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1. Incidence of Endogenous Fungal Endophthalmitis in Screening Dilated Exams in Patients with Elevated Beta-D-Glucan Levels versus Positive Fungal Blood Cultures

Author

Govindaraju VK, Chao JT, Duvall ER, Baker NS, Fahey KM, Lee R, Williams GA, and Stec LA

Subjects
endophthalmitis, candidemia, chorioretinitis, infectious disease, Ophthalmology, RE1-994
Abstract

Viren K Govindaraju,1 Jonathan T Chao,1 Elizabeth R Duvall,1 Nicolas S Baker,1 Kelly M Fahey,1 Ramon Lee,2,3 George A Williams,1,2 Lori A Stec1,2 1Department of Ophthalmology, Oakland University William Beaumont School of Medicine, Rochester, MI, USA; 2Department of Vitreoretinal Surgery, Associated Retinal Consultants, Royal Oak, MI, USA; 3Department of Vitreoretinal Surgery, Illinois Retina Associates, Rush University Medical Center, Chicago, IL, USACorrespondence: Lori A Stec, Email lori.stec@beaumont.eduPurpose: Endogenous endophthalmitis is a severe intraocular infectious condition requiring rapid diagnosis and treatment. This study examines the incidence of fungal endophthalmitis in patients with elevated beta-D-glucan (BG) levels and those with positive blood culture and the utility of ophthalmology consultation in these patients.Methods: Single center retrospective consecutive cohort study was conducted on patients at Beaumont Health from 2016– 2021 who either had positive fungal blood cultures or an elevated BG level.Results: A total of 147 patients were examined by the ophthalmology department where 30 patients had an elevated BG level and 100 patients had a positive fungal blood culture. Incidence of fungal endophthalmitis was 0% in the elevated BG group and 1.5% in the positive fungal culture group, corresponding to a relative risk ratio of 0.0 (p = 0.31).Conclusion: BG testing may be useful in diagnosing isolated cases outside the standard screening paradigm, however the data within this study support the conclusion that there is no compelling evidence at this time to add or use BG as a surrogate for endophthalmitis screening. Further studies are required to further elucidate the role of BG in the care of critically ill patients.Keywords: endophthalmitis, candidemia, chorioretinitis, infectious disease

Published
2022

2. Accuracy of Remote Diagnosis of Acute Posterior Segment Pathology by Residents and Attendings Captured with a Smartphone and Standard 20/28D Lens

Author

Omari A, Samad M, Bakhsh SR, Tajran J, and Williams GA

Subjects
fundus camera, emergency room, posterior segment, smartphone, retina., Ophthalmology, RE1-994
Abstract

Amro Omari,1,2 Momin Samad,3 Saaquib R Bakhsh,1,2 Jahan Tajran,4 George A Williams1,2 1Beaumont Eye Institute, Royal Oak, MI, USA; 2Oakland University William Beaumont School of Medicine, Rochester, MI, USA; 3Michigan State College of Human Medicine, Grand Rapids, MI, USA; 4Wayne State University School of Medicine, Detroit, MI, USACorrespondence: Amro Omari, Beaumont Eye Institute, 3535 West 13 Mile Road Suite #555, Royal Oak, MI, 48073, USA, Tel +1 248-551-2020, Email Amro.omari@beaumont.orgBackground and Objective: To assess the use of a smartphone-based fundus camera in diagnosing acute posterior segment disease in the emergency room (ER) of an academic center, where standard fundus cameras are currently unavailable.Study Design/Patients and Methods: Images were obtained on 10 eyes with various types of posterior segment pathology. These were analyzed retrospectively by 35 reviewers (21 residents and 14 attending physicians). Accuracy of diagnosis was compared to in-office fundus photography.Results: The average probability of correct diagnosis was over 78%. There was no difference between resident and attending reviewers, except for one of the vitreous hemorrhage cases where residents performed better (p=0.039).Conclusion: Smartphone-based cameras are effective in screening for ocular diseases in the ER of academic centers, where residents and fellows are often the first providers to see various types of vision and life-threatening pathology.Keywords: fundus camera, emergency room, posterior segment, smartphone, retina

Published
2022

3. Long-term surgical outcomes of retinal detachment in patients with Stickler syndrome

Author

Reddy DN, Yonekawa Y, Thomas BJ, Nudleman ED, and Williams GA

Subjects
Proliferative vitreoretinopathy, retinal detachment, scleral buckle, Stickler syndrome, visual acuity, vitrectomy, vitreoretinal surgery, Ophthalmology, RE1-994
Abstract

Devasis N Reddy,1 Yoshihiro Yonekawa,1–4 Benjamin J Thomas,1,2,5 Eric D Nudleman,6 George A Williams1,2 1Oakland University William Beaumont School of Medicine, Rochester, MI, 2Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, MI, 3Massachusetts Eye and Ear Infirmary, Boston, MA, 4Boston Children’s Hospital, Harvard Medical School, Boston, MA, 5Florida Retina Institute, Jacksonville, FL, 6Shiley Eye Institute, University of California San Diego School of Medicine, San Diego, CA, USA Purpose: The aim of the study was to present the long-term anatomical and visual outcomes of retinal detachment repair in patients with Stickler syndrome.Patients and methods: This study is a retrospective, interventional, consecutive case series of patients with Stickler syndrome undergoing retinal reattachment surgery from 2009 to 2014 at the Associated Retinal Consultants, William Beaumont Hospital.Results: Sixteen eyes from 13 patients were identified. Patients underwent a mean of 3.1 surgical interventions (range: 1–13) with a mean postoperative follow-up of 94 months (range: 5–313 months). Twelve eyes (75%) developed proliferative vitreoretinopathy. Retinal reattachment was achieved in 100% of eyes, with ten eyes (63%) requiring silicone oil tamponade at final follow-up. Mean preoperative visual acuity (VA) was 20/914, which improved to 20/796 at final follow-up (P=0.81). There was a significant correlation between presenting and final VA (P

