Publications by authors named "David Taylor"

1,328 Publications

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The Development of Equipment to Measure Mesh Erosion of Soft Tissue.

Materials (Basel) 2021 Feb 17;14(4). Epub 2021 Feb 17.

Department of Mechanical, Manufacturing and Biomedical Engineering, Trinity Centre for Biomedical Engineering, Trinity College Dublin, D02 PN40 Dublin, Ireland.

Mesh erosion is a phenomenon whereby soft tissue becomes damaged as a result of contact with implants made from surgical mesh, a fabric-like material consisting of fibers of polypropylene or other polymers. This paper describes the design and construction of a testing machine to generate mesh erosion in vitro. A sample of mesh in the form of a 10 mm wide tape is pressed against soft tissue (porcine muscle) with a given force, and a given reciprocating movement is applied between the mesh and the tissue. To demonstrate the capabilities of the equipment, we measured erosion using the same mesh and tissue type, varying the applied force and the reciprocating stroke length, including zero strokes (i.e., static loading). For comparison, we also tested four other samples of polypropylene with different edge characteristics. Analysis of the results suggests the existence of three different erosion mechanisms: cutting, wear and creep. It is concluded that the equipment provides a useful and realistic simulation of mesh erosion, a phenomenon that is of great clinical significance and merits further study.
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http://dx.doi.org/10.3390/ma14040941DOI Listing
February 2021

Early intervention in psychosis during the COVID-19 pandemic: Maudsley recommendations.

Eur Neuropsychopharmacol 2021 Feb 25. Epub 2021 Feb 25.

Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; OASIS service, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy. Electronic address:

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http://dx.doi.org/10.1016/j.euroneuro.2021.02.005DOI Listing
February 2021

Dynamic Assessment of Pulmonary Artery Pulsatility Index Provides Incremental Risk Assessment for Early Right Ventricular Failure after Left Ventricular Assist Device.

J Card Fail 2021 Feb 25. Epub 2021 Feb 25.

Heart and Vascular Institute, Cleveland Clinic, Cleveland OH; Department of Cardiology, Mater Misericordiae University Hospital, Dublin Ireland.

Background: Pulmonary artery pulsatility index (PAPi) has been studied to predict right ventricular failure (RVF) post-LVAD but only as a single time point pre-LVAD. Multiple clinical factors and therapies impact RV function in pre-LVAD patients. Thus, we hypothesized that serial PAPi measurements during cardiac intensive care (CICU) optimization pre-LVAD would provide incremental risk stratification for early RVF post-LVAD.

Methods: Consecutive patients who underwent sequential pulmonary artery catherization with CICU optimization pre durable-LVAD were included. Serial hemodynamics were retrospectively reviewed across the optimization period. The Optimal PAPi was defined by the initial PAPi + the PAPi at optimized hemodynamics. RVF was defined as need for right ventricular assist device or prolonged inotrope use >14 days post-operatively.

Results: Patients with early RVF had significantly lower mean Optimal PAPi (3.5 vs 7.5, P<.001) compared to those who did not develop RVF. After adjusting for established risk factors of early RVF post LVAD, Optimal PAPi was independently and incrementally associated with early RVF post-LVAD (OR .64, CI .532-.765, P<0001).

Conclusions: Optimal PAPi achieved during medical optimization prior to LVAD, provides independent and incremental risk stratification for early RVF, likely identifying dynamic RV reserve.
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http://dx.doi.org/10.1016/j.cardfail.2021.02.012DOI Listing
February 2021

Remdesivir is a delayed translocation inhibitor of SARS-CoV-2 replication.

Mol Cell 2021 Jan 28. Epub 2021 Jan 28.

Department of Molecular Biosciences, University of Texas at Austin, Austin, TX 78712, USA; Institute for Cellular and Molecular Biology, University of Texas at Austin, Austin, TX 78712, USA. Electronic address:

Remdesivir is a nucleoside analog approved by the US FDA for treatment of COVID-19. Here, we present a 3.9-Å-resolution cryo-EM reconstruction of a remdesivir-stalled RNA-dependent RNA polymerase complex, revealing full incorporation of 3 copies of remdesivir monophosphate (RMP) and a partially incorporated fourth RMP in the active site. The structure reveals that RMP blocks RNA translocation after incorporation of 3 bases following RMP, resulting in delayed chain termination, which can guide the rational design of improved antiviral drugs.
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http://dx.doi.org/10.1016/j.molcel.2021.01.035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843106PMC
January 2021

NMR-Based Quantum Mechanical Analysis Builds Trust and Orthogonality in Structural Analysis: The Case of a Bisdesmosidic Triglycoside as Aerial Parts Marker.

J Nat Prod 2021 Feb 24. Epub 2021 Feb 24.

