and support decision-making on government and health system level to address the pandemic and mitigate harms from COVID-19. Key messages International learning has and continues to inform the evolving COVID-19 public health response in Wales. Public Health Wales is contributing to an evidence-informed inclusive recovery from the pandemic in Wales and beyond.
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Affiliation(s)
- A Stielke
- WHO CC on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
| | - C Bowles
- WHO CC on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
| | - L Couzens
- WHO CC on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
| | - A Cotter-Roberts
- WHO CC on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
| | - J Allen
- WHO CC on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
| | - M Van Eimeren
- WHO CC on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
| | - B Bainham
- Improvement Cymru, Public Health Wales, Cardiff, UK
| | - M Dyakova
- WHO CC on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
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Allen J, Ramdharry G, Astin R, Turner C, Smith C. MYOTONIC DYSTROPHY. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.255] [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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Allen J, Ramdharry G, Astin R, Turner C, Smith C. MYOTONIC DYSTROPHY. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.256] [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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Allen J, Ramdharry G, Astin R, Turner C, Smith C. MYOTONIC DYSTROPHY. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.254] [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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Paulson C, Allen J, Davis J, Fritzges J, Jayant D, Nguyen M, Urban C, Worrilow C, Yenser D, Kane B. 53 Clerkship Student Perceived Educational Effectiveness of Virtual Simulation. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.07.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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40
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Allen J, Kiewsa S. 182 Treating Distal Femur Fractures Without Fluoroscopy: Comparison of Implants Used in a Rural Hospital in Tanzania. Br J Surg 2021. [DOI: 10.1093/bjs/znab135.042] [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]
Abstract
Abstract
Introduction
SIGN is a charity providing implants for hospitals with limited resources. There are two nails that can be inserted without fluoroscopy - the standard SIGN nail and the Fin nail. We aimed to evaluate the effectiveness of these implants in treating distal femur fractures.
Method
Retrospective analysis of SIGN database at Nkoaranga Hospital, Tanzania between July 2017 and January 2019. 28 patients (20 male, 8 female) with distal femur fractures had a standard nail (n = 14) or a Fin nail (n = 14). Inclusion criteria: distal femur fractures treated with intramedullary nail. Exclusion criteria: age<16, open injury, antegrade approach, no follow-up at 4 weeks.
Results
Mean age was 41.4 (18-81). Average time from injury to surgery was 29 days. Average first follow-up was 14 weeks (4-73). Painless weight-bearing was achieved in 93% (13/14) of standard nails and 100% (14/14) of Fin nails. Knee flexion >30° was 64% (9/14) in standard nails and 50% (7/14) in Fin nails. Screw loosening was seen in 7% (1/14) in standard nails and no patients with Fin nails. There were no instances of implant breakage, clinical deformity, or infection.
Conclusions
Patients had variable follow-up and presented late causing delayed treatment. Both nails can achieve excellent results. A larger sample size is required.
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Affiliation(s)
- J Allen
- Derriford Hospital, Plymouth, United Kingdom
| | - S Kiewsa
- Nkoaranga Hospital, Nkoaranga, United Republic of Tanzania
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Al Azzawi M, Bolger JC, Bolger EM, Whooley J, Allen J, Trench L, Downey E, Arumugasamy M, Robb WB. O61: TEXTBOOK SURGICAL OUTCOMES IN OESOPHAGO-GASTRIC CANCER: THE INFLUENCE OF NATIONAL KEY PERFORMANCE INDICATORS. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.061] [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]
Abstract
Abstract
Introduction
High quality surgery remains the cornerstone of treating oesophago-gastric malignancy. Recent work from the Dutch Upper-gastrointestinal Cancer Audit (DUCA) have defined ten surgical and perioperative ‘textbook’ parameters that correlate with improved overall survival. The aim of this project was to examine the proportion of patients attaining ‘textbook’ outcomes for oesophagectomy and gastrectomy in our unit before and after the introduction of national key performance indicators (KPIs).
