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Canadian Stroke Best Practice Recommendations, 7th Edition: Cerebral Venous Thrombosis, 2024
- Thalia S. Field, M. Patrice Lindsay, Theodore Wein, Derek B. Debicki, Johnathon Gorman, Manraj KS Heran, Leonard A. Levin, Rebecca Lund, Mahendranath Moharir, Lissa Peeling, Kanjana S. Perera, Deborah Siegal, Steve Verreault, Norine Foley, Chelsy Martin, Eric E. Smith, Anita Mountain, Jennifer Mandzia
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- Canadian Journal of Neurological Sciences / Accepted manuscript
- Published online by Cambridge University Press:
- 03 June 2024, pp. 1-57
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61 Network Segregation Predicts Processing Speed in the Cognitively Healthy Oldest-old
- Sara A Nolin, Mary E Faulkner, Paul Stewart, Leland Fleming, Stacy Merritt, Roxanne F Rezaei, Pradyumna K Bharadwaj, Mary Kathryn Franchetti, Daniel A Raichlen, Courtney J Jessup, Lloyd Edwards, G Alex Hishaw, Emily J Van Etten, Theodore P Trouard, David S Geldmacher, Virginia G Wadley, Noam Alperin, Eric C Porges, Adam J Woods, Ronald A Cohen, Bonnie E Levin, Tatjana Rundek, Gene E Alexander, Kristina M Visscher
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 367-368
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Objective:
Understanding the factors contributing to optimal cognitive function throughout the aging process is essential to better understand successful cognitive aging. Processing speed is an age sensitive cognitive domain that usually declines early in the aging process; however, this cognitive skill is essential for other cognitive tasks and everyday functioning. Evaluating brain network interactions in cognitively healthy older adults can help us understand how brain characteristics variations affect cognitive functioning. Functional connections among groups of brain areas give insight into the brain’s organization, and the cognitive effects of aging may relate to this large-scale organization. To follow-up on our prior work, we sought to replicate our findings regarding network segregation’s relationship with processing speed. In order to address possible influences of node location or network membership we replicated the analysis across 4 different node sets.
Participants and Methods:Data were acquired as part of a multi-center study of 85+ cognitively normal individuals, the McKnight Brain Aging Registry (MBAR). For this analysis, we included 146 community-dwelling, cognitively unimpaired older adults, ages 85-99, who had undergone structural and BOLD resting state MRI scans and a battery of neuropsychological tests. Exploratory factor analysis identified the processing speed factor of interest. We preprocessed BOLD scans using fmriprep, Ciftify, and XCPEngine algorithms. We used 4 different sets of connectivity-based parcellation: 1)MBAR data used to define nodes and Power (2011) atlas used to determine node network membership, 2) Younger adults data used to define nodes (Chan 2014) and Power (2011) atlas used to determine node network membership, 3) Older adults data from a different study (Han 2018) used to define nodes and Power (2011) atlas used to determine node network membership, and 4) MBAR data used to define nodes and MBAR data based community detection used to determine node network membership.
Segregation (balance of within-network and between-network connections) was measured within the association system and three wellcharacterized networks: Default Mode Network (DMN), Cingulo-Opercular Network (CON), and Fronto-Parietal Network (FPN). Correlation between processing speed and association system and networks was performed for all 4 node sets.
Results:We replicated prior work and found the segregation of both the cortical association system, the segregation of FPN and DMN had a consistent relationship with processing speed across all node sets (association system range of correlations: r=.294 to .342, FPN: r=.254 to .272, DMN: r=.263 to .273). Additionally, compared to parcellations created with older adults, the parcellation created based on younger individuals showed attenuated and less robust findings as those with older adults (association system r=.263, FPN r=.255, DMN r=.263).
Conclusions:This study shows that network segregation of the oldest-old brain is closely linked with processing speed and this relationship is replicable across different node sets created with varied datasets. This work adds to the growing body of knowledge about age-related dedifferentiation by demonstrating replicability and consistency of the finding that as essential cognitive skill, processing speed, is associated with differentiated functional networks even in very old individuals experiencing successful cognitive aging.