Department of Pharmaceutical Sciences, University of Illinois at Chicago, Chicago, Illinois 60612, United States.

The present study demonstrates the relationship between conventional and quantum mechanical (QM) NMR spectroscopic analyses, shown here to assist in building a convincingly orthogonal platform for the solution and documentation of demanding structures. Kaempferol-3--robinoside-7--glucoside, a bisdesmosidic flavonol triglycoside and botanical marker for the aerial parts of , served as an exemplary case. As demonstrated, QM-based H iterative full spin analysis (HiFSA) advances the understanding of both individual nuclear resonance spin patterns and the entire H NMR spectrum of a molecule and establishes structurally determinant, numerical HiFSA profiles. The combination of HiFSA with regular 1D H NMR spectra allows for simplified yet specific identification tests via comparison of high-quality experimental with QM-calculated spectra. HiFSA accounts for all features encountered in H NMR spectra: nonlinear high-order effects, complex multiplets, and their usually overlapped signals. As HiFSA replicates spectrum patterns from field-independent parameters with high accuracy, this methodology can be ported to low-field NMR instruments (40-100 MHz). With its reliance on experimental NMR evidence, the QM approach builds up confidence in structural characterization and potentially reduces identity analyses to simple 1D H NMR experiments. This approach may lead to efficient implementation of conclusive identification tests in pharmacopeial and regulatory analyses: from simple organics to complex natural products.
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http://dx.doi.org/10.1021/acs.jnatprod.0c01131DOI Listing
February 2021

Retention of lumpy skin disease virus in Stomoxys spp (Stomoxys calcitrans, Stomoxys sitiens, Stomoxys indica) following intrathoracic inoculation, Diptera: Muscidae.

PLoS One 2021 19;16(2):e0238210. Epub 2021 Feb 19.

Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, Australia.

Lumpy skin disease (LSD) is an emerging disease of cattle in Kazakhstan and the means of transmission remains uncertain. In the current study, retention of Lumpy Skin Disease Virus (LSDV) by three Stomoxys species following intrathoracic inoculation was demonstrated under laboratory conditions. A virulent LSDV strain was injected into the thorax of flies to bypass the midgut barrier. The fate of the pathogen in the hemolymph of the flies was examined using PCR and virus isolation tests. LSDV was isolated from all three Stomoxys species up to 24h post inoculation while virus DNA was detectable up to 7d post inoculation.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238210PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7894917PMC
February 2021

An International Comparison of the Information in the Regulatory-Approved Drug Labeling and Prescribing Guidelines for Pediatric Depression.

J Child Adolesc Psychopharmacol 2021 Feb 18. Epub 2021 Feb 18.

School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.

To determine the differences in information between prescribing guidelines and drug labeling, as well as to compare the approval of psychotropic medicines for major depression in pediatric patients ("pediatric depression") across countries. The recommendations of The Maudsley Prescribing Guidelines in Psychiatry (MPGP) for the treatment of pediatric depression (<18 years) were compared against the regulatory-approved drug-labeling documents from the United Kingdom, Australia, New Zealand, Canada, and the United States. The use of medicines outside of their regulatory approval is defined as off-label use, so differences between the drug labeling and MPGP were characterized according to unapproved age, indication, dosage, or route of administration. Information in the drug labeling was also compared across countries. MPGP provides recommendations for 6 medicines for the treatment of pediatric depression, for which, 30 drug labeling were retrieved. Three of 30 drug labeling were consistent with MPGP recommendations (fluoxetine in the United Kingdom, fluoxetine and escitalopram in the United States). Differences in information between MPGP and the drug labeling were identified in 26 of 30 drug labeling analyzed, most often due to age (24/26) followed by indication (2/26). No differences pertaining to dosage or route of administration information were identified. The number of approved psychotropic medicines varied across the studied countries and we found cross-country discrepancies in information in the drug labeling. Significant differences in information exists between MPGP and the drug labeling for psychotropic medicines for pediatric depression, due to unapproved ages or indications. Additionally, approval information in the drug labeling are not consistent across countries. Further research into reasons for variability and impact on practice may be warranted.
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http://dx.doi.org/10.1089/cap.2020.0154DOI Listing
February 2021

Failure mechanisms and bending strength of var. stems.

J R Soc Interface 2021 Feb 17;18(175):20201023. Epub 2021 Feb 17.

Trinity Centre for Biomedical Engineering, Department of Mechanical and Manufacturing Engineering, Trinity College Dublin, The University of Dublin, Ireland.

