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Article ; Online: Resumption of anticoagulant therapy after anticoagulant-related gastrointestinal bleeding.

Little, Derek / Siegal, Deborah M

2019 Volume 180, Page(s) 86

MeSH term(s)	Clinical Trials as Topic ; Factor Xa Inhibitors/adverse effects ; Factor Xa Inhibitors/therapeutic use ; Gastrointestinal Hemorrhage/chemically induced ; Gastrointestinal Hemorrhage/etiology ; Gastrointestinal Hemorrhage/therapy ; Humans ; Prevalence
Chemical Substances	Factor Xa Inhibitors
Language	English
Publishing date	2019-06-13
Publishing country	United States
Document type	Letter
ZDB-ID	121852-9
ISSN	1879-2472 ; 0049-3848
ISSN (online)	1879-2472
ISSN	0049-3848
DOI	10.1016/j.thromres.2019.06.003
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Article ; Online: Patient-facing, Semi-automated, solutions to enhance patient participation in measurement-based care practice standards in a tele-mental health specialty clinic for populations at higher risk for self-harm.

Price, Matthew S / Christensen, Hande / Urquhart, Joy / Butte, Sarly / Acierno, Ron / Little, Deborah M

International journal of medical informatics

2023 Volume 177, Page(s) 105155

Abstract: Purpose: Collecting validated surveys that describe symptom severity (measurement based care) during evidence-based psychotherapy is crucial to allow a therapist to tailor the speed and intensity of treatment. COVID clinic closures mandated we create a ... ...

Abstract	Purpose: Collecting validated surveys that describe symptom severity (measurement based care) during evidence-based psychotherapy is crucial to allow a therapist to tailor the speed and intensity of treatment. COVID clinic closures mandated we create a flexible, remote system to conduct measurement-based care, which was accomplished via RedCap. Methods: RedCap was used to create a semi-automated workflow allowing all clinically-indicated evidence-based surveys (including the PHQ-9) to be delivered via email to patients; with results automatically sent to their provider. Importantly, indications of suicidal ideation were automatically escalated to the provider. Results: PHQ-9 completion improved, while provider burden for collecting surveys was greatly reduced; however, depending largely upon initial provider-patient 'training', overall compliance could still be significantly improved. Conclusion: This workflow gave providers additional information compared to the typical telemedicine environment, and in fact, improved data collection rates over our in-person environment. However, when patients did not complete measures on their own, the burden on providers increased.
MeSH term(s)	Humans ; Patient Participation ; Mental Health ; COVID-19/epidemiology ; Surveys and Questionnaires ; Self-Injurious Behavior
Language	English
Publishing date	2023-07-17
Publishing country	Ireland
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1466296-6
ISSN	1872-8243 ; 1386-5056
ISSN (online)	1872-8243
ISSN	1386-5056
DOI	10.1016/j.ijmedinf.2023.105155
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Article ; Online: Numerical study of optical feedback coherence in semiconductor laser dynamics.

Radziunas, Mindaugas / Little, Douglas J / Kane, Deborah M

Optics letters

2019 Volume 44, Issue 17, Page(s) 4207–4210

Abstract: The nonlinear dynamics of a semiconductor laser with coherent, as compared to incoherent, delayed optical feedback systems have been discussed and contrasted in prior research literature. Here, we report simulations of how the dynamics change as the ... ...

Abstract	The nonlinear dynamics of a semiconductor laser with coherent, as compared to incoherent, delayed optical feedback systems have been discussed and contrasted in prior research literature. Here, we report simulations of how the dynamics change as the coherence of the optical feedback is systematically varied from being coherent, through several levels of partial coherence, to incoherent. An increasing rate of phase disturbance is used to vary the coherence. An edge-emitting, 830 nm, Fabry-Perot semiconductor laser with a long external cavity is simulated. Following this study, consideration of prior and future experimental studies should include evaluation of where on the continuum of partial coherence the delayed optical feedback sits. The level of partial coherence is an important factor affecting the dynamics.
Language	English
Publishing date	2019-09-05
Publishing country	United States
Document type	Journal Article
ISSN	1539-4794
ISSN (online)	1539-4794
DOI	10.1364/OL.44.004207
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Article ; Online: Subdiffraction-limited radius measurements of microcylinders using conventional bright-field optical microscopy.

