Browsing by Subject "Internationality"
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Item Open Access 10 Years with ICH E10: Choice of Control Groups.(Pharm Stat, 2011-09) Rockhold, Frank W; Enas, Gregory GItem Restricted A census of marine biodiversity knowledge, resources, and future challenges.(PLoS One, 2010-08-02) Costello, Mark John; Coll, Marta; Danovaro, Roberto; Halpin, Pat; Ojaveer, Henn; Miloslavich, PatriciaItem Open Access An Analysis of the Incidence and Outcomes of Major Versus Minor Neurological Decline After Complex Adult Spinal Deformity Surgery: A Subanalysis of Scoli-RISK-1 Study.(Spine, 2018-07) Kato, So; Fehlings, Michael G; Lewis, Stephen J; Lenke, Lawrence G; Shaffrey, Christopher I; Cheung, Kenneth MC; Carreon, Leah Y; Dekutoski, Mark B; Schwab, Frank J; Boachie-Adjei, Oheneba; Kebaish, Khaled M; Ames, Christopher P; Qiu, Yong; Matsuyama, Yukihiro; Dahl, Benny T; Mehdian, Hossein; Pellisé, Ferran; Berven, Sigurd HStudy design
A subanalysis from a prospective, multicenter, international cohort study in 15 sites (Scoli-RISK-1).Objective
To report detailed information regarding the severity of neurological decline related to complex adult spine deformity (ASD) surgery and to examine outcomes based on severity.Summary of background data
Postoperative neurological decline after ASD surgeries can occur due to nerve root(s) or spinal cord dysfunction. The impact of decline and the pattern of recovery may be related to the anatomic location and the severity of the injury.Methods
An investigation of 272 prospectively enrolled complex ASD surgical patients with neurological status measured by American Spinal Injury Association Lower Extremity Motor Scores (LEMS) was undertaken. Postoperative neurological decline was categorized into "major" (≥5 points loss) versus "minor" (<5 points loss) deficits. Timing and extent of recovery in LEMS were investigated for each group.Results
Among the 265 patients with LEMS available at discharge, 61 patients (23%) had neurological decline, with 20 (33%) experiencing major decline. Of note, 90% of the patients with major decline had deficits in three or more myotomes. Full recovery was seen in 24% at 6 weeks and increased to 65% at 6 months. However, 34% continued to experience some neurological decline at 24 months, with 6% demonstrating no improvement. Of 41 patients (67%) with minor decline, 73% had deficits in one or two myotomes. Full recovery was seen in 49% at 6 weeks and increased to 70% at 6 months. Of note, 26% had persistence of some neurological deficit at 24 months, with 18% demonstrating no recovery.Conclusion
In patients undergoing complex ASD correction, a rate of postoperative neurological decline of 23% was noted with 33% of these being "major." Although most patients showed substantial recovery by 6 months, approximately one-third continued to experience neurological dysfunction.Level of evidence
2.Item Open Access An international perspective on hospitalized patients with viral community-acquired pneumonia.(European journal of internal medicine, 2019-02) Radovanovic, Dejan; Sotgiu, Giovanni; Jankovic, Mateja; Mahesh, Padukudru Anand; Marcos, Pedro Jorge; Abdalla, Mohamed I; Di Pasquale, Marta Francesca; Gramegna, Andrea; Gramegna, Andrea; Terraneo, Silvia; Blasi, Francesco; Santus, Pierachille; Aliberti, Stefano; Reyes, Luis F; Restrepo, Marcos I; GLIMP Study GroupBackground
Who should be tested for viruses in patients with community acquired pneumonia (CAP), prevalence and risk factors for viral CAP are still debated. We evaluated the frequency of viral testing, virus prevalence, risk factors and treatment coverage with oseltamivir in patients admitted for CAP.Methods
Secondary analysis of GLIMP, an international, multicenter, point-prevalence study of hospitalized adults with CAP. Testing frequency, prevalence of viral CAP and treatment with oseltamivir were assessed among patients who underwent a viral swab. Univariate and multivariate analysis was used to evaluate risk factors.Results
