1
|
Wademan DT, Viljoen L, Jacobs S, Meyerson K, Nombewu Y, Busakwe L, Schaaf HS, Hesseling AC, Winckler J, Garcia-Prats AJ, Hoddinott G. Children´s priorities to improve the acceptability of MDR-TB treatment: qualitative data from South Africa. Int J Tuberc Lung Dis 2023; 27:543-550. [PMID: 37353869 DOI: 10.5588/ijtld.22.0573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND: Multidrug-resistant TB (MDR-TB) treatment for children frequently includes unpalatable drugs with low overall acceptability. This can negatively impact children and their caregivers´ treatment experiences and is an important contributor to poor adherence, and potentially, poor treatment outcomes. Children and their caregivers´ preferences for MDR-TB treatment are not well documented. We describe children and caregivers´ priorities to inform future MDR-TB treatment regimens.METHODS: We conducted a cross-sectional qualitative study at a TB hospital in South Africa using semi-structured interviews and participatory research activities with caregivers and children routinely diagnosed and treated for MDR-TB between June and August 2018.RESULTS: We conducted 15 interviews with children and their caregivers. Children ranged from 2 to 17 years of age (median age: 8.3 years). Children and caregivers had an overall negative experience of MDR-TB treatment. Children and caregivers described how future MDR-TB drugs and regimens should prioritise sweeter flavours, fewer pills, brighter colours, and formulations that are easy to prepare and administer and dispensed in colourful, small and discrete packaging.CONCLUSIONS: MDR-TB treatment acceptability remains low, and negatively impacts children and their caregivers´ treatment experiences. Improving the overall acceptability of MDR-TB treatment requires engaging with children and their caregivers to better understand their priorities for new treatment regimens and child-friendly formulations.
Collapse
Affiliation(s)
- D T Wademan
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - L Viljoen
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - S Jacobs
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - K Meyerson
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Y Nombewu
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - L Busakwe
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - H S Schaaf
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - A C Hesseling
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - J Winckler
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - A J Garcia-Prats
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa, Department of Paediatrics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - G Hoddinott
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| |
Collapse
|
2
|
Seston EM, Willis SC, Fenton C, Hindi AMK, Moss A, Stearns S, Astbury J, Jacobs S, McDermott I, Schafheutle EI. Implementation of behaviour change training in practice amongst pharmacy professionals in primary care settings: Analysis using the COM-B model. Res Social Adm Pharm 2023:S1551-7411(23)00239-5. [PMID: 37121797 DOI: 10.1016/j.sapharm.2023.04.123] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND The Pharmacy Integration Fund (PhIF) was established in England in 2016, with funded learning programmes or 'pathways' designed to support the development of clinical pharmacy practice in a range of settings. Despite pharmacy staff being well positioned to provide more clinical work, limited research has investigated behaviour change training targeted at widespread practice transformation. OBJECTIVE(S) To investigate implementation of PhIF learning in practice, using the COM-B model of behaviour change. METHODS An online survey distributed in February and October 2020 included questions on motivations for learning, confidence in target behaviours and impact of PhIF training on behaviour. The October 2020 survey also included questions exploring the effect of the COVID-19 pandemic. Quantitative data were analysed in SPSS. v.27 (IBM). Inferential statistics were used to compare between the pathways (Primary care pathways [PCP], Post-registration pathway [PRP] and Accuracy Checking Pharmacy Technician [ACPT] pathway). Free text comments were categorised and themed. RESULTS Three-hundred and eighty-three responses were received (49% PRP learners, 39% PCP learners and 12% ACPT learners). Learners generally had the capacity and opportunities to apply learning, and were strongly motivated to implement behaviours in practice, although learners based in community pharmacy (those on the PRP) were less likely to report receiving employer support. Enhanced knowledge/skills (capacity) were more commonly reported than change to patient-facing activities, leading clinical services and conducting medication reviews with patients with complex needs (clinical practice behaviours targeted by the pathways). The COVID-19 pandemic heightened barriers to implementing practice change. CONCLUSIONS Implementation of a range of clinical practice behaviours following at scale training appears to have been largely successful. Despite this, the community pharmacy context, where funded service opportunities may be lacking, continues to present challenges to workforce transformation plans. More work is needed to understand how training can be implemented to promote practice change for pharmacy professionals in all settings.
Collapse
Affiliation(s)
- E M Seston
- Centre for Pharmacy Workforce Studies Division of Pharmacy & Optometry Faculty of Biology, Medicine and Health Stopford Building, University of Manchester, M13 9PT, UK
| | - S C Willis
- Innovation Management and Policy Division, Alliance Manchester Business School, The University of Manchester, Booth Street West, Manchester, M15 6PB, UK.
| | - C Fenton
- ICF, Riverscape, 3rd Floor, 10 Queens Street Place, London, EC4R 1BE, UK
| | - A M K Hindi
- Centre for Pharmacy Workforce Studies Division of Pharmacy & Optometry Faculty of Biology, Medicine and Health Stopford Building, University of Manchester, M13 9PT, UK
| | - A Moss
- ICF, Riverscape, 3rd Floor, 10 Queens Street Place, London, EC4R 1BE, UK
| | - S Stearns
- ICF, Riverscape, 3rd Floor, 10 Queens Street Place, London, EC4R 1BE, UK
| | - J Astbury
- Centre for Pharmacy Workforce Studies Division of Pharmacy & Optometry Faculty of Biology, Medicine and Health Stopford Building, University of Manchester, M13 9PT, UK
| | - S Jacobs
- Centre for Pharmacy Workforce Studies Division of Pharmacy & Optometry Faculty of Biology, Medicine and Health Stopford Building, University of Manchester, M13 9PT, UK
| | - I McDermott
- Centre for Pharmacy Workforce Studies Division of Pharmacy & Optometry Faculty of Biology, Medicine and Health Stopford Building, University of Manchester, M13 9PT, UK
| | - E I Schafheutle
- Centre for Pharmacy Workforce Studies Division of Pharmacy & Optometry Faculty of Biology, Medicine and Health Stopford Building, University of Manchester, M13 9PT, UK
| |
Collapse
|
3
|
Kooij J, De Troy E, Vlasselaers D, Dauwe D, Janssens S, Vandenbriele C, Adriaenssens T, Dewolf P, Jacobs S, Meyns B. Using the SCAI Classification for Early Identification and Real-Time Monitoring of Cardiogenic Shock Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
|
4
|
Payne C, Jacobs S, Shaboodien S, Jumaar C, Pretorius A, Kgatla T, Sanni O, Maarman G. A pulmonary arterial hypertension diagnostic algorithm for a third-world context: SYMQUICK. J Investig Med 2023; 71:542-544. [PMID: 36789665 DOI: 10.1177/10815589231155194] [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: 02/16/2023]
|
5
|
Kikuchi JY, Yanek LR, Handa VL, Chen CCG, Jacobs S, Blomquist J, Patterson D. Prolapse and mesh reoperations following sacrocolpopexy: comparing supracervical hysterectomy, total hysterectomy, and no hysterectomy. Int Urogynecol J 2023; 34:135-145. [PMID: 35689689 DOI: 10.1007/s00192-022-05263-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/22/2022] [Indexed: 01/14/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Sacrocolpopexy is effective for apical prolapse repair and is often performed with hysterectomy. It is unknown whether supracervical or total hysterectomy at time of sacrocolpopexy influences prolapse recurrence and mesh complications. The primary objective of this study is to compare reoperations for recurrent prolapse after sacrocolpopexy with either supracervical hysterectomy or total hysterectomy, or without concomitant hysterectomy. We also sought to compare these three groups for the incidence of mesh complications and describe cervical interventions following supracervical hysterectomy. METHODS A retrospective cohort study of sacrocolpopexy was performed using the MarketScan® Research Database. Women > 18 years who underwent sacrocolpopexy between 2010 to 2014 were identified. Utilizing diagnostic and procedural codes, reoperations for prolapse and mesh complications were identified. Women with < 2 years of follow-up were excluded. RESULTS From 2010 to 2014, 3463 women underwent sacrocolpopexy with at least 2 years of follow-up, 910 (26.3%) with supracervical hysterectomy, 1243 (35.9%) with total hysterectomy, and 1310 (37.8%) without hysterectomy. Reoperations for prolapse were similar after supracervical hysterectomy (1.5%), after total hysterectomy (1.1%, p = 0.40), and without hysterectomy (1.5%, p = 0.98). Mesh complications after sacrocolpopexy were similar after supracervical hysterectomy (1.8%), after total hysterectomy (1.5%, p = 0.68), and without hysterectomy (2.8%, p = 0.11). Following supracervical hysterectomy, 0.9% underwent cervical procedures. CONCLUSIONS When comparing supracervical and total hysterectomy at time of sacrocolpopexy, there were no significant differences in reoperations for recurrent prolapse, reoperations for mesh complications, or mesh complication diagnoses. This study shows that surgeons can be reassured on performing hysterectomy with sacrocolpopexy.
