Publications by authors named "Jonathan Morris"

374 Publications

Phenology and flowering overlap drive specialisation in plant-pollinator networks.

Ecol Lett 2021 Sep 17. Epub 2021 Sep 17.

Department of Environmental Science and Policy, University of California-Davis, Davis, California, USA.

Variation in dietary specialisation stems from fundamental interactions between species and their environment. Consequently, understanding the drivers of this variation is key to understanding ecological and evolutionary processes. Dietary specialisation in wild bees has received attention due to their close mutualistic dependence on plants, and because both groups are threatened by biodiversity loss. Many principles governing pollinator specialisation have been identified, but they remain largely unvalidated. Organismal phenology has the potential to structure realised specialisation by determining concurrent resource availability and pollinator foraging activity. We evaluate this principle using mechanistic models of adaptive foraging in pollinators within plant-pollinator networks. While temporal resource overlap has little impact on specialisation in pollinators with extended flight periods, reduced overlap increases specialisation as pollinator flight periods decrease. These results are corroborated empirically using pollen load data taken from bees with shorter and longer flight periods across environments with high and low temporal resource overlap.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ele.13884DOI Listing
September 2021

Bilingual phonological development across generations: Segmental accuracy and error patterns in second- and third-generation British Bengali children.

J Commun Disord 2021 Sep-Oct;93:106140. Epub 2021 Jul 4.

Department of Child and Family Studies, Rongxiang Xu College of Health and Human Services, California State University, Los Angeles, 5151 State University Drive, Los Angeles, CA 90032, United States of America. Electronic address:

Introduction: While developmental norms for speech sound development have been widely reported for monolingual children, and increasingly for bilingual children, little is known about speech sound development across different generations of children growing up in heritage language settings. The purpose of the present study was to gain a better understanding of inter-generational differences in the phonological development of British Bengali children.

Methods: Typically-developing second-generation and third-generation Bengali heritage children living in Wales (n=19), aged between 4 and 5 years, participated in a picture-naming task in Sylheti and English. The single-word speech samples were transcribed phonetically and analyzed in terms of consonant and vowel accuracy measures, and error patterns. Subsequently, logistic mixed-effects regression models were fitted to identify the factors that predict accurate speech patterns in the children's productions.

Results: The results revealed high levels of accuracy in consonant and vowel production by both sets of children, particularly in English. On Sylheti consonants, second-generation children significantly outperformed third-generation children, however only on language-specific sounds. In contrast, generation was not a significant predictor for accuracy on English consonants, but all children performed better on shared sounds than on English-specific categories, and on stops than affricates. The third-generation children exhibited a greater number of error types in Sylheti than the second-generation children, and more common replacement of Sylheti dental stops with alveolars.

Conclusion: The results suggest that third-generation children have less developed pronunciation patterns in the heritage language, but not the majority language, than their age-matched second-generation peers, however only on language-specific sounds. These findings indicate that differentiating between the phonological norms of monolingual and bilingual children may not be clinically sufficiently sensitive, at least in the minority language, and that more fine-grained language use variables, such as the generation to which a bilingual child belongs, need to be considered.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jcomdis.2021.106140DOI Listing
July 2021

Diagnostic Yield of Intrathecal Gadolinium MR Myelography for CSF Leak Localization.

Clin Neuroradiol 2021 Jul 22. Epub 2021 Jul 22.

Department of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.

Purpose: Intrathecal gadolinium magnetic resonance (MR) myelography can be used to localize various types of spinal cerebrospinal fluid (CSF) leaks; however, its diagnostic yield is not well known. We sought to determine the diagnostic yield of MR myelography in patients with spontaneous intracranial hypotension.

Methods: A retrospective review was performed on all patients who had undergone intrathecal gadolinium MR myelography at our institution from 2002 to 2020 for suspected spinal CSF leak. The MR myelography images were reviewed for the presence or absence of a spinal CSF leak site. Images were also evaluated for the presence an extradural fluid collection.

Results: A total of 97 patients were included in the final cohort. The average age was 52.6 years; 67.0% were female, 4 patients underwent 2 examinations each, yielding a total of 101 MR myelograms. The source of a spinal CSF leak was localized in 14 patients. The diagnostic yield for CSF leak localization on intrathecal gadolinium MR myelography was 14/101 (13.9%) per GdM examination and 14/97 (14.4%) per patient. Among the subset of patients without extradural fluid collections, the yield was 15.7% per examination. All detected leaks were either CSF-venous fistulas or distal nerve root sleeve tears.

Conclusion: Intrathecal gadolinium MR myelography is capable of localizing CSF-venous fistulas and distal nerve root sleeve tears; however, our data show that it has a limited diagnostic yield. We suggest that other modalities may be a better first step before attempting intrathecal gadolinium MR myelography.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00062-021-01060-yDOI Listing
July 2021

Making the move to a learning healthcare system: has the pandemic brought us one step closer?

Aust Health Rev 2021 Jul 22. Epub 2021 Jul 22.

The notion of a learning healthcare system (LHS) is gaining traction to advance the objectives of high-quality patient-centred care. Within such a system, real-world data analysis, clinical research and health service research are core activities of the health system. To support the transition to an LHS, the Australian Government is implementing the National Clinical Trials Governance Framework, which extends health service accreditation standards to the conduct of clinical trials. This initiative encourages the integration of clinical trials into clinical care and the fostering of a culture of continuous improvement. However, implementing this initiative may prove challenging if health system leaders, clinicians and patients fail to recognise the value of clinical trials as a core health system activity. In this article we describe the enduring value of clinical trials and how the COVID-19 pandemic has enhanced their value by addressing longstanding deficiencies in the way trials are conducted. We also summarise best-practice advice on the embedding of trials into routine health care to enable their integration into health system operations.What is known about this topic?Many healthcare organisations seek to transition to a learning health system. In Australia, National Safety and Quality Health Service Standards, which support the embedding of clinical trials as a core health system activity, have been implemented to catalyse the move.What does this paper add?Because there is little practical advice on how to embed clinical trials into health system operations, this paper summarises best practice. It also provides a rationale for embedding trials as a core health system activity, because the creation of a strong research culture is an important determinant of success.What are the implications for practitioners?The successful transition to an LHS would significantly advance the goals of value-based care.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1071/AH21076DOI Listing
July 2021

The health and educational costs of preterm birth to 18 years of age in Australia.

Aust N Z J Obstet Gynaecol 2021 Jul 15. Epub 2021 Jul 15.

