Author: "Robert, Smith" / Topic: medicine - Searchworks@Jio Institute Digital Library Search Results

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1. Multifunction fluorescence open source in vivo/in vitro imaging system (openIVIS).

Author: John M Branning, Kealy A Faughnan, Austin A Tomson, Grant J Bell, Sydney M Isbell, Allen DeGroot, Lydia Jameson, Kramer Kilroy, Michael Smith, Robert Smith, Landon Mottel, Elizabeth G Branning, Zoe Worrall, Frances Anderson, Ashrit Panditaradyula, William Yang, Joseph Abdelmalek, Joshua Brake, and Kevin J Cash
Subjects: Medicine, Science
Abstract: The widespread availability and diversity of open-source microcontrollers paired with off-the-shelf electronics and 3D printed technology has led to the creation of a wide range of low-cost scientific instruments, including microscopes, spectrometers, sensors, data loggers, and other tools that can be used for research, education, and experimentation. These devices can be used to explore a wide range of scientific topics, from biology and chemistry to physics and engineering. In this study, we designed and built a multifunction fluorescent open source in vivo/in vitro imaging system (openIVIS) system that integrates a Raspberry Pi with commercial cameras and LEDs with 3D printed structures combined with an acrylic housing. Our openIVIS provides three excitation wavelengths of 460 nm, 520 nm, and 630 nm integrated with Python control software to enable fluorescent measurements across the full visible light spectrum. To demonstrate the potential applications of our system, we tested its performance against a diverse set of experiments including laboratory assays (measuring fluorescent dyes, using optical nanosensors, and DNA gel electrophoresis) to potentially fieldable applications (plant and mineral imaging). We also tested the potential use for a high school biology environment by imaging small animals and tracking their development over the course of ten days. Our system demonstrated its ability to measure a wide dynamic range fluorescent response from millimolar to picomolar concentrations in the same sample while measuring responses across visible wavelengths. These results demonstrate the power and flexibility of open-source hardware and software and how it can be integrated with customizable manufacturing to create low-cost scientific instruments with a wide range of applications. Our study provides a promising model for the development of low-cost instruments that can be used in both research and education.
Published: 2024
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2. Optical forces in heat-assisted magnetic recording head-disk interface

Author: Roshan Mathew Tom, Robert Smith, Oscar Ruiz, Qing Dai, and David B. Bogy
Subjects: Medicine, Science
Abstract: Abstract A main challenge in Heat-Assisted Magnetic Recording technology is the build-up of contaminants called smear on the near field transducer. In this paper, we investigate the role of optical forces originating from the electric field gradient in the formation of smear. First, based on suitable theoretical approximations, we compare this force with air drag and the thermophoretic force in the head-disk interface for two smear nanoparticle shapes. Then, we evaluate the force field’s sensitivity to the relevant parameter space. We find that the smear nanoparticle’s refractive index, shape, and volume significantly impact the optical force. Further, our simulations reveal that the interface conditions, such as spacing and the presence of other contaminants, also influence the magnitude of the force.
Published: 2023
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3. Uncovering the hydride ion diffusion pathway in barium hydride via neutron spectroscopy

Author: Eric Novak, Luke Daemen, Anibal Javier Ramirez-Cuesta, Yongqiang Cheng, Robert Smith, Takeshi Egami, and Niina Jalarvo
Subjects: Medicine, Science
Abstract: Abstract Solid state materials possessing the ability for fast ionic diffusion of hydrogen have immense appeal for a wide range of energy-related applications. Ionic hydrogen transport research is dominated by proton conductors, but recently a few examples of hydride ion conductors have been observed as well. Barium hydride, BaH2, undergoes a structural phase transition around 775 K that leads to an order of magnitude increase in the ionic conductivity. This material provides a prototypical system to understand hydride ion diffusion and how the altered structure produced by the phase transition can have an enormous impact on the diffusion. We employ quasielastic and inelastic neutron scattering to probe the atomic scale diffusion mechanism and vibrational dynamics of hydride ions in both the low- and high-temperature phases. Jump lengths, residence times, diffusion coefficients, and activation energies are extracted and compared to the crystal structure to uncover the diffusion pathways. We find that the hydrogen jump distances, residence times, and energy barriers become reduced following the phase transition, allowing for the efficient conduction of hydride ions through a series of hydrogen jumps of length L = 3.1 Å.
Published: 2022
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4. Circulating antibody-secreting cells are a biomarker for early diagnosis in patients with Lyme disease.

Author: Natalie S Haddad, Sophia Nozick, Shant Ohanian, Robert Smith, Susan Elias, Paul G Auwaerter, F Eun-Hyung Lee, and John L Daiss
Subjects: Medicine, Science
Abstract: BackgroundDiagnostic immunoassays for Lyme disease have several limitations including: 1) not all patients seroconvert; 2) seroconversion occurs later than symptom onset; and 3) serum antibody levels remain elevated long after resolution of the infection.IntroductionMENSA (Medium Enriched for Newly Synthesized Antibodies) is a novel diagnostic fluid that contains antibodies produced in vitro by circulating antibody-secreting cells (ASC). It enables measurement of the active humoral immune response.MethodsIn this observational, case-control study, we developed the MicroB-plex Anti-C6/Anti-pepC10 Immunoassay to measure antibodies specific for the Borrelia burgdorferi peptide antigens C6 and pepC10 and validated it using a CDC serum sample collection. Then we examined serum and MENSA samples from 36 uninfected Control subjects and 12 Newly Diagnosed Lyme Disease Patients.ResultsAmong the CDC samples, antibodies against C6 and/or pepC10 were detected in all seropositive Lyme patients (8/8), but not in sera from seronegative patients or healthy controls (0/24). Serum antibodies against C6 and pepC10 were detected in one of 36 uninfected control subjects (1/36); none were detected in the corresponding MENSA samples (0/36). In samples from newly diagnosed patients, serum antibodies identified 8/12 patients; MENSA antibodies also detected 8/12 patients. The two measures agreed on six positive individuals and differed on four others. In combination, the serum and MENSA tests identified 10/12 early Lyme patients. Typically, serum antibodies persisted 80 days or longer while MENSA antibodies declined to baseline within 40 days of successful treatment.DiscussionMENSA-based immunoassays present a promising complement to serum immunoassays for diagnosis and tracking therapeutic success in Lyme infections.
Published: 2023
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5. Exposure–lag response of smoking prevalence on lung cancer incidence using a distributed lag non-linear model

Author: Daniel Robert Smith, Alireza Behzadnia, Rabbiaatul Addawiyah Imawana, Muzammil Nahaboo Solim, and Michaela Louise Goodson
Subjects: Medicine, Science
Abstract: Abstract The prevalence of smokers is a major driver of lung cancer incidence in a population, though the “exposure–lag” effects are ill-defined. Here we present a multi-country ecological modelling study using a 30-year smoking prevalence history to quantify the exposure–lag response. To model the temporal dependency between smoking prevalence and lung cancer incidence, we used a distributed lag non-linear model (DLNM), controlling for gender, age group, country, outcome year, and population at risk, and presented the effects as the incidence rate ratio (IRR) and cumulative incidence rate ratio (IRRcum). The exposure–response varied by lag period, whilst the lag–response varied according to the magnitude and direction of changes in smoking prevalence in the population. For the cumulative lag–response, increments above and below the reference level was associated with an increased and decreased IRRcum respectively, with the magnitude of the effect varying across the lag period. Though caution should be exercised in interpretation of the IRR and IRRcum estimates reported herein, we hope our work constitutes a preliminary step towards providing policy makers with meaningful indicators to inform national screening programme developments. To that end, we have implemented our statistical model a shiny app and provide an example of its use.
Published: 2021
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6. Interruption of cancer screening services due to COVID-19 pandemic: lessons from previous disasters

Author: Douglas M. Puricelli Perin, Tess Christensen, Andrea Burón, Jennifer S. Haas, Aruna Kamineni, Nora Pashayan, Linda Rabeneck, Robert Smith, Miriam Elfström, and Mireille J.M. Broeders
Subjects: COVID-19, Health services, Early detection of cancer, Cancer screening program, Medicine
Abstract: Purpose: To review the scientific literature seeking lessons for the COVID-19 era that could be learned from previous health services interruptions that affected the delivery of cancer screening services. Methods: A systematic search was conducted up to April 17, 2020, with no restrictions on language or dates and resulted in 385 articles. Two researchers independently assessed the list and discussed any disagreements. Once a consensus was achieved for each paper, those selected were included in the review. Results: Eleven articles were included. Three studies were based in Japan, two in the United States, one in South Korea, one in Denmark, and the remaining four offered a global perspective on interruptions in health services due to natural or human-caused disasters. No articles covered an interruption due to a pandemic. The main themes identified in the reviewed studies were coordination, communication, resource availability and patient follow-up. Conclusion: Lessons learned applied to the context of COVID-19 are that coordination involving partners across the health sector is essential to optimize resources and resume services, making them more resilient while preparing for future interruptions. Communication with the general population about how COVID-19 has affected cancer screening, measures taken to mitigate it and safely re-establish screening services is recommended. Use of mobile health systems to reach patients who are not accessing services and the application of resource-stratified guidelines are important considerations. More research is needed to explore best strategies for suspending, resuming and sustaining cancer screening programs, and preparedness for future disruptions, adapted to diverse health care systems.
Published: 2021
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7. Social determinants of COVID-19 incidence and outcomes: A rapid review.

Author: Tara L Upshaw, Chloe Brown, Robert Smith, Melissa Perri, Carolyn Ziegler, and Andrew D Pinto
Subjects: Medicine, Science
Abstract: Early reports indicate that the social determinants of health are implicated in COVID-19 incidence and outcomes. To inform the ongoing response to the pandemic, we conducted a rapid review of peer-reviewed studies to examine the social determinants of COVID-19. We searched Ovid MEDLINE, Embase, PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials from December 1, 2019 to April 27, 2020. We also searched the bibliographies of included studies, COVID-19 evidence repositories and living evidence maps, and consulted with expert colleagues internationally. We included studies identified through these supplementary sources up to June 25, 2020. We included English-language peer-reviewed quantitative studies that used primary data to describe the social determinants of COVID-19 incidence, clinical presentation, health service use and outcomes in adults with a confirmed or presumptive diagnosis of COVID-19. Two reviewers extracted data and conducted quality assessment, confirmed by a third reviewer. Forty-two studies met inclusion criteria. The strongest evidence was from three large observational studies that found associations between race or ethnicity and socioeconomic deprivation and increased likelihood of COVID-19 incidence and subsequent hospitalization. Limited evidence was available on other key determinants, including occupation, educational attainment, housing status and food security. Assessing associations between sociodemographic factors and COVID-19 was limited by small samples, descriptive study designs, and the timeframe of our search. Systematic reviews of literature published subsequently are required to fully understand the magnitude of any effects and predictive utility of sociodemographic factors related to COVID-19 incidence and outcomes. PROSPERO: CRD4202017813.
Published: 2021
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8. Making health economic models Shiny: A tutorial [version 2; peer review: 2 approved]

Author: Robert Smith and Paul Schneider
Subjects: Medicine, Science
Abstract: Health economic evaluation models have traditionally been built in Microsoft Excel, but more sophisticated tools are increasingly being used as model complexity and computational requirements increase. Of all the programming languages, R is most popular amongst health economists because it has a plethora of user created packages and is highly flexible. However, even with an integrated development environment such as R Studio, R lacks a simple point and click user interface and therefore requires some programming ability. This might make the switch from Microsoft Excel to R seem daunting, and it might make it difficult to directly communicate results with decisions makers and other stakeholders. The R package Shiny has the potential to resolve this limitation. It allows programmers to embed health economic models developed in R into interactive web browser based user interfaces. Users can specify their own assumptions about model parameters and run different scenario analyses, which, in the case of regular a Markov model, can be computed within seconds. This paper provides a tutorial on how to wrap a health economic model built in R into a Shiny application. We use a four-state Markov model developed by the Decision Analysis in R for Technologies in Health (DARTH) group as a case-study to demonstrate main principles and basic functionality. A more extensive tutorial, all code, and data are provided in a GitHub repository.
Published: 2020
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9. Does ethnic density influence community participation in mass participation physical activity events? The case of parkrun in England [version 2; peer review: 2 approved, 1 approved with reservations]

Author: Robert Smith, Paul Schneider, Alice Bullas, Steve Haake, Helen Quirk, Rami Cosulich, and Elizabeth Goyder
Subjects: Medicine, Science
Abstract: Background: parkrun has been successful in encouraging people in England to participate in their weekly 5km running and walking events. However, there is substantial heterogeneity in parkrun participation across different communities in England: after controlling for travel distances, deprived communities have significantly lower participation rates. Methods: This paper expands on previous findings by investigating disparities in parkrun participation by ethnic density. We combined geo-spatial data available through the Office for National Statistics with participation data provided by parkrun, and fitted multivariable Poisson regression models to study the effect of ethnic density on participation rates at the Lower layer Super Output Level. Results: We find that areas with higher ethnic density have lower participation rates. This effect is independent of deprivation. Conclusions: An opportunity exists for parkrun to engage with these communities and reduce potential barriers to participation.
Published: 2020
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10. Does ethnic density influence community participation in mass participation physical activity events? The case of parkrun in England [version 1; peer review: 2 approved]

Author: Robert Smith, Paul Schneider, Alice Bullas, Steve Haake, Helen Quirk, Rami Cosulich, and Elizabeth Goyder
Subjects: Medicine, Science
Abstract: Background: parkrun has been successful in encouraging people in England to participate in their weekly 5km running and walking events. However, there is substantial heterogeneity in parkrun participation across different communities in England: after controlling for travel distances, deprived communities have significantly lower participation rates. Methods: This paper expands on previous findings by investigating disparities in parkrun participation by ethnic density. We combined geo-spatial data available through the Office for National Statistics with participation data provided by parkrun, and fitted multivariable Poisson regression models to study the effect of ethnic density on participation rates at the Lower layer Super Output Level. Results: We find that areas with higher ethnic density have lower participation rates. This effect is independent of deprivation. Conclusions: An opportunity exists for parkrun to engage with these communities and reduce potential barriers to participation.
Published: 2020
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11. Infection à VIH-2 au Sénégal: échecs virologiques et résistances aux antirétroviraux (ARV)

Author: Selly Ba, Ndeye Mery Dia Badiane, Steve Hawes, Louise Fortes Deguenonvo, Fatima Sall, Cheikh Ndour, Khadim Faye, Fatou Traoré, Macoumba Touré, Marie Sy1, Dana Raugi, Nancy Kiviat, Robert Smith, Moussa Seydi, Papa Salif Sow, and Gottlieb Geoffrey
Subjects: vih-2, echecs virologiques, résistances génotypiques, Medicine
Abstract: le VIH-2, endémique en Afrique de l'Ouest, est naturellement résistant aux inhibiteurs non nucléosidiques de la rétro transcriptase (INNRTI), ce qui rend difficile la prise en charge dans les pays en développement. L'objectif ici était de déterminé la prévalence de l'échec virologique au 12éme et 24éme mois (M12 et M24) de traitement antirétroviral de première ligne chez les patients infectés par le VIH-2 et d'en décrire les résistances génotypiques associées.Méthodes: il s'agit d'une étude descriptive longitudinale et prospective, durant la période de novembre 2005 à juin 2017. L'échec virologique a été défini comme toute charge virale supérieure à 50 copies/ml après 6 mois de traitement ARV à deux reprises. La recherche de mutations de résistance a été réalisée dans les régions codantes de la protéase et de la transcriptase inverse.Résultats: au total 110 patients ont été colligés, d'âge médian de 46 ans (Extrêmes 18-67) avec un ratio F/H de 2,54. A l'inclusion, la charge virale était détectable dans 44% des cas avec une médiane de 935cp/ml (Extrêmes 17-144038). Le schéma antirétroviral associait 2 INTI à 1IP dans 94% des cas. La durée médiane de suivi était estimée à 1200 jours (Extrêmes 1-3840). 94 puis 76 patients ont respectivement complété leur bilan à M12 et M24. Au suivi M24, 39 patients étaient en échec virologique soit une prévalence de 39% estimée à 33% à M12 et 11% à M24. 45% des patients avaient des résistances aux inhibiteurs nucléosidiques de la transcriptase inverse (INTI), 41% des résistances aux IP et 30% des multi résistances aux INTI et IP.Conclusion: il est impératif de rendre accessible les nouvelles classes thérapeutiques pour le traitement de sauvetage des patients infectés par le VIH-2 dans les pays à ressources limitées.
Published: 2019
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12. Shiga Toxin–Producing Escherichia coli O157, England and Wales, 1983–2012

Author: Natalie L. Adams, Lisa Byrne, Geraldine A. Smith, Richard Elson, John P. Harris, Roland Salmon, Robert Smith, Sarah J. O’Brien, Goutam K. Adak, and Claire Jenkins
Subjects: Shiga-toxigenic Escherichia coli, Escherichia coli O157, STEC, foodborne diseases, zoonoses, bacteria, Medicine, Infectious and parasitic diseases, RC109-216
Abstract: We evaluated clinical Shiga toxin–producing Escherichia coli O157 infections in England and Wales during 1983–2012 to describe changes in microbiological and surveillance methods. A strain replacement event was captured; phage type (PT) 2 decreased to account for just 3% of cases by 2012, whereas PT8 and PT21/28 strains concurrently emerged, constituting almost two thirds of cases by 2012. Despite interventions to control and reduce transmission, incidence remained constant. However, sources of infection changed over time; outbreaks caused by contaminated meat and milk declined, suggesting that interventions aimed at reducing meat cross-contamination were effective. Petting farm and school and nursery outbreaks increased, suggesting the emergence of other modes of transmission and potentially contributing to the sustained incidence over time. Studies assessing interventions and consideration of policies and guidance should be undertaken to reduce Shiga toxin–producing E. coli O157 infections in England and Wales in line with the latest epidemiologic findings.
Published: 2016
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13. Associations between age at first calving and subsequent lactation performance in UK Holstein and Holstein-Friesian dairy cows.

Author: Neil T Eastham, Amy Coates, Peter Cripps, Henry Richardson, Robert Smith, and Georgios Oikonomou
Subjects: Medicine, Science
Abstract: Lactation records from 396,534 pedigree Holstein and Holstein-Friesian primiparous cows from 6,985 UK milk recorded herds, calving for the first time during the period between the 1st of January 2006 and the 31st of December 2008, were examined in order to determine the associations between age at first calving (AFC) and subsequent production, udder health, fertility and survivability parameters. Heifers were grouped by AFC into single month classes ranging from 21 to 42 months. Mixed effects multivariable regression modelling was used for data analysis. Mean and median AFC were 29.1 and 28 months respectively. Within the study, only 48,567 heifers (12.3% of the studied population) calved for the first time at 24 months of age or younger. 162,157 heifers (40.9%) were 30 months or older at their first calving. An increased AFC was associated with increased first lactation milk, fat and protein yields. The lowest predicted mean 305-day yield (6,617kgs; 95% confidence interval (CI): 6,546-6,687 kgs) was recorded for the 21 month AFC class, significantly lower than any other class. The 36 month AFC class had the highest predicted mean (7,774 kgs; 95% CI: 7,737-7,811 kgs). However, an increased AFC was also associated with increased calving interval and increased first lactation somatic cell count (SCC). Animals calving at 21 months had a predicted mean lactation SCC of 72,765 (95% CI: 68427-77378). Animals calving at 36 months of age had a predicted mean lactation SCC of 86,648 (95% CI: 84,499-88,853). Importantly, an increased AFC was also associated with decreased lifetime daily milk yield and decreased likelihood of calving for a second successive time. Animals calving at 22 months of age had a predicted mean daily lifetime milk yield of 15.24 kgs (95% CI: 15.06-15.35); animals calving at 36 months of age had a predicted mean daily lifetime milk yield of 12.83 kgs (95% CI: 12.76-12.91). Our results highlight the importance of achieving a lower age at first calving which was here associated with improved udder health, increased lifetime daily milk yield, improved reproductive performance and increased likelihood of calving for a second time.
Published: 2018
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14. The effectiveness of pre- and post-operative rehabilitation for lung cancer: A systematic review and meta-analysis on postoperative pulmonary complications and length of hospital stay

Author: Agnes Yuen Kwan Lai, Denise Shuk Ting Cheung, Robert Smith, Chia Chin Lin, and Xinyi Xu
Subjects: medicine.medical_specialty, Lung Neoplasms, Rehabilitation, business.industry, Prehabilitation, medicine.medical_treatment, MEDLINE, Physical Therapy, Sports Therapy and Rehabilitation, Length of Stay, medicine.disease, Postoperative Complications, Meta-analysis, Preoperative Care, Perioperative care, Emergency medicine, Humans, Medicine, Postoperative Period, business, Lung cancer, Hospital stay, Pre and post
Abstract: Objective: To investigate the effects of rehabilitation either before or after operation for lung cancer on postoperative pulmonary complications and the length of hospital stay. Data sources: MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL Plus, SPORTDiscus, PsycInfo and Embase were searched from inception until June 2021. Review methods: Inclusion criteria were patients scheduled to undergo or had undergone operation for lung cancer, randomised controlled trials comparing rehabilitative interventions initiated before hospital discharge to usual care control. Two reviewers independently assessed eligibility, extracted data and risks of bias. Pooled odds ratios (ORs) or standardised mean differences (SMDs) with 95% Confidence Intervals (CI) were estimated using random-effects meta-analyses. Results: Twenty-three studies were included (12 preoperative, 10 postoperative and 1 perioperative), with 2068 participants. The pooled postoperative pulmonary complication risk and length of hospital stay were reduced after preoperative interventions (OR = 0.32; 95% CI = 0.22, 0.47; I2 = 0.0% and SMD = −1.68 days, 95% CI = −2.23, −1.13; I2 = 77.8%, respectively). Interventions delivered during the immediate postoperative period did not have any significant effects on either postoperative pulmonary complication or length of hospital stay (OR = 0.85; 95% CI = 0.56, 1.29; I2 = 0.0% and SMD = −0.23 days, 95% CI = −1.08, 0.63; I2 = 64.6%, respectively). Meta-regression showed an association between a higher number of supervised sessions and shorter hospital length of stay in preoperative studies (β = −0.17, 95% CI = −0.29, −0.05). Conclusion: Preoperative rehabilitation is effective in reducing postoperative pulmonary complications and length of hospital stay associated with lung cancer surgery. Short-term postoperative rehabilitation in inpatient settings is probably ineffective.
Published: 2021