Published
2016

4. Worsening anatomic outcomes following aflibercept for neovascular age-related macular degeneration in eyes previously well controlled with ranibizumab

Author

Nudleman E, Wolfe JD, Woodward MA, Yonekawa Y, Williams GA, and Hassan TS

Subjects
Aflibercept, age-related macular degeneration, anti-vascular endothelial growth factor, intravitreal injection, macula, ranibizumab, retina, Ophthalmology, RE1-994
Abstract

Eric Nudleman,1 Jeremy D Wolfe,2,3 Maria A Woodward,4 Yoshihiro Yonekawa,2,3 George A Williams,2,3 Tarek S Hassan2,3 1Department of Ophthalmology, Shiley Eye Center, University of California, San Diego, La Jolla, CA, 2Beaumont Eye Institute, Oakland University William Beaumont School of Medicine, 3Associated Retinal Consultants, Royal Oak, 4Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, MI, USA Purpose: Antivascular endothelial growth factor injection is the mainstay of treating neovascular age-related macular degeneration (AMD). Previous studies have shown that switching treatment from ranibizumab to aflibercept led to an improvement in eyes with recalcitrant activity. Herein, we identify a unique subset of patients whose eyes with neovascular AMD were previously well controlled with ranibizumab injections were then worsened after being switched to aflibercept. Methods: This is a retrospective interventional case series. Eyes with neovascular AMD, previously well controlled with monthly injections of ranibizumab, which then developed worsening of subretinal fluid after being switched to aflibercept were included. Results: A total of 17 eyes were included. All eyes developed increased subretinal fluid when switched from ranibizumab to aflibercept. Fourteen patients were switched back to ranibizumab after a single injection of aflibercept and had subsequent rapid resolution of subretinal fluid. Three patients continued with monthly aflibercept injections for two subsequent months and demonstrated the persistence of the increased subretinal fluid until they were switched back to treatment with ranibizumab at which time the fluid resolved. No eye had persistent decline in visual acuity. Conclusion: Switching from intravitreal ranibizumab to aflibercept in eyes with well-controlled neovascular AMD may result in worsening in a subset of patients and resolves when therapy is switched back to ranibizumab. Keywords: anti-VEGF; intravitreal injection; macula; optical coherence tomography; retina

Published
2016

5. theory of adiabatic fountain resonance

Author

Williams, GA

Subjects
Mathematical Physics, Classical Physics, Condensed Matter Physics, General Physics, Classical physics, Condensed matter physics
Published
2023

6. Worsening anatomic outcomes following aflibercept for neovascular age-related macular degeneration in eyes previously well controlled with ranibizumab [Corrigendum]

Author

Nudleman E, Wolfe JD, Woodward MA, Yonekawa Y, Williams GA, and Hassan TS

Subjects
Ophthalmology, RE1-994
Abstract

Nudleman E, Wolfe JD, Woodward MA, Yonekawa Y, Williams GA, Hassan TS. Clinical Ophthalmology. 2016;10: 1053–1057.A units error was published on page 1055, column 2, as “3.1%”; the correct units are “μm” (3.1 μm).Read the original article.

Published
2017

8. A comparison of social prescribing approaches across twelve high-income countries.

Author

Scarpetti, G, Shadowen, H, Williams, GA, Winkelmann, J, Kroneman, M, Groenewegen, PP, De Jong, JD, Fronteira, I, Augusto, GF, Hsiung, S, Slade, S, Rojatz, D, Kallayova, D, Katreniakova, Z, Nagyova, I, Kylänen, M, Vracko, P, Jesurasa, A, Wallace, Z, Wallace, C, Costongs, C, Barnes, AJ, van Ginneken, E, Scarpetti, G, Shadowen, H, Williams, GA, Winkelmann, J, Kroneman, M, Groenewegen, PP, De Jong, JD, Fronteira, I, Augusto, GF, Hsiung, S, Slade, S, Rojatz, D, Kallayova, D, Katreniakova, Z, Nagyova, I, Kylänen, M, Vracko, P, Jesurasa, A, Wallace, Z, Wallace, C, Costongs, C, Barnes, AJ, and van Ginneken, E

Abstract

BACKGROUND: Social prescribing connects patients with community resources to improve their health and well-being. It is gaining momentum globally due to its potential for addressing non-medical causes of illness while building on existing resources and enhancing overall health at a relatively low cost. The COVID-19 pandemic further underscored the need for policy interventions to address health-related social issues such as loneliness and isolation. AIM: This paper presents evidence of the conceptualisation and implementation of social prescribing schemes in twelve countries: Australia, Austria, Canada, England, Finland, Germany, Portugal, the Slovak Republic, Slovenia, the Netherlands, the United States and Wales. METHODS: Twelve countries were identified through the Health Systems and Policy Monitor (HSPM) network and the EuroHealthNet Partnership. Information was collected through a twelve open-ended question survey based on a conceptual model inspired by the WHO's Health System Framework. RESULTS: We found that social prescribing can take different forms, and the scale of implementation also varies significantly. Robust evidence on impact is scarce and highly context-specific, with some indications of cost-effectiveness and positive impact on well-being. CONCLUSIONS: This paper provides insights into social prescribing in various contexts and may guide countries interested in holistically tackling health-related social factors and strengthening community-based care. Policies can support a more seamless integration of social prescribing into existing care, improve collaboration among sectors and training programs for health and social care professionals.