Collapse
Affiliation(s)
- Jacqueline Y Kikuchi
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 4940 Eastern Ave, 301 Building, Suite 3200, Baltimore, MD, 21224, USA.
| | - Lisa R Yanek
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Victoria L Handa
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 4940 Eastern Ave, 301 Building, Suite 3200, Baltimore, MD, 21224, USA
| | - Chi Chiung Grace Chen
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 4940 Eastern Ave, 301 Building, Suite 3200, Baltimore, MD, 21224, USA
| | - Stephanie Jacobs
- Department of Obstetrics and Gynecology, Greater Baltimore Medical Center, Towson, MD, USA
| | - Joan Blomquist
- Department of Obstetrics and Gynecology, Greater Baltimore Medical Center, Towson, MD, USA
| | - Danielle Patterson
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 4940 Eastern Ave, 301 Building, Suite 3200, Baltimore, MD, 21224, USA
| |
Collapse
|
6
|
Swanepoel J, Zimri K, van der Zalm MM, Hoddinott G, Palmer M, Doruyter A, De Beer G, Kleynhans L, Johnson SM, Jongen V, Wademan D, Mcimeli K, Jacobs S, Swanepoel R, Van Zyl G, Allwood BW, Malherbe S, Heuvelings C, Griffith-Richards S, Whittaker E, Moore DAJ, Schaaf HS, Hesseling AC, Seddon JA. Understanding the biology, morbidity and social contexts of adolescent tuberculosis: a prospective observational cohort study protocol (Teen TB). BMJ Open 2022; 12:e062979. [PMID: 36600434 PMCID: PMC9772637 DOI: 10.1136/bmjopen-2022-062979] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION A considerable burden of the tuberculosis (TB) epidemic is found in adolescents. The reasons for increased susceptibility to TB infection and higher incidence of TB disease in adolescence, compared with the 5-10 years old age group, are incompletely understood. Despite the pressing clinical and public health need to better understand and address adolescent TB, research in this field remains limited. METHODS AND ANALYSIS Teen TB is an ongoing prospective observational cohort study that aims to better understand the biology, morbidity and social context of adolescent TB. The study plans to recruit 50 adolescents (10-19 years old) with newly diagnosed microbiologically confirmed pulmonary TB disease and 50 TB-exposed controls without evidence of TB disease in Cape Town, South Africa, which is highly endemic for TB. At baseline, cases and controls will undergo a detailed clinical evaluation, chest imaging, respiratory function assessments and blood collection for viral coinfections, inflammatory cytokines and pubertal hormone testing. At 2 weeks, 2 months and 12 months, TB disease cases will undergo further chest imaging and additional lung function testing to explore the patterns of respiratory abnormalities. At week 2, cases will complete a multicomponent quantitative questionnaire about psychological and social impacts on their experiences and longitudinal, in-depth qualitative data will be collected from a nested subsample of 20 cases and their families. ETHICS AND DISSEMINATION The study protocol has received ethical approval from the Stellenbosch University Health Research Ethics Committee (N19/10/148). The study findings will be disseminated through peer-reviewed publications, academic conferences and formal presentations to health professionals. Results will also be made available to participants and caregivers.
Collapse
Affiliation(s)
- Jeremi Swanepoel
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Klassina Zimri
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Marieke M van der Zalm
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Graeme Hoddinott
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Megan Palmer
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Alex Doruyter
- NuMeRI Node for Infection Imaging, Central Analytical Facilities, Stellenbosch University, Cape Town, South Africa
- Division of Nuclear Medicine, Department of Medical Imaging and Clinical Oncology, Stellenbosch University, Cape Town, South Africa
| | - Gezila De Beer
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Leanie Kleynhans
- South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, DSI-NRF Centre of Excellence, Stellenbosch University, Cape Town, Western Cape, South Africa
| | - Sarah M Johnson
- Department of Infectious Disease, Imperial College London, London, UK
| | - Vita Jongen
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, Netherlands
| | - Dillon Wademan
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Khanyisa Mcimeli
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Stephanie Jacobs
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Ruan Swanepoel
- Division of Pulmonology, Department of Internal Medicine, Tygerberg Hospital, Cape Town, Western Cape, South Africa
| | - Gert Van Zyl
- Division of Medical Virology, Department of Pathology, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa
| | - Brian W Allwood
- Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa
| | - Stephanus Malherbe
- South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, DSI-NRF Centre of Excellence, Stellenbosch University, Cape Town, Western Cape, South Africa
| | - Charlotte Heuvelings
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Stephanie Griffith-Richards
- Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa
| | | | - David A J Moore
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - H Simon Schaaf
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Anneke C Hesseling
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - James A Seddon
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Department of Infectious Disease, Imperial College London, London, UK
| |
Collapse
|
7
|
Jacobs S, Muhlheim L, Rienecke RD. Phase 2 of family-based treatment: an exploratory assessment of clinician practices. Eat Weight Disord 2022; 27:2137-2142. [PMID: 35076903 DOI: 10.1007/s40519-022-01360-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/05/2022] [Indexed: 10/19/2022] Open
Abstract
PURPOSE In manualized family-based treatment (FBT) for eating disorders, phase 1 of the 3-phase treatment-during which parents are put in control of eating-related issues-is perhaps the most critical phase, and is comprehensively addressed in the manual. Phase 2, during which control over eating is gradually returned to the patient, is more variable and the manual dedicates less space to this phase. The purpose of the current exploratory study was to assess Phase 2 practices of clinicians providing FBT and to compare these practices to the guidance offered in the manual. METHODS In the current study, a survey assessing Phase 2 practices was sent to clinicians. Twenty-seven providers responded. Two providers reported that they did not provide FBT in an outpatient setting. One reported not currently providing outpatient FBT but had in the past. The remaining providers were currently providing FBT in an outpatient setting. RESULTS No items addressing the core interventions of Phase 2, including encouraging age-appropriate independent eating, were endorsed by 100% of respondents as being addressed 100% of the time in Phase 2. CONCLUSION Responses reflected some adherence to the manual, along with examples of therapist drift and incorporation of therapeutic interventions that are not described in the FBT manual. Adherence to manualized treatments may improve outcome for some patients, while allowing for flexibility to address clinical situations that are not addressed in the manual. LEVEL OF EVIDENCE V. Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
Collapse
Affiliation(s)
- Stephanie Jacobs
- Private Practice, New York, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Renee D Rienecke
- Eating Recovery Center and Pathlight Mood and Anxiety Centers, 333 N. Michigan Avenue, Ste. 1900, Chicago, IL, 60601, USA. .,Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA.
| |
Collapse
|
8
|
Thouvenin J, Van Marcke C, Decoster L, Raicevic G, Punie K, Vandenbulcke M, Salgado R, Van Valckenborgh E, Maes B, Joris S, Steichel DV, Vranken K, Jacobs S, Dedeurwaerdere F, Martens G, Devos H, Duhoux FP, Rasschaert M, Pauwels P, Geboes K, Collignon J, Tejpar S, Canon JL, Peeters M, Rutten A, Van de Mooter T, Vermeij J, Schrijvers D, Demey W, Lybaert W, Van Huysse J, Mebis J, Awada A, Claes KBM, Hebrant A, Van der Meulen J, Delafontaine B, Bempt IV, Maetens J, de Hemptinne M, Rottey S, Aftimos P, De Grève J. PRECISION: the Belgian molecular profiling program of metastatic cancer for clinical decision and treatment assignment. ESMO Open 2022; 7:100524. [PMID: 35970014 PMCID: PMC9434164 DOI: 10.1016/j.esmoop.2022.100524] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/24/2022] [Accepted: 05/30/2022] [Indexed: 11/29/2022] Open
Abstract
PRECISION is an initiative from the Belgian Society of Medical Oncology (BSMO) in collaboration with several stakeholders, encompassing four programs that aim to boost genomic and clinical knowledge with the ultimate goal to offer patients with metastatic solid tumors molecularly guided treatments. The PRECISION 1 study has led to the creation of a clinico-genomic database. The Belgian Approach for Local Laboratory Extensive Tumor Testing (BALLETT) and GeNeo studies will increase the number of patients with advanced cancer that have comprehensive genotyping of their cancer. The PRECISION 2 project consists of investigator-initiated phase II studies aiming to provide access to a targeted drug for patients whose tumors harbor actionable mutations in case the matched drug is not available through reimbursement or clinical trials in Belgium.
Collapse
Affiliation(s)
- J Thouvenin
- Hospices Civils de Lyon, Medical Oncology, Lyon, France; Institut Jules Bordet, Medical Oncology Clinic, Brussels, Belgium
| | | | - L Decoster
- UZ Brussel, Medical Oncology, Brussels, Belgium
| | | | - K Punie
- KU Leuven University Hospitals Leuven, General Medical Oncology, Leuven, Belgium
| | | | - R Salgado
- GasthuisZusters Antwerpen, Pathology, Antwerp, Belgium
| | | | - B Maes
- Laboratory of Molecular Diagnostics, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium
| | - S Joris
- UZ Brussel, Medical Oncology, Brussels, Belgium
| | | | - K Vranken
- Pediatric Oncology, WIV-ISP, Leuven, Belgium
| | | | | | - G Martens
- Laboratoriumgeneeskunde, AZ Delta, Roeselare, Belgium
| | - H Devos
- Laboratoriumgeneeskunde, AZ Sint-Jan, Bruges, Belgium
| | - F P Duhoux
- UCLouvain, Ottignies-Louvain-la-Neuve, Belgium
| | - M Rasschaert
- Universitair Ziekenhuis Antwerpen, Medical Oncology, Antwerpen, Belgium; Medical Oncology, AZ Monica, Deurne, Belgium
| | - P Pauwels
- Universitair Ziekenhuis Antwerpen, Pathology, Antwerpen, Belgium
| | - K Geboes
- Division of Digestive Oncology, Department of Gastroenterology, UZ Gent, Gent, Belgium; Department of Internal Medicine and Pediatrics, UZ Gent, Gent, Belgium
| | - J Collignon
- Medical Oncology, CHU de Liege - Hospital Sart Tilman, Liège, Belgium
| | | | - J-L Canon
- Grand Hôpital de Charleroi Site Notre Dame, Service d'Oncologie-Hématologie, Charleroi, Belgium
| | - M Peeters
- Universitair Ziekenhuis Antwerpen, Oncology, Antwerpen, Belgium
| | - A Rutten
- GZA Ziekenhuizen Campus Sint-Vincentius, Medical Oncology, Antwerpen, Belgium
| | - T Van de Mooter
- GZA Ziekenhuizen Campus Sint-Vincentius, Medical Oncology, Antwerpen, Belgium
| | - J Vermeij
- ZNA Middelheim, Medical Oncology, Antwerpen, Belgium
| | | | - W Demey
- AZ Klina, Medical Oncology, Brasschaat, Belgium
| | - W Lybaert
- GZA Ziekenhuizen Campus Sint-Vincentius, Medical Oncology, Antwerpen, Belgium
| | - J Van Huysse
- AZ Sint-Jan Brugge-Oostende, Pathology, Brugge, Belgium
| | - J Mebis
- Laboratory of Molecular Diagnostics, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium
| | - A Awada
- Institut Jules Bordet, Medical Oncology Clinic, Anderlecht, Belgium
| | | | | | | | | | | | | | | | - S Rottey
- Medical Oncology Department, UZ Gent, Gent, Belgium
| | - P Aftimos
- Institut Jules Bordet, Medical Oncology Clinic, Anderlecht, Belgium
| | - J De Grève
- UZ Brussel, Medical Oncology, Brussels, Belgium.