15. Opioid Prescribing Risk Management Opportunities for the Advance Nurse Practitioners

Author: Robert Smith
Subjects: Nursing, business.industry, Nurse practitioners, Materials Chemistry, Medicine, business, Opioid prescribing, Risk management
Abstract: All clinicians are ethically obliged to prescribe responsibly and cautiously to diminish the potential for opioid diversion and to help minimize the growth of the current opioid abuse epidemic. Advance nurse practitioners should establish procedures to better control and limit opioid prescription and develop analgesic regimens to treat pain. The main purpose and goal for this review is to present data congruent with clinical, medical, and legal reports for allowing an appreciation of the possibility of the risk assumed when ordering and prescribing opioids within our podiatry profession. First, the concept and process of risk management as illustrated using a root cause analysis approach will be introduced as well as applying these principles specifically to opioid prescribing will be presented. Then, several examples found in both medical and legal literature documenting the reasons for opioid prescription risk will be presented. Finally, mitigating strategies for safe opioid prescribing will be presented so that mitigation of opioid harm can be possible and realized by the advance nurse practitioner
Published: 2021

16. Effect of qigong for sleep disturbance-related symptom clusters in cancer: a systematic review and meta-analysis

Author: Wing Fai Yeung, Chia Chin Lin, Xinyi Xu, Alina Yee Man Ng, Robert Smith, Naomi Takemura, Denise Shuk Ting Cheung, and Shing Fung Lee
Subjects: medicine.medical_specialty, Population, Psychological intervention, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Neoplasms, medicine, Humans, education, Fatigue, Depression (differential diagnoses), Depressive symptoms, education.field_of_study, Sleep disorder, business.industry, Qigong, Cancer, Syndrome, General Medicine, medicine.disease, 030228 respiratory system, Meta-analysis, Quality of Life, Physical therapy, Sleep, business, human activities, 030217 neurology & neurosurgery
Abstract: Objectives To examine the effects of qigong interventions on sleep disturbance-related symptom clusters for cancer patients and to explore the possible mediating role of fatigue and depression in affecting sleep. Methods In this systematic review and meta-analysis, a systematic search was conducted through October 2020 by searching multiple English and Chinese databases. Inclusion was limited to randomized controlled trials that measured the effect of qigong on sleep and fatigue/depressive symptoms in cancer patients. Eleven studies involving 907 cancer patients were included in the systematic review, whereas the meta-analysis included ten studies with 851 cancer patients. Results The most commonly investigated form of qigong was Taichi, and the intervention length ranged from 10 days to 6 months. All studies employed self-reported measurements. Overall, qigong significantly improved sleep (SMD = −1.28, 95% CI: −2.01, −0.55) and fatigue (SMD = −0.89, 95% CI: −1.59, −0.19) in cancer patients post-intervention, but not depressive symptoms (SMD = −0.69, 95% CI: −1.81, 0.42). Notably, the benefits on sleep and fatigue became non-significant after 3 months. Qigong's effect on sleep was significantly mediated by its effect on fatigue (β = 1.27, SE = 0.24, p = 0.002), but not depressive symptoms (β = 0.53, SE = 0.26, p = 0.106). Conclusions Qigong can be recommended for improving sleep disturbance-fatigue symptom clusters in the cancer population, while qigong's benefit on sleep is likely based on its effect on reducing fatigue. Future qigong studies should adopt more rigorous design and employ strategies to maintain longevity of intervention benefits.
Published: 2021

17. Wharton’s Jelly-Derived Mesenchymal Stromal Cells as a Promising Cellular Therapeutic Strategy for the Management of Graft-versus-Host Disease

Author: Joseph P. McGuirk, J. Robert Smith, Clint L. Divine, Micheal Zuniga, and Mark L. Weiss
Subjects: allo-HCT, GVHD, WJ-MSCs, Medicine, Pharmacy and materia medica, RS1-441
Abstract: Allogeneic hematopoietic cell transplantation (allo-HCT), a treatment option in hematologic malignancies and bone marrow failure syndromes, is frequently complicated by Graft-versus-host disease (GVHD). The primary treatment for GVHD involves immune suppression by glucocorticoids. However, patients are often refractory to the steroid therapy, and this results in a poor prognosis. Therefore alternative therapies are needed to treat GVHD. Here, we review data supporting the clinical investigation of a novel cellular therapy using Wharton’s jelly (WJ)-derived mesenchymal stromal cells (MSCs) as a potentially safe and effective therapeutic strategy in the management of GVHD. Adult-derived sources of MSCs have demonstrated signals of efficacy in the management of GVHD. However, there are limitations, including: limited proliferation capacity; heterogeneity of cell sources; lengthy expansion time to clinical dose; expansion failure in vitro; and a painful, invasive, isolation procedure for the donor. Therefore, alternative MSC sources for cellular therapy are sought. The reviewed data suggests MSCs derived from WJ may be a safe and effective cellular therapy for GVHD. Laboratories investigated and defined the immune properties of WJ-MSCs for potential use in cellular therapy. These cells represent a more uniform cell population than bone marrow-derived MSCs, displaying robust immunosuppressive properties and lacking significant immunogenicity. They can be collected safely and painlessly from individuals at birth, rapidly expanded and stored cryogenically for later clinical use. Additionally, data we reviewed suggested licensing MSCs (activating MSCs by exposure to cytokines) to enhance effectiveness in treating GVHD. Therefore, WJCs should be tested as a second generation, relatively homogeneous allogeneic cell therapy for the treatment of GVHD.
Published: 2015
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18. Modelling community-control strategies to protect hospital resources during an influenza pandemic in Ottawa, Canada.

Author: Patrick Saunders-Hastings, Bryson Quinn Hayes, Robert Smith, and Daniel Krewski
Subjects: Medicine, Science
Abstract: A novel influenza virus has emerged to produce a global pandemic four times in the past one hundred years, resulting in millions of infections, hospitalizations and deaths. There is substantial uncertainty about when, where and how the next influenza pandemic will occur.We developed a novel mathematical model to chart the evolution of an influenza pandemic. We estimate the likely burden of future influenza pandemics through health and economic endpoints. An important component of this is the adequacy of existing hospital-resource capacity. Using a simulated population reflective of Ottawa, Canada, we model the potential impact of a future influenza pandemic under different combinations of pharmaceutical and non-pharmaceutical interventions.There was substantial variation in projected pandemic impact and outcomes across intervention scenarios. In a population of 1.2 million, the illness attack rate ranged from 8.4% (all interventions) to 54.5% (no interventions); peak acute care hospital capacity ranged from 0.2% (all interventions) to 13.8% (no interventions); peak ICU capacity ranged from 1.1% (all interventions) to 90.2% (no interventions); and mortality ranged from 11 (all interventions) to 363 deaths (no interventions). Associated estimates of economic burden ranged from CAD $115 million to over $2 billion when extended mass school closure was implemented.Children accounted for a disproportionate number of pandemic infections, particularly in household settings. Pharmaceutical interventions effectively reduced peak and total pandemic burden without affecting timing, while non-pharmaceutical measures delayed and attenuated pandemic wave progression. The timely implementation of a layered intervention bundle appeared likely to protect hospital resource adequacy in Ottawa. The adaptable nature of this model provides value in informing pandemic preparedness policy planning in situations of uncertainty, as scenarios can be updated in real time as more data become available. However-given the inherent uncertainties of model assumptions-results should be interpreted with caution.
Published: 2017
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19. Knee Cartilage Thickness, T1ρ and T2 Relaxation Time Are Related to Articular Cartilage Loading in Healthy Adults.

Author: Sam Van Rossom, Colin Robert Smith, Lianne Zevenbergen, Darryl Gerard Thelen, Benedicte Vanwanseele, Dieter Van Assche, and Ilse Jonkers
Subjects: Medicine, Science
Abstract: Cartilage is responsive to the loading imposed during cyclic routine activities. However, the local relation between cartilage in terms of thickness distribution and biochemical composition and the local contact pressure during walking has not been established. The objective of this study was to evaluate the relation between cartilage thickness, proteoglycan and collagen concentration in the knee joint and knee loading in terms of contact forces and pressure during walking. 3D gait analysis and MRI (3D-FSE, T1ρ relaxation time and T2 relaxation time sequence) of fifteen healthy subjects were acquired. Experimental gait data was processed using musculoskeletal modeling to calculate the contact forces, impulses and pressure distribution in the tibiofemoral joint. Correlates to local cartilage thickness and mean T1ρ and T2 relaxation times of the weight-bearing area of the femoral condyles were examined. Local thickness was significantly correlated with local pressure: medial thickness was correlated with medial condyle contact pressure and contact force, and lateral condyle thickness was correlated with lateral condyle contact pressure and contact force during stance. Furthermore, average T1ρ and T2 relaxation time correlated significantly with the peak contact forces and impulses. Increased T1ρ relaxation time correlated with increased shear loading, decreased T1ρ and T2 relaxation time correlated with increased compressive forces and pressures. Thicker cartilage was correlated with higher condylar loading during walking, suggesting that cartilage thickness is increased in those areas experiencing higher loading during a cyclic activity such as gait. Furthermore, the proteoglycan and collagen concentration and orientation derived from T1ρ and T2 relaxation measures were related to loading.
Published: 2017
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20. The relationship between multisite peripheral joint pain and physical activity levels in older adults: A cross-sectional survey

Author: Andrew Finney, Krysia Dziedzic, Jonathan G Quicke, Gretl A. McHugh, Emma L. Healey, Robert Smith, and Martyn Lewis
Subjects: musculoskeletal diseases, medicine.medical_specialty, Nursing (miscellaneous), Cross-sectional study, Pain, Physical Therapy, Sports Therapy and Rehabilitation, Rheumatology, Quality of life, Rating scale, Surveys and Questionnaires, RC927, Health care, medicine, Humans, Orthopedics and Sports Medicine, Exercise, Aged, business.industry, Rehabilitation, Odds ratio, Arthralgia, R1, Mental health, Cross-Sectional Studies, Joint pain, Quality of Life, Physical therapy, Chiropractics, Analysis of variance, medicine.symptom, business, RA
Abstract: INTRODUCTION: Research on levels of physical activity (PA) in those with peripheral joint pain have only focused on single sites, in the knee or hips. This study investigated the levels of PA in adults with single-site and multisite peripheral joint pain compared to adults with no joint pain.\ud \ud METHODS: Analysis of a cross-sectional population survey mailed to adults aged ≥45 years (n = 28,443) was conducted. Respondents reported any peripheral joint pain in the last 12 months in either the hands, hips, knees or feet; PA levels were self-reported using the short telephone activity rating scale. The association between PA levels, peripheral joint pain and outcomes of health status (physical and mental component scores, using SF-12) pain intensity (10-point scale) and health-related quality of life (HRQoL) (EQ-5D) were investigated using analysis of variance and ordinal regressions. \ud \ud RESULTS: Compared to those with no joint pain, all pain groups reported lower levels of PA: joint pain in one site (odds ratio = 0.91, 95% CI: 0.83-0.99); two sites (0.74, 0.67-0.81), three sites (0.65, 0.59-0.72) and four sites (0.47, 0.42-0.53). Across all joint pain groups, levels of PA were associated with pain intensity, physical health status, mental health status and HRQoL. \ud \ud DISCUSSION: Adults with more sites of peripheral joint pain were more likely to report lower levels of PA. Those with more sites of pain and lower levels of PA reported poorer outcomes. Health care providers should be aware that those with multisite joint pain are most likely to have low levels of PA.
Published: 2022

21. Human Babesiosis, Maine, USA, 1995–2011

Author: Robert Smith, Susan P. Elias, Timothy J. Borelli, Bayan Missaghi, Brian J. York, Robert A. Kessler, Charles B. Lubelczyk, Eleanor H. Lacombe, Catherine M. Hayes, Michael S. Coulter, and Peter W. Rand
Subjects: Babesiosis, Babesia microti, Babesia odocoilei, blacklegged tick, Ixodes scapularis, Maine, Medicine, Infectious and parasitic diseases, RC109-216
Abstract: We observed an increase in the ratio of pathogenic Babesia microti to B. odocoilei in adult Ixodes scapularis ticks in Maine. Risk for babesiosis was associated with adult tick abundance, Borrelia burgdorferi infection prevalence, and Lyme disease incidence. Our findings may help track risk and increase the focus on blood supply screening.
Published: 2014
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22. Developing an innovative role for a clinical nurse specialist in structural heart disease services

Author: Lauren Connolly, Alison Pottle, and Robert Smith
Subjects: medicine.medical_specialty, Interventional cardiology, Heart disease, business.industry, 030204 cardiovascular system & hematology, medicine.disease, Clinical nurse specialist, 03 medical and health sciences, Nurse led, 0302 clinical medicine, medicine.anatomical_structure, Intervention (counseling), Mitral valve, General Earth and Planetary Sciences, Medicine, 030212 general & internal medicine, business, Intensive care medicine, General Environmental Science
Abstract: This article explores a new advanced nursing role within interventional cardiology. The role was jointly developed by the lead consultant and clinical nurse specialist, and has received the first official centre of excellence award in the world. As a result, the service will now deliver expert training programmes taught by the consultant team and specialist nurse. This service was created for patients with mitral valve disease. It has a dedicated and structured pathway, with the patient always at the centre of care. This article introduces the role of nurse second operator in complex valvular intervention, which allows the clinical nurse specialist to be fully involved in the entire patient journey from referral to discharge. The author describes how the role was established and the developments that have been made in the first 3 years of the post. The role encompasses both inpatient and outpatient care in a bespoke, nurse-led service, as well as responsibility for maintaining accurate data collection and adherence to the patient pathway throughout the service. This has facilitated a streamlined and tailored service that strives to deliver high-quality, equitable care to patients across the UK. It is hoped that this will encourage other centres to develop such roles for specialist nurses.
Published: 2021

23. Comparison of reliability, construct validity and responsiveness of the IPAQ‐SF and PASE in adults with osteoarthritis

Author: Krysia Dziedzic, Gretl A. McHugh, Jonathan G Quicke, Emma L. Healey, and Robert Smith
Subjects: Adult, medicine.medical_specialty, Nursing (miscellaneous), Physical activity, Physical Therapy, Sports Therapy and Rehabilitation, Osteoarthritis, Correlation, 03 medical and health sciences, 0302 clinical medicine, RC925, Rheumatology, Surveys and Questionnaires, medicine, Humans, Orthopedics and Sports Medicine, 030212 general & internal medicine, Cluster randomised controlled trial, Exercise, Reliability (statistics), Aged, Randomized Controlled Trials as Topic, 030203 arthritis & rheumatology, business.industry, Rehabilitation, Limits of agreement, Reproducibility of Results, Construct validity, medicine.disease, Standard error, Physical therapy, Chiropractics, business
Abstract: BACKGROUND: This study assessed the measurement properties of two commonly used self-report physical activity (PA) measures: the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Physical Activity Scale for the elderly (PASE) in adults with osteoarthritis. METHODS: Secondary analysis of the MOSAICS cluster randomised controlled trial baseline and 3-month follow-up questionnaires, total scores and subdomains of the IPAQ-SF and PASE were compared. Intra-class correlations (ICC) were used to assess test-retest reliability, measurement error was assessed using standard error of measurement (SEM), smallest detectable change (SDC) and 95% limits of agreement (LoA). Responsiveness was assessed using effect size (ES), standard responsive measurement (SRM) and response ratio (RR). RESULTS: There was moderate correlation (r = 0.56) between the total IPAQ-SF scores (score ranges 0-16,398) and the total PASE scores (score ranges 0-400). Subdomain correlations were also moderate (ranges 0.39-0.57). The PASE showed greater reliability compared to the IPAQ-SF (ICC = 0.68; 0.61-0.74 95% CI and ICC = 0.64; 0.55-0.72, respectively). Measurement errors in both measures were large: PASE SEM = 46.7, SDC = 129.6 and 95% LoA ranges = -117 to 136, the IPAQ-SF SEM = 3532.2 METS-1 min-1 week , SDC = 9790.8 and 95% LoA ranges = -5222 to 5597. Responsiveness was poor: ES -0.14 and -0.16, SRM -0.21 and -0.21, and RR 0.12 and 0.09 for the IPAQ-SF and PASE, respectively. DISCUSSION: The IPAQ-SF and PASE appear limited in reliability, measurement error and responsiveness. Researchers and clinicians should be aware of these limitations, particularly when comparing different levels of PA and monitoring PA levels changes over time in those with osteoarthritis.
Published: 2021

24. An international outbreak of Salmonella enterica serotype Enteritidis linked to eggs from Poland: a microbiological and epidemiological study

Author: Roan Pijnacker, Timothy J Dallman, Aloys S L Tijsma, Gillian Hawkins, Lesley Larkin, Saara M Kotila, Giusi Amore, Ettore Amato, Pamina M Suzuki, Sarah Denayer, Sofieke Klamer, Judit Pászti, Jacquelyn McCormick, Hassan Hartman, Gareth J Hughes, Lin C T Brandal, Derek Brown, Joël Mossong, Cecilia Jernberg, Luise Müller, Daniel Palm, Ettore Severi, Joannna Gołębiowska, Blaženka Hunjak, Slawomir Owczarek, Simon Le Hello, Patricia Garvey, Kirsten Mooijman, Ingrid H M Friesema, Coen van der Weijden, Menno van der Voort, Valentina Rizzi, Eelco Franz, Sophie Bertrand, Martine Brennan, Lynda Browning, Ryan Bruce, Vera Cantaert, Marie Chattaway, John Coia, Sarah Couper, Tjaša Žohar Čretnik, Ondřej Daniel, Anna Maria Dionisi, Laetitia Fabre, Ife Fitz-James, Karolina Florek, Martina Florianová, Eithne Fox, Tatjana Frelih, Eva Grilc, Vera Katalinic Jankovic, Nathalie Jourdan, Renata Karpíšková, Hans van den Kerkhof, Sjoerd Kuiling, Sanja Kurečić Filipović, Valeska Laisnez, Heidi Lange, Niall deLappes, Judith Leblanc, Ida Luzzi, Georgia Mandilara, Henry Mather, Wesley Mattheus, Kassiani Mellou, Deborah Morgan, Elizabeth de Pinna, Catherine Ragimbeau, Margrethe Hovda Røed, Saara Salmenlinna, Robert Smith, Alison Smith-Palmer, Michaela Špačková, Mia Torpdahl, Marija Trkov, Linda Trönnberg, Myrsini Tzani, Lara Utsi, Dariusz Wasyl, Pierre Weicherding, Graduate School, AII - Infectious diseases, National Institute for Public Health and the Environment [Bilthoven] (RIVM), Public Health England [London], Netherlands Food and Consumer Product Safety Authority (NVWA), Health Protection Scotland, European Centre for Disease Prevention and Control [Stockholm, Sweden] (ECDC), European Food Safety Authority (EFSA), European Commission [Brussels], Sciensano [Bruxelles], Réseau International des Instituts Pasteur (RIIP), National Centre for Epidemiology (NCE), Norwegian Institute of Public Health [Oslo] (NIPH), NHS Greater Glasgow and Clyde, Laboratoire National de Santé [Luxembourg] (LNS), Public Health Agency of Sweden, Statens Serum Institut [Copenhagen], Independent Author, Croatian Institute of Public Health [Zagreb] (CIPH), Istituto Superiore di Sanità (ISS), Institut Pasteur [Paris] (IP), Health Protection Surveillance Centre (HPSC), UMR 212 EME 'écosystèmes marins exploités' (EME), Institut de Recherche pour le Développement (IRD)-Institut Français de Recherche pour l'Exploitation de la Mer (IFREMER)-Université de Montpellier (UM), School of Chemistry [Southampton, UK], University of Southampton, Department of Infectious, Centre National de Référence - National Reference Center Escherichia coli, Shigella et Salmonella (CNR-ESS), Institut de Veille Sanitaire (INVS), Stobhill Hospital, Durrell Institute of Conservation and Ecology, University of Kent [Canterbury], Department of Microbiology, National Veterinary Research Institute [Pulawy, Pologne] (NVRI), This study received funding from the European Centre for Disease Prevention and Control, the Directorate General for Health and Food Safety of the European Commission, and the following national public health and food safety institutes: the National Institute for Public Health and the Environment (Netherlands), Public Health England, Health Protection Scotland, the National Institute for Public Health (Sciensano, Belgium), National Centre for Epidemiology (Hungary), the Norwegian Institute for Public Health, the National Health Laboratory (Luxembourg), the Public Health Agency of Sweden, Statens Serum Institut (Denmark), the Croatian Institute of Public Health, Instituto Superiore di Sanità (Italy), Institut Pasteur (France), Health Protection Surveillance Centre (Ireland), the Netherlands Food and Consumer Product Safety Authority, the Chief Veterinary Inspectorate (Poland), the Scottish Salmonella, Shigella, and Clostridium difficile Reference Laboratory, and the European Union Reference Laboratory for Salmonella (Netherlands). VR and GA are employed with the European Food Safety Authority (EFSA) in its BIOCONTAM Unit that provides scientific and administrative support to EFSA's scientific activities in the area of microbiological risk assessment. PMS and EA are employed with the European Commission at the Directorate-General for Health and Food Safety. The positions and opinions presented in this Article are those of the authors alone and are not intended to represent the views or scientific works of the European Commission or EFSA., International Outbreak Investigation Team Sophie Bertrand, Martine Brennan, Lynda Browning, Ryan Bruce, Vera Cantaert, Marie Chattaway, John Coia, Sarah Couper, Tjaša Žohar Čretnik, Ondřej Daniel, Anna Maria Dionisi, Laetitia Fabre, Sanja Kurečić Filipović, Ife Fitz-James, Karolina Florek, Martina Florianová, Eithne Fox, Tatjana Frelih, Eva Grilc, Vera Katalinic Jankovic, Nathalie Jourdan, Renata Karpíšková, Hans van den Kerkhof, Katalin Krisztalovics, Sjoerd Kuiling, Valeska Laisnez, Heidi Lange, Niall deLappes, Judith Leblanc, Ida Luzzi, Georgia Mandilara, Henry Mather, Wesley Mattheus, Kassiani Mellou, Deborah Morgan, Elizabeth de Pinna, Catherine Ragimbeau, Margrethe Hovda Røed, Saara Salmenlinna, Robert Smith, Alison Smith-Palmer, Michaela Špačková, Mia Torpdahl, Marija Trkov, Linda Trönnberg, Myrsini Tzani, Lara Utsi, Dariusz Wasyl, Pierre Weicherding., European Centre for Disease Prevention and Control (ECDC), Istituto Superiore di Sanita [Rome], Institut Pasteur [Paris], and Université de Montpellier (UM)-Institut Français de Recherche pour l'Exploitation de la Mer (IFREMER)-Institut de Recherche pour le Développement (IRD)
Subjects: Male, 0301 basic medicine, Serotype, Salmonella, medicine.medical_specialty, Eggs, Population, Serogroup, medicine.disease_cause, Disease Outbreaks, 03 medical and health sciences, 0302 clinical medicine, Environmental health, Epidemiology, medicine, Humans, Life Science, 030212 general & internal medicine, education, 2. Zero hunger, education.field_of_study, Whole Genome Sequencing, biology, business.industry, Public health, Outbreak, biology.organism_classification, Food safety, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, 3. Good health, Europe, Epidemiologic Studies, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, 030104 developmental biology, Infectious Diseases, Salmonella enteritidis, Salmonella enterica, Case-Control Studies, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Female, Salmonella Food Poisoning, Poland, business
Abstract: Summary Background Salmonella spp are a major cause of food-borne outbreaks in Europe. We investigated a large multi-country outbreak of Salmonella enterica serotype Enteritidis in the EU and European Economic Area (EEA). Methods A confirmed case was defined as a laboratory-confirmed infection with the outbreak strains of S Enteritidis based on whole-genome sequencing (WGS), occurring between May 1, 2015, and Oct 31, 2018. A probable case was defined as laboratory-confirmed infection with S Enteritidis with the multiple-locus variable-number tandem repeat analysis outbreak profile. Multi-country epidemiological, trace-back, trace-forward, and environmental investigations were done. We did a case-control study including confirmed and probable cases and controls randomly sampled from the population registry (frequency matched by age, sex, and postal code). Odds ratios (ORs) for exposure rates between cases and controls were calculated with unmatched univariable and multivariable logistic regression. Findings 18 EU and EEA countries reported 838 confirmed and 371 probable cases. 509 (42%) cases were reported in 2016, after which the number of cases steadily increased. The case-control study results showed that cases more often ate in food establishments than did controls (OR 3·4 [95% CI 1·6–7·3]), but no specific food item was identified. Recipe-based food trace-back investigations among cases who ate in food establishments identified eggs from Poland as the vehicle of infection in October, 2016. Phylogenetic analysis identified two strains of S Enteritidis in human cases that were subsequently identified in salmonella-positive eggs and primary production premises in Poland, confirming the source of the outbreak. After control measures were implemented, the number of cases decreased, but increased again in March, 2017, and the increase continued into 2018. Interpretation This outbreak highlights the public health value of multi-country sharing of epidemiological, trace-back, and microbiological data. The re-emergence of cases suggests that outbreak strains have continued to enter the food chain, although changes in strain population dynamics and fewer cases indicate that control measures had some effect. Routine use of WGS in salmonella surveillance and outbreak response promises to identify and stop outbreaks in the future. Funding European Centre for Disease Prevention and Control; Directorate General for Health and Food Safety, European Commission; and National Public Health and Food Safety Institutes of the authors' countries (see Acknowledgments for full list).
Published: 2019

