41 results on '"Sajobi, Tolulope T."'
Search Results
2. Quality of Life After Intravenous Thrombolysis for Acute Ischemic Stroke: Results From the AcT Randomized Controlled Trial.
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Sajobi, Tolulope T., Arimoro, Olayinka I., Ademola, Ayoola, Singh, Nishita, Bala, Fouzi, Almekhlafi, Mohammed A., Deschaintre, Yan, Coutts, Shelagh B., Thirunavukkarasu, Sibi, Khosravani, Houman, Appireddy, Ramana, Moreau, François, Gubitz, Gordon J., Tkach, Aleksander, Catanese, Luciana, Dowlatshahi, Dar, Medvedev, George, Mandzia, Jennifer, Pikula, Aleksandra, and Shankar, Jai Shiva
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- 2024
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3. Quality of Life After Intravenous Thrombolysis for Acute Ischemic Stroke: Results From the AcT Randomized Controlled Trial
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Sajobi, Tolulope T., Arimoro, Olayinka I., Ademola, Ayoola, Singh, Nishita, Bala, Fouzi, Almekhlafi, Mohammed A., Deschaintre, Yan, Coutts, Shelagh B., Thirunavukkarasu, Sibi, Khosravani, Houman, Appireddy, Ramana, Moreau, François, Gubitz, Gordon J., Tkach, Aleksander, Catanese, Luciana, Dowlatshahi, Dar, Medvedev, George, Mandzia, Jennifer, Pikula, Aleksandra, Shankar, Jai Shiva, Williams, Heather, Field, Thalia S., Manosalva, Alejandro, Siddiqui, Muzaffar, Zafar, Atif, Imoukhuede, Oje, Hunter, Gary, Demchuk, Andrew M., Mishra, Sachin M., Gioia, Laura C., Jalini, Shirin, Cayer, Caroline, Phillips, Stephen J., Elamin, Elsadig, Shoamanesh, Ashkan, Subramaniam, Suresh, Kate, Mahesh P., Jacquin, Gregory, Camden, Marie-Christine, Benali, Faysal, Alhabli, Ibrahim, Horn, MacKenzie, Stotts, Grant, Hill, Michael D., Gladstone, David J., Poppe, Alexandre Y., Sehgal, Arshia, Zhang, Qiao, Lethebe, Brendan, Doram, Craig, Shamy, Michel, Kenney, Carol, Buck, Brian H., Swartz, Richard H., and Menon, Bijoy K.
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- 2024
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4. Expert elicitation of risk factors for progression to dementia in individuals with mild cognitive impairment.
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Wang, Meng, Sajobi, Tolulope T., Hogan, David B., Ganesh, Aravind, Seitz, Dallas P., Chekouo, Thierry, Forkert, Nils D., Borrie, Michael J., Camicioli, Richard, Hsiung, Ging‐Yuek Robin, Masellis, Mario, Moorhouse, Paige, Tartaglia, Maria Carmela, Ismail, Zahinoor, and Smith, Eric E.
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Introduction: This study assesses experts' beliefs about important predictors of developing dementia in persons with mild cognitive impairment (MCI). Methods: Structured expert elicitation, a methodology to quantify expert knowledge, was used to elicit the most important risk factors for developing dementia. We recruited 11 experts (6 neurologists, 3 geriatricians, and 2 psychiatrists). Ten experts fully participated in introductory meetings, two rounds of surveys, and discussion meetings. The data from these ten experts were utilized for this study. Results: The expert elicitation identified age, CSF analysis, fluorodeoxyglucose‐positron emission tomography (FDG‐PET) findings, hippocampal atrophy, MoCA (or MMSE) score, parkinsonism, apathy, psychosis, informant report of cognitive symptoms, and global atrophy as the ten most important predictors of progressing to dementia in persons with MCI. Discussion: Several dementia predictors are not routinely collected in existing registries, observational studies, or usual care. This might partially explain the low uptake of existing published dementia risk scores in clinical practice. [ABSTRACT FROM AUTHOR]
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- 2023
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5. Association of comorbid-socioeconomic clusters with mortality in late onset epilepsy derived through unsupervised machine learning.
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Josephson, Colin B., Gonzalez-Izquierdo, Arturo, Engbers, Jordan D.T., Denaxas, Spiros, Delgado-Garcia, Guillermo, Sajobi, Tolulope T., Wang, Meng, Keezer, Mark R., and Wiebe, Samuel
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• The risk of premature mortality is elevated following late-onset epilepsy. • Unsupervised machine learning can be used to identify specific clusters of late onset epilepsy patients at uniquely high risk. • The clusters with the highest risk of death are defined by 'dementia and anxiety', 'brain tumours', 'intracerebral haemorrhage and alcohol misuse', and 'ischaemic stroke'. • Seizures and epilepsy were rarely reported as the direct cause of death, highlighting the need for management of comorbid disease. • Unsupervised machine learning approaches to premature mortality in epilepsy could be used to optimise randomised controlled trials and promote precision medicine. Late-onset epilepsy is a heterogenous entity associated with specific aetiologies and an elevated risk of premature mortality. Specific multimorbid-socioeconomic profiles and their unique prognostic trajectories have not been described. We sought to determine if specific clusters of late onset epilepsy exist, and whether they have unique hazards of premature mortality. We performed a retrospective observational cohort study linking primary and hospital-based UK electronic health records with vital statistics data (covering years 1998–2019) to identify all cases of incident late onset epilepsy (from people aged ≥65) and 1:10 age, sex, and GP practice-matched controls. We applied hierarchical agglomerative clustering using common aetiologies identified at baseline to define multimorbid-socioeconomic profiles, compare hazards of early mortality, and tabulating causes of death stratified by cluster. From 1,032,129 people aged ≥65, we identified 1048 cases of late onset epilepsy who were matched to 10,259 controls. Median age at epilepsy diagnosis was 68 (interquartile range: 66–72) and 474 (45%) were female. The hazard of premature mortality related to late-onset epilepsy was higher than matched controls (hazard ratio [HR] 1.73; 95% confidence interval [95%CI] 1.51–1.99). Ten unique phenotypic clusters were identified, defined by 'healthy' males and females, ischaemic stroke, intracerebral haemorrhage (ICH), ICH and alcohol misuse, dementia and anxiety, anxiety, depression in males and females, and brain tumours. Cluster-specific hazards were often similar to that derived for late-onset epilepsy as a whole. Clusters that differed significantly from the base late-onset epilepsy hazard were 'dementia and anxiety' (HR 5.36; 95%CI 3.31–8.68), 'brain tumour' (HR 4.97; 95%CI 2.89–8.56), 'ICH and alcohol misuse' (HR 2.91; 95%CI 1.76–4.81), and 'ischaemic stroke' (HR 2.83; 95%CI 1.83–4.04). These cluster-specific risks were also elevated compared to those derived for tumours, dementia, ischaemic stroke, and ICH in the whole population. Seizure-related cause of death was uncommon and restricted to the ICH, ICH and alcohol misuse, and healthy female clusters. Late-onset epilepsy is an amalgam of unique phenotypic clusters that can be quantitatively defined. Late-onset epilepsy and cluster-specific comorbid profiles have complex effects on premature mortality above and beyond the base rates attributed to epilepsy and cluster-defining comorbidities alone. [ABSTRACT FROM AUTHOR]
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- 2023
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6. Safety and Efficacy of Tenecteplase Compared With Alteplase in Patients With Large Vessel Occlusion Stroke: A Prespecified Secondary Analysis of the ACT Randomized Clinical Trial
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Bala, Fouzi, Singh, Nishita, Buck, Brian, Ademola, Ayoola, Coutts, Shelagh B., Deschaintre, Yan, Khosravani, Houman, Appireddy, Ramana, Moreau, Francois, Phillips, Stephen, Gubitz, Gord, Tkach, Aleksander, Catanese, Luciana, Dowlatshahi, Dar, Medvedev, George, Mandzia, Jennifer, Pikula, Aleksandra, Shankar, Jai Jai, Williams, Heather, Field, Thalia S., Manosalva Alzate, Alejandro, Siddiqui, Muzaffar, Zafar, Atif, Imoukhoude, Oje, Hunter, Gary, Alhabli, Ibrahim, Benali, Faysal, Horn, MacKenzie, Hill, Michael D., Shamy, Michel, Sajobi, Tolulope T., Swartz, Richard H., Menon, Bijoy K., and Almekhlafi, Mohammed
- Abstract
IMPORTANCE: It is unknown whether intravenous thrombolysis using tenecteplase is noninferior or preferable compared with alteplase for patients with acute ischemic stroke. OBJECTIVE: To examine the safety and efficacy of tenecteplase compared to alteplase among patients with large vessel occlusion (LVO) stroke. DESIGN, SETTING, AND PARTICIPANTS: This was a prespecified analysis of the Intravenous Tenecteplase Compared With Alteplase for Acute Ischaemic Stroke in Canada (ACT) randomized clinical trial that enrolled patients from 22 primary and comprehensive stroke centers across Canada between December 10, 2019, and January 25, 2022. Patients 18 years and older with a disabling ischemic stroke within 4.5 hours of symptom onset were randomly assigned (1:1) to either intravenous tenecteplase or alteplase and were monitored for up to 120 days. Patients with baseline intracranial internal carotid artery (ICA), M1-middle cerebral artery (MCA), M2-MCA, and basilar occlusions were included in this analysis. A total of 1600 patients were enrolled, and 23 withdrew consent. EXPOSURES: Intravenous tenecteplase (0.25 mg/kg) vs intravenous alteplase (0.9 mg/kg). MAIN OUTCOMES AND MEASURES: The primary outcome was the proportion of modified Rankin scale (mRS) score 0-1 at 90 days. Secondary outcomes were an mRS score from 0 to 2, mortality, and symptomatic intracerebral hemorrhage. Angiographic outcomes were successful reperfusion (extended Thrombolysis in Cerebral Infarction scale score 2b-3) on first and final angiographic acquisitions. Multivariable analyses (adjusting for age, sex, National Institute of Health Stroke Scale score, onset-to-needle time, and occlusion location) were carried out. RESULTS: Among 1577 patients, 520 (33.0%) had LVO (median [IQR] age, 74 [64-83] years; 283 [54.4%] women): 135 (26.0%) with ICA occlusion, 237 (45.6%) with M1-MCA, 117 (22.5%) with M2-MCA, and 31 (6.0%) with basilar occlusions. The primary outcome (mRS score 0-1) was achieved in 86 participants (32.7%) in the tenecteplase group vs 76 (29.6%) in the alteplase group. Rates of mRS 0-2 (129 [49.0%] vs 131 [51.0%]), symptomatic intracerebral hemorrhage (16 [6.1%] vs 11 [4.3%]), and mortality (19.9% vs 18.1%) were similar in the tenecteplase and alteplase groups, respectively. No difference was noted in successful reperfusion rates in the first (19 [9.2%] vs 21 [10.5%]) and final angiogram (174 [84.5%] vs 177 [88.9%]) among 405 patients who underwent thrombectomy. CONCLUSIONS AND RELEVANCE: The findings in this study indicate that intravenous tenecteplase conferred similar reperfusion, safety, and functional outcomes compared to alteplase among patients with LVO.