Division of Obstetrics and Gynaecology, The University of Western Australia, Perth, Western Australia, Australia.

Background: Preterm birth is the greatest cause of death up to five years of age and an important contributor to lifelong disability. There is increasing evidence that a meaningful proportion of early births may be prevented, but widespread introduction of effective preventive strategies will require financial support.

Aims: This study estimated the economic cost to the Australian government of preterm birth, up to 18 years of age.

Materials And Methods: A decision-analytic model was developed to estimate the costs of preterm birth in Australia for a hypothetical cohort of 314 814 children, the number of live births in 2016. Costs to Australia's eight jurisdictions included medical expenditures and additional costs to educational services.

Results: The total cost of preterm birth to the Australian government associated with the annual cohort was estimated at $1.413 billion (95% CI 1047-1781). Two-thirds of the costs were borne by healthcare services during the newborn period and one-quarter of the costs by educational services providing special assistance. For each child, the costs were highest for those born at the earliest survivable gestational age, but the larger numbers of children born at later gestational ages contributed heavily to the overall economic burden.

Conclusion: Preterm birth leaves many people with lifelong disabilities and generates a significant economic burden to society. The costs extend beyond those to the healthcare system and include additional educational needs. Assessments of economic costs should inform economic evaluations of interventions aimed at the prevention or treatment of preterm birth.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ajo.13405DOI Listing
July 2021

Three-Dimensional Surface Imaging and Printing in Anatomic Pathology.

J Pathol Inform 2021 18;12:22. Epub 2021 May 18.

Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.

Three-dimensional (3D) imaging is increasingly being incorporated into a variety of medical specialties: surgery and radiology being but two prominent examples. Image-intensive disciplines, such as anatomic pathology (AP), represent excellent potential candidates for further exploration of this innovative technology. Multiple potential use cases exist within AP, involving patient care, education, and research. These use cases broadly include direct utilization of the 3D digital assets for viewing on a 2D screen, populating 3D extended reality platforms (virtual reality, augmented reality, and mixed reality) as well as generation of 3D printed photorealistic specimen models. Herein, these use cases are explored with specific regard to our experiences and yet unrealized potential. Future directions and considerations are also discussed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jpi.jpi_8_21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8274305PMC
May 2021

Paradoxical Temporal Enlargement: An Expansion of Superficial Temporal Fat Pad Following Interfacial Technique for Pterional Craniotomy.

J Craniofac Surg 2021 Jun 28. Epub 2021 Jun 28.

Mayo Clinic Alix School of Medicine, Mayo Clinic Division of Plastic Surgery, Department of Surgery, Mayo Clinic Department of Neurosurgery, Mayo Clinic Department of Otolaryngology, Mayo Clinic Department of Radiology, Mayo Clinic, Rochester, MN.

Objective: Contour irregularities in the temporal region have been reported previously after procedures involving temporal dissection. In this study, we report paradoxical temporal enlargement (PTE) following interfascial pterional craniotomy.

Methods: A retrospective review of patients who underwent a unilateral transcranial procedure with frontotemporal approach at our institution between September 2013 and December 2017 was performed. Patients with a previous craniotomy or bilateral craniotomy were excluded. Radiological imaging series including computed tomography and magnetic resonance imaging were utilized to calculate temporal soft tissue volumes both preoperatively and postoperatively by using advanced software technology. Relative soft tissue volume differences between the operative side and the contralateral side were calculated at different time-points including preoperative, 3-months follow-up (3M), 12-months (12M) follow-up, and the last follow-up (LFU, over 1-year).

Results: Forty-three patients were included. Mean age was 52.7 ± 4.5 years. Mean follow-up was 27.9 ± 15.8 months. Significant changes of temporal fat pad relative-volume difference were observed between the preoperative and the corresponding 3M (t [82] = -2.8865, P = 0.0050); 12M (t [77] = -4.4321, P < 0.0001), and LFU (t [74] = -4.9862, P < 0.0001) postoperative time points. No significant change of the temporalis muscle was observed between the preoperative and the corresponding 3M (P = 0.3629), 12M (P = 0.1553), or LFU (P = 0.0715). Soft tissue volume showed a significant increase on the operative side between the preoperative and the corresponding LFU (t [74] = -2.5866, P =  0.0117).

Conclusions: Paradoxical temporal enlargement with more than 10% volumetric change was observed in 24% of the patients at their LFU (>1-year). This change was not due to temporalis muscle changes. Paradoxical temporal enlargement was due to hypertrophy of the superficial temporal fat pad. Before surgical correction of postoperative temporal contour changes, it is important to obtain imaging and characterize the etiology of the deformity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0000000000007730DOI Listing
June 2021

Are newly introduced criteria for the diagnosis of gestational diabetes mellitus associated with improved pregnancy outcomes and/or increased interventions in New South Wales, Australia? A population-based data linkage study.

BMJ Open Diabetes Res Care 2021 06;9(1)

Northern Sydney Local Health District, Kolling Institute, St Leonards, New South Wales, Australia.

Introduction: The incidence of gestational diabetes mellitus (GDM) is increasing in Australia, influenced by changed diagnostic criteria. We aimed to identify whether the diagnostic change was associated with improved outcomes and/or increased obstetric interventions using state-wide data in New South Wales (NSW), Australia.

Research Design And Methods: Perinatal and hospital data were linked for singleton births, 33-41 weeks' gestation, 2006-2015, NSW. An adjusted Poisson model was used to split pregnancies from 2011 onwards into those that would have been diagnosed under the old criteria ('previous GDM') and newly diagnosed cases ('additional GDM'). We compared actual rates of total and early (<39 weeks) planned births, cesareans, and maternal and neonatal adverse outcomes for GDM-diagnosed pregnancies using three predicted scenarios, where the 'additional GDM' group was assumed to have the same rates as: the 'previous GDM' group <2011 (scenario A); the 'non-GDM' group <2011 (scenario B); or the 'non-GDM' group ≥2011 (scenario C).

Results: GDM incidence more than doubled over the study period, with an inflection point observed at 2011. For those diagnosed with GDM since 2011, the actual incidence of interventions (planned births and cesareans) and macrosomia was consistent with scenario A, which meant higher intervention rates, but lower rates of macrosomia, than those with no GDM. Incidence of neonatal hypoglycemia was lower than scenario A and closer to the other scenarios. There was a reduction in perinatal deaths among those with GDM, lower than that predicted by all scenarios, indicating an improvement for all with GDM, not only women newly diagnosed. Incidence of maternal and neonatal morbidity indicators was within the confidence bounds for all three predicted scenarios.

