Publications by authors named "Thomas Curran"

70 Publications

Differential immune signatures in the tumor microenvironment are associated with colon cancer racial disparities.

Cancer Med 2021 Mar 9;10(5):1805-1814. Epub 2021 Feb 9.

Department of Surgery, Baylor College of Medicine, Houston, TX, USA.

Background: Disparities in colon cancer (CC) outcomes may be due to a more aggressive phenotype in African American patients in the setting of a decreased tumor immunity, though the precise mechanism for this result has not been well elucidated. To explore the molecular factors underlying CC disparities, we compared the immunogenomic signatures of CC from African American and European American patients.

Methods: We identified all CC patients from the publicly available Cancer Genome Atlas for whom race and survival data are available. Immunophenotype signatures were established for African American and European American patients. Comparisons were made regarding survival and a multivariable linear regression model was created to determine the association of immune cellular components with race. Differential gene expression was also assessed.

Results: Of the 254 patients identified, 58 (23%) were African American and 196 (77%) were European American. African American patients had a decreased progression free survival (p = 0.04). Tumors from African American patients displayed a reduced fraction of macrophages and CD8 T cells and an increased fraction of B cells compared with tumors from European Americans. Differences persisted when controlling for sex, age, and disease stage. Immunostimulatory and immunoinhibitory gene profiles including major histocompatibility complex expression differed by race.

Conclusions: Differences in the tumor immune microenvironment of African American as compared to European American CC specimens may play a role in the survival differences between the groups. These differences may provide targeted therapeutic opportunities.
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http://dx.doi.org/10.1002/cam4.3753DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7940243PMC
March 2021

Biofeedback for Pelvic Floor Disorders.

Clin Colon Rectal Surg 2021 Jan 4;34(1):56-61. Epub 2020 Sep 4.

Department of Surgery, Division of Colon and Rectal Surgery, Medical University of South Carolina, Charleston, South Carolina.

Defecatory disorders can include structural, neurological, and functional disorders in addition to concomitant symptoms of fecal incontinence, functional anorectal pain, and pelvic floor dyssynergia. These disorders greatly affect quality of life and healthcare costs. Treatment for pelvic floor disorders can include medications, botulinum toxin, surgery, physical therapy, and biofeedback. Pelvic floor muscle training for pelvic floor disorders aims to enhance strength, speed, and/or endurance or coordination of voluntary anal sphincter and pelvic floor muscle contractions. Biofeedback therapy builds on physical therapy by incorporating the use of equipment to record or amplify activities of the body and feed the information back to the patients. Biofeedback has demonstrated efficacy in the treatment of chronic constipation with dyssynergic defecation, fecal incontinence, and low anterior resection syndrome. Evidence for the use of biofeedback in levator ani syndrome is conflicting. In comparing biofeedback to pelvic floor muscle training alone, studies suggest that biofeedback is superior therapy.
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http://dx.doi.org/10.1055/s-0040-1714287DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843943PMC
January 2021

Controversies in the Management of Diverticulitis.

Adv Surg 2020 09 31;54:1-16. Epub 2020 May 31.

David Geffen School of Medicine at University of California Los Angeles, 10833 Le Conte Avenue, 72-215 CHS, Los Angeles, CA 90095-3075, USA.

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http://dx.doi.org/10.1016/j.yasu.2020.04.001DOI Listing
September 2020

A Cost-Effectiveness Evaluation of Surgical Approaches to Proctectomy.

J Gastrointest Surg 2020 May 11. Epub 2020 May 11.

Division of Colon and Rectal Surgery, University of Minnesota, Minneapolis, MN, USA.

Background: Robotic surgery is increasingly used for proctectomy, but the cost-effectiveness of this approach is uncertain. Robotic surgery is considered more expensive than open or laparoscopic approaches, but in certain situations has been demonstrated to be cost-effective. We examined the cost-effectiveness of open, laparoscopic, and robotic approaches to proctectomy from societal and healthcare system perspectives.

Methods: We developed a decision-analytic model to evaluate one-year costs and outcomes of robotic, laparoscopic, and open proctectomy based on data from the available literature. The robustness of our results was tested with one-way and multi-way sensitivity analyses.

Results: Open proctectomy had increased cost and lower quality of life (QOL) compared with laparoscopy and robotic approaches. In the societal perspective, robotic proctectomy costs $497/case more than laparoscopy, with minimal QOL improvements, resulting in an incremental cost-effectiveness ratio (ICER) of $751,056 per quality-adjusted life year (QALY). In the healthcare sector perspective, robotic proctectomy resulted in $983/case more and an ICER of $1,485,139/QALY. One-way sensitivity analyses demonstrated factors influencing cost-effectiveness primarily pertained to the operative cost and the postoperative length of stay (LOS). In a probabilistic sensitivity analysis, the cost-effective approach to proctectomy was laparoscopic in 42% of cases, robotic in 39%, and open in 19% at a willingness-to-pay (WTP) of $100,000/QALY.

Conclusions: Laparoscopic and robotic proctectomy cost less and have higher QALY than the open approach. Based on current data, laparoscopy is the most cost-effective approach. Robotic proctectomy can be cost-effective if modest differences in costs or postoperative LOS can be achieved.
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http://dx.doi.org/10.1007/s11605-020-04615-5DOI Listing
May 2020

Rate of urinary retention after ileostomy takedown in men and role of routine placement of urinary catheter.