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- 2023
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7. Independent Associations of Incident Epilepsy and Enzyme-Inducing and Non–Enzyme-Inducing Antiseizure Medications With the Development of Osteoporosis
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Josephson, Colin B., Gonzalez-Izquierdo, Arturo, Denaxas, Spiros, Sajobi, Tolulope T., Klein, Karl Martin, and Wiebe, Samuel
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IMPORTANCE: Both epilepsy and enzyme-inducing antiseizure medications (eiASMs) having varying reports of an association with increased risks for osteoporosis. OBJECTIVE: To quantify and model the independent hazards for osteoporosis associated with incident epilepsy and eiASMS and non-eiASMs. DESIGN, SETTING, AND PARTICIPANTS: This open cohort study covered the years 1998 to 2019, with a median (IQR) follow-up of 5 (1.7-11.1) years. Data were collected for 6275 patients enrolled in the Clinical Practice Research Datalink and from hospital electronic health records. No patients who met inclusion criteria (Clinical Practice Research Datalink–acceptable data, aged 18 years or older, follow-up after the Hospital Episode Statistics patient care linkage date of 1998, and free of osteoporosis at baseline) were excluded or declined. EXPOSURE: Incident adult-onset epilepsy using a 5-year washout and receipt of 4 consecutive ASMs. MAIN OUTCOMES AND MEASURES: The outcome was incident osteoporosis as determined through Cox proportional hazards or accelerated failure time models where appropriate. Incident epilepsy was treated as a time-varying covariate. Analyses controlled for age, sex, socioeconomic status, cancer, 1 or more years of corticosteroid use, body mass index, bariatric surgery, eating disorders, hyperthyroidism, inflammatory bowel disease, rheumatoid arthritis, smoking status, falls, fragility fractures, and osteoporosis screening tests. Subsequent analyses (1) excluded body mass index, which was missing in 30% of patients; (2) applied propensity score matching for receipt of an eiASM; (3) restricted analyses to only those with incident onset epilepsy; and (4) restricted analyses to patients who developed epilepsy at age 65 years or older. Analyses were performed between July 1 and October 31, 2022, and in February 2023 for revisions. RESULTS: Of 8 095 441 adults identified, 6275 had incident adult-onset epilepsy (3220 female [51%] and 3055 male [49%]; incidence rate, 62 per 100 000 person-years) with a median (IQR) age of 56 (38-73) years. When controlling for osteoporosis risk factors, incident epilepsy was independently associated with a 41% faster time to incident osteoporosis (time ratio [TR], 0.59; 95% CI, 0.52-0.67; P < .001). Both eiASMs (TR, 0.91; 95% CI, 0.87-0.95; P < .001) and non-eiASMs (TR, 0.77; 95% CI, 0.76-0.78; P < .001) were also associated with significant increased risks independent of epilepsy, accounting for 9% and 23% faster times to development of osteoporosis, respectively. The independent associations among epilepsy, eiASMs, and non-eiASMs remained consistent in propensity score–matched analyses, cohorts restricted to adult-onset epilepsy, and cohorts restricted to late-onset epilepsy. CONCLUSIONS AND RELEVANCE: These findings suggest that epilepsy is independently associated with a clinically meaningful increase in the risk for osteoporosis, as are both eiASMs and non-eiASMs. Routine screening and prophylaxis should be considered in all people with epilepsy.
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- 2023
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8. Association Between Frailty and Antiseizure Medication Tolerability in Older Adults With Epilepsy.
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Vary-O'Neal, Arielle, Miranzadeh, Sareh, Husein, Nafisa, Holroyd-Leduc, Jayna, Sajobi, Tolulope T., Wiebe, Samuel, Deacon, Charles, Tellez-Zenteno, Jose Francisco, Josephson, Colin Bruce, and Keezer, Mark R.
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- 2023
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9. Association Between Frailty and Antiseizure Medication Tolerability in Older Adults With Epilepsy
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Vary-O'Neal, Arielle, Miranzadeh, Sareh, Husein, Nafisa, Holroyd-Leduc, Jayna, Sajobi, Tolulope T., Wiebe, Samuel, Deacon, Charles, Tellez-Zenteno, Jose Francisco, Josephson, Colin Bruce, and Keezer, Mark R.
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- 2023
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10. Intravenous tenecteplase compared with alteplase for acute ischaemic stroke in Canada (AcT): a pragmatic, multicentre, open-label, registry-linked, randomised, controlled, non-inferiority trial
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Menon, Bijoy K, Buck, Brian H, Singh, Nishita, Deschaintre, Yan, Almekhlafi, Mohammed A, Coutts, Shelagh B, Thirunavukkarasu, Sibi, Khosravani, Houman, Appireddy, Ramana, Moreau, Francois, Gubitz, Gord, Tkach, Aleksander, Catanese, Luciana, Dowlatshahi, Dar, Medvedev, George, Mandzia, Jennifer, Pikula, Aleksandra, Shankar, Jai, Williams, Heather, Field, Thalia S, Manosalva, Alejandro, Siddiqui, Muzaffar, Zafar, Atif, Imoukhuede, Oje, Hunter, Gary, Demchuk, Andrew M, Mishra, Sachin, Gioia, Laura C, Jalini, Shirin, Cayer, Caroline, Phillips, Stephen, Elamin, Elsadig, Shoamanesh, Ashkan, Subramaniam, Suresh, Kate, Mahesh, Jacquin, Gregory, Camden, Marie-Christine, Benali, Faysal, Alhabli, Ibrahim, Bala, Fouzi, Horn, MacKenzie, Stotts, Grant, Hill, Michael D, Gladstone, David J, Poppe, Alexandre, Sehgal, Arshia, Zhang, Qiao, Lethebe, Brendan Cord, Doram, Craig, Ademola, Ayoola, Shamy, Michel, Kenney, Carol, Sajobi, Tolulope T, Swartz, Richard H, Srivastava, Abhilekh, Aljammaz, Ahmed M, Akindotun, Akintomide Femi, Jin, Albert Y, Fraser, Alexander, Khaw, Alexander V, Lemnaru, Alexandru, Southwell, Alisia, Ramji, Alnar, Alvarado-Bolaños, Alonso, Mouminah, Amr, Lahlouh, Amro B, Yu, Amy Y, Alrohimi, Anas, Lavoie, Andre, Rogge, Andrea, Micieli, Andrew, Nguyen, Andrew Linh, Callaghan-Brown, Angelique, Florendo-Cumbermack, Anita, Wadhwa, Ankur, Beaudoin, Ann-Marie, Cayley, Anne, Liddy, Anne Marie, Trivedi, Anurag, Katsanos, Aristeidis H, Shuaib, Ashfaq, Butt, Asif