Method
A retrospective review of all oesophagectomies and gastrectomies from January 2010 until June 2019 was performed. Clinical, pathological, perioperative, morbidity and mortality outcomes were recorded. 10 ‘textbook’ parameters were studied pre- and post-KPI introduction.
Result
269 and 284 patients underwent oesophagectomy and gastrectomy respectively, 167 pre-KPI and 386 post-KPI. There were no significant differences in age (67.6 vs 66.4 years, p=0.6), gender (71% male, 29% female vs 68% male, 22% female, p=0.48), ASA grade (p=0.6) or tumour stage (p=0.37) pre- and post-KPI. In the pre-KPI era, 28/167 (17%) patients achieved all ten textbook parameters, compared with 157/386, (41%, p=0.001) post-KPI. This compares favourably to DUCA ‘textbook’ data. There was an improvement in adequate lymphadenectomy (56% vs 83%, p=0.002), a reduction in margin positivity (21% vs 7%, p= 0.001) and peri-operative mortality (6% vs 2%, p=0.03) post-KPI.
Conclusion
There has been a significant improvement in perioperative outcomes in esophagectomy following the introduction of national KPIs in our unit. The number of patients achieving ‘textbook’ outcomes is comparable with international standards. The identification of textbook parameters allows further focus for future quality improvement initiatives.
Take-home message
National KPIs improve peri-operative outcomes in oesophago-gastric cancer.
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Affiliation(s)
| | - JC Bolger
- Beaumont Hospital, Beaumont, Dublin 9
| | - EM Bolger
- Beaumont Hospital, Beaumont, Dublin 9
| | - J Whooley
- Beaumont Hospital, Beaumont, Dublin 9
| | - J Allen
- Beaumont Hospital, Beaumont, Dublin 9
| | - L Trench
- Beaumont Hospital, Beaumont, Dublin 9
| | - E Downey
- Beaumont Hospital, Beaumont, Dublin 9
| | | | - WB Robb
- Beaumont Hospital, Beaumont, Dublin 9
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Zhang A, Sun Y, Thomas D, Allen J, Good D, McCurry K, Pei R, Budev M. Humoral Risk Factors Associated to Allograft Dysfunction after Lung Transplantation: The Alert of Non-HLA Auto Antibody and HLA-Donor Specific Antibody (DSA) with Non-DSA HLA Antibody. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Dunne B, Pozniak J, Campo-Canaveral DeLaCruz J, Lemaitre P, Begum Y, Allen J, Cypel M, de Perrot M, Donahoe L, Yasufuku K, Pierre A, Waddell T, Keshavjee S, Yeung J. Single Lung Transplantation with a Rejected Contralateral Lung: Improved Assessment and Donor Lung Utilization in the Era of Ex Vivo Lung Perfusion. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
Purpose Postswallow residue is a clinical sign of swallow impairment and has shown a strong association with aspiration. Videofluoroscopy (videofluoroscopic study of swallowing [VFSS]) is commonly used to visualize oropharyngeal swallowing and to identify pharyngeal residue. However, subjective binary observation (present or absent) fails to provide important information on volume or location and lacks objectivity and reproducibility. Reliable judgment of changes in residue over time and with treatment is therefore challenging. We aimed to (a) determine the reliability of quantifying pharyngeal residue in children using the bolus clearance ratio (BCR), (b) determine associations between BCR and other timing and displacement measures of oropharyngeal swallowing, and (c) explore the association between BCR and penetration-aspiration in children. Method In this single-center retrospective observational study, we obtained a set of quantitative and descriptive VFSS measures from 553 children (0-21 years old) using a standard protocol. VFSS data were recorded at 30 frames per second for quantitative analysis using specialized software. Results Good interrater (ICC = .86, 95% CI [.74, .961], p < .001) and excellent intrarater reliability was achieved for BCR (ICC = .97, 95% CI [.91, 1.000], p = 001). Significant correlations between BCR and pharyngeal constriction ratio and total pharyngeal transit time were reported (p < .05). Using binomial logistic regression modeling, we found BCR was predictive of penetration-aspiration in children, χ2(13) = 58.093, p < .001, 64.9%. Children with BCR of ≥ 0.1 were 4 times more likely to aspirate. Conclusion BCR is a reliable, clinically useful measure to quantify postswallow residue in children, which can be used to identify and treat children with swallow impairments, as well as to measure outcomes of intervention.
