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591.
Abul Kalam Azad Xin Qiu Kevin Boyd Qin Kuang Marjan Emami Nicole Perera Prakruthi Palepu Devalben Patel Zhuo Chen Dangxiao Cheng Ronald Feld Natasha B. Leighl Frances A. Shepherd Ming-Sound Tsao Wei Xu Geoffrey Liu Sinead Cuffe 《Lung cancer (Amsterdam, Netherlands)》2014
Introduction
Lung cancer is a leading cause of cancer-related mortality in North America. In addition to tobacco smoking, inherited genetic factors can also influence the development of lung cancer. These genetic factors may lead to biologically distinct subsets of cancers that have different outcomes. We evaluated whether genetic sequence variants (GSVs) associated with lung cancer risk are associated with overall survival (OS) and progression-free survival (PFS) in stage-III-IV non-small-cell lung cancer (NSCLC) patients.Methods
A total of 20 candidate GSVs in 12 genes previously reported to be associated with lung cancer risk were genotyped in 564 patients with stage-III or IV NSCLC. Multivariate Cox proportional hazard models adjusted for potential clinical prognostic factors were generated for OS and PFS.Results
After taking into account multiple comparisons, one GSV remained significant: rs4975616 on chromosome 5p15.33, located near the TERT-CLPTM1L gene. The adjusted hazard ratio (aHR) for OS was 0.75 (0.69–0.91), p = 0.002; for PFS aHR was 0.74 (0.62–0.89), p < 0.001 for each protective variant allele. Results were similar in both Stage III (OS: aHR = 0.70; PFS: aHR = 0.71) and Stage IV patients (OS: aHR = 0.81; PFS: aHR = 0.77).Conclusion
A GSV on 5p15.33 is not only a risk factor for lung cancer but may also be associated with survival in patients with late stage NSCLC. If validated, GSVs may define subsets of patients with different risk and prognosis of NSCLC. 相似文献592.
Werner C. Albrich Tarini Shankar Ghosh Sinead Ahearn-Ford Flora Mikaeloff Nonhlanhla Lunjani Brian Forde Nomie Suh Gian-Reto Kleger Urs Pietsch Manuel Frischknecht Christian Garzoni Rossella Forlenza Mary Horgan Corinna Sadlier Tommaso Rochat Negro Jrme Pugin Hannah Wozniak Andreas Cerny Ujjwal Neogi Paul W. OToole Liam OMahony 《Gut microbes》2022,14(1)
593.
Shirley V. Wang Anton Pottegård William Crown Peter Arlett Darren M. Ashcroft Eric I. Benchimol Marc L. Berger Gracy Crane Wim Goettsch Wei Hua Shaum Kabadi David M. Kern Xavier Kurz Sinead Langan Takahiro Nonaka Lucinda Orsini Susana Perez-Gutthann Simone Pinheiro Nicole Pratt Sebastian Schneeweiss Massoud Toussi Rebecca J. Williams 《Pharmacoepidemiology and drug safety》2023,32(1):44-55
594.
Deborah Donnell Fei Gao James P. Hughes Brett Hanscom Lawrence Corey Myron S. Cohen Srilatha Edupuganti Nyaradzo Mgodi Helen Rees Jared M. Baeten Glenda Gray Linda-Gail Bekker Mina Hosseinipour Sinead Delany-Moretlwe 《Journal of the International AIDS Society》2023,26(6):e26118
Introduction
Multiple antiretroviral agents have demonstrated efficacy for human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP). As a result, clinical trials of novel agents have transitioned from placebo- to active-controlled designs; however, active-controlled trials do not provide an estimate of efficacy versus no use of PrEP. Counterfactual placebo comparisons using other data sources could be employed to provide this information.Methods
We compared the active-controlled study (HPTN 084) of injectable cabotegravir (CAB-LA) versus daily oral emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) among women from seven countries in Africa to three external, contemporaneous randomized HIV prevention trials from which we constructed counterfactual placebo estimates. We used direct standardization via analysis weights to achieve the same distribution of person-years between the external study and HPTN 084, across strata predictive of HIV risk (country and selected risk covariates). We estimated prevention efficacy against a counterfactual placebo to provide information on the use of CAB-LA and FTC/TDF compared to no intervention. We compared the counterfactual placebo findings for FTC/TDF to previous placebo-controlled trials, adjusted for observed adherence to daily pills.Results
Distribution of age and baseline prevalence of gonorrhoea and chlamydia were similar among matched counterfactual placebo and observed HPTN 084 arms after standardization. Counterfactual estimates of CAB-LA versus placebo in all three settings showed a consistent risk reduction of 93%–94%, with lower bounds of the confidence intervals above 72%. Observed adherence (quantifiable tenofovir in plasma) in HPTN 084 was 54%–56%, and estimated efficacy of daily oral FTC/TDF against a counterfactual placebo was consistent with a predicted risk reduction of 39%–40% for this level of daily pill use.Conclusions
Counterfactual placebo rates of HIV acquisition derived from external trial data in similar locations and time can be used to support estimates of placebo-based efficacy of a novel HIV prevention agent. External trial data must be standardized to be representative of the clinical trial cohort testing the novel HIV prevention agent, accounting for confounders. 相似文献595.