Conclusions: Our study suggests that the widely adopted new diagnostic criteria for GDM are associated with increased obstetric intervention rates and lower rates of macrosomic babies, but with no clear impacts on maternal or neonatal morbidity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjdrc-2021-002277DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240580PMC
June 2021

Comparison of costs related to infant hospitalisations for spontaneous, induced and Caesarean births: population-based cohort study.

Aust Health Rev 2021 Aug;45(4):418-424

The University of Sydney Northern Clinical School, Women and Babies Research, Sydney, NSW, Australia. Email: and Northern Sydney Local Health District, Kolling Institute, Sydney, NSW, Australia; and School of Public Health and Community Medicine, UNSW, Sydney, NSW, Australia.

Objective This study examined hospitalisations and associated in-patient costs for babies during the first year of life following spontaneous labour, compared with labour induction or prelabour Caesarean section, at each gestational age. Methods Birth data for singleton liveborn babies from 33 weeks gestation in New South Wales from 2005 to 2014 were linked to hospital and death data. Generalised linear models were used to examine the association between the type of labour and the length of hospitalisations and hospital costs. Results From 2005 to 2014, 598640 women gave birth to 1187451 liveborn singleton babies. The mean total length of hospitalisations and costs of hospitalisations for babies in the first year of life decreased significantly as week of gestational age increased to 39 weeks, then plateaued. Overall, the total length of hospitalisations and hospital costs were significantly (P<0.001) lower for babies born after spontaneous labour (5.6 days and A$8405 respectively) than for babies born following labour induction (6.1 days and A$9452 respectively) or prelabour Caesarean section (8.2 days and A$12320 respectively). Conclusions Babies born following spontaneous labour spend less time in hospital and have lower hospital costs than those born following labour induction or prelabour Caesarean section. Hospitalisations and costs decrease with each week of gestational age until 39 weeks. What is known about the topic? It is known that induction of labour and prelabour Caesarean sections are increasing, and this increase has changed the distribution of gestational age towards birth at earlier ages. It is also known that babies born before 39 weeks of gestation are at increased risk of mortality and morbidity. What does this paper add? This study shows that babies born following spontaneous labour spend the least amount of time in hospital and subsequently have the lowest hospital costs at each week of gestation compared with babies born following labour induction or prelabour Caesarean section. This study also shows a small but significant economic advantage of labour induction compared with prelabour Caesarean delivery. This study quantifies the mean time babies spend in hospital in their first year of life, by week of gestational age and mode of birth. What are the implications for practitioners? The findings from this study can assist clinicians in judicious decision making when balancing the risks and benefits of early planned births. Clinicians can use the results of this study to inform women who are intending to have a planned birth of risks they may not have anticipated, such as the increased risk of rehospitalisation. The finding that hospitalisations and costs continue to decline until 39 weeks gestation can be used to reinforce the importance of continuing the pregnancy beyond 37 weeks if safe to do so, even though 37 weeks is considered term.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1071/AH20237DOI Listing
August 2021

Polyamine-Conjugated Nitroxides Are Efficacious Inhibitors of Oxidative Reactions Catalyzed by Endothelial-Localized Myeloperoxidase.

Chem Res Toxicol 2021 06 4;34(6):1681-1692. Epub 2021 Jun 4.

School of Chemistry, University of New South Wales, Sydney, New South Wales 2052, Australia.

The heme enzyme myeloperoxidase (MPO) is a key mediator of endothelial dysfunction and a therapeutic target in cardiovascular disease. During inflammation, MPO released by circulating leukocytes is internalized by endothelial cells and transcytosed into the subendothelial extracellular matrix of diseased vessels. At this site, MPO mediates endothelial dysfunction by catalytically consuming nitric oxide (NO) and producing reactive oxidants, hypochlorous acid (HOCl) and the nitrogen dioxide radical (NO). Accordingly, there is interest in developing MPO inhibitors that effectively target endothelial-localized MPO. Here we studied a series of piperidine nitroxides conjugated to polyamine moieties as novel endothelial-targeted MPO inhibitors. Electron paramagnetic resonance analysis of cell lysates showed that polyamine conjugated nitroxides were efficiently internalized into endothelial cells in a heparan sulfate dependent manner. Nitroxides effectively inhibited the consumption of MPO's substrate hydrogen peroxide (HO) and formation of HOCl catalyzed by endothelial-localized MPO, with their efficacy dependent on both nitroxide and conjugated-polyamine structure. Nitroxides also differentially inhibited protein nitration catalyzed by both purified and endothelial-localized MPO, which was dependent on NO scavenging rather than MPO inhibition. Finally, nitroxides uniformly inhibited the catalytic consumption of NO by MPO in human plasma. These studies show for the first time that nitroxides effectively inhibit local oxidative reactions catalyzed by endothelial-localized MPO. Novel polyamine-conjugated nitroxides, ethylenediamine-TEMPO and putrescine-TEMPO, emerged as efficacious nitroxides uniquely exhibiting high endothelial cell uptake and efficient inhibition of MPO-catalyzed HOCl production, protein nitration, and NO oxidation. Polyamine-conjugated nitroxides represent a versatile class of antioxidant drugs capable of targeting endothelial-localized MPO during vascular inflammation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1021/acs.chemrestox.1c00094DOI Listing
June 2021

Point of care virtual surgical planning and 3D printing in facial gender confirmation surgery: a narrative review.

Ann Transl Med 2021 Apr;9(7):614

Division of Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA.

Facial gender confirmation surgery (FGCS) is a powerful set of procedures in the armamentarium of plastic surgeons that can transform the male face into a gender-congruent female face and provide the transgender individual with improved quality of life, positive body image and help in social integration. The goals of the FGCS procedures are to address the individual patients' concerns and expectations about their facial appearance, offer safely executed surgery, minimize complications, and optimize surgical outcomes. Pre-operative computed tomography (CT) scanning and three-dimensional (3D) reconstruction before facial feminization or masculinization delineates important skeletal and sinus anatomy and can also be a useful tool in patient consultation. Virtual surgical planning (VSP) is a valuable tool in facial surgery. From free flap bony reconstruction after tumor resection and orthognathic surgery to craniosynostosis planning, VSP has become widely utilized in modern day cranio-maxillofacial surgery. The use of patient-specific cutting guides and implants helps in improving symmetry and safety of these procedures. Furthermore, 3D printed models are valuable tools in patient education and counseling prior to surgery. In this article we describe our approach to FGCS through the integration of point of care (POC) VSP and 3D printing (3DP) to help deliver safer and accurate FGCS outcomes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21037/atm-20-6369DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8105863PMC
April 2021

A Single-Institution Experience in Percutaneous Image-Guided Cryoablation of Lymph Node Metastases.