Validity of the NIH toolbox cognitive battery in a healthy oldest-old 85+ sample
- Sara A. Nolin, Hannah Cowart, Stacy Merritt, Katalina McInerney, P. K. Bharadwaj, Mary Kate Franchetti, David A. Raichlen, Cortney J. Jessup, G. Alex Hishaw, Emily J. Van Etten, Theodore P. Trouard, David S. Geldmacher, Virginia G. Wadley, Eric S. Porges, Adam J. Woods, Ron A. Cohen, Bonnie E. Levin, Tatjana Rundek, Gene E. Alexander, Kristina M. Visscher
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue 6 / July 2023
- Published online by Cambridge University Press:
- 14 October 2022, pp. 605-614
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Objective:
To evaluate the construct validity of the NIH Toolbox Cognitive Battery (NIH TB-CB) in the healthy oldest-old (85+ years old).
Method:Our sample from the McKnight Brain Aging Registry consists of 179 individuals, 85 to 99 years of age, screened for memory, neurological, and psychiatric disorders. Using previous research methods on a sample of 85 + y/o adults, we conducted confirmatory factor analyses on models of NIH TB-CB and same domain standard neuropsychological measures. We hypothesized the five-factor model (Reading, Vocabulary, Memory, Working Memory, and Executive/Speed) would have the best fit, consistent with younger populations. We assessed confirmatory and discriminant validity. We also evaluated demographic and computer use predictors of NIH TB-CB composite scores.
Results:Findings suggest the six-factor model (Vocabulary, Reading, Memory, Working Memory, Executive, and Speed) had a better fit than alternative models. NIH TB-CB tests had good convergent and discriminant validity, though tests in the executive functioning domain had high inter-correlations with other cognitive domains. Computer use was strongly associated with higher NIH TB-CB overall and fluid cognition composite scores.
Conclusion:The NIH TB-CB is a valid assessment for the oldest-old samples, with relatively weak validity in the domain of executive functioning. Computer use’s impact on composite scores could be due to the executive demands of learning to use a tablet. Strong relationships of executive function with other cognitive domains could be due to cognitive dedifferentiation. Overall, the NIH TB-CB could be useful for testing cognition in the oldest-old and the impact of aging on cognition in older populations.
P.002 Saccade parameters reveal cognitive impairment and differentially associate with cognitive domains across neurodegenerative diseases
- HC Riek, BC Coe, DC Brien, J Huang, A Abrahao, S Arnott, D Beaton, M Binns, S Black, M Borrie, L Casaubon, D Dowlatshahi, E Finger, C Fischer, A Frank, M Freedman, D Grimes, A Hassan, M Jog, S Kumar, D Kwan, A Lang, J Lawrence Dewar, B Levine, W Lou, J Mandzia, C Marras, M Masellis, P McLaughlin, J Orange, S Pasternak, A Peltsch, B Pollock, T Rajji, A Roberts, D Sahlas, G Saposnik, D Seitz, C Shoesmith, T Steeves, S Strother, S Sujanthan, K Sunderland, R Swartz, B Tan, D Tang-Wai, C Tartaglia, A Troyer, J Turnbull, L Zinman, ONDRI Investigators (), DP Munoz
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 49 / Issue s1 / June 2022
- Published online by Cambridge University Press:
- 24 June 2022, p. S8
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Background: Eye movements reveal neurodegenerative disease processes due to overlap between oculomotor circuitry and disease-affected areas. Characterizing oculomotor behaviour in context of cognitive function may enhance disease diagnosis and monitoring. We therefore aimed to quantify cognitive impairment in neurodegenerative disease using saccade behaviour and neuropsychology. Methods: The Ontario Neurodegenerative Disease Research Initiative recruited individuals with neurodegenerative disease: one of Alzheimer’s disease, mild cognitive impairment, amyotrophic lateral sclerosis, frontotemporal dementia, Parkinson’s disease, or cerebrovascular disease. Patients (n=450, age 40-87) and healthy controls (n=149, age 42-87) completed a randomly interleaved pro- and anti-saccade task (IPAST) while their eyes were tracked. We explored the relationships of saccade parameters (e.g. task errors, reaction times) to one another and to cognitive domain-specific neuropsychological test scores (e.g. executive function, memory). Results: Task performance worsened with cognitive impairment across multiple diseases. Subsets of saccade parameters were interrelated and also differentially related to neuropsychology-based cognitive domain scores (e.g. antisaccade errors and reaction time associated with executive function). Conclusions: IPAST detects global cognitive impairment across neurodegenerative diseases. Subsets of parameters associate with one another, suggesting disparate underlying circuitry, and with different cognitive domains. This may have implications for use of IPAST as a cognitive screening tool in neurodegenerative disease.