Javed, Bereznyakova, Olena, Beauchamp, Beth, Mahlitz, Breane, Graham, Brett R, Dewar, Brian, Buck, Brian H, Durafourt, Bryce A, Holtby, Caitlin, Jackson-Tarlton, Caitlin S, Bockus, Caitlyn, Stephenson, Caroline, Galloway, Camille, Odier, Céline, Deacon, Charles, Zerna, Charlotte, Vekhande, Chetan C, Bocti, Christian, Stapf, Christian, Hawkes, Christine, Stables, Christine Anne, Bogiatzi, Chrysi, Rodriguez, Claudia, Candale-Radu, Claudia, Murphy, Colleen, Casserly, Courtney Sarah, Fok, Daniel, Boasquevisque, Danielle de Sa, Wile, Daryl, Volders, David, Sahlas, Demetrios J, Shand, Elaine, Cora, Elena Adela, Battista, Eliane Di, Stewart, Eileen, Junk, Emily, Harrison, Emma L, Frenette, Eric, Teleg, Ericka, Abdellah, Eslam, Ghrooda, Esseddeeg, Akthar, Farhana, Evoy, François, Klein, Gary M, Maclean, Genoveva, Jickling, Glen C, Hawthorne, Glenda, Boyd, Gordon, Walker, Gregory, Saposnik, Gustavo, Lau, H Lee, Badr, Hanan E, Toma, Hassanain, Kalashyan, Hayrapet, Marion-Moffet, Hugo, Grant, Ian, Fatakdawala, Idris, Beaulieu-Boire, Isabelle, Williams, Janice, Brar, Jaskiran, Rivest, Jean, Wang, Jeffrey Z, Dawe, Jessica, Stang, Jillian, Day, Joanne, Miller, Jodi, Gorman, Johnathon, Hopyan, Julia Jasmine, Lee, Julian, Kromm, Julie, Foster, Kaitlyn, Ratnayake, Kanchana, Perera, Kanjana S, Murray, Karina Villaluna, Ryckborst, Karla, Lin, Katie, Sage, Kayla, Sivakuma, Keithan, MacDonald, Kelly A, Ng, Kelvin Kuan, Merchant, Ketki, Khan, Khurshid, Ghavami, Kimia, Johnston, Kyra, Mai, Lauren M, White, Leah, Barratt, Lee, Longpre, Linda, Crellin, Lisa, Peeling, Lissa, Piquette, Lori, Lomax, Lysa Boissé, Sadeghi, Mahsa, Kamra, Maneesha, Lavoie-April, Manuel, Moores, Margaret, Bullrich, Maria Bres, McClelland, Marie, Salluzzi, Marina, Wilcox, Mark, Boulos, Mark I, Marko, Martha, Boyko, Matthew, Lantagne-Hurtubise, Maude, AlHamid, May Adel, Shawawrah, Mays, Kelly, Michael E, Thorne, Michael W D, Shamy, Michel, Bussiere, Miguel, Dominc Tse, Ming Yin, Benguzzi, Mowad, Sharma, Mukul, Horton, Myles, Newcommon, Nancy, Simon, Nandy-Shelwine, Parks, Natalie E, Sultan, Nazeem, Markovic, Nevena, Daneault, Nicole, Ishaque, Noman, Fairall, Paige, Kostyrko, Pawel B, Stys, Peter K, Teal, Philip, Couillard, Philippe, King-Azote, Princess, Collier, Quentin, Epp, Rachel, Nair, Radhika, Joundi, Raed A, Jassal, Rajive, Schneider, Raphael, Hosseini, Reza, Bouchard, Rosalie, Whelan, Ruth, Cooley, S Regan, Sujanthan, Sajeevan, Mansoor, Salman, Yip, Samuel, Wasyliw, Sanchea, Taylor, Sean W., Friedman, Sebastian, Mann, Sharan, Maley, Sharleen Weese, Chiasson, Sherry, Hu, Sherry Xueying, Althubait, Shorog, Himed, Shuhira, Chen, Shuo, Bal, Simerpreet S, Page, Stacey A, Beck, Stacey D, Woodroffe, Stephanie, Reiter, Stephanie D, Gaal, Stephen van, Peters, Steven Ray, Darvesh, Sultan, Save, Supriya, Alcock, Susan, Piercey, Susannah, Adam, Suzie, Gosselin, Sylvie, Fitzpatrick, Tess, Perron, Thomas-Louis, Stewart, Tim, Benstead, Timothy J, Naidoo, Vishaya, Wahab, Wasan Abd, Oczkowski, Wiesław, Kingston, William, Leduc, William, To, William T H, Yu, Yeyao Joe, Liu, Zhongyu A, and Aljundi, Ziad Ezzat
- Abstract
Intravenous thrombolysis with alteplase bolus followed by infusion is a global standard of care for patients with acute ischaemic stroke. We aimed to determine whether tenecteplase given as a single bolus might increase reperfusion compared with this standard of care.
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- 2022
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11. Colorectal cancer patients with malnutrition suffer poor physical and mental health before surgery.
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Gillis, Chelsia, Richer, Lauren, Fenton, Tanis R., Gramlich, Leah, Keller, Heather, Culos-Reed, S. Nicole, Sajobi, Tolulope T., Awasthi, Rashami, and Carli, Francesco
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To determine whether there is an association between preoperative nutritional status and preoperative physical function, patient-reported quality of life, and body composition in colorectal cancer patients awaiting elective surgery. We conducted a pooled analysis of individual baseline patient data (n = 266) collected from 5 prehabilitation trials in colorectal cancer surgery. All data were collected approximately 4 weeks before surgery. Each patient's nutritional status was evaluated using the Patient-Generated Subjective Global Assessment: scores 4–8 indicated need for nutritional treatment, whereas ≥9 indicated critical need for a nutrition intervention. Physical function was measured with the 6-minute walk test; patient-reported quality of life was captured with the SF-36; body mass and composition were determined using multifrequency bioelectrical impedance. Mean Patient-Generated Subjective Global Assessment score was 5.3 (standard deviation: 3.9). Approximately two-thirds of patients had a Patient-Generated Subjective Global Assessment of 4-8 or ≥9 (n = 162/266). The 6-minute walk test was progressively worse with higher Patient-Generated Subjective Global Assessment scores (PG-SGA <4: 471(119) m; PG-SGA 4–8: 417(125) m; PG-SGA ≥9: 311(125) m, P <.001). Every component of the SF-36 was lower in those with a Patient-Generated Subjective Global Assessment ≥9 compared to Patient-Generated Subjective Global Assessment <4, indicating that malnourished patients suffer worse quality of life. Interestingly, only the male patients with a Patient-Generated Subjective Global Assessment ≥9 presented with statistically significant lower body mass, reduced fat-free mass index, and a lower percent body fat relative to those with Patient-Generated Subjective Global Assessment <4, in part due to the higher variability among the females. The consequences of malnutrition are far-reaching and are strongly associated with the physical and mental health of colorectal cancer patients awaiting elective resection. [ABSTRACT FROM AUTHOR]
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- 2021
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12. Association of Enzyme-Inducing Antiseizure Drug Use With Long-term Cardiovascular Disease
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Josephson, Colin B., Wiebe, Samuel, Delgado-Garcia, Guillermo, Gonzalez-Izquierdo, Arturo, Denaxas, Spiros, Sajobi, Tolulope T., Lamidi, Mubasiru, Wang, Meng, and Keezer, Mark R.