553 (14.9%) patients with CAP underwent nasal swab. Viral CAP was diagnosed in 157 (28.4%) patients. Influenza virus was isolated in 80.9% of cases. Testing frequency and viral CAP prevalence were inhomogeneous across the participating centers. Obesity (OR 1.59, 95%CI: 1.01-2.48; p = 0.043) and need for invasive mechanical ventilation (OR 1.62, 95%CI: 1.02-2.56; p = 0.040) were independently associated with viral CAP. Prevalence of empirical treatment with oseltamivir was 5.1%.Conclusion
In an international scenario, testing frequency for viruses in CAP is very low. The most common cause of viral CAP is Influenza virus. Obesity and need for invasive ventilation represent independent risk factors for viral CAP. Adherence to recommendations for treatment with oseltamivir is poor.Item Open Access Burden and risk factors for Pseudomonas aeruginosa community-acquired pneumonia: a multinational point prevalence study of hospitalised patients.(The European respiratory journal, 2018-08) Restrepo, Marcos I; Babu, Bettina L; Reyes, Luis F; Chalmers, James D; Soni, Nilam J; Sibila, Oriol; Faverio, Paola; Cilloniz, Catia; Rodriguez-Cintron, William; Aliberti, Stefano; GLIMPPseudomonas aeruginosa is a challenging bacterium to treat due to its intrinsic resistance to the antibiotics used most frequently in patients with community-acquired pneumonia (CAP). Data about the global burden and risk factors associated with P. aeruginosa-CAP are limited. We assessed the multinational burden and specific risk factors associated with P. aeruginosa-CAP.We enrolled 3193 patients in 54 countries with confirmed diagnosis of CAP who underwent microbiological testing at admission. Prevalence was calculated according to the identification of P. aeruginosa Logistic regression analysis was used to identify risk factors for antibiotic-susceptible and antibiotic-resistant P. aeruginosa-CAP.The prevalence of P. aeruginosa and antibiotic-resistant P. aeruginosa-CAP was 4.2% and 2.0%, respectively. The rate of P. aeruginosa CAP in patients with prior infection/colonisation due to P. aeruginosa and at least one of the three independently associated chronic lung diseases (i.e. tracheostomy, bronchiectasis and/or very severe chronic obstructive pulmonary disease) was 67%. In contrast, the rate of P. aeruginosa-CAP was 2% in patients without prior P. aeruginosa infection/colonisation and none of the selected chronic lung diseases.The multinational prevalence of P. aeruginosa-CAP is low. The risk factors identified in this study may guide healthcare professionals in deciding empirical antibiotic coverage for CAP patients.Item Open Access Capacity shortfalls hinder the performance of marine protected areas globally.(Nature, 2017-03-22) Gill, David A; Mascia, Michael B; Ahmadia, Gabby N; Glew, Louise; Lester, Sarah E; Barnes, Megan; Craigie, Ian; Darling, Emily S; Free, Christopher M; Geldmann, Jonas; Holst, Susie; Jensen, Olaf P; White, Alan T; Basurto, Xavier; Coad, Lauren; Gates, Ruth D; Guannel, Greg; Mumby, Peter J; Thomas, Hannah; Whitmee, Sarah; Woodley, Stephen; Fox, Helen EMarine protected areas (MPAs) are increasingly being used globally to conserve marine resources. However, whether many MPAs are being effectively and equitably managed, and how MPA management influences substantive outcomes remain unknown. We developed a global database of management and fish population data (433 and 218 MPAs, respectively) to assess: MPA management processes; the effects of MPAs on fish populations; and relationships between management processes and ecological effects. Here we report that many MPAs failed to meet thresholds for effective and equitable management processes, with widespread shortfalls in staff and financial resources. Although 71% of MPAs positively influenced fish populations, these conservation impacts were highly variable. Staff and budget capacity were the strongest predictors of conservation impact: MPAs with adequate staff capacity had ecological effects 2.9 times greater than MPAs with inadequate capacity. Thus, continued global expansion of MPAs without adequate investment in human and financial capacity is likely to lead to sub-optimal conservation outcomes.Item Open Access Clinical characteristics and outcomes of invasive Lomentospora prolificans infections: Analysis of patients in the FungiScope® registry.