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Ian Piper

Alex Carballo-Diéguez, Ivan C Balán, William Brown, Rebecca Giguere, Curtis Dolezal, Cheng-Shiun Leu, Mark A Marzinke, Craig W Hendrix, Jeanna M Piper, Barbra A Richardson, Cynthia Grossman, Sherri Johnson, Kailazarid Gomez, Stephanie Horn, Ratiya Pamela Kunjara Na Ayudhya, Karen Patterson, Cindy Jacobson, Linda-Gail Bekker, Suwat Chariyalertsak, Anupong Chitwarakorn, Pedro Gonzales, Timothy H Holtz, Albert Liu, Kenneth H Mayer, Carmen Zorrilla, Javier Lama, Ian McGowan, Ross D Cranston
Trials to assess microbicide safety require strict adherence to prescribed regimens. If adherence is suboptimal, safety cannot be adequately assessed. MTN-017 was a phase 2, randomized sequence, open-label, expanded safety and acceptability crossover study comparing 1) daily oral emtricitabine/tenofovir disoproxil fumarate (FTC/TDF), 2) daily use of reduced-glycerin 1% tenofovir (RG-TFV) gel applied rectally, and 3) RG-TFV gel applied before and after receptive anal intercourse (RAI)-if participants had no RAI in a week, they were asked to use two doses of gel within 24 hours...
2017: PloS One
Fabian Güiza, Geert Meyfroidt, Ian Piper, Giuseppe Citerio, Iain Chambers, Per Enblad, Pelle Nillson, Bart Feyen, Philippe Jorens, Andrew Maas, Martin U Schuhmann, Rob Donald, Laura Moss, Greet Van den Berghe, Bart Depreitere
The definition of cerebral perfusion pressure (CPP) secondary insults in severe traumatic brain injury remains unclear. The purpose of the present study is to visualize the association of intensity and duration of episodes below or above CPP thresholds and outcome. The analysis was based on prospectively collected minute-by-minute intracranial pressure (ICP) and blood pressure data and outcome from 259 adult patients. The relationship of episodes of CPP below or above a certain threshold for certain duration with the 6-month Glasgow Outcome Score was visualized separately for episodes of active or deficient autoregulation (AR)...
August 15, 2017: Journal of Neurotrauma
Konrad Neumann, Ulrike Grittner, Sophie K Piper, Andre Rex, Oscar Florez-Vargas, George Karystianis, Alice Schneider, Ian Wellwood, Bob Siegerink, John P A Ioannidis, Jonathan Kimmelman, Ulrich Dirnagl
Despite the potential benefits of sequential designs, studies evaluating treatments or experimental manipulations in preclinical experimental biomedicine almost exclusively use classical block designs. Our aim with this article is to bring the existing methodology of group sequential designs to the attention of researchers in the preclinical field and to clearly illustrate its potential utility. Group sequential designs can offer higher efficiency than traditional methods and are increasingly used in clinical trials...
March 2017: PLoS Biology
Karen M Mustian, Catherine M Alfano, Charles Heckler, Amber S Kleckner, Ian R Kleckner, Corinne R Leach, David Mohr, Oxana G Palesh, Luke J Peppone, Barbara F Piper, John Scarpato, Tenbroeck Smith, Lisa K Sprod, Suzanne M Miller
Importance: Cancer-related fatigue (CRF) remains one of the most prevalent and troublesome adverse events experienced by patients with cancer during and after therapy. Objective: To perform a meta-analysis to establish and compare the mean weighted effect sizes (WESs) of the 4 most commonly recommended treatments for CRF-exercise, psychological, combined exercise and psychological, and pharmaceutical-and to identify independent variables associated with treatment effectiveness...
July 1, 2017: JAMA Oncology
Geoffrey C S Smith, Ed Bateman, Ben Cass, Maurizio Damiani, Wade Harper, Hugh Jones, David Lieu, Jeff Petchell, Minas Petrelis, Kalman Piper, Doron Sher, Christopher J Smithers, John Trantalis, Sindy Vrancic, Ian A Harris
BACKGROUND: Proximal humeral fractures are common in older patients. The majority are minimally displaced and are associated with good outcomes after nonoperative treatment. Poorer outcomes are associated with displaced, multipart fractures. There is no clear benefit from surgical fracture fixation compared to nonoperative treatment. Replacement of the fractured humeral head with a hemiarthroplasty is another treatment option, but has not been shown to be clearly superior to nonoperative treatment or internal fixation...