25. Covid-19 Effects on the Medications Used to Treat Diabetes

Author: Robert Smith
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Diabetes mellitus, Medicine, business, medicine.disease, Intensive care medicine
Abstract: Minority patients taking prescription drugs for diabetes mellitus and hypertension are sick and vulnerable. They should not be subjected to poor quality medications that can make them worse. The purpose of this review is to present data fortifying an argument that Covid-19 will continue to disproportionally effect minorities who suffer with Type 2 Diabetes Mellitus, Hypertension, and GI ulcer disease by limiting drug safety for pharmaceuticals that are imported from oversea manufacturers even after the pandemic is over. As a foundation an overview of the Food and Drug Administration (FDA) overseas inspection process that have been validated by previously published reports will be offered to accent the procedural process. Limitations and challenges to the overseas drug inspection process as documented by congressional leadership and the FDA are offered. An accurate scientific description of N-nitrosodimethylamine (NDMA) will be presented to emphasize its danger to these patients. Five key points or initiatives recently published by the FDA to assist in food and drug safety from overseas manufacturers during the Covid-19 pandemic will be presented
Published: 2020

26. The relative risk of developing type 2 diabetes among individuals with prediabetes compared with individuals with normoglycaemia: Meta‐analysis and meta‐regression

Author: Pui Hing Chau, Janet Yuen Ha Wong, Angela Y. M. Leung, Robert Smith, Daniel Y. T. Fong, and Xin Yi Xu
Subjects: Blood Glucose, Risk, medicine.medical_specialty, Type 2 diabetes, Prediabetic State, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Internal medicine, medicine, Humans, Meta-regression, 030212 general & internal medicine, Prediabetes, General Nursing, Glycated Hemoglobin, 030504 nursing, business.industry, Incidence, medicine.disease, Impaired fasting glucose, Study heterogeneity, Diabetes Mellitus, Type 2, Meta-analysis, Relative risk, 0305 other medical science, business
Abstract: To assess the overall relative risk of diabetes in individuals with prediabetes based on updated diagnostic criteria, as compared with individuals with normoglycaemia; and to identify the study characteristics associated with the heterogeneity between studies.Meta-analysis, meta-regression.PubMed, CINAHL, British Nursing Index. Search time frame: December 1998-December 2018.The pooled relative risk of developing diabetes among individuals with prediabetes compared with those with normoglycaemia was calculated under a random effects model. Studies reported the natural progression from prediabetes to diabetes were included in this review. Sources of study heterogeneity were examined by a meta-regression.Fifty-nine eligible studies were systematically identified. The pooled relative risk for diabetes among individuals with prediabetes as compared with normoglycaemia was 5.88 (95% CI: 5.02-6.89). The annualized incidence rate (per 1,000 person-year) for diabetes among individuals with prediabetes defined by different criteria varied from 2.20-212.15, with high heterogeneity between studies (IIndividuals with prediabetes had higher risk of developing diabetes than those with normoglycaemia. Races and diagnostic criteria of prediabetes were associated with the magnitude of the estimated risk.Prediabetes is a precursor of diabetes. To screen people with prediabetes as early as possible, practitioners could consider haemoglobin A1c test as an alternative to fasting plasma glucose test. Nurses should educate people especially Asians with prediabetes for the prevention of progression to diabetes.目的: 根据更新的诊断标准,与正常血糖的个体相比,评估糖尿病前期个体患糖尿病的总体相对风险;并确定与研究间异质性相关的研究特征。设计: 荟萃分析、荟萃回归。数据来源: PubMed、CINAHL、英国护理学索引。搜索时间范围:1998年12月至2018年12月。审查方法: 在随机效应模型下,计算了与正常血糖个体相比,糖尿病前期个体患糖尿病的合并相对风险度。研究报告指出,从糖尿病前期发展为糖尿病的自然发展被纳入本审查中。通过荟萃回归检查了研究的异质性来源。结果: 系统化地确定了59项符合条件的研究。与正常血糖个体相比,糖尿病前期个体患糖尿病的合并相对风险度为5.88(95%置信区间:5.02-6.89)。按不同标准定义的糖尿病前期个体的糖尿病年发病率(每1000人-年)在2.20-212.15不等,研究间异质性较高(I2=96.64%,Q检验:P.001)。在多变量荟萃回归分析中,与白种人相比,亚洲人的相对风险度显著增加。此外,‘糖化血红蛋白A1c升高或空腹血糖受损’的人群与其他类型的糖尿病前期人群相比,相对风险度最高。结论: 糖尿病前期个体患糖尿病的风险血糖正常个体。糖尿病前期的个体类别和诊断标准与估计的风险量级有关。影响: 糖尿病前期是糖尿病的前兆。为了尽早筛查糖尿病前期人群,医生可以考虑用血红蛋白A1c测试来代替空腹血糖检测。护士应提醒人们,尤其是糖尿病前期的亚洲人,以防止发展成糖尿病。.
Published: 2020

27. Baseline sputum eosinophil + neutrophil subgroups’ clinical characteristics and longitudinal trajectories for NHLBI Severe Asthma Research Program (SARP 3) cohort

Author: Annette T. Hastie, David T. Mauger, Loren C. Denlinger, Andrea Coverstone, Mario Castro, Serpil Erzurum, Nijar Jarjour, Bruce D. Levy, Deborah A. Meyers, Wendy C. Moore, Brenda Phillips, Sally E. Wenzel, John V. Fahy, Elliot Israel, Eugene R. Bleecker, Allison Crosby-Thompson, Carrie Nettles, Angeles Cinelli, Meghan Le, Joy Lawrence, Donna Liu, Jenelle Mock, Danica Klaus, Gina Crisafi, Regina Smith, Jeff Krings, Rachel Weaver, Daniel Nguyen, Kristin McIntire, Sara Baicker-McKee, Annabelle Charbit, John Trudeau, Heather Floerke, Susan Foster, Brian Rector, Huiqing Yin-Declue, Dr Patricia Noel, Dr Tom Croxton, and Dr Robert Smith
Subjects: Adult, Male, 0301 basic medicine, medicine.medical_specialty, Neutrophils, Severe asthma, Immunology, Article, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Immunology and Allergy, Lung function, Aged, Asthma, Increased eosinophils, business.industry, Sputum, Middle Aged, respiratory system, Eosinophil, medicine.disease, respiratory tract diseases, Eosinophils, 030104 developmental biology, medicine.anatomical_structure, 030228 respiratory system, Healthcare utilization, Cohort, Female, medicine.symptom, business
Abstract: Combined elevated sputum eosinophils+neutrophils in asthma associated with lowest lung function, greater healthcare utilization, and longitudinally, further spirometric loss, implicating cell-cell interactions or overlapping inflammatory pathways while increased eosinophils or neutrophils alone show less effect.
Published: 2020

28. The 3D reconstructed skin micronucleus assay: considerations for optimal protocol design

Author: Sarah Phillips, Julie Clements, Jim Saul, Robert Smith, Darren Kidd, Teresa Chirom, James Whitwell, and Nicky Mason
Subjects: Nitrosourea, Nitrosourea Compound, Health, Toxicology and Mutagenesis, 010501 environmental sciences, Pharmacology, Toxicology, 01 natural sciences, 03 medical and health sciences, chemistry.chemical_compound, Clastogen, Genetics, medicine, Humans, Cytotoxicity, Genetics (clinical), Skin, 030304 developmental biology, 0105 earth and related environmental sciences, 0303 health sciences, Micronucleus Tests, Chemistry, Mitomycin C, Vinblastine, Micronucleus test, Biological Assay, Laboratories, Micronucleus, DNA Damage, Mutagens, medicine.drug
Abstract: Implementation of the seventh amendment to the EU Cosmetics Directive has driven much research into suitable in vitro alternative assays to support satisfactory risk assessments. One such assay is the reconstructed skin micronucleus (RSMN) assay. First reported in 2006, further development occurred and a standard protocol was published in 2011. To evaluate and optimise the assay at Covance Laboratories, we tested nine chemicals [4-nitrophenol (4-NP), cyclohexanone (CH), 2-ethyl-1,3-hexanediol (2-EHD), methyl methansulfonate (MMS), mitomycin C (MMC), ethyl nitrosourea (ENU), benzo[a]pyrene (BaP), cyclophosphamide (CPA) and vinblastine (VIN)] using the EpiDerm™ 3D skin model (MatTek Corporation®, IVLSL, Bratislava, Slovakia) and compared the data using the standard 48-h treatment regimen and also an emerging 72-h treatment protocol. The EpiDerm™ tissue has reportedly some metabolic capacity but data using 48-h treatments has provided mixed results. Our investigations demonstrate that the two chemicals requiring metabolic activation (BaP and CPA) were negative following the 48-h protocol but were clearly positive following 72-h treatment. Furthermore, Replication Index (RI) data showed higher RI values in vehicle control treatments (indicating increased cell division) across the treatment set following 72-h treatments. A general greater magnitude of micronucleus (MN) induction was also observed following test chemical treatment. These data suggest that the 72-h treatment protocol is more suitable as a standard approach for the detection of clastogenic, aneugenic and metabolically activated chemicals in the RSMN assay. For further assay optimisation, we compare the statistical power of scoring cells from duplicate or triplicate cultures per treatment concentration and provide recommendations.
Published: 2019