Eoin Keating Gayle Bennett Michelle A Murray Sinead Ryan John Aird Donal B O Connor Dermot O Toole Conor Lahiff 《World journal of gastrointestinal endoscopy》2023,15(5):368-375
Rectal neuroendocrine tumours represent a rare colorectal tumour with a 10 fold increased prevalence due to incidental detection in the era of colorectal screening. Patient outcomes with early diagnosis are excellent. However endoscopic recognition of this lesion is variable and misdiagnosis can result in suboptimal endoscopic resection with subsequent uncertainty in relation to optimal long-term management. Endoscopic techniques have shown particular utility in managing this under-recognized neuroendocrine tumour. 相似文献
596.
Nuala Quinn MBChB FRCPI Grantley Ward B-BMed MD Cyril Ong FRCR FRANZCR David Krieser MBBS FRACP Robert Melvin MBBS FACEM Allya Makhijani MBBS MM Joanne Grindlay MBBS FACEM Catherine Lynch MB FRACP Gabrielle Colleran MD MB BCh BAO Victoria Perry BMedSci MBBS FRACP Sinead M O'Donnell MB MD Ian Law Registered Nurse Dinesh Varma MBBS FRANZCR John Fitzgerald BSc BMedSci MBBS FRANZCR Hannah J Mitchell PhD Warwick J Teague DPhil FRACS FRCSEd 《Emergency medicine Australasia : EMA》2023,35(3):412-419
Objective
Life-threatening thoracic trauma requires emergency pleural decompression and thoracostomy and chest drain insertion are core trauma procedures. Reliably determining a safe site for pleural decompression in children can be challenging. We assessed whether the Mid-Arm Point (MAP) technique, a procedural aid proposed for use with injured adults, would also identify a safe site for pleural decompression in children.Methods
Children (0–18 years) attending four EDs were prospectively recruited. The MAP technique was performed, and chest wall skin marked bilaterally at the level of the MAP; no pleural decompression was performed. Radio-opaque markers were placed over the MAP-determined skin marks and corresponding intercostal space (ICS) reported using chest X-ray.Results
A total of 392 children participated, and 712 markers sited using the MAP technique were analysed. Eighty-three percentage of markers were sited within the ‘safe zone’ for pleural decompression (4th to 6th ICSs). When sited outside the ‘safe zone’, MAP-determined markers were typically too caudal. However, if the site for pleural decompression was transposed one ICS cranially in children ≥4 years, the MAP technique performance improved significantly with 91% within the ‘safe zone’.Conclusions
The MAP technique reliably determines a safe site for pleural decompression in children, albeit with an age-based adjustment, the Mid-Arm Point in PAEDiatrics (MAPPAED) rule: ‘in children aged ≥4 years, use the MAP and go up one ICS to hit the safe zone. In children <4 years, use the MAP.’ When together with this rule, the MAP technique will identify a site within the ‘safe zone’ in 9 out of 10 children. 相似文献597.
Anna Grimsrud Lynne Wilkinson Sinead Delany-Moretlwe Peter Ehrenkranz Kimberly Green Maureen Murenga Kenneth Ngure Nelson J. Otwoma Nittaya Phanuphak Wim Vandevelde Marco Vitoria Helen Bygrave 《Journal of the International AIDS Society》2023,26(Z2):e26095
Introduction
Long-acting and extended delivery (LAED) regimens for HIV treatment and prevention offer unique benefits to expand uptake, effective use and adherence. To date, research has focused on basic and clinical science around the safety and efficacy of these products. This commentary outlines opportunities in HIV prevention and treatment programmes, both for the health system and clients, that could be addressed through the inclusion of LAED regimens and the vital role of differentiated service delivery (DSD) in ensuring efficient and equitable access.Discussion
The realities and challenges within HIV treatment and prevention programmes are different. Globally, more than 28 million people are accessing HIV treatment—the vast majority on a daily fixed-dose combination oral pill that is largely available, affordable and well-tolerated. Many people collect extended refills outside of health facilities with clinical consultations once or twice a year. Conversely, uptake of daily oral pre-exposure prophylaxis (PrEP) has consistently missed global targets due to limited access with high individual cost and lack of choice contributing to substantial unmet PrEP need. Recent trends in demedicalization, simplification, additional method options and DSD for PrEP have led to accelerated uptake as its availability has become more aligned with user preferences. How people currently receive HIV treatment and prevention services and their barriers to adherence must be considered for the introduction of LAED regimens to achieve the expected improvements in access and outcomes. Important considerations include the building blocks of DSD: who (provider), where (location), when (frequency) and what (package of services). Ideally, all LAED regimens will leverage DSD models that emphasize access at the community level and self-management. For treatment, LAED regimens may address challenges with adherence but their delivery should provide clear advantages over existing oral products to be scaled. For prevention, LAED regimens expand a potential PrEP user's choice of methods, but like other methods, need to be delivered in a manner that can facilitate frequent re-initiation.Conclusions
To ensure that innovative LAED HIV treatment and prevention products reach those who most stand to benefit, service delivery and client considerations during development, trial and early implementation are critical. 相似文献598.
