Publications by authors named "M A Stevenson"

1,657 Publications

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Structural anatomy and morphometric analyses of sacra in greyhounds.

Anat Histol Embryol 2021 Jun 9. Epub 2021 Jun 9.

Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Vic., Australia.

This study was conducted to provide structural and morphological data on the sacra of greyhounds. Descriptive quantitative investigation was carried out on 171 sacra of greyhound`s cadavers and then classified into standard and fused sacra based on the number of fused sacral vertebrae. The weight, length and width of sacrum of sacra were measured. Both standard (59%) and fused sacra (41%) were identified. The average length and width of the standard sacrum were found to be 46.14 ± 2.53 mm and 57.89 ± 3.54 mm, respectively. The sacral length was 1.61-mm longer in males (p < .01), and the sacral width was 0.46-mm shorter in males but not significant (p = .51). The average weight of a standard sacrum was 26.54 ± 4.55 g and was 1.18 g heavier in males but not statistically significant (p = .24). Results showed that one-kilogram increase in the body mass was associated with a 0.3 mm (p < .001) increase in sacral length, and a 0.54 mm (p < .001) increase in sacral width, respectively. The morphological data of the standard and fused sacra provided in this study might help the veterinary community to improve treatment and rehabilitation and help the trainer to design the right training protocol for racing greyhounds. In addition, the results of this study are a step to understand the sacrum's functions and how the greyhound's body functions and future studies are required to investigate the biological importance of these findings.
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http://dx.doi.org/10.1111/ahe.12677DOI Listing
June 2021

Medicinal cannabis and driving: the intersection of health and road safety policy.

Int J Drug Policy 2021 Jun 6;97:103307. Epub 2021 Jun 6.

Behaviours and Health Risks Program, Burnet Institute, Melbourne, VIC 3004, Australia. National Drug Research Institute, Curtin University, Melbourne, VIC 3004, Australia.

Background: Recent shifting attitudes towards the medical use of cannabis has seen legal access pathways established in many jurisdictions in North America, Europe and Australasia. However, the positioning of cannabis as a legitimate medical product produces some tensions with other regulatory frameworks. A notable example of this is the so-called 'zero tolerance' drug driving legal frameworks, which criminalise the presence of THC (tetrahydrocannabinol) in a driver's bodily fluids irrespective of impairment. Here we undertake an analysis of this policy issue based on a case study of the introduction of medicinal cannabis in Australia.

Methods: We examine the regulatory approaches used for managing road safety risks associated with potentially impairing prescription medicines and illicit drugs in Australian jurisdictions, as well as providing an overview of evidence relating to cannabis and road safety risk, unintended impacts of the 'zero-tolerance' approach on patients, and the regulation of medicinal cannabis and driving in comparable jurisdictions.

Results: Road safety risks associated with medicinal cannabis appear similar or lower than numerous other potentially impairing prescription medications. The application of presence-based offences to medicinal cannabis patients appears to derive from the historical status of cannabis as a prohibited drug with no legitimate medical application. This approach is resulting in patient harms including criminal sanctions when not impaired and using the drug as directed by their doctor, or the forfeiting of car use and related mobility. Others who need to drive are excluded from accessing a needed medication and associated therapeutic benefit. 'Medical exemptions' for medicinal cannabis in comparable jurisdictions and other drugs included in presence offences in Australia (e.g. methadone) demonstrate a feasible alternative approach.

Conclusion: We conclude that in medical-only access models there is little evidence to justify the differential treatment of medicinal cannabis patients, compared with those taking other prescription medications with potentially impairing effects.
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http://dx.doi.org/10.1016/j.drugpo.2021.103307DOI Listing
June 2021

Racial differences in sun-protective behaviors: a retrospective, cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) 2003-2018.

J Am Acad Dermatol 2021 May 28. Epub 2021 May 28.

The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2021.05.031DOI Listing
May 2021

Association Between Bitter Taste Receptor Phenotype and Clinical Outcomes Among Patients With COVID-19.

JAMA Netw Open 2021 05 3;4(5):e2111410. Epub 2021 May 3.

Rhinology and Skull Base Research Group, Baton Rouge General Medical Center, Baton Rouge, Louisiana.

Importance: Bitter taste receptors (T2Rs) have been implicated in sinonasal innate immunity, and genetic variation conferred by allelic variants in T2R genes is associated with variation in upper respiratory tract pathogen susceptibility, symptoms, and outcomes. Bitter taste receptor phenotype appears to be associated with the clinical course and symptom duration of SARS-CoV-2 infection.