(Mycoses, 2020-05) Jenks, Jeffrey D; Seidel, Danila; Cornely, Oliver A; Chen, Sharon; van Hal, Sebastiaan; Kauffman, Carol; Miceli, Marisa H; Heinemann, Melina; Christner, Martin; Jover Sáenz, Alfredo; Burchardt, Alexander; Kemmerling, Björn; Herbrecht, Raoul; Steinmann, Joerg; Shoham, Shmuel; Gräber, Sandra; Pagano, Livio; Deeren, Dries; Slavin, Monica A; Hoenigl, MartinOBJECTIVES:Invasive fungal infections caused by Lomentospora prolificans are associated with very high mortality rates and can be challenging to treat given pan-drug resistance to available antifungal agents. The objective of this study was to describe the clinical presentation and outcomes in a cohort of patients with invasive L prolificans infections. METHODS:We performed a retrospective review of medical records of patients with invasive L prolificans infection in the FungiScope® registry of rare invasive fungal infections. Patients diagnosed between 01 January 2008 and 09 September 2019 were included in for analysis. RESULTS:The analysis included 41 patients with invasive L prolificans infection from eight different countries. Haematological/oncological malignancies were the most frequent underlying disease (66%), disseminated infection was frequent (61%), and the lung was the most commonly involved organ (44%). Most infections (59%) were breakthrough infections. Progression/deterioration/treatment failure was observed in 23/40 (58%) of patients receiving antifungal therapy. In total, 21/41 (51%) patients, and 77% of patients with underlying haematological/oncological malignancy, had a fatal outcome attributed to invasive fungal infection. Combination antifungal therapy was frequent (24/40) and associated with improved survival. In particular, treatment regimens including terbinafine were significantly associated with higher treatment success at final assessment (P = .012), with a positive trend observed for treatment regimens that included voriconazole (P = .054). CONCLUSIONS:Lomentospora prolificans infections were associated with mortality rates of 77% and above in patients with underlying haematological/oncological malignancies and those with disseminated infections. While combination therapy is the preferred option for now, the hope lies with novel antifungals currently under development.Item Open Access Current perspectives on the use of ancillary materials for the manufacture of cellular therapies.(Cytotherapy, 2016-01) Solomon, Jennifer; Csontos, Lynn; Clarke, Dominic; Bonyhadi, Mark; Zylberberg, Claudia; McNiece, Ian; Kurtzberg, Joanne; Bell, Rosemarie; Deans, RobertContinued growth in the cell therapy industry and commercialization of cell therapies that successfully advance through clinical trials has led to increased awareness around the need for specialized and complex materials utilized in their manufacture. Ancillary materials (AMs) are components or reagents used during the manufacture of cell therapy products but are not intended to be part of the final products. Commonly, there are limitations in the availability of clinical-grade reagents used as AMs. Furthermore, AMs may affect the efficacy of the cell product and subsequent safety of the cell therapy for the patient. As such, AMs must be carefully selected and appropriately qualified during the cell therapy development process. However, the ongoing evolution of cell therapy research, limited number of clinical trials and registered cell therapy products results in the current absence of specific regulations governing the composition, compliance, and qualification of AMs often leads to confusion by suppliers and users in this field. Here we provide an overview and interpretation of the existing global framework surrounding AM use and investigate some common misunderstandings within the industry, with the aim of facilitating the appropriate selection and qualification of AMs. The key message we wish to emphasize is that in order to most effectively mitigate risk around cell therapy development and patient safety, users must work with their suppliers and regulators to qualify each AM to assess source, purity, identity, safety, and suitability in a given application.Item Open Access Data monitoring and interim analyses in the pharmaceutical industry: ethical and logistical considerations.