James Thomas Connell Ahmed Bassiouni Ella Harrison Stephanie Laden Sinead O'Brien Raguwinder Sahota A. Simon Carney Andrew Foreman Suren Krishnan John-Charles Hodge 《Clinical otolaryngology》2023,48(2):226-234
Objectives
Customised acoustic therapy aims to moderate the neural pathways implicated in the pathophysiology of tinnitus. This study aimed to assess the efficacy of customised acoustic therapy administered via a web-based treatment platform.Design
Clinical trial with prospective recruitment. Fifty-eight participants underwent 6 weeks of customised acoustic therapy.Setting
Treatment was delivered for 2 h each day using a smartphone, tablet or computer. Treatment was integrated into usual daily activities.Participants
Participants with subjective tinnitus were recruited through public and private otolaryngology clinics and electronic and print media.Main Outcomes Measured
FiveQ, a novel 5 question tinnitus questionnaire, was measured at baseline and each week of treatment. Statistical analyses, including Wilcoxon, Mann–Whitney and mixed linear regression, were used to assess treatment efficacy and identify factors associated with treatment response.Results
39/58 participants (67.2%) had an improvement in symptom severity scores, 4 had no change (6.9%) and 15 had a decline from baseline (25.9%). Mean FiveQ scores improved by 22.9% from 40.8 (SD = 21.4) at baseline to 31.5 (SD = 21.3) following 6 weeks of treatment (p < 0.001). With the exception of the slight tinnitus group, all other groups (from mild to catastrophic) demonstrated a treatment response. Participants with low frequency tinnitus (<2000 Hz) had a significantly greater treatment response (p < 0.001).Conclusion
Customised acoustic therapy administered via a web-based platform demonstrated encouraging efficacy. At least mild symptoms at baseline and low frequency tinnitus were associated with a greater treatment response. Customised acoustic therapy offers accessible and efficacious tinnitus treatment, however longer term clinical studies are required to confirm the observed initial benefit is maintained. 相似文献599.
Sinead Ahern Sarah Marshall Geraldine Wallbank Danielle Jawad Sarah Taki Louise A. Baur Li Ming Wen 《Obesity reviews》2023,24(12):e13634
Children from culturally and linguistically diverse backgrounds experience higher rates of obesity and have poorer outcomes in obesity prevention studies. Interventions tailored to specific cultural groups may be limited within linguistically diverse, multicultural communities, and thus, alternative approaches to childhood obesity prevention in these communities are needed. This study aims to describe communication strategies used in interventions targeting prevention of obesity/obesity-related behaviors, among children 0–5 years, from linguistically diverse communities, and assess their effectiveness. A rapid review was conducted by systematically searching Medline, Embase, and CINAHL. The inclusion criteria are as follows: Studies reported an intervention tailored to linguistically diverse communities targeting at least one obesity-related behavior among children 0–5 years. The exclusion criteria are as follows: Interventions used simple language translations, targeted one language group, or treated obesity. A total of 4677 articles were identified with 14 studies meeting inclusion criteria. Key communication strategies included materials in multiple languages, English text written at a set readability level, and multimodal delivery. Six studies reported effectiveness data, of which five had effective primary or secondary outcomes. This is the first rapid review to identify communication strategies used in childhood obesity prevention interventions for linguistically diverse communities, highlighting a need for future research to incorporate and evaluate the communication strategies identified. 相似文献
600.
Natalie L. McEvoy Oisin Friel Jennifer Clarke Emmet Browne Pierce Geoghegan Aglecia Budri Pinar Avsar Sinead Connolly Declan Patton Gerard F. Curley Zena Moore 《Nursing in critical care》2023,28(6):1115-1123