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Affiliation(s)
- Isuru Dharmarathna
- Speech Science, School of Psychology, Faculty of Science, The University of Auckland, New Zealand
- Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Colombo, Sri Lanka
| | - Anna Miles
- Speech Science, School of Psychology, Faculty of Science, The University of Auckland, New Zealand
| | - Jacqui Allen
- Department of Surgery, The University of Auckland, New Zealand
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Dharmarathna I, Miles A, Allen J. Predicting penetration-aspiration through quantitative swallow measures of children: a videofluoroscopic study. Eur Arch Otorhinolaryngol 2021; 278:1907-1916. [PMID: 33564910 DOI: 10.1007/s00405-021-06629-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 09/02/2020] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Quantitative measures have improved the reliability and accuracy in interpretation and reporting of videofluoroscopy (VFSS). Associations between quantitative VFSS measures and swallow safety in children are not widely reported. The ability to predict aspiration in children, even if not observed during brief VFSS, will improve diagnostic reporting and potentially reduce the need for extended radiation time. The aims of this study were to determine associations between quantitative fluoroscopic swallow measures and penetration-aspiration and to predict likelihood of penetration-aspiration. METHODS We selected videofluoroscopic data of 553 children from a pediatric hospital database for this single-center retrospective observational study. A standard protocol of VFSS administration was used and data were recorded at 30 frames-per-second. A set of quantitative and descriptive swallow measures was obtained using a specialized software with satisfactory inter-rater and intra-rater reliability. Binomial logistic regression with backward likelihood ratio was conducted, while controlling for age, gender, and etiology. RESULTS We found bolus clearance ratio (BCR), pharyngeal constriction ratio (PCR), duration to hyoid maximal elevation (Hdur), and total pharyngeal transit time (TPT) to be predictive of penetration-aspiration in children. PCR was the most predictive of penetration-aspiration in children (61.5%). Risk of aspiration was more than 100 times, when BCR = ≥ 0.1, TPT = ≥ 2 s, Hdur = > 1 s or PCR = ≥ 0.2 (p < 0.05 for all measures). CONCLUSION The results confirm the potential of objective quantitative swallow measures in predicting the risk of aspiration in children with dysphagia. These parameters provide predictive measures of aspiration risk that are clinically useful in identifying children of concern, even if no aspiration is observed during VFSS.
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Affiliation(s)
- Isuru Dharmarathna
- Speech Science, School of Psychology, Faculty of Science, The University of Auckland, Building 507, Level 2 (B.065), 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand. .,Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
| | - Anna Miles
- Speech Science, School of Psychology, Faculty of Science, The University of Auckland, Building 507, Level 2 (B.065), 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand
| | - Jacqui Allen
- Department of Surgery, The University of Auckland, Auckland, New Zealand
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Dharmarathna I, Miles A, Fuller L, Allen J. Quantitative video-fluoroscopic analysis of swallowing in infants. Int J Pediatr Otorhinolaryngol 2020; 138:110315. [PMID: 32861978 DOI: 10.1016/j.ijporl.2020.110315] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To utilize objective, quantitative videofluoroscopic swallow measures to profile swallowing in infants and to determine the likelihood of objective swallow measures to predict risk of swallow impairments such as airway violation, reflux and post swallow residue. STUDY DESIGN Our single center retrospective observational study used a cohort of 146 bottle-fed infants (0-9 months) referred for VFSS with any kind of feeding related concern. Frame-by-frame analysis of 20-s video loops of mid-feed sucking was completed to obtain quantitative timing, displacement and coordination measures as well as presence of other findings including aspiration, residue and naso-pharyngeal reflux (NPR) and esophago-pharyngeal reflux (EPR). Spearman correlation, Mann-Whitney U test and binomial logistic regression were conducted to determine statistical associations between swallow measures and binary reporting of swallow impairments. RESULTS Videofluoroscopic data of 146 infants were reviewed and analyzed. 49% of infants demonstrated at least one penetration or aspiration event. Total pharyngeal transit time (TPT) and suck-swallow ratio were associated with aspiration (p < .05). Infants with >3 sucks per swallow had significantly longer TPT and their risk of aspiration was greater than those with <3 sucks per swallow (RR 1.23, 95% CI 0.43-8.507, p = .03). Pharyngeal constriction ratio (PCR) and bolus clearance ratio (BCR) were associated with residue, NPR and EPR (p < .05). CONCLUSION Objective measures provide clinicians with reliable timing and displacement data even in the very young. These measures correlate with swallowing safety and may help to identify enhanced risk in some infants, which may influence management recommendations.