Little, Douglas J / Kane, Deborah M

Optics letters

2014 Volume 39, Issue 17, Page(s) 5196–5199

Abstract: A technique for measuring the radius of dielectric microcylinders with subdiffraction-limited precision is presented. Diffraction fringes arising from the dielectric cylinder are measured using conventional bright-field optical microscopy and compared ... ...

Abstract	A technique for measuring the radius of dielectric microcylinders with subdiffraction-limited precision is presented. Diffraction fringes arising from the dielectric cylinder are measured using conventional bright-field optical microscopy and compared with theory to deduce the radii. The technique has been demonstrated measuring the radii of the major-ampullate silks from Plebs eburnus spiders. Precision better than 50 nm is demonstrated, using a standard optical microscope with a numerical aperture of 0.6 for the objective. Accuracy was verified using scanning electron microscopy. This technique will facilitate rapid, precise measurement of dielectric microcylinder radii, enabling a new optical-microscopy-based measurement approach for these challenging micro-optics.
Language	English
Publishing date	2014-09-01
Publishing country	United States
Document type	Journal Article
ISSN	1539-4794
ISSN (online)	1539-4794
DOI	10.1364/OL.39.005196
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Article ; Online: Follow-up from the A041202 study shows continued efficacy of ibrutinib regimens for older adults with CLL.

Woyach, Jennifer A / Perez Burbano, Gabriela / Ruppert, Amy S / Miller, Cecelia / Heerema, Nyla A / Zhao, Weiqiang / Wall, Anna / Ding, Wei / Bartlett, Nancy L / Brander, Danielle M / Barr, Paul M / Rogers, Kerry A / Parikh, Sameer A / Stephens, Deborah M / Brown, Jennifer R / Lozanski, Gerard / Blachly, James / Nattam, Sreenivasa / Larson, Richard A /

Erba, Harry / Litzow, Mark / Luger, Selina / Owen, Carolyn / Kuzma, Charles / Abramson, Jeremy S / Little, Richard F / Dinner, Shira / Stone, Richard M / Uy, Geoffrey / Stock, Wendy / Mandrekar, Sumithra J / Byrd, John C

Blood

2024 Volume 143, Issue 16, Page(s) 1616–1627

Abstract: Abstract: A041202 (NCT01886872) is a phase 3 study comparing bendamustine plus rituximab (BR) with ibrutinib and the combination of ibrutinib plus rituximab (IR) in previously untreated older patients with chronic lymphocytic leukemia (CLL). The initial ...

Abstract	Abstract: A041202 (NCT01886872) is a phase 3 study comparing bendamustine plus rituximab (BR) with ibrutinib and the combination of ibrutinib plus rituximab (IR) in previously untreated older patients with chronic lymphocytic leukemia (CLL). The initial results showed that ibrutinib-containing regimens had superior progression-free survival (PFS) and rituximab did not add additional benefits. Here we present an updated analysis. With a median follow-up of 55 months, the median PFS was 44 months (95% confidence interval [CI], 38-54) for BR and not yet reached in either ibrutinib-containing arm. The 48-month PFS estimates were 47%, 76%, and 76% for BR, ibrutinib, and IR, respectively. The benefit of ibrutinib regimens over chemoimmunotherapy was consistent across subgroups of patients defined by TP53 abnormalities, del(11q), complex karyotype, and immunoglobulin heavy chain variable region (IGHV). No significant interaction effects were observed between the treatment arm and del(11q), the complex karyotype, or IGHV. However, a greater difference in PFS was observed among the patients with TP53 abnormalities. There was no difference in the overall survival. Notable adverse events with ibrutinib included atrial fibrillation (afib) and hypertension. Afib was observed in 11 patients (pts) on BR (3%) and 67 pts on ibrutinib (18%). All-grade hypertension was observed in 95 pts on BR (27%) and 263 pts on ibrutinib (55%). These data show that ibrutinib regimens prolong PFS compared with BR for older patients with treatment-naïve CLL. These benefits were observed across subgroups, including high-risk groups. Strikingly, within the ibrutinib arms, there was no inferior PFS for patients with abnormalities in TP53, the highest risk feature observed in CLL. These data continue to demonstrate the efficacy of ibrutinib in treatment-naïve CLL.
MeSH term(s)	Humans ; Aged ; Rituximab/therapeutic use ; Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy ; Follow-Up Studies ; Atrial Fibrillation/etiology ; Bendamustine Hydrochloride/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; Hypertension/etiology ; Adenine/analogs & derivatives ; Piperidines
Chemical Substances	Rituximab (4F4X42SYQ6) ; ibrutinib (1X70OSD4VX) ; Bendamustine Hydrochloride (981Y8SX18M) ; Adenine (JAC85A2161) ; Piperidines
Language	English
Publishing date	2024-01-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	80069-7
ISSN	1528-0020 ; 0006-4971
ISSN (online)	1528-0020
ISSN	0006-4971
DOI	10.1182/blood.2023021959
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Article ; Online: Heartworm prevalence in dogs versus cats: Multiple diagnostic modalities provide new insights.

