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Moore L, Wu HHL, Ponnusamy A. Is home dialysis an optimal option during pregnancy? Ther Apher Dial 2024; 28:467-468. [PMID: 38084647 DOI: 10.1111/1744-9987.14095] [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] [Received: 10/13/2023] [Revised: 11/02/2023] [Accepted: 11/27/2023] [Indexed: 04/30/2024]
Affiliation(s)
- Louise Moore
- Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Henry H L Wu
- Renal Research, Kolling Institute of Medical Research, Royal North Shore Hospital & The University of Sydney, Sydney, New South Wales, Australia
| | - Arvind Ponnusamy
- Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
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Stoneman S, Balmer F, Moore L, Fontana M, Kielstein JT, Woywodt A. Meet and greet but avoid the heat: a reflection on the carbon footprint of congresses prompted by ERA2023. Clin Kidney J 2024; 17:sfae062. [PMID: 38699480 PMCID: PMC11063956 DOI: 10.1093/ckj/sfae062] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Indexed: 05/05/2024] Open
Affiliation(s)
- Sinead Stoneman
- Department of Nephrology, Cork University Hospital, Cork, Ireland
| | - Frances Balmer
- Sustainability Fellow, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK
| | - Louise Moore
- Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK
| | | | - Jan T Kielstein
- Medical Clinic V, Nephrology, Rheumatology and Blood Purification, Academic Teaching Hospital Braunschweig, Braunschweig, Germany
| | - Alexander Woywodt
- Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK
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Moore L, Balmer F, Woywodt A. The environmental impact of changing to virtual renal transplant aftercare: 2-year experience with a single outpatient clinic. Future Healthc J 2024; 11:100004. [PMID: 38646053 PMCID: PMC11025045 DOI: 10.1016/j.fhj.2024.100004] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Affiliation(s)
- Louise Moore
- Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, U.K
| | - Frances Balmer
- Sustainability Fellow, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, U.K
| | - Alexander Woywodt
- Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, U.K
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Russell MD, Dey M, Flint J, Davie P, Allen A, Crossley A, Frishman M, Gayed M, Hodson K, Khamashta M, Moore L, Panchal S, Piper M, Reid C, Saxby K, Schreiber K, Senvar N, Tosounidou S, van de Venne M, Warburton L, Williams D, Yee CS, Gordon C, Giles I. British Society of Rheumatology guideline working group response to European Medicines Agency safety update on Hydroxychloroquine. Rheumatology (Oxford) 2024; 63:e37-e38. [PMID: 37522866 PMCID: PMC10834932 DOI: 10.1093/rheumatology/kead384] [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] [Received: 05/30/2023] [Revised: 06/27/2023] [Accepted: 07/13/2023] [Indexed: 08/01/2023] Open
Affiliation(s)
- Mark D Russell
- Centre for Rheumatic Diseases, King's College London, London, UK
| | - Mrinalini Dey
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Julia Flint
- Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Shropshire, UK
| | - Philippa Davie
- Centre for Rheumatic Diseases, King's College London, London, UK
| | - Alexander Allen
- British Society for Rheumatology, Clinical Affairs, London, UK
| | | | - Margreta Frishman
- Queen's Hospital, Maternity Services, Barking Havering & Redbridge University NHS Trust, UK
| | - Mary Gayed
- Rheumatology, Sandwell and West Birmingham Hospital, UK
| | | | - Munther Khamashta
- Department of Women & Children's Health, King's College London, London, UK
| | - Louise Moore
- Rheumatic and Musculoskeletal Disease Unit, Our Lady's Hospice and Care Service, Dublin, Ireland
| | - Sonia Panchal
- Rheumatology, University Hospitals of Leicester, Leicester, UK
| | - Madeleine Piper
- Royal National Hospital for Rheumatic Diseases, Royal United Hospital, Bath, UK
| | | | - Katherine Saxby
- University College London Hospitals NHS Foundation Trust, Pharmacy, London, UK
| | - Karen Schreiber
- Thrombosis and Haemostasis, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Danish Hospital for Rheumatic Diseases, Sonderborg, Denmark
- Department of Regional Health Research (IRS), University of Southern Denmark, Odense, Denmark
| | - Naz Senvar
- Obstetrics and Gynaecology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Sofia Tosounidou
- Lupus UK Centre of Excellence, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | | | | | - David Williams
- Womens Health, University College London Hospitals NHS Foundation Trust, London, UK
| | - Chee-Seng Yee
- Department of Rheumatology, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK
| | - Caroline Gordon
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Ian Giles
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
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O'Farrell R, Maguire S, Moore L, Murray K, Gorman A, Ball E, Riddell C, O'Neill M, Jordan N, O'Shea F, Veale D, Donnelly S, Murphy G, Fitzgerald G. Delivering Care for Pregnant Women with Rheumatic and Musculoskeletal Diseases. Ir Med J 2024; 117:894. [PMID: 38259237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
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Anderson BM, Moore L, Moore KL, Bojechko C. EPIDEEP: Using a Deep Learning Model to Predict In Vivo Electronic Portal Imaging Device (EPID) Transit Images. Int J Radiat Oncol Biol Phys 2023; 117:e645. [PMID: 37785921 DOI: 10.1016/j.ijrobp.2023.06.2060] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To create a deep-learning model to predict in-vivo electronic portal imaging device (EPID) transit images for IMRT treatments. This model was created to predict in-vivo images to identify machine and patient-related errors that occur during beam delivery and are undetectable with current QA approaches. The deep-learning model can make image predictions much faster than Monte Carlo approaches, making image prediction feasible for application in online adaptive radiotherapy. Additionally, the model does not rely on any proprietary information and can be easily utilized by other clinics. MATERIALS/METHODS Our approach separates the primary and scatter components of in-vivo transit images. The attenuation of primary radiation reaching the EPID panel is modeled analytically, using attenuation measurements from phantoms of known thicknesses. The scatter component is estimated using a convolutional neural network (CNN). The CNN training uses information from the on-treatment cone-beam CTs (CBCTs), and a pretreatment EPID image with no patient in the beam. We acquired 193 IMRT fields/images from 118 patients previously treated on the Varian Halcyon. Treatment sites included the pelvis, abdomen, lungs, and extremities. CBCTs were collected immediately before treatment, to provide an accurate representation of the anatomy. A 3-channel input image was used, consisting of the pretreatment EPID image, a ray tracing projection through the CBCT to the EPID panel, and a projection to isocenter. Model training:validation:test set ratios were 133:20:40 images. The primary and scatter components are added together to give the predicted transit image. Prediction accuracy was assessed by comparing model-predicted and measured in-vivo EPID images with a 3%/3mm and 5%/3mm gamma pass rate. RESULTS The gamma pass rate for the patients in the training:validation:test was 91.5%:90.4%:92.1% for 3%/3mm and 96.7%:96.6%:97.0% for 5%/3mm. The model can make image predictions in 20 milliseconds. The poor passing rates of some images may be due to CBCT artifacts and patient motion that occurs between the time of CBCT and treatment. CONCLUSION This model can predict in-vivo EPID images with an average gamma pass rate greater than 90%. Image predictions from this model can be used to detect in-vivo treatment errors and changes in patient anatomy, providing an additional layer of patient-specific quality assurance. The speed of image predictions is 20 milliseconds, making use feasible for online adaptive treatments, which currently do not utilize patient-specific measurements of the delivered radiation. Upcoming studies will assess the model's ability in detecting clinically relevant errors and changes in patient anatomy that can adversely affect treatment. Future goals include acquiring more data to further improve the model and extending the model to make predictions for VMAT treatments.
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Affiliation(s)
- B M Anderson
- University of California San Diego, Department of Radiation Medicine and Applied Sciences, La Jolla, CA
| | - L Moore
- University of California San Diego, Department of Radiation Medicine and Applied Sciences, La Jolla, CA
| | - K L Moore
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA
| | - C Bojechko
- University of California San Diego, Department of Radiation Medicine and Applied Sciences, La Jolla, CA
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Schreiber K, Giles I, Costedoat-Chalumeau N, Nelson-Piercy C, Dolhain RJ, Mosca M, Förger F, Fischer-Betz R, Molto A, Tincani A, Pasquier E, Marin B, Elefant E, Salmon J, Bermas BL, Sammaritano L, Clowse MEB, Chambers C, Buyon J, Inoue SA, Agmon-Levin N, Aguilera S, Emadi SA, Andersen J, Andrade D, Antovic A, Arnaud L, Christiansen AA, Avcin T, Badreh-Wirström S, Bertsias G, Bini I, Bobirca A, Branch W, Brucato A, Bultink I, Capela S, Cecchi I, Cervera R, Chighizola C, Cobilinschi C, Cuadrado MJ, Dey D, Etomi O, Espinosa G, Flint J, Fonseca JE, Fritsch-Stork R, Gerosa M, Glintborg B, Skorpen CG, Goulden B, Graversgaard C, Gunnarsson I, Gupta L, Hetland M, Hodson K, Hunt BJ, Isenberg D, Jacobsen S, Khamashta M, Levy R, Linde L, Lykke J, Meissner Y, Moore L, Morand E, Navarra S, Opris-Belinski D, Østensen M, Ozawa H, Perez-Garcia LF, Petri M, Pons-Estel GJ, Radin M, Raio L, Rottenstreich A, Ruiz-Irastorza G, Tunjić SR, Rygg M, Sciascia S, Strangfeld A, Svenungsson E, Tektonidou M, Troldborg A, Vinet E, Vojinovic J, Voss A, Wallenius M, Andreoli L. Global comment on the use of hydroxychloroquine during the periconception period and pregnancy in women with autoimmune diseases. Lancet Rheumatol 2023; 5:e501-e506. [PMID: 38251494 DOI: 10.1016/s2665-9913(23)00215-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Affiliation(s)
- Karen Schreiber
- Danish Centre for Expertise in Rheumatology (CeViG), Danish Hospital for Rheumatic Diseases, Sonderborg, Denmark (KS); Institute for Regional Health, Southern Danish University, Odense, Denmark.