- Abstract
IMPORTANCE: Enzyme-inducing antiseizure medications (eiASMs) have been hypothesized to be associated with long-term risks of cardiovascular disease. OBJECTIVE: To quantify and model the putative hazard of cardiovascular disease secondary to eiASM use. DESIGN, SETTING, AND PARTICIPANTS: This cohort study covered January 1990 to March 2019 (median [IQR] follow-up, 9 [4-15], years). The study linked primary care and hospital electronic health records at National Health Service hospitals in England. People aged 18 years or older diagnosed as having epilepsy after January 1, 1990, were included. All eligible patients were included with a waiver of consent. No patients were approached who withdrew consent. Analysis began January 2021 and ended August 2021. EXPOSURES: Receipt of 4 consecutive eiASMs (carbamazepine, eslicarbazepine, oxcarbazepine, phenobarbital, phenytoin, primidone, rufinamide, or topiramate) following an adult-onset (age ≥18 years) epilepsy diagnosis or repeated exposure in a weighted cumulative exposure model. MAIN OUTCOMES AND MEASURES: Three cohorts were isolated, 1 of which comprised all adults meeting a case definition for epilepsy diagnosed after 1990, 1 comprised incident cases diagnosed after 1998 (hospital linkage date), and 1 was limited to adults diagnosed with epilepsy at 65 years or older. Outcome was incident cardiovascular disease (ischemic heart disease or ischemic or hemorrhagic stroke). Hazard of incident cardiovascular disease was evaluated using adjusted propensity-matched survival analyses and weighted cumulative exposure models. RESULTS: Of 10 916 166 adults, 50 888 (0.6%) were identified as having period-prevalent cases (median [IQR] age, 32 [19-50] years; 16 584 [53%] female), of whom 31 479 (62%) were diagnosed on or after 1990 and were free of cardiovascular disease at baseline. In a propensity-matched Cox proportional hazards model adjusted for age, sex, baseline socioeconomic status, and cardiovascular risk factors, the hazard ratio for incident cardiovascular disease was 1.21 (95% CI, 1.06-1.39) for those receiving eiASMs. The absolute difference in cumulative hazard diverges by more than 1% and greater after 10 years. For those with persistent exposure beyond 4 prescriptions, the median hazard ratio increased from amedian (IQR) of 1.54 (1.28-1.79) when taking a relative defined daily dose of an eiASM of 1 to 2.38 (1.52-3.56) with a relative defined daily dose of 2 throughout a maximum of 25 years’ follow-up compared with those not receiving an eiASM. The hazard was elevated but attenuated when restricting analyses to incident cases or those diagnosed when older than 65 years. CONCLUSIONS AND RELEVANCE: The hazard of incident cardiovascular disease is higher in those receiving eiASMs. The association is dose dependent and the absolute difference in hazard seems to reach clinical significance by approximately 10 years from first exposure.
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- 2021
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13. Older frail prehabilitated patients who cannot attain a 400 m 6-min walking distance before colorectal surgery suffer more postoperative complications.
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Gillis, Chelsia, Fenton, Tanis R., Gramlich, Leah, Sajobi, Tolulope T., Culos-Reed, S. Nicole, Bousquet-Dion, Guillaume, Elsherbini, Noha, Fiore JR, Julio F., Minnella, Enrico M., Awasthi, Rashami, Liberman, A. Sender, Boutros, Marylise, and Carli, F.
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SURGICAL complications ,PROCTOLOGY ,COLORECTAL cancer ,ELECTIVE surgery ,PHYSICAL mobility ,GERIATRIC surgery - Abstract
Recent efforts to prehabilitate intermediately frail and frail (Fried frailty criteria ≥2) elective colorectal cancer patients did not influence clinical nor functional outcomes. The objective of this secondary analysis was to describe the subset of intermediately frail and frail prehabilitated patients who could not attain a minimum 400 m (a prognostic cut-point used in other patient populations) 6-min walking distance (6MWD) before elective surgery. Secondary analysis of a randomized controlled trial. Patients participated in multimodal prehabilitation at home and in-hospital for approximately four weeks before colorectal surgery. Primary outcome was incidence of postoperative complications within 30 days of hospital discharge. Sixty percent of the patients who participated in prehabilitation did not reach a minimum walking distance of 400 m in 6 min before surgery. Compared to the group that attained ≥400 m 6MWD (n = 19), the <400 m group (n = 28) were older, had higher percent body fat, lower physical function, lower self-reported physical activity, higher American Society of Anesthesiologists (ASA) classification, and twice as many were in critical need of a nutrition intervention at baseline. No group differences were observed regarding frailty status (P = 0.775). Sixty-one percent of the <400 m 6MWD group experienced at least one complication within 30 days of surgery compared to 21% in the ≥400 m group (P = 0.009). Several preoperative characteristics were identified in the <400 m 6MWD group that could be useful in screening and targeting future prehabilitative treatments. Future trials should investigate use of a 400 m standard for the 6MWD as a minimal treatment target for prehabilitation. [ABSTRACT FROM AUTHOR]
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- 2021
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14. Association of Levels of Specialized Care With Risk of Premature Mortality in Patients With Epilepsy
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Lowerison, Mark W., Josephson, Colin B., Jetté, Nathalie, Sajobi, Tolulope T., Patten, Scott, Williamson, Tyler, Deardon, Rob, Barkema, Herman W., and Wiebe, Samuel
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IMPORTANCE: Patients with epilepsy are at an elevated risk of premature mortality. Interventions to reduce this risk are crucial. OBJECTIVE: To determine if the level of care (non-neurologist, neurologist, or comprehensive epilepsy program) is negatively associated with the risk of premature mortality. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective open cohort study, all adult patients 18 years or older who met the administrative case definition for incident epilepsy in linked databases (Alberta Health Services administrative health data and the Comprehensive Calgary Epilepsy Programme Registry [CEP]) inclusive of the years 2002 to 2016 were followed up until death or loss to follow-up. The final analyses were performed on May 1, 2019. EXPOSURES: Evaluation by a non-neurologist, neurologist, or epileptologist. MAIN OUTCOMES AND MEASURES: The outcome was all-cause mortality. We used extended Cox models treating exposure to a neurologist or the CEP as time-varying covariates. Age, sex, socioeconomic deprivation, disease severity, and comorbid burden at index date were modeled as fixed-time coefficients. RESULTS: A total 23 653 incident cases were identified (annual incidence of 89 per 100 000); the mean age (SD) at index date was 50.8 (19.1) years and 12 158 (50.3%) were women. A total of 14 099 (60%) were not exposed to specialist neurological care, 9554 (40%) received care by a neurologist, and 2054 (9%) received care in the CEP. In total, 4098 deaths (71%) occurred in the nonspecialist setting, 1481 (26%) for those seen by a neurologist, and 176 (3%) for those receiving CEP care. The standardized mortality rate was 7.2% for the entire cohort, 9.4% for those receiving nonspecialist care, 5.6% for those seen by a neurologist, and 2.8% for those seen in the CEP. The hazard ratio (HR) of mortality was lower in those receiving neurologist (HR, 0.85; 95% CI, 0.77-0.93) and CEP (HR, 0.49; 95% CI, 0.38-0.62) care. In multivariable modeling, specialist care, the age at index, and disease severity were retained in the final model of the association between specialist care and mortality. CONCLUSIONS AND RELEVANCE: Exposure to specialist care is associated with incremental reductions in the hazard of premature mortality. Those referred to a comprehensive epilepsy program received the greatest benefit.