Hays, Kellie M / Rodriguez, Jessica Y / Little, Susan E / Litster, Annette L / Mwacalimba, Kennedy K / Sundstrom, Kellee D / Amodie, Deborah M / Serrano, Maria A / Guerios, Simone D / Lane, Jennifer N / Levy, Julie K

Veterinary parasitology: X

2020 Volume 4, Page(s) 100027

Abstract: The cornerstones of diagnosis of heartworm (HW) in dogs are the detection of circulating antigen from adult ... ...

Abstract	The cornerstones of diagnosis of heartworm (HW) in dogs are the detection of circulating antigen from adult female
Language	English
Publishing date	2020-06-12
Publishing country	Netherlands
Document type	Journal Article
ISSN	2590-1389
ISSN (online)	2590-1389
DOI	10.1016/j.vpoa.2020.100027
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Article ; Online: Biological resurfacing in a canine model of hip osteoarthritis.

Estes, Bradley T / Enomoto, Masataka / Moutos, Franklin T / Carson, Megan A / Toth, Jeffrey M / Eggert, Peter / Stallrich, Jonathan / Willard, Vincent P / Veis, Deborah J / Little, Dianne / Guilak, Farshid / Lascelles, B Duncan X

Science advances

2021 Volume 7, Issue 38, Page(s) eabi5918

Abstract: Articular cartilage has unique load-bearing properties but has minimal capacity for intrinsic repair. Here, we used three-dimensional weaving, additive manufacturing, and autologous mesenchymal stem cells to create a tissue-engineered, bicomponent ... ...

Abstract	Articular cartilage has unique load-bearing properties but has minimal capacity for intrinsic repair. Here, we used three-dimensional weaving, additive manufacturing, and autologous mesenchymal stem cells to create a tissue-engineered, bicomponent implant to restore hip function in a canine hip osteoarthritis model. This resorbable implant was specifically designed to function mechanically from the time of repair and to biologically integrate with native tissues for long-term restoration. A massive osteochondral lesion was created in the hip of skeletally mature hounds and repaired with the implant or left empty (control). Longitudinal outcome measures over 6 months demonstrated that the implant dogs returned to normal preoperative values of pain and function. Anatomical structure and functional biomechanical properties were also restored in the implanted dogs. Control animals never returned to normal and exhibited structurally deficient repair. This study provides clinically relevant evidence that the bicomponent implant may be a potential therapy for moderate hip osteoarthritis.
Language	English
Publishing date	2021-09-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2810933-8
ISSN	2375-2548 ; 2375-2548
ISSN (online)	2375-2548
ISSN	2375-2548
DOI	10.1126/sciadv.abi5918
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Article ; Online: Randomized, double-blinded, placebo-controlled trial comparing two multimodal opioid-minimizing pain management regimens following transsphenoidal surgery.