| |
Collapse
|
9
|
Mossakowski M, Jacobs S, Hanseeuw B, Duprez T, Van Marcke C. Acute leukoencephalopathy and thyroiditis induced by capecitabine. Acta Neurol Belg 2022; 122:1373-1375. [PMID: 35152372 DOI: 10.1007/s13760-022-01893-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/05/2022] [Indexed: 01/16/2023]
|
10
|
Eulert-Grehn JJ, Sterner I, Schoenrath F, Stein J, Mulzer J, Kurz S, Lanmüller P, Barthel F, Unbehaun A, Klein C, Jacobs S, Falk V, Potapov E, Starck C. Defibrillator Generator Replacements in Patients with Left Ventricular Assist Device Support: The Risks of Hematoma and Infection. J Heart Lung Transplant 2022; 41:810-817. [DOI: 10.1016/j.healun.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 02/13/2022] [Accepted: 02/23/2022] [Indexed: 11/16/2022] Open
|
11
|
Muñiz KS, Wainger J, Diaz S, Mgboji GE, Yanek LR, Pandya PR, Kikuchi JY, Patterson D, Chen CCG, Blomquist J, Jacobs S, Handa VL. Obstructed defecation syndrome in the first week after pelvic reconstructive surgery. Int Urogynecol J 2022; 33:2985-2992. [PMID: 34977953 DOI: 10.1007/s00192-021-04978-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/09/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Research shows that patients are concerned about postoperative bowel function after pelvic reconstructive surgery. The objectives of this study were to estimate the proportion of patients with obstructed defecation syndrome (ODS), a subtype of constipation, in the week after surgery, to identify associated patient-level and perioperative characteristics and the associated bother. METHODS Women completed a preoperative and postoperative ODS questionnaire and postoperative bowel diary. Characteristics of women with and without postoperative ODS were compared. Chi-squared or Fisher's exact tests compared categorical variables. Student's t test or Wilcoxon rank-sum tests compared continuous variables. Multivariate logistic regression was assessed for independent effects. Wilcoxon rank-sum tests compared the groups with regard to bother. Spearman correlation coefficients described the relationship among bother, postoperative ODS score, and bowel diary variables. RESULTS Of the 186 participants enrolled, 165 completed the postoperative ODS questionnaire. Of these, 39 women (23.6%, 95% CI 17.2-30.1) had postoperative ODS. Postoperative ODS was significantly associated with preoperative ODS (p < 0.001), posterior colporrhaphy (p = 0.03), surgery type (p = 0.01), and longer duration of surgery (p = 0.03). Using multivariate logistic regression controlling for age, only preoperative ODS was significantly associated with postoperative ODS (OR 2.68, 95% CI 1.73-4.17). Women with postoperative ODS reported more bother with their defecatory symptoms (p < 0.001). The degree of bother was significantly associated with postoperative ODS score (p < 0.001). CONCLUSION Using a validated disease-specific questionnaire to identify ODS, this complication was identified in 23.6% of patients in the week after pelvic reconstructive surgery. Preoperative ODS was a significant and important risk factor for this complication.
Collapse
Affiliation(s)
- Keila S Muñiz
- Department of Gynecology and Obstetrics, Division of Female Pelvic Medicine and Reconstructive Surgery, Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center 4940 Eastern Avenue, 301 Building, Suite 3200, Baltimore, MD, 21224, USA.
| | - Julia Wainger
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sophia Diaz
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Glory E Mgboji
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lisa R Yanek
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Prerna R Pandya
- Department of Gynecology and Obstetrics, Division of Female Pelvic Medicine and Reconstructive Surgery, Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center 4940 Eastern Avenue, 301 Building, Suite 3200, Baltimore, MD, 21224, USA
| | - Jacqueline Y Kikuchi
- Department of Gynecology and Obstetrics, Division of Female Pelvic Medicine and Reconstructive Surgery, Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center 4940 Eastern Avenue, 301 Building, Suite 3200, Baltimore, MD, 21224, USA
| | - Danielle Patterson
- Department of Gynecology and Obstetrics, Division of Female Pelvic Medicine and Reconstructive Surgery, Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center 4940 Eastern Avenue, 301 Building, Suite 3200, Baltimore, MD, 21224, USA
| | - Chi Chiung Grace Chen
- Department of Gynecology and Obstetrics, Division of Female Pelvic Medicine and Reconstructive Surgery, Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center 4940 Eastern Avenue, 301 Building, Suite 3200, Baltimore, MD, 21224, USA
| | - Joan Blomquist
- Department of Gynecology, Greater Baltimore Medical Center, Baltimore, MD, USA
| | - Stephanie Jacobs
- Department of Gynecology, Greater Baltimore Medical Center, Baltimore, MD, USA
| | - Victoria L Handa
- Department of Gynecology and Obstetrics, Division of Female Pelvic Medicine and Reconstructive Surgery, Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center 4940 Eastern Avenue, 301 Building, Suite 3200, Baltimore, MD, 21224, USA
| |
Collapse
|
12
|
Nash M, Lewis B, Szempruch J, Jacobs S, Silver S. Together, Apart: Communication Dynamics among Academic Librarians during the COVID-19 Pandemic. CRL 2022. [DOI: 10.5860/crl.83.6.946] [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: 11/06/2022]
|
13
|
Hall W, Li J, You Y, Gollub M, Grajo J, Rosen M, dePrisco G, Yothers G, Dorth J, Gross H, Peterson R, Faller B, Moxley K, Jacobs S, Stella P, Haddock M, Hong T, George T. Prospective Validation of the Magnetic Resonance Tumor Regression Grade (MR-TRG) and Correlation With Pathologic Endpoints Score in NRG Oncology GI002. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
14
|
Jacobs S, Maldonado-Slootjes S, Verhulst D, Gille M. Fatal encephalopathy with brainstem involvement under dabrafenib and trametinib in a BRAF-positive metastatic melanoma. Rev Neurol (Paris) 2021; 177:1195-1198. [PMID: 34167806 DOI: 10.1016/j.neurol.2020.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/17/2020] [Accepted: 12/21/2020] [Indexed: 11/15/2022]
Affiliation(s)
- S Jacobs
- Departments of Neurology and Oncology, Cliniques de l'Europe, Brussels, Belgium
| | | | - D Verhulst
- Cliniques de l'Europe, Brussels, Belgium
| | - M Gille
- Departments of Neurology and Oncology, Cliniques de l'Europe, Brussels, Belgium.
| |
Collapse
|
15
|
Shams-White MM, Korycinski RW, Dodd KW, Barrett B, Jacobs S, Subar AF, Park Y, Bowles HR. Examining the association between meal context and diet quality: an observational study of meal context in older adults. Int J Behav Nutr Phys Act 2021; 18:67. [PMID: 34016140 PMCID: PMC8136192 DOI: 10.1186/s12966-021-01122-x] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 04/12/2021] [Indexed: 11/10/2022] Open
Abstract
Background Though a healthy diet is widely associated with reduced risks for chronic disease and mortality, older adults in the U.S. on average do not meet dietary recommendations. Given that few studies have examined the association between meal context on older adult diet quality, the aims of this study were (1) to compare the dietary quality of foods consumed in different meal contexts, as measured by the Healthy Eating Index 2015 (HEI-2015): meal location, the presence of others, and the use of electronic screens; and (2) to examine which components of the HEI-2015 drove differences in HEI-2015 total scores by meal context. Methods Interactive Diet and Activity Tracking in AARP study participants (50–74 years) completed the Automated Self-Administered 24-h Dietary Assessment tool (ASA24, version 2011) that included foods and beverages consumed and three meal contexts: “at home” versus “away from home,” “alone” versus “with company,” and “with screen time” versus “without screen time.” A population ratio approach was used to estimate HEI-2015 total and component scores for all food items consumed by meal context. Mean HEI-2015 scores (range: 0–100) for the three meal context variables were compared using t-tests. Where there were significant differences in total scores, additional t-tests were used to explore which HEI-2015 components were the primary drivers. All tests were stratified by sex and adjusted for multiple comparisons. Results HEI-2015 scores were lower for meals consumed away vs. at home (mean difference (SE), males: − 8.23 (1.02); females: − 7.29 (0.93); both p < 0.0001) and for meals eaten with vs. without company (mean difference (SE), males: − 6.61 (1.06); females: − 7.34 (1.18); both p < 0.0001). There was no difference comparing with vs. without screen time. When HEI-2015 component scores were examined, fewer total fruits, whole grains, and dairy were consumed away from home or with company; more total vegetables and greens and beans, and less added sugars were consumed with company. Conclusions Our findings suggest an association between the behavior cues of meal location and companions and dietary choices among older adults. Future studies can explore the individual and interactive effects of meal context on diet quality and subsequent health outcomes.
Collapse
Affiliation(s)
- Marissa M Shams-White
- Division of Cancer Control and Population Sciences, Epidemiology and Genomics Research Program, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892, USA.
| | - Robert W Korycinski
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, 20892, USA
| | - Kevin W Dodd
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, 20892, USA
| | - Brian Barrett
- Information Management Services, Inc., Rockville, MD, 20850, USA
| | - Stephanie Jacobs
- Information Management Services, Inc., Rockville, MD, 20850, USA
| | - Amy F Subar
- Division of Cancer Control and Population Sciences, Epidemiology and Genomics Research Program, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Yikyung Park
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Heather R Bowles
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, 20892, USA
| |
Collapse
|
16
|
Vandersmissen K, Roppe M, Droogne W, Jacobs S, Meyns B. Driveline Infections after Implantation of a Left Ventricular Assist Device. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
17
|
Hindi A, Willis S, Jacobs S, Schafheutle E. Cross-sector pre-registration pharmacist placements in general practice in England: lessons from a national evaluation. International Journal of Pharmacy Practice 2021. [DOI: 10.1093/ijpp/riab015.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
In 2019/2020, the Pharmacy Integration Fund commissioned delivery of cross-sector pre-registration pharmacist training incorporating 3–6 month placements in general practice (GP). GP placements were managed by Health Education England (HEE) and organised as one (or more) blocks, or as spilt weeks/days across base sector (hospital/community) and GP. Trainees had a pharmacist tutor at base and in GP.
Aim
to evaluate the implementation of cross-sector pre-registration pharmacy placements in GP in England, and to identify barriers and enablers of a successful placement.