Healthcare-associated infections on the intensive care unit in 21 Brazilian hospitals during the early months of the coronavirus disease 2019 (COVID-19) pandemic: An ecological study
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- Ana Paula M. Porto, Igor C. Borges, Lewis Buss, Anna Machado, Bil R. Bassetti, Brunno Cocentino, Camila S. Bicalho, Claudia M.D.M. Carrilho, Cristhieni Rodrigues, Eudes A.S. Neto, Evelyne S. Girão, Filipe Piastrelli, Giovanna Sapienza, Glaucia Varkulja, Karin Kolbe, Luciana Passos, Patricia Esteves, Pollyana Gitirana, Regia D.F. Feijó, Rosane L. Coutinho, Thais Guimarães, Tiago L.L. Ferraz, Anna S. Levin, Silvia F. Costa
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 44 / Issue 2 / February 2023
- Published online by Cambridge University Press:
- 18 March 2022, pp. 284-290
- Print publication:
- February 2023
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Objective:
The coronavirus disease 2019 (COVID-19) pandemic has caused a global health crisis and may have affected healthcare-associated infection (HAI) prevention strategies. We evaluated the impact of the COVID-19 pandemic on HAI incidence in Brazilian intensive care units (ICUs).
Methods:In this ecological study, we compared adult patients admitted to the ICU from April through June 2020 (pandemic period) with the same period in 2019 (prepandemic period) in 21 Brazilian hospitals. We used the Wilcoxon signed rank-sum test in a pairwise analysis to compare the following differences between the pandemic and the prepandemic periods: microbiologically confirmed central-line–associated bloodstream infection (CLABSI) and ventilator-associated pneumonia (VAP) incidence density (cases per 1,000 central line and ventilator days, respectively), the proportion of organisms that caused HAI, and antibiotic consumption (DDD).
Results:We detected a significant increase in median CLABSI incidence during the pandemic: 1.60 (IQR, 0.44–4.20) vs 2.81 (IQR, 1.35–6.89) (P = .002). We did not detect a significant difference in VAP incidence between the 2 periods. In addition, we detected a significant increase in the proportion of CLABSI caused by Enterococcus faecalis and Candida spp during the pandemic, although only the latter retained statistical significance after correction for multiple comparisons. We did not detect a significant change in ceftriaxone, piperacillin–tazobactam, meropenem, or vancomycin consumption between the studied periods.
Conclusions:There was an increase in CLABSI incidence in Brazilian ICUs during the first months of COVID-19 pandemic. Additionally, we detected an increase in the proportion of CLABSI caused by E. faecalis and Candida spp during this period. CLABSI prevention strategies must be reinforced in ICUs during the COVID-19 pandemic.