Updates Surg 2020 Dec 27;72(4):1181-1185. Epub 2020 Apr 27.

Gastrointestinal Surgery Northwestern Medicine, Feinberg School of Medicine, 676 North St Clair Street, Suite 650, Chicago, IL, 60611, USA.

Ileostomy takedown has been proposed as one of the procedures where the placement of the catheters can be avoided, however, the rate of UR after ileostomy takedown is unknown. The aim of this study is to investigate the rate of UR after ileostomy takedown and the potential benefit of perioperative Tamsulosin. Retrospective cohort study of men undergoing ileostomy takedown after pelvic colorectal surgery between January 2009 and December 2016. A total of 100 patients were identified. The rate of UR after ileostomy takedown was high at 26%. There were no instances of urinary tract infection, however, most instances of UR were in patients who did not have catheter in surgery (96% vs. 4%, p = 0.044). Perioperative use of tamsulosin did not result in significant decrease in urinary retention. Rates of urinary retention after ileostomy takedown are high. Although not placing the catheter may be protective against urinary tract infections, patients should be counseled about the possibility of UR after ileostomy takedown.
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http://dx.doi.org/10.1007/s13304-020-00763-0DOI Listing
December 2020

Correction to: Surgeon-delivered laparoscopic transversus abdominis plane blocks are non-inferior to anesthesia-delivered ultrasound-guided transversus abdominis plane blocks: a blinded, randomized non-inferiority trial.

Surg Endosc 2020 Jul;34(7):3020

Division of Colon & Rectum Surgery, Beth Israel Lahey Health Medical Center, Harvard Medical School, Boston, MA, 02215, USA.

The following text should have been included in the Acknowledgments.
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http://dx.doi.org/10.1007/s00464-020-07505-8DOI Listing
July 2020

What happens before the first step? A New Approach to Quantifying Gait Initiation Using a Wearable Sensor.

Gait Posture 2020 02 9;76:128-135. Epub 2019 Nov 9.

Center for the study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, United States; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, United States; Sagol School of Neuroscience, Tel Aviv University, Israel; Department of Physical Therapy, Sackler Faculty of Medicine, Israel.

Background: Walking is a volitional behavior that requires planning and initiation before a step is observed. Following a signal to begin walking, studies of gait initiation in specialized labs have identified three phases that occur during the transition from a standing position via anticipatory postural adjustment (APA) to the first step. Routine instrumented gait testing outside of the laboratory setting focuses on gait execution and does not include gait initiation measures.

Research Question: Can a single IMU sensor be used for performing gait initiation evaluations outside the lab?

Methods: We recorded walking in young (N = 41) and older (N = 26) adults using an instrumented gait mat while they were wearing a 3D accelerometer on their lower back. Subjects were instructed to begin walking following an auditory signal. An algorithm was developed to extract the following measures from the acceleration signal: gait initiation time, measured from the start of the auditory cue to begin walking and ends at the heel-strike of the swing leg, time-to-APA (reaction time), APA duration and swing time (execution of the first step).

Results: Intraclass correlation coefficient analysis showed good to excellent agreement between gait initiation metrics obtained with the gait mat and the wearable sensor (mean 0.88, range [0.75-0.96]). Except for swing time, all measures were longer in the older subjects, compared to the young adults (p < 0.01).

Significance: Extracting gait initiation measures from routine instrumented gait testing may facilitate studies that can better determine the extent to which impaired gait planning and execution contribute to mobility impairments.
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http://dx.doi.org/10.1016/j.gaitpost.2019.11.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015786PMC
February 2020

Gastrocolic Fistula Involving the Pancreas in a Patient With Crohn's Disease.

Am J Gastroenterol 2019 11;114(11):1823-1824

Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.

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http://dx.doi.org/10.14309/ajg.0000000000000418DOI Listing
November 2019

Surgery for ulcerative colitis in geriatric patients is safe with similar risk to younger patients.

Eur J Gastroenterol Hepatol 2019 Nov;31(11):1356-1360

Surgery and Division of Colorectal Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.

Objective: A prior study indicated that postoperative mortality and complications were higher in geriatrics with inflammatory bowel disease (IBD). We sought to assess the rates of surgical complications and mortality in patients aged ≥65 years after colectomy for ulcerative colitis (UC).

Methods: This is a single center retrospective study at a tertiary care center. We reviewed all hospital discharges with ICD-9 code 556.X between January 2002 and January 2014. Patients were included if they underwent a colectomy for UC. All records were manually reviewed for demographics, complications and mortality within 90 days postoperatively.

Results: A total of 259 patients underwent surgery for UC during the study period and 34 patients were ≥65 years old (range 65-82) at the time of their surgery. There was no difference in overall length of stay (10.5 days vs. 9.6 days; P = 0.645) or complication rates (44% vs. 47%; P = 0.854) in the ≥65 cohort compared with the under 65 cohort. Mortality was higher in the geriatric cohort but this included only two deaths within 90 days, one of which was unrelated to the surgery, compared with one death related to surgery within 90 days in the younger cohort. Readmissions occurred in 24% of both cohorts within 90 days.

Conclusion: Geriatric patients undergoing surgery for UC are not at increased risk of surgery-related morbidity or mortality compared with a younger cohort.
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http://dx.doi.org/10.1097/MEG.0000000000001529DOI Listing
November 2019

Surgeon-delivered laparoscopic transversus abdominis plane blocks are non-inferior to anesthesia-delivered ultrasound-guided transversus abdominis plane blocks: a blinded, randomized non-inferiority trial.