Methods
A qualitative approach was taken, with case study sites purposively sampled for maximum variation: pharmacy base (hospital/community), number of pre-registration pharmacist trainees in base doing GP placement, length of GP placement, organisation of GP placement and geographical location. With consent, trainees and tutors identified as meeting sampling criteria were emailed invitation letters and participant information sheets. Where the trainee and their tutor(s) agreed to participate, semi-structured telephone interviews were conducted January - July 2020. Questions developed from literature(1, 2) and the HEE handbook were tailored to understanding trainees’ and tutors’ views on the implementation of pre-registration pharmacist placements in GP, including benefits, unintended consequences and impacts. Thematic analysis across sites was undertaken with a focus on exploring inter and intra group themes.
Results
Thirty-four interviews were completed in 11 study sites (5 GP/hospital; 6 GP/community pharmacy). Trainees and tutors considered GP placements had been successful. Contributing factors were: placement planning (induction, contingency arrangements for cover should GP tutor be unavailable); tutors working together (good communication and collaboration); GP tutor support (regular contact, reflection; identifying learning needs; opportunities for learning); integration of GP placements within training year (specific learning/training activities at base during GP placement); and GP tutors having backing of their organisation to supervise effectively. A lack of these impacted negatively. Trainees completed a wide spectrum of activities and gradually moved from administrative to clinical tasks. They built up confidence to undertake patient-facing activities, with more direct supervision at the beginning moving to indirect supervision using debriefing. Thirteen weeks in GP was considered an appropriate minimum duration by all trainees and tutors; those based in community felt that 26 weeks in GP provided more opportunities for clinical and consultation skills learning. Cross-sector experience facilitated a better understanding of patient pathways and the importance of holistic patient care. All trainees considered working in GP in future but highlighted the lack of a cross-sector GP foundation programme. Base tutors felt the time commitment was comparable to single sector placements. Base and GP tutors felt that a clear set of competencies for GP placements and a broader governance framework would ensure standards and consistency.
Conclusion
This is the first national evaluation of cross-sector pre-registration pharmacists in general practice placements in England. Sampling as case studies enabled data triangulation and generated a multi-faceted understanding on factors impacting GP placements. A key limitation was the volunteer bias associated with recruitment. Key attributes of a successful pre-registration cross-sector training experience are highlighted and can inform policy reforms including change from pre-registration to foundation year training.
References
1. Gray N. Review of Experience of Pre-registration Pharmacist Placements in the General Practice Setting – Final Report. 2019.
2. Jee SD, Schafheutle EI, Noyce PR. Is pharmacist pre-registration training equitable and robust? Higher Education, Skills and Work-Based Learning. 2019;9(3):347–58.
Collapse
Affiliation(s)
- A Hindi
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - S Willis
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - S Jacobs
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - E Schafheutle
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| |
Collapse
|
18
|
Van Praet K, Kofler M, Schambach J, Akansel S, Meyer A, Jacobs S, Falk V, Kempfert J. The Conventional Median Sternotomy Approach versus Minimally Invasive Surgical Treatment of Patients with Native Mitral Valve Infective Endocarditis. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
19
|
Morse RM, Myburgh H, Reubi D, Archey AE, Busakwe L, Garcia-Prats AJ, Hesseling AC, Jacobs S, Mbaba S, Meyerson K, Seddon JA, van der Zalm MM, Wademan DT, Hoddinott G. Opportunities for Mobile App-Based Adherence Support for Children With Tuberculosis in South Africa. JMIR Mhealth Uhealth 2020; 8:e19154. [PMID: 33174850 PMCID: PMC7688382 DOI: 10.2196/19154] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 09/03/2020] [Accepted: 09/07/2020] [Indexed: 01/20/2023] Open
Abstract
Tuberculosis is the number one infectious cause of death globally. Young children, generally those younger than 5 years, are at the highest risk of progressing from tuberculosis infection to tuberculosis disease and of developing the most severe forms of tuberculosis. Most current tuberculosis drug formulations have poor acceptability among children and require consistent adherence for prolonged periods of time. These challenges complicate children’s adherence to treatment and caregivers’ daily administration of the drugs. Rapid developments in mobile technologies and apps present opportunities for using widely available technology to support national tuberculosis programs and patient treatment adherence. Pilot studies have demonstrated that mobile apps are a feasible and acceptable means of enhancing children’s treatment adherence for other chronic conditions. Despite this, no mobile apps that aim to promote adherence to tuberculosis treatment have been developed for children. In this paper, we draw on our experiences carrying out research in clinical pediatric tuberculosis studies in South Africa. We present hypothetical scenarios of children’s adherence to tuberculosis medication to suggest priorities for behavioral and educational strategies that a mobile app could incorporate to address some of the adherence support gaps faced by children diagnosed with tuberculosis. We argue that a mobile app has the potential to lessen some of the negative experiences that children associate with taking tuberculosis treatment and to facilitate a more positive treatment adherence experience for children and their caregivers.
Collapse
Affiliation(s)
- Rachel M Morse
- Department of Global Health and Social Medicine, King's College London, London, United Kingdom
| | - Hanlie Myburgh
- Desmond Tutu Tuberculosis Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands
| | - David Reubi
- Department of Global Health and Social Medicine, King's College London, London, United Kingdom
| | - Ava E Archey
- College of Arts and Sciences, University of Virginia, Charlottesville, VA, United States
| | - Leletu Busakwe
- Desmond Tutu Tuberculosis Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Social Aspects of Public Health, Human Sciences Research Council, Cape Town, South Africa
| | - Anthony J Garcia-Prats
- Desmond Tutu Tuberculosis Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Anneke C Hesseling
- Desmond Tutu Tuberculosis Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Stephanie Jacobs
- Desmond Tutu Tuberculosis Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sharon Mbaba
- Desmond Tutu Tuberculosis Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Kyla Meyerson
- Desmond Tutu Tuberculosis Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - James A Seddon
- Desmond Tutu Tuberculosis Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Department of Infectious Diseases, Imperial College London, London, United Kingdom
| | - Marieke M van der Zalm
- Desmond Tutu Tuberculosis Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Dillon T Wademan
- Desmond Tutu Tuberculosis Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Graeme Hoddinott
- Desmond Tutu Tuberculosis Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| |
Collapse
|
20
|
Vandenbriele C, Balthazar T, Wilson J, Ledot S, Smith R, Caetano A, Adriaenssens T, Goetschalckx K, Janssens S, Dubois C, Jacobs S, Meyns B, Davies S, Price S. Left heart Impella-device to bridge acute mitral regurgitation to MitraClip-procedure: a novel implementation of percutaneous mechanical circulatory support. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Acute mitral regurgitation (MR) is an emergency, often requiring urgent surgery. Severe acute MR presenting with hemodynamic collapse is usually caused by papillary muscle rupture or dysfunction after acute myocardial infarction (AMI) or chordal rupture, resulting in flail mitral leaflet(s). Preoperative stabilization is complex due to concomitant hemodynamic collapse and hypoxic respiratory failure. Finding the right balance between both preload and inotropic support is challenging. When patients are too sick for immediate surgical intervention, mechanical circulatory support can be considered because of its ability to both unload and reduce of cardiac work while increasing coronary perfusion and cardiac output. Nevertheless, even after initial stabilization, surgical risk remains high in critically ill acute severe MR patients and transcatheter treatments such as MitraClip are increasingly being explored.
Methods
Between August 2017 and September 2019, patients presenting with acute severe mitral regurgitation and considered too ill for immediate surgical intervention (EURO-II score >11.2% plus pulmonary oedema necessitating mechanical ventilation and/or hemodynamic instability), were selected for an Impella-assisted LV unloading technique as bridge to MitraClip-procedure. Five patients were selected for the combined left Impella/MitraClip-procedure in two tertiary cardiac ICUs.
Results
The mean age was 72 years. The cause of MR was ischemic in 20% and all patients presented in cardiogenic shock state, necessitating mechanical ventilation. The overall cardiac operative risk assessment (Euro-II) score predicted a 35% chance of in-hospital mortality. Cardiac output was severely impaired (mean LVOT VTI 8.2 cm). All patients were on inotropic support and supported by an Impella-CP pVAD (mean flow 2.5 Liter per minute; mean 6.3 days of support). In all cases, we managed to reduce the LVEDP below 15 mmHg using the combination of medical therapy (afterload reduction, inotropes), mechanical ventilation and pVAD-therapy. The MR was significantly reduced by a MitraClip-procedure in each Impella supported patient. The overall survival at discharge was 80%. One patient with late referral and multiple organ failure at presentation deceased due to refractory cardiogenic shock. Overall, severe MR was reduced to grade 1+ and all four patients survived 6 months after discharge with only one readmission for decompensated heart failure.