ATMOSPHERIC RADIOCARBON FOR THE PERIOD 1950–2019
- Quan Hua, Jocelyn C Turnbull, Guaciara M Santos, Andrzej Z Rakowski, Santiago Ancapichún, Ricardo De Pol-Holz, Samuel Hammer, Scott J Lehman, Ingeborg Levin, John B Miller, Jonathan G Palmer, Chris S M Turney
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- Journal:
- Radiocarbon / Volume 64 / Issue 4 / August 2022
- Published online by Cambridge University Press:
- 23 November 2021, pp. 723-745
- Print publication:
- August 2022
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This paper presents a compilation of atmospheric radiocarbon for the period 1950–2019, derived from atmospheric CO2 sampling and tree rings from clean-air sites. Following the approach taken by Hua et al. (2013), our revised and extended compilation consists of zonal, hemispheric and global radiocarbon (14C) data sets, with monthly data sets for 5 zones (Northern Hemisphere zones 1, 2, and 3, and Southern Hemisphere zones 3 and 1–2). Our new compilation includes smooth curves for zonal data sets that are more suitable for dating applications than the previous approach based on simple averaging. Our new radiocarbon dataset is intended to help facilitate the use of atmospheric bomb 14C in carbon cycle studies and to accommodate increasing demand for accurate dating of recent (post-1950) terrestrial samples.
Cost-effectiveness of carbapenem-resistant Enterobacteriaceae (CRE) surveillance in Maryland
- Gary Lin, Katie K. Tseng, Oliver Gatalo, Diego A. Martinez, Jeremiah S. Hinson, Aaron M. Milstone, Scott Levin, Eili Klein, for the CDC Modeling Infectious Diseases in Healthcare Program
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 43 / Issue 9 / September 2022
- Published online by Cambridge University Press:
- 22 October 2021, pp. 1162-1170
- Print publication:
- September 2022
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Objective:
We analyzed the efficacy, cost, and cost-effectiveness of predictive decision-support systems based on surveillance interventions to reduce the spread of carbapenem-resistant Enterobacteriaceae (CRE).
Design:We developed a computational model that included patient movement between acute-care hospitals (ACHs), long-term care facilities (LTCFs), and communities to simulate the transmission and epidemiology of CRE. A comparative cost-effectiveness analysis was conducted on several surveillance strategies to detect asymptomatic CRE colonization, which included screening in ICUs at select or all hospitals, a statewide registry, or a combination of hospital screening and a statewide registry.
Setting:We investigated 51 ACHs, 222 LTCFs, and skilled nursing facilities, and 464 ZIP codes in the state of Maryland.
Patients or participants:The model was informed using 2013–2016 patient-mix data from the Maryland Health Services Cost Review Commission. This model included all patients that were admitted to an ACH.
Results:On average, the implementation of a statewide CRE registry reduced annual CRE infections by 6.3% (18.8 cases). Policies of screening in select or all ICUs without a statewide registry had no significant impact on the incidence of CRE infections. Predictive algorithms, which identified any high-risk patient, reduced colonization incidence by an average of 1.2% (3.7 cases) without a registry and 7.0% (20.9 cases) with a registry. Implementation of the registry was estimated to save $572,000 statewide in averted infections per year.
Conclusions:Although hospital-level surveillance provided minimal reductions in CRE infections, regional coordination with a statewide registry of CRE patients reduced infections and was cost-effective.
Factors associated with typical enteropathogenic Escherichia coli infection among children <5 years old with moderate-to-severe diarrhoea in rural western Kenya, 2008–2012
- K. Fagerli, R. Omore, S. Kim, J. B. Ochieng, T. L. Ayers, J. Juma, T. H. Farag, D. Nasrin, S. Panchalingam, R. M. Robins-Browne, J. P. Nataro, K. L. Kotloff, M. M. Levine, J. Oundo, M. B. Parsons, K. F. Laserson, E. D. Mintz, R. F. Breiman, C. E. O'Reilly
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- Journal:
- Epidemiology & Infection / Volume 148 / 2020
- Published online by Cambridge University Press:
- 16 November 2020, e281
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Typical enteropathogenic Escherichia coli (tEPEC) infection is a major cause of diarrhoea and contributor to mortality in children <5 years old in developing countries. Data were analysed from the Global Enteric Multicenter Study examining children <5 years old seeking care for moderate-to-severe diarrhoea (MSD) in Kenya. Stool specimens were tested for enteric pathogens, including by multiplex polymerase chain reaction for gene targets of tEPEC. Demographic, clinical and anthropometric data were collected at enrolment and ~60-days later; multivariable logistic regressions were constructed. Of 1778 MSD cases enrolled from 2008 to 2012, 135 (7.6%) children tested positive for tEPEC. In a case-to-case comparison among MSD cases, tEPEC was independently associated with presentation at enrolment with a loss of skin turgor (adjusted odds ratio (aOR) 2.08, 95% confidence interval (CI) 1.37–3.17), and convulsions (aOR 2.83, 95% CI 1.12–7.14). At follow-up, infants with tEPEC compared to those without were associated with being underweight (OR 2.2, 95% CI 1.3–3.6) and wasted (OR 2.5, 95% CI 1.3–4.6). Among MSD cases, tEPEC was associated with mortality (aOR 2.85, 95% CI 1.47–5.55). This study suggests that tEPEC contributes to morbidity and mortality in children. Interventions aimed at defining and reducing the burden of tEPEC and its sequelae should be urgently investigated, prioritised and implemented.