AJR Am J Roentgenol 2021 07 14;217(1):152-156. Epub 2021 Apr 14.

Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905.

The purpose of this study was to assess the feasibility, safety, and efficacy of percutaneous cryoablation for the treatment of lymph node metastases. In this single-institution retrospective study 55 patients were identified who underwent CT-guided cryoablation of metastatic lymph nodes between November 2006 and September 2019. Patient demographics, disease characteristics, and procedural details were recorded. The primary endpoints were technical success and major complications. The secondary endpoints were time to local and time to distant progression. Complications were graded according to the Society of Interventional Radiology consensus guidelines. The study sample comprised 55 patients (42 men, 13 women; mean age 64 ± 12 years) who underwent 61 cryoablation procedures to treat 65 lymph node metastases. Targeted nodes measured 1.7 ± 1.2 cm in mean short-axis diameter. Technical success was achieved in 60 of 61 cryoablation procedures (98%). Adjunctive maneuvers performed to protect adjacent structures included hydrodissection ( = 40), ureteral stenting ( = 3), and neural monitoring ( = 3). There were two Society of Interventional Radiology major complications (3%): pneumothorax ( = 1) and bleeding ( = 1). Local tumor control was achieved in treatment of 53 of 65 (82%) nodal metastases within a median of 25 months (range, 1-121 months) of follow-up. Local progression occurred in 12 of 65 cases (18%); the median time to recurrence was 11 months. Percutaneous cryoablation of nodal metastases is feasible and safe. Further investigation is warranted to assess the long-term efficacy of this technique and to define its role in oncologic care.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2214/AJR.20.22861DOI Listing
July 2021

Combining structured and unstructured data in EMRs to create clinically-defined EMR-derived cohorts.

BMC Med Inform Decis Mak 2021 03 8;21(1):91. Epub 2021 Mar 8.

Department of Cardiology, Concord Hospital, Sydney, Australia.

Background: There have been few studies describing how production EMR systems can be systematically queried to identify clinically-defined populations and limited studies utilising free-text in this process. The aim of this study is to provide a generalisable methodology for constructing clinically-defined EMR-derived patient cohorts using structured and unstructured data in EMRs.

Methods: Patients with possible acute coronary syndrome (ACS) were used as an exemplar. Cardiologists defined clinical criteria for patients presenting with possible ACS. These were mapped to data tables within the production EMR system creating seven inclusion criteria comprised of structured data fields (orders and investigations, procedures, scanned electrocardiogram (ECG) images, and diagnostic codes) and unstructured clinical documentation. Data were extracted from two local health districts (LHD) in Sydney, Australia. Outcome measures included examination of the relative contribution of individual inclusion criteria to the identification of eligible encounters, comparisons between inclusion criterion and evaluation of consistency of data extracts across years and LHDs.

Results: Among 802,742 encounters in a 5 year dataset (1/1/13-30/12/17), the presence of an ECG image (54.8% of encounters) and symptoms and keywords in clinical documentation (41.4-64.0%) were used most often to identify presentations of possible ACS. Orders and investigations (27.3%) and procedures (1.4%), were less often present for identified presentations. Relevant ICD-10/SNOMED CT codes were present for 3.7% of identified encounters. Similar trends were seen when the two LHDs were examined separately, and across years.

Conclusions: Clinically-defined EMR-derived cohorts combining structured and unstructured data during cohort identification is a necessary prerequisite for critical validation work required for development of real-time clinical decision support and learning health systems.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12911-021-01441-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7938556PMC
March 2021

Wages, Travel and Lodging Reimbursement by the National Kidney Registry: An Important Step Towards Financial Neutrality for Living Kidney Donors in the United States.

Transplantation 2021 Feb 23. Epub 2021 Feb 23.

Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA Division of Nephrology, University of California - Los Angeles, CA, USA Terasaki Institute of Biomedical Innovation, Los Angeles, CA, USA UW Health, Madison, WI, USA Allegheny General Hospital, Pittsburgh, PA, USA MedStar Georgetown Transplant Institute, Washington, DC, USA.

Background: Since 2007, the National Living Donor Assistance Center has provided the most financial support to US living donors meeting specific income criteria by reimbursing travel, meal and lodging expenses. In 2019, the National Kidney Registry (NKR) started providing lost wages, travel and lodging reimbursement via their Donor Shield program. Donor Shield is automatically provided to donors who participate in kidney paired donation through the NKR or who donate at a Donor Shield Direct center, without any income restrictions.

Methods: The support donors across the US received from the Donor Shield program between January 2019 and February 2020 was studied.

Results: During the study period, 326 (25.9%) of the 1,260 donors covered by Donor Shield, from 46 programs received reimbursements amounting to a total of $647,384.45, with $472,389.97 (73.0%) covering lost wages. Median reimbursement per donor was $1,813.80 (range: $44.0 - $ 7,165.63). 81% of 108 reimbursed donors who were surveyed reported that the lack of these reimbursements would have posed a financial hardship, and 4% said they would have been unable to donate without this support.

Conclusions: Expansion of lost wages reimbursement programs to all donors in the US would be an important step towards achieving financial neutrality for this unique population, and could also help meet the growing demand for transplantable organs by increasing living donation rates.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/TP.0000000000003721DOI Listing
February 2021

A portrait of the early and differential mental health impacts of the COVID-19 pandemic in Canada: Findings from the first wave of a nationally representative cross-sectional survey.

Prev Med 2021 04 26;145:106333. Epub 2021 Jan 26.