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- 2019
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15. Trimodal prehabilitation for colorectal surgery attenuates post-surgical losses in lean body mass: A pooled analysis of randomized controlled trials.
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Gillis, Chelsia, Fenton, Tanis R., Sajobi, Tolulope T., Minnella, Enrico Maria, Awasthi, Rashami, Loiselle, Sarah-Ève, Liberman, A Sender, Stein, Barry, Charlebois, Patrick, and Carli, Francesco
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Preservation of lean body mass is an important cancer care objective. The capacity for prehabilitation interventions to modulate the lean body mass (LBM) of colorectal cancer patients before and after surgery is unknown. A pooled analysis of two randomized controlled trials of trimodal prehabilitation vs. trimodal rehabilitation at a single university-affiliated tertiary center employing Enhanced Recovery After Surgery (ERAS) care was conducted. The prehabilitation interventions included exercise, nutrition, and anxiety-reduction elements that began approximately four weeks before surgery and continued for eight weeks after surgery. The rehabilitation interventions were identical to the prehabilitation interventions but were initiated only after surgery. Body composition, measured using multifrequency bioelectrical impedance analysis, was recorded at baseline, pre-surgery, 4 and 8 weeks after surgery. The primary outcome was change in LBM before and after colorectal surgery for cancer. A mixed effects regression model was used to estimate changes in body mass and body composition over time controlling for age, sex, baseline body mass index (BMI), baseline six-minute walk test (6MWT), and postoperative compliance to the interventions. NCT02586701 & NCT01356264. Pooled data included 76 patients who followed prehabilitation and 63 patients who followed rehabilitation (n = 139). Neither group experienced changes in preoperative LBM. Compared to rehabilitated patients, prehabilitated patients had significantly more absolute and relative LBM at four and eight-weeks post-surgery in models controlling for age, sex, baseline BMI, baseline 6MWT, and compliance to the postoperative intervention. Trimodal prehabilitation attenuated the post-surgical LBM loss compared to the loss observed in patients who received the rehabilitation intervention. Patients who receive neither intervention (i.e., standard of care) would be likely to lose more LBM. Offering a prehabilitation program to colorectal cancer patients awaiting resection is a useful strategy to mitigate the impact of the surgical stress response on lean tissue in an ERAS setting, and, in turn, might have a positive impact on the cancer care course. NCT02586701 & NCT01356264 (clinicaltrials.gov). [ABSTRACT FROM AUTHOR]
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- 2019
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16. Association between glycemic load and cognitive function in community-dwelling older adults: Results from the Brain in Motion study.
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Garber, Anna, Csizmadi, Ilona, Friedenreich, Christine M., Sajobi, Tolulope T., Longman, Richard S., Tyndall, Amanda V., Drogos, Lauren L., Davenport, Margie H., and Poulin, Marc J.
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Summary Background Impaired glucose tolerance is a risk factor for non-age-related cognitive decline and is also associated with measures of physical activity (PA) and cardiorespiratory fitness (CRF). A low glycemic load (GL) diet can aid in the management of blood glucose levels, but little is known about its effect on cognition with poor glucoregulation. Objective We assessed the relation between GL and cognitive function by glucoregulation and possible mediatory effects by CRF and PA in older adults from the Brain in Motion Study. Design A cross-sectional analysis of 194 cognitively healthy adults aged ≥55 years (mean = 65.7, SD = 6.1) was conducted. GL was assessed using a quantitative food frequency questionnaire, and glucoregulation was characterized on the HOMA-IR index. Subjects also completed a cognitive assessment, CRF testing, a validated self-reported PA questionnaire, and a blood draw. Multiple linear regression models adjusted for significant covariates were used to evaluate the relation between GL and cognition, and mediation by CRF and PA was also assessed. Results GL was inversely associated with global cognition (β = −0.014; 95% CI −0.024, −0.004) and figural memory (β = −0.035; 95% CI −0.052, −0.018) in subjects with poor glucoregulation. Neither CRF nor PA mediated these relations. In subjects with good glucoregulation, no association was found between GL and cognitive function (p > 0.05). Conclusions A low GL diet is associated with better cognitive function in older adults with poor glucoregulation. This study provides supportive evidence for the role of GL in maintaining better cognitive function during the aging process. [ABSTRACT FROM AUTHOR]
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- 2018
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17. Trajectories of Health-Related Quality of Life in Coronary Artery Disease.