29. Contemporary Management of Severe Symptomatic Aortic Stenosis

Author: Marc Eugène, Piotr Duchnowski, Bernard Prendergast, Olaf Wendler, Cécile Laroche, Jean-Luc Monin, Yannick Jobic, Bogdan A. Popescu, Jeroen J. Bax, Alec Vahanian, Bernard Iung, Jeroen Bax, Michele De Bonis, Victoria Delgado, Michael Haude, Gerhard Hindricks, Aldo P. Maggioni, Luc Pierard, Susanna Price, Raphael Rosenhek, Frank Ruschitzka, Stephan Windecker, Souad Mekhaldi, Katell Lemaitre, Sébastien Authier, Magdy Abdelhamid, Astrid Apor, Gani Bajraktari, Branko Beleslin, Alexander Bogachev-Prokophiev, Daniela Cassar Demarco, Agnes Pasquet, Sait Mesut Dogan, Andrejs Erglis, Arturo Evangelista, Artan Goda, Nikolaj Ihlemann, Huseyin Ince, Andreas Katsaros, Katerina Linhartova, Julia Mascherbauer, Erkin Mirrakhimov, Vaida Mizariene, Shelley Rahman-Haley, Regina Ribeiras, Fuad Samadov, Antti Saraste, Iveta Simkova, Elizabeta Srbinovska Kostovska, Lidia Tomkiewicz-Pajak, Christophe Tribouilloy, Eliverta Zera, Mimoza Metalla, Ervina Shirka, Elona Dado, Loreta Bica, Jorida Aleksi, Gerti Knuti, Lidra Gjyli, Rudina Pjeci, Eritinka Shuperka, Erviola Lleshi, Joana Rustemaj, Marsjon Qordja, Mirald Gina, Senada Husi, Daniel Basic, Regina Steringer-Mascherbauer, Charlotte Huber, Christian Ebner, Elisabeth Sigmund, Andrea Ploechl, Thomas Sturmberger, Veronica Eder, Tanja Koppler, Maria Heger, Andreas Kammerlander, Franz Duca, Christina Binder, Matthias Koschutnik, Leonard Perschy, Lisa Puskas, Chen-Yu Ho, Farid Aliyev, Vugar Guluzada, Galib Imanov, Firdovsi Ibrahimov, Abbasali Abbasaliyev, Tahir Ahmedov, Fargana Muslumova, Jamil Babayev, Yasmin Rustamova, Tofig Jahangirov, Rauf Samadov, Muxtar Museyibov, Elnur Isayev, Oktay Musayev, Shahin Xalilov, Saleh Huseynov, Madina Yuzbashova, Vuqar Zamanov, Vusal Mammadov, Gery Van Camp, Martin Penicka, Hedwig Batjoens, Philippe Debonnaire, Daniel Dendooven, Sebastien Knecht, Mattias Duytschaever, Yves Vandekerckhove, Luc Missault, Luc Muyldermans, René Tavernier, Tineke De Grande, Patrick Coussement, Joyce DeTroyer, Katrien Derycker, Kelly De Jaegher, Antoine Bondue, Christophe Beauloye, Céline Goffinet, Daniela Corina Mirica, Frédéric Vanden Eynden, Philippe Van de Borne, Béatrice Van Frachen, David Vancraeynest, Jean Louis Vanoverschelde, Sophie Pierard, Mihaela Malanca, Florence Sinnaeve, Séverine Tahon, Marie De Clippel, Frederic Gayet, Jacques Loiseau, Nico Van de Veire, Veronique Moerman, Anne-Marie Willems, Bernard Cosyns, Steven Droogmans, Andreea Motoc, Dirk Kerkhove, Daniele Plein, Bram Roosens, Caroline Weytjens, Patrizio Lancellotti, Elena Raluca Dulgheru, Ilona Parenicova, Helena Bedanova, Frantisek Tousek, Stepanka Sindelarova, Julia Canadyova, Milos Taborsky, Jiri Ostransky, null Ivona simkova, Marek Vicha, Libor Jelinek, Irena Opavska, Miroslav Homza, Miriam Kvrayola, Radim Brat, Dan Mrozek, Eva Lichnerova, Iveta Docekalova, Marta Zarybnicka, Marketa Peskova, Patrik Roucka, Vlasta Stastna, Dagmar Jungwirtova Vondrackova, Alfred Hornig, Matus Niznansky, Marian Branny, Alexandra Vodzinska, Miloslav Dorda, Libor Snkouril, Krystyna Kluz, Jana Kypusova, Radka Nezvalova, Niels Thue Olsen, Hosam Hasan Ali, Salma Taha, Mohamed Hassan, Ahmed Afifi, Hamza Kabil, Amr Mady, Hany Ebaid, Yasser Ahmed, Mohammad Nour, Islam Talaat, CairoMaiy El Sayed, Ahmad Elsayed Mostafa, CairoYasser Sadek, CairoSherif Eltobgi, Sameh Bakhoum, Ramy Doss, Mahmoud Sheashea, Abd Allah Elasry, Ahmed Fouad, Mahmoud Baraka, Sameh Samir, Alaa Roshdy, Yasmin AbdelRazek, Mostafa M. Abd Rabou, Ahmed Abobakr, Moemen Moaaz, Mohamed Mokhtar, Mohamed Ashry, Khaled Elkhashab, Haytham Soliman Ghareeb, Mostafa Kamal, Gomaa AbdelRazek, GizaNabil Farag, Giza:Ahmed Elbarbary, Evette Wahib, Ghada Kazamel, Diaa Kamal, Mahmoud Tantawy, Adel Alansary, Mohammed Yahia, Raouf Mahmoud, Tamer El Banna, Mohamed Atef, Gamela Nasr, Salah Ahmed, Ehab E. El Hefny, Islam Saifelyazal, Mostafa Abd El Ghany, Abd El Rahman El Hadary, Ahmed Khairy, Jyri Lommi, Mika Laine, Minna Kylmala, Katja Kankanen, Anu Turpeinen, Juha Hartikainen, Lari Kujanen, Juhani Airaksinen, Tuija Vasankari, Catherine Szymanski, Yohann Bohbot, Mesut Gun, Justine Rousseaux, Loic Biere, Victor Mateus, Martin Audonnet, Jérémy Rautureau, Charles Cornet, Emmanuel Sorbets, BourgesKarine Mear, Adi Issa, Florent Le Ven, Marie-Claire Pouliquen, Martine Gilard, Alice Ohanessian, Ali Farhat, Alina Vlase, Fkhar Said, Caroline Lasgi, Carlos Sanchez, Romain Breil, Marc Peignon, Jean-Philippe Elkaim, Virginie Jan-Blin, Sylvain Ropars BertrandM'Ban, Hélène Bardet, Samuel Sawadogo, Aurélie Muschoot, Dieudonné Tchatchoua, Simon Elhadad, Aline Maubert, Tahar Lazizi, Kais Ourghi, Philippe Bonnet, Clarisse Menager-Gangloff, Sofiene Gafsi, Djidjiga Mansouri, Victor Aboyans, Julien Magne, Elie Martins, Sarah Karm, Dania Mohty, Guillaume Briday, Amandine David, Sylvestre Marechaux, Caroline Le Goffic, Camille Binda, Aymeric Menet, Francois Delelis, Anne Ringlé, Anne-Laure Castel, Ludovic Appert, Domitille Tristram, Camille Trouillet, Yasmine Nacer, Lucas Ngoy, MarseilleGilbert Habib, Franck Thuny, Julie Haentjens, Jennifer Cautela, Cécile Lavoute, Floriane Robin, Pauline Armangau, Ugo Vergeylen, Khalil Sanhadji, Nessim Hamed Abdallah, Hassan Kerzazi, Mariana Perianu, François Plurien, Chaker Oueslati, Mathieu Debauchez, Zannis Konstantinos, Alain Berrebi, Alain Dibie, Emmanuel Lansac, Aurélie Veugeois, Christelle Diakov, Christophe Caussin, Daniel Czitrom, Suzanna Salvi, Nicolas Amabile, Patrice Dervanian, Stéphanie Lejeune, Imane Bagdadi, Yemmi Mokrane, Gilles Rouault, Jerome Abalea, Marion Leledy, Patrice Horen, Erwan Donal, Christian Bosseau, Elise Paven, Elena Galli, Edouard Collette, Jean-Marie Urien, Valentin Bridonneau, Renaud Gervais, Fabrice Bauer, Houzefa Chopra, Arthur Charbonnier, David Attias, Nesrine Dahouathi, Moukda Khounlaboud, Magalie Daudin, Christophe Thebault, Cécile Hamon, Philippe Couffon, Catherine Bellot, Maelle Vomscheid, Anne Bernard, Fanny Dion, Djedjiga Naudin, Mohammed Mouzouri, Mathilde Rudelin, Alain Berenfeld, Thibault Vanzwaelmen, Tarik Alloui, Marija Gjerakaroska Radovikj, Slavica Jordanova, Werner Scholtz, Eva Liberda-Knoke, Melanie Wiemer, Andreas Mugge, Georg Nickenig, Jan-Malte Sinning, Alexander Sedaghat, Matthias Heintzen, Jan Ballof, Daniel Frenk, Rainer Hambrecht, Harm Wienbergen, Annemarie Seidel, Rico Osteresch, Kirsten Kramer, Janna Ziemann, Ramona Schulze, Wolfgang Fehske, Clarissa Eifler, Bahram Wafaisade, Andreas Kuhn, Sören Fischer, Lutz Lichtenberg, Mareike Brunold, Judith Simons, Doris Balling, Thomas Buck, Bjoern Plicht, Wolfgang Schols, Henning Ebelt, Marwan Chamieh, Jelena Anacker, Tienush Rassaf, Alexander Janosi, Alexander Lind, Julia Lortz, Peter Lüdike, Philipp Kahlert, Harald Rittger, Gabriele Eichinger, Britta Kuhls, Stephan B. Felix, Kristin Lehnert, Ann-Louise Pedersen, Marcus Dorr, Klaus Empen, Sabine Kaczmarek, Mathias Busch, Mohammed Baly, Fikret Er, Erkan Duman, Linda Gabriel, Christof Weinbrenner, Johann Bauersachs, Julian Wider, Tibor Kempf, Michael Bohm, Paul-Christian Schulze, C. Tudor Poerner, Sven Möbius-Winkler, Karsten Lenk, Kerstin Heitkamp, Marcus Franz, Sabine Krauspe, Burghard Schumacher, Volker Windmuller, Sarah Kurwitz, Holger Thiele, Thomas Kurz, Roza Meyer-Saraei, Ibrahim Akin, Christian Fastner, Dirk Lossnitzer, Ursula Hoffmann, Martin Borggrefe, Stefan Baumann, Brigitte Kircher, Claudia Foellinger, Heike Dietz, Bernhard Schieffer, Feraydoon Niroomand, Harald Mudra, Lars Maier, Daniele Camboni, Christoph Birner, Kurt Debl, Michael Paulus, Benedikt Seither, Nour Eddine El Mokhtari, Alper Oner, Evren Caglayan, Mohammed Sherif, Seyrani Yucel, Florian Custodis, Robert Schwinger, Marc Vorpahl, Melchior Seyfarth, Ina Nover, Till Koehler, Sarah Christiani, David Calvo Sanchez, Barbel Schanze, Holger Sigusch, Athir Salman, Jane Hancock, John Chambers, Camelia Demetrescue, Claire Prendergast, Miles Dalby, Robert Smith, Paula Rogers, Cheryl Riley, Dimitris Tousoulis, Ioannis Kanakakis, Konstantinos Spargias, Konstantinos Lampropoulos, Tolis Panagiotis, Athanasios Koutsoukis, Lampros Michalis, Ioannis Goudevenos, Vasileios Bellos, Michail Papafaklis, Lampros Lakkas, George Hahalis, Athanasios Makris, Haralampos Karvounis, Vasileios Kamperidis, Vlasis Ninios, Vasileios Sachpekidis, Pavlos Rouskas, Leonidas Poulimenos, Georgios Charalampidis, Eftihia Hamodraka, Athanasios Manolis, Robert Gabor Kiss, Tunde Borsanyi, Zoltan Jarai, Andras Zsary, Elektra Bartha, Annamaria Kosztin, Alexandra Doronina, Attila Kovacs, Barabas Janos Imre, Chun Chao, Kalman Benke, Istvan Karoczkai, Kati Keltai, Zsolt Förchécz, Zoltán Pozsonyi, Zsigmond Jenei, Adam Patthy, Laszlo Sallai, Zsuzsanna Majoros, Tamás Pál, Jusztina Bencze, Ildiko Sagi, Andrea Molnar, Anita Kurczina, Gabor Kolodzey, Istvan Edes, Valeria Szatmari, Zsuzsanna Zajacz, Attila Cziraki, Adam Nemeth, Reka Faludi, Laszlone Vegh, Eva Jebelovszki, Geza Karoly Lupkovics, Zsofia Kovacs, Andras Horvath, Gezim Berisha, Pranvera Ibrahimi, Luan Percuku, Rano Arapova, Elmira Laahunova, Kseniia Neronova, Zarema Zhakypova, Gulira Naizabekova, Gulnazik Muratova, Iveta Sime, Nikolajs Sorokins, Ginta Kamzola, Irina Cgojeva-Sproge, Gita Rancane, Ramune Valentinaviciene, Laima Rudiene, Rasa Raugaliene, Aiste Bardzilauske, Regina Jonkaitiene, Jurate Petrauskaite, Monika Bieseviciene, Raimonda Verseckaite, Ruta Zvirblyte, Danute Kalibatiene, Greta Radauskaite, Gabija Janaviciute-Matuzeviciene, Dovile Jancauskaite, Deimile Balkute, Juste Maneikyte, Ingrida Mileryte, Monika Vaisvilaite, Lina Gedvilaite, Mykolas Biliukas, Vaiva Karpaviciene, Robert George Xuereb, Elton Pllaha, Roxana Djaberi, Klaudiusz Komor, Agnieszka Gorgon-Komor, Beata Loranc, Jaroslaw Myszor, Katarzyna Mizia-Stec, Adrianna Berger-Kucza, Magdalena Mizia, Mateusz Polak, Piotr Bogacki, Piotr Podolec, Monika Komar, Ewa Sedziwy, Dorota Sliwiak, Bartosz Sobien, Beata Rog, Marta Hlawaty, Urszula Gancarczyk, Natasza Libiszewska, Danuta Sorysz, Andrzej Gackowski, Malgorzata Cieply, Agnieszka Misiuda, Franciszek Racibor, Anna Nytko, Kazimierz Widenka, Maciej Kolowca, Janusz Bak, Andrzej Curzytek, Mateusz Regulski, Malgorzata Kamela, Mateusz Wisniowski, Tomasz Hryniewiecki, Piotr Szymanski, Monika Rozewicz, Maciej Grabowski, Andrzej Budaj, Beata Zaborska, Ewa Pilichowska-Paskiet, Malgorzata Sikora-Frac, Tomasz Slomski, Isabel Joao, Ines Cruz, Hélder Pereira, Rita Cale, Ana Marques, Ana Rita Pereira, Carlos Morais, Antonio Freitas, David Roque, Nuno Antunes, Antonio Costeira Pereira, Catarina Vieira, Nuno Salome, Juliana Martins, Isabel Campos, Goncalo Cardoso, Claudia Silva, Afonso Oliveira, Mariana Goncalves, Rui Martins, Nuno Quintal, Bruno Mendes, Joseline Silva, Joao Ferreira, James Milner, Patricia Alves, Vera Marinho, Paula Gago, Jose Amado, Joao Bispo, Dina Bento, Inocencia Machado, Margarida Oliveira, Lucy Calvo, Pedro von Hate, Bebiana Faria, Ana Galrinho, Luisa Branco, Antonio Goncalves, Tiago Mendonca, Mafalda Selas, Filipe Macedo, Carla Sousa, Sofia Cabral, Filomena Oliveira, Maria Trepa, Marta Fontes-Oliveira, Alzira Nunes, Paulo Araújo, Vasco Gama Ribeiro, Joao Almeida, Alberto Rodrigues, Pedro Braga, Sonia Dias, Sofia Carvalho, Catarina Ferreira, Alberto Ferreira, Pedro Mateus, Miguel Moz, Silvia Leao, Renato Margato, Ilidio Moreira, Jose Guimanaes, Joana Ribeiro, Fernando Goncalves, Jose Cabral, Ines Almeida, Luisa Goncalves, Mariana Tarusi, Calin Pop, Claudia Matei, Diana Tint, Sanziana Barbulescu, Sorin Micu, Ioana Pop, Costica Baba, Doina Dimulescu, Maria Dorobantu, Carmen Ginghina, Roxana Onut, Andreea Popescu, Brandusa Zamfirescu, Raluca Aflorii, Mihaela Popescu, Liviu Ghilencea, Andreeea Rachieru, Monica Stoian, Nicoleta Oprescu, Silvia Iancovici, Iona Petre, Anca Doina Mateescu, Andreea Calin, Simona Botezatu, Roxana Enache, Monica Rosca, Daniela Ciuperca, Evelyn Babalac, Ruxandra Beyer, Laura Cadis, Raluca Rancea, Raluca Tomoaia, Adela Rosianu, Emese Kovacs, Constantin Militaru, Alina Craciun, Oana Mirea, Mihaela Florescu, Lucica Grigorica, Daniela Dragusin, Luiza Nechita, Mihai Marinescu, Teodor Chiscaneanu, Lucia Botezatu, Costela Corciova, Antoniu Octavian Petris, Catalina Arsenescu-Georgescu, Delia Salaru, Dan Mihai Alexandrescu, Carmjen Plesoianu, Ana Tanasa, Ovidiu Mitu, Irina Iuliana Costache, Ionut Tudorancea, Catalin Usurelu, Gabriela Eminovici, Ioan Manitiu, Oana Stoia, Adriana Mitre, Dan-Octavian Nistor, Anca Maier, Silvia Lupu, Mihaela Opris, Adina Ionac, Irina Popescu, Simina Crisan, Cristian Mornos, Flavia Goanta, Liana Gruescu, Oana Voinescu, Madalina Petcu, Ramona Cozlac, Elena Damrina, Liliya Khilova, Irina Ryazantseva, Dmitry Kozmin, Maria Kiseleva, Marina Goncharova, Kamila Kitalaeva, Victoria Demetskay, Artem Verevetinov, Mikhail Fomenko, Elena Skripkina, Viktor Tsoi, Georgii Antipov, Yuri Schneider, Denis Yazikov, Marina Makarova, Aleksei Cherkes, Natalya Ermakova, Aleksandr Medvedev, Anastasia Sarosek, Mikhail Isayan, Tatyana Voronova, Oleg Kulumbegov, Alina Tuchina, Sergei Stefanov, Margarita Klimova, Konstantin Smolyaninov, Zhargalma Dandarova, Victoriya Magamet, Natalia Spiropulos, Sergey Boldyrev, Kirill Barbukhatty, Dmitrii Buyankov, Vladimir Yurin, Yuriy Gross, Maksim Boronin, Mariya Mikhaleva, Mariya Shablovskaya, Alex Zotov, Daniil Borisov, Vasily Tereshchenko, Ekaterina Zubova, A. Kuzmin, Ivan Tarasenko, Alishir Gamzaev, Natalya Borovkova, Tatyana Koroleva, Svetlana Botova, Ilya Pochinka, Vera Dunaeva, Victoria Teplitskaya, Elena I. Semenova, Olga V. Korabel'Nikova, Denis S. Simonov, Elena Denisenko, Natalia Harina, Natalia Yarohno, Svetlana Alekseeva, Julia Abydenkova, Lyubov Shabalkina, Olga Mayorova, Valeriy Tsechanovich, Igor Medvedev, Michail Lepilin, PenzaEvgenii Nemchenko, Vadim Karnahin, Vasilya Safina, Yaroslav Slastin, Venera Gilfanova, Roman Gorbunov, Ramis Jakubov, Aigul Fazylova, Mansur Poteev, Laysan Vazetdinova, Indira Tarasova, Rishat Irgaliyev, Olga Moiseeva, Mikhail Gordeev, Olga Irtyuga, Raisa Moiseeva, Nina Ostanina, Dmitry Zverev, Patimat Murtazalieva, Dmitry Kuznetsov, Mariya Skurativa, Larisa Polyaeva, Kirill Mihaiilov, Biljana Obrenovic-Kircanski, Svetozar Putnik, Dragan Simic, Milan Petrovic, Natasa Markovic Nikolic, Ljiljana Jovovic, Dimitra Kalimanovska Ostric, Milan Brajovic, Milica Dekleva Manojlovic, Vladimir Novakovic, Danijela Zamaklar-Trifunovic, Bojana Orbovic, Olga Petrovic, Marija Boricic-Kostic, Kristina Andjelkovic, Marko Milanov, Maja Despotovic-Nikolic, Sreten Budisavljevic, Sanja Veljkovic, Nataša Cvetinovic, Daniijela Lepojevic, Aleksandra Todorovic, Aleksandra Nikolic, Branislava Borzanovic, Ljiljana Trkulja, Slobodan Tomic, Milan Vukovic, Jelica Milosavljevic, Mirjana Milanovic, Vladan Stakic, Aleksandra Cvetkovic, Suzana Milutinovic, Olivera Bozic, Miodrag Miladinovic, Zoran Nikolic, Dinka Despotovic, Dimitrije Jovanovic, Anastazija Stojsic-Milosavljevic, Aleksandra Ilic, Mirjana Sladojevic, Stamenko Susak, Srdjan Maletin, Salvo Pavlovic, Vladimir Kuzmanovic, Nikola Ivanovic, Jovana Dejanovic, Dusan Ruzicic, Dragana Drajic, Danijel Cvetanovic, Marija Mirkovic, Jon Omoran, Roman Margoczy, Katarina Sedminova, Adriana Reptova, Eva Baranova, Tatiana Valkovicova, Gabriel Valocik, Marian Kurecko, Marianna Vachalcova, Alzbeta Kollarova, Martin Studencan, Daniel Alusik, Marek Kozlej, Jana Macakova, Sergio Moral, Merce Cladellas, Daniele Luiso, Alicia Calvo, Jordi Palet, Juli Carballo, Gisela Teixido Tura, Giuliana Maldonado, Laura Gutierrez, Teresa Gonzalez-Alujas, Rodriguez Palomares Jose Fernando, Nicolas Villalva, Ma Jose Molina-Mora, Ramon Rubio Paton, Juan Jose Martinez Diaz, Pablo Ramos Ruiz, Alfonso Valle, Ana Rodriguez, Edgardo Alania, Emilio Galcera, Julia Seller, Gonzalo de la Morena Valenzuela, Daniel Saura Espin, Dolores Espinosa Garcia, Maria Jose Oliva Sandoval, Josefa Gonzalez, Miguel Garcia Navarro, Maria Teresa Perez-Martinez, Jose Ramon Ortega Trujillo, Irene Menduina Gallego, Daniel San Roman, Eliu David Perez Nogales, Olga Medina, Rodolfo Antonio Montiel Quintero, Pablo Felipe Bujanda Morun, Marta Lopez Perez, Jimmy Plasencia Huaripata, Juan Jose Morales Gonzalez, Veronica Quevedo Nelson, Jose Luis Zamorano, Ariana Gonzalez Gomez, Alfonso Fraile, Maria Teresa Alberca, Joaquin Alonso Martin, Covadonga Fernandez-Golfin, Javier Ramos, Sergio Hernandez Jimenez, Cristina Mitroi, Pedro L. Sanchez Fernandez, Elena Diaz-Pelaez, Beatriz Garde, Luis Caballero, Fermin Martinez Garcia, Francisco Cambronero, Noelia Castro, Antonio Castro, Alejandro De La Rosa, Pastora Gallego, Irene Mendez, David Villagomez Villegas, Manuel Gonzalez Correa, Roman Calvo, Francisco Florian, Rafael Paya, Esther Esteban, Francisco Buendia, Andrés Cubillos, Carmen Fernandez, Juan Pablo Cárdenas, José Leandro Pérez-Boscá, Joan Vano, Joaquina Belchi, Cristina Iglesia-Carreno, Francisco Calvo Iglesias, Aida Escudero-Gonzalez, Sergio Zapateria-Lucea, Juan Sterling Duarte, Lara Perez-Davila, Rafael Cobas-Paz, Rosario Besada-Montenegro, Maribel Fontao-Romeo, Elena Lopez-Rodriguez, Emilio Paredes-Galan, Berenice Caneiro-Queija, Alba Guitian Gonzalez, Abdi Bozkurt, Serafettin Demir, Durmus Unlu, Caglar Emre Cagliyan, Muslum Firat Ikikardes, Mustafa Tangalay, Osman Kuloglu, Necla Ozer, Ugur Canpolat, Melek Didem Kemaloglu, Abdullah Orhan Demirtas, Didar Elif Akgün, Eyup Avci, Gokay Taylan, Mustafa Adem Yilmaztepe, Fatih Mehmet Ucar, Servet Altay, Muhammet Gurdogan, Naile Eris Gudul, Mujdat Aktas, Mutlu Buyuklu, Husnu Degirmenci, Mehmet Salih Turan, Kadir Ugur Mert, Gurbet Ozge Mert, Muhammet Dural, Sukru Arslan, Nurten Sayar, Batur Kanar, Beste Ozben Sadic, Ahmet Anil Sahin, Ahmet Buyuk, Onur Kilicarslan, Cem Bostan, Tarik Yildirim, Seda Elcim Yildirim, Kahraman Cosansu, Perihan Varim, Ersin Ilguz, Recep Demirbag, Asuman Yesilay, Abdullah Cirit, Eyyup Tusun, Emre Erkus, Muhammet Rasit Sayin, Zeynep Kazaz, Selim Kul, Turgut Karabag, Belma Kalayci, Clinical sciences, Cardio-vascular diseases, and Cardiology
Subjects: Male, medicine.medical_specialty, Multivariate analysis, Clinical Decision-Making, Risk Assessment, Severity of Illness Index, decision making, surgery, Risk Factors, Internal medicine, Intervention (counseling), medicine, Clinical endpoint, Humans, 03.02. Klinikai orvostan, guidelines, Symptomatic aortic stenosis, Aged, Retrospective Studies, Aged, 80 and over, business.industry, valvular heart disease, Disease Management, aortic stenosis, Aortic Valve Stenosis, Odds ratio, medicine.disease, Europe, Stenosis, Treatment Outcome, Echocardiography, Aortic Valve, Charlson comorbidity index, transcatheter aortic valve replacement, Female, Morbidity, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies, surgical aortic valve replacement
Abstract: BACKGROUND There were gaps between guidelines and practice when surgery was the only treatment for aortic stenosis (AS). OBJECTIVES This study analyzed the decision to intervene in patients with severe AS in the EORP VHD (EURObservational Research Programme Valvular Heart Disease) II survey. METHODS Among 2,152 patients with severe AS, 1,271 patients with high-gradient AS who were symptomatic fulfilled a Class I recommendation for intervention according to the 2012 European Society of Cardiology guidelines; the primary end point was the decision for intervention. RESULTS A decision not to intervene was taken in 262 patients (20.6%). In multivariate analysis, the decision not to intervene was associated with older age (odds ratio [OR]: 1.34 per 10-year increase; 95% CI: 1.11 to 1.61; P = 0.002), New York Heart Association functional classes I and II versus III (OR: 1.63; 95% CI: 1.16 to 2.30; P = 0.005), higher age adjusted Charlson comorbidity index (OR: 1.09 per 1-point increase; 95% CI: 1.01 to 1.17; P = 0.03), and a lower transaortic mean gradient (OR: 0.81 per 10-mm Hg decrease; 95% CI: 0.71 to 0.92; P < 0.001). During the study period, 346 patients (40.2%, median age 84 years, median EuroSCORE II [European System for Cardiac Operative Risk Evaluation II] 3.1%) underwent transcatheter intervention and 515 (59.8%, median age 69 years, median EuroSCORE II 1.5%) underwent surgery. A decision not to intervene versus intervention was associated with lower 6-month survival (87.4%; 95% CI: 82.0 to 91.3 vs 94.6%; 95% CI: 92.8 to 95.9; P < 0.001). CONCLUSIONS A decision not to intervene was taken in 1 in 5 patients with severe symptomatic AS despite a Class I recommendation for intervention and the decision was particularly associated with older age and combined comorbidities. Transcatheter intervention was extensively used in octogenarians. (J Am Coll Cardiol 2021;78:2131-2143) (c) 2021 by the American College of Cardiology Foundation.
Published: 2021

30. Protocol of a systematic review and network meta-analysis for the prevention and treatment of perinatal depression

Author: Shehzad Ali, Robert Smith, Claire A Wilson, Hoi Lam Ip, Daniel Y. T. Fong, Joyce Goh, Sze Chai Hung, and Kris Yuet Wan Lok
Subjects: medicine.medical_specialty, Network Meta-Analysis, Psychological intervention, Placebo, Meta-Analysis as Topic, Pregnancy, Obstetrics and Gynaecology, Humans, Medicine, Child, Intensive care medicine, Depression (differential diagnoses), Protocol (science), Depressive Disorder, maternal medicine, Depression, business.industry, Bayes Theorem, General Medicine, Mental health, Treatment Outcome, Meta-analysis, depression & mood disorders, Female, business, Healthcare providers, Perinatal Depression, mental health, Systematic Reviews as Topic
Abstract: IntroductionPerinatal depression is common and can often lead to adverse health outcomes for mother and child. Multiple pharmacological and non-pharmacological treatments have been evaluated against usual care or placebo controls in meta-analyses for preventing and treating perinatal depression compared. It is not yet established which of these candidate treatments might be the optimal approach for prevention or treatment.Methods and analysisA systematic review and Bayesian network meta-analyses will be conducted. Eight electronic databases shall be searched for randomised controlled trials that have evaluated the effectiveness of treatments for prevention and/or treatment of perinatal depression. Screening of articles shall be conducted by two reviewers independently. One network meta-analysis shall evaluate the effectiveness of interventions in preventing depression during the perinatal period. A second network meta-analysis shall compare the effectiveness of treatments for depression symptoms in women with perinatal depression. Bayesian 95% credible intervals shall be used to estimate the pooled mean effect size of each treatment, and surface under cumulative ranking area will be used to rank the treatments’ effectiveness.Ethics and disseminationWe shall report our findings so that healthcare providers can make informed decisions on what might be the optimal approach for addressing perinatal depression to prevent cases and improve outcomes in those suffering from depression through knowledge exchange workshops, international conference presentations and journal article publications.PROSPERO registration numberCRD42020200081.
Published: 2021

31. Periodically Disturbing the Spatial Structure of Biofilms Can Affect the Production of an Essential Virulence Factor in Pseudomonas aeruginosa