Surg Endosc 2020 07 4;34(7):3011-3019. Epub 2019 Sep 4.

Division of Colon & Rectum Surgery, Beth Israel Lahey Health Medical Center, Harvard Medical School, Boston, MA, 02215, USA.

Background: The transversus abdominis plane (TAP) block is an important non-narcotic adjunct for post-operative pain control in abdominal surgery. Surgeons can use laparoscopic guidance for TAP block placement (LTAP), however, direct comparisons to conventional ultrasound-guided TAP (UTAPs) have been lacking. The aim of this study is to determine if surgeon placed LTAPs were non-inferior to anesthesia placed UTAPs for post-operative pain control in laparoscopic colorectal surgery.

Methods: This was a prospective, randomized, patient and observer blinded parallel-arm non-inferiority trial conducted at a single tertiary academic center between 2016 and 2018 on adult patients undergoing laparoscopic colorectal surgery. Narcotic consumption and pain scores were compared for LTAP vs. UTAP for 48 h post-operatively.

Results: 60 patients completed the trial (31 UTAP, 29 LTAP) of which 25 patients were female (15 UTAP, 10 LTAP) and the mean ages (SD) were 60.0 (13.6) and 61.5 (14.3) in the UTAP and LTAP groups, respectively. There was no significant difference in post-operative narcotic consumption between UTAP and LTAP at the time of PACU discharge (median [IQR] milligrams of morphine, 1.8 [0-4.5] UTAP vs. 0 [0-8.7] LTAP P = .32), 6 h post-operatively (5.4 [1.8-17.1] UTAP vs. 3.6 [0-12.6] LTAP P = .28), at 12 h post-operatively (9.0 [3.6-29.4] UTAP vs. 7.2 [0.9-22.5] LTAP P = .51), at 24 h post-operatively (9.0 [3.6-29.4] UTAP vs. 7.2 [0.9-22.5] LTAP P = .63), and 48 h post-operatively (39.9 [7.5-70.2] UTAP vs. 22.2 [7.5-63.8] LTAP P = .41). Patient-reported pain scores as well as pre-, intra-, and post-operative course were similar between groups. Non-inferiority criteria were met at all post-op time points up to and including 24 h but not at 48 h.

Conclusions: Surgeon-delivered LTAPs are safe, effective, and non-inferior to anesthesia-administered UTAPs in the immediate post-operative period.

Trial Registry: The trial was registered at clinicaltrials.gov Identifier NCT03577912.
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http://dx.doi.org/10.1007/s00464-019-07097-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103091PMC
July 2020

Locally Excised T1 Rectal Cancers: Need for Specialized Surveillance Protocols.

Dis Colon Rectum 2019 09;62(9):1055-1062

Colon and Rectal Surgery Associates, Minneapolis, Minnesota.

Background: Local excision of T1 rectal cancers helps avoid major surgery, but the frequency and pattern of recurrence may be different than for patients treated with total mesorectal excision.

Objective: This study aims to evaluate pattern, frequency, and means of detection of recurrence in a closely followed cohort of patients with locally excised T1 rectal cancer.

Design: This study is a retrospective review.

Settings: Patients treated by University of Minnesota-affiliated physicians, 1994 to 2014, were selected.

Patients: Patients had pathologically confirmed T1 rectal cancer treated with local excision and had at least 3 months of follow-up.

Interventions: Patients underwent local excision of T1 rectal cancer, followed by multimodality follow-up with physical examination, CEA, CT, endorectal ultrasound, and proctoscopy.

Main Outcome Measures: The primary outcomes measured were the presence of local recurrence and the means of detection of recurrence.

Results: A total of 114 patients met the inclusion criteria. The local recurrence rate was 11.4%, and the rate of distant metastasis was 2.6%. Local recurrences occurred up to 7 years after local excision. Of the 14 patients with recurrence, 10 of the recurrences were found by ultrasound and/or proctoscopy rather than by traditional methods of surveillance such as CEA or imaging. Of these 10 patients, 4 had an apparent scar on proctoscopy, and ultrasound alone revealed findings concerning for recurrent malignancy. One had recurrent malignancy demonstrated on ultrasound, but no concurrent proctoscopy was performed.

Limitations: This was a retrospective review, and the study was conducted at an institution where endorectal ultrasound is readily available.

Conclusions: Locally excised T1 rectal cancers should have specific surveillance guidelines distinct from stage I cancers treated with total mesorectal excision. These guidelines should incorporate a method of local surveillance that should be extended beyond the traditional 5-year interval of surveillance. An ultrasound or MRI in addition to or instead of flexible sigmoidoscopy or proctoscopy should also be strongly considered. See Video Abstract at http://links.lww.com/DCR/A979. CÁNCERES RECTALES T1 EXTIRPADOS LOCALMENTE: NECESIDAD DE PROTOCOLOS DE VIGILANCIA ESPECIALIZADOS: La escisión local de los cánceres de recto T1 ayuda a evitar una cirugía mayor, pero la frecuencia y el patrón de recurrencia pueden ser diferentes a los de los pacientes tratados con escisión mesorectal total.