School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, British Columbia V6T 1Z3, Canada; Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, 5881-1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada; The Human Early Learning Partnership, University of British Columbia, Suite 440, 2206 East Mall, Vancouver, British Columbia V6T 1Z3, Canada. Electronic address:

Evidence on the population-level mental health impacts of COVID-19 are beginning to amass; however, to date, there are significant gaps in our understandings of whose mental health is most impacted, how the pandemic is contributing to widening mental health inequities, and the coping strategies being used to sustain mental health. The first wave of a repeated cross-sectional monitoring survey was conducted between May 14-29, 2020 to assess the mental health impacts of the pandemic and to identify the disproportionate impacts on populations or groups identified as experiencing increased risks due to structural vulnerability and pre-existing health and social inequities. Respondents included a nationally representative probability sample (n = 3000) of Canadian adults 18 years and older. Overall, Canadian populations are experiencing a deterioration in mental health and coping due to the pandemic. Those who experience health, social, and/or structural vulnerabilities due to pre-existing mental health conditions, disability, income, ethnicity, sexuality, and/or gender are more likely to endorse mental health deterioration, challenging emotions, and difficulties coping. This monitoring study highlights the differential mental health impacts of the pandemic for those who experience health, social, and structural inequities. These data are critical to informing responsive, equity-oriented public health, and policy responses in real-time to protect and promote the mental health of those most at risk during the pandemic and beyond.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ypmed.2020.106333DOI Listing
April 2021

Protocol for probiotic therapy vs placebo for preterm prelabour rupture of membranes to prolong pregnancy duration (Pro-PPROM) trial.

Aust N Z J Obstet Gynaecol 2021 04 23;61(2):E12-E17. Epub 2021 Jan 23.

Sydney Medical School Northern, The University of Sydney, Sydney, New South Wales, Australia.

Background: Preterm prelabour rupture of membranes (PPROM) is a common preterm birth antecedent. Preterm infants experience increased adverse newborn outcome risks. Infection is a risk factor for early birth in PPROM. Current management is antibiotic therapy, antenatal corticosteroids and to plan delivery at 37 weeks gestation. The microbiota and probiotics are potentially protective and may improve outcomes.

Aims: The primary aim is to evaluate whether oral probiotic therapy (Lactobacillus fermentum CECT5716) administered during PPROM between 24 and 34 weeks gestation prolongs pregnancy duration. The secondary aim is to evaluate maternal and neonatal outcomes.

Materials And Methods: This is a pragmatic, multicentre, double-blind, placebo-controlled randomised controlled trial in Australia. The population will be women with a singleton pregnancy and PPROM less than 34 weeks gestation. The intervention will be an oral probiotic therapy compared with a placebo control. The primary outcome will be the proportion of women still pregnant at seven days following PPROM. One-to-one randomisation will occur within 24 h of PPROM. The trial is powered (80%, alpha = 0.05) to detect an absolute percentage increase in the primary outcome of 30%, (from expected rate of 20% up to 50%).

Discussion: This trial will provide evidence for the effectiveness of the probiotic in prolonging pregnancy duration. Findings will inform the feasibility of a larger trial to examine the effect of oral probiotics on clinically important maternal and neonatal outcomes in PPROM.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ajo.13313DOI Listing
April 2021

Diagnostic Yield of Lateral Decubitus Digital Subtraction Myelogram Stratified by Brain MRI Findings.

Neurology 2021 03 20;96(9):e1312-e1318. Epub 2021 Jan 20.

From the Departments of Radiology (D.K.K., C.M.C., J.C.B., F.E.D., V.T.L., G.B.L., J.M.M., P.P.M., J.T.V., W.B.), Neurology (J.K.C.-G.), and Neurosurgery (J.D.A.), Mayo Clinic, Rochester, MN.

Objective: To assess the diagnostic yield of lateral decubitus digital subtraction myelography (LDDSM) and stratify LDDSM diagnostic yield by the Bern spontaneous intracranial hypotension (SIH) score of preprocedure brain MRI.

Methods: This retrospective diagnostic study included consecutive adult patients investigated for SIH who underwent LDDSM. Patients without preprocedure brain and spine MRI and patients with extradural fluid collection on spine MRI (type 1 leak) were excluded. LDDSM images and brain MRIs were assessed by 2 independent blinded readers; a third reader adjudicated any discrepancies. Diagnostic yield of LDDSM was assessed, both overall and stratified by Bern SIH scoring.

Results: Of the 62 patients included in this study, 33 (53.2%) had a CSF leak identified on LDDSM. Right-sided leaks were more common (70.6%), and the most commonly identified levels of leaks were at T6, T7, and T10. No leak was found in any of the 9 patients with Bern SIH score of 2 or less. Of the 11 patients with Bern SIH score of 3-4, 5 (45.5%) had a CSF leak identified; of the 42 patients with Bern SIH score of 5 or higher, 28 (66.7%) had a CSF leak identified.

Conclusions: LDDSM has a high diagnostic yield for finding the exact location of spinal CSF leak, and the diagnostic yield increases with higher Bern SIH score. No leaks were found in patients with Bern SIH score of 2 or less, suggesting that foregoing invasive testing such as LDDSM in these patients may be appropriate unless accompanied by high clinical suspicion.

Classification Of Evidence: This study provides Class II evidence that for patients with suspected SIH, higher Bern SIH scores are associated with a greater likelihood of LDDSM-identified CSF leaks.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1212/WNL.0000000000011522DOI Listing
March 2021

A multi-centre, open label, randomised, parallel-group, superiority Trial to compare the efficacy of URsodeoxycholic acid with RIFampicin in the management of women with severe early onset Intrahepatic Cholestasis of pregnancy: the TURRIFIC randomised trial.

BMC Pregnancy Childbirth 2021 Jan 12;21(1):51. Epub 2021 Jan 12.

Obstetrics and Gynaecology, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Derby Rd, Nottingham, NG7 2UH, UK.

Background: Severe early onset (less than 34 weeks gestation) intrahepatic cholestasis of pregnancy (ICP) affects 0.1% of pregnant women in Australia and is associated with a 3-fold increased risk of stillbirth, fetal hypoxia and compromise, spontaneous preterm birth, as well as increased frequencies of pre-eclampsia and gestational diabetes. ICP is often familial and overlaps with other cholestatic disorders. Treatment options for ICP are not well established, although there are limited data to support the use of ursodeoxycholic acid (UDCA) to relieve pruritus, the main symptom. Rifampicin, a widely used antibiotic including in pregnant women, is effective in reducing pruritus in non-pregnancy cholestasis and has been used as a supplement to UDCA in severe ICP. Many women with ICP are electively delivered preterm, although there are no randomised data to support this approach.

Methods: We have initiated an international multicentre randomised clinical trial to compare the clinical efficacy of rifampicin tablets (300 mg bd) with that of UDCA tablets (up to 2000 mg daily) in reducing pruritus in women with ICP, using visual pruritus scores as a measuring tool.