NTRK2 Fusion Driven Pediatric Glioblastoma: Identification of key molecular drivers by personalized oncology
- Levine, Y Shen, K Mungall, J Serrano, M Snuderl, E Pleasance, SJM Jones, J Laskin, MA Marra, R Rassekh, R Deyell, S Yip, S Cheng, C Dunham
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- Canadian Journal of Neurological Sciences / Volume 46 / Issue s2 / September 2019
- Published online by Cambridge University Press:
- 05 September 2019, p. S64
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We describe the case of an 11-month-old girl with a rare cerebellar glioblastoma driven by a NACC2-NTRK2 (Nucleus Accumbens Associated Protein 2-Neurotrophic Receptor Tyrosine Kinase 2) fusion. Initial workup of our case demonstrated homozygous CDKN2A deletion, but immunohistochemistry for other driver mutations, including IDH1 R132H, BRAF V600E, and H3F3A K27M were negative, and ATRX was retained. Tissue was subsequently submitted for personalized oncogenomic analysis, including whole genome and whole transcriptome sequencing, which demonstrated an activating NTRK2 fusion, as well as high PD-L1 expression, which was subsequently confirmed by immunohistochemistry. Furthermore, H3 and IDH demonstrated wildtype status. These findings suggested the possibility of treatment with either NTRK- or immune checkpoint- inhibitors through active clinical trials. Ultimately, the family pursued standard treatment that involved Head Start III chemotherapy and proton radiotherapy. Notably, at most recent follow upapproximately two years from initial diagnosis, the patient is in disease remission and thriving, suggesting favorable biology despite histologic malignancy. This case illustrates the value of personalized oncogenomics, as the molecular profiling revealed two actionable changes that would not have been apparent through routine diagnostics. NTRK fusions are known oncogenic drivers in a range of cancer types, but this is the first report of a NACC2-NTRK2 fusion in a glioblastoma.