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Affiliation(s)
- Isuru Dharmarathna
- Speech Science, School of Psychology, The University of Auckland, New Zealand; Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Sri Lanka.
| | - Anna Miles
- Speech Science, School of Psychology, The University of Auckland, New Zealand
| | - Laura Fuller
- Speech Science, School of Psychology, The University of Auckland, New Zealand; Counties Manukau Health, Auckland, New Zealand
| | - Jacqui Allen
- Department of Surgery, The University of Auckland, New Zealand
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Shirokova LS, Payandi-Rolland D, Lim AG, Manasypov RM, Allen J, Rols JL, Bénézeth P, Karlsson J, Pokrovsky OS. Diel cycles of carbon, nutrient and metal in humic lakes of permafrost peatlands. Sci Total Environ 2020; 737:139671. [PMID: 32521361 DOI: 10.1016/j.scitotenv.2020.139671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 06/11/2023]
Abstract
Despite the importance of surface waters of permafrost landscapes in carbon (C) emission and dissolved C and metal storage and export, the majority of available observations in high latitude aquatic systems deal with punctual or seasonal sampling without accounting for diurnal variations in temperature and primary productivity-respiration cycles. Towards providing comprehensive understanding of diel variations in CO2 emission, organic C and element concentrations in lakes of frozen peatlands, we monitored, each 2 h over 2 days, the water temperature, pH, CO2 fluxes, CO2, CH4, dissolved organic and inorganic carbon (DOC and DIC, respectively), nutrients, carboxylic acids, bacterial number, and major and trace elements in two acidic (pH = 3.6 and 4.0) and humic (DOC = 15 and 35 mg L-1) thermokarst lakes of discontinuous permafrost zone in Western Siberia. We discovered a factor of 2 to 3 higher CO2 concentrations and fluxes during the night compared to daytime in the high-DOC lake. The emission fluxes in the low-DOC lake increased from zero to negative values during the day to highly positive values during the end of night and early morning. The methane concentration varied within a factor of 5 without any link to the diurnal cycle. The bulk of dissolved (< 0.45 μm) hydrochemical parameters remained highly stable with ±10% variation in concentration over 2 days of observation (DOC, DIC, SUVA254nm, carboxylates (formate, oxalate, puryvate and glutarate), Mn, Fe, Al, other trace elements). Concentrations of Si, P, K, Cu varied within ±20% whereas those of Zn and Ni ranged by a factor of 2 to 4 without any link to diurnal pattern. Overall, the impact of diel cycle on CH4, DOC, nutrient and metal concentration was below 10%. However, neglecting night-time period may underestimate net CO2 emission by ca. 30 to 50% in small organic-rich thaw ponds and switch the CO2 exchange from uptake/zero to net emission in larger thermokarst lakes. Given the dominance of large lakes in permafrost regions, the global underestimation of the emission flux may be quite high. As such, monitoring CO2 concentrations and fluxes in thermokarst lakes during months of extended night time (August to October) is mandatory for assessing the net emissions from lentic waters of frozen peatlands.