Objetivo: Evaluar el patrón, la frecuencia y los medios de detección de recidiva en una cohorte de pacientes con cáncer de recto T1 extirpado localmente bajo un régimen de seguimiento especifico. DISEÑO:: Revisión retrospectiva.

Ajustes: Pacientes tratados por hospitales afiliados a la Universidad de Minnesota, 1994-2014 PACIENTES:: Pacientes con cáncer de recto T1 confirmado patológicamente, tratados con escisión local y con al menos 3 meses de seguimiento.

Intervenciones: Extirpación local del cáncer de recto T1, con un seguimiento multimodal incluyendo examen físico, antígeno carcinoembrionario (CEA), TC, ecografía endorrectal y proctoscopia.

Principales Medidas De Resultado: Presencia de recurrencia local y medios de detección de recurrencia.

Resultados: Un total de 114 pacientes cumplieron con los criterios de inclusión. La tasa de recurrencia local fue del 11,4% y la tasa de metástasis a distancia fue del 2,6%. Las recurrencias locales se presentaron hasta 7 años después de la escisión local. De los 14 pacientes con recurrencia, 10 de las recurrencias se detectaron por ultrasonido y / o proctoscopia en lugar de los métodos tradicionales de vigilancia, como CEA o imágenes. De estos diez pacientes, cuatro tenían una cicatriz aparente en la proctoscopia y el ultrasonido solo reveló hallazgos relacionados con tumores malignos recurrentes. En una ecografía se demostró malignidad recurrente, pero no se realizó proctoscopia concurrente.

Limitaciones: Revisión retrospectiva; estudio realizado en una institución donde se dispone fácilmente de ultrasonido endorrectal CONCLUSIONES:: Los cánceres de recto T1 extirpados localmente deben tener una vigilancia específica distinta de los cánceres en etapa I tratados con TME. El régimen de seguimiento deberá de extender más allá del intervalo tradicional de 5 años de vigilancia. También se debe considerar la posibilidad de realizar una ecografía o una resonancia magnética (IRM) además de la sigmoidoscopía flexible o la proctoscopía. Vea el Resumen del video en http://links.lww.com/DCR/A979.
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http://dx.doi.org/10.1097/DCR.0000000000001439DOI Listing
September 2019

Quantitative mobility metrics from a wearable sensor predict incident parkinsonism in older adults.

Parkinsonism Relat Disord 2019 08 22;65:190-196. Epub 2019 Jun 22.

Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.

Introduction: Mobility metrics derived from wearable sensor recordings are associated with parkinsonism in older adults. We examined if these metrics predict incident parkinsonism.

Methods: Parkinsonism was assessed annually in 683 ambulatory, community-dwelling older adults without parkinsonism at baseline. Four parkinsonian signs were derived from a modified Unified Parkinson's Disease Rating Scale (UPDRS). Parkinsonism was based on the presence of 2 or more signs. Participants wore a sensor on their back while performing a 32 foot walk, standing posture, and Timed Up and Go (TUG) tasks. 12 mobility scores were extracted. Cox proportional hazards models with backward elimination were used to identify combinations of mobility scores independently associated with incident parkinsonism.

Results: During follow-up of 2.5 years (SD = 1.28), 139 individuals developed parkinsonism (20.4%). In separate models, 6 of 12 mobility scores were individually associated with incident parkinsonism, including: Speed and Regularity (from 32 ft walk), Sway (from standing posture), and 3 scores from TUG subtasks (Posterior sit to stand transition, Range stand to sit transition, and Yaw, a measure of turning efficiency). When all mobility scores were analyzed together in a single model, 2 TUG subtask scores, Range from stand to sit transition (HR, 1.42, 95%CI, 1.09, 1.82) and Yaw from turning (HR, 0.56, 95%CI, 0.42, 0.73) were independently associated with incident parkinsonism. These results were unchanged when controlling for chronic health covariates.

Conclusion: Mobility metrics derived from a wearable sensor complement conventional gait testing and have potential to enhance risk stratification of older adults who may develop parkinsonism.
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http://dx.doi.org/10.1016/j.parkreldis.2019.06.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6774889PMC
August 2019

Different Combinations of Mobility Metrics Derived From a Wearable Sensor Are Associated With Distinct Health Outcomes in Older Adults.

J Gerontol A Biol Sci Med Sci 2020 05;75(6):1176-1183

Rush Alzheimer's Disease Center, Chicago, Illinois.

Background: Gait speed is a robust nonspecific predictor of health outcomes. We examined if combinations of gait speed and other mobility metrics are associated with specific health outcomes.

Methods: A sensor (triaxial accelerometer and gyroscope) placed on the lower back, measured mobility in the homes of 1,249 older adults (77% female; 80.0, SD = 7.72 years). Twelve gait scores were extracted from five performances, including (a) walking, (b) transition from sit to stand, (c) transition from stand to sit, (d) turning, and (e) standing posture. Using separate Cox proportional hazards models, we examined which metrics were associated with time to mortality, incident activities of daily living disability, mobility disability, mild cognitive impairment, and Alzheimer's disease dementia. We used a single integrated analytic framework to determine which gait scores survived to predict each outcome.

Results: During 3.6 years of follow-up, 10 of the 12 gait scores predicted one or more of the five health outcomes. In further analyses, different combinations of 2-3 gait scores survived backward elimination and were associated with the five outcomes. Sway was one of the three scores that predicted activities of daily living disability but was not included in the final models for other outcomes. Gait speed was included along with other metrics in the final models predicting mortality and activities of daily living disability but not for other outcomes.