| | - Ian Giles
- Centre for Rheumatology, UCL Division of Medicine, London, UK
| | - Nathalie Costedoat-Chalumeau
- AP-HP, Hôpital Cochin, Centre de Référence Maladies Auto-Immunes et Systémiques Rares, Paris, France; Université Paris Cité, Paris, France
| | - Catherine Nelson-Piercy
- Department of Obstetric Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK (CN-P, OE)
| | - Radboud Jem Dolhain
- Erasmus MC, University Medical Centre, Department of Rheumatology, Rotterdam, Netherlands
| | - Marta Mosca
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Frauke Förger
- Department of Rheumatology, Immunology and Allergology, University Hospital of Bern, Bern, Switzerland
| | - Rebecca Fischer-Betz
- Department for Rheumatology and Hiller Research Institute, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Anna Molto
- Rheumatology Department, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM (U1153), PRES Sorbonne Paris-Cité, Paris, France
| | - Angela Tincani
- Rheumatology and Clinical Immunology Unit, ASST-Spedali Civili and University, Brescia, Italy
| | - Elisabeth Pasquier
- Département de Médecine Interne et Pneumologie, CHRU de Brest, Hôpital de la Cavale Blanche, Brest, France; INSERM, Centre d'Investigation Clinique 1412, CHRU de Brest, Brest, France
| | - Benoit Marin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Trousseau, Département de Santé Publique, Centre de Référence sur les Agents Tératogènes, F75012, Paris, France
| | - Elisabeth Elefant
- AP-HP, Sorbonne Université, Hôpital Trousseau, Département de Santé Publique, Centre de Référence sur les Agents Tératogènes, F75012, Paris, France
| | - Jane Salmon
- Weill Cornell Medicine, Hospital for Special Surgery, New York, New York, USA
| | | | - Lisa Sammaritano
- Weill Cornell Medicine, Hospital for Special Surgery, New York, New York, USA
| | - Megan E B Clowse
- Division of Rheumatology and Immunology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Christina Chambers
- Department of Paediatrics, University of California, San Diego, La Jolla, CA, USA
| | - Jill Buyon
- Division of Rheumatology, New York University Grossman School of Medicine, New York, NY, USA
| | - Saori Abe Inoue
- Department of Rheumatology, Institute of Medicine, University of Tsukuba, Japan
| | - Nancy Agmon-Levin
- The Zabludowicz Centre for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel; The Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | | | | | - Danieli Andrade
- Rheumatology, University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil
| | - Aleksandra Antovic
- Department of Medicine, Division of Rheumatology Karolinska Institutet and Rheumatology, Karolinska University Hospital Stockholm, Sweden
| | - Laurent Arnaud
- Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, Centre National de Références Maladies Auto-Immunes, Strasbourg, France
| | - Alice Ashouri Christiansen
- Danish Center for Expertise in Rheumatology, Danish Hospital for Rheumatic Diseases, Sønderborg, Denmark
| | - Tadej Avcin
- Department of Allergology, Rheumatology and Clinical Immunology, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Sara Badreh-Wirström
- Senior European and Regulatory Affairs Project Manager, EULAR PARE, Brussels, Belgium
| | - George Bertsias
- Rheumatology, University of Crete School of Medicine, Iraklio, Greece; Laboratory of Autoimmunity-Inflammation, Institute of Molecular Biology and Biotechnology, Heraklion, Greece
| | | | - Anca Bobirca
- Department of Internal Medicine and Rheumatology, Dr I Cantacuzino Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ware Branch
- Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Antonio Brucato
- Department of Biomedical and Clinical Sciences, University of Milano, Fatebenefratelli Hospital, Milano, Italy
| | - Irene Bultink
- Department of Rheumatology, Amsterdam Rheumatology and immunology Centre, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Susanna Capela
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte EPE, Faculty of Medicine, University of Lisbon, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Irene Cecchi
- Centre of Research of Immunopathology and Rare Diseases, Department of Clinical and Biological Sciences, University of Turin, San Giovanni Hospital, Turin, Italy
| | - Ricard Cervera
- Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Cecilia Chighizola
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Paediatric Rheumatology Unit, ASST Pini, CTO, Milan, Italy
| | - Claudia Cobilinschi
- Department of Internal Medicine and Rheumatology Sânta Maria Clinical Hospital, Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Dzifa Dey
- Rheumatology Unit, Department of Medicine and Therapeutics, Korle Bu Teaching Hospital, University of Ghana Medical School, Accra, Ghana
| | - Oseme Etomi
- Department of Obstetric Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK (CN-P, OE)
| | - Gerard Espinosa
- Department of Autoimmune Diseases, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | - Julia Flint
- Department of Rheumatology, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, UK
| | - João-Eurico Fonseca
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa and Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Ruth Fritsch-Stork
- Health Care Centre Mariahilf, ÖGK and Rheumatology Department at the Sigmund Freud Private University, Vienna, Austria
| | - Maria Gerosa
- Department of Clinical Sciences and Community Health, Research Centre for Adult and Paediatric Rheumatic Diseases, University of Milan, Milan, Italy; Clinical Rheumatology Unit, ASST G Pini and CTO, Milan, Italy
| | - Bente Glintborg
- DANBIO and Copenhagen Centre for Arthritis Research, Centre for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
| | - Carina Gøtestam Skorpen
- Department of Neuromedicine and Movement Science, The Norwegian University of Science and Technology, Trondheim, Norway; Department of Rheumatology Ålesund, Helse More og Romsdal, Ålesund, Norway
| | - Bethan Goulden
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Centre for Rheumatology Research, UCL Division of Medicine, University College London, London; Women's Health, University College London Hospital, London, UK
| | - Christine Graversgaard
- Danish Hospital for Rheumatic Diseases, Sønderborg, Denmark; Department of Rheumatology, Aarhus Universitetshospital, Aarhus, Denmark
| | - Iva Gunnarsson
- Department of Medicine, Division of Rheumatology, Karolinska Institutet, Stockholm, Sweden; Solna and Rheumatology, Karolinska University Hospital, Stockholm, Sweden
| | - Latika Gupta
- Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK; Division of Musculoskeletal and Dermatological Sciences, Centre for Musculoskeletal Research, School of Biological Sciences, The University of Manchester, Manchester, UK; Department of Rheumatology, City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Merete Hetland
- DANBIO and Copenhagen Centre for Arthritis Research, Centre for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ken Hodson
- UK Teratology Information Service, Newcastle upon Tyne, UK
| | - Beverley J Hunt
- Thrombosis and Haemophilia, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - David Isenberg
- Centre for Rheumatology, UCL Division of Medicine, London, UK
| | - Søren Jacobsen
- Copenhagen Research Centre for Autoimmune Connective Tissue Diseases, COPEACT, Rigshospitalet, Copenhagen, Denmark
| | | | | | - Louise Linde
- Copenhagen Research Centre for Autoimmune Connective Tissue Diseases, Lupus and Vasculitis Clinic, Copenhagen university hospital, Rigshospitalet, Denmark
| | - Jacob Lykke
- Department of Obstetrics, Copenhagen university hospital, Rigshospitalet, Denmark
| | - Yvette Meissner
- Epidemiology and Health Services Research, German Rheumatism Research Centre, Berlin, Germany
| | - Louise Moore
- Rheumatic and Musculoskeletal Disease Unit, Our Lady's Hospice and Care Services, Harold's Cross, Dublin, Ireland
| | - Eric Morand
- Centre for Inflammatory Disease, Monash University, Melbourne, VIC, Australia
| | - Sandra Navarra
- Centre for Inflammatory Disease, Monash University, Melbourne, VIC, Australia
| | - Daniela Opris-Belinski
- Joint and Bone Center, University of Santo Tomas Hospital, Manila, Philippines; Rheumatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Monika Østensen
- Department of Rheumatology, Sorlandet Hospital Kristiansand, Kristiansand, Norway (MØ)
| | - Hiroki Ozawa
- Immuno-Rheumatology Centre, St Luke's International Hospital, Tokyo, Japan
| | | | - Michelle Petri
- Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Massimo Radin
- Centre of Research of Immunopathology and Rare Diseases, Department of Clinical and Biological Sciences, University of Turin, San Giovanni Hospital, Turin, Italy
| | - Luigi Raio
- Department of Obstetrics and Gynaecology, University Hospital of Bern, Inselspital, Bern, Switzerland
| | - Amihai Rottenstreich
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra and Northwell, New York, NY, USA; Laboratory of Blood and Vascular Biology, Rockefeller University, New York, NY, USA; Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Guillermo Ruiz-Irastorza
- Autoimmune Diseases Research Unit, Biocruces Bizkaia Health Research Institute, University of the Basque Country, Bizkaia, Spain
| | | | - Marite Rygg
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Savino Sciascia
- Centre of Research of Immunopathology and Rare Diseases, Department of Clinical and Biological Sciences, University of Turin, San Giovanni Hospital, Turin, Italy
| | - Anja Strangfeld
- Epidemiology and Health Care Research, German Rheumatism Research Center Berlin, Berlin, Germany
| | - Elisabet Svenungsson
- Department of Medicine, Division of Rheumatology, Karolinska Institutet, Solna and Rheumatology, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Tektonidou
- First Department of Propaedeutic and Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Anne Troldborg
- Department of Rheumatology, Aarhus University Hospital, and Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Evelyne Vinet
- McGill University, McGill University Health Centre, Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Jelena Vojinovic
- University of Nis, Faculty of Medicine, Clinic for Pediatrics University Clinical Center Nis, Nis, Serbia
| | - Anne Voss
- Department of Rheumatology C, Odense University Hospital, Odense, Denmark
| | - Marianne Wallenius
- Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, Department of Rheumatology, Trondheim University Hospital, St Olavs Hospital, Trondheim, Norway; Department of Neuromedicine and Movement Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Laura Andreoli
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology Unit, Spedali Civili and University of Brescia, Brescia, Italy
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Schreiber K, Frishman M, Russell MD, Dey M, Flint J, Allen A, Crossley A, Gayed M, Hodson K, Khamashta M, Moore L, Panchal S, Piper M, Reid C, Saxby K, Senvar N, Tosounidou S, van de Venne M, Warburton L, Williams D, Yee CS, Gordon C, Giles I. Executive Summary: British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: comorbidity medications used in rheumatology practice. Rheumatology (Oxford) 2023; 62:1388-1397. [PMID: 36318970 PMCID: PMC10070061 DOI: 10.1093/rheumatology/keac559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 04/05/2023] Open
Affiliation(s)
- Karen Schreiber
- Thrombosis & Haemophilia Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Department of Rheumatology, Danish Hospital for Rheumatic Diseases, Sonderborg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Margreta Frishman
- Obstetrics and Gynaecology, North Middlesex University Hospital NHS Trust, London, UK
| | - Mark D Russell
- Centre for Rheumatic Diseases, King's College London, London, UK
| | - Mrinalini Dey
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Julia Flint
- Department of Rheumatology, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Shropshire, UK
| | - Alexander Allen
- Clinical Affairs, British Society for Rheumatology, London, UK
| | | | - Mary Gayed
- Rheumatology, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - Kenneth Hodson
- UK Teratology Information Service, Newcastle upon Tyne, UK
| | - Munther Khamashta
- Division of Women's Health, Lupus Research Unit, King's College London, London, UK
| | - Louise Moore
- Rheumatic and Musculoskeletal Disease Unit, Our Lady's Hospice and Care Service, Dublin, Ireland
| | - Sonia Panchal
- Rheumatology, South Warwickshire NHS Foundation Trust, Warwickshire, UK
| | - Madeleine Piper
- Royal National Hospital for Rheumatic Diseases, Royal United Hospital, Bath, UK
| | | | - Katherine Saxby
- Pharmacology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Naz Senvar
- Obstetrics and Gynaecology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Sofia Tosounidou
- Lupus UK Centre of Excellence, Sandwell and West Birmingham NHS Trust, Birmingham, UK
| | | | - Louise Warburton
- Shropshire Community NHS Trust, Shropshire, UK
- Primary Care and Health Sciences, Keele University, Keele, UK
| | - David Williams
- Obstetrics, University College London Hospitals NHS Foundation Trust, London, UK
| | - Chee-Seng Yee
- Department of Rheumatology, Doncaster and Bassetlaw, Teaching Hospitals NHS Foundation Trust, Doncaster, UK
| | - Caroline Gordon
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Ian Giles
- Centre for Rheumatology, Department of Inflammation, Division of Medicine, University College London, London, UK
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9
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Russell MD, Dey M, Flint J, Davie P, Allen A, Crossley A, Frishman M, Gayed M, Hodson K, Khamashta M, Moore L, Panchal S, Piper M, Reid C, Saxby K, Schreiber K, Senvar N, Tosounidou S, van de Venne M, Warburton L, Williams D, Yee CS, Gordon C, Giles I. Executive Summary: British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: immunomodulatory anti-rheumatic drugs and corticosteroids. Rheumatology (Oxford) 2023; 62:1370-1387. [PMID: 36318965 PMCID: PMC10070067 DOI: 10.1093/rheumatology/keac558] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 04/05/2023] Open
Affiliation(s)
- Mark D Russell
- Centre for Rheumatic Diseases, King's College London, London, UK
| | - Mrinalini Dey
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Julia Flint
- Department of Rheumatology, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Shropshire, UK
| | - Philippa Davie
- Centre for Rheumatic Diseases, King's College London, London, UK
| | - Alexander Allen
- Clinical Affairs, British Society for Rheumatology, London, UK
| | | | - Margreta Frishman
- Rheumatology, North Middlesex University Hospital NHS Trust, London, UK
| | - Mary Gayed
- Rheumatology, Sandwell and West Birmingham Hospital, Birmingham, UK
| | | | - Munther Khamashta
- Lupus Research Unit, Division of Women's Health, King's College London, London, UK
| | - Louise Moore
- Rheumatic and Musculoskeletal Disease Unit, Our Lady's Hospice and Care Service, Dublin, Ireland
| | - Sonia Panchal
- Department of Rheumatology, South Warwickshire NHS Foundation Trust, Warwickshire, UK