Published
2024

9. Dynamics of the forward vortex cascade in two-dimensional quantum turbulence

Author

Forrester, A and Williams, GA

Subjects
Atomic, Molecular, Nuclear, Particle and Plasma Physics, Condensed Matter Physics, Other Physical Sciences
Abstract

The dynamics of the forward vortex cascade in 2D turbulence in a superfluid film is investigated using analytic techniques. The cascade is formed by injecting pairs with the same initial seperation (the stirring code) at a constant rate. They move to smaller scales with constant current under the action of frictional forces, finally reaching the core size separation, where they annihilate and the energy is removed by a thermal bath. On switching off the injection, the pair distribution first decays starting from the initial stirring scale, with the total vortex density decreasing linearly in time at a rate equal to the initial injection rate. As pairs at smaller scales decay, the vortex density then falls off as a power law, the same power law found in recent exact solutions of quenched 2D superfluids.

Published
2014

10. Non-universal Casimir effect in saturated superfluid 4He films at Tλ

Author

Abraham, JBS, Williams, GA, and Penanen, K

Subjects
Atomic, Molecular, Nuclear, Particle and Plasma Physics, Condensed Matter Physics, Other Physical Sciences, Atomic, Molecular, Nuclear, Particle and Plasma Physics
Abstract

Measurements of Casimir effects in 4He films in the vicinity of the bulk superfluid transition temperature Tλ have been carried out, where changes in the film thickness and the superfluid density are both monitored as a function of temperature. The Kosterlitz-Thouless superfluid onset temperature in the film is found to occur just as the Casimir dip in the film thickness from critical fluctuations becomes evident. Additionally, a new film-thickening effect is observed precisely at Tλ when the temperature is swept extremely slowly. We propose that this is a non-universal Casimir effect arising from the viscous suppression of second sound modes in the film.

Published
2014

11. Third sound measurements of superfluid 4He films on multiwall carbon nanotubes below 1 K

Author

Menachekanian, E, Abraham, JBS, Chen, B, Iaia, V, Li, A, and Williams, GA

Subjects
Atomic, Molecular, Nuclear, Particle and Plasma Physics, Condensed Matter Physics, Other Physical Sciences, Atomic, Molecular, Nuclear, Particle and Plasma Physics
Abstract

Third sound is studied for superfluid films of 4He adsorbed on multiwall carbon nanotubes packed into an annular resonator. The third sound is generated with mechanical oscillation of the cell, and detected with carbon bolometers. A filling curve at temperatures near 250 mK shows oscillations in the third sound velocity, with maxima at the completion of the 4th and 5th atomic layers. Sharp changes in the Q factor of the third sound are found at partial layer fillings. Temperature sweeps at a number of fill points show strong broadening effects on the Kosterlitz-Thouless (KT) transition, and rapidly increasing dissipation, in qualitative agreement with the predictions of Machta and Guyer. At the 4th layer completion there is a sudden reduction of the transition temperature TKT, and then a recovery back to linear variation with temperature, although the slope is considerably smaller than the KT prediction.

Published
2014

15. Understanding and managing the interactive impacts of growth in urban land use and climate change on freshwater biota: A case study using the platypus (Ornithorhynchus anatinus)

Author

Coleman, RA, Chee, YE, Bond, NR, Weeks, A, Griffiths, J, Serena, M, Williams, GA, Walsh, CJ, Coleman, RA, Chee, YE, Bond, NR, Weeks, A, Griffiths, J, Serena, M, Williams, GA, and Walsh, CJ

Abstract

Globally, urban expansion and climate change interact to threaten stream ecosystems and are accelerating the loss of aquatic biodiversity. Waterway managers urgently need tools to understand the potential combined impacts of urbanization and climate change and to identify effective mitigating management interventions for protecting freshwater biota. We address this challenge using the semi-aquatic mammal the platypus (Ornithorhynchus anatinus) as a focal species. We developed high-resolution environmental spatial data for stream networks and spatially explicit habitat suitability models (HSMs) to explore the impact of threats and to identify the combination of management actions most likely to maintain or improve habitat suitability over the next 50 years in greater Melbourne, Australia. We developed and evaluated platypus HSMs (males-and-females and females-only) including validation using an independent environmental DNA data set. Platypus occurred more commonly in larger, cooler streams with greater catchment-weighted discharge, following periods of greater stream flow. They were positively associated with near-stream forest cover and negatively associated with annual air temperature and urban stormwater runoff. Extensive reductions in suitable platypus habitat are predicted to occur under urbanization and climate change scenarios, with the greatest threat expected from reduced streamflows. This emphasizes the importance of maintaining flow regimes as part of conserving platypus in the region; however, substantial additional benefit is predicted by concurrent riparian revegetation and urban stormwater management efforts (that also have the potential to contribute to the streamflow objectives). Provision of adequate streamflows in a future with increasing water demands and water security requirements will likely require creative integrated water management solutions. Our high-resolution stream network and HSMs have allowed predictions of potential range-shifts due

Published
2022

16. Dietary olive‑garlic extract oil supplementation: influence on performance and haematological indices of broilers

Author

Williams Gabriel Adedotun, Babatunde Adetutu Victoria, Bello Fatimah Damilola, Alausa Bolajoko Suliat, and Adewale Adebayo Oluwafemi

Subjects
broiler, garlic, olive oil, weight gain, wbc, rbc, pcv, haemoglobin, Agriculture
Abstract