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Affiliation(s)
- L S Shirokova
- Géosciences Environnement Toulouse, GET - CNRS - IRD - OMP - Université de Toulouse, 14, Avenue Edouard Belin, 31400 Toulouse, France; Institute of Ecological Problems of the North, Russian Academy of Science, 23, Naberezhnaya Sev. Dviny, Arkhangelsk, Russia
| | - D Payandi-Rolland
- Géosciences Environnement Toulouse, GET - CNRS - IRD - OMP - Université de Toulouse, 14, Avenue Edouard Belin, 31400 Toulouse, France
| | - A G Lim
- BIO-GEO-CLIM Laboratory, Tomsk State University, 36 Lenina Pr., Tomsk, Russia
| | - R M Manasypov
- BIO-GEO-CLIM Laboratory, Tomsk State University, 36 Lenina Pr., Tomsk, Russia
| | - J Allen
- EcoLab, Université de Toulouse, CNRS, Toulouse, France
| | - J-L Rols
- EcoLab, Université de Toulouse, CNRS, Toulouse, France
| | - P Bénézeth
- Géosciences Environnement Toulouse, GET - CNRS - IRD - OMP - Université de Toulouse, 14, Avenue Edouard Belin, 31400 Toulouse, France
| | - J Karlsson
- Climate Impacts Research Centre (CIRC), Department of Ecology and Environmental Science, Umeå University, SE-901 87 Umeå, Sweden
| | - O S Pokrovsky
- Géosciences Environnement Toulouse, GET - CNRS - IRD - OMP - Université de Toulouse, 14, Avenue Edouard Belin, 31400 Toulouse, France.
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Zgadzaj R, Silva T, Khudyakov VK, Sosedkin A, Allen J, Gessner S, Li Z, Litos M, Vieira J, Lotov KV, Hogan MJ, Yakimenko V, Downer MC. Dissipation of electron-beam-driven plasma wakes. Nat Commun 2020; 11:4753. [PMID: 32958741 PMCID: PMC7506535 DOI: 10.1038/s41467-020-18490-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 08/24/2020] [Indexed: 11/09/2022] Open
Abstract
Metre-scale plasma wakefield accelerators have imparted energy gain approaching 10 gigaelectronvolts to single nano-Coulomb electron bunches. To reach useful average currents, however, the enormous energy density that the driver deposits into the wake must be removed efficiently between shots. Yet mechanisms by which wakes dissipate their energy into surrounding plasma remain poorly understood. Here, we report picosecond-time-resolved, grazing-angle optical shadowgraphic measurements and large-scale particle-in-cell simulations of ion channels emerging from broken wakes that electron bunches from the SLAC linac generate in tenuous lithium plasma. Measurements show the channel boundary expands radially at 1 million metres-per-second for over a nanosecond. Simulations show that ions and electrons that the original wake propels outward, carrying 90 percent of its energy, drive this expansion by impact-ionizing surrounding neutral lithium. The results provide a basis for understanding global thermodynamics of multi-GeV plasma accelerators, which underlie their viability for applications demanding high average beam current.
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Affiliation(s)
- Rafal Zgadzaj
- University of Texas at Austin, 1 University Station C1600, Austin, TX, 78712-1081, USA
| | - T Silva
- GoLP/Instituto de Plasmas e Fusão Nuclear-Laboratório Associado, Insituto Superior Técnico, Lisboa, Portugal
| | - V K Khudyakov
- Budker Institute of Nuclear Physics, 630090, Novosibirsk, Russia
- Novosibirsk State University, 630090, Novosibirsk, Russia
| | - A Sosedkin
- Budker Institute of Nuclear Physics, 630090, Novosibirsk, Russia
- Novosibirsk State University, 630090, Novosibirsk, Russia
| | - J Allen
- SLAC National Accelerator Laboratory, Menlo Park, CA, 94025, USA
| | - S Gessner
- SLAC National Accelerator Laboratory, Menlo Park, CA, 94025, USA
| | - Zhengyan Li
- University of Texas at Austin, 1 University Station C1600, Austin, TX, 78712-1081, USA
- Huazhong University of Science and Technology, Wuhan, China
| | - M Litos
- SLAC National Accelerator Laboratory, Menlo Park, CA, 94025, USA
- Center for Integrated Plasma Studies, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - J Vieira
- GoLP/Instituto de Plasmas e Fusão Nuclear-Laboratório Associado, Insituto Superior Técnico, Lisboa, Portugal
| | - K V Lotov
- Budker Institute of Nuclear Physics, 630090, Novosibirsk, Russia
- Novosibirsk State University, 630090, Novosibirsk, Russia
| | - M J Hogan
- SLAC National Accelerator Laboratory, Menlo Park, CA, 94025, USA
| | - V Yakimenko
- SLAC National Accelerator Laboratory, Menlo Park, CA, 94025, USA
| | - M C Downer
- University of Texas at Austin, 1 University Station C1600, Austin, TX, 78712-1081, USA.