Shepherd, Deborah M / Jahnke, Heidi / White, William L / Little, Andrew S

Journal of neurosurgery

2017 Volume 128, Issue 2, Page(s) 444–451

Abstract: OBJECTIVE Pain control is an important clinical consideration and quality-of-care metric. No studies have examined postoperative pain control following transsphenoidal surgery for pituitary lesions. The study goals were to 1) report postoperative pain ... ...

Abstract	OBJECTIVE Pain control is an important clinical consideration and quality-of-care metric. No studies have examined postoperative pain control following transsphenoidal surgery for pituitary lesions. The study goals were to 1) report postoperative pain scores following transsphenoidal surgery, 2) determine if multimodal opioid-minimizing pain regimens yielded satisfactory postoperative pain control, and 3) determine if intravenous (IV) ibuprofen improved postoperative pain scores and reduced opioid use compared with placebo. METHODS This study was a single-center, randomized, double-blinded, placebo-controlled intervention trial involving adult patients with planned transsphenoidal surgery for pituitary tumors randomized into 2 groups. Group 1 patients were treated with scheduled IV ibuprofen, scheduled oral acetaminophen, and rescue opioids. Group 2 patients were treated with IV placebo, scheduled oral acetaminophen, and rescue opioids. The primary end point was patient pain scores (visual analog scale [VAS], rated 0-10) for 48 hours after surgery. The secondary end point was opioid use as estimated by oral morphine equivalents (OMEs). RESULTS Of 136 patients screened, 62 were enrolled (28 in Group 1, 34 in Group 2). The study was terminated early because the primary and secondary end points were reached. Baseline characteristics between groups were well matched except for age (Group 1, 59.3 ± 14.4 years; Group 2, 49.8 ± 16.2 years; p = 0.02). Mean VAS pain scores were significantly different, with a 43% reduction in Group 1 (1.7 ± 2.2) compared with Group 2 (3.0 ± 2.8; p < 0.0001). Opioid use was significantly different, with a 58% reduction in Group 1 (26.3 ± 28.7 mg OME) compared with Group 2 (62.5 ± 63.8 mg OME; p < 0.0001). CONCLUSIONS Multimodal opioid-minimizing pain-management protocols resulted in acceptable pain control following transsphenoidal surgery. IV ibuprofen resulted in significantly improved pain scores and significantly decreased opioid use compared with placebo. Postoperative multimodal pain management, including a nonsteroidal antiinflammatory medication, should be considered after surgery to improve patient comfort and to limit opioid use. Clinical trial registration no.: NCT02351700 (clinicaltrials.gov) ■ CLASSIFICATION OF EVIDENCE Type of question: therapeutic; study design: randomized, controlled trial; evidence: Class III.
MeSH term(s)	Acetaminophen/therapeutic use ; Administration, Intravenous ; Adult ; Aged ; Aged, 80 and over ; Analgesics, Non-Narcotic/therapeutic use ; Analgesics, Opioid/administration & dosage ; Analgesics, Opioid/adverse effects ; Analgesics, Opioid/therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal/administration & dosage ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Double-Blind Method ; Hemorrhage/chemically induced ; Hemorrhage/epidemiology ; Humans ; Ibuprofen/administration & dosage ; Ibuprofen/therapeutic use ; Male ; Middle Aged ; Pain Management/methods ; Pain Measurement ; Pain, Postoperative/drug therapy ; Sphenoid Bone/surgery ; Treatment Outcome ; Young Adult
Chemical Substances	Analgesics, Non-Narcotic ; Analgesics, Opioid ; Anti-Inflammatory Agents, Non-Steroidal ; Acetaminophen (362O9ITL9D) ; Ibuprofen (WK2XYI10QM)
Language	English
Publishing date	2017-03-03
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Randomized Controlled Trial
ZDB-ID	3089-2
ISSN	1933-0693 ; 0022-3085
ISSN (online)	1933-0693
ISSN	0022-3085
DOI	10.3171/2016.10.JNS161355
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Article ; Online: Management of antithrombotic therapy after gastrointestinal bleeding: A mixed methods study of health-care providers.