(Stat Med, 1993-03) Rockhold, FW; Enas, GGThe characteristics of data monitoring and the need for the use of data monitoring committees in clinical trials sponsored by the pharmaceutical industry differ from those of trials sponsored by government. Data monitoring is a continuous process in industry trials due to the regulatory requirements and the need to more thoroughly evaluate safety of new compounds. As part of this process, interim analyses are employed to make decisions about treatment effects. In some cases, such analyses may require the use of an external data monitoring committee to assist in the data review, analysis and decision making. A number of examples of interim analyses, with and without data monitoring committees, are discussed. Issues surrounding the need for external data monitoring committees and recommendations are presented. In particular the issues of sponsor participation in the data monitoring committee and controls of the decision making process are considered.Item Open Access Gaps in Hypertension Guidelines in Low- and Middle-Income Versus High-Income Countries: A Systematic Review.(Hypertension (Dallas, Tex. : 1979), 2016-12) Owolabi, Mayowa; Olowoyo, Paul; Miranda, J Jaime; Akinyemi, Rufus; Feng, Wuwei; Yaria, Joseph; Makanjuola, Tomiwa; Yaya, Sanni; Kaczorowski, Janusz; Thabane, Lehana; Van Olmen, Josefien; Mathur, Prashant; Chow, Clara; Kengne, Andre; Saulson, Raelle; Thrift, Amanda G; Joshi, Rohina; Bloomfield, Gerald S; Gebregziabher, Mulugeta; Parker, Gary; Agyemang, Charles; Modesti, Pietro Amedeo; Norris, Shane; Ogunjimi, Luqman; Farombi, Temitope; Melikam, Ezinne Sylvia; Uvere, Ezinne; Salako, Babatunde; Ovbiagele, Bruce; COUNCIL InitiativeItem Open Access Genetic diversity fuels gene discovery for tobacco and alcohol use.(Nature, 2022-12) Saunders, Gretchen RB; Wang, Xingyan; Chen, Fang; Jang, Seon-Kyeong; Liu, Mengzhen; Wang, Chen; Gao, Shuang; Jiang, Yu; Khunsriraksakul, Chachrit; Otto, Jacqueline M; Addison, Clifton; Akiyama, Masato; Albert, Christine M; Aliev, Fazil; Alonso, Alvaro; Arnett, Donna K; Ashley-Koch, Allison E; Ashrani, Aneel A; Barnes, Kathleen C; Barr, R Graham; Bartz, Traci M; Becker, Diane M; Bielak, Lawrence F; Benjamin, Emelia J; Bis, Joshua C; Bjornsdottir, Gyda; Blangero, John; Bleecker, Eugene R; Boardman, Jason D; Boerwinkle, Eric; Boomsma, Dorret I; Boorgula, Meher Preethi; Bowden, Donald W; Brody, Jennifer A; Cade, Brian E; Chasman, Daniel I; Chavan, Sameer; Chen, Yii-Der Ida; Chen, Zhengming; Cheng, Iona; Cho, Michael H; Choquet, Hélène; Cole, John W; Cornelis, Marilyn C; Cucca, Francesco; Curran, Joanne E; de Andrade, Mariza; Dick, Danielle M; Docherty, Anna R; Duggirala, Ravindranath; Eaton, Charles B; Ehringer, Marissa A; Esko, Tõnu; Faul, Jessica D; Fernandes Silva, Lilian; Fiorillo, Edoardo; Fornage, Myriam; Freedman, Barry I; Gabrielsen, Maiken E; Garrett, Melanie E; Gharib, Sina A; Gieger, Christian; Gillespie, Nathan; Glahn, David C; Gordon, Scott D; Gu, Charles C; Gu, Dongfeng; Gudbjartsson, Daniel F; Guo, Xiuqing; Haessler, Jeffrey; Hall, Michael E; Haller, Toomas; Harris, Kathleen Mullan; He, Jiang; Herd, Pamela; Hewitt, John K; Hickie, Ian; Hidalgo, Bertha; Hokanson, John E; Hopfer, Christian; Hottenga, JoukeJan; Hou, Lifang; Huang, Hongyan; Hung, Yi-Jen; Hunter, David J; Hveem, Kristian; Hwang, Shih-Jen; Hwu, Chii-Min; Iacono, William; Irvin, Marguerite R; Jee, Yon Ho; Johnson, Eric O; Joo, Yoonjung Y; Jorgenson, Eric; Justice, Anne E; Kamatani, Yoichiro; Kaplan, Robert C; Kaprio, Jaakko; Kardia, Sharon LR; Keller, Matthew C; Kelly, Tanika N; Kooperberg, Charles; Korhonen, Tellervo; Kraft, Peter; Krauter, Kenneth; Kuusisto, Johanna; Laakso, Markku; Lasky-Su, Jessica; Lee, Wen-Jane; Lee, James