LEARNING OBJECTIVESThis presentation will enable the learner to:
1. Explore the current molecular landscape of pediatric high grade gliomas
2. Recognize the value of personalized oncogenomic analysis, particularly in rare and/or aggressive tumors
3. Discuss the current status of NTRK inhibitor clinical trials
Diarrhoea, enteric pathogen detection and nutritional indicators among controls in the Global Enteric Multicenter Study, Kenya site: an opportunity to understand reference populations in case–control studies of diarrhoea
- D. M. Berendes, C. E. O'Reilly, S. Kim, R. Omore, J. B. Ochieng, T. Ayers, K. Fagerli, T. H. Farag, D. Nasrin, S. Panchalingam, J. P. Nataro, K. L. Kotloff, M. M. Levine, J. Oundo, K. Laserson, R. F. Breiman, E. D. Mintz
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- Journal:
- Epidemiology & Infection / Volume 147 / 2019
- Published online by Cambridge University Press:
- 15 November 2018, e44
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Given the challenges in accurately identifying unexposed controls in case–control studies of diarrhoea, we examined diarrhoea incidence, subclinical enteric infections and growth stunting within a reference population in the Global Enteric Multicenter Study, Kenya site. Within ‘control’ children (0–59 months old without diarrhoea in the 7 days before enrolment, n = 2384), we examined surveys at enrolment and 60-day follow-up, stool at enrolment and a 14-day post-enrolment memory aid for diarrhoea incidence. At enrolment, 19% of controls had ⩾1 enteric pathogen associated with moderate-to-severe diarrhoea (‘MSD pathogens’) in stool; following enrolment, many reported diarrhoea (27% in 7 days, 39% in 14 days). Controls with and without reported diarrhoea had similar carriage of MSD pathogens at enrolment; however, controls reporting diarrhoea were more likely to report visiting a health facility for diarrhoea (27% vs. 7%) or fever (23% vs. 16%) at follow-up than controls without diarrhoea. Odds of stunting differed by both MSD and ‘any’ (including non-MSD pathogens) enteric pathogen carriage, but not diarrhoea, suggesting control classification may warrant modification when assessing long-term outcomes. High diarrhoea incidence following enrolment and prevalent carriage of enteric pathogens have implications for sequelae associated with subclinical enteric infections and for design and interpretation of case–control studies examining diarrhoea.
29 Unraveling molecular drivers of brain cancers at the clinical setting
- D. Wong, Y. Shen, A. B. Levine, T. Hoon Lee, E. Pleasance, M. Jones, B. Thiessen, B. Toyota, C.M, J. Laskin, S. Jones, M. A Marra, S. Yip
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- Canadian Journal of Neurological Sciences / Volume 45 / Issue S3 / June 2018
- Published online by Cambridge University Press:
- 27 July 2018, p. S15
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Brain tumor behavior is driven by aberrations in the genome and epigenome. Many of these changes, such as IDH mutations in diffuse low-grade glioma (DLGG), are common amongst the same class of tumour and can be incorporated into the diagnostic criteria. However, any given tumor may have other, less common genomic aberrations that are essential for its biological behavior and may inform on underlying aberrant cellular pathways, and potential therapeutic agents. Precision oncology is a genomics-based approach which profiles these alterations to better manage cancer patients and has established itself within the practice of oncology and is slowly making its way into neuro-oncology. The BC Cancer’s Personalized OncoGenomics (POG) program has profiled 16 adult tumours originating from the central nervous system using whole genome and transcriptome analysis (WGTA), for the first time, within a meaningful clinical timeframe/setting. As expected, primary genomic drivers were consistent with their respective diagnoses, though secondary drivers were found to be unique to each tumour. Although these analyses did not result in altered clinical management for these patients, primarily due to availability of drug or clinical trials, they highlight the heterogeneity of secondary drivers in cancers and provide clinicians with meaningful biological information. Lastly, the data generated by POG has highlighted the frequency and complexity of novel driver fusions which are predicted to behave similarly to canonical driver events in their respective tumours. The information available to clinicians through POG has provided paramount knowledge into the biology of each unique tumour.
P.017 Results of a Pilot feasibility study to develop reduce wait times strategy in the evaluation of children with new onset epilepsy
- JA Mailo, M Diebold, E Mazza, P Guertjens, H Gangam, S Levin, C Campbell, AN Prasad
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 45 / Issue s2 / June 2018
- Published online by Cambridge University Press:
- 27 June 2018, p. S20
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Background: The goal was to understand factors leading to prolonged wait times for neurological assessment of children with new onset seizures. A second objective was to develop an innovative approach to patient flow through and achieve a reduction in waiting times utilizing limited resources.