Conclusions
A combined strategy of Impella and MitraClip appears to be a novel, feasible alternative for patients presenting with acute, severe MR unable to proceed to a corrective surgical procedure at presentation due to severe left ventricular forward flow failure. In these cases, the early initiation of pVAD-support may reduce the risk of development of irreversible end- organ damage and dysfunction. Exploration in a larger, randomised population is warranted to investigate this strategy further.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- C Vandenbriele
- Royal Brompton and Harefield NHS Foundation Trust, Adult Intensive Care, London, United Kingdom
| | - T Balthazar
- University Hospitals (UZ) Leuven, Leuven, Belgium
| | - J Wilson
- Royal Brompton and Harefield NHS Foundation Trust, Adult Intensive Care, London, United Kingdom
| | - S Ledot
- Royal Brompton and Harefield NHS Foundation Trust, Adult Intensive Care, London, United Kingdom
| | - R Smith
- Royal Brompton and Harefield NHS Foundation Trust, Adult Intensive Care, London, United Kingdom
| | - A.F Caetano
- Royal Brompton and Harefield NHS Foundation Trust, Adult Intensive Care, London, United Kingdom
| | | | | | - S Janssens
- University Hospitals (UZ) Leuven, Leuven, Belgium
| | - C Dubois
- University Hospitals (UZ) Leuven, Leuven, Belgium
| | - S Jacobs
- University Hospitals (UZ) Leuven, Leuven, Belgium
| | - B Meyns
- University Hospitals (UZ) Leuven, Leuven, Belgium
| | - S Davies
- Royal Brompton and Harefield NHS Foundation Trust, Adult Intensive Care, London, United Kingdom
| | - S Price
- Royal Brompton and Harefield NHS Foundation Trust, Adult Intensive Care, London, United Kingdom
| |
Collapse
|
21
|
Gottlieb D, Jacobs S, Berman A, Donegan D, Steele F, Abecassis S, Sayeen Nagarajan M, Davis F, Willis H, Kwon N. 253 Investigating the Relationship between 72-hour Revisits to the Emergency Department and Initial Emergency Service Index Triage Levels. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.267] [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]
|
22
|
Farid L, Jacobs D, Moreau C, Baille G, Jacobs S. Évaluation à domicile de la marche chez les patients parkinsoniens à l’aide de semelles connectées. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.04.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
23
|
Rahman F, Dunn D, Baneman E, Sullivan T, Fuller R, Jacobs S, Pinney S, Barghash M, Rana M, Taimur S. Strongyloides Screening in Heart Transplant Candidates. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.041] [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] Open
|
24
|
|
25
|
Allender S, Hayward J, Gupta S, Sanigorski A, Rana S, Seward H, Jacobs S, Venkatesh S. Bayesian strategy selection identifies optimal solutions to complex problems using an example from GP prescribing. NPJ Digit Med 2020; 3:7. [PMID: 31993505 PMCID: PMC6971230 DOI: 10.1038/s41746-019-0205-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/26/2019] [Indexed: 11/12/2022] Open
Abstract
Complex health problems require multi-strategy, multi-target interventions. We present a method that uses machine learning techniques to choose optimal interventions from a set of possible interventions within a case study aiming to increase General Practitioner (GP) discussions of physical activity (PA) with their patients. Interventions were developed based on a causal loop diagram with 26 GPs across 13 clinics in Geelong, Australia. GPs prioritised eight from more than 80 potential interventions to increase GP discussion of PA with patients. Following a 2-week baseline, a multi-arm bandit algorithm was used to assign optimal strategies to GP clinics with the target outcome being GP PA discussion rates. The algorithm was updated weekly and the process iterated until the more promising strategies emerged (a duration of seven weeks). The top three performing strategies were continued for 3 weeks to improve the power of the hypothesis test of effectiveness for each strategy compared to baseline. GPs recorded a total of 11,176 conversations about PA. GPs identified 15 factors affecting GP PA discussion rates with patients including GP skills and awareness, fragmentation of care and fear of adverse outcomes. The two most effective strategies were correctly identified within seven weeks of the algorithm-based assignment of strategies. These were clinic reception staff providing PA information to patients at check in and PA screening questionnaires completed in the waiting room. This study demonstrates an efficient way to test and identify optimal strategies from multiple possible solutions.
Collapse
Affiliation(s)
- S. Allender
- Global Obesity Centre, Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3221 Australia
| | - J. Hayward
- Global Obesity Centre, Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3221 Australia
| | - S. Gupta
- Applied Artificial Intelligence Institute, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC 3216 Australia
| | - A. Sanigorski
- Global Obesity Centre, Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3221 Australia
| | - S. Rana
- Applied Artificial Intelligence Institute, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC 3216 Australia
| | - H. Seward
- School of Medicine, Deakin University, 1 Gheringhap St, Geelong, VIC 3221 Australia
| | - S. Jacobs
- Applied Artificial Intelligence Institute, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC 3216 Australia
| | - S. Venkatesh
- Applied Artificial Intelligence Institute, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC 3216 Australia
| |
Collapse
|
26
|
Shagalow S, Facchini R, Masur D, Weiss E, Schneider S, Jacobs S, Yozawitz E, McGinley J. A-58 Rare Case of Klinefelter Syndrome with 13/14 Balanced Translocation and Absence Epilepsy: Impact of Combined Genotypes on Cognitive Neuropsychological Phenotype. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objective
Klinefelter syndrome (KS) and Robertsonian translocation of 13/14 [rob t(13;14)] are the most common sex-chromosome disorder and chromosome rearrangement, respectively (Engels et al., 2008; Skakkebæk, Wallentin, & Gravholt, 2015). Both are associated with increased risk of cognitive/intellectual disability (ID). A case of KS and de novo (i.e., unbalanced) rob t(13;14) was previously reported (Gül & Şayli, 1994). A case of KS with balanced rob t(13;14) and well-controlled generalized absence epilepsy will be presented with consideration for pediatric neuropsychological practice.
Method
Neuropsychological evaluation of a 12-year-old, right-handed boy diagnosed with comorbid KS, rob t(13;14), and generalized absence epilepsy. Particular attention was given to language given his KS diagnosis. The patient is in a 12:1:1 self-contained classroom with speech-language therapy and social skills groups in place. The patient’s mother is confirmed to have rob t(13;14), whereas paternal contribution is unknown.
Results
Adolescent with a history of language difficulties, especially comprehension. Recent school-based WISC-V FSIQ was in the extremely low range (SS = 53), with weaker verbal comprehension and working memory. Academic achievement was globally very low. Expressive and receptive language, visual perception and motor coordination were extremely low to low average. Verbal list learning and visual attention were near average to average.
Conclusions
This case contributes to the very limited body of pediatric neuropsychological data on the combined genotype of KS with rob t(13;14) and absence epilepsy. Both the KS and rob t(13;14) cognitive phenotypes have been characterized as highly variable, with the comorbidity a likely increased risk for ID.
Collapse
|
27
|
Schneider S, Weiss E, Facchini R, Shagalow S, Jacobs S, McGinley J, Masur D. B-32 The Use of Repeat Neuropsychological Assessment to Guide Treatment of Possible Normal Pressure Hydrocephalus in a Complex Case. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
Normal Pressure Hydrocephalus (NPH) is a condition that is characterized by the buildup of cerebrospinal fluid (CSF) in the brain that can cause urinary incontinence, gait disturbance, and cognitive impairment. NPH can be progressive but may be managed or reversed with shunt placement. External Lumbar Drainage (ELD) trials in determining if shunt placement is appropriate are common, but the role of repeat neuropsychological assessments during ELD procedures is not well documented in the literature. Repeat, pre-, peri and post- ELD trial, assessment in a complex case of possible NPH is presented.
Method
33-year-old Hispanic English-Speaking female with cognitive/memory complaints following intraventricular hemorrhage (IVH) secondary to vasculopathy was initially seen for post IVH outpatient neuropsychological evaluation. MRI showed enlarged ventricles/communicating hydrocephalus and workup for NPH was initiated. Repeat inpatient evaluations were completed during the ELD trial, with annual outpatient neuropsychological follow-up.
Results
Gait evaluation was inconclusive. Inpatient testing demonstrated minor improvement immediately following ELD opening, but performances were variable across the 4 days of re-evaluation. Shunt placement was rejected due to neuropsychological findings. Outpatient follow-up of patient over several years has demonstrated mild improvement and not evidence of cognitive decline since ELD trial.
Conclusions
Assessment of cognitive functioning in outpatient and inpatient settings before, during, and for several years following ELD testing was beneficial to ascertain the decision not to place a shunt. Repeat neuropsychological assessment in inpatient and outpatient settings provided crucial information for guiding treatment decisions.
Collapse
|
28
|
Jacobs S, Facchini R, Weiss E, McGinley J, Masur D. A-34 An Atypical Case of Primary Progressive Aphasia: Implications for Differentiating the Semantic Variant. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
Primary progressive aphasia is a neurodegenerative condition consisting of three primary variants. The semantic variant (svPPA) is typically associated with anomia and word-finding issues paired with fluent speech, although other symptoms can arise over time including non-verbal deficits and behavioral changes. A complex case of svPPA with evidence of robust impairment across multiple domains in the presence of notable psychosocial and medical factors is presented.
Method
Sixty-year-old woman with complaints of worsening memory and language changes in the context of marked behavioral disinhibition, deterioration of daily functioning, and indication of delusions was seen for outpatient neuropsychological evaluation. Medical history includes severe depression, anxiety, hypertension, and rheumatic heart disease. CT scan was significant for frontal and temporal atrophy and chronic right cerebellar infarct.
Results
Neuropsychological evaluation revealed uniformly extremely low scores. Presentation was notable for inappropriate behaviors, and expressive and receptive language difficulties. Significant confusion and functional impairment were evident. Her time awareness varied and she at some moments spoke about events from 20-30 years ago as if they were recent. Global language impairment was evident on formal testing and clearly moderated all other performances, including tasks of memory which were impaired. Notable weakness in visual-spatial processing and executive function were also present.
Conclusions
Complex medical and psychosocial history, and atypical decline patterns complicated the diagnosis of a patient with profound progressive expressive language impairment. SvPPA is offered as the diagnosis.
Collapse
|
29
|
Dowsett M, Jacobs S, Johnston S, Bliss J, Wheatley D, Holcombe C, Stein R, McIntosh S, Barry P, Dolling D, Snowdon C, Perry S, Batten L, Dodson A, Martins V, Modi A, Cornman C, Puhalla S, Wolmark N, Julian T, Pogue-Geile K, Robidoux A, Provencher L, Boileau JF, Shalaby I, Thirlwell M, Fisher K, Huang Bartlett C, Koehler M, Osborne K, Rimawi M. Abstract GS3-02: PALLET: A neoadjuvant study to compare the clinical and antiproliferative effects of letrozole with and without palbociclib. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-gs3-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
Abstract
Background: CDK4/6 inhibitors, such as palbociclib, are used to treat ER+ metastatic breast cancer in combination with endocrine therapy with trials ongoing in patients with primary disease. No biomarkers exist to identify those who do/do not benefit from added CDK4/6 inhibition. PALLET is an investigator-initiated/led phase II randomized trial collaboration between UK and NSABP investigators evaluating the biological and clinical effects of palbociclib with letrozole combination as neoadjuvant therapy.
Methods: Postmenopausal women with ER+ primary breast cancer and tumors >2.0cm (ultrasound) were randomized to one of 4 treatment groups (3:2:2:2 ratio): Group A: letrozole (2.5mg/d) for 14 weeks; Group B: letrozole for 2 weeks followed by letrozole + palbociclib to 14 weeks; Group C: palbociclib for 2 weeks followed by letrozole + palbociclib to 14 weeks; Group D: letrozole + palbociclib for 14 weeks. Palbociclib was given 125mg/d PO on a 21 days on, 7 days off schedule. Post-14 week treatment was at the discretion of the treating clinician including letrozole until surgery. Core-cut biopsies were taken at baseline, 2 weeks and 14 weeks. Co-primary endpoints for letrozole alone vs palbociclib groups (Group A vs Groups B+C+D) were: (i) change in Ki67 (IHC) between baseline and 14 weeks (log-fold change, Mann-Whitney test); (ii) clinical response (ultrasound) after 14 weeks (4 group, ordinal, Mann-Whitney test). Complete cell-cycle arrest (CCCA) (Ki67≤2.7%) was analyzed using a logistic regression model adjusting for recruitment region. Pre-specified exploratory biomarkers included c-PARP (apoptosis).