J; Levy, Daniel; Li, Liming; Li, Kevin; Li, Yuqing; Lin, Kuang; Lind, Penelope A; Liu, Chunyu; Lloyd-Jones, Donald M; Lutz, Sharon M; Ma, Jiantao; Mägi, Reedik; Manichaikul, Ani; Martin, Nicholas G; Mathur, Ravi; Matoba, Nana; McArdle, Patrick F; McGue, Matt; McQueen, Matthew B; Medland, Sarah E; Metspalu, Andres; Meyers, Deborah A; Millwood, Iona Y; Mitchell, Braxton D; Mohlke, Karen L; Moll, Matthew; Montasser, May E; Morrison, Alanna C; Mulas, Antonella; Nielsen, Jonas B; North, Kari E; Oelsner, Elizabeth C; Okada, Yukinori; Orrù, Valeria; Palmer, Nicholette D; Palviainen, Teemu; Pandit, Anita; Park, S Lani; Peters, Ulrike; Peters, Annette; Peyser, Patricia A; Polderman, Tinca JC; Rafaels, Nicholas; Redline, Susan; Reed, Robert M; Reiner, Alex P; Rice, John P; Rich, Stephen S; Richmond, Nicole E; Roan, Carol; Rotter, Jerome I; Rueschman, Michael N; Runarsdottir, Valgerdur; Saccone, Nancy L; Schwartz, David A; Shadyab, Aladdin H; Shi, Jingchunzi; Shringarpure, Suyash S; Sicinski, Kamil; Skogholt, Anne Heidi; Smith, Jennifer A; Smith, Nicholas L; Sotoodehnia, Nona; Stallings, Michael C; Stefansson, Hreinn; Stefansson, Kari; Stitzel, Jerry A; Sun, Xiao; Syed, Moin; Tal-Singer, Ruth; Taylor, Amy E; Taylor, Kent D; Telen, Marilyn J; Thai, Khanh K; Tiwari, Hemant; Turman, Constance; Tyrfingsson, Thorarinn; Wall, Tamara L; Walters, Robin G; Weir, David R; Weiss, Scott T; White, Wendy B; Whitfield, John B; Wiggins, Kerri L; Willemsen, Gonneke; Willer, Cristen J; Winsvold, Bendik S; Xu, Huichun; Yanek, Lisa R; Yin, Jie; Young, Kristin L; Young, Kendra A; Yu, Bing; Zhao, Wei; Zhou, Wei; Zöllner, Sebastian; Zuccolo, Luisa; 23andMe Research Team; Biobank Japan Project; Batini, Chiara; Bergen, Andrew W; Bierut, Laura J; David, Sean P; Gagliano Taliun, Sarah A; Hancock, Dana B; Jiang, Bibo; Munafò, Marcus R; Thorgeirsson, Thorgeir E; Liu, Dajiang J; Vrieze, ScottTobacco and alcohol use are heritable behaviours associated with 15% and 5.3% of worldwide deaths, respectively, due largely to broad increased risk for disease and injury1-4. These substances are used across the globe, yet genome-wide association studies have focused largely on individuals of European ancestries5. Here we leveraged global genetic diversity across 3.4 million individuals from four major clines of global ancestry (approximately 21% non-European) to power the discovery and fine-mapping of genomic loci associated with tobacco and alcohol use, to inform function of these loci via ancestry-aware transcriptome-wide association studies, and to evaluate the genetic architecture and predictive power of polygenic risk within and across populations. We found that increases in sample size and genetic diversity improved locus identification and fine-mapping resolution, and that a large majority of the 3,823 associated variants (from 2,143 loci) showed consistent effect sizes across ancestry dimensions. However, polygenic risk scores developed in one ancestry performed poorly in others, highlighting the continued need to increase sample sizes of diverse ancestries to realize any potential benefit of polygenic prediction.Item Restricted Gold mining in the Peruvian Amazon: global prices, deforestation, and mercury imports.(PLoS One, 2011-04-19) Swenson, Jennifer J; Carter, Catherine E; Domec, Jean-Christophe; Delgado, Cesar IMany factors such as poverty, ineffective institutions and environmental regulations may prevent developing countries from managing how natural resources are extracted to meet a strong market demand. Extraction for some resources has reached such proportions that evidence is measurable from space. We present recent evidence of the global demand for a single commodity and the ecosystem destruction resulting from commodity extraction, recorded by satellites for one of the most biodiverse areas of the world. We find that since 2003, recent mining deforestation in Madre de Dios, Peru is increasing nonlinearly alongside a constant annual rate of increase in international gold price (∼18%/yr). We detect that the new pattern of mining