Methods:
Audit of the referrals, flow through, wait times
Identification of bottlenecks
Development of triaging strategy:
Suspected Febrile seizures and non-epileptic events;
Suspected benign and absence epilepsies;
Suspected other Focal epilepsies, generalized epilepsies, epilepsy under 2 years
Initiation of early telephone contact and support
Development of a ketogenic diet
Results: Using a triaging strategy and focusing on timely access to investigations, wait times for clinic evaluations were shortened despite larger numbers of referrals (mean wait time reductions from 179 to 91 days). Limiting factors such increase in referral numbers, attrition in support staff, interfered with sustainability of reduced wait times achieved in the initial phase of the program. Conclusions: This pilot study highlights the effectiveness of an innovative triaging strategy and improvements in patient flow through in achieving the goals of reduction in wait times for clinical evaluation and timely investigations to improve care for children with new onset seizures. Insights into limitations of such strategies and factors determining sustainability are discussed.
Pulsar Searches with the SKA
- L. Levin, W. Armour, C. Baffa, E. Barr, S. Cooper, R. Eatough, A. Ensor, E. Giani, A. Karastergiou, R. Karuppusamy, M. Keith, M. Kramer, R. Lyon, M. Mackintosh, M. Mickaliger, R van Nieuwpoort, M. Pearson, T. Prabu, J. Roy, O. Sinnen, L. Spitler, H. Spreeuw, B. W. Stappers, W. van Straten, C. Williams, H. Wang, K. Wiesner, the SKA TDT team
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- Journal:
- Proceedings of the International Astronomical Union / Volume 13 / Issue S337 / September 2017
- Published online by Cambridge University Press:
- 04 June 2018, pp. 171-174
- Print publication:
- September 2017
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The Square Kilometre Array will be an amazing instrument for pulsar astronomy. While the full SKA will be sensitive enough to detect all pulsars in the Galaxy visible from Earth, already with SKA1, pulsar searches will discover enough pulsars to increase the currently known population by a factor of four, no doubt including a range of amazing unknown sources. Real time processing is needed to deal with the 60 PB of pulsar search data collected per day, using a signal processing pipeline required to perform more than 10 POps. Here we present the suggested design of the pulsar search engine for the SKA and discuss challenges and solutions to the pulsar search venture.
Two Novel Psychomotor Tasks in Idiopathic Normal Pressure Hydrocephalus
- Maria A. Rossetti, Irene Piryatinsky, Fayeza S. Ahmed, Petra M. Klinge, Norman R. Relkin, Stephen Salloway, Lisa D. Ravdin, Einat Brenner, Paul F. Malloy, Bonnie E. Levin, Michael Broggi, Rebecca Gavett, James S. Maniscalco, Heather Katzen
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- Journal of the International Neuropsychological Society / Volume 22 / Issue 3 / March 2016
- Published online by Cambridge University Press:
- 28 January 2016, pp. 341-349
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Objective: Idiopathic normal pressure hydrocephalus (INPH) is a neurological disorder presenting with gait, cognitive, and bladder symptoms in the context of ventricular enlargement. Although gait is the primary indicator for treatment candidacy and outcome, additional monitoring tools are needed. Line Tracing Test (LTT) and Serial Dotting Test (SDT), two psychomotor tasks, have been introduced as potential outcome measures but have not been widely studied. This preliminary study examined whether LTT and SDT are sensitive to motor dysfunction in INPH and determined if accuracy and time are important aspects of performance. Methods: Eighty-four INPH subjects and 36 healthy older adults were administered LTT and SDT. Novel error scoring procedures were developed to make scoring practical and efficient; interclass correlation showed good reliability of scoring procedures for both tasks (0.997; p<.001). Results: The INPH group demonstrated slower performance on SDT (p<.001) and made a greater number of errors on both tasks (p<.001). Combined Time/Error scores revealed poorer performance in the INPH group for original-LTT (p<.001), modified-LTT (p≤.001) and SDT (p<.001). Conclusions: These findings indicate LTT and SDT may prove useful for monitoring psychomotor skills in INPH. While completion time reflects impaired processing speed, reduced accuracy may suggest planning and self-monitoring difficulties, aspects of executive functioning known to be compromised in INPH. This is the first study to underscore the importance of performance accuracy in INPH and introduce practical/reliable error scoring for these tasks. Future work will establish reliability and validity of these measures and determine their utility as outcome tools. (JINS, 2016, 22, 341–349)
Assessing Emergency Preparedness and Response Capacity Using Community Assessment for Public Health Emergency Response Methodology: Portsmouth, Virginia, 2013
- Katie M. Kurkjian, Michelle Winz, Jun Yang, Kate Corvese, Ana Colón, Seth J. Levine, Jessica Mullen, Donna Ruth, Rexford Anson-Dwamena, Tesfaye Bayleyegn, David S. Chang
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- Journal:
- Disaster Medicine and Public Health Preparedness / Volume 10 / Issue 2 / April 2016
- Published online by Cambridge University Press:
- 22 January 2016, pp. 193-198
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Objective
For the past decade, emergency preparedness campaigns have encouraged households to meet preparedness metrics, such as having a household evacuation plan and emergency supplies of food, water, and medication. To estimate current household preparedness levels and to enhance disaster response planning, the Virginia Department of Health with remote technical assistance from the Centers for Disease Control and Prevention conducted a community health assessment in 2013 in Portsmouth, Virginia.