Results: 307 patients were recruited between 27 Feb 2015 and 08 Mar 2018; 103 were randomized to letrozole alone and 204 to letrozole + palbociclib. 279 (90.9%) patients were evaluable for 14 week clinical response. Clinical response was not significantly different between letrozole vs letrozole + palbociclib groups [(p=0.20; CR+PR 49.5% (46/93) vs 54.3% (101/186) and PD 5.4% (5/93) vs 3.2% (6/186)] nor was the small proportion of patients with pathological CR (1/87, 1.1% vs 6/180, 3.3%; p=0.43). 190 (61.9%) patients were evaluable for 14 week change in Ki67. The median log-fold change in Ki67 was greater with letrozole + palbociclib vs letrozole alone (-4.1 vs -2.2; p<0.001) corresponding to a geometric mean change of -97.4% vs -88.5%. Similarly, a greater proportion of patients who received letrozole + palbociclib achieved CCCA (90% vs 59%, p<0.001). 146 (47.6%) patients were evaluable for c-PARP and the log-fold change (suppression) was greater with letrozole + palbociclib vs letrozole alone (-0.80 vs -0.42; p=0.003) corresponding to a geometric mean change of -56.8% vs -31.4%. Other biomarkers of response / resistance are being evaluated. A higher proportion of patients had a grade ≥3 toxicity on letrozole + palbociclib than letrozole alone (49.8% vs 17.0%; p<0.001) mainly due to asymptomatic neutropenia.
Conclusion: Adding palbociclib to letrozole markedly enhanced the suppression of malignant cell proliferation as assessed by Ki67 but did not substantially increase the clinical response of primary ER+ breast cancer over a 14-week period. Concurrent reductions in cell death may have reduced the speed of tumor shrinkage.
Citation Format: Dowsett M, Jacobs S, Johnston S, Bliss J, Wheatley D, Holcombe C, Stein R, McIntosh S, Barry P, Dolling D, Snowdon C, Perry S, Batten L, Dodson A, Martins V, Modi A, Cornman C, Puhalla S, Wolmark N, Julian T, Pogue-Geile K, Robidoux A, Provencher L, Boileau JF, Shalaby I, Thirlwell M, Fisher K, Huang Bartlett C, Koehler M, Osborne K, Rimawi M. PALLET: A neoadjuvant study to compare the clinical and antiproliferative effects of letrozole with and without palbociclib [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS3-02.
Collapse
Affiliation(s)
- M Dowsett
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - S Jacobs
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - S Johnston
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - J Bliss
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - D Wheatley
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - C Holcombe
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - R Stein
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - S McIntosh
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - P Barry
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - D Dolling
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - C Snowdon
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - S Perry
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - L Batten
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - A Dodson
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - V Martins
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - A Modi
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - C Cornman
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - S Puhalla
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - N Wolmark
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - T Julian
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - K Pogue-Geile
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - A Robidoux
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - L Provencher
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - JF Boileau
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - I Shalaby
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - M Thirlwell
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - K Fisher
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - C Huang Bartlett
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - M Koehler
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - K Osborne
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - M Rimawi
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| |
Collapse
|
30
|
Muntifering JR, Linklater WL, Naidoo R, !Uri‐≠Khob S, Preez PD, Beytell P, Jacobs S, Knight AT. Sustainable close encounters: integrating tourist and animal behaviour to improve rhinoceros viewing protocols. Anim Conserv 2018. [DOI: 10.1111/acv.12454] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- J. R. Muntifering
- Minnesota Zoo Apple Valley MN USA
- Save the Rhino Trust Swakopmund Namibia
- Department of Conservation Ecology and Entomology Stellenbosch University Matieland South Africa
| | - W. L. Linklater
- Centre for Biodiversity and Restoration Ecology School of Biological Sciences Victoria University of Wellington Wellington New Zealand
- Centre for African Conservation Ecology Department of Zoology Nelson Mandela Metropolitan University Port Elizabeth South Africa
| | | | | | - P. D. Preez
- Ministry of Environment and Tourism Windhoek Namibia
| | - P. Beytell
- Ministry of Environment and Tourism Windhoek Namibia
| | - S. Jacobs
- Department of Conservation Ecology and Entomology Stellenbosch University Matieland South Africa
| | - A. T. Knight
- Department of Life Sciences Imperial College London Ascot UK
- ARC Centre of Excellence in Environmental Decisions The University of Queensland St. Lucia QLD Australia
- Department of Botany Nelson Mandela Metropolitan University Port Elizabeth Eastern Cape South Africa
| |
Collapse
|
31
|
Haghikia A, Martinovic M, Jacobs S, Moter A, Lauten A. Infektiöse Endokarditis. Z Herz- Thorax- Gefäßchir 2018. [DOI: 10.1007/s00398-018-0208-z] [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]
|
32
|
Brogna D, Dufrêne M, Michez A, Latli A, Jacobs S, Vincke C, Dendoncker N. Forest cover correlates with good biological water quality. Insights from a regional study (Wallonia, Belgium). J Environ Manage 2018; 211:9-21. [PMID: 29408087 DOI: 10.1016/j.jenvman.2018.01.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 07/12/2017] [Revised: 12/05/2017] [Accepted: 01/04/2018] [Indexed: 06/07/2023]
Abstract
Forested catchments are generally assumed to provide higher quality water in opposition to agricultural and urban catchments. However, this should be tested in various ecological contexts and through the study of multiple variables describing water quality. Indeed, interactions between ecological variables, multiple land use and land cover (LULC) types, and water quality variables render the relationship between forest cover and water quality highly complex. Furthermore, the question of the scale at which land use within stream catchments most influences stream water quality and ecosystem health remains only partially answered. This paper quantifies, at the regional scale and across five natural ecoregions of Wallonia (Belgium), the forest cover effect on biological water quality indices (based on diatoms and macroinvertebrates) at the riparian and catchment scales. Main results show that forest cover - considered alone - explains around one third of the biological water quality at the regional scale and from 15 to 70% depending on the ecoregion studied. Forest cover is systematically positively correlated with higher biological water quality. When removing spatial, local morphological variations, or population density effect, forest cover still accounts for over 10% of the total biological water quality variation. Partitioning variance shows that physico-chemical water quality is one of the main drivers of biological water quality and that anthropogenic pressures often explain an important part of it (shared or not with forest cover). The proportion of forest cover in each catchment at the regional scale and across all ecoregions but the Loam region is more positively correlated with high water quality than when considering the proportion of forest cover in the riparian zones only. This suggests that catchment-wide impacts and a fortiori catchment-wide protection measures are the main drivers of river ecological water quality. However, distinctive results from the agricultural and highly human impacted Loam region show that riparian forests are positively linked to water quality and should therefore be preserved.
Collapse
Affiliation(s)
- D Brogna
- University of Namur, Department of Geography, 61 Rue de Bruxelles, 5000 Namur, Belgium.
| | - M Dufrêne
- University of Liège, Gembloux Agro-Bio Tech, UR TERRA, Biodiversity and Landscape Group, 2 Passage des Déportés, 5030 Gembloux, Belgium.
| | - A Michez
- University of Liege, Gembloux Agro-Bio Tech, Biosystem Engineering Research Unit, 2 Passage des Déportés, 5030 Gembloux, Belgium.
| | - A Latli
- University of Namur, Research Unit in Environmental and Evolutionary Ecology, 61 Rue de Bruxelles, 5000 Namur, Belgium.
| | - S Jacobs
- Research Group Nature & Society, Research Institute of Nature and Forest INBO, Kliniekstraat 25, 1070 Brussels, Belgium; Belgian Biodiversity Platform BBPF, Avenue Louise 231 Louizalaan, 1050 Brussels, Belgium.
| | - C Vincke
- Université Catholique de Louvain, Faculty of Bioscience Engineering & Earth and Life Institute, Belgium.
| | - N Dendoncker
- University of Namur, Department of Geography, 61 Rue de Bruxelles, 5000 Namur, Belgium.
| |
Collapse
|
33
|
Cunha SC, Trabalón L, Jacobs S, Castro M, Fernandez-Tejedor M, Granby K, Verbeke W, Kwadijk C, Ferrari F, Robbens J, Sioen I, Pocurull E, Marques A, Fernandes JO, Domingo JL. UV-filters and musk fragrances in seafood commercialized in Europe Union: Occurrence, risk and exposure assessment. Environ Res 2018; 161:399-408. [PMID: 29197758 DOI: 10.1016/j.envres.2017.11.015] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [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: 07/20/2017] [Revised: 11/05/2017] [Accepted: 11/09/2017] [Indexed: 05/24/2023]
Abstract
In the framework of the FP7 ECsafeSeafood project, 62 seafood samples commercialized in Europe Union from several representative species - mackerel, tuna, salmon, seabream, cod, monkfish, crab, shrimp, octopus, perch and plaice - were analysed for residues of 21 personal care products (PCPs), including 11 UV-filters (UV-Fs) and 10 musk fragrances (musks). PCPs analysis were performed by Quick, Easy, Cheap, Effective Rugged, Safe (QuEChERS), combined with liquid-liquid extraction (LLE) or dispersive solid-phase extraction (dSPE), followed by gas chromatography-tandem mass spectrometry (GC-MS/MS). The results showed the presence in a wide range of samples of nine out of eleven UV-Fs compounds analysed, namely 2-ethylhexyl salicylate (EHS), 2-ethylhexyl,4-methoxycinnamate (EHMC), 4-methylbenzylidenecamphor (4-MBC), benzophenone-1 (BP1), benzophenone-3 (BP3), isoamyl-4-methoxycinnamate (IMC), 2,2'-dihydroxy-4,4'-dimethoxybenzophenone (DHMB), homosalate (HS), and octocrylene (OC), whereas galaxolide (HHCB), galaxolide lactone (HHCB-lactone), and tonalide (AHTN) were the most found musks. The potential risks to human health associated with the exposure to eight of the more prevalent PCPs - EHS, EHMC, 4-MBC, BP1, BP3, IMC, HHCB, and AHTN - through seafood consumption were assessed for consumers from five European countries (Belgium, Ireland, Italy, Portugal and Spain). Results showed that the human exposure to UV-Fs and musks estimated from the concentration values found in seafood and the daily consumption of concerned seafood species, were far below toxicological reference values.