The use of antibiotic growth promoters in broiler production has been the norm in developing countries, however, the increased rate of antibiotic resistance in humans has resulted in the search for alternatives without negative residual effects. This study investigated the effect of dietary olive garlic extract oil (OGEO) supplementation on the performance and haematological indices of broilers. The experiment lasted for 42 days and broilers were fed varying levels of OGEO‑supplemented diets at the starter (0–21 days) and finisher (22–42 days) phases using two hundred and forty unsexed Ross broilers. Four experimental diets were formulated for the two phases and the diets were designated as diet 1(control (without OGEO)) while diets 2, 3, and 4 were supplemented with OGEO at 1 % (10 g/kg diet) 3 % (30 g/kg diet) and 5 % (50 g/kg diet). Each had four replicates containing fifteen birds per replicate. Performance was measured weekly and haematological indices were determined on days 21 and 42. Data collected were analysed in a one‑way analysis of variance (SAS, 2000) and significant differences were determined using Tukey’s test. Body weight (BW) increased linearly (L) (p = 0.003) and quadratically (Q) (p = 0.006) with dietary supplementation of OGEO at 1 % for broilers on day 21. Similarly, at day 42, BW increased (L, p = 0.006; Q, p = 0.029) for the broiler on the same treatment. Mortality reduced (Q, p = 0.035) for broilers fed 1 % OGEO‑supplemented diet at day 42. At day 21, Packed cell volume (PCV, 47.33 %) (Q, p = 0.033) and mean corpuscular volume (MCV, 130.83pg) (Q, p = 0.008) increased for broilers fed 1 % and 3 % OGEO supplemented diet respectively. Supplementation of OGEO at 3 % increased (Q, p = 0.036) PCV (37.33 %) and haemoglobin (Q, p = 0.021) (137.30 g/L) at day 42. In conclusion, the supplementation of OGEO in the diet of broilers at 1 % resulted in improved WG and reduced mortality. The PCV and haemoglobin of broilers can be increased with the supplementation of OGEO up to 3 % in the diet of broilers; it is thus a suitable alternative to antibiotics for improved performance and immunity.

Published
2024
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18. Benchmarking of vertically-integrated CO2 flow simulations at the Sleipner Field, North Sea

Author

Cowton, LR, Neufeld, JA, White, NJ, Bickle, MJ, Williams, GA, White, JC, Chadwick, RA, Cowton, LR [0000-0003-4301-4536], White, NJ [0000-0001-8227-0677], and Apollo - University of Cambridge Repository

Subjects
geological CO2 storage, numerical fluid flow simulation, porous gravity current
Abstract

© 2018 Numerical modeling plays an essential role in both identifying and assessing sub-surface reservoirs that might be suitable for future carbon capture and storage projects. Accuracy of flow simulations is tested by benchmarking against historic observations from on-going CO2 injection sites. At the Sleipner project located in the North Sea, a suite of time-lapse seismic reflection surveys enables the three-dimensional distribution of CO2 at the top of the reservoir to be determined as a function of time. Previous attempts have used Darcy flow simulators to model CO2 migration throughout this layer, given the volume of injection with time and the location of the injection point. Due primarily to computational limitations preventing adequate exploration of model parameter space, these simulations usually fail to match the observed distribution of CO2 as a function of space and time. To circumvent these limitations, we develop a vertically-integrated fluid flow simulator that is based upon the theory of topographically controlled, porous gravity currents. This computationally efficient scheme can be used to invert for the spatial distribution of reservoir permeability required to minimize differences between the observed and calculated CO2 distributions. When a uniform reservoir permeability is assumed, inverse modeling is unable to adequately match the migration of CO2 at the top of the reservoir. If, however, the width and permeability of a mapped channel deposit are allowed to independently vary, a satisfactory match between the observed and calculated CO2 distributions is obtained. Finally, the ability of this algorithm to forecast the flow of CO2 at the top of the reservoir is assessed. By dividing the complete set of seismic reflection surveys into training and validation subsets, we find that the spatial pattern of permeability required to match the training subset can successfully predict CO2 migration for the validation subset. This ability suggests that it might be feasible to forecast migration patterns into the future with a degree of confidence. Nevertheless, our analysis highlights the difficulty in estimating reservoir parameters away from the region swept by CO2 without additional observational constraints.

Published
2018

19. An exploratory study of the association between online gaming addiction and enjoyment motivations for playing massively multiplayer online role-playing games

Author

Hussain, Z, Williams, GA, and Griffiths, MD

Subjects
Class (computer programming), Addiction, media_common.quotation_subject, Exploratory research, Novelty, Social class, Latent class model, Human-Computer Interaction, Entertainment, Arts and Humanities (miscellaneous), mental disorders, Psychology, Association (psychology), Social psychology, General Psychology, media_common
Abstract

Latent Class Analysis revealed seven classes of motivations for playing MMORPGs.Five classes of gaming addiction-related experiences were extracted.Three classes of motivations for playing were linked to higher risk of addiction. Massively multiplayer online role-playing games (MMORPGs) are a popular form of entertainment used by millions of gamers worldwide. Potential problems relating to MMORPG play have emerged, particularly in relation to being addicted to playing in such virtual environments. In the present study, factors relating to online gaming addiction and motivations for playing in MMORPGs were examined to establish whether they were associated with addiction. A sample comprised 1167 gamers who were surveyed about their gaming motivations. Latent Class Analysis revealed seven classes of motivations for playing MMORPGs, which comprised: (1) novelty; (2) highly social and discovery-orientated; (3) aggressive, anti-social and non-curious; (4) highly social, competitive; (5) low intensity enjoyment; (6) discovery-orientated; and (7) social classes. Five classes of gaming addiction-related experiences were extracted including: (1) high risk of addiction, (2) time-affected, (3) intermediate risk of addiction, (4) emotional control, and (5) low risk of addiction classes. Gender was a significant predictor of intermediate risk of addiction and emotional control class membership. Membership of the high risk of addiction class was significantly predicted by belonging to a highly social and competitive class, a novelty class, or an aggressive, anti-social, and non-curious class. Implications of these findings for assessment and treatment of MMORPG addiction are discussed.