Author: Lauren E. Krausfeldt, Rebecca J Quinn, Laura A Enzinna, Travis J. A. Craddock, Robert Smith, Kerollos Ibrahim, Laura García-Diéguez, Morgan E Thorn, Omar Tonsi Eldakar, Ivana Barraza, and Camryn Pajon
Subjects: Physiology, Population, Virulence, medicine.disease_cause, Biochemistry, Microbiology, Virulence factor, chemistry.chemical_compound, Genetics, medicine, education, Molecular Biology, Ecology, Evolution, Behavior and Systematics, education.field_of_study, Pyoverdine, biology, Pseudomonas aeruginosa, Chemistry, Biofilm, food and beverages, biology.organism_classification, QR1-502, Computer Science Applications, Intermediate Disturbance Hypothesis, Modeling and Simulation, Bacteria
Abstract: Understanding the environmental factors that affect the production of virulence factors has major implications in evolution and medicine. While spatial structure is important in virulence factor production, observations of this relationship have occurred in undisturbed or continuously disturbed environments. However, natural environments are subject to periodic fluctuations, including changes in physical forces, which could alter the spatial structure of bacterial populations and impact virulence factor production. Using Pseudomonas aeruginosa PA14, we periodically applied a physical force to biofilms and examined production of pyoverdine. Intermediate frequencies of disturbance reduced the amount of pyoverdine produced compared to undisturbed or frequently disturbed conditions. To explore the generality of this finding, we examined how an intermediate disturbance frequency affected pyoverdine production in 21 different strains of P. aeruginosa. Periodic disturbance increased, decreased, or did not change the amount of pyoverdine produced relative to undisturbed populations. Mathematical modeling predicts that interactions between pyoverdine synthesis rate and biofilm density determine the amount of pyoverdine synthesized. When the pyoverdine synthesis rates are high, depletion of the biofilm due to disturbance reduces the accumulation of pyoverdine. At intermediate synthesis rates, production of pyoverdine increases during disturbance as bacteria dispersed into the planktonic state enjoy increased growth and pyoverdine production rates. At low synthesis rates, disturbance does not alter the amount of pyoverdine produced since disturbance-driven access to nutrients does not augment pyoverdine synthesis. Our results suggest that environmental conditions shape robustness in the production of virulence factors and may lead to novel approaches to treat infections. IMPORTANCE Virulence factors are required to cause infections. Previous work has shown that the spatial organization of a population, such as a biofilm, can increase the production of some virulence factors, including pyoverdine, which is produced by Pseudomonas aeruginosa. Pyoverdine is essential for the infection process, and reducing its production can limit infections. We have discovered that periodically changing the spatial structure of a biofilm of P. aeruginosa strain PA14 using a physical force can reduce the production of pyoverdine. A mathematical model suggests that this is due to the disruption of spatial organization. Using additional strains of P. aeruginosa isolated from patients and the environment, we use experiments and modeling to show that this reduction in pyoverdine is due to interactions between biofilm density and the synthesis rate of pyoverdine. Our results identify conditions where pyoverdine production is reduced and may lead to novel ways to treat infections.
Published: 2021

32. Epidemiology of Acute Myocarditis/Pericarditis in Hong Kong Adolescents Following Comirnaty Vaccination

Author: Elaine Kan, Wilfred Hing Sang Wong, Tak Ching Yu, Chun Bong Chow, Janette Kwok, Celine S L Chui, Daniel Leung, Wing Kei Carol Ng, Yu-Lung Lau, Godfrey Chi-Fung Chan, Shuk Mui Tai, Ming-Yen Ng, Chit Kwong Chow, Agnes Sze Yin Leung, Ying Kit Lin, Kelvin K. W. To, Ka Wah Li, Wing Leung, Tian Tian, Joshua Sung Chih Wong, Chi Chiu Shek, Kwok Piu Lee, Gilbert T. Chua, Kwok-Yung Yuen, Hing Wai Tsang, Patrick Ip, Victor Chi Man Chan, Mike Yat Wah Kwan, Daniel Lee, Edmund Chi-Lok Cheung, Kin Lai Chung, Wai Yuk Fung, Miriam T.Y. Leung, Sabrina Tsao, Johnny Ma, Ian C. K. Wong, and Robert Smith
Subjects: Microbiology (medical), Male, Pediatrics, medicine.medical_specialty, Myocarditis, COVID-19 Vaccines, Adolescent, Cohort Studies, Pericarditis, Epidemiology, Pharmacovigilance, medicine, Major Article, Humans, adolescents, Adverse effect, Child, business.industry, Incidence (epidemiology), Vaccination, COVID-19, medicine.disease, Confidence interval, Infectious Diseases, AcademicSubjects/MED00290, Comirnaty, Hong Kong, Female, business
Abstract: Background Age-specific incidence of acute myocarditis/pericarditis in adolescents following Comirnaty vaccination in Asia is lacking. This study aimed to study the clinical characteristics and incidence of acute myocarditis/pericarditis among Hong Kong adolescents following Comirnaty vaccination. Methods This is a population cohort study in Hong Kong that monitored adverse events following immunization through a pharmacovigilance system for coronavirus disease 2019 (COVID-19) vaccines. All adolescents aged between 12 and 17 years following Comirnaty vaccination were monitored under the COVID-19 vaccine adverse event response and evaluation program. The clinical characteristics and overall incidence of acute myocarditis/pericarditis in adolescents following Comirnaty vaccination were analyzed. Results Between 14 June 2021 and 4 September 2021, 33 Chinese adolescents who developed acute myocarditis/pericarditis following Comirnaty vaccination were identified. In total, 29 (87.88%) were male and 4 (12.12%) were female, with a median age of 15.25 years. And 27 (81.82%) and 6 (18.18%) cases developed acute myocarditis/pericarditis after receiving the second and first dose, respectively. All cases are mild and required only conservative management. The overall incidence of acute myocarditis/pericarditis was 18.52 (95% confidence interval [CI], 11.67–29.01) per 100 000 persons vaccinated. The incidence after the first and second doses were 3.37 (95% CI, 1.12–9.51) and 21.22 (95% CI, 13.78–32.28 per 100 000 persons vaccinated, respectively. Among male adolescents, the incidence after the first and second doses were 5.57 (95% CI, 2.38–12.53) and 37.32 (95% CI, 26.98–51.25) per 100 000 persons vaccinated. Conclusions There is a significant increase in the risk of acute myocarditis/pericarditis following Comirnaty vaccination among Chinese male adolescents, especially after the second dose.
Published: 2021

33. 282Social isolation and incident coronary heart disease in two large UK prospective studies

Author: Robert Smith, Jane Green, Valerie Beral, Isobel Barnes, Sarah Floud, and Gillian K Reeves
Subjects: Million Women Study, medicine.medical_specialty, Isolation (health care), Epidemiology, business.industry, Terminally ill, General Medicine, Coronary heart disease, Hospital admission, Ischemic stroke, Emergency medicine, medicine, Social isolation, medicine.symptom, Prospective cohort study, business
Abstract: Background Social isolation is associated with CHD mortality but evidence of association with incident CHD is mixed. We prospectively examined this association in the Million Women Study (MWS) and UK Biobank (UKB). Methods 481,946 MWS and 456,612 UKB participants reported on social isolation (living alone, little contact with family/friends/groups). Excluding those reporting previous CHD or stroke, participants were followed for incident CHD using linkage to hospital admission and death records. Cox regression yielded relative risks (RR) by 3 levels of social isolation, adjusted for relevant confounders. Results During 7 years follow-up in the MWS and UKB, there were 42,402 first coronary heart disease events in total (of which 1,834 were fatal without an associated hospital admission). After adjustment, social isolation was not associated with hospital admission for first CHD events (combined RR for both studies: RR = 1.01, 95% CI: 0.98–1.04). However, the risk of fatal first CHD events without an associated hospital admission was substantially higher in the most isolated group than the least isolated group (1.86 [1.63–2.12]) This association with fatal first CHD events was driven by the association with living alone. Conclusions Social isolation was not associated with increased risk of first CHD hospital admissions but was associated with increased risk of death from CHD. Key messages Social isolation is likely not a risk factor for developing CHD, but people living alone may be at greater risk of dying from a coronary event than those not living alone.
Published: 2021

34. Prospective Phase II Study to Evaluate Response to Two Induction Courses (12 intravesical instillations) of BCG Therapy for High-Risk Non-Muscle-Invasive Bladder Cancer

Author: Eugene K. Cha, Guido Dalbagni, John P. Sfakianos, Robert Smith, Daniel Sjöberg, Emily Vertosick, Harry W. Herr, and Nicole Benfante
Subjects: Male, medicine.medical_specialty, Urology, Phases of clinical research, Risk Assessment, Article, Adjuvants, Immunologic, Biopsy, medicine, Humans, Neoplasm Invasiveness, Prospective Studies, Adverse effect, Aged, Response rate (survey), Bladder cancer, medicine.diagnostic_test, business.industry, Cystoscopy, Middle Aged, medicine.disease, Clinical trial, Administration, Intravesical, Treatment Outcome, Urinary Bladder Neoplasms, Tumor progression, BCG Vaccine, Female, business
Abstract: Objective To test whether 2 sequential BCG-induction courses improve the response of high-risk non–muscle invasive bladder cancer. Achieving a complete response (CR) to BCG is critical to disease-free survival. Patients with preexisting BCG-specific immunity owing to prior exposure to BCG have longer disease-free survival than BCG-naive patients likely due to heterologous immunity from the initial priming of the immune system. We evaluated this hypothesis in a phase II prospective clinical trial. Methods From 2015 to 2018, we recruited patients with primary or recurrent NMIBC (high-grade Ta, T1 tumors, with or without CIS) to receive 2-induction courses (12 intra-vesical instillations) of BCG. The primary aim of the study was CR rate 6 months after start of the first BCG induction. CR was defined as no tumor at cystoscopy or TURB biopsy. No maintenance BCG was given. We targeted at least 75 evaluable patients, and a CR of 80% or better was deemed significant. Results Eighty-one patients agreed to participate. Five withdrew before starting BCG, leaving 76 evaluable patients. Sixty-three patients (83%) completed the 12 instillations on schedule. Of these, 62 patients (91%) had a CR at 6 months. None of the patients had tumor progression. Serious adverse event was seen in 1 patient (1%). Recurrence-free survival at 2 years after complete response was 85% (95% CI 77%, 95%). Conclusion The high response rate in patients with high-risk non–muscle-invasive bladder cancer justifies 2 BCG induction cycles in current practice.
Published: 2021

35. A single oral glucose load decreases arterial plasma [K+] during exercise and recovery

Author: Irene Ng, Collene H. Steward, Malcolm J. Brown, Michael J. McKenna, Robert Smith, and Nigel K. Stepto
Subjects: Blood Glucose, Male, medicine.medical_specialty, insulin, Physiology, medicine.medical_treatment, oral glucose tolerance test, Young Adult, Double-Blind Method, Forearm, Physiology (medical), Internal medicine, Na+,K+‐ATPase, medicine, Humans, Ingestion, QP1-981, Na+/K+-ATPase, Glucose tolerance test, Cross-Over Studies, medicine.diagnostic_test, exercise, Chemistry, Insulin, potassium, Venous Plasma, Original Articles, Carbohydrate, Crossover study, Glucose, medicine.anatomical_structure, Endocrinology, Muscle Fatigue, Original Article, Female, fatigue
Abstract: Aim We investigated whether acute carbohydrate ingestion reduced arterial potassium concentration ([K+]) during and after intense exercise and delayed fatigue. Methods In a randomized, double‐blind crossover design, eight males ingested 300 ml water containing 75 g glucose (CHO) or placebo (CON); rested for 60 min, then performed high‐intensity intermittent cycling (HIIC) at 130% V˙O2peak, comprising three 45‐s exercise bouts (EB), then a fourth EB until fatigue. Radial arterial (a) and antecubital venous (v) blood was sampled at rest, before, during and after HIIC and analyzed for plasma ions and metabolites, with forearm arteriovenous differences (a‐v diff) calculated to assess inactive forearm muscle effects. Results Glucose ingestion elevated [glucose]a and [insulin]a above CON (p = .001), being, respectively, ~2‐ and ~5‐fold higher during CHO at 60 min after ingestion (p = .001). Plasma [K+]a rose during and declined following each exercise bout in HIIC (p = .001), falling below baseline at 5 min post‐exercise (p = .007). Both [K+]a and [K+]v were lower during CHO (p = .036, p = .001, respectively, treatment main effect). The [K+]a‐v diff across the forearm widened during exercise (p = .001), returned to baseline during recovery, and was greater in CHO than CON during EB1, EB2 (p = .001) and EB3 (p = .005). Time to fatigue did not differ between trials. Conclusion Acute oral glucose ingestion, as used in a glucose tolerance test, induced a small, systemic K+‐lowering effect before, during, and after HIIC, that was detectable in both arterial and venous plasma. This likely reflects insulin‐mediated, increased Na+,K+‐ATPase induced K+ uptake into non‐contracting muscles. However, glucose ingestion did not delay fatigue., Acute glucose intake substantially elevated insulin, with a systemic K+‐lowering effect evident in arterial and antecubital venous plasma before, during, and post‐exercise. An increased arterio‐venous K+ difference across the relatively inactive forearm musculature with glucose ingestion was consistent with increased K+ uptake in non‐active muscle; this was likely mediated via insulin‐induced activation of sodium‐potassium ATPase.
Published: 2021

36. Q Fever Outbreak in Industrial Setting

Author: Hugo C. van Woerden, Brendan W. Mason, Lika K. Nehaul, Robert Smith, Roland L. Salmon, Brendan Healy, Manoj Valappil, Diana Westmoreland, Sarah de Martin, Meirion R. Evans, Graham Lloyd, Marysia Hamilton-Kirkwood, and Nina S. Williams
Subjects: Q fever, Coxiella burnetii, disease outbreak, straw, construction materials, Wales, Medicine, Infectious and parasitic diseases, RC109-216
Abstract: An outbreak of Q fever occurred in South Wales, United Kingdom, from July 15 through September 30, 2002. To investigate the outbreak a cohort and nested case-control study of persons who had worked at a cardboard manufacturing plant was conducted. The cohort included 282 employees and subcontractors, of whom 253 (90%) provided blood samples and 214 (76%) completed questionnaires. Ninety-five cases of acute Q fever were identified. The epidemic curve and other data suggested an outbreak source likely occurred August 5–9, 2002. Employees in the factory’s offices were at greatest risk for infection (odds ratio 3.46; 95% confidence interval 1.38–9.06). The offices were undergoing renovation work around the time of likely exposure and contained straw board that had repeatedly been drilled. The outbreak may have been caused by aerosolization of Coxiella burnetii spore-like forms during drilling into contaminated straw board.
Published: 2004
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37. Upper Gastrointestinal Tract Lymphoma With Natalizumab

Author: Emily Watson, Edward Morris, Lauren Gomes, Mike Boggild, and Matthew Robert Smith
Subjects: medicine.drug_class, business.industry, Progressive multifocal leukoencephalopathy, Leukocyte adhesion molecule, Multiple sclerosis, Case, Monoclonal antibody, medicine.disease, Lymphoma, Blockade, Immune system, Natalizumab, Immunology, medicine, Neurology (clinical), business, medicine.drug
Abstract: The humanised recombinant monoclonal antibody natalizumab (Tysabri), is a selective antagonist of the α4 subunit of the leukocyte adhesion molecule integrin, VLA-3. Blockade of VLA-3 leads to inhibition of immune cell transmigration into target organs, notably the intestinal lining and central nervous system.1,2 Natalizumab is approved to treat relapsing-remitting Multiple Sclerosis (RRMS) in the US and Europe, and Crohn’s Disease in the US. Following approval in 2004, natalizumab was withdrawn in 2005 due to 3 reported cases of progressive multifocal leukoencephalopathy (PML). In 2006, it re-entered the market with additional monitoring requirements.
Published: 2020

38. The public and private benefit of an impure public good determines the sensitivity of bacteria to population collapse in a snowdrift game

Author: Tom Abraham, Rebecca J Quinn, Meghan Haas, Aimee Doiron, Louis R. Nemzer, Marla C. Fortoul, Ivana Barraza, Khadija Chowdhury, Rodrigo Muzquiz, and Robert Smith
Subjects: genetic structures, Cheating, Population, Biology, Bacterial Physiological Phenomena, Microbiology, beta-Lactamases, 03 medical and health sciences, Development economics, Escherichia coli, medicine, education, Ecology, Evolution, Behavior and Systematics, Collapse (medical), 030304 developmental biology, 0303 health sciences, Entire population, education.field_of_study, 030306 microbiology, fungi, Public good, Biological Evolution, Public benefit, Anti-Bacterial Agents, Ampicillin, medicine.symptom
Abstract: When cooperation is critical for survival, cheating can lead to population collapse. One mechanism of cooperation that permits the coexistence of cooperators and cheaters is an impure public good, whose public benefits are shared, but with a private benefit retained by the cooperator. It has yet to be determined how the contributions of the public and private benefit affect population survival. Using simulations and experiments with β-lactamase-expressing bacteria, we found that for a given amount of public and private benefit, the population was most sensitive to collapse when initiated from an intermediate fraction of cooperators due to the near-concurrent collapse of the cooperator and cheater populations. We found that increasing the ratio of public to private benefit increased sensitivity to collapse. A low ratio allowed cooperators to survive on their private benefit after the public benefit could not rescue the cheaters. A high ratio allowed the cheaters to survive to high concentrations of ampicillin due to the high public benefit. However, small increases in ampicillin caused a rapid decline in the entire population as the private benefit was insufficient to allow self-rescue of the cooperators. Our findings have implications in the persistence of populations that rely on cooperation for survival.
Published: 2019

39. The Effects of Ultraviolet C Irradiation in the Treatment of Chronic Wounds: A Retrospective, Descriptive Study

Author: Audrey Lynn Millar, Robert Smith, and Douglas D. Yarboro
Subjects: Adult, Male, medicine.medical_specialty, Ultraviolet Rays, Wound care, Patient age, North Carolina, medicine, Humans, Prospective cohort study, Adverse effect, Aged, Retrospective Studies, Aged, 80 and over, Wound Healing, integumentary system, business.industry, General Medicine, Middle Aged, medicine.disease, Diabetic foot, Surgery, Diabetic foot ulcer, Wound area, Wounds and Injuries, Female, Wound healing, business
Abstract: Although there is evidence supporting the bactericidal effects of ultraviolet C (UVC) in chronic wounds, clinical studies examining the effects of UVC on wound healing are limited. PURPOSE The objective of this single-center, retrospective, descriptive study was to evaluate the effect of UVC as an adjunct modality to standard wound care. METHODS Data from January 1, 2015, through August 30, 2015, from all patients receiving UVC treatment and wound etiology-appropriate standard care provided twice weekly at a wound care center and lymphedema clinic were extracted from the electronic health records. Demographic (age, gender) and clinical wound data (duration, type, initial and final dimensions, number of UVC treatments, time to healing, healed versus not healed, and adverse events) were extracted, deidentified, and analyzed using descriptive and chi-squared analysis and analysis of variance. Wound type categories with small sample sizes were combined for analysis. RESULTS Among the 127 patients studied (64 women [50.4%], average age 69 ± 15.0 years; and 63 men [49.6 %], average age 61 ± 15.8 years; P = .03), 224 wounds received UVC treatment. Initial average wound area was 24.1 ± 121.8 cm², and the most common type of wound was venous (58, 25.9%), followed by neuropathic/diabetic foot ulcer and traumatic wounds (43 each, 19.2% each). Mean wound duration was 57.7 ± 63 days; overall average patient age was 64.8 ± 15.9 years. Average number of treatments of 11.9 ± 13.4, and average time to healing was 45.2 ± 44.4 days. A total of 127 patients with 161 wounds (71.9%) healed after an average of 45 (range 4-260) days, including 36 venous leg ulcers (62.1%) and 33 neuropathic wounds/diabetic foot ulcers (76.7%). No adverse events were recorded. CONCLUSION UVC may be an effective adjuvant treatment modality when used with standard care in the treatment of chronic wounds. Prospective studies are needed to ascertain the effectiveness and efficacy of UVC in the treatment of chronic wounds.
Published: 2019

40. Coronary artery bypass confers intermediate-term survival benefit over percutaneous coronary intervention with new-generation stents in real-world patients with multivessel coronary artery disease, including left main disease: a retrospective analysis of 6383 patients

Author: Richard Grocott-Mason, Habib Khan, Mark Mason, Shahzad G. Raja, Thomas F. Lüscher, Vasileios F. Panoulas, Konstantinos Kalogeras, Tito Kabir, Robert Smith, Maria Monteagudo Vela, C Ilsley, Miles Dalby, and Ian Cummings
Subjects: Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.medical_treatment, Coronary Artery Disease, 030204 cardiovascular system & hematology, Revascularization, Coronary artery disease, 03 medical and health sciences, Coronary artery bypass surgery, Percutaneous Coronary Intervention, 0302 clinical medicine, Left coronary artery, medicine.artery, Internal medicine, medicine, Humans, cardiovascular diseases, 030212 general & internal medicine, Coronary Artery Bypass, Survival rate, Aged, Retrospective Studies, business.industry, Hazard ratio, Percutaneous coronary intervention, Drug-Eluting Stents, General Medicine, Middle Aged, medicine.disease, surgical procedures, operative, Conventional PCI, Cardiology, Female, Surgery, Cardiology and Cardiovascular Medicine, business
Abstract: OBJECTIVES The intermediate-term all-cause mortality rate of real-world patients with multivessel disease (MVD) treated with percutaneous coronary intervention (PCI) with new-generation drug-eluting stents or coronary artery bypass grafting (CABG) remains unknown. We sought to compare the intermediate-term all-cause mortality rates of real-world patients with MVD including left main stem disease, treated with CABG or PCI. METHODS All consecutive all-comer patients with MVD undergoing CABG or PCI with second/third generation drug-eluting stents from 2007 to 2015 in Harefield Hospital, UK were included in this study. The revascularization modality was based on heart team discussions. Primary outcome was all-cause mortality. Mean follow-up of the study was 3.3 years. Cox regression analysis and propensity matching were used. RESULTS Of 6383 patients with MVD, 4230 underwent CABG, whereas 2153 had PCI with new-generation stents. In the CABG group, the mean age was 66.4 ± 10 years, whereas in the PCI group it was 65.3 ± 12.1 years (P CONCLUSIONS In this contemporary cohort of real-world patients with MVD, CABG was associated with increased intermediate-term survival compared to PCI with new-generation drug-eluting stents.
Published: 2019

41. Inclusion of an extended treatment with recovery improves the results for the human peripheral blood lymphocyte micronucleus assay