| | - Madeleine Piper
- Royal National Hospital for Rheumatic Diseases, Royal United Hospital, Bath, UK
| | | | - Katherine Saxby
- Pharmacy, University College London Hospitals NHS Foundation Trust, London, UK
| | - Karen Schreiber
- Thrombosis and Haemostasis, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Department of Rheumatology, Danish Hospital for Rheumatic Diseases, Sonderborg, Denmark
- Department of Regional Health Research (IRS), University of Southern Denmark, Odense, Denmark
| | - Naz Senvar
- Obstetrics and Gynaecology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Sofia Tosounidou
- Lupus UK Centre of Excellence, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | | | | | - David Williams
- Obstetrics, University College London Hospitals NHS Foundation Trust, London, UK
| | - Chee-Seng Yee
- Department of Rheumatology, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK
| | - Caroline Gordon
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Ian Giles
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
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Schreiber K, Frishman M, Russell MD, Dey M, Flint J, Allen A, Crossley A, Gayed M, Hodson K, Khamashta M, Moore L, Panchal S, Piper M, Reid C, Saxby K, Senvar N, Tosounidou S, van de Venne M, Warburton L, Williams D, Yee CS, Gordon C, Giles I, Giles I, Roddy E, Armon K, Astell L, Cotton C, Davidson A, Fordham S, Jones C, Joyce C, Kuttikat A, McLaren Z, Merrison K, Mewar D, Mootoo A, Williams E. British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: comorbidity medications used in rheumatology practice. Rheumatology (Oxford) 2022; 62:e89-e104. [PMID: 36318967 PMCID: PMC10070063 DOI: 10.1093/rheumatology/keac552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Karen Schreiber
- Thrombosis & Haemophilia Centre, Guy's and St Thomas' NHS Foundation Trust , London, UK
- Department of Rheumatology, Danish Hospital for Rheumatic Diseases , Sonderborg, Denmark
- Department of Regional Health Research, University of Southern Denmark , Odense, Denmark
| | - Margreta Frishman
- Obstetrics and Gynaecology, North Middlesex University Hospital NHS Trust , London, UK
| | - Mark D Russell
- Centre for Rheumatic Diseases, King’s College London , London, UK
| | - Mrinalini Dey
- Institute of Life Course and Medical Sciences, University of Liverpool , Liverpool, UK
| | - Julia Flint
- Department of Rheumatology, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust , Shropshire, UK
| | - Alexander Allen
- Clinical Affairs, British Society for Rheumatology , London, UK
| | | | - Mary Gayed
- Rheumatology, University Hospital Birmingham NHS Foundation Trust , Birmingham, UK
| | - Kenneth Hodson
- The UK Teratology Information Service , Newcastle upon Tyne, UK
| | - Munther Khamashta
- Division of Women’s Health, Lupus Research Unit, King's College London , London, UK
| | - Louise Moore
- Rheumatic and Musculoskeletal Disease Unit, Our Lady’s Hospice and Care Service , Dublin, Ireland
| | - Sonia Panchal
- Rheumatology, South Warwickshire NHS Foundation Trust , Warwickshire, UK
| | - Madeleine Piper
- Royal National Hospital for Rheumatic Diseases, Royal United Hospital , Bath, UK
| | | | - Katherine Saxby
- Pharmacology, University College London Hospitals NHS Foundation Trust , London, UK
| | - Naz Senvar
- Obstetrics and Gynaecology, St George's University Hospitals NHS Foundation Trust , London, UK
| | - Sofia Tosounidou
- Lupus UK Centre of Excellence, Sandwell and West Birmingham NHS Trust , Birmingham, UK
| | | | - Louise Warburton
- Shropshire Community NHS Trust , Shropshire, UK
- Primary Care and Health Sciences, Keele University , Keele, UK
| | - David Williams
- Obstetrics, University College London Hospitals NHS Foundation Trust , London, UK
| | - Chee-Seng Yee
- Department of Rheumatology, Doncaster and Bassetlaw, Teaching Hospitals NHS Foundation Trust , Doncaster, UK
| | - Caroline Gordon
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham , Birmingham, UK
| | - Ian Giles
- Centre for Rheumatology, Department of Inflammation, Division of Medicine, University College London , London, UK
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11
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Russell MD, Dey M, Flint J, Davie P, Allen A, Crossley A, Frishman M, Gayed M, Hodson K, Khamashta M, Moore L, Panchal S, Piper M, Reid C, Saxby K, Schreiber K, Senvar N, Tosounidou S, van de Venne M, Warburton L, Williams D, Yee CS, Gordon C, Giles I, Roddy E, Armon K, Astell L, Cotton C, Davidson A, Fordham S, Jones C, Joyce C, Kuttikat A, McLaren Z, Merrison K, Mewar D, Mootoo A, Williams E. British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: immunomodulatory anti-rheumatic drugs and corticosteroids. Rheumatology (Oxford) 2022; 62:e48-e88. [PMID: 36318966 PMCID: PMC10070073 DOI: 10.1093/rheumatology/keac551] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Mark D Russell
- Centre for Rheumatic Diseases, King's College London, London, UK
| | - Mrinalini Dey
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Julia Flint
- Department of Rheumatology, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Shropshire, UK
| | - Philippa Davie
- Centre for Rheumatic Diseases, King's College London, London, UK
| | - Alexander Allen
- Clinical Affairs, British Society for Rheumatology, London, UK
| | | | - Margreta Frishman
- Rheumatology, North Middlesex University Hospital NHS Trust, London, UK
| | - Mary Gayed
- Rheumatology, Sandwell and West Birmingham Hospitals, Birmingham, UK
| | | | - Munther Khamashta
- Lupus Research Unit, Division of Women's Health, King's College London, London, UK
| | - Louise Moore
- Rheumatic and Musculoskeletal Disease Unit, Our Lady's Hospice and Care Service, Dublin, Ireland
| | - Sonia Panchal
- Department of Rheumatology, South Warwickshire NHS Foundation Trust, Warwickshire, UK
| | - Madeleine Piper
- Royal National Hospital for Rheumatic Diseases, Royal United Hospital, Bath, UK
| | | | - Katherine Saxby
- Pharmacy, University College London Hospitals NHS Foundation Trust, London, UK
| | - Karen Schreiber
- Thrombosis and Haemostasis, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Rheumatology, Danish Hospital for Rheumatic Diseases, Sonderborg, Denmark.,Department of Regional Health Research (IRS), University of Southern Denmark, Odense, Denmark
| | - Naz Senvar
- Obstetrics and Gynaecology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Sofia Tosounidou
- Lupus UK Centre of Excellence, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | | | | | - David Williams
- Obstetrics, University College London Hospitals NHS Foundation Trust, London, UK
| | - Chee-Seng Yee
- Department of Rheumatology, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK
| | - Caroline Gordon
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Ian Giles
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
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Abernathy S, Moore L, Morales M. PATIENT CHARACTERISTICS AND RESPONSE TO BIOLOGIC THERAPIES IN MODERATE-TO-SEVERE PEDIATRIC ASTHMA. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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13
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Gorman Á, Sundanum S, Moore L, O'Brien C, McAuliffe F, Veale DJ. Pregnancy outcomes in women with psoriatic arthritis: comment on the article by Remaeus et al. Arthritis Rheumatol 2022; 74:1720. [PMID: 35656909 DOI: 10.1002/art.42253] [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] [Received: 03/09/2022] [Accepted: 05/10/2022] [Indexed: 11/11/2022]
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14
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Duval C, Sirois C, Savoie-White F, Tardif P, Bérubé M, Turgeon-Fournier A, Cook D, Lauzier F, Moore L. 83 - Compression pneumatique intermittente adjuvante : revue systématique et méta-analyse. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.06.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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15
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Campbell A, Smith R, Petersen B, Moore L, Khan A, Barrie A. O-125 Application of artificial intelligence using big data to devise and train a machine learning model on over 63,000 human embryos to automate time-lapse embryo annotation. Hum Reprod 2022. [DOI: 10.1093/humrep/deac105.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Can a machine learning (ML) model, developed using modern neural network architecture produce comparable annotation data; utilisable for algorithmic outcome prediction, to manual time-lapse annotations?
Summary answer
The model automatically annotated unseen embryos with comparable results to manual methods, generating morphokinetic data to enable comparably predictive outputs from an embryo selection algorithm.
What is known already
The application of artificial intelligence across healthcare industries, including fertility, is increasing. Several ML models are available that seek to generate or analyse embryo images and morphokinetic data, and to determine embryo viability potential. Along with photographic images, the use of time-lapse in IVF laboratories has amassed numeric data, resulting predominantly from annotated manual assessment of images over time. Embryo annotation practice is variable in quality, can be subjective and is time-consuming; commonly taking several minutes per embryo. The development of rapid, accurate automatic annotation would represent a significant time-saving as well as an increase in reproducibility and accuracy.
Study design, size, duration
Multicentre quality assured annotation data from 63,383 time-lapse monitored embryos (EmbryoScope®), comprising over 400 million individual images, were used to train a ML model to automatically generate morphokinetic annotations. Data was derived from 8 UK clinics within a cohesive group between 2012-2021. Accuracy was assessed using 900 unseen embryos (with live birth outcome) by comparing the output of an established in-house, prospectively validated embryo selection model when the input was either ML-automated, or manual annotations.
Participants/materials, setting, methods
Multi-focal plane images were processed on the Azure cloud (Microsoft) and resampled to 300x300 pixels. A Laplacian-based focal stacking algorithm merged frames into a single image. The model consisted of an EfficientNetB4 Convolutional Neural Network classifier to extract features and classify the stage of embryo images. A Temporal Convolutional Network interpreted a time-series of image features; producing annotations from pronuclear fading through to blastocyst. Soft localisation loss function used QA data to integrate annotation subjectivities.
Main results and the role of chance
The ML model rapidly and automatically generated annotations. Efficacy and comparability of the ML model to automate reliable, utilisable annotations was demonstrated by comparison with manual annotation data and the ML model’s ability to auto-generate annotations which could be used to predict live birth by providing annotation data to an established, validated in house embryo selection model. Live birth-predictive capability was measured, and benchmarked against manual annotation, using the area under the receiver operating characteristic curve (AUC).
When tested on time-lapse images, collected from pronuclear fading to full blastulation, representing 900 previously unseen, transferred blastocysts where live birth outcomes were blinded, the in-house developed auto-annotation ML model resulted in an AUC of 0.686 compared with 0.661 for manual annotations, for live birth prediction.
Auto annotation using the developed model took only milliseconds to complete per embryo. The developed auto-annotation model, built and tested on large data, is considered suitable for productionisation with the aim of being validated and integrated into an application to support IVF laboratory practice.
Limitations, reasons for caution
Whilst this model was trained to recognise key morphokinetic events, there are other morphokinetic variables that may be useful in the prediction of live birth and further improve embryo selection, or deselection, ability. Akin to manual interpretation, some embryos may fail to be annotated or need second opinion.
Wider implications of the findings
There is increasing evidence supporting the application of ML to utilise big data from time-lapse imaging and fertility care generally. Whilst promising benefits to IVF clinics and patients, responsible use of data is required alongside large high-quality datasets, and rigorous validation, to ensure safe and robust applications.
Trial registration number
N/A
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Affiliation(s)
- A Campbell
- CARE Fertility Group , Embryology, Nottingham, United Kingdom
| | - R Smith
- CARE Fertility Group , Embryology, Nottingham, United Kingdom
| | - B Petersen
- BMP Analytics, Mathematics , Aarhus, Denmark
| | - L Moore
- BJSS, Data Science , Leeds, United Kingdom
| | - A Khan
- BJSS, Data Science , Leeds, United Kingdom
| | - A Barrie
- CARE Fertility Group , Embryology, Nottingham, United Kingdom
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16
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Donnez J, Taylor H, Gemzell-Danielsson K, Catherino W, Bestel E, Gotteland J, Humberstone A, Moore L, Garner E. O-306 LINZAGOLIX FOR ENDOMETRIOSIS-ASSOCIATED PAIN: SAFETY RESULTS FROM EDELWEISS 3, A PHASE 3, RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL. Hum Reprod 2022. [DOI: 10.1093/humrep/deac105.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Is once-daily linzagolix treatment for women with moderate to severe endometriosis-associated pain (EAP) safe for use for up to 6 months of treatment?
Summary answer
Both doses of linzagolix were well-tolerated with minimal BMD decrease and few TEAEs >5% in either linzagolix arm.
What is known already
Linzagolix (LGX) is an investigational once-daily oral GnRH receptor antagonist that reduces serum estradiol in a dose-dependent manner and is being developed in two dosages for the treatment of endometriosis-associated pain (EAP): 75 mg, and 200 mg dose with hormonal add-back therapy (ABT).
Study design, size, duration
EDELWEISS 3 is a randomized, double-blind, placebo-controlled, multicenter Phase 3 trial of linzagolix in women with moderate to severe EAP. The trial includes 3 treatment arms: 75 mg LGX, 200 mg LGX with ABT (E2 1 mg/ NETA 0.5 mg), or placebo. Here we present safety results up to 6 months (24 weeks) of treatment.
Participants/materials, setting, methods
Eligible reproductive-aged women with moderate-to-severe EAP were randomized and treated (n = 484) for 6 months with 75 mg LGX, 200 mg LGX with ABT (E2 1 mg/ NETA 0.5 mg), or placebo. Safety and tolerability objectives reported here include 6-month results for treatment emergent adverse events (TEAEs), assessment of mean percent change from baseline (CfB) in lumbar spine (LS) bone mineral density (BMD) and Z-scores.
The safety analysis set included 484 subjects across the 3 treatment groups.
