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32 results on '"Clark, Justin"'

4. Physical interventions to interrupt or reduce the spread of respiratory viruses

Author

Jefferson, Tom, additional, Dooley, Liz, additional, Ferroni, Eliana, additional, Al-Ansary, Lubna A, additional, van Driel, Mieke L, additional, Bawazeer, Ghada A, additional, Jones, Mark A, additional, Hoffmann, Tammy C, additional, Clark, Justin, additional, Beller, Elaine M, additional, Glasziou, Paul P, additional, and Conly, John M, additional

Published
2023
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6. Exenatide for weight‐loss maintenance in adolescents with severe obesity: A randomized, placebo‐controlled trial

Author

Fox, Claudia K., primary, Clark, Justin M., additional, Rudser, Kyle D., additional, Ryder, Justin R., additional, Gross, Amy C., additional, Nathan, Brandon M., additional, Sunni, Muna, additional, Dengel, Donald R., additional, Billington, Charles J., additional, Bensignor, Megan O., additional, and Kelly, Aaron S., additional

Published
2022
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11. Physical interventions to interrupt or reduce the spread of respiratory viruses

Author

Jefferson, Tom, additional, Del Mar, Chris B, additional, Dooley, Liz, additional, Ferroni, Eliana, additional, Al-Ansary, Lubna A, additional, Bawazeer, Ghada A, additional, van Driel, Mieke L, additional, Jones, Mark A, additional, Thorning, Sarah, additional, Beller, Elaine M, additional, Clark, Justin, additional, Hoffmann, Tammy C, additional, Glasziou, Paul P, additional, and Conly, John M, additional

Published
2020
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16. A unified framework for bias assessment in clinical research

Author

Stone, Jennifer, Glass, Kathryn, Clark, Justin, Munn, Zachary, Tugwell, Peter, Doi, Suhail A R, Stone, Jennifer, Glass, Kathryn, Clark, Justin, Munn, Zachary, Tugwell, Peter, and Doi, Suhail A R

Abstract

Methodological flaws, limitations, and inadequate practices in research are well known and pose threats to the internal validity of any research study. However, there are ways of safeguarding research conduct to reduce the chance of research producing distorted results. Numerous tools now exist to assess the incorporation of such safeguards into primary research studies (also known as quality and/or risk-of-bias assessment). These tools typically include a variety of items that are then checked against those implemented in the study. Despite a lot of research in this area, no comprehensive generic classification of safeguards across study designs exist, although attempts have been made to clarify aspects of this. We review the developments in this area as well as use preliminary data from 100 methodological studies to illustrate our proposed approach. We conclude by proposing a new framework for identifying research studies at risk of being biased and the information in this article will promote a unification of the diverse approaches to facilitating bias assessment in clinical research.

Published
2019

26. The effect of right ventricular apical and non-apical pacing on the short- and long-term changes in left ventricular ejection fraction: a systematic review and meta-analysis of randomized-controlled trials

Author

Hussain, Mohammad Akhtar, Furuya-Kanamori, Luis, Kaye, Gerald, Clark, Justin, Doi, Suhail A. R., Hussain, Mohammad Akhtar, Furuya-Kanamori, Luis, Kaye, Gerald, Clark, Justin, and Doi, Suhail A. R.

Abstract

BACKGROUND The right ventricular apex (RVA) is the traditional lead site for chronic pacing but in some patients may cause impaired left ventricular (LV) systolic function over time. Comparisons with non-apical (RVNA) pacing sites have generated inconsistent results and recent meta-analyses have demonstrated unclear benefit due to heterogeneity across studies. METHODS AND RESULTS A systematic search for randomized controlled trials that compared LVEF outcomes between RVNA and RVA pacing was performed up to October 2014. Twenty four studies (n = 1628 patients) met the inclusion criteria. To avoid between study heterogeneity two homogenous groups were created; group one where studies reported a difference (in favor of RVNA pacing) and group two where studies reported no difference between pacing sites. For group one weighted mean difference (WMD) between RVNA and RVA pacing in terms of LVEF at follow-up was 5.40% (95% CI: 3.94 to 6.87), related in part to group one's RVA arm demonstrating a significant reduction (mean loss -3.31%; 95% CI: -6.19 to -0.43) in LVEF between study baseline and end of follow-up. Neither of these finding were seen in group two. Weighted regression modeling demonstrated that inclusion of poor baseline LVEF (<40%) in combination with greater than 12 months follow-up was three times more common in group one compared to group two (weighted RR 2.82; 95% CI 1.03 - 7.72; P = 0.043). CONCLUSIONS In patients requiring chronic right ventricular pacing where there is inclusion of impaired baseline LVEF (<40%), RVA pacing is associated with deterioration in LV function relative to RVNA pacing. This article is protected by copyright. All rights reserved.