Author: Sarah Phillips, Victoria Hargreaves, Gary P. Watters, Teresa Chirom, Julie Clements, Robert Smith, James Whitwell, and Mel Lloyd
Subjects: Adult, Male, Time Factors, Adolescent, Anti-HIV Agents, Health, Toxicology and Mutagenesis, Lymphocyte, Cell Culture Techniques, Antineoplastic Agents, Pharmacology, Toxicology, Young Adult, 03 medical and health sciences, Clastogen, 0302 clinical medicine, Genetics, medicine, Humans, Lymphocytes, Cytotoxicity, Cells, Cultured, Micronuclei, Chromosome-Defective, Genetics (clinical), 030304 developmental biology, Phytohaemagglutinin, 0303 health sciences, Micronucleus Tests, biology, Mutagenicity Tests, Chemistry, Reproducibility of Results, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Micronucleus test, Toxicity, biology.protein, Cytarabine, Female, Micronucleus, Mutagens, medicine.drug
Abstract: The in vitro micronucleus (IVMN) test was endorsed for regulatory genotoxicity testing with adoption of the Organisation for Economic Co-operation and Development (OECD) test guideline (TG) 487 in 2010. This included two equally acceptable options for extended treatment in the absence of metabolic activation: a treatment for 1.5–2.0 cell cycles with harvest at the end of treatment (Option A) or treatment for 1.5–2.0 cell cycles followed by recovery for 1.5–2.0 cell cycles prior to harvest (Option B). Although no preferences were discussed, TG 487 cautions that Option B may not be appropriate for stimulated lymphocytes where exponential growth may be declining at 96 h after phytohaemagglutinin (PHA) stimulation. Following revision of TG 487 in 2014 and 2016, emphasis has been placed on using Option A. Given the purpose of the IVMN assay is to determine both clastogenic and aneugenic potential, the authors believe the assay is compromised if an extended treatment with recovery is not included for sensitive detection of certain classes of chemical. In this study, average generation time (via bromodeoxyuridine incorporation) of human peripheral blood lymphocytes (HPBL) was measured up to 144 h after PHA stimulation. In addition, the HPBL micronucleus (MN) assay was performed using Option A and B treatment schedules. Cytotoxicity (replication index) and MN induction were determined following treatment with 14 chemicals. The data demonstrate that lymphocytes actively divide beyond 96 h after PHA stimulation. Furthermore, MN induction was only observed with some aneugenic chemicals and nucleoside analogues in HPBLs following extended treatment with a recovery period. For the majority of chemicals tested the magnitude of MN induction was generally greater and MN induction was observed across a wider concentration range following the Option B treatment schedule. In addition, steep concentration-related toxicity following treatment without recovery is more common, making selection of suitable concentrations (within regulatory toxicity limits) for MN analysis challenging.
Published: 2019

42. Postoperative critical care and high-acuity care provision in the United Kingdom, Australia, and New Zealand

Author: Swarna Baskar Sharma, Mansoor Sange, Michael Girgis, Joanne Humphreys, Vishal Patil, Nick Greenwood, Sai Tim Yam, Santhana Kannan, Marc Slorach, Julian Giles, Suman Shrestha, Philippa Marshall, Vinanti Cherian Mcivor, Moore Joanna, Elizabeth Thomas, Stuart M. White, James Hanison, Suhail Zaidi, Andrew Burtenshaw, Douglas Campbell, Jaya Nariani, Ross Freebairn, Omar Alex Pemberton, Davina Ross-Anderson, Lisa M. Barneto, Shabir Qadri, Giles Bond-Smith, Pallavi Kumar, Khaled Razouk, M. Amir Rafi, Dermot Moloney, Ashok Raj, Kirtida Mukherjee, Vasheya Naidoo, Sonia Sathe, Jason Cupitt, Priya Shanmuganathan, Andrew Brammar, David Saunders, Anna Batchelor, James R. Anderson, Hew D.T. Torrance, Catriona Barr, Helen Melsom, Adrian Taylor, Jon Bramall, Sumant Shanbhag, Jenny Ritzema, Winston Cheung, Alexandra Frankpitt, David Shan, Killian McCourt, Chiraag Talati, Richard Kennedy, Ravishankar Jakkala Saibaba, Abigail Hine, Cathryn Matthews, Christian Frey, Laurin Allen, Gary Minto, Thomas Fitzgerald, James Bain, Dominik Teisseyre, Stephen Hill, M. Dickinson, Subhamay Ghosh, J.A. Ezihe-Ejiofor, Vincent Hamlyn, Karuna Kotur, Joyce Yeung, Helen Roberts, Johann Harten, Stefan Schraag, Jonathan Aldridge, Alexander Garden, Carol McArthur, Louis Guy, John Orr, Tom Pettigrew, Atideb Mitra, Cindy Persad, Abhinav Kant, Robin Alston, Nicolas Price, Sarang Puranik, Jacqueline Howes, Ritoo Kapoor, Peter Knowlden, Mai Wakatsuki, Charles Allen, Deepa Jumani, Mark MacGregor, Prashant Kakodkar, Dhir Bhattacharya, Valerie J. Page, Narendra Siddaiah, Dick Ongley, Vandana Goel, Sibtain Anwar, Bronwyn Posselt, Rebecca Sutton, David Scott, Danny J.N. Wong, Austin Rattray, Paul S. Myles, Mrutyunjaya Rao Rambhatla, Richard Dobson, Kathryn Jenkins, Tim J. Smith, Helen Bromhead, Zhana Ignatova, Katheryn Fogg, Lynne Williams, Sanjeev Garg, Nikhil Patel, Gary Lau, Sock Huang Koh, Stephen Merron, David Robinson, Nagendra Natarajan, Seema Charters, Mark Welch, Laura Farmer, Simon Young, Susan Kirby, Madhushankar Balasubramaniam, Robert Wonders, Paul Glyn Jones, Satyanarayana Jakkampudi, Mizan Khondoker, Paul Rowe, Andrew Jones, Monica Diczbalis, Manju Agarwal, Andrew Robinson, Emert White, Catherine Hunter, Stephen T. Webb, Srikanth Chukkambotla, Jenny Henry, Catriona Ferguson, Manish Kakkar, Waisun Kok, Colin Williams, Vijayakumar Gopal, Vidhya Nagaratnam, Shafi Ahmed, Melinda Same, Doug Campbell, Stuart P. D. Gill, Scott Popham, Gabor Debreceni, Dancho Ignatov, D. L. Williams, I.J. Wrench, Andrew Claxton, Eleanor Ford, Shondipon Laha, Laurie Dwyer, Christopher Littler, Stephan Clements, David Gillespie, Ceri Lynch, Lillian Coventry, Paul Clements, Paul Foley, Claire Ireland, Vikramjit Singh, M. H. Nathanson, R. Jonathan T. Wilson, Shilpa Rawat, Pieter Bothma, David Pritchard, Victor Birioukov, Robert Campbell, Brien Hennessy, Stephanie Bell, Robert Smith, Muhammad Usman Latif, Nicolas Hooker, Anand Kulkarni, Chelsea Hicks, Steve Harris, Caroline Reavley, Claire Botfield, Christopher Nutt, Andrew Gorman, Peter J O'Brien, Murray Geddes, Carlos Kidel, Samar Al-Rawi, atyas Andorka, John John, Stephen Washington, Peter Csabi, Anil Hormis, Emily Dana, Sharon Hilton-Christie, Brian Spain, Suganthi Joachim, Richard Partridge, Tony Miller-Greenman, Andrew Marshall Wilson, Samuel Perrin, Carol Bradbury, Christopher Goddard, Paul Cooper, Simon Williams, Iain K. Moppett, Han Truong, Stephen J. Brett, Robert Orme, Alexandra Matson, Michael P.W. Grocott, Sunita Agarwal, Jonathan Chambers, Georgina Prassas, Rachel Markham, Kevin Hamilton, Jane Wright, Julian Sonksen, Robert Spencer, James Limb, Tehal Kooner, James Tozer, Sujesh Bansal, Fiona Graham, Suresh Singaravelu, Adrienne Stewart, Sophie Gormack, Buzz Shephard, Julian Berry, Nick Spittle, Philip Blackie, Richard Stewart, R. Sneyd, Laura Kwan, Ben Chandler, Helen Lindsay, Wendy Lum Hee, Vivien Edwards, David Highton, Helen A. Lindsay, Tendai Ramhewa, Daphne Varveris, Liam McLoughlin, Duncan Brown, Justin Woods, Annabelle Whapples, Jonathan Panckhurst, Garry Henry, Kate Campbell, Jeremy Henning, Stephanie Sim, Baigel Gary, Nam Le, Joellene Mitchell, Laura Tasker, Geoff Wright, Con Papageorgiou, Simon Whiteley, Richard Pugh, Joel Matthews, Suneetha Ramani Moonesinghe, Andrew M. Wilson, Sandeep Varma, Chris Hargreaves, Malcolm Gunning, Agnieszka Kubisz-Pudelko, Richard Shawyer, N. M. Wharton, Janette Moss, Gurunath Hosdurga, Catherine Plowright, Jane Montgomery, Stuart McLellan, Emma Gent, Patrick Dill-Russell, James Craig, Nirav Shah, Julius Dale-Gandar, Geoff Thorning, Lawrence Wilson, Roddy Chapman, Andrew Gratrix, Kate Bailey, Sunil kumar Chaurasia, Sophie Wallace, Rob Dawson, Richard Siviter, Christine Range, Helen McNamara, Tim Cook, Khong Tan, Michael Brett, Alan Kakos, Samuel Armanious, Liana Zucco, Sam Clark, Laura Troth, Rajeev Jha, Michael Weisz, James Pennington, Chris Bowden, Jeremy Drake, David Rogerson, Ritesh Maharaj, Alison Jackson, Sophie van Oudenaaren, Rohit Juneja, and Naomi Goodwin
Subjects: medicine.medical_specialty, Critical Care, Population, Staffing, Care provision, Patient safety, Postoperative Complications, medicine, Per capita, Humans, education, Postoperative Care, Response rate (survey), education.field_of_study, Tertiary Healthcare, business.industry, Australia, Health services research, Emergency department, United Kingdom, Intensive Care Units, Anesthesiology and Pain Medicine, Hospital Bed Capacity, Health Care Surveys, Emergency medicine, Health Services Research, business, New Zealand
Abstract: Background Decisions to admit high-risk postoperative patients to critical care may be affected by resource availability. We aimed to quantify adult ICU/high-dependency unit (ICU/HDU) capacity in hospitals from the UK, Australia, and New Zealand (NZ), and to identify and describe additional ‘high-acuity' beds capable of managing high-risk patients outside the ICU/HDU environment. Methods We used a modified Delphi consensus method to design a survey that was disseminated via investigator networks in the UK, Australia, and NZ. Hospital- and ward-level data were collected, including bed numbers, tertiary services offered, presence of an emergency department, ward staffing levels, and the availability of critical care facilities. Results We received responses from 257 UK (response rate: 97.7%), 35 Australian (response rate: 32.7%), and 17 NZ (response rate: 94.4%) hospitals (total 309). Of these hospitals, 91.6% reported on-site ICU or HDU facilities. UK hospitals reported fewer critical care beds per 100 hospital beds (median=2.7) compared with Australia (median=3.7) and NZ (median=3.5). Additionally, 31.1% of hospitals reported having high-acuity beds to which high-risk patients were admitted for postoperative management, in addition to standard ICU/HDU facilities. The estimated numbers of critical care beds per 100 000 population were 9.3, 14.1, and 9.1 in the UK, Australia, and NZ, respectively. The estimated per capita high-acuity bed capacities per 100 000 population were 1.2, 3.8, and 6.4 in the UK, Australia, and NZ, respectively. Conclusions Postoperative critical care resources differ in the UK, Australia, and NZ. High-acuity beds may have developed to augment the capacity to deliver postoperative critical care.
Published: 2019