Conclusions: When analyzing multiple mobility metrics together, different combinations of mobility metrics are related to specific adverse health outcomes. Digital technology enhances our understanding of impaired mobility and may provide mobility biomarkers that predict distinct health outcomes.
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http://dx.doi.org/10.1093/gerona/glz160DOI Listing
May 2020

Development of Perfectionism in Junior Athletes: A Three-Sample Study of Coach and Parental Pressure.

J Sport Exerc Psychol 2019 Jun 13;41(3):167-175. Epub 2019 Jun 13.

University of Kent.

Perfectionism predicts cognitions, emotions, and behaviors in sport. Nonetheless, our understanding of the factors that influence its development is limited. The authors sought to address this issue by examining the role of coach and parental pressure in the development of perfectionism in sport. Using 3 samples of junior athletes (16-19 years; cross-sectional  = 212, 3-month longitudinal  = 101, and 6-month longitudinal  = 110), the authors examined relations between coach pressure to be perfect, parental pressure to be perfect, perfectionistic strivings, and perfectionistic concerns. Mini meta-analysis of the combined cross-sectional data ( = 423) showed that both coach pressure and parental pressure were positively correlated with perfectionistic strivings and perfectionistic concerns. In contrast, longitudinal analyses showed that only coach pressure predicted increased perfectionistic strivings and perfectionistic concerns over time. Overall, our findings provide preliminary evidence that coaches may play a more important role in the development of junior athletes' perfectionism than parents.
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http://dx.doi.org/10.1123/jsep.2018-0287DOI Listing
June 2019

Expanding instrumented gait testing in the community setting: A portable, depth-sensing camera captures joint motion in older adults.

PLoS One 2019 15;14(5):e0215995. Epub 2019 May 15.

Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, United States of America.

Background: Currently, it is not feasible to obtain laboratory-based measures of joint motion in large numbers of older adults. We assessed the utility of a portable depth-sensing camera for quantifying hip and knee joint motion of older adults during mobility testing in the community.

Methods: Participants were 52 older adults enrolled in the Rush Memory and Aging Project, a community-based cohort study of aging. In a subset, we compared dynamic hip and knee flexion/extension obtained via the depth-sensing camera with that obtained concurrently using a laboratory-based optoelectronic motion capture system. Then we recorded participants' annual instrumented gait assessment in the community setting with the depth-sensing camera and examined the inter-relationships of hip and knee range of motion (ROM) with mobility metrics derived from a wearable sensor and other mobility-related health measures.

Results: In the community, we successfully acquired joint motion from 49/52 participants using the depth-sensing camera. Hip and knee ROMs were related to diverse sensor-derived metrics of mobility performance (hip: Pearson's r = 0.31 to 0.58; knee: Pearson's r = 0.29 to 0.51), as well as daily physical activity, conventional motor measures, self-report hip and knee pain and dysfunction, mobility disability, and falls.

Conclusions: The depth-sensing camera's high rate of successful data acquisition and correlations of its hip and knee ROMs with other mobility measures suggest that this device can provide a cost-efficient means of quantifying joint motion in large numbers of community-dwelling older adults who span the health spectrum.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0215995PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519784PMC
January 2020

Alterations to the vision-associated transcriptome of zebrafish (Danio rerio) following developmental norethindrone exposure.

Environ Toxicol Pharmacol 2019 Jul 1;69:137-142. Epub 2019 May 1.

Dept. of Biological Sciences, University of North Texas, 1155 Union Circle, Denton, TX 76203, United States.

Synthetic sex steroids, like the synthetic progestin norethindrone (NET), can affect a wide variety of biological processes via highly conserved mechanisms. NET is prevalent in surface waters, yet the sub-lethal effects of NET exposure are not are net yet well characterized in aquatic biota. A few targeted gene expression and behavioral studies have concluded that NET affects the vision of adult fish; however, early life stage (ELS) fish are often more sensitive to contaminants. Furthermore, many species of fish rely heavily on visual perception for survival during development. The goal of the present study was to characterize the effects of developmental exposure to environmentally relevant concentrations of NET on the visual system of ELS zebrafish, using transcriptomics and histological methods. Results indicate that exposure to relatively low levels of NET in aquatic systems may be sufficient to affect the visual function of developing fish.
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http://dx.doi.org/10.1016/j.etap.2019.04.011DOI Listing
July 2019

Combined Hartmann's Reversal and Abdominal Wall Reconstruction: Defining Postoperative Morbidity.

J Surg Res 2019 08 28;240:136-144. Epub 2019 Mar 28.

Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota.

Background: Ventral hernias are common after Hartmann's procedure and add complexity to Hartmann's reversal. Colostomy reversal and abdominal wall reconstruction may be performed in a staged or concurrent fashion, although data are limited as to which strategy is optimal. We aimed to define the complication profile of concurrent abdominal wall reconstruction with colostomy reversal as compared to either procedure alone.

Materials And Methods: For this retrospective cohort study, we used the National Surgery Quality Improvement Project Database from 2012 to 2015. All patients undergoing elective colostomy reversal, abdominal wall reconstruction with component separation, or combined colostomy reversal with component separation were identified. Propensity score matching was used to compare outcomes among similar patients undergoing colostomy reversal alone versus combined procedure. Groups were evaluated for postoperative morbidity including reoperation.