In the course of biological evolution, plant stems have evolved mechanical properties and an internal structure that makes them resistant to various types of failure. The mechanisms involved during damage development and failure in bending are complex and incompletely understood. The work presented builds on a theoretical framework outlined by Ennos and van Casteren, who applied engineering mechanics theory to explain why different woody stems fail in different ways. Our work has extended this approach, applying it to a detailed analysis of one particular species: var. . When subjected to three-point bending, stems of this species exhibited one of two failure mechanisms: a plastic hinge or a greenstick fracture. We developed a predictive model using a computer simulation and a mathematical analysis using the theory of plastic bending. Required material properties were obtained from tests, the literature and imaging techniques. We found that greenstick fractures are more likely to occur in more lignified stems with a higher density. We discovered a new failure mode: an internal crack caused by tensile transverse stress. This work helps in understanding how plants have evolved their bending resistance and may assist in the creation of novel engineering structures inspired by these principles.
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http://dx.doi.org/10.1098/rsif.2020.1023DOI Listing
February 2021

Point-of-care measurement of clozapine concentration using a finger-stick blood sample.

J Psychopharmacol 2021 Mar 12;35(3):279-283. Epub 2021 Feb 12.

Institute of Psychiatry, Psychology and Neuroscience, King�s College London, London, UK.

Background: The use of clozapine demands regular monitoring of clozapine plasma concentrations and of white blood cell parameters. The delay between sending blood samples for analysis and receiving the results hinders clinical care. Point-of-care testing (POCT) can provide drug assay results within a few minutes.

Aim: This study aimed to investigate the utility of a novel point-of-care device that can measure clozapine concentrations using capillary blood samples collected via a finger stick.

Method: During a five-week period starting in June 2019 eligible patients were asked to provide a finger-stick capillary sample in addition to their usual venous blood sample. Samples were analysed by the novel point-of-care device and by the standard laboratory method. Capillary blood samples were tested by the MyCare™ Insite POCT analyser, and a quantitative measurement of clozapine concentration was provided within six minutes.

Results: A total of 309 patients agreed to measurements by the two methods. Analysis revealed clozapine concentrations in venous blood as determined by the laboratory method ranged from 20 to 1310 ng/mL and by POCT from 7 to 1425 ng/mL. There was a strong positive correlation ( = 0.89) between the results from the venous and the capillary sample methods. The slope of the association between standard assay and MyCare™ Insite was 1.0 with an intercept of -21 ng/mL, indicating minimal bias.

Conclusion: Clozapine concentrations can be accurately measured at the point of care using capillary blood samples collected via a finger stick. This approach may be more acceptable than venous sampling to patients and, with almost instant results available, more useful to clinicians.
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http://dx.doi.org/10.1177/0269881121991567DOI Listing
March 2021

At the heart of mitochondrial quality control: many roads to the top.

Cell Mol Life Sci 2021 Feb 5. Epub 2021 Feb 5.

Smidt Heart Institute, Cedars-Sinai Medical Center, AHSP9313, 127 S. San Vicente Blvd., Los Angeles, CA, 90048, USA.

Mitochondrial quality control depends upon selective elimination of damaged mitochondria, replacement by mitochondrial biogenesis, redistribution of mitochondrial components across the network by fusion, and segregation of damaged mitochondria by fission prior to mitophagy. In this review, we focus on mitochondrial dynamics (fusion/fission), mitophagy, and other mechanisms supporting mitochondrial quality control including maintenance of mtDNA and the mitochondrial unfolded protein response, particularly in the context of the heart.
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http://dx.doi.org/10.1007/s00018-021-03772-3DOI Listing
February 2021

There Is Life After the UK Clozapine Central Non-Rechallenge Database.

Schizophr Bull 2021 Feb 5. Epub 2021 Feb 5.

Pharmacy Department, South London and Maudsley NHS Foundation Trust, London, UK.

Background And Aims: In the United Kingdom, patients on clozapine whose hematological parameters fall below certain thresholds are placed on the Central Non-Rechallenge Database (CNRD), meaning that they cannot be prescribed clozapine again except under exceptional circumstances. This practice was discontinued in the United States in 2015 by expanding the hematological monitoring guidelines, allowing more patients to receive clozapine. Our objective was to investigate the implications this policy change would have on clozapine utilization in the United Kingdom.

Methods: This was an observational, retrospective analysis of patients registered on the CNRD in a large mental health trust. The first objective was to compare the number of patients placed on the CNRD under the United Kingdom and the US Food and Drug Administration (FDA) criteria. The second objective was to explore the hematological and clinical outcomes of CNRD patients. The third objective was to investigate the hematological outcomes of patients rechallenged on clozapine after nonrechallengeable status.

Results: One hundred and fifteen patients were placed on CNRD from 2002 to 2019, of whom 7 (6%) met the equivalent criteria for clozapine discontinuation under the FDA guidelines. Clinical outcomes, as measured by the Clinical Global Impression-Severity scale, were worse 3 months after clozapine cessation than on clozapine (t = -7.4862; P < .001). Sixty-two (54%) patients placed on CNRD were rechallenged. Fifty-nine of those (95%) were successfully rechallenged; 3 patients were placed back on CNRD, only one of which would have had to stop clozapine again under FDA criteria.