43. Natural History of Drusenoid Pigment Epithelial Detachment Associated with Age-Related Macular Degeneration

Author: Jeannette J. Yu, Elvira Agrón, Traci E. Clemons, Amitha Domalpally, Freekje van Asten, Tiarnan D. Keenan, Catherine Cukras, Emily Y. Chew, Frederick L. Ferris, John Paul SanGiovanni, Traci Clemons, Anne Lindblad, Robert Lindblad, Nilay Shah, Robert Sperduto, Wendy McBee, Gary Gensler, Molly Harrington, Alice Henning, Katrina Jones, Kumar Thotapally, Diana Tull, Valerie Watson, Kayla Williams, Christina Gentry, Francine Kaufman, Chris Morrison, Elizabeth Saverino, Sherrie Schenning, Barbara Blodi, Ronald P. Danis, Matthew Davis, Kathy Glander, Gregory Guilfoil, Larry D. Hubbard, Kristine Johnson, Ronald Klein, Barbara Nardi, Michael Neider, Nancy Robinson, Eileen Rosensteel, Hugh Wabers, Grace Zhang, Alan J. Ruby, Antonio Capone, Bawa Dass, Kimberly Drenser, Bruce R. Garretson, Tarek S. Hassan, Michael Trese, George A. Williams, Jeremy Wolfe, Tina Bell, Mary Zajechowski, Dennis Bezaire, Fran McIver, Anthony Medina, Jackie Pagett, Stephanie Hatch Smith, Lynn Swartz, Tom Treuter, Andrew Antoszyk, Justin Brown, David J. Browning, Walter Holland, Angella Karow, Kelly Stalford, Angela Price, Sarah Ennis, Sherry Fredenberg, Jenna Herby, Uma Balasubramaniam, Loraine Clark, Donna McClain, Michael McOwen, Lynn Watson, Michael Klein, Steven T. Bailey, Thomas J. Hwang, Andreas Lauer, J. Timothy Stout, Patty McCollum, Milt Johnson, Patrick B. Rice, Ivana Kim, John Loewenstein, Joan Miller, Lucia Sobrin, Lucy Young, Jacqueline Sullivan, Patricia Houlihan, Linda Merry, Ann Marie Lane, Ursula Lord Bator, Claudia Evans, Sarah Brett, Charleen Callahan, Marcia Grillo, David Walsh, Kamella Lau Zimmerman, Gary Edd Fish, Rajiv Anand, Lori E. Coors, Dwain G. Fuller, Rand Spencer, Robert C. Wang, Karen Duignan, Sally Arceneaux, Hank Aguado, Nicholas Hesse, Michael Mackens, Brian Swan, Wai T. Wong, Monica Dalal, Naima Jacobs-El, Catherine Meyerle, Benjamin Nicholson, Henry Wiley, Katherine Hall Shimel, Angel Garced, Janice Oparah, Greg Short, Alana Temple, Babilonia Ayukawa, Guy Foster, Darryl Hayes, Dessie Koutsandreas, Roula Nashwinter, John Rowan, Michael Bono, Denise Cunningham, Marilois Palmer, Alicia Zetina, David H. Orth, Kourous Rezaei, Joseph Civantos, Sohail Hasan, Kirk Packo, Celeste Figliulo, Pam Stanberry, Tara Farmer, Kiersten Nelson, Shannya Townsend-Patrick, Philip Rosenfeld, Royce Chen, Rishi Doshi, Sander Dubovy, Brian T. Kim, Matthew Lowrance, Andrew Moshfeghi, Zayna Nahas, Gary Schienbaum, John Vishak, Christina Weng, Zohar Yehoshua, Belen Rodriguez, Jose Rebimbas, Jane Gleichauf, Mike Kicak, Jason Mena, Tim Odem, Elizabeth Sferza-Camp, Alicia Disgdiertt, Jim Oramas, Isabel Rams, Stephanie Thatcher, Susan B. Bressler, Neil M. Bressler, Daniel Finkelstein, Steven H. Sherman, Sharon Solomon, Howard S. Ying, Rita Denbow, Deborah Phillips, Elizabeth Radcliffe, Judy Belt, Dennis Cain, David Emmert, Mark Herring, Jacquelyn McDonald, G. Baker Hubbard, Chris S. Bergstrom, Blaine Cribbs, Andrew Hendrick, Brandon Johnson, Philip Laird, Sonia Mehta, Timothy Olsen, Justin Townsend, Jion Yan, Steven Yeh, Linda Curtis, Judy Brower, Hannah Yi, Jannah Rutter Dobbs, Debbie Jordan, Michael J. Elman, Robert A. Liss, JoAnn Starr, Jennifer Belz, Charlene Putzulo, Teresa Coffey, Ashley Davis, Pamela Singletary, Giorya Shabi Andreani, Theresa Cain, Daniel Ketner, Peter Sotirakos, Suresh Chandra, Barbara A. Blodi, Michael M. Altaweel, Justin L. Gottlieb, Michael Ip, T. Michael Nork, Thomas S. Stevens, Kathryn Burke, Shelly Olson, Kristine Dietzman, Barbara Soderling, Guy Somers, Angie Wealti, Denise Krolnik, John Peterson, Sandra Reed, Thomas Friberg, Andrew Eller, Denise Gallagher, Leanne Labriola, Melissa Pokrifka, Aron Gedansky, Natalie Anthony, Cassandra Grzybowski, Dawn Matthews, Sharon Murajda-Jumba, Jessica Toro, David G. Callanan, Wayne A. Solley, Patrick Williams, Sandy Lash, Bob Boleman, Chris Dock, Michel Shami, Brenda Arrington, Ashaki Meeks, Alan R. Margherio, Paul Raphaelian, Debra Markus, Justin Langdon, Elizabeth Truax, Sandy Lewis, Brad Terry, Amy Noffke, Kean Oh, Ramin Sarrafizadeh, Scott Sneed, Julie Hammersley, Serena Neal, Mary Doran, Nan Jones, Lisa Preston, Heather Jessick, Tanya Tracy Marsh, Michael Tolentino, Adam Berger, Richard Hamilton, David Misch, Suk Jin Moon, Dawn Sutherland, Vera Dilts, Sara Henderson, Esmeralda Medina, Donald Trueman, Laura Holm, Jason Strickland, Darmakusuma Ie, Jeffrey L. Lipkowitz, Kekul B. Shah, Susan Geraghty, Beverly Sannazzaro, Morgan Harper, Krista Bayer, Mary B. Lansing, Lauren B. Fox, Rebecca Lee, Jay B. Stallman, Michael Jacobson, Sean Koh, Scott Lampert, John Miller, Mark Rivellese, Atul Sharma, Robert A. Stoltz, Stephanie Vanderveldt, Leslie Marcus, Starr Hendricks, Ryan Hollman, Grethel Betanzos, Leslie Ellorin, Shelly Fulbright, Debbie McCormick, Paul A. Edwards, Julianne Hall, Mary Monk, Melanie Gutkowski, Melina Mazurek, Janet Murphy, Katherine Gusas, Crystal Moffett, David Burley, Nicole Chesney, Katie Kilgo, Brian Rusinek, Bradley Stern, Tracy Troszak, Rhonda Baker-Levingston, Carl W. Baker, Tracey Caldwell, Tammy Walker, Lynnette F. Lambert, Tracey Martin, Mary Jill Palmer, Tana Williams, Michael A. Novak, Joseph Coney, David G. Miller, Scott Pendergast, Lawrence Singerman, Nicholas Zakov, Hernando Zegarra, Kim DuBois, Susan Rath, Lori Revella, Tammy Brink, Kim Drury, Lisa Hogue, Mary Ilc, Connie Keller, Elizabeth McNamara, Vivian Tanner, Tamara Cunningham, John DuBois, Gregg Greanoff, Trina Nitzsche, Sheila Smith-Brewer, Ricky D. Isernhagen, John W. Kitchens, Thomas W. Stone, William J. Wood, Diana Holcomb, Virginia Therrien, Michelle Buck, Jeanne Van Arsdall, Edward Slade, Todd E. Schneiderman, David J. Spinak, Jackie Gaedke, Heather Davis Brown, Dan Helgren, Jenifer Garrison Pangelinan, Lawrence Halperin, Scott Anagnoste, Mandeep Dhalla, Krista Rosenberg, Barry Taney, W. Scott Thompson, Jaclyn Lopez, Monica Hamlin, Monica Lopez, Jamie Mariano, Evelyn Quinchia, Patricia Aramayo, Rita Veksler, Michael Lee, Richard Dreyer, Irvin Handelman, Colin Ma, Mark Peters, Stephen Hobbs, Amanda Milliron, Marcia Kopfer, Michele Connaughton, A. Christine Hoerner, R. Joseph Logan, Harry J. Wohlsein, David Boyer, Thomas G. Chu, Pouya Dayani, David Liao, Roger L. Novack, Firas M. Rahhal, Richard Roe, Homayoun Tabandeh, Janet Bayramyan, Tammy Gasparyan, Connie Hoang, Janet Kurokouchi, Tammy Eileen Lo, Richard Ngo, Mary Ann Nguyen, Michael Peyton, Charles Yoon, Julio Sierra, Adam Zamboni, Jeff Kessinger, Eric Protacio, Adam Smucker, Pamela Rath, Robert Bergren, Bernard Doft, Judy Liu, Karl Olsen, Lori Merlotti, Willia Ingram, Kellianne Marfisi, Kimberly Yeckel, Heather Schultz Carmelo, Amanda Fec, Keith McBroom, David Steinberg, Marc Levy, Jody Abrams, Melvin Chen, Waldemar Torres, Peggy Jelemensky, Mark Prybylski, Tara Raphael, Diana Appleby, Charlotte Rodman, Mark Sneath, Robert H. Rosa, Vanessa Hoelscher, Adelia Castano, Jocelyn Parker, John Hoskins, Nicholas Anderson, Joseph Googe, Tod A. McMillan, James Miller, Stephen Perkins, Kristina Oliver, Jennifer Beerbower, Bruce Gilliland, Cecile Hunt, Mike Jacobus, Raul Lince, Christopher Morris, Sarah Oelrich, Jerry Whetstone, Clement K. Chan, Steven Lin, Kim Walther, Tiana Gonzales, Lenise Myers, Kenneth Huff, David M. Brown, Eric Chen, Matthew S. Benz, Richard H. Fish, Rosa Y. Kim, James Major, Tien Pei Wong, Charles Wycoff, Cassandra Cone, Debbie Goates Gilaspia, Nubia Landaverde, Robert Smith, Deneva Zamora, Veronica Sneed, Melina Vela, Eric Kegley, Craig Greven, Shree Kurup, Charles Richards, Madison Slusher, Cara Everhart, Joan Fish, Mark Clark, David Miller, Marshall Tyler, J. Michael Jumper, Arthur D. Fu, Robert N. Johnson, Brandon Lujan, H. Richard McDonald, Rosa Rodriguez, Nina Ansari, Jeanifer Joaquin, Silvia Linares, Lizette Lopez, Jessica Sabio, Sean Grout, Chad Indermill, Yesmin Urias, Roberto Zimmerman, Linda Margulies, Sara J. Schmidt, Joy L. Meier, Sherry L. Hadley, William Rosenthal, Barbara Johnson, Lois Swafford, Richard Shields, R. Scott Varner, Richard Rosen, Ronald Gentile, Melissa Rivas, Katy W. Tai, Wanda Carrasquillo-Boyd, Robert Masini, Glenn Stoller, Ken Carnevale, Diane M. LaRosa, Barbara Burger, Tereza Conway, Carla Del Castillo, Julissa Diaz, Susan Jones, Nina Mondoc, Charlene Balfour, C.H. Vitha, Jennifer Lutz, Barbara McGinley, Fadi El Baba, Ann Marie Lavorna, Renee Jones, Jean Lewis, Ruth Tenzler, Mary Salvas-Mladek, Diane Van Kesteren, W. Copley McLean, W. Zachery Bridges, Cameron Stone, Denise Ammons, Mary Lamy, Andrea Menzel, Lea Doll Raymer, Barbara Campbell, Lisa Hawkins, Leslie Rickman, Lorraine Sherlin, Paula Price, Albert Sinyai, Ronald Kingsley, Reagan H. Bradford, Robert E. Leonard, Sonny Icks, Vanessa Bergman, Brittany Ross, Russ Burris, Amanda Butt, Rob Richmond, Alice Lyon, Manjot Gill, Lee Jampol, Rukhsana Mizra, Zuzanna Rozenbajgier, Jeremy Chapman, Lori Kaminski, Andrea Degillio, Evica Simjanoski, Jeffrey Heier, Hyung Cho, Tina Scheufele Cleary, Darin Goldman, Chirag Shah, Trexler Topping, Marissa Weber, Torsten Wiegand, Jeremy Schindelheim, Joy Bankert, Jennifer Stone, Alison Nowak, Sandy Chong, Lindsay Williams, Steven Bennett, Dennis Donovan, Margaret Graham, Cullen Jones, Anne Fung, Jan-Kristine Bayabo, Razelda Bosch, Esperanza Cruz, Ashley Emerson, Alycia Fleming, Denice Barsness, Jorge Rodriguez, Marina Soboleva, Ingrid U. Scott, Esther Bowie, Kimberly A. Neely, David A. Quillen, Laura Walter, Timothy Bennett, James Strong, John Wells, Lloyd Clark, David Johnson, Peggy Miller, Mallie Taylor, Tiffany Swinford, Robbin Spivey, Michael Banach, Lawrence Ho, Richard Lanning, Thomas R. Pheasant, Jay G. Prensky, Steven Truong, Julia Teatsworth, Michelle Dietrich, Ann Wasilus, Ann Miller, Megan Rakes, Teresa Slagle, Michelle Richards, Patricia Schuessler, Lacy Stover, Paul Beer, Naomi S. Falk, Mary Beth Shannon, Jeannie Olmeda, Don Berdeen, Joseph F. Fisher, James Folk, Stephen Russell, Barbara Taylor, Connie Hinz, Jean Walshire, Heather Stockman, Bruce Critser, Stefani Karakas, Cindy Montague, Randy Verdick, Omesh Gupta, Joseph Maguire, Christopher Brady, Francis Char DeCroos, Michael Dollin, Sunir Garg, Adam Gerstenblith, Julia Haller, Allen C. Ho, Jason Hsu, Richard Kaiser, John Pitcher, Carl Regillo, Rajiv Shah, Marc Spirn, William Tasman, James Vander, Noga Senderowitsch, Michele Formoso, Michelle Markun, Cedric George, Christina Centinaro, Lisa Grande, Stefanie Carey, Elaine Liebenbaum, SriniVas Sadda, Mark Humayun, Rachel Sierra, Elizabeth Corona, Margaret Padilla, Moonseok Nu, Sylvia Ramos, Cullen Barnett, Glenn Currie, Cornelia Gottlieb, Richard Garfinkel, Daniel Berinstein, Marcus Colyer, William Deegan, Michael Min-Shyue Lai, Robert Murphy, Michael Osman, Michael Rivers, Reginald Sanders, Manfred A. von Fricken, Debbie Oliver, Jeanne Kirshon, Tanya Alexander Snowden, Thomas Blondo, Alysia Cronise, Vanessa Denny, Kylie Mendez, Janine Newgen, Justin Davis, Mike Flory, Robert Frantz, Bryan Murphy, Steve Rauch, Judy E. Kim, Jane Bachman, Thomas B. Connor, Dennis P. Han, Kimberly Stepian, David V. Weinberg, William J. Wirostko, Krissa Packard, Tracy Kaczanowski, Vesper Williams, Vicki Barwick, Judy Flanders, Dennis Backes, Joe Beringer, Kristy Keller, Kathy Selchert, Paul Bernstein, Michael Teske, Albert Vitale, Susan Allman, Bonnie Carlstrom, Kimberley Wegner, Anne Haroldsen, Deborah Harrison, Cyrie Fry, James Gilman, Glen Jenkins, Paula Morris, Michael Rauser, Joseph Fan, Mukesh Suthar, Gisela Santiago, Kara Rollins Halsey, Christy Quesada, William Kiernan, Jesse Knabb, Richard Alan Lewis, Cindy Dorenbach, Steven Spencer, Dana Barnett, Joseph Morales, Barron C. Fishburne, Jeffrey G. Gross, Michael A. Magee, Amy Flowers, Angie McDowell, Randall Price, Suber Huang, Johnny Tang, Shawn Wilker, Cherie Hornsby, Lisa Ferguson, Kirk Krogstad, Riva Adamovsky, Peggy Allchin, Kathleen Carlton, Claudia Clow, Kelly Sholtis, Stephanie Burke, Mark Harrod, Stacie Hrvatin, Geoffrey Pankhurst, Nelson R. Sabates, Michael Cassell, Komal Desai, Abraham Poulose, Felix Sabates, Yin Chen, Gary Gallimore, Yolanda Konior, Nicola Kim, Sami Uwaydat, Deborah Troillett, Karen Aletter, Robert N. Frank, Gary Abrams, James Puklin, Asheesh Tewari, Cheryl Milanovic, Melanie Bailey, David Griffith, Dena McDonald, Kit Morehead, Zlatan Sadikovic, Lisa Schillace, Elizabeth Silvis, Brian Joondeph, Nancy Christmas, Alan Kimura, Mimi Liu, Stephen Petty, John Zilis, Jenny Benitez, Cassandra Berryman Catlett, Eric Fluegel, Shane Mowry, Hoang Nguyen, David Reflow, Odette M. Houghton, Seema Garg, Maurice B. Landers, Travis Meredith, Sandy Barnhart, Megha Karmalkar, Debra Cantrell, Rona Lyn Esquejo-Leon, Linda Manor, Sue Pope, David Stines, Amelia Stokely, Dean Hainsworth, Dyann Helming, Debbie Eichelberger, Mary Paige Leaton, Chuck Hamm, Edward Chaum, Alessandro Iannaccone, Barbara Jennings, Tracy Murray, Joe Mastellone, Robert Millay, Brian Kim, Theresa Goddard, Liza Jarrett Beaudette, Nina Changelian-Aitken, Fernando Corrada, Jason Dubuque, Raymond Iezzi, Sophie J. Bakri, Jose S. Pulido, Diane Vogen, Rebecca Nielsen, Karin Berg, Jean Burrington, Shannon Howard, Joan Overend, Zbigniew Krason, Denise Lewison, Thomas Link, Kevin J. Blinder, Nicholas E. Engelbrecht, M. Gilbert Grand, Daniel P. Joseph, Gaurav K. Shah, Bradley Smith, Matthew Thomas, Rhonda Weeks, Lynda Boyd, Dana Gabel, Ron Adelman, John Huang, James Kempton, Aaron Parnes, Jennifer Dupont, Elizabeth Perotti, Victoria Donaldson, Kenneth Fong, Pamela Ossorio, Anita Agarwal, Paul Sternberg, Sandy Owings, Tony Adkins, Elaine Lok, Garvin Munn, Buddy Skellie, Neelakshi Bhagat, Monique S. Roy, Marco Zarbin, Catherine Fay, Michael Lazar, Beth Malpica, Tatiana Mikheyav, Lawrence Ulanski, Jennifer Lim, Marcia Niec, Tametha Johnson, Yesenia Ovando, Catherine Nail Carroll, Mark Janowicz, Steven Schwartz, David Cupp, Michael Gorin, Gad Heilweil, Hamid Hosseini, Jean-Pierre Hubschman, Allan Kreiger, Tara Young McCannel, Carolyn Pan, David Sarraf, Irena Tsui, Joshua Udoetek, Vinad Voleti, Logan Hitchcock, Rosaleen Ostrick, Melissa Chun, Jennie Kageyama, Nilo Davila, Kristin Lipka, Christina Shin, Cynthia Owsley, Michael Albert, Richard Feist, John Mason, Martin Thomley, Angelia Johnson, Tracy Emond, Joanna Hamela, Angela Marsh, Karen Searcey, Kia Rookard, Yu-Guang He, Rafael L. Ufret-Vincenty, Mike Molai, William Anderson, John Horna, Alan Letson, Colleen Cebulla, Susie Chang, Fred Davidorf, Jill Salerno, Laura Sladoje, Christina Stetson, Jeri Perry, Scott Savage, Cynthia Toth, Glenn Jaffe, Stefanie Schuman, Neeru Sarin, Jim Crowell, Tiffanie Keaton, Michael Kelly, Brian Lutman, Marriner Skelly, Lauren Welch, Lawrence Morse, Allan Hunter, Susanna Soon-Chun Park, Cynthia Wallace, Ember Dhillon, Marisa Salvador, Barbara Holderreed, Karishma Chandra, Sashi Kaur, Ellen Redenbo, Smiley Hom, Michael Cooney, Irene Barbazetto, James M. Klancnik, John A. Sorenson, Lawrence Yannuzzi, Maria Scolaro, Eugene Agresta, Nancy Gonzalez, Sandeep Grover, K.V. Chalam, Shailesh Gupta, Christopher Lyons, Wenhua Li, Chirag Patel, Jose Carrion, Henry Ferreyra, Amberly Rodriguez, Iliana Molina, Gabriel Balea, Pam Emory, Marlene Rico, Giorgio Siqueiros, Alexander J. Brucker, Joshua Dunaief, Juan Grunwald, Benjamin Kim, Albert M. Maguire, Brian VanderBeek, Sheri Drossner, Joan DuPont, Rebecca Salvo, Jim Berger, Cheryl Devine, Bill Nyberg, Laurel Weeney, David DiLoreto, Mina Chung, Valerie Davis, Peter MacDowell, George O. Gara, Daniel Castillo, Andrea Czubinski, Melissa Keim, Brandi Hardy, Rachel Grunhaus Hollar, Lynn Schueckler, Alice T. Lyon, Aaron Weinberg, Mira Shiloach, Nicole Pelkofer, Qin Zhou, Laura McPoland, Rajendra Apte, P. Kumar Rao, Sam Pistorius, Jamie Kambarian, Eve Adcock, Sarah Gould, Melanie Quinn, Rhonda Curtis, Amy Frost, Charla Meyer, and Greg Rathert
Subjects: 0303 health sciences, medicine.medical_specialty, Visual acuity, genetic structures, business.industry, Eye disease, Hazard ratio, Age-Related Eye Disease Study, Retrospective cohort study, Fundus (eye), Macular degeneration, medicine.disease, eye diseases, 03 medical and health sciences, Ophthalmology, 0302 clinical medicine, 030221 ophthalmology & optometry, medicine, sense organs, medicine.symptom, Prospective cohort study, business, 030304 developmental biology
Abstract: Purpose To investigate the natural history and genetic associations of drusenoid pigment epithelial detachment (DPED) associated with age-related macular degeneration (AMD). Design Retrospective analysis of a prospective cohort study. Participants Of the 4203 Age-Related Eye Disease Study 2 (AREDS2) participants, 391 eyes (325 participants) had DPED without late AMD at the time of DPED detection. Genetic analyses included 120 white AREDS2 participants and 145 Age-Related Eye Disease Study (AREDS) participants with DPED. Methods Baseline and annual stereoscopic fundus photographs were graded centrally to detect DPED, a well-defined yellow elevated mound of confluent drusen ≥433 μm in diameter, and to evaluate progression rates to late AMD: geographic atrophy (GA) and neovascular (NV)-AMD. Five single nucleotide polymorphisms (CFH [rs10611670], C3 [rs2230199], CFI [rs10033900], C2/CFB [rs114254831], ARMS2 [rs10490924]) and genetic risk score (GRS) group were investigated for association with DPED development. Kaplan–Meier analyses and multivariable proportional hazard regressions were performed. Main Outcome Measures Progression rates to late AMD and decrease of ≥3 lines in visual acuity (VA) from the time of DPED detection; association of rate of DPED development with genotype. Results Mean (standard deviation [SD]) follow-up time from DPED detection was 4.7 (0.9) years. DPED was associated with increased risk of progression to late AMD (hazard ratio [HR], 2.36; 95% confidence interval [CI], 1.98–2.82; P Conclusions This study replicates the results of previous natural history studies of eyes with DPED including the high rates of progression to late AMD and vision loss (regardless of progression to late AMD). The genetic associations are consistent with genes associated with AMD progression.
Published: 2019

44. Evolution of the Infirmary during the Medieval; Social, Economic and Religious Status

Author: Robert Smith, Efstathios Drampalos, Levent Bayam, Sajid Khawaja, and Vasileios Stogiannos
Subjects: business.industry, Medicine, General Medicine, Ancient history, business
Published: 2019

45. Simvastatin inhibits glucose metabolism and legumain activity in human myotubes.

Author: Robert Smith, Rigmor Solberg, Linn Løkken Jacobsen, Anette Larsen Voreland, Arild Christian Rustan, G Hege Thoresen, and Harald Thidemann Johansen
Subjects: Medicine, Science
Abstract: Simvastatin, a HMG-CoA reductase inhibitor, is prescribed worldwide to patients with hypercholesterolemia. Although simvastatin is well tolerated, side effects like myotoxicity are reported. The mechanism for statin-induced myotoxicity is still poorly understood. Reports have suggested impaired mitochondrial dysfunction as a contributor to the observed myotoxicity. In this regard, we wanted to study the effects of simvastatin on glucose metabolism and the activity of legumain, a cysteine protease. Legumain, being the only known asparaginyl endopeptidase, has caspase-like properties and is described to be involved in apoptosis. Recent evidences indicate a regulatory role of both glucose and statins on cysteine proteases in monocytes. Satellite cells were isolated from the Musculus obliquus internus abdominis of healthy human donors, proliferated and differentiated into polynuclear myotubes. Simvastatin with or without mevalonolactone, farnesyl pyrophosphate or geranylgeranyl pyrophosphate were introduced on day 5 of differentiation. After 48 h, cells were either harvested for immunoblotting, ELISA, cell viability assay, confocal imaging or enzyme activity analysis, or placed in a fuel handling system with [¹⁴C]glucose or [³H]deoxyglucose for uptake and oxidation studies. A dose-dependent decrease in both glucose uptake and oxidation were observed in mature myotubes after exposure to simvastatin in concentrations not influencing cell viability. In addition, simvastatin caused a decrease in maturation and activity of legumain. Dysregulation of glucose metabolism and decreased legumain activity by simvastatin points out new knowledge about the effects of statins on skeletal muscle, and may contribute to the understanding of the myotoxicity observed by statins.
Published: 2014
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46. Progression of Geographic Atrophy in Age-related Macular Degeneration