deforestation (1915 ha/year, 2006-2009) is outpacing that of nearby settlement deforestation. We show that gold price is linked with exponential increases in Peruvian national mercury imports over time (R(2) = 0.93, p = 0.04, 2003-2009). Given the past rates of increase we predict that mercury imports may more than double for 2011 (∼500 t/year). Virtually all of Peru's mercury imports are used in artisanal gold mining. Much of the mining increase is unregulated/artisanal in nature, lacking environmental impact analysis or miner education. As a result, large quantities of mercury are being released into the atmosphere, sediments and waterways. Other developing countries endowed with gold deposits are likely experiencing similar environmental destruction in response to recent record high gold prices. The increasing availability of satellite imagery ought to evoke further studies linking economic variables with land use and cover changes on the ground.Item Open Access International comparisons of the management of patients with non-ST segment elevation acute myocardial infarction in the United Kingdom, Sweden, and the United States: The MINAP/NICOR, SWEDEHEART/RIKS-HIA, and ACTION Registry-GWTG/NCDR registries.(Int J Cardiol, 2014-08-01) McNamara, RL; Chung, SC; Jernberg, T; Holmes, D; Roe, M; Timmis, A; James, S; Deanfield, J; Fonarow, GC; Peterson, ED; Jeppsson, A; Hemingway, HOBJECTIVES: To compare management of patients with acute non-ST segment elevation myocardial infarction (NSTEMI) in three developed countries with national ongoing registries. BACKGROUND: Results from clinical trials suggest significant variation in care across the world. However, international comparisons in "real world" registries are limited. METHODS: We compared the use of in-hospital procedures and discharge medications for patients admitted with NSTEMI from 2007 to 2010 using the unselective MINAP/NICOR [England and Wales (UK); n=137,009], the unselective SWEDEHEART/RIKS-HIA (Sweden; n=45,069), and the selective ACTION Registry-GWTG/NCDR [United States (US); n=147,438] clinical registries. RESULTS: Patients enrolled among the three registries were generally similar except those in the US who were younger but had higher rates of smoking, diabetes, hypertension, prior heart failure, and prior MI than in Sweden or in UK. Angiography and percutaneous coronary intervention (PCI) were performed more often in the US (76% and 44%) and Sweden (65% and 42%) relative to the UK (32% and 22%). Discharge betablockers were also prescribed more often in the US (89%) and Sweden (89%) than in the UK (76%). In contrast, discharge statins, angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB), and dual antiplatelet agents (among those not receiving PCI) were higher in the UK (92%, 79%, and 71%) than in the US (85%, 65%, 41%) and Sweden (81%, 69%, and 49%). CONCLUSIONS: The care for patients with NSTEMI differed substantially among the three countries. These differences in care among countries provide an opportunity for future comparative effectiveness research as well as identify opportunities for global quality improvement.Item Open Access International prevalence and risk factors evaluation for drug-resistant Streptococcus pneumoniae pneumonia.(The Journal of infection, 2019-10) Aliberti, Stefano; Cook, Grayden S; Babu, Bettina L; Reyes, Luis F; H Rodriguez, Alejandro; Sanz, Francisco; Soni, Nilam J; Anzueto, Antonio; Faverio, Paola; Sadud, Ricardo Franco; Muhammad, Irfan; Prat, Cristina; Vendrell, Ester; Neves, Joao; Kaimakamis, Evangelos; Feneley, Andrew; Swarnakar, Rajesh; Franzetti, Fabio; Carugati, Manuela; Morosi, Manuela; Monge, Elisa; Restrepo, Marcos I; GLIMP investigatorsObjective
Streptococcus pneumoniae is the most frequent bacterial pathogen isolated in subjects with Community-acquired pneumonia (CAP) worldwide. Limited data are available regarding the current global burden and risk factors associated with drug-resistant Streptococcus pneumoniae (DRSP) in CAP subjects. We assessed the multinational prevalence and risk factors for DRSP-CAP in a multinational point-prevalence study.Design