Conclusion: Implementation of the updated FDA's monitoring criteria in the United Kingdom would significantly reduce clozapine discontinuation due to hematological reasons. The evidence suggests an urgent need for revising the UK clozapine monitoring guidelines to improve outcomes in treatment-resistant schizophrenia.
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http://dx.doi.org/10.1093/schbul/sbab006DOI Listing
February 2021

Medium-Term Clinical and Radiographic Results of an All-Polyethylene, Pegged, Bone-Ingrowth Glenoid Component: A Concise Follow-up of a Previous Report.

J Bone Joint Surg Am 2021 Feb;103(3):251-256

Melbourne Orthopaedic Group, Windsor, Victoria, Australia.

Abstract: We previously reported the mean 4-year outcomes of anatomic total shoulder replacement using an all-polyethylene, pegged, hybrid-fixation (bone ingrowth and cement) glenoid component. In the present study, we report on that patient cohort after another 4 years of follow-up (mean, 101 months; range, 77 to 146 months). At that time, the median American Shoulder and Elbow Surgeons (ASES) score was 92 points (interquartile range [IQR], 81.7 to 98.3) and the median Oxford Shoulder Score was 47 points (IQR, 41 to 48). Osseointegration, demonstrated by bone ingrowth between the flanges on the central peg as seen on coronal computed tomography (CT), was complete in 75% of the shoulders, partial in 21%, and absent in 4%. There were radiolucent lines at the bone-prosthesis interface on CT, with a median Yian score of 1 (IQR, 0 to 2; range, 0 to 18). The conclusion in the present study was that shoulder arthroplasty with an all-polyethylene, hybrid-fixation (bone ingrowth and cement) pegged glenoid component has durable clinical and radiographic outcomes at medium-term follow-up.

Level Of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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http://dx.doi.org/10.2106/JBJS.20.00084DOI Listing
February 2021

Relapse and frequency of injection of monthly paliperidone palmitate-A retrospective case-control study.

Eur Psychiatry 2021 Feb 3;64(1):e11. Epub 2021 Feb 3.

Pharmacy Department, Maudsley Hospital, LondonSE5 8AZ, United Kingdom.

Background: Outcomes with long-acting injections (LAIs) are generally better than with oral antipsychotic therapy. However, the use of LAIs does not assure compliance with treatment and in clinical practice patients often miss injections or receive their injections later than intended.

Method: We conducted a case-control study to identify demographic and treatment associations with relapse (cases) on paliperidone 1-monthly injection (PP1M) compared with age-, gender-, and ethnicity-matched controls.

Results: We identified 16 cases and matched 43 controls. Baseline variables did not differ except that cases had received significantly more antipsychotic drugs before initiation with PP1M (3.94 vs. 2.12; p < 0.001). Cases had fewer PP1M injections administered compared with the control group (9.69 vs. 11.37; p < 0.001) and this group had a longer interval between injections than the control group (37 vs. 33 days; p < 0.001).

Conclusions: Relapse on PP1M is associated with reduced frequency of injection and a longer interval between doses.
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http://dx.doi.org/10.1192/j.eurpsy.2021.4DOI Listing
February 2021

Prescription medication use by emergency department doctors to improve work and academic performance, and to manage stress and anxiety.

Emerg Med Australas 2021 Feb 2. Epub 2021 Feb 2.

Department of Emergency Medicine Research, Austin Hospital, Melbourne, Victoria, Australia.

Objective: To determine medications used by ED doctors to improve work and academic performance, and to manage stress and anxiety.

Methods: We undertook an online, voluntary, anonymous survey of ACEM fellows and trainees.

Results: One hundred and thirty-nine (46.5%) respondents used a medication under examination. Sleep aids included melatonin (19.1% of respondents) and benzodiazepines (8.7%). Medications to improve performance included modafinil (4.7%), pseudoephedrine (2.0%), melatonin (2.0%) and beta blockers (1.3%). Some medications were taken prior to shifts. Medications to manage stress and anxiety included benzodiazepines (3.0%) and beta blockers (2.0%).

Conclusion: Medication use is common and support for some doctors may be required.
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http://dx.doi.org/10.1111/1742-6723.13733DOI Listing
February 2021

An evaluation of the variation and underuse of clozapine in the United Kingdom.

Acta Psychiatr Scand 2021 Jan 27. Epub 2021 Jan 27.

Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neurosciences, Kings College, London, UK.