Discussion: Our study will be the first to examine the outcomes of treatment specifically in the severe early onset form of ICP, comparing "standard" UDCA therapy with rifampicin, and so be able to provide for the first-time high-quality evidence for use of rifampicin in severe ICP. It will also allow an assessment of feasibility of a future trial to test whether elective early delivery in severe ICP is beneficial.

Trial Identifiers: Australian New Zealand Clinical Trials Registration Number (ANZCTR): 12618000332224p (29/08/2018). HREC No: HREC/18/WCHN/36. EudraCT number: 2018-004011-44. IRAS: 272398. NHMRC registration: APP1152418 and APP117853.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12884-020-03481-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802989PMC
January 2021

Pollen production for 13 urban North American tree species: Allometric equations for tree trunk diameter and crown area.

Aerobiologia (Bologna) 2020 Sep 7;36(3):401-415. Epub 2020 Apr 7.

School of Public Health, University of Michigan - Ann Arbor, MI, USA.

Estimates of airborne pollen concentrations at the urban scale would be useful for epidemiologists, land managers, and allergy sufferers. Mechanistic models could be well suited for this task, but their development will require data on pollen production across cities, including estimates of pollen production by individual trees. In this study, we developed predictive models for pollen production as a function of trunk size, canopy area, and height, which are commonly recorded in tree surveys or readily extracted from remote sensing data. Pollen production was estimated by measuring the number of flowers per tree, the number of anthers per flower, and the number of pollen grains per anther. Variability at each morphological scale was assessed using bootstrapping. Pollen production was estimated for the following species: x and Basal area predicted pollen production with a mean R of 0.72 (range: 0.41 - 0.99), whereas canopy area predicted pollen production with a mean R of 0.76 (range: 0.50 - 0.99). These equations are applied to two tree datasets to estimate total municipal pollen production and the spatial distribution of street tree pollen production for the focal species. We present some of the first individual-tree based estimates of pollen production at the municipal scale; the observed spatial heterogeneity in pollen production is substantial and can feasibly be included in mechanistic models of airborne pollen at fine spatial scales.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10453-020-09638-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748260PMC
September 2020

Protocol for the development and validation of a risk prediction model for stillbirths from 35 weeks gestation in Australia.

Diagn Progn Res 2020 Dec 16;4(1):21. Epub 2020 Dec 16.

NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute - University of Queensland, Level 3 Aubigny Place, Brisbane, 4101, Australia.

Background: Despite advances in the care of women and their babies in the past century, an estimated 1.7 million babies are born still each year throughout the world. A robust method to estimate a pregnant woman's individualized risk of late-pregnancy stillbirth is needed to inform decision-making around the timing of birth to reduce the risk of stillbirth from 35 weeks of gestation in Australia, a high-resource setting.

Methods: This is a protocol for a cross-sectional study of all late-pregnancy births in Australia (2005-2015) from 35 weeks of gestation including 5188 stillbirths among 3.1 million births at an estimated rate of 1.7 stillbirths per 1000 births. A multivariable logistic regression model will be developed in line with current Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD) guidelines to estimate the gestation-specific probability of stillbirth with prediction intervals. Candidate predictors were identified from systematic reviews and clinical consultation and will be described through univariable regression analysis. To generate a final model, elimination by backward stepwise multivariable logistic regression will be performed. The model will be internally validated using bootstrapping with 1000 repetitions and externally validated using a temporally unique dataset. Overall model performance will be assessed with R, calibration, and discrimination. Calibration will be reported using a calibration plot with 95% confidence intervals (α = 0.05). Discrimination will be measured by the C-statistic and area underneath the receiver-operator curves. Clinical usefulness will be reported as positive and negative predictive values, and a decision curve analysis will be considered.

Discussion: A robust method to predict a pregnant woman's individualized risk of late-pregnancy stillbirth is needed to inform timely, appropriate care to reduce stillbirth. Among existing prediction models designed for obstetric use, few have been subject to internal and external validation and many fail to meet recommended reporting standards. In developing a risk prediction model for late-gestation stillbirth with both providers and pregnant women in mind, we endeavor to develop a validated model for clinical use in Australia that meets current reporting standards.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s41512-020-00089-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7739473PMC
December 2020

Pregnancy outcomes for women with a history of stroke: A population-based record linkage study.

Aust N Z J Obstet Gynaecol 2021 04 12;61(2):239-243. Epub 2020 Nov 12.

Women and Babies Research, The University of Sydney Northern Clinical School, Sydney, New South Wales, Australia.

Background: Little is known about the pregnancy outcomes of women who have had a stroke prior to a first pregnancy.

Aim: To identify a cohort of primiparous women giving birth to a single baby and compare the pregnancy outcomes of those with a pre-pregnancy stroke hospitalisation record to those without a stroke hospitalisation record.

Materials And Methods: Record linkage study of all primiparous women aged 15-44 years with singleton pregnancies birthing in New South Wales, Australia from 2003 to 2015. Stroke was identified from 2001 to 2015 hospital data using International Classification of Diseases tenth Edition - Australian Modification codes I60-64. Women whose first hospital record of stroke was during pregnancy or <42 days after birth were excluded. Outcomes included diabetes or hypertension during pregnancy, mode of delivery, haemorrhage, severe maternal morbidity (validated composite outcome indicator), gestational age at birth, Apgar score (1 min < 7), and small-for-gestational age.

Results: Of 487 767 women with a first pregnancy, 124 (2.5/10 000) had a hospital record which included a pre-pregnancy stroke diagnosis. Women with a stroke history were more likely to have an early-term delivery (37-38 weeks; relative risk (RR) 1.49, 95% CI 1.17-1.90) and a pre-labour caesarean (RR 2.83, 95% CI 2.20-3.63). There were no significant differences in other maternal or neonatal outcomes.

Conclusion: This is the largest reported study of pregnancy and birth outcomes for women with a history of stroke. With the exception of pre-labour caesarean, there were no differences in pregnancy outcomes for women with a history of stroke compared with women with no history of stroke.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ajo.13267DOI Listing
April 2021

Complex Roles of PsbS and Xanthophylls in the Regulation of Nonphotochemical Quenching in under Fluctuating Light.

J Phys Chem B 2020 11 9;124(46):10311-10325. Epub 2020 Nov 9.

Department of Chemistry, University of California, Berkeley, California 94720, United States.