Main results and the role of chance
The overall incidence of TEAEs was similar between the placebo and LGX 75 mg group (46.9%) and slightly higher (56.8%) in the LGX 200 mg + ABT group. There were few (3) serious TEAEs, and none were related to LGX. TEAEs that occurred in over 5% of patients in either active treatment arm included headache (10.5%, 8.1%, and 8.0%), hot flush (6.8%, 7.5%, and 2.5%), and fatigue (6.8%, 3.8%, and 2.5%) for the 200 mg LGX with ABT, 75 mg LGX, and placebo groups, respectively. Mean percent CfB (95% CI) in LS BMD was -0.79% (-1.15, -0.43%), -0.89% (-1.31, -0.47%), and +0.78% (0.41, 1.15%) for the 200 mg LGX with ABT, 75 mg LGX, and placebo groups, respectively. Z-scores at 6 months remained within the same range as baseline in all groups.
Limitations, reasons for caution
Additional efficacy and safety results from the trial's 24 weeks (6 mo) extension phase are pending. (Edelweiss 6 protocol: NCT04335591)
Wider implications of the findings
These results support further development of ABT and non-ABT doses of linzagolix that have potential to provide flexibility and choice for women seeking treatment for EAP. A non-ABT option is important for women who have a contraindication to, are at increased risk for complications, or prefer not to use ABT.
Trial registration number
ClinicalTrials.gov: NCT02778399
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Affiliation(s)
- J Donnez
- Catholic University of Louvain , Ob/Gyn, Brussels, Belgium
| | - H Taylor
- Yale University , Ob/Gyn, New Haven, U.S.A
| | | | - W Catherino
- Uniformed Services University of the Health Sciences , Ob/Gyn, Bethesda, U.S.A
| | - E Bestel
- ObsEva SA, Research & Development , Geneva, Switzerland
| | - J.P Gotteland
- ObsEva SA, Research & Development , Geneva, Switzerland
| | | | - L Moore
- ObsEva Inc., Medical Affairs , Boston, U.S.A
| | - E Garner
- ObsEva Inc., Medical Affairs , Boston, U.S.A
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17
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Esmail A, Kodali S, Graviss E, Nguyen D, Moore L, Saharia A, Uosef A, Victor D, Abdelrahim M. P-163 Tyrosine kinase inhibitors (TKIs) plus transarterial chemoembolization (TACE) compared to TACE alone as downstaging therapy in transplant recipients with hepatocellular carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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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18
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Cassidy C, Moore L, Ryan J, Brennan S. Audit on Oral Health Examinations in an Approved Psychiatric Centre. Ir Med J 2022; 115:527. [PMID: 35279061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- C Cassidy
- Department of Psychiatry, South Tipperary Hospital, Clonmel, Tipperary
| | - L Moore
- Department of Psychiatry, South Tipperary Hospital, Clonmel, Tipperary
| | - J Ryan
- Suirside Medical Practice, Clonmel, Tipperary
| | - S Brennan
- Department of Psychiatry, South Tipperary Hospital, Clonmel, Tipperary
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19
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Moore L. An evaluation of the nutritional requirements of post-operative colorectal patients. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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20
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Ahrens L, List R, Gott K, Lonabaugh K, Haney H, Moore L, Knight D, Garrod A, Mason K, Froh D. 140: Oh gee! Time tested OGTT annual screening improvement: A single-center experience. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01565-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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21
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Abstract
Abstract
Few interventions are truly simple; complexity can arise from various sources, e.g.:
Aspects of the intervention itself, such as the number of intervention components, the number of groups targeted, how dynamic the intervention is permitted to be. The context in which the intervention is developed and delivered, such as the social, political, economic, and geographical context.
Complex intervention research should be approached with an awareness of these sources of complexity. Systems thinking can be helpful to understanding the dynamic interaction between interventions and their context. This presentation will introduce concepts of complex adaptive systems, e.g. feedback loops, adaptation, emergence, that should be considered when developing and evaluating complex interventions. It will then introduce participants to the research perspectives set out in the new framework: efficacy, effectiveness, theory-based, and systems perspectives. Each perspective is associated with a different type of research question, and therefore appropriate in different circumstances. The presentation will provide information to support participants to consider the research perspective(s) most suited to the research challenge that they are aiming to address.
Main messages
There are multiple sources of complexity, each of which can affect how the intervention works or contributes to change. Complex intervention research can take an efficacy, effectiveness, theory-based, or systems perspective, the choice of which is based on what is known already and what further evidence would be most useful.
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Affiliation(s)
- K Skivington
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - P Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - L Moore
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - L Matthews
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - S Simpson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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22
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Craig P, Skivington K, Moore L, Simpson S, Matthews L. The new Framework and the Core Elements of complex intervention research. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
The new framework will be presented. The main phases of intervention research: development or identification, feasibility, evaluation and implementation are connected to 6 core elements:
Context: any feature of the circumstances in which an intervention is conceived, developed, evaluated and implemented Programme theory: how an intervention is expected to lead to its effects and under what conditions. Programme theory should be tested and refined at all stages and used to guide the identification of uncertainties and research questions Stakeholders: those who are targeted by the intervention, involved in its development or delivery, or more broadly those whose personal or professional interests are affected, that is who have a stake in the topic. This includes patients, the public, and professionals Refinement: the process of ‘fine tuning' or making changes to the intervention once a preliminary version has been developed Uncertainties: identifying key uncertainties that exist given what is already known and what the programme theory, researchers and stakeholders identify as being most important to find out. These judgements inform the framing of research questions that, in turn, govern research perspective choice Economic considerations: exploring the comparative resource and outcome consequences of the interventions for those people and organisations affected
The presentation will discuss how to use the framework, highlighting that complex intervention research can be an iterative process. Repeating of phases is preferable to automatic progression to the next phase if uncertainties remain unresolved.
Main messages
Complex intervention research may begin at any phase, depending on what is appropriate for the intervention in question, and does not necessarily move sequentially through the phases. The core elements should be considered early and revisited continually throughout, as this will make it most likely that the intervention will be implementable in practice.
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Affiliation(s)
- P Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - K Skivington
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - L Moore
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - S Simpson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - L Matthews
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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23
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Fong JN, Miketinas D, Moore L, Everts H, Warren C, Juma S, Patterson M. Precision Nutrition Model Predicts Postprandial Glucose Response Following Potato Intake. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.08.032] [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] [Indexed: 11/24/2022]
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24
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Loibl S, Loirat D, Tolaney S, Punie K, Oliveira M, Rugo H, Bardia A, Hurvitz S, Brufsky A, Kalinsky K, Cortés J, O'Shaughnessy J, Dieras V, Carey L, Gianni L, Gharaibeh M, Moore L, Shi L, Piccart M. 257P Health-related quality of life (HRQoL) in the ASCENT study of sacituzumab govitecan (SG) in metastatic triple-negative breast cancer (mTNBC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.540] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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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Giles I, Allen A, Crossley A, Flint J, Frishman M, Gayed M, Kamashta M, Moore L, Panchal S, Piper M, Reid C, Saxby K, Schreiber K, Senvar N, Tosounidou S, van de Venne M, Warburton L, Wiliams D, Yee CS, Gordon C. Prescribing anti-rheumatic drugs in pregnancy and breastfeeding-the British Society for Rheumatology guideline scope. Rheumatology (Oxford) 2021; 60:3565-3569. [PMID: 33848327 DOI: 10.1093/rheumatology/keab334] [Citation(s) in RCA: 3] [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] [Received: 01/18/2021] [Revised: 03/08/2021] [Accepted: 04/01/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ian Giles
- Centre For Rheumatology Research, UCL Division of Medicine, University College, London, UK
| | - Alexander Allen
- Clinical Affairs, British Society for Rheumatology, London, UK
| | | | - Julia Flint
- Rheumatology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Margreta Frishman
- Rheumatology, North Middlesex University Hospital NHS Trust, London, UK
| | - Mary Gayed
- Rheumatology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Munther Kamashta
- Division of Women's Health, Lupus Research Unit, King's College London, London, UK
| | - Louise Moore
- Rheumatic and Musculoskeletal Disease Unit, Our Lady's Hospice and Care Service, Dublin, Ireland
| | - Sonia Panchal
- Rheumatology, University Hospitals of Leicester, Leicester, UK
| | | | | | - Katherine Saxby
- Pharmacy, University College London Hospitals NHS Foundation Trust, London, UK
| | - Karen Schreiber
- Thrombosis and Haemophilia Centre, Guy's and Saint Thomas' NHS Foundation Trust, London, UK
| | - Naz Senvar
- Obstetrics and Gynaecology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Sofia Tosounidou
- Lupus UK Centre of Excellence, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | | | | | - David Wiliams
- Maternal and Fetal Medicine, UCL EGA Institute for Womens Health, University College London, London, UK
| | - Chee-Seng Yee
- Department of Rheumatology, Doncaster and Bassetlaw Hospitals NHS Foundation Trust, Doncaster Royal Infirmary, Doncaster, UK
| | - Caroline Gordon
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
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O'Donoghue J, Moore L, Bhakyapaibul T, Melin H, Stallard T, Connerney JEP, Tao C. Global upper-atmospheric heating on Jupiter by the polar aurorae. Nature 2021; 596:54-57. [PMID: 34349293 PMCID: PMC8338559 DOI: 10.1038/s41586-021-03706-w] [Citation(s) in RCA: 6] [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: 02/25/2021] [Accepted: 06/08/2021] [Indexed: 11/18/2022]
Abstract
Jupiter's upper atmosphere is considerably hotter than expected from the amount of sunlight that it receives1-3. Processes that couple the magnetosphere to the atmosphere give rise to intense auroral emissions and enormous deposition of energy in the magnetic polar regions, so it has been presumed that redistribution of this energy could heat the rest of the planet4-6. Instead, most thermospheric global circulation models demonstrate that auroral energy is trapped at high latitudes by the strong winds on this rapidly rotating planet3,5,7-10. Consequently, other possible heat sources have continued to be studied, such as heating by gravity waves and acoustic waves emanating from the lower atmosphere2,11-13. Each mechanism would imprint a unique signature on the global Jovian temperature gradients, thus revealing the dominant heat source, but a lack of planet-wide, high-resolution data has meant that these gradients have not been determined. Here we report infrared spectroscopy of Jupiter with a spatial resolution of 2 degrees in longitude and latitude, extending from pole to equator. We find that temperatures decrease steadily from the auroral polar regions to the equator. Furthermore, during a period of enhanced activity possibly driven by a solar wind compression, a high-temperature planetary-scale structure was observed that may be propagating from the aurora. These observations indicate that Jupiter's upper atmosphere is predominantly heated by the redistribution of auroral energy.
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Affiliation(s)
- J O'Donoghue
- Department of Solar System Science, JAXA Institute of Space and Astronautical Science, Sagamihara, Japan.
- NASA Goddard Space Flight Center, Greenbelt, MD, USA.
| | - L Moore
- Center for Space Physics, Boston University, Boston, MA, USA
| | - T Bhakyapaibul
- Center for Space Physics, Boston University, Boston, MA, USA
| | - H Melin
- Department of Physics and Astronomy, University of Leicester, Leicester, UK
| | - T Stallard
- Department of Physics and Astronomy, University of Leicester, Leicester, UK
| | - J E P Connerney
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
- Space Research Corporation, Annapolis, MD, USA
| | - C Tao
- National Institute of Information and Communications Technology (NICT), Tokyo, Japan
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27
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Ouellet V, Boucher V, Beauchamp F, Neveu X, Archambault P, Berthelot S, Chauny JM, De Guise E, Émond M, Frenette J, Lang E, Lee J, Mercier, Moore L, Ouellet MC, Perry J, Le Sage N. Influence of concomitant injuries on post-concussion symptoms after a mild traumatic brain injury - a prospective multicentre cohort study. Brain Inj 2021; 35:1028-1034. [PMID: 34224275 DOI: 10.1080/02699052.2021.1945145] [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
Objectives: To compare post-concussion symptoms (PCS) and return to normal activities between mild Traumatic Brain Injury (mTBI) patients with or without concomitant injuries at 7-and 90 days post-mTBI.Methods: Design: Sub-analysis of a multicentre prospective cohort study. PARTICIPANTS AND SETTING patients with mTBI from 7 Canadian Emergency Departments. PROCEDURE Research assistants conducted telephone follow-ups using the Rivermead Postconcussion Symptoms Questionnaire (RPQ) at 7-, 30- and 90 days post-mTBI. MAIN OUTCOME Presence of PCS (RPQ: ≥3 symptoms) at 90 days. SECONDARY OUTCOMES RPQ score ≥21, prevalence of individual RPQ symptoms and patients' return to normal activities, at 7- and 90-days. Adjusted risk ratios (RR) were calculated.Results: 1725 mTBI patients were included and 1055 (61.1%) had concomitant injuries. Patients with concomitant injuries were at higher risk of having ≥3 symptoms on the RPQ (RR:1.26 [95% CI 1.01-1.58]) at 90 days. They were also at higher risk of experiencing specific symptoms (dizziness, fatigue, headaches and taking longer to think) and of non-return to their normal activities (RR:2.11 [95% CI 1.30-3.45]).Conclusion: Patients with concomitant injuries have slightly more PCS and seemed to be at higher risk of non-return to their normal activities 90 days, compared to patients without concomitant injuries.