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Sajobi, Tolulope T., Meng Wang, Awosoga, Oluwagbohunmi, Santana, Maria, Southern, Danielle, Zhiying Liang, Galbraith, Diane, Wilton, Stephen B., Hude Quan, Graham, Michelle M., James, Matthew T., Ghali, William A., Knudtson, Merrill L., Norris, Colleen, Wang, Meng, Liang, Zhiying, Quan, Hude, and APPROACH Investigators
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Background: Health-related quality of life (HRQOL) assessment is an important health outcome for measuring the efficacy of treatments and interventions for coronary artery disease (CAD). HRQOL is known to improve over the first year after interventions for CAD, but there is limited knowledge of the changes in HRQOL beyond 1 year. We investigated heterogeneity in long-term trajectories of HRQOL in patients with CAD.Methods and Results: Data were obtained from 6226 patients identified from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease with at least 1-vessel CAD who underwent their first catheterization between 2006 and 2009. HRQOL was assessed using the Seattle Angina Questionnaire, a 19-item disease-specific measure of HRQOL for patients with CAD. Group-based trajectory analysis was used to identify various subgroups of Seattle Angina Questionnaire trajectories over time while adjusting for missing data through a longitudinal multiple imputation model. Multinomial logistic regression was used to identify the predictors of differences among the identified subgroups. Our analysis revealed significant improvements in HRQOL across all the 5 domains of Seattle Angina Questionnaire overtime for the whole data. Multitrajectory analyses revealed 4 HRQOL trajectory subgroups including high (25.1%), largely increased (32.3%), largely decreased (25.0%), and low (17.6%) trajectories. Age, sex, body mass index, diabetes mellitus, previous history of myocardial infarction, smoking, depression, anxiety, type of treatment received, and perceived social support were significant predictors of differences among these trajectory subgroups.Conclusions: This study highlights variations in longitudinal trajectories of HRQOL in patients with CAD. Despite overall improvements in HRQOL, about a quarter of our cohort experienced a significant decline in their HRQOL over the 5-year period. Understanding these HRQOL trajectories may help personalize prognostic information, identify patients and HRQOL domains on which clinical interventions are most beneficial, and support treatment decisions for patients with CAD. [ABSTRACT FROM AUTHOR]- Published
- 2018
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18. Population-based study of home-time by stroke type and correlation with modified Rankin score.
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Yu, Amy Y. X., Rogers, Edwin, Meng Wang, Sajobi, Tolulope T., Coutts, Shelagh B., Menon, Bijoy K., Hill, Michael D., Smith, Eric E., and Wang, Meng
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- 2017
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19. Clinical Decision Support to Reduce Contrast-Induced Kidney Injury During Cardiac Catheterization: Design of a Randomized Stepped-Wedge Trial
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James, Matthew T., Har, Bryan J., Tyrrell, Ben D., Ma, Bryan, Faris, Peter, Sajobi, Tolulope T., Allen, David W., Spertus, John A., Wilton, Stephen B., Pannu, Neesh, Klarenbach, Scott W., and Graham, Michelle M.
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Contrast-induced acute kidney injury (CI-AKI) is a common and serious complication of invasive cardiac procedures. Quality improvement programs have been associated with a lower incidence of CI-AKI over time, but there is a lack of high-quality evidence on clinical decision support for prevention of CI-AKI and its impact on processes of care and clinical outcomes.
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- 2019
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20. Prediction Tools for Psychiatric Adverse Effects After Levetiracetam Prescription
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Josephson, Colin B., Engbers, Jordan D. T., Jette, Nathalie, Patten, Scott B., Singh, Shaily, Sajobi, Tolulope T., Marshall, Deborah, Agha-Khani, Yahya, Federico, Paolo, Mackie, Aaron, Macrodimitris, Sophie, McLane, Brienne, Pillay, Neelan, Sharma, Ruby, and Wiebe, Samuel
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IMPORTANCE: Levetiracetam is a commonly used antiepileptic drug, yet psychiatric adverse effects are common and may lead to treatment discontinuation. OBJECTIVE: To derive prediction models to estimate the risk of psychiatric adverse effects from levetiracetam use. DESIGN, SETTING, AND PARTICIPANTS: Retrospective open cohort study. All patients meeting the case definition for epilepsy after the Acceptable Mortality Reporting date in The Health Improvement Network (THIN) database based in the United Kingdom (inclusive January 1, 2000, to May 31, 2012) who received a first-ever prescription for levetiracetam were included. Of 11 194 182 patients registered in THIN, this study identified 7400 presumed incident cases (66.1 cases per 100 000 persons) over a maximum of 12 years’ follow-up. The index date was when patients received their first prescription code for levetiracetam, and follow-up lasted 2 years or until an event, loss to follow-up, or censoring. The analyses were performed on April 22, 2018. EXPOSURE: A presumed first-ever prescription for levetiracetam. MAIN OUTCOMES AND MEASURES: The outcome of interest was a Read code for any psychiatric sign, symptom, or disorder as reached through consensus by 2 authors. This study used regression techniques to derive 2 prediction models, one for the overall population and one for those without a history of a psychiatric sign, symptom, or disorder during the study period. RESULTS: Among 1173 patients with epilepsy receiving levetiracetam, the overall median age was 39 (interquartile range, 25-56) years, and 590 (50.3%) were female. A total of 14.1% (165 of 1173) experienced a psychiatric symptom or disorder within 2 years of index prescription. The odds of reporting a psychiatric symptom were significantly elevated for women (odds ratio [OR], 1.41; 95% CI, 0.99-2.01; P = .05) and those with a preexposure history of higher social deprivation (OR, 1.15; 95% CI, 1.01-1.31; P = .03), depression (OR, 2.20; 95% CI, 1.49-3.24; P < .001), anxiety (OR, 1.74; 95% CI, 1.11-2.72; P = .02), or recreational drug use (OR, 2.02; 95% CI, 1.20-3.37; P = .008). The model performed well after stratified k = 5-fold cross-validation (area under the curve [AUC], 0.68; 95% CI, 0.58-0.79). There was a gradient in risk, with probabilities increasing from 8% for 0 risk factors to 11% to 17% for 1, 17% to 31% for 2, 30% to 42% for 3, and 49% when all risk factors were present. For those free of a preexposure psychiatric code, a second model performed comparably well after k = 5-fold cross-validation (AUC, 0.72; 95% CI, 0.54-0.90). Specificity was maximized using threshold cutoffs of 0.10 (full model) and 0.14 (second model); a score below these thresholds indicates safety of prescription. CONCLUSIONS AND RELEVANCE: This study derived 2 simple models that predict the risk of a psychiatric adverse effect from levetiracetam. These algorithms can be used to guide prescription in clinical practice.
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- 2019
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21. Use of Noncontrast Computed Tomography and Computed Tomographic Perfusion in Predicting Intracerebral Hemorrhage After Intravenous Alteplase Therapy.