February 28, 2017: Trials
Ross D Cranston, Javier R Lama, Barbra A Richardson, Alex Carballo-Diéguez, Ratiya Pamela Kunjara Na Ayudhya, Karen Liu, Karen B Patterson, Cheng-Shiun Leu, Beth Galaska, Cindy E Jacobson, Urvi M Parikh, Mark A Marzinke, Craig W Hendrix, Sherri Johnson, Jeanna M Piper, Cynthia Grossman, Ken S Ho, Jonathan Lucas, Jim Pickett, Linda-Gail Bekker, Suwat Chariyalertsak, Anupong Chitwarakorn, Pedro Gonzales, Timothy H Holtz, Albert Y Liu, Kenneth H Mayer, Carmen Zorrilla, Jill L Schwartz, James Rooney, Ian McGowan
Background: Human immunodeficiency virus (HIV) disproportionately affects men who have sex with men (MSM) and transgender women (TGW). Safe and acceptable topical HIV prevention methods that target the rectum are needed. Methods: MTN-017 was a phase 2, 3-period, randomized sequence, open-label, expanded safety and acceptability crossover study comparing rectally applied reduced-glycerin (RG) 1% tenofovir (TFV) and oral emtricitabine/TFV disoproxil fumarate (FTC/TDF)...
March 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
John Kinsella, Martin Shaw, Christopher Hawthorne, Ian Piper, Richard Elliott, Christine Lee, Laura Moss
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Christopher Hawthorne, Martin Shaw, Laura Moss, Ian Piper, Richard Elliott, Christine Lee, John Kinsella
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Fabian Güiza, Bart Depreitere, Ian Piper, Giuseppe Citerio, Philippe G Jorens, Andrew Maas, Martin U Schuhmann, Tsz-Yan Milly Lo, Rob Donald, Patricia Jones, Gottlieb Maier, Greet Van den Berghe, Geert Meyfroidt
OBJECTIVE: A model for early detection of episodes of increased intracranial pressure in traumatic brain injury patients has been previously developed and validated based on retrospective adult patient data from the multicenter Brain-IT database. The purpose of the present study is to validate this early detection model in different cohorts of recently treated adult and pediatric traumatic brain injury patients. DESIGN: Prognostic modeling. Noninterventional, observational, retrospective study...
March 2017: Critical Care Medicine
Keaton Piper, Hanna Algattas, Ian A DeAndrea-Lazarus, Kristopher T Kimmell, Yan Michael Li, Kevin A Walter, Howard J Silberstein, G Edward Vates
OBJECTIVE Patients undergoing spinal surgery are at risk for developing venous thromboembolism (VTE). The authors sought to identify risk factors for VTE in these patients. METHODS The American College of Surgeons National Surgical Quality Improvement Project database for the years 2006-2010 was reviewed for patients who had undergone spinal surgery according to their primary Current Procedural Terminology code(s). Clinical factors were analyzed to identify associations with VTE. RESULTS Patients who underwent spinal surgery (n = 22,434) were identified...
January 2017: Journal of Neurosurgery. Spine
Andrew R Green, Daniele Soria, Jacqueline Stephen, Desmond G Powe, Christopher C Nolan, Ian Kunkler, Jeremy Thomas, Gillian R Kerr, Wilma Jack, David Cameron, Tammy Piper, Graham R Ball, Jonathan M Garibaldi, Emad A Rakha, John Ms Bartlett, Ian O Ellis
The Nottingham Prognostic Index Plus (NPI+) is a clinical decision making tool in breast cancer (BC) that aims to provide improved patient outcome stratification superior to the traditional NPI. This study aimed to validate the NPI+ in an independent series of BC. Eight hundred and eighty five primary early stage BC cases from Edinburgh were semi-quantitatively assessed for 10 biomarkers [Estrogen Receptor (ER), Progesterone Receptor (PgR), cytokeratin (CK) 5/6, CK7/8, epidermal growth factor receptor (EGFR), HER2, HER3, HER4, p53, and Mucin 1] using immunohistochemistry and classified into biological classes by fuzzy logic-derived algorithms previously developed in the Nottingham series...
January 2016: Journal of Pathology. Clinical Research
Anna Teresa Mazzeo, Claudia Filippini, Rosalba Rosato, Vito Fanelli, Barbara Assenzio, Ian Piper, Timothy Howells, Ilaria Mastromauro, Maurizio Berardino, Alessandro Ducati, Luciana Mascia
BACKGROUND: Neuroinflammation has been proposed as a possible mechanism of brain damage after traumatic brain injury (TBI), but no consensus has been reached on the most relevant molecules. Furthermore, secondary insults occurring after TBI contribute to worsen neurological outcome in addition to the primary injury. We hypothesized that after TBI, a specific pattern of cytokines is related to secondary insults and outcome. METHODS: A prospective observational clinical study was performed...
June 21, 2016: Journal of Neuroinflammation
Konstantinos Georgatzis, Partha Lal, Christopher Hawthorne, Martin Shaw, Ian Piper, Claire Tarbert, Rob Donald, Christopher K I Williams
INTRODUCTION: High-resolution, artefact-free and accurately annotated physiological data are desirable in patients with brain injury both to inform clinical decision-making and for intelligent analysis of the data in applications such as predictive modelling. We have quantified the quality of annotation surrounding artefactual events and propose a factorial switching linear dynamical systems (FSLDS) approach to automatically detect artefact in physiological data collected in the neurological intensive care unit (NICU)...