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Affiliation(s)
- V Ouellet
- CHU De Québec-Université Laval Research Center, Quebec, Canada.,Centre De Recherche Sur Les Soins Et Les Services De Première Ligne De l'Université Laval (CERSSPL-UL), Canada.,Département De Médecine Familiale Et De Médecine D'urgence, Faculté De Médecine, Université Laval Québec Canada
| | - V Boucher
- CHU De Québec-Université Laval Research Center, Quebec, Canada.,Centre De Recherche Sur Les Soins Et Les Services De Première Ligne De l'Université Laval (CERSSPL-UL), Canada
| | - F Beauchamp
- CHU De Québec-Université Laval Research Center, Quebec, Canada.,Centre De Recherche Sur Les Soins Et Les Services De Première Ligne De l'Université Laval (CERSSPL-UL), Canada.,Département De Médecine Familiale Et De Médecine D'urgence, Faculté De Médecine, Université Laval Québec Canada
| | - X Neveu
- CHU De Québec-Université Laval Research Center, Quebec, Canada.,Centre De Recherche Sur Les Soins Et Les Services De Première Ligne De l'Université Laval (CERSSPL-UL), Canada
| | - P Archambault
- Département De Médecine Familiale Et De Médecine D'urgence, Faculté De Médecine, Université Laval Québec Canada.,Centre Intégré De Santé Et De Services Sociaux De Chaudière-Appalaches, Centre Hospitalier Affilié Universitaire Hôtel-Dieu De Lévis, Lévis (Quebec) Canada
| | - S Berthelot
- CHU De Québec-Université Laval Research Center, Quebec, Canada.,Centre De Recherche Sur Les Soins Et Les Services De Première Ligne De l'Université Laval (CERSSPL-UL), Canada.,Département De Médecine Familiale Et De Médecine D'urgence, Faculté De Médecine, Université Laval Québec Canada
| | - J M Chauny
- Université De Montréal, Montréal, Québec, Canada
| | - E De Guise
- Université De Montréal, Montréal, Québec, Canada.,Research-Institute, McGill University Health CentreMontreal, Quebec, Canada.,Centre De Recherche Interdisciplinaire En Réadaptation Du Montréal Métropolitain (CRIR), Montreal, Quebec, Canada
| | - M Émond
- CHU De Québec-Université Laval Research Center, Quebec, Canada.,Centre De Recherche Sur Les Soins Et Les Services De Première Ligne De l'Université Laval (CERSSPL-UL), Canada.,Département De Médecine Familiale Et De Médecine D'urgence, Faculté De Médecine, Université Laval Québec Canada
| | - J Frenette
- Centre De Recherche Sur Les Soins Et Les Services De Première Ligne De l'Université Laval (CERSSPL-UL), Canada
| | - E Lang
- University of Calgary, Calgary, Alberta, Canada
| | - J Lee
- Schwartz/Reisman Emergency Medicine Institute, Toronto, Ontario, Canada
| | - Mercier
- CHU De Québec-Université Laval Research Center, Quebec, Canada.,Centre De Recherche Sur Les Soins Et Les Services De Première Ligne De l'Université Laval (CERSSPL-UL), Canada.,Département De Médecine Familiale Et De Médecine D'urgence, Faculté De Médecine, Université Laval Québec Canada
| | - L Moore
- Department of Social and Preventive Medicine, Faculté De Médecine, Université Laval Québec Canada
| | - M C Ouellet
- Département De Psychologie, Université Laval Québec Canada.,Centre Interdisciplinaire De Recherche En Réadaptation Et Intégration Sociale CIRRIS, Quebec, Canada
| | - J Perry
- Department of Emergency Medicine, Ottawa Hospital Research Institute, University of Ottawa Ottawa Canada
| | - N Le Sage
- CHU De Québec-Université Laval Research Center, Quebec, Canada.,Centre De Recherche Sur Les Soins Et Les Services De Première Ligne De l'Université Laval (CERSSPL-UL), Canada.,Département De Médecine Familiale Et De Médecine D'urgence, Faculté De Médecine, Université Laval Québec Canada
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Low R, Young K, Verani L, Cotton DT, Welman T, Moore L, Horwitz MD. 540 Point of Care Testing for Tetanus Immunity: A Systematic Review. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.448] [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
All patients presenting to emergency departments (EDs) with traumatic injuries require tetanus immunity assessments. Inaccurate tetanus vaccination history based on patient recall incurs unnecessary costs on the NHS. Point-of-care immunochromatographic tests (Tetanus Quick Sticks [TQS]) quickly identify tetanus immunity status. We aim to evaluate the diagnostic accuracy and cost-efficacy of TQS to assess their relevance in emergency care.
Method
The systematic review followed PRISMA guidelines. A retrospective search of MEDLINE, Embase, Global Health, HMIC and The Cochrane Library was conducted. Studies were eligible if sensitivity, specificity, or cost-efficacy of TQS were reported. At least two authors independently analysed the data from each study.
Results
12 studies were suitable for inclusion (n = 1,662,865 participants): one retrospective and 11 prospective observational cohort studies. Eight studies assessed diagnostic accuracy with the median sensitivity at 86% (55-100) and the median specificity at 97.5% (1-100). All six studies investigating cost-efficacy reported greater savings when using TQS instead of using vaccination history, due to a decrease in unnecessary tetanus vaccine and immunoglobulin administration.
Conclusions
TQS is a safe diagnostic tool, especially when used by trained operators. TQS widely reduces costs in comparison to traditional vaccination history. We recommend the use of TQS in Emergency Departments throughout the NHS.
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Affiliation(s)
- R Low
- Imperial College London, London, United Kingdom
| | - K Young
- Imperial College London, London, United Kingdom
| | - L Verani
- Imperial College London, London, United Kingdom
| | - D T Cotton
- Imperial College London, London, United Kingdom
| | - T Welman
- Hand Unit Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
- Department of Plastic Surgery, The Royal London Hospital, Barts Health NHS Foundation Trust, London, United Kingdom
| | - L Moore
- Imperial College London, London, United Kingdom
- Hand Unit Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
- North West London Pathology, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - M D Horwitz
- Hand Unit Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
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O'Brien J, Fryer S, Parker J, Moore L. The effect of ego depletion on challenge and threat evaluations during a potentially stressful public speaking task. Anxiety Stress Coping 2021; 34:266-278. [PMID: 33141603 DOI: 10.1080/10615806.2020.1839732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/05/2020] [Accepted: 08/11/2020] [Indexed: 06/11/2023]
Abstract
It has been well established that challenge and threat evaluations affect the performance of potentially stressful tasks. However, the factors that influence these evaluations have rarely been examined. Objective: This study examined the effects of ego depletion on challenge and threat evaluations during a public speaking task. Method: 262 participants (150 males, 112 females; Mage = 20.5, SD = 4.3) were randomly assigned to either an ego depletion or control group. Participants then completed self-report measures of trait self-control. The ego depletion group performed a written transcription task requiring self-control, while the control group transcribed the text normally. Before the public speaking task, participant's challenge and threat evaluations and subjective ratings of performance were assessed via self-report items. Results: The results of independent t-tests supported the effectiveness of the self-control manipulation. There were no significant differences between the ego depletion and control groups in terms of challenge and threat evaluations or subjective performance. Additional correlation analyses revealed that trait measures of self-control were significantly and negatively related to challenge and threat evaluations and subjective performance. Conclusion: Findings suggest that ego depletion might not influence appraisals of potentially stressful tasks, and thus add to recent evidence questioning the ego-depletion phenomenon.
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Affiliation(s)
- J O'Brien
- Faculty of Applied Sciences, School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
| | - S Fryer
- Faculty of Applied Sciences, School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
| | - J Parker
- Higher Education Sport, Hartpury University, Gloucester, UK
| | - L Moore
- Department for Health, University of Bath, Bath, UK
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Moore L, Moses JI, Melin H, Stallard TS, O’Donoghue J. Atmospheric implications of the lack of H 3+ detection at Neptune. Philos Trans A Math Phys Eng Sci 2020; 378:20200100. [PMID: 33161862 PMCID: PMC7658779 DOI: 10.1098/rsta.2020.0100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/02/2020] [Indexed: 05/04/2023]
Abstract
H3+ has been detected at all of the solar system giant planets aside from Neptune. Current observational upper limits imply that there is far less H3+ emission at Neptune than rudimentary modelling would suggest. Here, we explore via modelling a range of atmospheric conditions in order to find some that could be consistent with observational constraints. In particular, we consider that the upper atmosphere might be much cooler than it was during the 1989 Voyager 2 encounter, and we examine the impact of an enhanced influx of external material that could act to reduce H3+ density. Resulting ionosphere models that are consistent with existing H3+ observational constraints have an exospheric temperature of 450 K or less, 300 K lower than the Voyager 2 value. Alternatively, if a topside CO influx of 2 × 108 cm-2 s-1 is imposed, the upper atmospheric temperature can be higher, up to 550 K. The potential cooling of Neptune's atmosphere is relevant for poorly understood giant planet thermospheric energetics, and would also impact aerobreaking manoeuvers for any future spacecraft. Such a large CO influx, if present, could imply Triton is a very active moon with prominent atmospheric escape, and/or that Neptune's rings significantly modify its upper atmosphere, and the introduction of so much exogenic material would complicate interpretation of the origin of species observed in Neptune's lower atmosphere. This article is part a discussion meeting issue 'Future exploration of ice giant systems'.
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Affiliation(s)
- L. Moore
- Boston University, Boston, MA, USA
| | | | - H. Melin
- University of Leicester, Leicester, UK
| | | | - J. O’Donoghue
- JAXA Institute of Space and Astronautical Science, Tokyo, Japan
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31
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Davies A, Teare L, Falder S, Dumville J, Shah M, Jenkins A, Collins D, Dheansa B, Coy K, Booth S, Moore L, Marlow K, Agha R, Young A. Consensus demonstrates four indicators needed to standardize burn wound infection reporting across trials in a single-country study (ICon-B study). J Hosp Infect 2020; 106:217-225. [DOI: 10.1016/j.jhin.2020.07.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 07/22/2020] [Indexed: 01/10/2023]
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Abstract
Aims:To compare the effectiveness of a manualised group cognitive behaviour therapy (CBT) programme for people with bipolar disorder (BPD) and major depressive disorder (MDD).Method:In addition to treatment as usual (TAU), 17 people with BPD and 17 matched controls with MDD completed 8 or 12 sessions of twice weekly group CBT, followed by 6 booster sessions, held at monthly intervals. Participants completed the Structured Clinical Interview for DSM-IV Axis 1 Disorders, Clinician Version (SCID-1) and the University of Rhode Island Change Assessment (URICA) prior to therapy. They completed the Beck Depression Inventory - II (BDI), the Beck Anxiety Inventory (BAI), the Clinical Outcomes in Routine Evaluation (CORE), the World Health Organisation Quality of Life Brief Version (WHOQoL - BREF) and the Dysfunctional Attitudes Scale (DAS) before and after therapy and at the final follow-up session. The BDI and BAI were also completed at each group session.Results:Both groups showed statistically and clinically significant improvement on the BDI and BAI after treatment and at follow-up. Both groups showed a significant improvement on the psychological health sub-scale on the WHOQoL-BREF.Conclusions:Manualised group CBT leads to a reduction in the symptoms of depression and anxiety in people with both BPD and MDD and helps improve their perceived quality of life.Declaration of interest:None.
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Murray K, Moore L, Young F, McAulliffe F, Veale DJ. P256 Reproductive health outcomes in women with PsA. Rheumatology (Oxford) 2020. [DOI: 10.1093/rheumatology/keaa111.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
There is quality data showing rheumatoid arthritis (RA) improves in pregnancy and flares postpartum and that active disease is associated with adverse foetal outcomes. For psoriatic arthritis (PsA), the data is less clear, with previous studies giving contrasting results. We prospectively monitored disease control, maternal and foetal outcomes in women with PsA attending our multidisciplinary service.