Author: Tiarnan D. Keenan, Elvira Agrón, Amitha Domalpally, Traci E. Clemons, Freekje van Asten, Wai T. Wong, Ronald G. Danis, SriniVas Sadda, Philip J. Rosenfeld, Michael L. Klein, Rinki Ratnapriya, Anand Swaroop, Frederick L. Ferris, Emily Y. Chew, John Paul SanGiovanni, Traci Clemons, Anne Lindblad, Robert Lindblad, Nilay Shah, Robert Sperduto, Wendy McBee, Gary Gensler, Molly Harrington, Alice Henning, Katrina Jones, Kumar Thotapally, Diana Tull, Valerie Watson, Kayla Williams, Christina Gentry, Francine Kaufman, Chris Morrison, Elizabeth Saverino, Sherrie Schenning, Barbara Blodi, Ronald P. Danis, Matthew Davis, Kathy Glander, Gregory Guilfoil, Larry D. Hubbard, Kristine Johnson, Ronald Klein, Barbara Nardi, Michael Neider, Nancy Robinson, Eileen Rosensteel, Hugh Wabers, Grace Zhang, Alan J. Ruby, Antonio Capone, Bawa Dass, Kimberly Drenser, Bruce R. Garretson, Tarek S. Hassan, Michael Trese, George A. Williams, Jeremy Wolfe, Tina Bell, Mary Zajechowski, Dennis Bezaire, Fran McIver, Anthony Medina, Jackie Pagett, Stephanie Hatch Smith, Lynn Swartz, Tom Treuter, Andrew Antoszyk, Justin Brown, David J. Browning, Walter Holland, Angella Karow, Kelly Stalford, Angela Price, Sarah Ennis, Sherry Fredenberg, Jenna Herby, Uma Balasubramaniam, Loraine Clark, Donna McClain, Michael McOwen, Lynn Watson, Michael Klein, Steven T. Bailey, Thomas J. Hwang, Andreas Lauer, J. Timothy Stout, Patty McCollum, Milt Johnson, Patrick B. Rice, Ivana Kim, John Loewenstein, Joan Miller, Lucia Sobrin, Lucy Young, Jacqueline Sullivan, Patricia Houlihan, Linda Merry, Ann Marie Lane, Ursula Lord Bator, Claudia Evans, Sarah Brett, Charleen Callahan, Marcia Grillo, David Walsh, Kamella Lau Zimmerman, Gary Edd Fish, Rajiv Anand, Lori E. Coors, Dwain G. Fuller, Rand Spencer, Robert C. Wang, Karen Duignan, Sally Arceneaux, Hank Aguado, Nicholas Hesse, Michael Mackens, Brian Swan, Catherine Cukras, Monica Dalal, Naima Jacobs-El, Catherine Meyerle, Benjamin Nicholson, Henry Wiley, Katherine Hall Shimel, Angel Garced, Janice Oparah, Greg Short, Alana Temple, Babilonia Ayukawa, Guy Foster, Darryl Hayes, Dessie Koutsandreas, Roula Nashwinter, John Rowan, Michael Bono, Denise Cunningham, Marilois Palmer, Alicia Zetina, David H. Orth, Kourous Rezaei, Joseph Civantos, Sohail Hasan, Kirk Packo, Celeste Figliulo, Pam Stanberry, Tara Farmer, Kiersten Nelson, Shannya Townsend-Patrick, Philip Rosenfeld, Royce Chen, Rishi Doshi, Sander Dubovy, Brian T. Kim, Matthew Lowrance, Andrew Moshfeghi, Zayna Nahas, Gary Schienbaum, John Vishak, Christina Weng, Zohar Yehoshua, Belen Rodriguez, Jose Rebimbas, Jane Gleichauf, Mike Kicak, Jason Mena, Tim Odem, Elizabeth Sferza-Camp, Alicia Disgdiertt, Jim Oramas, Isabel Rams, Stephanie Thatcher, Susan B. Bressler, Neil M. Bressler, Daniel Finkelstein, Steven H. Sherman, Sharon Solomon, Howard S. Ying, Rita Denbow, Deborah Phillips, Elizabeth Radcliffe, Judy Belt, Dennis Cain, David Emmert, Mark Herring, Jacquelyn McDonald, G. Baker Hubbard, Chris S. Bergstrom, Blaine Cribbs, Andrew Hendrick, Brandon Johnson, Philip Laird, Sonia Mehta, Timothy Olsen, Justin Townsend, Jion Yan, Steven Yeh, Linda Curtis, Judy Brower, Hannah Yi, Jannah Rutter Dobbs, Debbie Jordan, Michael J. Elman, Robert A. Liss, JoAnn Starr, Jennifer Belz, Charlene Putzulo, Teresa Coffey, Ashley Davis, Pamela Singletary, Giorya Shabi Andreani, Theresa Cain, Daniel Ketner, Peter Sotirakos, Suresh Chandra, Barbara A. Blodi, Michael M. Altaweel, Justin L. Gottlieb, Michael Ip, T. Michael Nork, Thomas S. Stevens, Kathryn Burke, Shelly Olson, Kristine Dietzman, Barbara Soderling, Guy Somers, Angie Wealti, Denise Krolnik, John Peterson, Sandra Reed, Thomas Friberg, Andrew Eller, Denise Gallagher, Leanne Labriola, Melissa Pokrifka, Aron Gedansky, Natalie Anthony, Cassandra Grzybowski, Dawn Matthews, Sharon Murajda-Jumba, Jessica Toro, David G. Callanan, Wayne A. Solley, Patrick Williams, Sandy Lash, Bob Boleman, Chris Dock, Michel Shami, Brenda Arrington, Ashaki Meeks, Alan R. Margherio, Paul Raphaelian, Debra Markus, Justin Langdon, Elizabeth Truax, Sandy Lewis, Brad Terry, Amy Noffke, Kean Oh, Ramin Sarrafizadeh, Scott Sneed, Julie Hammersley, Serena Neal, Mary Doran, Nan Jones, Lisa Preston, Heather Jessick, Tanya Tracy Marsh, Michael Tolentino, Adam Berger, Richard Hamilton, David Misch, Suk Jin Moon, Dawn Sutherland, Vera Dilts, Sara Henderson, Esmeralda Medina, Donald Trueman, Laura Holm, Jason Strickland, Darmakusuma Ie, Jeffrey L. Lipkowitz, Kekul B. Shah, Susan Geraghty, Beverly Sannazzaro, Morgan Harper, Krista Bayer, Mary B. Lansing, Lauren B. Fox, Rebecca Lee, Jay B. Stallman, Michael Jacobson, Sean Koh, Scott Lampert, John Miller, Mark Rivellese, Atul Sharma, Robert A. Stoltz, Stephanie Vanderveldt, Leslie Marcus, Starr Hendricks, Ryan Hollman, Grethel Betanzos, Leslie Ellorin, Shelly Fulbright, Debbie McCormick, Paul A. Edwards, Julianne Hall, Mary Monk, Melanie Gutkowski, Melina Mazurek, Janet Murphy, Katherine Gusas, Crystal Moffett, David Burley, Nicole Chesney, Katie Kilgo, Brian Rusinek, Bradley Stern, Tracy Troszak, Rhonda Baker-Levingston, Carl W. Baker, Tracey Caldwell, Tammy Walker, Lynnette F. Lambert, Tracey Martin, Mary Jill Palmer, Tana Williams, Michael A. Novak, Joseph Coney, David G. Miller, Scott Pendergast, Lawrence Singerman, Nicholas Zakov, Hernando Zegarra, Kim DuBois, Susan Rath, Lori Revella, Tammy Brink, Kim Drury, Lisa Hogue, Mary Ilc, Connie Keller, Elizabeth McNamara, Vivian Tanner, Tamara Cunningham, John DuBois, Gregg Greanoff, Trina Nitzsche, Sheila Smith-Brewer, Ricky D. Isernhagen, John W. Kitchens, Thomas W. Stone, William J. Wood, Diana Holcomb, Virginia Therrien, Michelle Buck, Jeanne Van Arsdall, Edward Slade, Todd E. Schneiderman, David J. Spinak, Jackie Gaedke, Heather Davis Brown, Dan Helgren, Jenifer Garrison Pangelinan, Lawrence Halperin, Scott Anagnoste, Mandeep Dhalla, Krista Rosenberg, Barry Taney, W. Scott Thompson, Jaclyn Lopez, Monica Hamlin, Monica Lopez, Jamie Mariano, Evelyn Quinchia, Patricia Aramayo, Rita Veksler, Michael Lee, Richard Dreyer, Irvin Handelman, Colin Ma, Mark Peters, Stephen Hobbs, Amanda Milliron, Marcia Kopfer, Michele Connaughton, A. Christine Hoerner, R. Joseph Logan, Harry J. Wohlsein, David Boyer, Thomas G. Chu, Pouya Dayani, David Liao, Roger L. Novack, Firas M. Rahhal, Richard Roe, Homayoun Tabandeh, Janet Bayramyan, Tammy Gasparyan, Connie Hoang, Janet Kurokouchi, Tammy Eileen Lo, Richard Ngo, Mary Ann Nguyen, Michael Peyton, Charles Yoon, Julio Sierra, Adam Zamboni, Jeff Kessinger, Eric Protacio, Adam Smucker, Pamela Rath, Robert Bergren, Bernard Doft, Judy Liu, Karl Olsen, Lori Merlotti, Willia Ingram, Kellianne Marfisi, Kimberly Yeckel, Heather Schultz Carmelo, Amanda Fec, Keith McBroom, David Steinberg, Marc Levy, Jody Abrams, Melvin Chen, Waldemar Torres, Peggy Jelemensky, Mark Prybylski, Tara Raphael, Diana Appleby, Charlotte Rodman, Mark Sneath, Robert H. Rosa, Vanessa Hoelscher, Adelia Castano, Jocelyn Parker, John Hoskins, Nicholas Anderson, Joseph Googe, Tod A. McMillan, James Miller, Stephen Perkins, Kristina Oliver, Jennifer Beerbower, Bruce Gilliland, Cecile Hunt, Mike Jacobus, Raul Lince, Christopher Morris, Sarah Oelrich, Jerry Whetstone, Clement K. Chan, Steven Lin, Kim Walther, Tiana Gonzales, Lenise Myers, Kenneth Huff, David M. Brown, Eric Chen, Matthew S. Benz, Richard H. Fish, Rosa Y. Kim, James Major, Tien Pei Wong, Charles Wycoff, Cassandra Cone, Debbie Goates Gilaspia, Nubia Landaverde, Robert Smith, Deneva Zamora, Veronica Sneed, Melina Vela, Eric Kegley, Craig Greven, Shree Kurup, Charles Richards, Madison Slusher, Cara Everhart, Joan Fish, Mark Clark, David Miller, Marshall Tyler, J. Michael Jumper, Arthur D. Fu, Robert N. Johnson, Brandon Lujan, H. Richard McDonald, Rosa Rodriguez, Nina Ansari, Jeanifer Joaquin, Silvia Linares, Lizette Lopez, Jessica Sabio, Sean Grout, Chad Indermill, Yesmin Urias, Roberto Zimmerman, Linda Margulies, Sara J. Schmidt, Joy L. Meier, Sherry L. Hadley, William Rosenthal, Barbara Johnson, Lois Swafford, Richard Shields, R. Scott Varner, Richard Rosen, Ronald Gentile, Melissa Rivas, Katy W. Tai, Wanda Carrasquillo-Boyd, Robert Masini, Glenn Stoller, Ken Carnevale, Diane M. LaRosa, Barbara Burger, Tereza Conway, Carla Del Castillo, Julissa Diaz, Susan Jones, Nina Mondoc, Charlene Balfour, C.H. Vitha, Jennifer Lutz, Barbara McGinley, Fadi El Baba, Ann Marie Lavorna, Renee Jones, Jean Lewis, Ruth Tenzler, Mary Salvas-Mladek, Diane Van Kesteren, W. Copley McLean, W. Zachery Bridges, Cameron Stone, Denise Ammons, Mary Lamy, Andrea Menzel, Lea Doll Raymer, Barbara Campbell, Lisa Hawkins, Leslie Rickman, Lorraine Sherlin, Paula Price, Albert Sinyai, Ronald Kingsley, Reagan H. Bradford, Robert E. Leonard, Sonny Icks, Vanessa Bergman, Brittany Ross, Russ Burris, Amanda Butt, Rob Richmond, Alice Lyon, Manjot Gill, Lee Jampol, Rukhsana Mizra, Zuzanna Rozenbajgier, Jeremy Chapman, Lori Kaminski, Andrea Degillio, Evica Simjanoski, Jeffrey Heier, Hyung Cho, Tina Scheufele Cleary, Darin Goldman, Chirag Shah, Trexler Topping, Marissa Weber, Torsten Wiegand, Jeremy Schindelheim, Joy Bankert, Jennifer Stone, Alison Nowak, Sandy Chong, Lindsay Williams, Steven Bennett, Dennis Donovan, Margaret Graham, Cullen Jones, Anne Fung, Jan-Kristine Bayabo, Razelda Bosch, Esperanza Cruz, Ashley Emerson, Alycia Fleming, Denice Barsness, Jorge Rodriguez, Marina Soboleva, Ingrid U. Scott, Esther Bowie, Kimberly A. Neely, David A. Quillen, Laura Walter, Timothy Bennett, James Strong, John Wells, Lloyd Clark, David Johnson, Peggy Miller, Mallie Taylor, Tiffany Swinford, Robbin Spivey, Michael Banach, Lawrence Ho, Richard Lanning, Thomas R. Pheasant, Jay G. Prensky, Steven Truong, Julia Teatsworth, Michelle Dietrich, Ann Wasilus, Ann Miller, Megan Rakes, Teresa Slagle, Michelle Richards, Patricia Schuessler, Lacy Stover, Paul Beer, Naomi S. Falk, Mary Beth Shannon, Jeannie Olmeda, Don Berdeen, Joseph F. Fisher, James Folk, Stephen Russell, Barbara Taylor, Connie Hinz, Jean Walshire, Heather Stockman, Bruce Critser, Stefani Karakas, Cindy Montague, Randy Verdick, Omesh Gupta, Joseph Maguire, Christopher Brady, Francis Char DeCroos, Michael Dollin, Sunir Garg, Adam Gerstenblith, Julia Haller, Allen C. Ho, Jason Hsu, Richard Kaiser, John Pitcher, Carl Regillo, Rajiv Shah, Marc Spirn, William Tasman, James Vander, Noga Senderowitsch, Michele Formoso, Michelle Markun, Cedric George, Christina Centinaro, Lisa Grande, Stefanie Carey, Elaine Liebenbaum, Mark Humayun, Rachel Sierra, Elizabeth Corona, Margaret Padilla, Moonseok Nu, Sylvia Ramos, Cullen Barnett, Glenn Currie, Cornelia Gottlieb, Richard Garfinkel, Daniel Berinstein, Marcus Colyer, William Deegan, Michael Min-Shyue Lai, Robert Murphy, Michael Osman, Michael Rivers, Reginald Sanders, Manfred A. von Fricken, Debbie Oliver, Jeanne Kirshon, Tanya Alexander Snowden, Thomas Blondo, Alysia Cronise, Vanessa Denny, Kylie Mendez, Janine Newgen, Justin Davis, Mike Flory, Robert Frantz, Bryan Murphy, Steve Rauch, Judy E. Kim, Jane Bachman, Thomas B. Connor, Dennis P. Han, Kimberly Stepian, David V. Weinberg, William J. Wirostko, Krissa Packard, Tracy Kaczanowski, Vesper Williams, Vicki Barwick, Judy Flanders, Dennis Backes, Joe Beringer, Kristy Keller, Kathy Selchert, Paul Bernstein, Michael Teske, Albert Vitale, Susan Allman, Bonnie Carlstrom, Kimberley Wegner, Anne Haroldsen, Deborah Harrison, Cyrie Fry, James Gilman, Glen Jenkins, Paula Morris, Michael Rauser, Joseph Fan, Mukesh Suthar, Gisela Santiago, Kara Rollins Halsey, Christy Quesada, William Kiernan, Jesse Knabb, Richard Alan Lewis, Cindy Dorenbach, Steven Spencer, Dana Barnett, Joseph Morales, Barron C. Fishburne, Jeffrey G. Gross, Michael A. Magee, Amy Flowers, Angie McDowell, Randall Price, Suber Huang, Johnny Tang, Shawn Wilker, Cherie Hornsby, Lisa Ferguson, Kirk Krogstad, Riva Adamovsky, Peggy Allchin, Kathleen Carlton, Claudia Clow, Kelly Sholtis, Stephanie Burke, Mark Harrod, Stacie Hrvatin, Geoffrey Pankhurst, Nelson R. Sabates, Michael Cassell, Komal Desai, Abraham Poulose, Felix Sabates, Yin Chen, Gary Gallimore, Yolanda Konior, Nicola Kim, Sami Uwaydat, Deborah Troillett, Karen Aletter, Robert N. Frank, Gary Abrams, James Puklin, Asheesh Tewari, Cheryl Milanovic, Melanie Bailey, David Griffith, Dena McDonald, Kit Morehead, Zlatan Sadikovic, Lisa Schillace, Elizabeth Silvis, Brian Joondeph, Nancy Christmas, Alan Kimura, Mimi Liu, Stephen Petty, John Zilis, Jenny Benitez, Cassandra Berryman Catlett, Eric Fluegel, Shane Mowry, Hoang Nguyen, David Reflow, Odette M. Houghton, Seema Garg, Maurice B. Landers, Travis Meredith, Sandy Barnhart, Megha Karmalkar, Debra Cantrell, Rona Lyn Esquejo-Leon, Linda Manor, Sue Pope, David Stines, Amelia Stokely, Dean Hainsworth, Dyann Helming, Debbie Eichelberger, Mary Paige Leaton, Chuck Hamm, Edward Chaum, Alessandro Iannaccone, Barbara Jennings, Tracy Murray, Joe Mastellone, Robert Millay, Brian Kim, Theresa Goddard, Liza Jarrett Beaudette, Nina Changelian-Aitken, Fernando Corrada, Jason Dubuque, Raymond Iezzi, Sophie J. Bakri, Jose S. Pulido, Diane Vogen, Rebecca Nielsen, Karin Berg, Jean Burrington, Shannon Howard, Joan Overend, Zbigniew Krason, Denise Lewison, Thomas Link, Kevin J. Blinder, Nicholas E. Engelbrecht, M. Gilbert Grand, Daniel P. Joseph, Gaurav K. Shah, Bradley Smith, Matthew Thomas, Rhonda Weeks, Lynda Boyd, Dana Gabel, Ron Adelman, John Huang, James Kempton, Aaron Parnes, Jennifer Dupont, Elizabeth Perotti, Victoria Donaldson, Kenneth Fong, Pamela Ossorio, Anita Agarwal, Paul Sternberg, Sandy Owings, Tony Adkins, Elaine Lok, Garvin Munn, Buddy Skellie, Neelakshi Bhagat, Monique S. Roy, Marco Zarbin, Catherine Fay, Michael Lazar, Beth Malpica, Tatiana Mikheyav, Lawrence Ulanski, Jennifer Lim, Marcia Niec, Tametha Johnson, Yesenia Ovando, Catherine Nail Carroll, Mark Janowicz, Steven Schwartz, David Cupp, Michael Gorin, Gad Heilweil, Hamid Hosseini, Jean-Pierre Hubschman, Allan Kreiger, Tara Young McCannel, Carolyn Pan, David Sarraf, Irena Tsui, Joshua Udoetek, Vinad Voleti, Logan Hitchcock, Rosaleen Ostrick, Melissa Chun, Jennie Kageyama, Nilo Davila, Kristin Lipka, Christina Shin, Cynthia Owsley, Michael Albert, Richard Feist, John Mason, Martin Thomley, Angelia Johnson, Tracy Emond, Joanna Hamela, Angela Marsh, Karen Searcey, Kia Rookard, Yu-Guang He, Rafael L. Ufret-Vincenty, Mike Molai, William Anderson, John Horna, Alan Letson, Colleen Cebulla, Susie Chang, Fred Davidorf, Jill Salerno, Laura Sladoje, Christina Stetson, Jeri Perry, Scott Savage, Cynthia Toth, Glenn Jaffe, Stefanie Schuman, Neeru Sarin, Jim Crowell, Tiffanie Keaton, Michael Kelly, Brian Lutman, Marriner Skelly, Lauren Welch, Lawrence Morse, Allan Hunter, Susanna Soon-Chun Park, Cynthia Wallace, Ember Dhillon, Marisa Salvador, Barbara Holderreed, Karishma Chandra, Sashi Kaur, Ellen Redenbo, Smiley Hom, Michael Cooney, Irene Barbazetto, James M. Klancnik, John A. Sorenson, Lawrence Yannuzzi, Maria Scolaro, Eugene Agresta, Nancy Gonzalez, Sandeep Grover, K.V. Chalam, Shailesh Gupta, Christopher Lyons, Wenhua Li, Chirag Patel, Jose Carrion, Henry Ferreyra, Amberly Rodriguez, Iliana Molina, Gabriel Balea, Pam Emory, Marlene Rico, Giorgio Siqueiros, Alexander J. Brucker, Joshua Dunaief, Juan Grunwald, Benjamin Kim, Albert M. Maguire, Brian VanderBeek, Sheri Drossner, Joan DuPont, Rebecca Salvo, Jim Berger, Cheryl Devine, Bill Nyberg, Laurel Weeney, David DiLoreto, Mina Chung, Valerie Davis, Peter MacDowell, George O. Gara, Daniel Castillo, Andrea Czubinski, Melissa Keim, Brandi Hardy, Rachel Grunhaus Hollar, Lynn Schueckler, Alice T. Lyon, Aaron Weinberg, Mira Shiloach, Nicole Pelkofer, Qin Zhou, Laura McPoland, Rajendra Apte, P. Kumar Rao, Sam Pistorius, Jamie Kambarian, Eve Adcock, Sarah Gould, Melanie Quinn, Rhonda Curtis, Amy Frost, Charla Meyer, and Greg Rathert
Subjects: 0301 basic medicine, medicine.medical_specialty, genetic structures, business.industry, Eye disease, Incidence (epidemiology), Fundus (eye), Macular degeneration, medicine.disease, eye diseases, Confidence interval, Geographic atrophy, 03 medical and health sciences, Ophthalmology, 030104 developmental biology, 0302 clinical medicine, Age related, 030221 ophthalmology & optometry, medicine, sense organs, Prospective cohort study, business
Abstract: Purpose To analyze the prevalence, incidence, and clinical characteristics of eyes with geographic atrophy (GA) in age-related macular degeneration (AMD), including clinical and genetic factors affecting enlargement. Design Prospective cohort study within a controlled clinical trial. Participants Age-Related Eye Disease Study 2 (AREDS2) participants, aged 50–85 years. Methods Baseline and annual stereoscopic color fundus photographs were evaluated for GA presence and area. Analyses included GA prevalence and incidence rates, Kaplan-Meier rates, mixed-model regression, and multivariable analysis of the square root of GA, area adjusted for covariates, including clinical/imaging characteristics and genotype. Main Outcome Measures (1) Presence or development of GA; (2) change in the square root of GA area over time. Results At baseline, 517 eyes (6.2%) of 411 participants (9.8%) had pre-existing GA (without neovascular AMD), with the following characteristics: 33% central, 67% noncentral; and the following configurations: 36% small, 26% solid/unifocal, 24% multifocal, 9% horseshoe/ring, and 6% indeterminate. Of the remaining 6530 eyes at risk, 1099 eyes (17.3%) of 883 participants developed incident GA without prior neovascular disease during mean follow-up of 4.4 years. The Kaplan-Meier rate of incident GA was 19% of eyes at 5 years. In eyes with incident GA, 4-year risk of subsequent neovascular AMD was 29%. In eyes with incident noncentral GA, 4-year risk of central involvement was 57%. GA enlargement rate (following square root transformation) was similar in eyes with pre-existing GA (0.29 mm/year; 95% confidence interval 0.27–0.30) and incident GA (0.28 mm/year; 0.27–0.30). In the combined group, GA enlargement was significantly faster with noncentrality, multifocality, intermediate baseline size, and bilateral GA (P Conclusions Analyses of AREDS2 data on natural history of GA provide representative data on GA evolution and enlargement. GA enlargement, which was influenced by lesion features, was relentless, resulting in rapid central vision loss. The genetic variants associated with faster enlargement were partially distinct from those associated with risk of incident GA. These findings are relevant to further investigations of GA pathogenesis and clinical trial planning.
Published: 2018

47. Altered Mental Status and Respiratory Failure in an 11-Year-Old Female

Author: Emily R Ribeiro, Madelyn Kahana, Robert Smith, and Floyd Livingston
Subjects: Pediatrics, medicine.medical_specialty, Pulmonology, tracheostomy, 030204 cardiovascular system & hematology, Congenital central hypoventilation syndrome, Late presentation, 03 medical and health sciences, 0302 clinical medicine, Altered Mental Status, central congenital hypoventilation, medicine, Genetics, business.industry, General Engineering, medicine.disease, Sleep in non-human animals, Hypoventilation, Respiratory failure, hypoventilation, phox2b, late onset congenital central hypoventilation syndrome, medicine.symptom, business, 030217 neurology & neurosurgery, PHOX2B gene
Abstract: Congenital central hypoventilation syndrome (CCHS) is a rare disorder that results in profound hypoventilation that is most prominent during periods of sleep. Caused by a genetic mutation in the PHOX2B gene, CCHS typically presents in the newborn period with symptoms of hypoventilation. However, there is a subset of patients with the same genetic mutation who present much later in life, which is termed late-onset congenital central hypoventilation syndrome (LO-CCHS). The reason for its late presentation is unclear but is often dramatic. Given its rarity, the diagnosis can be difficult to establish but can be accomplished by using a systematic approach. Here, we present a case of LO-CCHS in an 11-year-old female who presented with respiratory failure and altered mental status.
Published: 2021

48. Feasibility, acceptability, and potential efficacy of an innovative postnatal home-based breastfeeding peer support programme in Hong Kong: a feasibility and pilot randomised controlled trial

Author: Yan-Shing Chang, Jeffery Sheung Yu Shing, Charlotte L. Y. Chow, Christine Lam, Kris Yuet Wan Lok, Debra Bick, and Robert Smith
Subjects: Postnatal Care, medicine.medical_specialty, Breastfeeding, Pilot Projects, Intervention group, Peer support, Pediatrics, World health, RJ1-570, law.invention, Standard care, Randomized controlled trial, law, Pregnancy, Intervention (counseling), Medicine, Humans, business.industry, Research, Obstetrics and Gynecology, Infant, Pilot, Home based, Breast Feeding, Family medicine, Pediatrics, Perinatology and Child Health, Feasibility Studies, Hong Kong, Female, Public aspects of medicine, RA1-1270, business
Abstract: Background As suggested by the World Health Organization, breastfeeding peer support is being introduced worldwide to support women’s breastfeeding needs. Evidence has shown that when such support is offered to women, the duration and exclusivity of breastfeeding is increased. We developed an innovative home-based intervention to sustain exclusive breastfeeding in Hong Kong. However, potential barriers must be addressed before a full randomised controlled trial (RCT) is conducted. The aim of this study was to determine the feasibility of a breastfeeding support programme with home-based visits from peer supporters over a six month period among postpartum Chinese women in Hong Kong. Methods We conducted a feasibility and pilot randomised controlled trial. Twenty primiparous women intending to breastfeed their healthy term singleton infant were recruited from a hospital in Kowloon, Hong Kong between February and March 2019. Participants were randomly allocated to the intervention or control group. Participants in the intervention group received five home-based visits with a peer supporter over a six month period, as well as standard care, whereas participants in the control group received standard care only. We assessed feasibility, compliance, and acceptability of the breastfeeding peer support programme. Other outcomes assessed were breastfeeding self-efficacy, duration, and exclusivity. Results It was feasible to recruit and train existing peer supporters, and peer supporters were able to deliver the intervention, which was acceptable to women, but rates of stopping the intervention and loss to follow-up were high. There was higher retention seen within the first month. Women interviewed at the end of the study reported that the intervention was positive. The cessation risk of any, and exclusive breastfeeding were not statistically different between the intervention and control groups. Conclusions This study provided valuable information on feasibility of the trial design and intervention. Modifications to the intervention, such as targeting women with lower breastfeeding self-efficacy, or combining home visits with technology and telephone follow-up may be more appropriate in a larger trial. Implementing the programme early during the antenatal phase and tailoring peer support to most appropriately sustain exclusive breastfeeding and other feeding modes should be incorporated in a future home-based peer support arm. Trial registration NCT03705494 on 15 Oct 2018.
Published: 2021

49. Lyme Disease Surveillance in England and Wales, 1986-1998

Author: Robert Smith, Susan O'Connell, and Stephen Palmer
Subjects: lyme disease, England, Wales, Surveillance, lyme borreliosis, borrelia burdorferi sensu lato, Medicine, Infectious and parasitic diseases, RC109-216
Abstract: Improved surveillance indicates that Lyme borreliosis, an emerging zoonosis in the United Kingdom, has increased from 0.06/100,000 during 1986-1992 to 0.32/100,000 since 1996. Case reports peaked in the third quarter of each year. Several high-incidence localities were identified. Erythema migrans was reported in 41% of patients; arthritis in 4%; musculoskeletal symptoms in 18%; and neuroborreliosis in 15%.
Published: 2000
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50. Documenting the Role of UK Agricultural Colleges in Propagating the Farming-Dyslexia-Entrepreneurship Nexus

Author: Gillian Conley, Robert Smith, and Louise Manning
Subjects: Economic growth, Entrepreneurship, Agriculture, business.industry, Political science, Dyslexia, medicine, business, medicine.disease, Nexus (standard)
Published: 2020

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