MethodsUsing the Community Assessment for Public Health Emergency Response (CASPER) methodology with 2-stage cluster sampling, we randomly selected 210 households for in-person interviews. Households were questioned about emergency planning and supplies, information sources during emergencies, and chronic health conditions.
ResultsInterview teams completed 180 interviews (86%). Interviews revealed that 70% of households had an emergency evacuation plan, 67% had a 3-day supply of water for each member, and 77% had a first aid kit. Most households (65%) reported that the television was the primary source of information during an emergency. Heart disease (54%) and obesity (40%) were the most frequently reported chronic conditions.
ConclusionsThe Virginia Department of Health identified important gaps in local household preparedness. Data from the assessment have been used to inform community health partners, enhance disaster response planning, set community health priorities, and influence Portsmouth’s Community Health Improvement Plan. (Disaster Med Public Health Preparedness. 2016;10:193–198)
Maternal group B Streptococcus and the infant gut microbiota
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- A. E. Cassidy-Bushrow, A. Sitarik, A. M. Levin, S. V. Lynch, S. Havstad, D. R. Ownby, C. C. Johnson, G. Wegienka
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- Journal of Developmental Origins of Health and Disease / Volume 7 / Issue 1 / February 2016
- Published online by Cambridge University Press:
- 12 August 2015, pp. 45-53
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Early patterns of gut colonization may predispose children to adult disease. Exposures in utero and during delivery are associated with the infant gut microbiome. Although ~35% of women carry group B strep (GBS; Streptococcus agalactiae) during pregnancy, it is unknown if GBS presence influences the infant gut microbiome. As part of a population-based, general risk birth cohort, stool specimens were collected from infant’s diapers at research visits conducted at ~1 and 6 months of age. Using the Illumina MiSeq (San Diego, CA) platform, the V4 region of the bacterial 16S rRNA gene was sequenced. Infant gut bacterial community compositional differences by maternal GBS status were evaluated using permutational multivariate analysis of variance. Individual operational taxonomic units (OTUs) were tested using a zero-inflated negative binomial model. Data on maternal GBS and infant gut microbiota from either 1 (n=112) or 6-month-old stool (n=150) specimens was available on 262 maternal-child pairs. Eighty women (30.5%) were GBS+, of who 58 (72.5%) were given intrapartum antibiotics. After adjusting for maternal race, prenatal antifungal use and intrapartum antibiotics, maternal GBS status was statistically significantly associated with gut bacterial composition in the 6 month visit specimen (Canberra R2=0.008, P=0.008; Unweighted UniFrac R2=0.010, P=0.011). Individual OTU tests revealed that infants of GBS+ mothers were significantly enriched for specific members of the Clostridiaceae, Ruminococcoceae, and Enterococcaceae in the 6 month specimens compared with infants of GBS- mothers. Whether these taxonomic differences in infant gut microbiota at 6 months lead to differential predisposition for adult disease requires additional study.
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. 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