Background: Clozapine is the only licensed treatment for treatment refractory schizophrenia. Despite this, it remains grossly underused relative to the prevalence of refractory schizophrenia. The extent of underuse and the degree of regional variation in prescribing in the United Kingdom is unknown. It is also unclear, how the UK compares with other European countries in rates of clozapine prescribing.

Methods: We obtained data relating to all clozapine prescribing in the UK from the relevant clozapine registries. We examined regional variation in clozapine use across England, corrected for the known prevalence of severe mental illness (SMI). We also compared the UK rate of clozapine use per 100,000 population to that described in other European countries.

Findings: There is substantial variation in clozapine prescribing across different regions of England and only about a third of potentially eligible patients were prescribed the drug in the UK. Clozapine prescribing rate in the UK was lower than in several European countries.

Interpretation: There is clear regional inequity in access to the most effective treatment in refractory schizophrenia in England. Strategies to increase clozapine use, by overcoming both real and perceived barriers, are urgently necessary to reduce treatment inequity for patients with refractory schizophrenia.
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http://dx.doi.org/10.1111/acps.13280DOI Listing
January 2021

Structure and Functional Characterization of a Humanized Anti-CCL20 Antibody following Exposure to Serum Reveals the Formation of Immune Complex That Leads to Toxicity.

J Immunol 2021 Mar 22;206(5):1067-1076. Epub 2021 Jan 22.

Biopharm Analytical Sciences, Biopharm Product Development and Supply, GlaxoSmithKline, Collegeville, PA 19426.

mAbs have revolutionized the treatment of autoimmune disorders. Even though mAbs have shown impressive efficacy in blocking T cell or B cell activation and/or recruitment to sites of inflammation, this group of biologicals are not devoid of adverse effects. The most serious adverse effects include infusion reactions, including the activation of the complement pathway. In this study, we present a detailed structure-function study of an anti-CCL20 humanized IgG1 mAb that neutralizes CCL20 chemokine and prevents the recruitment of Th17 cells to sites of inflammation. We demonstrate that the anti-CCL20 Ab changes significantly following administration to humans and monkeys and exposure to human serum. Analysis of the drug product revealed that the anti-CCL20 Ab has unexpectedly high C1q binding. This high binding was linked to immune complex formation in vivo but not during in vitro serum incubation. The immune complex contained multiple complement components. Anti-CCL20 Ab-mediated, complement-dependent cytotoxicity occurred when the Ab bound to CCL20 tethered to the cell membrane of target cells. Taken together, these results provide a likely cause for the animal toxicity observed. In addition, anti-CCL20 revealed progressive acidification because of N100 (located in CDR) deamidation over time, which did not directly impact Ag binding. Our study demonstrates that the safety profiling of mAbs should include the evaluation of effector functions in addition to typical stressed conditions.
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http://dx.doi.org/10.4049/jimmunol.2000336DOI Listing
March 2021

Protecting the world's finest athletes: periodic health evaluation practices of the top performing National Olympic Committees from the 2016 Rio or 2018 PyeongChang Olympic Games.

Br J Sports Med 2021 Jan 19. Epub 2021 Jan 19.

Oslo Sports Trauma Research Center, Oslo, Norway.

Aim: To describe the periodic health evaluation (PHE) practices of the top performing National Olympic Committees (NOCs).

Methods: We sent a survey to NOCs finishing in the top 8 for medal count at the 2016 Rio Olympic Games or 2018 PyeongChang Olympic Games. The survey included four sections: (1) PHE staff composition and roles, (2) beliefs regarding the PHE, (3) a ranking of risk factors for future injury and (4) details on the elements of the PHE.

Results: All 14 NOCs with top 8 finishes at the 2016 Rio Olympic Games or 2018 PyeongChang Olympic Games completed the survey. NOCs included a median of seven staff specialties in the PHE, with physicians and physiotherapists having the highest level of involvement. There was agreement that PHEs are effective in identifying current health conditions (13/14) and that athletes should receive individualised action plans after their PHE (14/14), but less agreement (6/14) that PHEs can predict future injury. The practices of NOCs were diverse and often specific to the athlete population being tested, but always included the patient's health history, laboratory studies, cardiovascular screening and assessments of movement capacity. The top three risk factors for future injury were thought to be previous injury, age and training experience.

Conclusions: Among the top performing NOCs, the PHE is a comprehensive, multidisciplinary process aimed to identify existing conditions and provide baseline health and performance profiles in the event of future injury. Research linking PHEs to injury prevention is needed.
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http://dx.doi.org/10.1136/bjsports-2020-103481DOI Listing
January 2021

Erosion of soft tissue by polypropylene mesh products.

J Mech Behav Biomed Mater 2021 03 14;115:104281. Epub 2020 Dec 14.