Methods
Age, medications, disease control, maternal and foetal outcomes were reviewed and descripitive statistics applied.
Results
14 patients were reviewed. 12 became pregnant. There were 20 pregnancies in total. Eight patients had 1 pregnancy. Two patients had 3 pregnancies, 1 patient was pregnant twice and 1 patient had 4 pregnancies and is currently pregnant. Two patients failed to become pregnant.
There were 13 live births (one set of twins), 7 vaginal deliveries and 5 Caesarean sections. There were 6 intrauterine deaths (4 1st trimester, 2 2nd trimester). Two patients had postpartum complications (grade 4 vaginal tear and Caesarean wound infection). Mean foetal birth weight was 3.54kg (national average 3.49kg). 8 infants (55%) were breastfeeding at 6 weeks (national average 62%). 14 patients were on a DMARD (including oral steroids) in pregnancy. There were 8 pregnancies on a bDMARD alone, one on a bDMARD plus prednisolone. The bDMARDs used were certolizumab (five times), adalimumab (twice), infliximab (once) and etanercept (once). Two patients were on prednisolone alone. One patient on sulfasalazine plus prednisolone. One pregnancy on sulfasalazine plus hydroxychloroquine, 1 on sulfasalazine alone. Two patients were on NSAIDs. Disease activity was measured using DAS28-CRP 3 as this is validated for use in RA during pregnancy. Overall, the mean disease activity scores decreased during pregnancy and increased postpartum. After applying the European League Against Rheumatism-defined response criteria disease activity, almost half of the women had at least a moderate response during pregnancy and more than one-third had at least a moderate flare post partum, particularly at 6 weeks. The postpartum flare may be underestimated as medication use was remarkably increased after delivery. At 6 weeks, in five cases the bDMARD therapies had already been restarted. In two cases, the patients missed this appointment. One patient was started on methotrexate at their 6-week review.
Conclusion
Disease activity generally improved during pregnancy and flared postpartum. Miscarriage rates were higher than the general population (32% v 20%). Birth weights and breastfeeding rates at six weeks were similar.
Disclosures
K. Murray None. L. Moore None. F. Young None. F. McAulliffe None. D. Veale None.
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Affiliation(s)
- Kieran Murray
- Rheumatology, Saint Vincent's University Hospital, Dublin 4, IRELAND
| | - Louise Moore
- Rheumatology, Saint Vincent's University Hospital, Dublin 4, IRELAND
| | - Francis Young
- Rheumatology, Saint Vincent's University Hospital, Dublin 4, IRELAND
| | | | - Douglas J Veale
- Rheumatology, Saint Vincent's University Hospital, Dublin 4, IRELAND
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Murray K, Moore L, O'Brien C, Clohessy A, Brophy C, McAuliffe F, Veale DJ. P208 A multidisciplinary approach to reproductive healthcare in women with rheumatic disease. Rheumatology (Oxford) 2020. [DOI: 10.1093/rheumatology/keaa111.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Rheumatic disease (RD) patients when family planning must consider fertility, disease activity, and management from preconception to lactation. A clear understanding is necessary, especially for those receiving disease-modifying antirheumatic medications. Previous studies have highlighted unmet needs in the care of women with RDs with reproductive healthcare needs. This study describes, to our knowledge, the first published standardised reproductive care pathway for women with RDs and the outcomes of this approach.
Methods
We developed the care pathway with multidisciplinary input from rheumatologists, rheumatology nurse specialists, obstetricians, midwives, maternal medicine specialists, and pharmacists. We identified patients’ emotional and healthcare needs, ensured access to expert advice, maintenance of good disease control, and positive reproductive outcomes. We prospectively followed the patients and report the results of the service.
Results
Ninety-eight women with median age (range) of 35 years (19-48) were assessed. The majority had an inflammatory arthritis. Seventy-six babies were born to 62 mothers. There were 12 miscarriages and one perinatal death. Breastfeeding rates at 6 weeks were low (28%).
Conclusion
We describe the first published evidence-based integrated multidisciplinary reproductive care pathway for women with RDs and the results of this approach. Seventy percent of women successful in trying to conceive delivered a healthy baby, and 90% of patients were ‘very satisfied’ with the service.
Disclosures
K. Murray: None. L. Moore: None. C. O'Brien: None. A. Clohessy: None. C. Brophy: None. F. McAuliffe: None. D. Veale: None.
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Affiliation(s)
- Kieran Murray
- Rheumatology, Saint Vincent's University Hospital, Dublin 4, IRELAND
| | - Louise Moore
- Rheumatology, Our Lady's Hospice, Dublin 6, IRELAND
| | - Celine O'Brien
- Maternal Medicine, National Maternity Hospital, Dublin 2, IRELAND
| | - Anne Clohessy
- Maternal Medicine, National Maternity Hospital, Dublin 2, IRELAND
| | - Caroline Brophy
- Maternal Medicine, National Maternity Hospital, Dublin 2, IRELAND
| | | | - Douglas J Veale
- Rheumatology, Saint Vincent's University Hospital, Dublin 4, IRELAND
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Frey J, Najib U, Petrone A, Tirumalai P, Sherman J, Moore L, Lilly C, Casingal C, Colantonio L, Clairmont C, Adcock A. Abstract WP195: Accelerated Repetitive Transcranial Magnetic Stimulation (rTMS) as a Treatment for Subacute Post-Stroke Depression (PSD). Stroke 2020. [DOI: 10.1161/str.51.suppl_1.wp195] [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: 11/16/2022]
Abstract
Introduction:
Depression affects more than 50% of stroke survivors, reducing quality of life and increasing adverse outcomes. As stroke survivorship improves, the need for innovative treatments for associated stroke morbidity such as PSD is even more urgent. Alternative therapies are necessary due to the limited efficacy of antidepressants and counseling. rTMS is well established as an effective treatment for Major Depressive Disorder (MDD) and some small trials have shown that rTMS may be effective for chronic PSD; however, no trials have looked at an accelerated rTMS protocol in the subacute stroke period for PSD.
Hypothesis:
An accelerated rTMS protocol will be a safe and feasible option to effectively reduce PSD symptoms within 6 months of ischemic stroke onset.
Methods:
Patients (N = 6) with radiographic evidence of ischemic stroke within the last 2 weeks to 6 months who had Hamilton Depression Rating Scale (HAMD-17) scores ≥ 8 were recruited for an open label study using an accelerated rTMS protocol as follows: High frequency (20 Hz) rTMS at 110% resting motor threshold (RMT) was applied to the left dorsolateral prefrontal cortex (DLPFC) during 5 sessions per day over 4 consecutive days for a total of 20 sessions. Forty trains of 2 second duration were applied with a 12 second intertrain interval for a total of 1560 pulses per session. Before and after the 4-day neurostimulation protocol, outcome measures were obtained for the HAMD, modified Rankin Scale (mRS), functional independence measures (FIM), and National Institutes of Health Stroke Scales (NIHSS). These same measures were obtained at 3-month follow up.
Results:
HAMD significantly decreased (Wilcoxon p = 0.03) from M=15.5 (2.81) to 4.17 (0.98) following rTMS, a difference which persisted to the 3-month follow-up (p=0.03). No statistically significant difference in FIM, mRS, or NIHSS were observed. No significant adverse events related to the treatment were observed.
Conclusions:
Our preliminary results indicate that an accelerated rTMS protocol is safe and feasible, and may be an effective alternative or adjunctive therapy for patients suffering from PSD. Future planned studies include a larger, randomized controlled trial in this population.
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Sawadogo D, Moore L, Tardif PA, Farhat I, Lauzier F, Turgeon AF. Trends of clinical outcomes in patients with a Traumatic Brain Injury (TBI) in Canada between 2006 and 2012. Injury 2020; 51:76-83. [PMID: 31515061 DOI: 10.1016/j.injury.2019.08.023] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 07/11/2019] [Accepted: 08/17/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Traumatic brain injuries (TBI) are the leading cause of death for people aged <40 years. In Canada, the structure of trauma care has evolved independently across provinces during the last decade. However, little is known about the evolution of clinical outcomes. We aimed to compare trends in hospital mortality, unplanned readmission, hospital length of stay (LOS) and intensive care unit (ICU) LOS for TBI between 2006 and 2012 across Canadian provinces. METHODS We conducted a retrospective multicentre cohort study based on TBI admissions across Canadian level I and II trauma centres. Data were extracted from the National Trauma Registry linked to hospital discharge databases. All adults with an injury severity score ≥12 were included. Multilevel generalized linear models were used to evaluate trends in clinical outcomes. RESULTS Between 2006 and 2012, we observed a decrease in mortality in Canada (odd ratio [OR] = 0.95; 95% confidence intervals [CI] = 0.92-0.98) mostly driven by Ontario (OR = 0.95; 95% CI = 0.93-0.98). We observed a significant decrease in hospital length of stay in Canada (hazard ratio [HR]: hazard of being discharged alive from hospital = 1.02; 95% CI = 1.01-1.02) mostly driven by a decrease in Quebec (HR = 1.03; 95% CI = 1.01-1.04). We observed a decrease in ICU Length of stay only in Alberta (HR = 1.05; 95% CI = 1.01-1.09). No trend was observed for hospital readmissions. CONCLUSION We observed significant decreases in mortality, hospital and ICU length of stay for TBI in Canada between 2006 and 2012 but only in certain provinces. This study may represent the first step towards a better understanding of the influence of trauma system configuration on the burden of injuries in Canada.
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Affiliation(s)
- D Sawadogo
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec - Hôpital de l'Enfant Jésus, Québec, Canada.
| | - L Moore
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec - Hôpital de l'Enfant Jésus, Québec, Canada
| | - P A Tardif
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec - Hôpital de l'Enfant Jésus, Québec, Canada
| | - I Farhat
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec - Hôpital de l'Enfant Jésus, Québec, Canada
| | - F Lauzier
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec - Hôpital de l'Enfant Jésus, Québec, Canada; Département d'anesthésiologie, Faculté de médecine, Université Laval, Québec, Canada
| | - A F Turgeon
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec - Hôpital de l'Enfant Jésus, Québec, Canada
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Brown R, Bauld L, de Lacy E, Hallingberg B, Maynard O, McKell J, Moore L, Moore G. A qualitative study of e-cigarette emergence and the potential for renormalisation of smoking in UK youth. Int J Drug Policy 2019; 75:102598. [PMID: 31785547 PMCID: PMC6983925 DOI: 10.1016/j.drugpo.2019.11.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 03/28/2019] [Revised: 10/09/2019] [Accepted: 11/10/2019] [Indexed: 12/21/2022]
Abstract
Background Growth of e-cigarette use among smokers has raised concerns over uptake by non-smokers, particularly young people. Legislative changes aimed in part at reducing youth exposure to e-cigarettes include the EU Tobacco Products Directive (TPD). A core justification for such measures is the belief that e-cigarettes can lead to tobacco smoking through mechanisms of renormalisation including: mimicking and normalizing the act of smoking; increasing product acceptability via marketing; nicotine exposure. These mechanisms are here explored in relation to findings from qualitative research. Methods This paper reports results from twenty-one group interviews with 14–15 year olds in Wales, England and Scotland, conducted as part of an ongoing evaluation of the impact of the TPD on youth smoking and e-cigarette use. Interviews were conducted around the end of the transitional period for TPD implementation, and explored perceptions of e-cigarettes and tobacco, as well as similarities and differences between them. Results Young people differentiated between tobacco and e-cigarettes, rejecting the term e-cigarette in favour of alternatives such as ‘vapes’. Experimental or occasional use was common and generally approved of where occurring within social activity with peers. However, regular use outside of this context was widely disapproved of, unless for the purpose of stopping smoking. Increased prevalence of e-cigarettes did not challenge strongly negative views of smoking or reduce perceived harms caused by it, with disapproval of smoking remaining high. Nicotine use was variable, with flavour a stronger driver for choice of e-liquid, and interest more generally. Conclusion The extent to which participants differentiated between vaping and smoking, including styles and reasons for use in adults and young people; absence of marketing awareness; and continued strong disapproval of smoking provides limited support for some of the potential mechanisms through which e-cigarettes may renormalise smoking. However caution over nicotine exposure is still necessary.