The prevalence of DRSP-CAP was assessed by identification of DRSP in blood or respiratory samples among adults hospitalized with CAP in 54 countries. Prevalence and risk factors were compared among subjects that had microbiological testing and antibiotic susceptibility data. Multivariate logistic regressions were used to identify risk factors independently associated with DRSP-CAP.Results
3,193 subjects were included in the study. The global prevalence of DRSP-CAP was 1.3% and continental prevalence rates were 7.0% in Africa, 1.2% in Asia, and 1.0% in South America, Europe, and North America, respectively. Macrolide resistance was most frequently identified in subjects with DRSP-CAP (0.6%) followed by penicillin resistance (0.5%). Subjects in Africa were more likely to have DRSP-CAP (OR: 7.6; 95%CI: 3.34-15.35, p<0.001) when compared to centres representing other continents.Conclusions
This multinational point-prevalence study found a low global prevalence of DRSP-CAP that may impact guideline development and antimicrobial policies.Item Open Access Neurologic Outcomes of Complex Adult Spinal Deformity Surgery: Results of the Prospective, Multicenter Scoli-RISK-1 Study.(Spine, 2016-02) Lenke, Lawrence G; Fehlings, Michael G; Shaffrey, Christopher I; Cheung, Kenneth MC; Carreon, Leah; Dekutoski, Mark B; Schwab, Frank J; Boachie-Adjei, Oheneba; Kebaish, Khaled M; Ames, Christopher P; Qiu, Yong; Matsuyama, Yukihiro; Dahl, Benny T; Mehdian, Hossein; Pellisé-Urquiza, Ferran; Lewis, Stephen J; Berven, Sigurd HStudy design
Prospective, multicenter, international observational study.Objective
To evaluate motor neurologic outcomes in patients undergoing surgery for complex adult spinal deformity (ASD).Summary of background data
The neurologic outcomes after surgical correction for ASD have been reported with significant variability and have not been measured as a primary endpoint in any prospective, multicenter, observational study.Methods
The primary outcome measure was the change in American Spinal Injury Association (ASIA) Lower Extremity Motor Scores (LEMS) obtained preoperatively, and at hospital discharge, 6 weeks and 6 months postoperatively.Results
A total of 273 patients with complex ASD underwent surgery at 15 sites worldwide. One patient was excluded for lack of preoperative LEMS. The remaining 272 patients were divided into two groups: normal preoperative LEMS (=50) (Preop NML, N = 204, 75%) and abnormal preoperative LEMS (<50) (Preop ABNML, N = 68, 25%). At hospital discharge, 22.18% of patients showed a decline in LEMS compared with 12.78% who showed an improvement. At 6 weeks, there was a significant change compared with discharge: 17.91% patients showed a decline in LEMS and 16.42% showed an improvement. At 6 months, 10.82% patients showed a decline in preoperative LEMS, 20.52% improvement, and 68.66% maintenance. This was a significant change compared with 6 weeks and at discharge.Conclusion
Although complex ASD surgery can restore neurologic function in patients with a preoperative neurologic deficit, a significant portion of patients with ASD experienced postoperative decline in LEMS. Measures that can anticipate and reduce the risk of postoperative neurologic complications are warranted.Level of evidence
3.Item Open Access Relational Mobility Predicts Faster Spread of COVID-19: A 39-Country Study.(Psychological science, 2020-10) Salvador, Cristina E; Berg, Martha K; Yu, Qinggang; San Martin, Alvaro; Kitayama, ShinobuIt has become increasingly clear that COVID-19 is transmitted between individuals. It stands to reason that the spread of the virus depends on sociocultural ecologies that facilitate or inhibit social contact. In particular, the community-level tendency to engage with strangers and freely choose friends, called relational mobility, creates increased opportunities to interact with a larger and more variable range of other people. It may therefore be associated with a faster spread of infectious diseases, including COVID-19. Here, we tested this possibility by analyzing growth curves of confirmed cases of and deaths due to COVID-19 in the first 30 days of the outbreaks in 39 countries. We found that growth was significantly accelerated as a function of a country-wise measure of relational mobility. This relationship was robust either with or without a set of control variables, including demographic variables, reporting bias, testing availability, and cultural dimensions of individualism, tightness, and government efficiency. Policy implications are also discussed.Item Open Access The second international conference "genetics of aging and longevity".