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Cunningham TK, Draper H, Bexhell H, Allgar V, Allen J, Mikl D, Phillips K. A double-blinded randomised controlled study to investigate the effect of intraperitoneal levobupivacaine on post laparoscopic pain. Facts Views Vis Obgyn 2020; 12:155-161. [PMID: 33123690 PMCID: PMC7580260] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Laparoscopic surgery is the cornerstone of modern gynaecological surgery, with shorter hospital stays and a quicker return to normal activities. However postoperative pain remains problematic. No strategy to reduce phrenic nerve irritation, including heating or humidifying the insufflating gas, alternatives to CO2, and intraperitoneal analgesics, has shown superiority. METHODS 100 women undergoing laparoscopic surgery were randomly allocated, having either 40ml of 0.25% levobupivacaine or 40ml 0.9% sodium chloride solution administered into the peritoneal cavity following surgery. The patients and the main researcher were blinded. All women received standardised anaesthetic and laparoscopic technique, and postoperative pain control including nursing position and nature of analgesia. Postoperative pain was assessed 3 hours, 8 hours, day 1 and day 4/5 postoperatively. RESULTS 100 patients were recruited undergoing surgery for benign causes aged 19-73(mean 40.3±13). There was no difference between the groups for age(p=0.64) or length of operation(p=0.56). There were no adverse events related to use of intraperitoneal instillation. There was a significant reduction in shoulder-tip pain scores in the levobupivacaine group at 3 hours(p=0.04). Furthermore, there was a significant reduction in wound-pain scores in the levobupivacaine group at 8hrs(p=0.04) and at day 4(p=0.04). No difference was found in pelvic pain between the two groups. No significant difference was found in the use of post-operative analgesia. CONCLUSIONS Intraperitoneal instillation of 40ml of levobupivacaine has some benefit in reducing postoperative pain and need for analgesia in the initial hours following gynaecological surgery. However, further well-designed randomised control trials are required to decide the optimum route and concentration of administering local anaesthetic.
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Affiliation(s)
- TK Cunningham
- Department of Obstetrics & Gynaecology, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom, HU32JZ
| | - H Draper
- Department of Obstetrics & Gynaecology, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom, HU32JZ
| | - H Bexhell
- Department of Obstetrics & Gynaecology, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom, HU32JZ
| | - V Allgar
- Centre for Health and Population Sciences, Hull York Medical School, Hull, United Kingdom, HU6 7RX
| | - J Allen
- Department of Obstetrics & Gynaecology, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom, HU32JZ
| | - D Mikl
- Department of Obstetrics & Gynaecology, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom, HU32JZ
| | - K Phillips
- Department of Obstetrics & Gynaecology, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom, HU32JZ
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50
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McLoughlin IV, Perrotin O, Sharifzadeh H, Allen J, Song Y. Automated Assessment of Glottal Dysfunction Through Unified Acoustic Voice Analysis. J Voice 2020; 36:743-754. [DOI: 10.1016/j.jvoice.2020.08.032] [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: 04/17/2020] [Revised: 08/23/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
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