Trinity Centre for Bioengineering, Trinity College Dublin, The University of Dublin, Ireland. Electronic address:

Surgical mesh products made from polypropylene (PP) have been extensively used in the treatment of stress urinary incontinence, pelvic organ prolapse and other conditions. Since the onset of the use of such implants, major complications have been reported. Mesh erosion, where neighbouring tissues are worn from the rubbing of mesh, occurs in a significant number of cases. However, there is still a lack in literature exploring the mechanics of this phenomenon. In this study, a purpose-built apparatus was used to generate erosion in soft tissue (porcine muscle) through the application of a force and a reciprocating action. Four different commercial products were tested, all made from knitted PP fibres: Monarc™ Gynecare™ and Obtryx™ slings and Sutulene™ mesh sheet material. A PP suture and three PP sheets with different edge roughness were also tested. Large differences were found in the erosion rates. Significantly, we found that meshes in which the edge had been formed using heat to cause partial melting gave much higher rates of erosion than mechanically cut edges. Heat-formed edges tended to retain their shape whilst mechanically cut edges degraded by unravelling. Several features of the mesh edge appear to be significant, including roughness, flexibility and the tendency to degrade. Constant load (non-reciprocating) tests were also carried out, revealing that creep can also cause erosion. These findings have significance for the design of surgical mesh products to minimise their adverse effects.
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http://dx.doi.org/10.1016/j.jmbbm.2020.104281DOI Listing
March 2021

The combined effects of temperature and relative humidity parameters on the reproduction of Stomoxys species in a laboratory setting.

PLoS One 2020 21;15(12):e0242794. Epub 2020 Dec 21.

Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, Australia.

In this study, Stomoxys species (S. calcitrans, S. sitiens and S. indica) were examined to improve on the current technique for mass rearing using a method of combined incubation parameters. Moreover, the reproductive potential of immature forms at various stages of development was defined. Immature forms of stable flies were incubated according to species. There was no significant difference in the number of immature forms obtained among species incubated under the same conditions. Six incubation parameters were used in combination, at temperatures (T) of 32°C, 27°C and 22°C and relative humidity (RH) of 90% and 70% RH. The combined method resulted in a higher number of eggs hatching at 32°C and 90% humidity as well as an increase in the number of larva pupated and emergence of imago at 27°C and 70% humidity.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0242794PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7751869PMC
January 2021

Low-Level Laser Light Therapy Dosage Variables vs Treatment Efficacy of Neuromusculoskeletal Conditions: A Scoping Review.

J Chiropr Med 2020 Jun 13;19(2):119-127. Epub 2020 Aug 13.

Basic Science Department, Texas Chiropractic College, Pasadena, Texas.

Objective: The purpose of this scoping review was to identify and synthesize literature on dosage variables on the efficacy of low-level laser therapy (LLLT) for neuromusculoskeletal conditions.

Methods: A scoping literature review was conducted by searching the following databases: the Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature, Medline, the Physiotherapy Evidence Database, the Index to Chiropractic Literature, manufacturer websites, and online guidelines. The search was modeled after STARLITE criteria. The reporting used Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews (PRISMA-ScR). Articles were included if LLLT was used in any treatment group for a neuromusculoskeletal complaint with dosage and effectiveness reported. This was tabulated by source, dosage variables, conditions, outcome measures, and conclusions. Data were charted in Excel format. Frequency counts were performed on ordinal data. Descriptive statistics were computed for the continuous data.

Results: A total of 86 articles were included in the review. They revealed a broad range of musculoskeletal conditions and diverse dosage parameters. Seven individual parameters were found that would alter the dosage. Although duration of application is an independent clinical factor, the negative-outcome studies were inconsistent in duration. There was lack of statistical difference between the studies with improved vs unimproved outcomes. No statistical differences were noted between the dosage parameters and efficacy.

Conclusion: Although many articles were found on LLLT for neuromusculoskeletal conditions, the studies had amorphous parameters. A heterogeneity of reported doses precluded the synthesis of sufficient evidence to correlate dosage variables with improved or unimproved outcomes. Therefore, based on the current literature, dosage variables for the efficacy of LLLT for neuromusculoskeletal conditions are uncertain at this time.
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http://dx.doi.org/10.1016/j.jcm.2020.06.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729198PMC
June 2020

Canadian Pioneers of Amyotrophic Lateral Sclerosis: A Brief History.

Can J Neurol Sci 2020 Dec 14:1-7. Epub 2020 Dec 14.

Vice President Research, ALS Canada, Toronto, Ontario, Canada.