Results: We identified 11,689 patients; 6951 (64%) underwent component separation alone, 4563 (35%) colostomy reversal alone, and 175 (1%) combined component separation and colostomy reversal. The combined group, as compared to colostomy reversal alone, showed an increased overall complication rate (39% versus 25%; P < 0.01) and increased rate of reoperation (9% versus 5%; P = 0.03). Differences in overall complication rate (43% versus 24%; P < 0.01) and reoperation rate (9% versus 3%; P = 0.03) persisted on propensity matched analysis.

Conclusions: This analysis shows that in patients undergoing colostomy takedown, concurrent abdominal wall reconstruction is associated with increased morbidity including increased rate of reoperation, even when controlling for patient factors. Consideration may be given to a staged approach.
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http://dx.doi.org/10.1016/j.jss.2019.02.044DOI Listing
August 2019

A case for multiple pathways to increasing perfectionism: Reply to Soenens and Vansteenkiste (2019).

Psychol Bull 2019 04;145(4):433-435

Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath.

We respond to Soenens and Vansteenkiste's (2019) commentary on our meta-analysis (Curran & Hill, 2019) that evidenced increases in college students' perfectionism from 1989 to 2016. In speculating on possible reasons for the increase, we argued that increases in anxious and controlling parenting could partly account for this trend. Soenens and Vansteenkiste argue that in doing so we did not differentiate between parental control as structure and parental control as pressure, with only the latter being important for the development of perfectionism. They also argue that when this distinction is made, research suggests that parental control as pressure is decreasing. Finally, they caution for the risk of parent blame. In our response, we acknowledge the potential importance of the distinction between parental control as structure and parental control as pressure but note that so far this distinction has not been common in perfectionism research. We also acknowledge that the evidence provided by Soenens and Vansteenkiste could be suggestive of declining control as pressure. However, we highlight that our arguments hinged on a wider array of evidence that placed changes in parental behavior in context of broader social change and multiple pathways to increases in perfectionism. We close our response by agreeing that parents are not to blame for increasing perfectionism. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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http://dx.doi.org/10.1037/bul0000189DOI Listing
April 2019

Mental health first aid for the UK Armed Forces.

Health Promot Int 2020 Feb;35(1):132-139

School of Sport and Exercise, University of Gloucestershire, Gloucester, UK.

Education programmes in mental health literacy can address stigma and misunderstanding of mental health. This study investigated self-rated differences in knowledge, attitudes and confidence around mental health issues following participation in a bespoke Mental Health First Aid (MHFA) training course for the Armed Forces. The mixed methods approach comprised quantitative surveys and qualitative interviews. A survey, administered immediately post-training (n = 602) and again at 10-months post-attendance (n = 120), asked participants to rate their knowledge, attitudes and confidence around mental health issues pre- and post-training. Quantitative findings revealed a significant increase in knowledge, positive attitudes and confidence from the post-training survey which was sustained at 10-months follow-up.Semi-structured telephone interviews (n = 13) were conducted at follow-up, 6-months post-attendance. Qualitative findings revealed that participation facilitated an 'ambassador' type role for participants. This study is the first to have investigated the effect of MHFA in an Armed Forces community. Findings show participants perceived the training to increase knowledge regarding mental health and to enhance confidence and aptitude for identifying and supporting people with mental health problems. Results suggest that such an intervention can provide support for personnel, veterans and their families, regarding mental health in Armed Forces communities.
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http://dx.doi.org/10.1093/heapro/day112DOI Listing
February 2020

A Test of Perfectionistic Vulnerability Following Competitive Failure Among College Athletes.

J Sport Exerc Psychol 2018 Oct 13;40(5):269-279. Epub 2018 Nov 13.

2 York St John University.

Perfectionism purportedly bestows vulnerability to distress through an interaction with achievement and interpersonal stress. The authors test this by assessing athletes' perfectionism and subsequent self-conscious emotion following repeated competitive failure. A total of 60 college athletes undertook three 4-min competitive sprint trials on a cycle ergometer and were instructed that they had performed the worst of all competitors on each occasion. Measures of perfectionism (self-oriented and socially prescribed) were taken at baseline and measures of pride, guilt, and shame were taken at baseline and three times following each successive failure. Across the successive failures, self-oriented perfectionism predicted within-person trajectories of decreasing pride and increasing guilt. Socially prescribed perfectionism predicted within-person trajectories of increasing shame and guilt. Furthermore, a combination of high self-oriented and high socially prescribed perfectionism predicted the steepest within-person increases in shame and guilt. Findings support an achievement-specific vulnerability hypothesis whereby those higher in perfectionism experience pronounced distress following competitive failure.
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http://dx.doi.org/10.1123/jsep.2018-0059DOI Listing
October 2018

Mapping ammonia risk on sensitive habitats in Ireland.

Sci Total Environ 2019 Feb 30;649:1580-1589. Epub 2018 Aug 30.

UCD School of Biosystems and Food Engineering, University College Dublin, Belfield, Dublin 4, Ireland.