Objective: To evaluate the association between T2R phenotype and patient clinical course after infection with SARS-CoV-2.

Design, Setting, And Participants: A prospective cohort study was performed from July 1 through September 30, 2020, at a tertiary outpatient clinical practice and inpatient hospital in the United States among 1935 participants (patients and health care workers) with occupational exposure to SARS-CoV-2.

Exposure: Exposure to SARS-CoV-2.

Main Outcomes And Measures: Participants underwent T2R38 phenotype taste testing to determine whether they were supertasters (those who experienced greater intensity of bitter tastes), tasters, or nontasters (those who experienced low intensity of bitter tastes or no bitter tastes) and underwent evaluation for lack of infection with SARS-CoV-2 via polymerase chain reaction (PCR) testing and IgM and IgG testing. A group of participants was randomly selected for genotype analysis to correlate phenotype. Participants were followed up until confirmation of infection with SARS-CoV-2 via PCR testing. Phenotype of T2R38 was retested after infection with SARS-CoV-2. The results were compared with clinical course.

Results: A total of 1935 individuals (1101 women [56.9%]; mean [SD] age, 45.5 [13.9] years) participated in the study. Results of phenotype taste testing showed that 508 (26.3%) were supertasters, 917 (47.4%) were tasters, and 510 (26.4%) were nontasters. A total of 266 participants (13.7%) had positive PCR test results for SARS-CoV-2. Of these, 55 (20.7%) required hospitalization. Symptom duration among patients with positive results ranged from 0 to 48 days. Nontasters were significantly more likely than tasters and supertasters to test positive for SARS-CoV-2 (odds ratio, 10.1 [95% CI, 5.8-17.8]; P < .001), to be hospitalized once infected (odds ratio, 3.9 [1.5-10.2]; P = .006), and to be symptomatic for a longer duration (mean [SE] duration, 23.7 [0.5] days vs 13.5 [0.4] days vs 5.0 [0.6] days; P < .001). A total of 47 of 55 patients (85.5%) with COVID-19 who required inpatient admission were nontasters. Conversely, 15 of 266 patients (5.6%) with positive PCR test results were supertasters.

Conclusions And Relevance: This cohort study suggests that T2R38 receptor allelic variants were associated with participants' innate immune response toward SARS-CoV-2. The T2R phenotype was associated with patients' clinical course after SARS-CoV-2 infection. Nontasters were more likely to be infected with SARS-CoV-2 than the other 2 groups, suggesting enhanced innate immune protection against SARS-CoV-2.
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http://dx.doi.org/10.1001/jamanetworkopen.2021.11410DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8150696PMC
May 2021

Skin Cancers and Lung Transplant.

Semin Respir Crit Care Med 2021 Jun 24;42(3):483-496. Epub 2021 May 24.

The Ronald O. Perelman Department of Dermatology, NYU Langone Health, New York, New York.

It is well known that solid-organ transplant recipients (SOTRs) have a 65- to 100-fold increase in the risk of developing skin cancer, namely, nonmelanoma skin cancers (NMSCs) such as cutaneous squamous cell carcinoma (cSCC) and basal cell carcinoma (BCC). In addition, these patients are also at increased risk for development of melanoma as well as other less common cutaneous malignancies (Merkel's cell carcinoma, Kaposi's sarcoma). SOTRs with NMSC (namely cSCC) are also at significantly increased risk of poor clinical outcomes including local recurrence, nodal and distant metastasis, and disease-specific death relative to patients who are not immunosuppressed. Increased surveillance and monitoring in patients at risk of aggressive disease and poor outcomes who are on immunosuppression is essential in patients with lung transplants given the high degree of immunosuppression. Increased awareness of risks, treatments, and management allows for improved outcomes in these patients. This article will provide an overview of the risk factors for the development of cutaneous malignancies in organ transplant recipients as well as a detailed discussion of various immunosuppressant and prophylactic medications used in this patient population that contribute to the risk of developing cutaneous malignancies, with an emphasis on NMSC (cSCC and BCC) in lung transplant recipients. Finally, this article includes a discussion on the clinical and dermatologic management of this high-risk immunosuppressed population including a review of topical and systemic agents for field therapy of actinic damage and chemoprevention of keratinocyte carcinomas. In addition, indications for additional treatment and preventive measures such as adjuvant radiation treatment after surgical management of cutaneous malignancies and potential modification of immunosuppressive medication regimens are discussed.
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http://dx.doi.org/10.1055/s-0041-1728798DOI Listing
June 2021