Protection of photosystem II against damage from excess light by nonphotochemical quenching (NPQ) includes responses on a wide range of timescales. The onset of the various phases of NPQ overlap in time making it difficult to discern if they influence each other or involve different photophysical mechanisms. To unravel the complex relationship of the known actors in NPQ, we perform fluorescence lifetime snapshot measurements throughout multiple cycles of alternating 2 min periods of high light and darkness. By comparing the data with an empirically based mathematical model that describes both fast and slow quenching responses, we suggest that the rapidly reversible quenching response depends on the state of the slower response. By studying a series of mutants, we find that removing zeaxanthin (Zea) or enhancing PsbS concentration, for example, influences the amplitudes of the slow quenching induction and recovery, but not the timescales. The plants' immediate response to high light appears independent of the illumination history, while PsbS and Zea have distinct roles in both quenching and recovery. We further identify two parameters in our model that predominately influence the recovery amplitude and propose that our approach may prove useful for screening new mutants or overexpressors with enhanced biomass yields under field conditions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1021/acs.jpcb.0c06265DOI Listing
November 2020

Three-Dimensional-Printed Liver Model Helps Learners Identify Hepatic Subsegments: A Randomized-Controlled Cross-Over Trial.

Am J Gastroenterol 2020 11;115(11):1906-1910

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.

Introduction: The purpose of this study was to find out whether 3-dimensional (3D)-printed models improved the learners' ability to identify liver segments.

Methods: A total of 116 physicians from 3 disciplines were tested in a cross-over trial at baseline and after teaching with 3D models and 2-dimensional (2D) images. Adjusted multilevel-mixed models were used to compare scores at baseline and after 3D and 2D.

Results: Accuracy in identifying hepatic segments was higher with 3D first than 2D (77% vs 69%; P = 0.05) and not significantly improved by a combination of 3D and 2D. Increased confidence in segment identification was highest in trainees after 3D (P = 0.04).

Discussion: 3D-printed models facilitate learning hepatic segmental anatomy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14309/ajg.0000000000000958DOI Listing
November 2020

Self-reported symptoms from exposure to Covid-19 provide support to clinical diagnosis, triage and prognosis: An exploratory analysis.

Travel Med Infect Dis 2020 Nov - Dec;38:101909. Epub 2020 Nov 3.

Health Care Solutions, IQVIA, USA.

Background: Symptomatic COVID-19 is prevalent in the community. We identify factors indicating COVID-19 positivity in non-hospitalized patients and prognosticators of moderate-to-severe disease.

Methods: Appeals conducted in April-June 2020 in social media, collaborating medical societies and patient advocacy groups recruited 20,476 participants ≥18 years who believed they had COVID-19 exposure. Volunteers consented on-line and reported height, weight, concomitant illnesses, medication and supplement use, residential, occupational or community COVID-19 exposure, symptoms and symptom severity on a 4-point scale. Of the 12,117 curated analytic population 2279 reported a COVID-19 viral test result: 865 positive (COVID+) and 1414 negative (COVID-).

Results: The triad of anosmia, ageusia and fever best distinguished COVID+ from COVID-participants (OR 6.07, 95% CI: 4.39 to 8.47). COVID + subjects with BMI≥30, concomitant respiratory disorders or an organ transplant had increased risk of moderate-to- severe dyspnoea. Race and anti-autoimmunity medication did not affect moderate-to-severe dyspnea risk.

Conclusions: The triad of anosmia, ageusia and fever differentiates COVID-19. Elevated risks of severe symptoms outside the hospital were most evident among the obese and those with pulmonary comorbidity. Race and use of medication for autoimmune disease did not predict severe disease. These findings should facilitate rapid COVID-19 diagnosis and triage in settings without testing.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.tmaid.2020.101909DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7606076PMC
January 2021

Radiofrequency Ablation for the Palliative Treatment of Bone Metastases: Outcomes from the Multicenter OsteoCool Tumor Ablation Post-Market Study (OPuS One Study) in 100 Patients.

J Vasc Interv Radiol 2020 Nov;31(11):1745-1752

Department of Interventional Radiology, Prostate Centers USA, LLC, Vascular Interventional Partners NOVA, 2755 Hartland Road, Falls Church, VA 22043. Electronic address:

Purpose: To evaluate the effectiveness of radiofrequency (RF) ablation as measured by change in worst pain score from baseline to 3 mo after RF ablation for the palliative treatment of painful bone metastases.

Materials And Methods: One hundred patients (mean age, 64.6 y) underwent RF ablation for metastatic bone disease and were followed up to 6 mo. Subjects' pain and quality of life were measured before RF ablation and postoperatively by using the Brief Pain Index and European Quality of Life questionnaires. Opioid agent use and device-, procedure-, and/or therapy-related adverse events (AEs) were collected.

Results: Eighty-seven patients were treated for tumors involving the thoracolumbar spine and 13 for tumors located in the pelvis and/or sacrum. All ablations were technically successful, and 97% were followed by cementoplasty. Mean worst pain score decreased from 8.2 ± 1.7 at baseline to 3.5 ± 3.2 at 6 mo (n = 22; P < 0.0001 for all visits). Subjects experienced significant improvement for all visits in average pain (P < .0001), pain interference (P < .0001), and quality of life (P < .003). Four AEs were reported, of which 2 resulted in hospitalization for pneumonia and respiratory failure. All 30 deaths reported during the study were attributed to the underlying malignancy and not related to the study procedure.

Conclusions: Results from this study show rapid (within 3 d) and statistically significant pain improvement with sustained long-term relief through 6 mo in patients treated with RF ablation for metastatic bone disease.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jvir.2020.07.014DOI Listing
November 2020

Stillbirth in Australia 5: Making respectful care after stillbirth a reality: The quest for parent-centred care.

Women Birth 2020 Nov;33(6):531-536

Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Australia.

Stillbirth is a tragedy that can leave parents feeling powerless and vulnerable. Respectful and supportive bereavement care is essential to reducing adverse psychosocial impact. Initiatives of the Australian Centre of Research Excellence in Stillbirth are designed to improve care after stillbirth. At their heart are the voices of perinatally bereaved parents and support organisations and shared decision making between parents and health care providers. Priorities in future perinatal bereavement care research include ensuring appropriate care for population groups who experience higher rates of stillbirth and addressing implementation challenges to best practice in respectful and supportive bereavement care within our health systems.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.wombi.2020.08.006DOI Listing
November 2020

Stillbirth in Australia 1: The road to now: Two decades of stillbirth research and advocacy in Australia.