This is an historical account of Canadian pioneers working in amyotrophic lateral sclerosis (ALS) in the 1970s and 1980s. Key contributions included the development of specialized clinics, the ALS Society of Canada, human motor unit estimates in vivo, use of transcranial magnetic stimulation (TMS), the dementias of ALS, the importance of neurofilaments and axonal flow, neuroinflammation and immunity related to ALS, use of tissue culture to study pathogenesis, and the story of ALS in Guam. Their work set the stage for future generations of ALS physicians and scientists to bring about meaningful therapies and hopefully a cure for ALS.
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http://dx.doi.org/10.1017/cjn.2020.269DOI Listing
December 2020

The Value of the Patient History in the Periodic Health Evaluation: Patient Interviews Capture 4 Times More Injuries Than Electronic Questionnaires.

J Orthop Sports Phys Ther 2021 01 11;51(1):46-51. Epub 2020 Dec 11.

Objective: To assess the value of the patient interview and electronic questionnaire methods of health history data collection in elite athletes.

Design: Cohort study.

Methods: A retrospective chart review compared health history data collected by questionnaire and by interview in a cohort of 142 athletes who participated in a periodic health evaluation at the US Olympic & Paralympic Training Center sports medicine clinic. The main outcome measure was number of injuries reported by either interview or written questionnaire.

Results: Six hundred twenty-six injuries were reported by interview and 157 by questionnaire. The mean ± SD number of injuries reported per participant was 4.4 ± 4.2 by interview and 1.1 ± 1.3 by questionnaire (difference, 3.3; <.001). Capture rate by method was similar across sexes and for both Olympic and Paralympic athletes. More injuries were reported by interview than by questionnaire for all injury categories, except for concussions and surgeries.

Conclusion: Patient interviews capture 4 times as many past or current injuries than electronic questionnaires in athletes training for the Olympic and Paralympic Games. Questionnaires provide incomplete health history information in this patient population. .
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http://dx.doi.org/10.2519/jospt.2021.9821DOI Listing
January 2021

Conference presentations: A research primer for low- and middle-income countries.

Afr J Emerg Med 2020 11;10(Suppl 2):S158-S160. Epub 2020 May 11.

Cleveland Clinic Akron General, Department of Emergency Medicine, 1 Akron General Ave. Akron, Ohio 44307, United States of America.

Presenting research at a conference is an opportunity to disseminate the findings, network with other researchers, and to develop your academic track record. Although every conference will have some local differences, there are common approaches to presenting your research in the best manner. This will differ depending on whether it is an oral or a poster presentation. This research primer aims to support researchers in the early stages of their careers to undertake the best possible presentation.
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http://dx.doi.org/10.1016/j.afjem.2020.05.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7718443PMC
May 2020

Basic statistics: A research primer for low- and middle-income countries.

Afr J Emerg Med 2020 11;10(Suppl 2):S145-S149. Epub 2020 Jul 11.

Department of Medicine, University of Melbourne, Parkville, Victoria, Australia.

Statistics can be used to describe data or make inferences about populations using samples. Median values (the 50th percentile) better represent central tendency of data samples than means (averages), particularly when data have extreme values. Errors resulting from use of inferential statistics when using classical hypothesis testing include type I (finding a difference between groups when one does not exist) and type II (failure to find a true difference) errors. Confounding variables (those that vary with both the dependent variable and independent variable) may lead to spurious associations. Classical hypothesis testing and reporting only -values tends to be greatly overused and overemphasized. Confidence intervals provide a range of values for a sample within a certain probability (commonly 95%). Confidence intervals can thus describe sizes of likely differences between samples, and are much more clinically useful information than only -values. Before doing a study, the required sample size should be calculated to assess study feasibility. Doing so requires specification of the acceptable risk of type I and II errors and the size of the lowest clinically meaningful difference between groups.
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http://dx.doi.org/10.1016/j.afjem.2020.06.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7718448PMC
July 2020

Research skills and the data spreadsheet: A research primer for low- and middle-income countries.

Afr J Emerg Med 2020 7;10(Suppl 2):S140-S144. Epub 2020 Jun 7.

Cleveland Clinic Akron General, Department of Emergency Medicine, Akron, OH, United States of America.

The specialty of Emergency Medicine continues to expand and mature worldwide. As a relatively new specialty, the body of research that underpins patient management in the emergency department (ED) setting needs to be expanded for optimum patient care. Research in the ED, however, is complicated by a number of issues including limited time and resources, urgency for some therapeutic investigations and interventions, and difficulties in obtaining truly informed patient consent. Notwithstanding these issues, many of the fundamental principles of medical research apply equally to ED research. In all medical disciplines, data needs to be collected, collated and stored for analysis and a data spreadsheet is employed for this purpose. Like other aspects of clinical research, the use of the data spreadsheet needs to be exacting and appropriate. This research primer explores the choice of available spreadsheets and a range of principles for their best-practice use. It is deliberately, not an exhaustive review of the subject. However, we aim to explore basic principles and some of the most accessible and widely used data spreadsheets.
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http://dx.doi.org/10.1016/j.afjem.2020.05.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7718460PMC
June 2020

Cardiac markers in Black, Asian and minority ethnic (BAME) patients with COVID-19.