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Affiliation(s)
- R Brown
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, Cardiff University, UK.
| | - L Bauld
- Usher Institute of Population Health Sciences & Informatics, University of Edinburgh, UK; Director, SPECTRUM Consortium
| | - E de Lacy
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, Cardiff University, UK
| | - B Hallingberg
- Department of Applied Psychology, Cardiff Metropolitan University
| | - O Maynard
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, UK/UK Centre for Tobacco and Alcohol Studies (UKCTAS) and School of Psychological Science, University of Bristol, Bristol, UK
| | - J McKell
- Institute for Social Marketing, University of Stirling and UK Centre for Tobacco and Alcohol Studies, UK
| | - L Moore
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK
| | - G Moore
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, Cardiff University, UK; SPECTRUM Consortium
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Melin H, Fletcher LN, Stallard TS, Miller S, Trafton LM, Moore L, O'Donoghue J, Vervack RJ, Dello Russo N, Lamy L, Tao C, Chowdhury MN. The H 3+ ionosphere of Uranus: decades-long cooling and local-time morphology. Philos Trans A Math Phys Eng Sci 2019; 377:20180408. [PMID: 31378181 PMCID: PMC6710888 DOI: 10.1098/rsta.2018.0408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/07/2019] [Indexed: 05/04/2023]
Abstract
The upper atmosphere of Uranus has been observed to be slowly cooling between 1993 and 2011. New analysis of near-infrared observations of emission from H3+ obtained between 2012 and 2018 reveals that this cooling trend has continued, showing that the upper atmosphere has cooled for 27 years, longer than the length of a nominal season of 21 years. The new observations have offered greater spatial resolution and higher sensitivity than previous ones, enabling the characterization of the H3+ intensity as a function of local time. These profiles peak between 13 and 15 h local time, later than models suggest. The NASA Infrared Telescope Facility iSHELL instrument also provides the detection of a bright H3+ signal on 16 October 2016, rotating into view from the dawn sector. This feature is consistent with an auroral signal, but is the only of its kind present in this comprehensive dataset. This article is part of a discussion meeting issue 'Advances in hydrogen molecular ions: H3+, H5+ and beyond'.
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Affiliation(s)
- Henrik Melin
- Department of Physics & Astronomy, University of Leicester, Leicester, UK
| | - L. N. Fletcher
- Department of Physics & Astronomy, University of Leicester, Leicester, UK
| | - T. S. Stallard
- Department of Physics & Astronomy, University of Leicester, Leicester, UK
| | - S. Miller
- Department of Physics & Astronomy, University College London, London, UK
| | - L. M. Trafton
- Department of Astronomy, University of Texas, Austin, TX, USA
| | - L. Moore
- Center for Space Physics, Boston University, Boston, MA, USA
| | | | - R. J. Vervack
- Johns Hopkins Applied Physics Laboratory, Laurel, MD, USA
| | - N. Dello Russo
- Johns Hopkins Applied Physics Laboratory, Laurel, MD, USA
| | - L. Lamy
- LESIA, Observatoire de Paris, PSL, CNRS, Sorbonne Université, Meudon, France
| | - C. Tao
- National Institute of Information and Communications Technology, Tokyo, Japan
| | - M. N. Chowdhury
- Department of Physics & Astronomy, University of Leicester, Leicester, UK
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Moore L, Melin H, O'Donoghue J, Stallard TS, Moses JI, Galand M, Miller S, Schmidt CA. Modelling H 3+ in planetary atmospheres: effects of vertical gradients on observed quantities. Philos Trans A Math Phys Eng Sci 2019; 377:20190067. [PMID: 31378180 PMCID: PMC6710898 DOI: 10.1098/rsta.2019.0067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/07/2019] [Indexed: 05/20/2023]
Abstract
Since its detection in the aurorae of Jupiter approximately 30 years ago, the H3+ ion has served as an invaluable probe of giant planet upper atmospheres. However, the vast majority of monitoring of planetary H3+ radiation has followed from observations that rely on deriving parameters from column-integrated paths through the emitting layer. Here, we investigate the effects of density and temperature gradients along such paths on the measured H3+ spectrum and its resulting interpretation. In a non-isothermal atmosphere, H3+ column densities retrieved from such observations are found to represent a lower limit, reduced by 20% or more from the true atmospheric value. Global simulations of Uranus' ionosphere reveal that measured H3+ temperature variations are often attributable to well-understood solar zenith angle effects rather than indications of real atmospheric variability. Finally, based on these insights, a preliminary method of deriving vertical temperature structure is demonstrated at Jupiter using model reproductions of electron density and H3+ measurements. The sheer diversity and uncertainty of conditions in planetary atmospheres prohibits this work from providing blanket quantitative correction factors; nonetheless, we illustrate a few simple ways in which the already formidable utility of H3+ observations in understanding planetary atmospheres can be enhanced. This article is part of a discussion meeting issue 'Advances in hydrogen molecular ions: H3+, H5+ and beyond'.
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Affiliation(s)
- L. Moore
- Boston University, Boston, MA, USA
| | - H. Melin
- University of Leicester, Leicester, UK
| | - J. O'Donoghue
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | | | | | - M. Galand
- Department of Physics, Imperial College London, London, UK
| | - S. Miller
- University College London, London, UK
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Moore L, Jayaweera H, Redshaw M, Quigley M. Migration, ethnicity and mental health: evidence from mothers participating in the Millennium Cohort Study. Public Health 2019; 171:66-75. [PMID: 31103615 DOI: 10.1016/j.puhe.2019.03.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 03/21/2019] [Accepted: 03/29/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Over a quarter of UK births are to women who were born outside of the UK. Black and Minority Ethnic (BME) women are disproportionately affected by poor mental health and inequitable access to mental health care in the perinatal period, yet the influence of the migrant status (mothers' UK vs. non-UK birth) is poorly understood. This study aimed to explore the relationship between ethnicity, migration and mental health indicators among mothers participating in a large nationally representative cohort study. STUDY DESIGN This is a secondary analysis of data from the Millennium Cohort Study. METHODS Logistic regression quantified the crude and adjusted effects of self-reported ethnicity and migrant status on prevalence of psychological distress and treatment for anxiety/depression at 9-month and 5-year postpartum. RESULTS We found substantial variation in the prevalence of distress according to ethnicity and migrant status, with Indian and Pakistani women at greatest risk. Despite equal or greater risk, BME and migrant women were less likely to report treatment for anxiety/depression. Mutually adjusted analyses showed ethnicity to be a stronger predictor of both outcomes than migrant status; however, at 5 years, being a migrant independently predicted lower odds of treatment, for a statistically similar level of distress. CONCLUSIONS Migrant women are likely to be at high risk of poor mental health in the perinatal period and beyond, yet may face significant barriers to accessing mental health care. A better understanding of ethnicity and migration as interrelated risk factors for perinatal mental ill-health is needed to help National Health Service organisations develop policy and practice that is flexible and responsive to diversity.
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Affiliation(s)
- L Moore
- Oxford School of Public Health, Old Road Campus, Headington, Oxford OX3 7LF, UK.
| | - H Jayaweera
- School of Anthropology, University of Oxford, 53 Banbury Rd, Oxford OX2 6PF, UK.
| | - M Redshaw
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK.
| | - M Quigley
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK.
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Stanczak H, Nastasi N, Helmick D, CHEN X, Windreich R, Barnum J, Carella B, Byersdorfer C, Donnenberg A, Moore L, Szabolcs P. Processing and CD3+/CD19+ depletion of cadaveric vertebral bone marrow for primary immunodeficiency patients undergoing sequential bilateral orthotopic lung transplant (BOLT) and bone marrow transplant (BMT). Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Beaudoin C, Moore L, Gagné M, Bessette L, Ste-Marie LG, Brown JP, Jean S. Performance of predictive tools to identify individuals at risk of non-traumatic fracture: a systematic review, meta-analysis, and meta-regression. Osteoporos Int 2019; 30:721-740. [PMID: 30877348 DOI: 10.1007/s00198-019-04919-6] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 02/26/2019] [Indexed: 01/28/2023]
Abstract
UNLABELLED There is no consensus on which tool is the most accurate to assess fracture risk. The results of this systematic review suggest that QFracture, Fracture Risk Assessment Tool (FRAX) with BMD, and Garvan with BMD are the tools with the best discriminative ability. More studies assessing the comparative performance of current tools are needed. INTRODUCTION Many tools exist to assess fracture risk. This review aims to determine which tools have the best predictive accuracy to identify individuals at high risk of non-traumatic fracture. METHODS Studies assessing the accuracy of tools for prediction of fracture were searched in MEDLINE, EMBASE, Evidence-Based Medicine Reviews, and Global Health. Studies were eligible if discrimination was assessed in a population independent of the derivation cohort. Meta-analyses and meta-regressions were performed on areas under the ROC curve (AUCs). Gender, mean age, age range, and study quality were used as adjustment variables. RESULTS We identified 53 validation studies assessing the discriminative ability of 14 tools. Given the small number of studies on some tools, only FRAX, Garvan, and QFracture were compared using meta-regression models. In the unadjusted analyses, QFracture had the best discriminative ability to predict hip fracture (AUC = 0.88). In the adjusted analysis, FRAX with BMD (AUC = 0.81) and Garvan with BMD (AUC = 0.79) had the highest AUCs. For prediction of major osteoporotic fracture, QFracture had the best discriminative ability (AUC = 0.77). For prediction of osteoporotic or any fracture, FRAX with BMD and Garvan with BMD had higher discriminative ability than their versions without BMD (FRAX: AUC = 0.72 vs 0.69, Garvan: AUC = 0.72 vs 0.65). A significant amount of heterogeneity was present in the analyses. CONCLUSIONS QFracture, FRAX with BMD, and Garvan with BMD have the highest discriminative performance for predicting fracture. Additional studies in which the performance of current tools is assessed in the same individuals may be performed to confirm this conclusion.
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Affiliation(s)
- C Beaudoin
- Department of Social and Preventive Medicine, Medicine Faculty, Laval University, Ferdinand Vandry Pavillon, 1050 Avenue de la Médecine, Quebec City, QC, G1V 0A6, Canada.
- CHU de Québec-Université Laval Research Center, Québec, QC, Canada.
- Bureau d'information et d'études en santé des populations, Institut National de Santé Publique du Québec, 945, Avenue Wolfe, Québec, G1V 5B3, Canada.
| | - L Moore
- Department of Social and Preventive Medicine, Medicine Faculty, Laval University, Ferdinand Vandry Pavillon, 1050 Avenue de la Médecine, Quebec City, QC, G1V 0A6, Canada
- CHU de Québec-Université Laval Research Center, Québec, QC, Canada
| | - M Gagné
- Bureau d'information et d'études en santé des populations, Institut National de Santé Publique du Québec, 945, Avenue Wolfe, Québec, G1V 5B3, Canada
| | - L Bessette
- CHU de Québec-Université Laval Research Center, Québec, QC, Canada
- Department of Medicine, Medicine Faculty, Laval University, Ferdinand Vandry Pavillon, 1050 Avenue de la Médecine, Quebec City, QC, G1V 0A6, Canada
| | - L G Ste-Marie
- Department of Medicine, Medicine Faculty, University of Montréal, Montréal, QC, Canada
| | - J P Brown
- CHU de Québec-Université Laval Research Center, Québec, QC, Canada
- Department of Medicine, Medicine Faculty, Laval University, Ferdinand Vandry Pavillon, 1050 Avenue de la Médecine, Quebec City, QC, G1V 0A6, Canada
| | - S Jean
- Bureau d'information et d'études en santé des populations, Institut National de Santé Publique du Québec, 945, Avenue Wolfe, Québec, G1V 5B3, Canada
- Department of Medicine, Medicine Faculty, Laval University, Ferdinand Vandry Pavillon, 1050 Avenue de la Médecine, Quebec City, QC, G1V 0A6, Canada
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Goranova T, Ennis D, Piskorz AM, Macintyre G, Lewsley LA, Stobo J, Wilson C, Kay D, Glasspool RM, Lockley M, Brockbank E, Montes A, Walther A, Sundar S, Edmondson R, Hall GD, Clamp A, Gourley C, Hall M, Fotopoulou C, Gabra H, Freeman S, Moore L, Jimenez-Linan M, Paul J, Brenton JD, McNeish IA. Correction: Safety and utility of image-guided research biopsies in relapsed high-grade serous ovarian carcinoma-experience of the BriTROC consortium. Br J Cancer 2019; 120:868. [PMID: 30862952 PMCID: PMC6474310 DOI: 10.1038/s41416-019-0433-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
This article was originally published under a CC BY NC SA License, but has now been made available under a CC BY 4.0 License.