Collapse
Affiliation(s)
- S C Cunha
- LAQV-Requimte, Laboratory of Bromatology and Hydrology, Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal.
| | - L Trabalón
- Department of Analytical Chemistry and Organic Chemistry, Universitat Rovira i Virgili, Tarragona, Catalonia, Spain
| | - S Jacobs
- Department of Public Health, Ghent University, Belgium; Department of Agricultural Economics, Ghent University, Belgium
| | - M Castro
- LAQV-Requimte, Laboratory of Bromatology and Hydrology, Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - M Fernandez-Tejedor
- Institute of Agrifood Research and Technology (IRTA), Ctra. de Poble Nou, E-43540 Sant Carles de la Ràpita, Tarragona, Spain
| | - K Granby
- Technical University of Denmark, National Food Institute, Denmark
| | - W Verbeke
- Department of Agricultural Economics, Ghent University, Belgium
| | - C Kwadijk
- Institute for Marine Resources and Ecosystem Studies (IMARES), Netherlands
| | - F Ferrari
- Aeiforia Srl, aggiola 12-16, 29027 Gariga di Podenzano, Piacenza, Italy
| | - J Robbens
- Institute for Agricultural and Fisheries Research (ILVO), Animal Sciences Unit - Fisheries, Belgium
| | - I Sioen
- Department of Public Health, Ghent University, Belgium; Department of Food Safety and Food Quality, Ghent University, Belgium
| | - E Pocurull
- Department of Analytical Chemistry and Organic Chemistry, Universitat Rovira i Virgili, Tarragona, Catalonia, Spain
| | - A Marques
- Portuguese Institute for the Sea and Atmosphere, I.P. (IPMA), Portugal; Interdisciplinary Centre of Marine and Environmental Research (CIIMAR), Portugal
| | - J O Fernandes
- LAQV-Requimte, Laboratory of Bromatology and Hydrology, Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - J L Domingo
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Spain
| |
Collapse
|
34
|
Van Praet K, Sündermann S, Meyer A, Montagner M, Nazari Shafti T, Jacobs S, Falk V, Kempfert J. The Periareolar Approach in Minimally Invasive Surgical Mitral Valve Repair—A Feasible, Safe, and Cosmetically Appealing Technique: A Report on 64 Patients. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- K. Van Praet
- Herz-, Thorax-, und Gefäßchirurgie, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - S. Sündermann
- Herz-, Thorax-, und Gefäßchirurgie, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - A. Meyer
- Herz-, Thorax-, und Gefäßchirurgie, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - M. Montagner
- Herz-, Thorax-, und Gefäßchirurgie, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - T. Nazari Shafti
- Herz-, Thorax-, und Gefäßchirurgie, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - S. Jacobs
- Herz-, Thorax-, und Gefäßchirurgie, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - V. Falk
- Herz-, Thorax-, und Gefäßchirurgie, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - J. Kempfert
- Herz-, Thorax-, und Gefäßchirurgie, Deutsches Herzzentrum Berlin, Berlin, Germany
| |
Collapse
|
35
|
Olagaray KE, Shaffer JE, Armendariz CK, Bellamine A, Jacobs S, Titgemeyer EC, Bradford BJ. Relative bioavailability of carnitine delivered by ruminal or abomasal infusion or by encapsulation in dairy cattle. J Dairy Sci 2017; 101:2060-2071. [PMID: 29274978 DOI: 10.3168/jds.2017-13656] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/31/2017] [Indexed: 12/14/2022]
Abstract
Two studies were designed to evaluate the relative bioavailability of l-carnitine delivered by different methods in dairy cattle. In experiment 1, 4 Holstein heifers were used in a split-plot design to compare ruminally or abomasally infused l-carnitine. The study included 2 main-plot periods, with infusion routes allocated in a crossover design. Within main-plot periods, each of 3 subplot periods consisted of 4-d infusions separated with 4-d rest periods. Subplot treatments were infusion of 1, 3, and 6 g of l-carnitine/d in conjunction with 6 g/d of arabinogalactan given in consideration of eventual product manufacturing. Doses increased within a period to minimize carryover risk. Treatments were solubilized in 4 L of water and delivered in two 10-h infusions daily. Blood was collected before the start of infusion period and on d 4 of each infusion period to obtain baseline and treatment l-carnitine concentrations. There was a dose × route interaction and route effect for increases in plasma carnitine above baseline, with increases above baseline being greater across all dose levels when infused abomasally compared with ruminally. Results demonstrated superior relative bioavailability of l-carnitine when ruminal exposure was physically bypassed. In experiment 2, 56 lactating Holstein cows (143 ± 72 d in milk) were used in 2 cohorts in randomized complete block designs (blocked by parity and milk production) to evaluate 2 rumen-protected products compared with crystalline l-carnitine. Treatments were (1) control, (2) 3 g/d of crystalline l-carnitine (crystalline), (3) 6 g/d of crystalline, (4) 5 g/d of 40COAT (40% coating, 60% l-carnitine), (5) 10 g/d of 40COAT, (6) 7.5 g/d of 60COAT (60% coating, 40% l-carnitine), and (7) 15 g/d of 60COAT. Treatments were top-dressed to diets twice daily. Each cohort used 14-d and included a 6-d baseline measurement period with the final 2 d used for data and sample collection, and an 8-d treatment period with the final 2 d used for data and sample collection. Plasma, urine, and milk samples were analyzed for l-carnitine. Crystalline and 40COAT linearly increased plasma l-carnitine, and 60COAT tended to linearly increase plasma l-carnitine. Total excretion (milk + urine) of l-carnitine averaged 1.52 ± 0.04 g/d in controls, increased linearly with crystalline and 40COAT, and increased quadratically with 60COAT. Crystalline increased plasma l-carnitine and l-carnitine excretion more than 40COAT and 60COAT. In conclusion, preventing ruminal degradation of l-carnitine increased delivery of bioavailable carnitine to cattle, but effective ruminal protection and postruminal bioavailability is challenging.
Collapse
Affiliation(s)
- K E Olagaray
- Department of Animal Sciences and Industry, Kansas State University, Manhattan 66506
| | - J E Shaffer
- Department of Animal Sciences and Industry, Kansas State University, Manhattan 66506
| | - C K Armendariz
- Department of Animal Sciences and Industry, Kansas State University, Manhattan 66506
| | | | | | - E C Titgemeyer
- Department of Animal Sciences and Industry, Kansas State University, Manhattan 66506
| | - B J Bradford
- Department of Animal Sciences and Industry, Kansas State University, Manhattan 66506.
| |
Collapse
|
36
|
Aigner A, Becher H, Jacobs S, Wilkens LR, Boushey CJ, Le Marchand L, Haiman CA, Maskarinec G. Low Diet Quality and the Risk of Stroke Mortality: The Multiethnic Cohort Study. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- A Aigner
- Institut für Medizinische Biometrie und Epidemiologie, Epidemiologie, Hamburg
| | - H Becher
- Institut für Medizinische Biometrie und Epidemiologie, Epidemiologie, Hamburg
| | - S Jacobs
- University of Heidelberg, Institute of Public Health, Heidelberg
| | - LR Wilkens
- University of Hawaii Cancer Center, Cancer Epidemiology, Honolulu
| | - CJ Boushey
- University of Hawaii Cancer Center, Cancer Epidemiology, Honolulu
| | - L Le Marchand
- University of Hawaii Cancer Center, Cancer Epidemiology, Honolulu
| | - CA Haiman
- Norris Cancer Center, University of Southern California, Department of Preventive Medicine, Los Angeles
| | - G Maskarinec
- University of Hawaii Cancer Center, Cancer Epidemiology, Honolulu
| |
Collapse
|
37
|
Jacobs S. Zeichen – Bücher – Netze: Das Deutsche Buch- und Schriftmuseum der Deutschen Nationalbibliothek. Bibliothek Forschung und Praxis 2017. [DOI: 10.1515/bfp-2017-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
ZusammenfassungDie Sammlung, Ausstellung und wissenschaftliche Bearbeitung buch- und mediengeschichtlicher Zeugnisse ist die Aufgabe des Deutschen Buch- und Schriftmuseums. Im Fokus der Arbeit steht das Buch mit seinen zahllosen Gesichtern und Funktionen – auch nach dem Übergang ins Zeitalter der digitalen Netzwelt. Einerseits wissenschaftliche Dokumentationsstätte für Buchkultur und Mediengeschichte lädt das Museum andererseits mit seinen Ausstellungen und museumspädagogischen Programmen als ein lebendiger Ort kultureller Bildung und Vermittlung zum Verweilen ein.