Little, Derek H W / Robertson, Tara / Douketis, James / Dionne, Joanna C / Holbrook, Anne / Xenodemetropoulos, Ted / Siegal, Deborah M

Journal of thrombosis and haemostasis : JTH

2020 Volume 19, Issue 1, Page(s) 153–160

Abstract: Essentials The factors influencing anticoagulation management after gastrointestinal bleeding are unclear. Focus groups and a discrete choice experiments survey of health-care providers were conducted. Re-bleeding risk and thrombosis risk were the most ... ...

Abstract	Essentials The factors influencing anticoagulation management after gastrointestinal bleeding are unclear. Focus groups and a discrete choice experiments survey of health-care providers were conducted. Re-bleeding risk and thrombosis risk were the most important factors influencing decision making. Preference variability exists with a minority most sensitive to the anticoagulation indication. ABSTRACT: Background Oral anticoagulants (OACs) are permanently discontinued in up to 50% of patients after gastrointestinal (GI) bleeding despite evidence of benefit to restarting. Objectives We aimed to identify factors influencing health-care provider decision making regarding resuming OAC after GI bleeding and to identify preference groups. Patients/Methods We conducted focus group discussions (FGDs) with health-care providers. Themes identified and ranked through a dot voting exercise became the attributes for a discrete choice experiment survey of health-care providers developed using Sawtooth (Sawtooth Software, Provo, UT, USA). Hierarchical Bayes analysis was used to estimate preference coefficients (utilities) for each attribute. Preference groups were identified using latent class analysis. Results We conducted four FGDs involving 29 participants. The five most important factors identified in the FGDs were included in the survey. There were 250 survey respondents (mean age 45 years, 53% male). The most important factor was re-bleeding risk followed by thrombosis risk, index bleed severity, indication for OAC, and patient characteristics. Two preference groups were identified, a majority group (87% of respondents) placed the highest utility on re-bleeding risk followed by thrombosis risk, while a minority group (13% of respondents) placed the highest utility on OAC indication. Conclusions Overall, the most important factor influencing provider decision making was re-bleeding risk followed closely by thrombosis risk, although the indication for OAC was most important for a minority of respondents. This highlights variability among providers in an area lacking high-quality data to guide practice. Further research is needed to determine absolute rates of outcomes and patient values and preferences.
MeSH term(s)	Administration, Oral ; Anticoagulants/adverse effects ; Atrial Fibrillation/drug therapy ; Bayes Theorem ; Female ; Fibrinolytic Agents/adverse effects ; Gastrointestinal Hemorrhage/chemically induced ; Gastrointestinal Hemorrhage/diagnosis ; Humans ; Male ; Middle Aged ; Risk Factors
Chemical Substances	Anticoagulants ; Fibrinolytic Agents
Language	English
Publishing date	2020-10-21
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2112661-6
ISSN	1538-7836 ; 1538-7933
ISSN (online)	1538-7836
ISSN	1538-7933
DOI	10.1111/jth.15111
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Article ; Online: Hybrid immersion-polarization method for measuring birefringence applied to spider silks.

Little, Douglas J / Kane, Deborah M

Optics letters

2011 Volume 36, Issue 20, Page(s) 4098–4100

Abstract: A technique for accurate measurement of the principle refractive indices and birefringence for silklike samples is presented. It is based on rotating the linear polarization of the illuminating light on a silk immersed in reference liquid to achieve ... ...

Abstract	A technique for accurate measurement of the principle refractive indices and birefringence for silklike samples is presented. It is based on rotating the linear polarization of the illuminating light on a silk immersed in reference liquid to achieve index matching at the silk/liquid interface. The technique was used to measure the principal refractive indices of a P. eburnus radial silk at different strains. This in turn allows the calculation of strain-optic coefficients. The first measurement of the strain-optic coefficients of spider silk is presented. The technique is more generally applicable to strain-optic study of birefringent micro-optic samples.
MeSH term(s)	Algorithms ; Animals ; Birefringence ; Immersion ; Insect Proteins/chemistry ; Refractometry/methods ; Silk ; Spiders/chemistry ; Stress, Mechanical
Chemical Substances	Insect Proteins ; Silk
Language	English
Publishing date	2011-10-15
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ISSN	1539-4794
ISSN (online)	1539-4794
DOI	10.1364/OL.36.004098
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