Published
2015
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20. Above all, do no harm: towards more ethical ways of being and acting in psychological formulation

Author

Charura, D, McFarlane, K, Walker, B, and Williams, GA

Subjects
Clinical Psychology, BF
Abstract

Recent evidence seems to suggest mental health service users can be at risk of persistent harm as a result of psychological interventions. This article analyses ways of addressing harm by using the ‘lenses’ of four ethical theories to view psychological formulation.

Published
2017

24. Latent class analysis and latent profile analysis

Author

Williams, GA, Kibowski, F, Jason, LA, and Glenwick, DS

Abstract

Latent class analysis (LCA) and latent profile analysis (LPA) are powerful techniques that enable researchers to glean insights into “hidden” psychological experiences to create typologies and profiles to provide better-informed community-based policies and practice. These analytic methods have been used in a variety of domains, such as: psychosis symptomatology in the general population (Kibowski & Williams, 2012; Murphy, Shevlin, & Adamson, 2007; Shevlin, Murphy, Dorahy, & Adamson, 2007); substance abuse (Cleveland, Collins, Lanza, Greenberg, & Feinberg, 2010; James, McField, & Montgomery, 2013), peer victimization (Nylund, Bellmore, Nishina, & Graham, 2007), and anti-social/self-defeating behavior (Rosato & Baer, 2010). LCA and LPA are versatile methods of dealing with data of interest to community-based researchers in a deep and psychologically grounded way. This chapter will address the nuances of how and when to use LCA and LPA. Case studies of LCA and LPA will also be presented to illustrate the applicability of these techniques.

Published
2016

25. Radiation therapy for melanoma brain metastases: a systematic review

Author

Thompson John F., Williams Gabrielle J., and Hong Angela M.

Subjects
radiation therapy, stereotactic radiosurgery, melanoma, brain metastases, Medical physics. Medical radiology. Nuclear medicine, R895-920
Abstract

Radiation therapy (RT) for melanoma brain metastases, delivered either as whole brain radiation therapy (WBRT) or as stereotactic radiosurgery (SRS), is an established component of treatment for this condition. However, evidence allowing comparison of the outcomes, advantages and disadvantages of the two RT modalities is scant, with very few randomised controlled trials having been conducted. This has led to considerable uncertainty and inconsistent guideline recommendations. The present systematic review identified 112 studies reporting outcomes for patients with melanoma brain metastases treated with RT. Three were randomised controlled trials but only one was of sufficient size to be considered informative. Most of the evidence was from non-randomised studies, either specific treatment series or disease cohorts. Criteria for determining treatment choice were reported in only 32 studies and the quality of these studies was variable. From the time of diagnosis of brain metastasis, the median survival after WBRT alone was 3.5 months (IQR 2.4–4.0 months) and for SRS alone it was 7.5 months (IQR 6.7–9.0 months). Overall patient survival increased over time (pre-1989 to 2015) but this was not apparent within specific treatment groups.

Published
2022
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28. Latent Class Analysis and Latent Profile Analysis

Author

Jason, LA, Glenwick, DS, Williams, GA, Kibowski, F, Jason, LA, Glenwick, DS, Williams, GA, and Kibowski, F

Abstract

Latent class analysis (LCA) and latent profile analysis (LPA) are powerful techniques that enable researchers to glean insights into “hidden” psychological experiences to create typologies and profiles to provide better-informed community-based policies and practice. These analytic methods have been used in a variety of domains, such as: psychosis symptomatology in the general population (Kibowski & Williams, 2012; Murphy, Shevlin, & Adamson, 2007; Shevlin, Murphy, Dorahy, & Adamson, 2007); substance abuse (Cleveland, Collins, Lanza, Greenberg, & Feinberg, 2010; James, McField, & Montgomery, 2013), peer victimization (Nylund, Bellmore, Nishina, & Graham, 2007), and anti-social/self-defeating behavior (Rosato & Baer, 2010). LCA and LPA are versatile methods of dealing with data of interest to community-based researchers in a deep and psychologically grounded way. This chapter will address the nuances of how and when to use LCA and LPA. Case studies of LCA and LPA will also be presented to illustrate the applicability of these techniques.

Published
2016

33. Implementing Community Arts Programs – A Case Study of Effective Processes and Inherent Challenges

Author

Williams, GA

Abstract

It is widely recognised that participation in artistic and creative activities can contribute to individual and community well-being and empowerment. However, the methods and processes that translate these activities into beneficial effects are less understood. This seminar will aim to demonstrate through exploration of a case study that community arts activities can contribute to well-being and support individuals in a variety of ways. I will demonstrate the extent to which community arts programs can have a positive and sustained effect on participants, examine methods for implementing and evaluating such programs, and will be discussing the inherent challenges of employing these methods. In this case study, I will examine the processes of facilitating successful and challenging community arts initiatives and will explore these dynamics through analysis of qualitative data. For this specific scheme that we developed for those in a deprived part of Warwickshire who were living with on-going health difficulties. Interviews were conducted with participants, artists, link coordinators and health care providers and themes were extracted from the various stakeholders’ perceptions. Other qualitative data analysed were diary entries that were kept by the artists and link coordinators who facilitated each session. Main themes from the initial piloting of this programme were those relating to (1) the positive impact on well-being; (2) appropriate labelling of the programme; (3) perceptions of support from service providers; (4) the dynamics of being inclusive and participative; (5) difficulties with the evaluation process; and (6) making the transition from the pilot programme to a regular programme of drop-in sessions. Further interviewing with stakeholders at different stages of the integrated drop-in sessions led to the extraction of the following themes: (1) ‘Life-lines’, (2) Community building, (3) Improvements, (4) Skills-building, and (5) ‘Stepping stones’. It is hoped that these analyses will offer insights into the dynamics of successful running of community arts initiatives. Audience members will be encouraged to consider and discuss the implementation methods and processes involved in provision of community arts programmes and their potential application with other marginalised community groups. Audience members will also be invited to share their own experiences of working within arts and health settings; through this session, it is hoped that we can all glean some transferable practices and lessons from the successes and challenges of implementing and evaluating such programmes.