The aim of this study was to provide a simple, cost-effective, risk-based map of terrestrial areas in Ireland where environmental quality may be at risk from atmospheric ammonia. This risk-based approach identifies Natura 2000 sites in Ireland at risk from agricultural atmospheric ammonia, collating best available data using Geographical Information Systems (GIS). In mapping ammonia risk on sensitive habitats (MARSH), the method identifies sources of ammonia, classifying them on a scale of risk from 0 to 5. These sources are subsequently summed based on a weighting determined by their contribution to national emissions divided by their potentially impacted area. A Pearson's correlation coefficient of 0.72 allows for concentrations from United Kingdom's FRAME modelling to be applied to the MARSH model, which are corrected based on recent monitoring. Applying Designation Weighted Indicators (DWI), the MARSH model predicts that 80.7, 34.3 and 5.9% of Natura 2000 sites in Ireland may exceed ambient concentrations of 1, 2, and 3 μg/m, respectively. A Nitroindex map of Ireland based on available lichen records was also developed and is presented as part of this study. This Nitroindex was used to identify areas where impacts have already been recorded, thus informing the classification of sites "at-risk". The combination of both the MARSH and Nitroindex models ascertains which Natura 2000 sites are most at risk, thereby providing valuable data to relevant authorities. The MARSH model acts as a first step towards screening and assessing Natura 2000 sites most at risk from atmospheric ammonia, providing a tool to demonstrate compliance with the National Emissions Ceilings Directive.
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http://dx.doi.org/10.1016/j.scitotenv.2018.08.424DOI Listing
February 2019

Alterations to the Intestinal Microbiome and Metabolome of Pimephales promelas and Mus musculus Following Exposure to Dietary Methylmercury.

Environ Sci Technol 2018 08 13;52(15):8774-8784. Epub 2018 Jul 13.

Department of Biological Sciences and Advanced Environmental Research Institute , University of North Texas , 1155 Union Circle , Denton , Texas 76203 , United States.

Mercury is a global contaminant, which may be microbially transformed into methylmercury (MeHg), which bioaccumulates. This results in potentially toxic body burdens in high trophic level organisms in aquatic ecosystems and maternal transfer to offspring. We previously demonstrated effects on developing fish including hyperactivity, altered time-to-hatch, reduced survival, and dysregulation of the dopaminergic system. A link between gut microbiota and central nervous system function in teleosts has been established with implications for behavior. We sequenced gut microbiomes of fathead minnows exposed to dietary MeHg to determine microbiome effects. Dietary exposures were repeated with adult CD-1 mice. Metabolomics was used to screen for metabolome changes in mouse brain and larval fish, and results indicate effects on lipid metabolism and neurotransmission, supported by microbiome data. Findings suggest environmentally relevant exposure scenarios may cause xenobiotic-mediated dysbiosis of the gut microbiome, contributing to neurotoxicity. Furthermore, small-bodied teleosts may be a useful model species for studying certain types of neurodegenerative diseases, in lieu of higher vertebrates.
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http://dx.doi.org/10.1021/acs.est.8b01150DOI Listing
August 2018

An Accurate and Rapid System to Identify Play Patterns in Tennis using Video Recording Material: Break Point Situations as a Case Study.

J Hum Kinet 2018 Jun 13;62:199-212. Epub 2018 Jun 13.

Faculty of Education and Sports Sciences, University of Vigo, Vigo, Spain.

The goal of this study was to present an accurate and rapid detection system to identify patterns in tennis, based on t-pattern analysis. As a case study, the break point situations in the final matches of the clay court tournaments played during the seasons 2011 and 2012 between the tennis players Novak Djokovic and Rafael Nadal were chosen. The results show that Nadal achieves a higher conversion rate with respect to Djokovic in the break point situations, independent of the outcome of the match. Some repetitive patterns of both players were revealed in break point circumstances. In long rally sequences (higher than seven hits), the Spanish player won more break points, both serving and receiving, as a result of unforced errors of his opponent's backhand. In medium rally sequences (between four and seven hits), other factors such as the type, direction or serve location have shown to play an important role in the outcome of the point. The study also reveals that Djokovic frequently commits double faults in these critical situations of the match. This is the first time that t-patterns have been used to analyze the sport of tennis. The technique is based on computer vision algorithms and video recording material to detect particular relationships between events and helps to discover the hidden mechanistic sequences of tennis players.
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http://dx.doi.org/10.1515/hukin-2017-0170DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6006543PMC
June 2018

The Digest.

J Sport Exerc Psychol 2018 04;40(2):111-115

California State University-Fullerton.

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http://dx.doi.org/10.1123/jsep.2017-0292DOI Listing
April 2018

The membrane pacemaker hypothesis: novel tests during the ontogeny of endothermy.

J Exp Biol 2018 03 29;221(Pt 7). Epub 2018 Mar 29.

Department of Biological Sciences, University of North Texas, Denton, TX 76201, USA.

The 'membrane pacemaker' hypothesis proposes a biochemical explanation for among-species variation in resting metabolism, based on the positive correlation between membrane docosahexaenoic acid (DHA) and metabolic rate. We tested this hypothesis using a novel model, altricial red-winged blackbird nestlings, predicting that the proportion of DHA in muscle and liver membranes should increase with the increasing metabolic rate of the nestling as it develops endothermy. We also used a dietary manipulation, supplementing the natural diet with fish oil (high DHA) or sunflower oil (high linoleic acid) to alter membrane composition and then assessed metabolic rate. In support of the membrane pacemaker hypothesis, DHA proportions increased in membranes from pectoralis muscle, muscle mitochondria and liver during post-hatch development. By contrast, elevated dietary DHA had no effect on resting metabolic rate, despite causing significant changes to membrane lipid composition. During cold challenges, higher metabolic rates were achieved by birds that had lower DHA and higher linoleic acid in membrane phospholipids. Given the mixed support for this hypothesis, we conclude that correlations between membrane DHA and metabolic rate are likely spurious, and should be attributed to a still-unidentified confounding variable.
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http://dx.doi.org/10.1242/jeb.174466DOI Listing
March 2018

Photo-induced toxicity in early life stage fiddler crab (Uca longisignalis) following exposure to Deepwater Horizon oil.