Collapse
|
38
|
Vandersmissen K, Driesen J, Van den Bossche K, Droogne W, Jacobs S, Fresiello L, Rega F, Gerits K, Meyns B. Do LVAD Patients Need a Specific Diet to Control Weight? J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
39
|
Meyer A, Van Praet K, Jacobs S, Sündermann S, Kukucka M, Falk V, Kempfert J. Minimally Invasive Mitral 3D Fully Endoscopic versus Direct Vision Approach: A Propensity Score Matched Comparison. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A. Meyer
- Klinik für Herz-, Thorax- und Gefäßchirurgie, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - K. Van Praet
- Klinik für Herz-, Thorax- und Gefäßchirurgie, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - S. Jacobs
- Klinik für Herz-, Thorax- und Gefäßchirurgie, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - S. Sündermann
- Klinik für Herz-, Thorax- und Gefäßchirurgie, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - M. Kukucka
- Anästhesiologie, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - V. Falk
- Klinik für Herz-, Thorax- und Gefäßchirurgie, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - J. Kempfert
- Klinik für Herz-, Thorax- und Gefäßchirurgie, Deutsches Herzzentrum Berlin, Berlin, Germany
| |
Collapse
|
40
|
Sündermann S, Van Praet K, Kukucka M, Meyer A, Schönrath F, Knierim J, Kempfert J, Falk V, Jacobs S. Mitraclip Implantation in High Risk Heart Failure Patients with Functional Mitral Valve Regurgitation in a Surgical Department as First Line Treatment for Patients Evaluated for Assist Device Implantation and/or Heart Transplantation. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- S.H. Sündermann
- Deutsches Herzzentrum Berlin, Klinik für Herz-, Thorax- und Gefäßchirurgie, Berlin, Germany
| | - K. Van Praet
- Deutsches Herzzentrum Berlin, Klinik für Herz-, Thorax- und Gefäßchirurgie, Berlin, Germany
| | - M. Kukucka
- Deutsches Herzzentrum Berlin, Klinik für Anästhesie, Berlin, Germany
| | - A. Meyer
- Deutsches Herzzentrum Berlin, Klinik für Herz-, Thorax- und Gefäßchirurgie, Berlin, Germany
| | - F. Schönrath
- Deutsches Herzzentrum Berlin, Klinik für Herz-, Thorax- und Gefäßchirurgie, Berlin, Germany
| | - J. Knierim
- Deutsches Herzzentrum Berlin, Klinik für Herz-, Thorax- und Gefäßchirurgie, Berlin, Germany
| | - J. Kempfert
- Deutsches Herzzentrum Berlin, Klinik für Herz-, Thorax- und Gefäßchirurgie, Berlin, Germany
| | - V. Falk
- Deutsches Herzzentrum Berlin, Klinik für Herz-, Thorax- und Gefäßchirurgie, Berlin, Germany
| | - S. Jacobs
- Deutsches Herzzentrum Berlin, Klinik für Herz-, Thorax- und Gefäßchirurgie, Berlin, Germany
| |
Collapse
|
41
|
Xie K, Fox GE, Liu J, Lyu C, Lee JC, Kuang H, Jacobs S, Li M, Liu T, Song S, Tsien JZ. Brain Computation Is Organized via Power-of-Two-Based Permutation Logic. Front Syst Neurosci 2016; 10:95. [PMID: 27895562 PMCID: PMC5108790 DOI: 10.3389/fnsys.2016.00095] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 11/07/2016] [Indexed: 11/17/2022] Open
Abstract
There is considerable scientific interest in understanding how cell assemblies—the long-presumed computational motif—are organized so that the brain can generate intelligent cognition and flexible behavior. The Theory of Connectivity proposes that the origin of intelligence is rooted in a power-of-two-based permutation logic (N = 2i–1), producing specific-to-general cell-assembly architecture capable of generating specific perceptions and memories, as well as generalized knowledge and flexible actions. We show that this power-of-two-based permutation logic is widely used in cortical and subcortical circuits across animal species and is conserved for the processing of a variety of cognitive modalities including appetitive, emotional and social information. However, modulatory neurons, such as dopaminergic (DA) neurons, use a simpler logic despite their distinct subtypes. Interestingly, this specific-to-general permutation logic remained largely intact although NMDA receptors—the synaptic switch for learning and memory—were deleted throughout adulthood, suggesting that the logic is developmentally pre-configured. Moreover, this computational logic is implemented in the cortex via combining a random-connectivity strategy in superficial layers 2/3 with nonrandom organizations in deep layers 5/6. This randomness of layers 2/3 cliques—which preferentially encode specific and low-combinatorial features and project inter-cortically—is ideal for maximizing cross-modality novel pattern-extraction, pattern-discrimination and pattern-categorization using sparse code, consequently explaining why it requires hippocampal offline-consolidation. In contrast, the nonrandomness in layers 5/6—which consists of few specific cliques but a higher portion of more general cliques projecting mostly to subcortical systems—is ideal for feedback-control of motivation, emotion, consciousness and behaviors. These observations suggest that the brain’s basic computational algorithm is indeed organized by the power-of-two-based permutation logic. This simple mathematical logic can account for brain computation across the entire evolutionary spectrum, ranging from the simplest neural networks to the most complex.
Collapse
Affiliation(s)
- Kun Xie
- Brain and Behavior Discovery Institute and Department of Neurology, Medical College of Georgia, Augusta UniversityAugusta, GA, USA; The Brain Decoding Center, Banna Biomedical Research Institute, Yunnan Academy of Science and TechnologyYunnan, China
| | - Grace E Fox
- Brain and Behavior Discovery Institute and Department of Neurology, Medical College of Georgia, Augusta University Augusta, GA, USA
| | - Jun Liu
- Brain and Behavior Discovery Institute and Department of Neurology, Medical College of Georgia, Augusta UniversityAugusta, GA, USA; The Brain Decoding Center, Banna Biomedical Research Institute, Yunnan Academy of Science and TechnologyYunnan, China
| | - Cheng Lyu
- Department of Computer Science and Brain Imaging Center, University of GeorgiaAthens, GA, USA; School of Automation, Northwestern Polytechnical UniversityXi'an, China
| | - Jason C Lee
- Brain and Behavior Discovery Institute and Department of Neurology, Medical College of Georgia, Augusta University Augusta, GA, USA
| | - Hui Kuang
- Brain and Behavior Discovery Institute and Department of Neurology, Medical College of Georgia, Augusta University Augusta, GA, USA
| | - Stephanie Jacobs
- Brain and Behavior Discovery Institute and Department of Neurology, Medical College of Georgia, Augusta University Augusta, GA, USA
| | - Meng Li
- Brain and Behavior Discovery Institute and Department of Neurology, Medical College of Georgia, Augusta UniversityAugusta, GA, USA; The Brain Decoding Center, Banna Biomedical Research Institute, Yunnan Academy of Science and TechnologyYunnan, China
| | - Tianming Liu
- Department of Computer Science and Brain Imaging Center, University of Georgia Athens, GA, USA
| | - Sen Song
- McGovern Institute for Brain Research and Center for Brain-Inspired Computing Research, Tsinghua University Beijing, China
| | - Joe Z Tsien
- Brain and Behavior Discovery Institute and Department of Neurology, Medical College of Georgia, Augusta UniversityAugusta, GA, USA; The Brain Decoding Center, Banna Biomedical Research Institute, Yunnan Academy of Science and TechnologyYunnan, China
| |
Collapse
|
42
|
Berk L, Mason N, Jacobs S. Hemibody Irradiation Using Helical Tomotherapy Planning. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.2247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
43
|
Olagaray KE, Shaffer JE, Armendariz CK, Bellamine A, Jacobs S, Titgemeyer EC, Bradford BJ. 1581 Relative bioavailability of l-carnitine delivered by ruminal or abomasal infusion or by encapsulation in dairy cattle. J Anim Sci 2016. [DOI: 10.2527/jam2016-1581] [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: 11/13/2022] Open
|
44
|
Jacobs S, Tsien JZ. Adult forebrain NMDA receptors gate social motivation and social memory. Neurobiol Learn Mem 2016; 138:164-172. [PMID: 27575297 DOI: 10.1016/j.nlm.2016.08.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 06/20/2016] [Revised: 08/12/2016] [Accepted: 08/25/2016] [Indexed: 01/13/2023]
Abstract
Motivation to engage in social interaction is critical to ensure normal social behaviors, whereas dysregulation in social motivation can contribute to psychiatric diseases such as schizophrenia, autism, social anxiety disorders and post-traumatic stress disorder (PTSD). While dopamine is well known to regulate motivation, its downstream targets are poorly understood. Given the fact that the dopamine 1 (D1) receptors are often physically coupled with the NMDA receptors, we hypothesize that the NMDA receptor activity in the adult forebrain principal neurons are crucial not only for learning and memory, but also for the proper gating of social motivation. Here, we tested this hypothesis by examining sociability and social memory in inducible forebrain-specific NR1 knockout mice. These mice are ideal for exploring the role of the NR1 subunit in social behavior because the NR1 subunit can be selectively knocked out after the critical developmental period, in which NR1 is required for normal development. We found that the inducible deletion of the NMDA receptors prior to behavioral assays impaired, not only object and social recognition memory tests, but also resulted in profound deficits in social motivation. Mice with ablated NR1 subunits in the forebrain demonstrated significant decreases in sociability compared to their wild type counterparts. These results suggest that in addition to its crucial role in learning and memory, the NMDA receptors in the adult forebrain principal neurons gate social motivation, independent of neuronal development.
Collapse
Affiliation(s)
- Stephanie Jacobs
- Brain and Behavior Discovery Institute and Department of Neurology, Medical College of Georgia at Augusta University, Augusta, GA 30907, USA
| | - Joe Z Tsien
- Brain and Behavior Discovery Institute and Department of Neurology, Medical College of Georgia at Augusta University, Augusta, GA 30907, USA.
| |
Collapse
|
45
|
Sündermann S, Czesla M, Jacobs S, Kempfert J, Walther T, Nataf P, Raanani E, Alfieri O, Maisano F, Falk V. Durable Mitral Valve Repair with an Adjustable Annuloplasty Ring Two Years after Implantation. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
46
|
Jacobs S, Sündermann S, Pasic M, Falk V. Beating Heart Mitral Valve Surgery: Results in 120 Consecutive Patients Considered Non-suitable Candidates for Conventional Mitral Valve Surgery. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
47
|
|
48
|
|
49
|
Abstract
We present the case of a 20 year-old woman with a vulvar mass, found to be a paraurethral leiomyoma. She subsequently underwent supermedial-approach paraurethral mass excision, distal urethral reconstruction and cystourethroscopy. Paraurethral leiomyoma make up approximately five percent of urethral tumors. This case depicts the presentation and treatment of a paraurethral leiomyoma in one of the youngest women reported in the literature.
Collapse
Affiliation(s)
- Emily Adams-Piper
- Department of Obstetrics/Gynecology, Division of Urogynecology, University of California, Irvine, Orange, CA, United States
| | - Stephanie Jacobs
- Department of Obstetrics/Gynecology, Division of Urogynecology, University of California, Irvine, Orange, CA, United States
| | - Gamal M Ghoniem
- Department of Urology, University of California, Irvine, Orange, CA, United States
| |
Collapse
|
50
|
Hanton G, Jacobs S, Cosyns K, Stohr T, De Brabandere V, McDonald P, Dillon K. Establishment of a method for a juvenile inhalation study in very young rats. Toxicol Lett 2015. [DOI: 10.1016/j.toxlet.2015.08.975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|