Published
2013

35. Verteporfin therapy of subfoveal choroidal neovascularization in age-related macular degeneration: Two-year results of a randomized clinical trial including lesions with occult with no classic choroidal neovascularization-verteporfin in photodynamic therapy report 2

Author

Arnold J, Kilmartin D, Olson J, Neville S, Robinson K, Laird A, Richmond C, Farrow A, McKay S, McKechnie R, Evans G, Aaberg TM, Brower J, Waldron R, Loupe D, Gillman J, Myles B, Saperstein DA, Schachat AP, Bressler NM, Bressler SB, Nesbitt P, Porter T, Hawse P, Harnett M, Eager A, Belt J, Cain D, Emmert D, George T, Herring M, McDonald J, Mones J, Corcostegui B, Gilbert M, Duran N, Sisquella M, Nolla A, Margalef A, Miller JW, Gragoudas ES, Lane AM, Emmanuel N, Holbrook A, Evans C, Lord US, Walsh DK, Callahan CD, DuBois JL, Moy J, Kenney AG, Milde I, Platz ES, Lewis H, Kaiser PK, Holody LJ, Lesak E, Lichterman S, Siegel H, Fattori A, Ambrose G, Fecko T, Ross D, Burke S, Conway J, Singerman L, Zegarra H, Novak M, Bartel M, Tilocco DuBois K, Ilc M, Schura S, Joyce S, Tanner V, Rowe P, Smith Brewer S, Greanoff G, Daley G, DuBois J, Lehnhardt D, Kukula D, Fish GE, Jost BF, Anand R, Callanan D, Arceneaux S, Arnwine J, Ellenich P, King J, Aguado H, Rollins R, Anderson T, Nork C, Duignan K, Boleman B, Jurklies B, Pauleikhoff D, Hintzmann A, Fischer M, Sowa C, Behne E, Pournaras CJ, Donati G, Kapetanios AD, Cavaliere K, Guney Wagner S, Gerber N, Sickenberg M, Sickenberg V, Gans A, Hosner B, Sbressa A, Kozma C, Curchod M, Ardoni S, Harding S, Yang YC, Briggs M, Briggs S, Phil EB, Tompkin V, Jackson R, Pearson S, Natha S, Sharp J, Tompkin A, Lim JI, Flaxel C, Padilla M, Levin L, Walonker F, Cisneros L, Nichols T, Schmidt Erfurth U, Barbazetto I, Laqua H, Kupfer R, Bulow R, Glisovic B, Bredfeldt T, Elsner H, Wintzer V, Bahlmann D, Michels S, Gordes R, Neppert B, Grote M, Honnicke K, Blumenkranz MS, Little HL, Jack R, Espiritu LM, Unyi L, Regan J, Lamborn L, Silvestri C, Rosa RH, Rosenfeld PJ, Lewis ML, Rodriguez B, Torres A, Munoz N, Contreras T, Galvez M, Hess D, Cubillas T, Rams I, Slakter JS, Sorenson JA, Bruschi PA, Burke K, Schnipper E, Maranan L, Scolaro M, Riff M, Agresta E, Napoli J, Johansson I, Dedorsson I, Stenkula S, Hvarfner C, Carlsson T, Liljedahl AM, Fallstrom S, Jacobsson E, Hendeberg K, Soubrane G, Kuhn D, Oubraham H, Benelhani A, Kunsch A, Delhoste B, Ziverec G, Lasnier M, Debibie C, Lobes LA, Olsen K, Bahr BJ, Worstell NT, Wilcox LA, Wellman LA, Vagstad G, Steinberg D, Campbell A, Ma C, Dreyer R, Williamson B, Johnson M, Crider H, Anderson H, Brown T, Jelinek K, Graves D, Pope S, Boone R, Beaumont W, Margherio RR, Williams GA, Zajechowski M, Stanley C, Kulak M, Streasick P, Szdlowski L, Falk R, Shoichet S, Regan G, Manatrey P, Cumming K, Fadel R, Mitchel B, Vandell L, Yesestrepsky D, Medina T, Bridges C, Huston G, Koenig F, Benchaboune M, Mezmate K, Fontanay S, Meredith T, Binning J, Gualdoni J, Boyd L, Ort E, Barts B, Allen R, Dahl J, Holle T, Harvey PT, Kaus L, Leuschner D, Bolychuk S, Hewitt I, Voyce J, Menchini U, Virgili G, Lanzetta P, Ambesi M, Pirracchio A, Tedeschi M, Potter MJ, Sahota B, Hall L, Le G, Rai S, Johnson D, Stur M, Lukas J, Tittl M, Docker S, Vogl K, Pieramici DJ, Manos KS, Cooper R, Denbow RL, Lowery ER, Phillips DA, Thibeault SK, Tian Y, Alexander J, Orr PR, Black N, Escartin P, Hartley D, Haworth P, Hecker T, Hiscock D, Jamali F, Maradan N, North J, Norton B, Stapleton Hayes T, Taylor R, Huber G, Deslandes JY, Fsadni M, Hess I, de Pommerol H, Bobillier A, Reaves A, Banasik S, Birch R, Koester J, Stickles R, Truett K, McAlister L, Parker F, Strong HA, Azab M, Buskard N, Gray T, Manjuris U, Hao Y, Su XY, Mason M, Hynes L, Barbezetto I, Birngruber R, Flaxel CJ, Harvey P, Koester JM, Meredith TA, Murphy SA, Strong A, Ulrike M, Beck RW, Bird AC, Coscas G, Deutman A, Jampol L, Klein R, Maguire M, Rosenfeld P, Acreneaux S, Margherio RP, Staflin P, Mones JM, Schmidt Erfurth U., BANDELLO , FRANCESCO, Arnold, J, Kilmartin, D, Olson, J, Neville, S, Robinson, K, Laird, A, Richmond, C, Farrow, A, Mckay, S, Mckechnie, R, Evans, G, Aaberg, Tm, Brower, J, Waldron, R, Loupe, D, Gillman, J, Myles, B, Saperstein, Da, Schachat, Ap, Bressler, Nm, Bressler, Sb, Nesbitt, P, Porter, T, Hawse, P, Harnett, M, Eager, A, Belt, J, Cain, D, Emmert, D, George, T, Herring, M, Mcdonald, J, Mones, J, Corcostegui, B, Gilbert, M, Duran, N, Sisquella, M, Nolla, A, Margalef, A, Miller, Jw, Gragoudas, E, Lane, Am, Emmanuel, N, Holbrook, A, Evans, C, Lord, U, Walsh, Dk, Callahan, Cd, Dubois, Jl, Moy, J, Kenney, Ag, Milde, I, Platz, E, Lewis, H, Kaiser, Pk, Holody, Lj, Lesak, E, Lichterman, S, Siegel, H, Fattori, A, Ambrose, G, Fecko, T, Ross, D, Burke, S, Conway, J, Singerman, L, Zegarra, H, Novak, M, Bartel, M, Tilocco DuBois, K, Ilc, M, Schura, S, Joyce, S, Tanner, V, Rowe, P, Smith Brewer, S, Greanoff, G, Daley, G, Dubois, J, Lehnhardt, D, Kukula, D, Fish, Ge, Jost, Bf, Anand, R, Callanan, D, Arceneaux, S, Arnwine, J, Ellenich, P, King, J, Aguado, H, Rollins, R, Anderson, T, Nork, C, Duignan, K, Boleman, B, Jurklies, B, Pauleikhoff, D, Hintzmann, A, Fischer, M, Sowa, C, Behne, E, Pournaras, Cj, Donati, G, Kapetanios, Ad, Cavaliere, K, Guney Wagner, S, Gerber, N, Sickenberg, M, Sickenberg, V, Gans, A, Hosner, B, Sbressa, A, Kozma, C, Curchod, M, Ardoni, S, Harding, S, Yang, Yc, Briggs, M, Briggs, S, Phil, Eb, Tompkin, V, Jackson, R, Pearson, S, Natha, S, Sharp, J, Tompkin, A, Lim, Ji, Flaxel, C, Padilla, M, Levin, L, Walonker, F, Cisneros, L, Nichols, T, Schmidt Erfurth, U, Barbazetto, I, Laqua, H, Kupfer, R, Bulow, R, Glisovic, B, Bredfeldt, T, Elsner, H, Wintzer, V, Bahlmann, D, Michels, S, Gordes, R, Neppert, B, Grote, M, Honnicke, K, Blumenkranz, M, Little, Hl, Jack, R, Espiritu, Lm, Unyi, L, Regan, J, Lamborn, L, Silvestri, C, Rosa, Rh, Rosenfeld, Pj, Lewis, Ml, Rodriguez, B, Torres, A, Munoz, N, Contreras, T, Galvez, M, Hess, D, Cubillas, T, Rams, I, Slakter, J, Sorenson, Ja, Bruschi, Pa, Burke, K, Schnipper, E, Maranan, L, Scolaro, M, Riff, M, Agresta, E, Napoli, J, Johansson, I, Dedorsson, I, Stenkula, S, Hvarfner, C, Carlsson, T, Liljedahl, Am, Fallstrom, S, Jacobsson, E, Hendeberg, K, Soubrane, G, Kuhn, D, Oubraham, H, Benelhani, A, Kunsch, A, Delhoste, B, Ziverec, G, Lasnier, M, Debibie, C, Lobes, La, Olsen, K, Bahr, Bj, Worstell, Nt, Wilcox, La, Wellman, La, Vagstad, G, Steinberg, D, Campbell, A, Ma, C, Dreyer, R, Williamson, B, Johnson, M, Crider, H, Anderson, H, Brown, T, Jelinek, K, Graves, D, Pope, S, Boone, R, Beaumont, W, Margherio, Rr, Williams, Ga, Zajechowski, M, Stanley, C, Kulak, M, Streasick, P, Szdlowski, L, Falk, R, Shoichet, S, Regan, G, Manatrey, P, Cumming, K, Fadel, R, Mitchel, B, Vandell, L, Yesestrepsky, D, Medina, T, Bridges, C, Huston, G, Koenig, F, Benchaboune, M, Mezmate, K, Fontanay, S, Meredith, T, Binning, J, Gualdoni, J, Boyd, L, Ort, E, Barts, B, Allen, R, Dahl, J, Holle, T, Harvey, Pt, Kaus, L, Leuschner, D, Bolychuk, S, Hewitt, I, Voyce, J, Menchini, U, Bandello, Francesco, Virgili, G, Lanzetta, P, Ambesi, M, Pirracchio, A, Tedeschi, M, Potter, Mj, Sahota, B, Hall, L, Le, G, Rai, S, Johnson, D, Stur, M, Lukas, J, Tittl, M, Docker, S, Vogl, K, Pieramici, Dj, Manos, K, Cooper, R, Denbow, Rl, Lowery, Er, Phillips, Da, Thibeault, Sk, Tian, Y, Alexander, J, Orr, Pr, Black, N, Escartin, P, Hartley, D, Haworth, P, Hecker, T, Hiscock, D, Jamali, F, Maradan, N, North, J, Norton, B, Stapleton Hayes, T, Taylor, R, Huber, G, Deslandes, Jy, Fsadni, M, Hess, I, de Pommerol, H, Bobillier, A, Reaves, A, Banasik, S, Birch, R, Koester, J, Stickles, R, Truett, K, Mcalister, L, Parker, F, Strong, Ha, Azab, M, Buskard, N, Gray, T, Manjuris, U, Hao, Y, Su, Xy, Mason, M, Hynes, L, Barbezetto, I, Birngruber, R, Flaxel, Cj, Harvey, P, Koester, Jm, Meredith, Ta, Murphy, Sa, Strong, A, Ulrike, M, Beck, Rw, Bird, Ac, Coscas, G, Deutman, A, Jampol, L, Klein, R, Maguire, M, Rosenfeld, P, Acreneaux, S, Margherio, Rp, Staflin, P, Mones, Jm, and Schmidt Erfurth, U.