Published
2015

31. Time Above All Else: Pharmacodynamic Analysis of β-Lactams in Critically Ill Patients.

Author

Landmesser KB, Clark JA, and Burgess DS

Subjects
Anti-Bacterial Agents, Cefepime pharmacology, Humans, Meropenem pharmacology, Microbial Sensitivity Tests, Monte Carlo Method, Piperacillin pharmacokinetics, Pseudomonas aeruginosa, Tazobactam pharmacology, Critical Illness, beta-Lactams
Abstract

β-Lactams are the most commonly used antibiotics in intensive care units (ICUs). As critically ill patients often experience pharmacokinetic aberrations, and rates of antimicrobial resistance vary between hospital settings, reliance on tertiary sources or package labeling to guide empiric dosing often results in suboptimal β-lactam exposure. The primary objective was to identify β-lactam regimens capable of achieving ≥90% cumulative fraction of response (CFR) against 7 Gram-negative pathogens within 4 ICUs at our institution. Unit-specific minimal inhibitory concentration (MIC) distribution data was used in combination with published pharmacokinetic parameters in critically ill patients to perform Monte Carlo simulations. The percentage of time for which the unbound concentration of antibiotic remained above the MIC (%ƒT > MIC) was used as the pharmacodynamic target: 70%ƒT >MIC for cefepime, 40%ƒT > MIC for meropenem, and 50%ƒT > MIC for piperacillin/tazobactam. Regimens were modeled to determine the likelihood of achieving ≥90% CFR. Overall, intermittently dosed cefepime, meropenem, and piperacillin/tazobactam failed to achieve ≥90% CFR for every organism. Cefepime 2 g intermittent bolus every 8 hours failed to achieve ≥90% CFR for Klebsiella pneumoniae or Enterobacter cloacae despite susceptibility rates exceeding 90%. Piperacillin/tazobactam 4.5 g prolonged infusion (PI) every 6 hours achieved <85% CFR for Pseudomonas aeruginosa and <50% CFR for Acinetobacter baumannii in every ICU. Meropenem 2 g PI every 8 hours and meropenem 2 g PI every 6 hours were the only regimens capable of achieving ≥90% CFR for P aeruginosa in all units. Use of Monte Carlo simulations, with incorporation of local MIC distribution data, provides a mechanism to effectively predict optimal agent and dose selection within specific hospital systems, thereby enhancing pharmacokinetic/pharmacodynamic optimization and improving clinical efficacy., (© 2021, The American College of Clinical Pharmacology.)

Published
2022
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32. 25-Hydroxyvitamin D Concentrations and Clostridium difficile Infection: A Meta-Analysis.

Author

Furuya-Kanamori L, Wangdi K, Yakob L, McKenzie SJ, Doi SAR, Clark J, Paterson DL, Riley TV, and Clements ACA

Subjects
Anti-Bacterial Agents administration & dosage, Anti-Bacterial Agents adverse effects, Clostridium Infections diagnosis, Humans, Risk Factors, Severity of Illness Index, Vitamin D blood, Vitamin D Deficiency diagnosis, Clostridium Infections blood, Clostridium Infections drug therapy, Vitamin D analogs & derivatives
Abstract

Background: Well-known risk factors for Clostridium difficile infection (CDI) are exposure to antibiotics and gastric acid suppressants. Recent studies have provided some evidence of an association between hypovitaminosis D and the risk of CDI. Therefore, this meta-analysis aimed to pool all the existing evidence to investigate the association between 25-hydroxyvitamin D (25[OH]D) and CDI., Methods: A systematic search was conducted in 3 databases (PubMed, Embase, and Web of Sciences) for epidemiological studies that examined the association between mean 25(OH)D concentrations and CDI as well as between 25(OH)D status and CDI severity or recurrence. 25(OH)D status was defined as "lower" or "higher" at a threshold concentration of <20 or ≥20 ng/mL, respectively. Pooled effect sizes were computed using the inverse variance heterogeneity model of meta-analysis., Results: Eight publications (n = 4479 patients) were included in the meta-analysis. The mean concentration of 25(OH)D in patients with CDI was 3.54 ng/mL (95% confidence interval [CI], 0.39-6.89 ng/mL) lower than in patients without CDI. Patients with lower 25(OH)D status had a higher odds (odds ratio [OR], 1.61; 95% CI, 1.02-2.53) of developing severe CDI compared with those with a higher 25(OH)D status. No significant association was found between 25(OH)D status and CDI recurrence., Conclusion: The results of this meta-analysis suggest that lower mean concentrations of 25(OH)D were associated with CDI. A lower 25(OH)D status increased the odds of severe CDI but not of CDI recurrence.

Published
2017
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