J Clin Pathol 2020 Dec 10. Epub 2020 Dec 10.

Department of Clinical Biochemistry, King's College Hospital NHS Foundation Trust, London, UK.

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http://dx.doi.org/10.1136/jclinpath-2020-207188DOI Listing
December 2020

Using the Technology Acceptance Model to conceptualise experiences of the usability and acceptability of a self-management app (COPD.Pal®) for Chronic Obstructive Pulmonary Disease.

Health Technol (Berl) 2020 Nov 26:1-7. Epub 2020 Nov 26.

Hywel Dda University Health Board, Carmarthen, UK.

Chronic Obstructive Pulmonary Disease (COPD) is a long-term progressive inflammatory lung disease causing chronic breathlessness and many hospital admissions. It affects up to 1.2 million people in the UK. To help people with COPD self-manage their condition we developed, in partnership with healthcare users, a digital mobile phone app called COPD.Pal®. We report the first user feedback of COPD.Pal®, applying the Technology Acceptance Model (TAM) theoretical framework. 11 participants engaged with a click dummy version of COPD.Pal® before being asked questions relating to their experiences. A deductive, semantic, reflexive thematic analysis was conducted to analyse their individual and collective experiences. The study was registered at Clinical Trials.gov (NCT04142957). Two overarching themes resulted: Ease of Use and Perceived Usefulness. Within the former, participants discussed how they wanted flexibility and choice in how they engaged with the app; including how often they used it. Additionally, they discussed how the app layout should make it straightforward to use, whilst unanimously agreeing that COPD.Pal® provided this. Within Perceived Usefulness, participants discussed how they wanted the information they entered into the app to be useful, in addition to the app providing resources regarding COPD. Lastly, there was disagreement regarding preferences for further app development. We found that COPD.Pal® was usable and acceptable by people with COPD and TAM provided a useful theoretical framework for both structuring discussions with users and analysing their comments.
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http://dx.doi.org/10.1007/s12553-020-00494-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7690946PMC
November 2020

Antipsychotics and mortality - more clarity needed.

Psychol Med 2020 12 2;50(16):2814-2815. Epub 2020 Dec 2.

University College, London, UK.

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http://dx.doi.org/10.1017/S0033291720004535DOI Listing
December 2020

A retrospective chart review study to quantify the monthly medical resource use and costs of treating patients with treatment resistant depression in the United Kingdom.

Curr Med Res Opin 2021 Feb 25;37(2):311-319. Epub 2021 Jan 25.

Tavistock & Portman NHS Foundation Trust, London, UK.

Introduction: Major depressive disorder (MDD) is a globally prevalent chronic psychiatric illness with a significant disease impact. As many as 30% of patients with MDD do not adequately respond to two therapies and are considered to be treatment resistant. This study aimed to quantify healthcare costs associated with treatment resistant depression (TRD) in the UK.

Methods: A retrospective chart review of patients with TRD was conducted in primary and secondary care settings over a 2 year period. Data abstracted from medical records of patients included demographics, clinical characteristics and healthcare resource utilization (HCRU; number of consultations, use of Crisis Resolution and Home Treatment Teams [CRHTTs], non-drug and drug interventions, and hospitalizations). HCRU per patient per month (28 days) was calculated for three health states: major depressive episode (MDE), remission and recovery. Unit costs were from the British National Formulary (BNF) and the Personal Social Services Research Unit (PSSRU).

Results: A total of 295 patients with TRD were recruited between January 2016 and May 2018. The mean age of the total sample was 43.3 years; 60.3% were female. Costs per patient, per 28 days, were highest in the MDE state, with the average cost (£992) mainly driven by consultations, non-drug treatment, hospitalizations and CRHTT, with a considerable fall in costs as patients moved into remission and subsequent recovery.

Conclusion: The results suggest that antidepressant treatments for TRD that are more effective in reducing the time spent in an MDE health state, and helping patients achieve remission and recovery, are essential for reducing the overall HCRU and costs in patients with TRD. Cost of TRD in the UK Strengths and limitations of this study This observational study of TRD is the first to assess the HCRU impact associated with different predefined health states. Using retrospective data from both primary and secondary care physicians from regions across the UK ensures a representative real-world patient population. One limitation is that the selection of patients is based on criteria that define TRD that rely on physician judgement. Although the study captures direct HCRU costs, the indirect costs of lost productivity and care are not included in the overall burden. This study has defined the current clinical management of patients with TRD in the UK and provides an estimate of the associated HCRU and associated costs.
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http://dx.doi.org/10.1080/03007995.2020.1857580DOI Listing
February 2021