Abstract

PURPOSE: To determine if photodynamic therapy with verteporfin (Visudyne; Novartis AG, Bulach, Switzerland), termed verteporfin therapy, can safely reduce the risk of vision loss compared with a placebo (with sham treatment) in patients with subfoveal choroidal neovascularization caused by age-related macular degeneration who were identified with a lesion composed of occult with no classic choroidal neovascularization, or with presumed early onset classic choroidal neovascularization with good visual acuity letter score, METHODS: This was a double-masked, placebo controlled (sham treatment), randomized, multicenter clinical trial involving 28 ophthalmology practices in Europe and North America. The study population was patients with age related macular degeneration, with subfoveal choroidal neovascularization lesions measuring no greater than 5400 mum in greatest linear dimension with either 1) occult with no classic choroidal neovascularization, best-corrected visual acuity score of at least 50 (Snellen equivalent approximately 20/100), and evidence of hemorrhage or recent disease progression; or 2) evidence of classic choroidal neovascularization with a best-corrected visual acuity score of at least 70 (better than a Snellen equivalent of approximately 20/40); assigned randomly (2:1) to verteporfin therapy or placebo therapy. Verteporfin (6 mg per square meter of body surface area) or placebo (5% dextrose in water) was administered by means of intravenous infusion of 30 mi over 10 minutes. Fifteen minutes after the start of the infusion, a laser light at 689 nm delivered 50 J/cm(2) by application of an intensity of 600 mW/cm(2) over 83 seconds using a spot size with a diameter 1000 mum larger than the greatest linear dimension of the choroidal neovascularization lesion on the retina. At follow-up examinations every 3 months, retreatment with the same regimen was applied if angiography showed fluorescein leakage. The main outcome measure was at least moderate vision loss, that is, a loss of at least 15 letters (approximately 3 lines), adhering to an intent-to treat analysis with the last observation carried forward to impute for missing data. RESULTS: Two hundred ten (93%) and 193 (86%) of the 225 patients in the verteporfin group compared with 104 (91%) and 99 (87%) of the 114 patients in the placebo group completed the month 12 and 24 examinations, respectively. On average, verteporfin-treated patients received five treatments over the 24 months of follow-up. The primary outcome was similar for the verteporfin-treated and the placebo-treated eyes through the month 12 examination, although a number of secondary visual and angiographic outcomes significantly favored the verteporfin-treated group. Between the month 12 and 24 examinations, the treatment benefit grew so that by the month 24 examination, the vertepor-fin-treated eyes were less likely to have moderate or severe vision loss. Of the 225 verteporfin-treated patients, 121 (54%) compared with 76 (67%) of 114 placebo-treated patients lost at least 15 letters (P =.023). Likewise, 61 of the verteporfin-treated patients (30%) compared with 54 of the placebo-treated patients (47%) lost at least 30 letters (P = .001). Statistically significant results favoring verteporfin therapy at the month 24 examination were consistent between the total population and the subgroup of patients with a baseline lesion composition identified as occult choroidal neovascularization with no classic choroidal neovascularization, This subgroup included 166 of the 225 verteporfin-treated patients (74%) and 92 of the 114 placebo-treated patients (81%). In these patients, 91 of the verteporfin-treated group (55%) compared with 63 of the placebo-treated group (68%) lost at least 15 letters (P =.032), whereas 48 of the verteporfin-treated group (29%) and 43 of the placebo-treated group (47%) lost at least 30 letters (P =.004). Other secondary outcomes, including visual acuity letter score worse than 34 (approximate Snellen equivalent of 20/200 or worse), mean change in visual acuity letter score, development of classic choroidal neovascularization, progression of classic choroidal neovascularization and size of lesion, favored the verteporfin-treated group at both the month 12 and month 24 examination for both the entire study group and the subgroup of cases with occult with no classic choroidal neovascularization at baseline. Subgroup analyses of lesions composed of occult with no classic choroidal neovascularization at baseline suggested that the treatment benefit was greater for patients with either smaller lesions (4 disc areas or less) or lower levels of visual acuity (letter score less than 65, an approximate Snellen equivalent of 20/50(-1) or worse) at baseline. Prospectively planned multivariable analyses confirmed that these two baseline variables affected the magnitude of treatment benefit. Of the 123 verteporfin-treated patients and 64 placebo-heated patients with either visual acuity score Less than 65 or lesion size 4 disc areas or less at baseline, 60 (49%) and 48 (75%) lost at least 15 letters (P < .001), respectively, and 26 (21%) and 31 (48%) lost at least 30 letters (P 2001 by Elsevier Science Inc. All rights reserved.).

Published
2001

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