2016: Acta Neurochirurgica. Supplement
Laura Moss, Martin Shaw, Ian Piper, D K Arvind, Christopher Hawthorne
The non-surgical management of patients with traumatic brain injury is the treatment and prevention of secondary insults, such as low cerebral perfusion pressure (CPP). Most clinical pressure monitoring systems measure pressure relative to atmospheric pressure. If a patient is managed with their head tilted up, relative to their arterial pressure transducer, then a hydrostatic pressure gradient (HPG) can act against arterial pressure and cause significant errors in calculated CPP.To correct for HPG, the arterial pressure transducer should be placed level with the intracranial pressure transducer...
2016: Acta Neurochirurgica. Supplement
Bart Depreitere, Fabian Güiza, Greet Van den Berghe, Martin U Schuhmann, Gottlieb Maier, Ian Piper, Geert Meyfroidt
BACKGROUND: The concept of CPPopt, a variable cerebral perfusion pressure (CPP) target based on cerebrovascular autoregulatory capacity in severe traumatic brain injury (TBI), is promising. CPPopt calculation is based on the continuous plotting of the pressure reactivity Index (PRx) against CPP and requires processing of waveform quality data. The aim of this study is to investigate whether CPPopt can also be calculated based on minute-by-minute data. METHODS: A low-resolution autoregulation index (LAx) was defined as the minute-by-minute intracranial pressure-mean arterial pressure correlation over varying time intervals...
2016: Acta Neurochirurgica. Supplement
Flora McLennan, Christopher Hawthorne, Martin Shaw, Ian Piper
In neurological intensive care units (NICUs) we are collecting an ever increasing quantity of data. These range from patient demographics and physiological monitoring to treatment strategies and outcomes. The BrainIT database is an example of this type of rich data source. It contains validated data on 264 patients who suffered traumatic brain injury (TBI) admitted to 22 NICUs in 11 European countries between March 2003 and July 2005 [1, 6].
2016: Acta Neurochirurgica. Supplement
Martin Shaw, Ian Piper, Christopher Hawthorne
Intracranial pressure (ICP) monitoring is a key clinical tool in the assessment and treatment of patients in neurointensive care. ICP morphology analysis can be useful in the classification of waveform features.A methodology for the decomposition of an ICP signal into clinically relevant dimensions has been devised that allows the identification of important ICP waveform types. It has three main components. First, multi-resolution convolution analysis is used for the main signal decomposition. Then, an impulse function is created, with multiple parameters, that can represent any form in the signal under analysis...
2016: Acta Neurochirurgica. Supplement
Thomas Beez, Roddy O'Kane, Ian Piper, David Koppel, Meharpal Sangra
Syndromic and nonsyndromic craniosynostosis can be associated with raised intracranial pressure (ICP). After corrective surgery, raised ICP persists or reoccurs in a subgroup of patients. The standard procedure for monitoring ICP is insertion of a percutaneous intraparenchymal probe for a limited time, usually 24 to 48 hours. However, in selected patients repeated ICP measurements might be useful in the clinical setting, and a noninvasive method for achieving this would be desirable. The authors present the use of a telemetric ICP monitoring system implanted during cranial vault expansion in a child with syndromic craniosynostosis...
June 2016: Journal of Craniofacial Surgery
Rory J Piper, Shadia Mikhael, Joanna M Wardlaw, David H Laidlaw, Ian R Whittle, Mark E Bastin
Differentiation of cerebral tumor pathology currently relies on interpretation of conventional structural MRI and in some cases histology. However, more advanced MRI methods may provide further insight into the organization of cerebral tumors and have the potential to aid diagnosis. The objective of this study was to use multimodal quantitative MRI to measure the imaging signatures of meningioma and low-grade glioma (LGG). Nine adults with meningioma and 11 with LGG were identified, and underwent standard structural, quantitative longitudinal relaxation time (T1) mapping, magnetization transfer and diffusion tensor MRI...
May 2016: Magnetic Resonance Imaging
Betsy C Herold, Beatrice A Chen, Robert A Salata, Mark A Marzinke, Clifton W Kelly, Charlene S Dezzutti, Ian McGowan, Beth Galaska, Lisa Levy, Jeanna M Piper, Sharon Hillier, Craig W Hendrix
BACKGROUND: Tenofovir (TFV) gel partially protected against human immunodeficiency virus (HIV) in one but not subsequent trials. The disappointing results were attributed largely to poor adherence. However, timing of gel application relative to sex may impact pharmacokinetics and contribute to outcomes. Thus, we conducted a single-dose pharmacokinetic study of TFV gel applied 1 or 24 hours before or 1 hour before and 1 hour after (BAT) sex and compared results with dosing without sex...
February 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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