(Aging (Albany NY), 2012-05) Anisimov, Vladimir N; Bartke, Andrzej; Barzilai, Nir; Batin, Mikhail A; Blagosklonny, Mikhail V; Brown-Borg, Holly; Budovskaya, Yelena; Campisi, Judith; Friguet, Bertrand; Fraifeld, Vadim; Franceschi, Claudio; Gems, David; Gladyshev, Vadim; Gorbunova, Vera; Gudkov, Andrei V; Kennedy, Brian; Konovalenko, Maria; Kraemer, Brian; Moskalev, Alexey; Petropoulos, Isabelle; Pasyukova, Elena; Rattan, Suresh; Rogina, Blanka; Seluanov, Andrei; Shaposhnikov, Mikhail; Shmookler Reis, Robert; Tavernarakis, Nektarios; Vijg, Jan; Yashin, Anatoli; Zimniak, PiotrItem Open Access World regional differences in outcomes for patients with peripheral artery disease: Insights from the EUCLID trial.(Vascular medicine (London, England), 2022-02) Norgren, Lars; North, Rebecca; Baumgartner, Iris; Berger, Jeffrey S; Blomster, Juuso I; Hiatt, William R; Jones, W Schuyler; Katona, Brian G; Mahaffey, Kenneth W; Mulder, Hillary; Patel, Manesh R; Rockhold, Frank W; Fowkes, F Gerry RRegional variations exist in the epidemiology of peripheral artery disease (PAD), in comorbidities, use of secondary prevention, and outcomes. Large studies of these variations in worldwide populations are rare. The EUCLID (Examining Use of tiCagreLor In peripheral artery Disease) trial included 13,885 patients with PAD from four geographical regions (Central/South America, Europe, Asia, North America) and compared monotherapy with ticagrelor and clopidogrel. Inclusion criteria were either an ankle-brachial index < 0.80 or a prior revascularization. The primary efficacy endpoint was time to first occurrence of any event in the composite of cardiovascular death, myocardial infarction, or ischemic stroke and did not differ between the study arms. This post hoc analysis of EUCLID confirmed that regional differences occurred in the inclusion criteria with more prior revascularization in North America (73.9%) and Asia (72.5%) compared with Central/South America (34.0%) and Europe (51.6%). The characteristics of patients also differed. Prior amputation at baseline was most frequent in Central/South America (6.3%) compared with other regions (1.6-2.8%). A history of stroke was most common in Asia, coronary heart disease in North America, and diabetes in Central/South America compared with other regions. The incidence of outcomes in patients with PAD varied by region. North America had the highest rate of the primary combined endpoint (5.97 events/100 patient-years). Corresponding rates were 4.80, 3.95, and 3.87 for Asia, Europe, and Central/South America, respectively. Hospitalization for acute limb ischemia (events/100 patient-years) was most frequent in Europe (0.75) and North America (0.74) compared with Asia (0.60) and Central/South America (0.33). Adjustment for inclusion criteria and relevant PAD characteristics did not have a major impact on these regional differences. Further adjustment for concomitant disease, risk factors, and preventive medication modified the regional differences only marginally. In conclusion, substantial regional differences were found in cardiovascular and limb outcomes in patients with PAD and were not explained by variation in the category of included patients, concomitant disease, risk factors, and prevention. Such differences, which may be due to variation in other factors such as background population rates or clinical care, need to be considered when designing and interpreting large international studies (ClinicalTrials.gov Identifier: NCT01732822).