Women Birth 2020 Nov;33(6):506-513

NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute - The University of Queensland (MRI-UQ), South Brisbane, Australia; International Stillbirth Alliance, Australia; Griffith University and Gold Coast University Hospital, Gold Coast, Australia.

Stillbirth is a major public health problem with an enormous mortality burden and psychosocial impact on parents, families and the wider community both globally and in Australia. In 2015, Australia's late gestation stillbirth rate was over 30% higher than that of the best-performing countries globally, highlighting the urgent need for action. We present an overview of the foundations which led to the establishment of Australia's NHMRC Centre of Research Excellence in Stillbirth (Stillbirth CRE) in 2017 and highlight key activities in the following areas: Opportunities to expand and improve collaborations between research teams; Supporting the conduct and development of innovative, high quality, collaborative research that incorporates a strong parent voice; Promoting effective translation of research into health policy and/or practice; and the Regional and global work of the Stillbirth CRE. We highlight the first-ever Senate Inquiry into Stillbirth in Australia in 2018. These events ultimately led to the development of a National Stillbirth Action and Implementation Plan for Australia with the aims of reducing stillbirth rates by 20% over the next five years, reducing the disparity in stillbirth rates between advantaged and disadvantaged communities, and improving care for all families who experience this loss.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.wombi.2020.09.005DOI Listing
November 2020

A Case Series of Long-Term Surgical Outcomes of Primary Pulmonary Artery Sarcomas With Opportunities for 3D-Printed Models in Surgical Planning.

Innovations (Phila) 2021 Jan-Feb;16(1):94-100. Epub 2020 Oct 20.

12346 Division of General Thoracic Surgery, Mayo Clinic, Rochester, MN, USA.

There are limited data regarding the surgical management of primary pulmonary artery sarcomas (PPAS) because of their rarity and complicated diagnostic history. The objective of this study was to analyze our institution's long-term surgical management outcomes for PPAS in the absence of a care pathway. From May 1997 to June 2013, 8 patients (mean age 60.6 ± 11.8 years; range, 40-73 years; 5 women and 3 men) underwent surgical intervention for PPAS at our institution. The most common computed tomography finding was a luminal filling defect obstructing the pulmonary artery (PA), without evidence of extraluminal extension. Three patients underwent debulking/pulmonary endarterectomy alone and 5 patients underwent a more radical resection with PA patch angioplasty, PA resection and reconstruction, pulmonary valve replacement, and unilateral pneumonectomy. The mean postoperative survival in this series was 3.8 ± 3.6 years (range, 1-11.9 years), with 2 radical surgical resection patients alive at 4.9 and 11.9 years, respectively. For those patients with incomplete resection, 3-dimensional (3D) models were created to demonstrate the advantage of a preoperative guide for a more complete resection and what it would entail. Six patients had local recurrences with mean disease-free interval of 14 ± 10.9 months (range, 2 months-2.5 years), and 2 patients with re-resections had an overall postoperative survival of 2.8 and 11.9 years, respectively. In our small cohort of PPAS, patients treated with radical surgical resection had better survival. The small number of PPAS cases in this series makes proving this association unlikely but warrants consideration.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1556984520960716DOI Listing
October 2020

Exploring a role for fatty acid synthase in prostate cancer cell migration.

Small GTPases 2021 Jul 12;12(4):265-272. Epub 2020 Oct 12.

School of Cancer and Pharmaceutical Sciences, Kings College London, London, UK.

Fatty acid synthase (FASN) is commonly overexpressed in prostate cancer and associated with tumour progression. FASN is responsible for synthesis of the fatty acid palmitate; the building block for protein palmitoylation. A functional role for FASN in regulating cell proliferation is widely accepted. We recently reported that FASN activity can also mediate prostate cancer HGF-mediated cell motility. Moreover, we found that modulation of FASN expression specifically impacts on the palmitoylation of RhoU. Findings we will describe here. We now report that loss of FASN expression also impairs HGF-mediated cell dissociation responses. Taken together our results provide compelling evidence that FASN activity directly promotes cell migration and supports FASN as a potential therapeutic target in metastatic prostate cancer.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/21541248.2020.1826781DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8205051PMC
July 2021

Rates of neonatal morbidity by maternal region of birth and gestational age in New South Wales, Australia 2003-2016.

Acta Obstet Gynecol Scand 2021 02 22;100(2):331-338. Epub 2020 Oct 22.

Women and Babies Research, The University of Sydney Northern Clinical School, St Leonards, NSW, Australia.

Introduction: Research suggests that neonatal morbidity differs by maternal region of birth at different gestational ages. This study aimed to determine the overall and gestation-specific risk of neonatal morbidity by maternal region of birth, after adjustment for maternal, infant and birth characteristics, for women giving birth in New South Wales, Australia, from 2003 to 2016.

Material And Methods: The study utilized a retrospective cohort study design using linked births, hospital and deaths data. Modified Poisson regression was used to determine risk with 95% confidence intervals (95% CI) of neonatal morbidity by maternal region of birth, overall and at each gestational age, compared with Australian or New Zealand-born women giving birth at 39 weeks.

Results: There were 1 074 930 live singleton births ≥32 weeks' gestation that met the study inclusion criteria, and 44 394 of these were classified as morbid, giving a neonatal morbidity rate of 4.13 per 100 live births. The gestational age-specific neonatal morbidity rate declined from 32 weeks' gestation, reaching a minimum at 39 weeks in all maternal regions of birth. The unadjusted neonatal morbidity rate was highest in South Asian-born women at most gestations. Adjusted rates of neonatal morbidity between 32 and 44 weeks were significantly lower for babies born to East (adjusted relative risk [aRR] 0.65, 95% CI 0.62-0.68), South-east (aRR 0.76, 95% CI 0.73-0.79) and West Asian-born (aRR 0.93, 95% CI 0.88-0.98) mothers, and higher for babies of Oceanian-born (aRR 1.11, 95% CI 1.04-1.18) mothers, compared with Australian or New Zealand-born mothers. Babies of African, Oceanian, South Asian and West Asian-born women had a lower adjusted risk of neonatal morbidity than Australian or New Zealand-born women until 37 or 38 weeks' gestation, and thereafter an equal or higher risk in the term and post-term periods.

Conclusions: Maternal region of birth is an independent risk factor for neonatal morbidity in New South Wales.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/aogs.14012DOI Listing
February 2021
-->