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Affiliation(s)
- T Goranova
- Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK
| | - D Ennis
- Institute of Cancer Sciences, University of Glasgow, Glasgow, G61 1QH, UK
| | - A M Piskorz
- Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK
| | - G Macintyre
- Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK
| | - L A Lewsley
- Cancer Research UK Clinical Trials Unit, Glasgow, G12 0YN, UK
| | - J Stobo
- Cancer Research UK Clinical Trials Unit, Glasgow, G12 0YN, UK
| | - C Wilson
- Cancer Research UK Clinical Trials Unit, Glasgow, G12 0YN, UK
| | - D Kay
- Department of Radiology, Gartnavel General Hospital, Glasgow, G12 0YN, UK
| | - R M Glasspool
- Beatson West of Scotland Cancer Centre, Glasgow, G12 0YN, UK
| | - M Lockley
- Barts Cancer Institute, London, EC1M 6BQ, UK
- University College Hospital, London, WC1E 6BD, UK
| | - E Brockbank
- Barts Cancer Institute, London, EC1M 6BQ, UK
| | - A Montes
- Guy's Hospital, London, SE1 9RT, UK
| | - A Walther
- Bristol Haematology and Oncology Centre, Bristol, BS2 8ED, UK
| | - S Sundar
- City Hospital, Birmingham, B18 7QH, UK
| | | | - G D Hall
- St James Hospital, Leeds, LS9 7TF, UK
| | - A Clamp
- The Christie Hospital, Manchester, M20 4BX, UK
| | - C Gourley
- Edinburgh Cancer Research Centre, Edinburgh, EH4 2XR, UK
| | - M Hall
- Mount Vernon Cancer Centre, Northwood, HA6 2RN, UK
| | | | - H Gabra
- Imperial College, London, W12 0HS, UK
| | - S Freeman
- Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - L Moore
- Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | | | - J Paul
- Cancer Research UK Clinical Trials Unit, Glasgow, G12 0YN, UK
| | - J D Brenton
- Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK.
- Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.
| | - I A McNeish
- Institute of Cancer Sciences, University of Glasgow, Glasgow, G61 1QH, UK.
- Beatson West of Scotland Cancer Centre, Glasgow, G12 0YN, UK.
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Murray K, Moore L, McAuliffe F, Veale DJ. Reproductive health outcomes in women with psoriatic arthritis. Ann Rheum Dis 2019; 78:850-852. [PMID: 30770410 DOI: 10.1136/annrheumdis-2018-214790] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 01/22/2019] [Accepted: 02/04/2019] [Indexed: 11/04/2022]
Affiliation(s)
- Kieran Murray
- Rheumatology, Dublin Academic Medical Centre, Dublin, Ireland
| | - Louise Moore
- Rheumatology Rehabilitation, Our Lady's Hospice, Dublin, Ireland
| | - Fionnuala McAuliffe
- Maternal Medicine, National Maternity Hospital, Dublin 2, Ireland.,Perinatal Research Centre, University College Dublin, Dublin, Ireland
| | - Douglas J Veale
- EULAR Centre For Arthritis And Rheumatic Diseases, Dublin Academic Medical Centre, Dublin, Ireland.,The Conway Institute, University College Dublin, Dublin, Ireland
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Vetsch J, Wakefield CE, Doolan EL, Signorelli C, McGill BM, Moore L, Techakesari P, Pieters R, Patenaude AF, McCarthy M, Cohn RJ. 'Why us?' Causal attributions of childhood cancer survivors, survivors' parents and community comparisons - a mixed methods analysis. Acta Oncol 2019; 58:209-217. [PMID: 30614350 DOI: 10.1080/0284186x.2018.1532600] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Understanding the cause of their cancer is important for many cancer patients. Childhood cancer survivors'/survivors' parents' beliefs about cancer etiology are understudied. We aimed to assess survivors'/parents' beliefs about what causes childhood cancer, compared with beliefs in the community. We also investigated the influence of clinical and socio-demographic characteristics on the participants' beliefs about cancer etiology. METHODS This two-stage study investigated the participants' beliefs, by using questionnaires assessing causal attributions related to childhood cancer (stage 1) and then undertaking telephone interviews (stage 2; survivors/survivors' parents only) to get an in-depth understanding of survivors'/survivors' parents beliefs. We computed multivariable regressions to identify factors associated with the most commonly endorsed attributions: bad luck/chance, environmental factors and genetics. We analyzed interviews using thematic analysis. RESULTS Six hundred one individuals (64.6% survivors and 35.4% survivors' parents) and 510 community comparisons (53.1% community adults, 46.9% community parents) completed the question on causal attributions. We conducted 87 in-depth interviews. Survivors/survivors' parents (73.9%) were more likely to believe that chance/bad luck caused childhood cancer than community participants (42.4%). Community participants more frequently endorsed that genetics (75.3%) and environmental factors (65.3%) played a major role in childhood cancer etiology (versus survivors' and survivors' parents: genetics 20.6%, environmental factors: 19.3%). Community participants, participants with a first language other than English, and reporting a lower quality of life were less likely to attribute bad luck as a cause of childhood cancer. Community participants, all participants with a higher income and higher education were more likely to attribute childhood cancer etiology to environmental factors. CONCLUSION Causal attributions differed between survivors/survivors' parents and community participants. Most of the parents and survivors seem to understand that there is nothing they have done to cause the cancer. Understanding survivors' and survivors' parents' causal attributions may be crucial to address misconceptions, offer access to services and to adapt current and future health behaviors.
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Affiliation(s)
- J. Vetsch
- School of Women’s and Children’s Health, UNSW, Sydney, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
| | - C. E. Wakefield
- School of Women’s and Children’s Health, UNSW, Sydney, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
| | - E. L. Doolan
- School of Women’s and Children’s Health, UNSW, Sydney, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
| | - C. Signorelli
- School of Women’s and Children’s Health, UNSW, Sydney, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
| | - B. M. McGill
- School of Women’s and Children’s Health, UNSW, Sydney, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
| | - L. Moore
- John Hunter Children’s Hospital, New Lambton Heights NSW, Sydney, Australia
| | - P. Techakesari
- School of Women’s and Children’s Health, UNSW, Sydney, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
| | - R. Pieters
- School of Women’s and Children’s Health, UNSW, Sydney, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
| | - A. F. Patenaude
- Department of Psychiatry at The Children’s Hospital, Boston, MA, USA
- Department of Psychiatry at Harvard Medical School, Boston, MA, USA
| | - M. McCarthy
- Royal Children’s Hospital, Melbourne, Australia
- Murdoch Children’s Hospital, Melbourne, Australia
| | - R. J. Cohn
- School of Women’s and Children’s Health, UNSW, Sydney, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
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Dunn C, Moore L. GENETIC TESTING IDENTIFIES CAUSE OF ENTEROPATHY AND GROWTH FAILURE IN A 10 YEAR OLD MALE. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Waite JH, Perryman RS, Perry ME, Miller KE, Bell J, Cravens TE, Glein CR, Grimes J, Hedman M, Cuzzi J, Brockwell T, Teolis B, Moore L, Mitchell DG, Persoon A, Kurth WS, Wahlund JE, Morooka M, Hadid LZ, Chocron S, Walker J, Nagy A, Yelle R, Ledvina S, Johnson R, Tseng W, Tucker OJ, Ip WH. Chemical interactions between Saturn’s atmosphere and its rings. Science 2018; 362:362/6410/eaat2382. [DOI: 10.1126/science.aat2382] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 09/10/2018] [Indexed: 11/03/2022]
Abstract
The Pioneer and Voyager spacecraft made close-up measurements of Saturn’s ionosphere and upper atmosphere in the 1970s and 1980s that suggested a chemical interaction between the rings and atmosphere. Exploring this interaction provides information on ring composition and the influence on Saturn’s atmosphere from infalling material. The Cassini Ion Neutral Mass Spectrometer sampled in situ the region between the D ring and Saturn during the spacecraft’s Grand Finale phase. We used these measurements to characterize the atmospheric structure and material influx from the rings. The atmospheric He/H2 ratio is 10 to 16%. Volatile compounds from the rings (methane; carbon monoxide and/or molecular nitrogen), as well as larger organic-bearing grains, are flowing inward at a rate of 4800 to 45,000 kilograms per second.
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Walker GJ, Moore L, Heerasing N, Hendy P, Perry MH, McDonald TJ, Debenham T, Bethune R, Bewshea C, Hyde C, Heap GA, Singh A, Calvert C, Kennedy NA, Goodhand JR, Ahmad T. Faecal calprotectin effectively excludes inflammatory bowel disease in 789 symptomatic young adults with/without alarm symptoms: a prospective UK primary care cohort study. Aliment Pharmacol Ther 2018; 47:1103-1116. [PMID: 29508423 DOI: 10.1111/apt.14563] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 12/16/2017] [Accepted: 01/22/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Primary care faecal calprotectin testing distinguishes inflammatory bowel disease (IBD) from functional gut disorder in young patients presenting with abdominal symptoms; however, previous evaluations have excluded patients with alarm symptoms. AIMS We sought to evaluate the diagnostic accuracy of calprotectin to distinguish IBD from functional gut disorder in young adults in whom general practitioners (GPs) suspected IBD; including patients reporting gastrointestinal alarm symptoms. We hypothesised that calprotectin would reduce secondary care referrals and healthcare costs. METHODS We undertook a prospective cohort study of 789 young adults (18-46 years old) presenting with gastrointestinal symptoms to 49 local general practices that had undergone calprotectin testing (1053 tests: between Jan 2014 and May 2016) because of suspected IBD. We considered calprotectin levels of ≥100 μg/g positive. Primary and secondary care records over 12 months from the point of calprotectin testing were used as the reference standard. RESULTS Overall, 39% (308/789) patients reported gastrointestinal alarm symptoms and 6% (50/789) tested patients were diagnosed with IBD. The positive and negative predictive values of calprotectin testing for distinguishing IBD from functional gut disorder in patients with gastrointestinal alarm symptoms were 50% (95% CI 36%-64%) and 98% (96%-100%): and in patients without gastrointestinal alarm symptoms were 27% (16%-41%) and 99% (98%-100%), respectively. We estimate savings of 279 referrals and £160 per patient. CONCLUSIONS Calprotectin testing of young adults with suspected IBD in primary care accurately distinguishes IBD from functional gut disorder, even in patients with gastrointestinal alarm symptoms and reduces secondary care referrals and diagnostic healthcare costs.
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McCarthy D, Matz B, Wright J, Moore L. Investigation of the HotDog patient warming system: detection of thermal gradients. J Small Anim Pract 2018; 59:298-304. [PMID: 29363138 DOI: 10.1111/jsap.12816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 12/05/2017] [Accepted: 12/11/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the performance of an active patient-warming device. MATERIALS AND METHODS Temperatures of an active patient-warming device (HotDog system) were measured at various time points using an infrared thermometer. The study was conducted in two phases: Phase 1 compared temperatures among four different areas of the warming blanket. Phase 2 compared conditions simulating different scenarios using a weighted patient simulator. RESULTS Phase 1: Three out of four positions on the warming blanket had significantly different temperature measurements. Phase 2: Temperature output by the warming blanket was reduced: (1) in the absence of the patient simulator placed across the blanket (-1·9°C, P=0·013); (2) if the patient simulator was placed away from the blanket sensor (-2·0°C, P=0·009); and (3) if there was fluid between the patient simulator and warming blanket (-2·2°C, P=0·004). In a majority of measurements (95%), the set temperature of 43°C on the control unit was not reached (range, 29·8 to 42·9°C) and 2·3% of measurements were higher (range, 43·1 to 45·8°C) than the control unit set temperature of 43°C. CLINICAL SIGNIFICANCE Measured temperatures on the active warming blanket did not reflect control unit settings. This could result in the potential for hyperthermic injury, ineffectual heating and uneven heat distribution.
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Affiliation(s)
- D McCarthy
- Coral Springs Animal Hospital, 2160 North University Drive, Coral Springs, FL, 33071, USA
| | - B Matz
- Department of Clinical Sciences, Auburn University, Auburn, AL 36849, USA.,Auburn University College of Veterinary Medicine, 1220 Wire Rd, Auburn, AL 36849, USA
| | - J Wright
- Auburn University College of Veterinary Medicine, 1220 Wire Rd, Auburn, AL 36849, USA.,Department of Pathobiology, Auburn University, Auburn, AL 36849, USA
| | - L Moore
- IndyVet Emergency & Specialty Hospital, 5425 Victory Drive, Indianapolis, IN 46203, USA
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Rule A, Moore L. The commissioning and implementation of total body irradiation at Livingstone Hospital. Phys Med 2017. [DOI: 10.1016/s1120-1797(17)30290-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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