Ecotoxicology 2018 May 20;27(4):440-447. Epub 2018 Feb 20.

Department of Biological Sciences & Advanced Environmental Research Institute, University of North Texas, Denton, TX, USA.

The 2010 explosion of the Deepwater Horizon (DWH) oil rig led to the release of millions of barrels of oil in the Gulf of Mexico. Oil in aquatic ecosystems exerts toxicity through multiple mechanisms, including photo-induced toxicity following co-exposure with UV radiation. The timing and location of the spill coincided with both fiddler crab reproduction and peak yearly UV intensities, putting early life stage fiddler crabs at risk of injury due to photo-induced toxicity. The present study assessed sensitivity of fiddler crab larvae to photo-induced toxicity during co-exposure to a range of environmentally relevant dilutions of high-energy water accommodated fractions of DWH oil, and either <10, 50, or 100% ambient sunlight, achieved with filters that allowed for variable UV penetration. Solar exposures (duration: 7-h per day) were conducted for two consecutive days, with a dark recovery period (duration: 17-h) in between. Survival was significantly decreased in treatments the presence of >10% UV and relatively low concentrations of oil. Results of the present study indicate fiddler crab larvae are sensitive to photo-induced toxicity in the presence of DWH oil. These results are of concern, as fiddler crabs play an important role as ecosystem engineers, modulating sediment biogeochemical processes via burrowing action. Furthermore, they occupy an important place in the food web in the Gulf of Mexico.
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http://dx.doi.org/10.1007/s10646-018-1908-6DOI Listing
May 2018

THE DIGEST.

J Sport Exerc Psychol 2018 02;40(1):40-43

California State University-Fullerton.

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http://dx.doi.org/10.1123/jsep.2017-0325DOI Listing
February 2018

Mortality Is Rare Following Elective and Non-elective Surgery for Ulcerative Colitis, but Mild Postoperative Complications Are Common.

Dig Dis Sci 2018 Mar 20;63(3):713-722. Epub 2018 Jan 20.

Department of Surgery and Division of Colorectal Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

Background Data: Currently, data regarding the rates of morbidity and mortality following non-elective colectomy for ulcerative colitis (UC) are variable. We sought to determine the rates and predictors of 90-day mortality and complications following colectomy for UC.

Methods: Patients undergoing an initial surgery for UC at a tertiary care center between January 2002 and January 2014 were included. Patients were identified using ICD-9 code 556.x. Each record was manually reviewed for demographic information, medical histories, UC history, medications, and data regarding the admission and discharge. Charts were reviewed for mortality and complications within 90 days of surgery. Complications were classified using the Clavien-Dindo classification system. Univariate and multivariate analyses were performed using IBM SPSS Statistics, version 23.0.

Results: Two hundred and fifty-eight patients underwent surgery for UC. 69% were elective, and 31% were urgent/emergent. There were no deaths reported within 30 days of surgery. At 90 days, there were 2 deaths in the elective group and 1 death in the urgent/emergent group. The death in the urgent/emergent group was likely related to the initial surgery, while the elective group death was not directly related to the initial surgery for UC. Complications occurred in 47% of patients. There were no significant differences in rates of complications in either surgical cohort. Majority (62%) of the complications were Clavien-Dindo grade 1 or 2 with no difference in the elective or urgent/emergent group. Unplanned readmissions occurred in 24% of cases.

Conclusion: Surgery for UC is not associated with any mortality at 30 days and very low mortality at 90 days. However, surgery is associated with an increased rate of minor postoperative complications and readmissions.
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http://dx.doi.org/10.1007/s10620-018-4922-xDOI Listing
March 2018

Perfectionism is increasing over time: A meta-analysis of birth cohort differences from 1989 to 2016.

Psychol Bull 2019 04 28;145(4):410-429. Epub 2017 Dec 28.

School of Sport, York St John University.

From the 1980s onward, neoliberal governance in the United States, Canada, and the United Kingdom has emphasized competitive individualism and people have seemingly responded, in kind, by agitating to perfect themselves and their lifestyles. In this study, the authors examine whether cultural changes have coincided with an increase in multidimensional perfectionism in college students over the last 27 years. Their analyses are based on 164 samples and 41,641 American, Canadian, and British college students, who completed the Multidimensional Perfectionism Scale (Hewitt & Flett, 1991) between 1989 and 2016 (70.92% female, Mage = 20.66). Cross-temporal meta-analysis revealed that levels of self-oriented perfectionism, socially prescribed perfectionism, and other-oriented perfectionism have linearly increased. These trends remained when controlling for gender and between-country differences in perfectionism scores. Overall, in order of magnitude of the observed increase, the findings indicate that recent generations of young people perceive that others are more demanding of them, are more demanding of others, and are more demanding of themselves. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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http://dx.doi.org/10.1037/bul0000138DOI Listing
April 2019