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Batchelor, Connor, Pordeli, Pooneh, d'Esterre, Christopher D., Najm, Mohamed, Al-Ajlan, Fahad S., Boesen, Mari E., McDougall, Connor, Hur, Lisa, Fainardi, Enrico, Jai Jai Shiva Shankar, Rubiera, Marta, Khaw, Alexander V., Hill, Michael D., Demchuk, Andrew M., Sajobi, Tolulope T., Goyal, Mayank, Ting-Yim Lee, Aviv, Richard I., Menon, Bijoy K., and Shankar, Jai Jai Shiva
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- 2017
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22. Early Trajectory of Stroke Severity Predicts Long-Term Functional Outcomes in Ischemic Stroke Subjects: Results From the ESCAPE Trial (Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to...
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Sajobi, Tolulope T., Menon, Bijoy K., Meng Wang, Lawal, Oluwaseyi, Shuaib, Ashfaq, Williams, David, Poppe, Alexandre Y., Jovin, Tudor G., Casaubon, Leanne K., Devlin, Thomas, Dowlatshahi, Dar, Fanale, Chris, Lowerison, Mark W., Demchuk, Andrew M., Goyal, Mayank, Hill, Michael D., Wang, Meng, and ESCAPE Trial Investigators
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- 2017
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23. Patient satisfaction with epilepsy surgery: what is important to patients
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Lunney, Meaghan, Wahby, Sandra, Sauro, Khara M., Atkinson, Mark J., Josephson, Colin B., Girgis, Fady, Singh, Shaily, Patten, Scott B., Jetté, Nathalie, Sajobi, Tolulope T., Hader, Walter, and Wiebe, Samuel
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Aims. Patient satisfaction with therapeutic interventions is an important outcome of care. Although generic measures of patient satisfaction exist, there is no validated scale for measuring patient satisfaction with epilepsy surgery. We aimed to systematically obtain patient‐identified factors related to satisfaction with epilepsy surgery as a means of informing clinicians about the ways that patients evaluate outcomes of their treatment and as a conceptual basis for the future development of epilepsy surgery patient satisfaction scales. Methods. Focus group discussions with epilepsy surgery patients (n=9) were conducted to identify themes relevant to patient satisfaction with epilepsy surgery and to draft initial items of importance. Consensus methodology (Delphi technique) was used to obtain expert opinion (n=13) to refine the items. Member‐checking with focus group participants was performed to ensure the identified items were relevant, clear, and inclusive. Results. A list of 31 items embodied 12 themes related to patient‐reported satisfaction with epilepsy surgery. These included adverse effects, medical care or rehabilitation, seizure control, post‐operative recovery, anti‐seizure medication, independence, seizure worry, ability to drive, social relationships, self‐confidence, improved cognitive function, and improved physical health. Conclusions. This study used a systematic approach to identify factors that are important to patients when assessing satisfaction with epilepsy surgery. This knowledge can assist clinicians caring for these patients and is also a critical step towards the validation of a formal scale to assess satisfaction with epilepsy surgery.
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- 2018
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24. Population-based study of home-time by stroke type and correlation with modified Rankin score
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Yu, Amy Y.X., Rogers, Edwin, Wang, Meng, Sajobi, Tolulope T., Coutts, Shelagh B., Menon, Bijoy K., Hill, Michael D., and Smith, Eric E.
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- 2017
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25. An investigation into the psychosocial effects of the postictal state.
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Josephson, Colin B., Engbers, Jordan D. T., Sajobi, Tolulope T., Jette, Nathalie, Agha-Khani, Yahya, Federico, Paolo, Murphy, William, Pillay, Neelan, and Wiebe, Samuel
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- 2016
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26. Time-Dependent Computed Tomographic Perfusion Thresholds for Patients With Acute Ischemic Stroke.
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d'Esterre, Christopher D., Boesen, Mari E., Ahn, Seong Hwan, Pordeli, Pooneh, Najm, Mohamed, Minhas, Priyanka, Davari, Paniz, Fainardi, Enrico, Rubiera, Marta, Khaw, Alexander V., Zini, Andrea, Frayne, Richard, Hill, Michael D., Demchuk, Andrew M., Sajobi, Tolulope T., Forkert, Nils D., Goyal, Mayank, Lee, Ting Y., and Menon, Bijoy K.
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- 2015
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27. Use of Noncontrast Computed Tomography and Computed Tomographic Perfusion in Predicting Intracerebral Hemorrhage After Intravenous Alteplase Therapy
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Batchelor, Connor, Pordeli, Pooneh, d’Esterre, Christopher D., Najm, Mohamed, Al-Ajlan, Fahad S., Boesen, Mari E., McDougall, Connor, Hur, Lisa, Fainardi, Enrico, Shankar, Jai Jai Shiva, Rubiera, Marta, Khaw, Alexander V., Hill, Michael D., Demchuk, Andrew M., Sajobi, Tolulope T., Goyal, Mayank, Lee, Ting-Yim, Aviv, Richard I., and Menon, Bijoy K.
- Abstract
Supplemental Digital Content is available in the text.
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- 2017
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28. Association of Depression and Treated Depression With Epilepsy and Seizure Outcomes: A Multicohort Analysis
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Josephson, Colin B., Lowerison, Mark, Vallerand, Isabelle, Sajobi, Tolulope T., Patten, Scott, Jette, Nathalie, and Wiebe, Samuel
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IMPORTANCE: A bidirectional relationship exists between epilepsy and depression. However, any putative biological gradient between depression severity and the risk of epilepsy, and the degree to which depression mediates the influence of independent risk factors for epilepsy, has yet to be examined. OBJECTIVE: To determine the effect of depression on the risk of epilepsy and seizure outcomes. DESIGN, SETTING, AND PARTICIPANTS: An observational study of a population-based primary care cohort (all patients free of prevalent depression and epilepsy at 18-90 years of age who were active after the Acceptable Mortality Reporting date in The Health Improvement Network database) and a prospectively collected tertiary care cohort (all patients whose data were prospectively collected from the Calgary Comprehensive Epilepsy Programme). The analyses were performed on March 16, 2016. MAIN OUTCOME AND MEASURES: The hazard of developing epilepsy after incident depression and vice versa was calculated. In addition, a mediation analysis of the effect of depression on risk factors for epilepsy and the odds of seizure freedom stratified by the presence of depression were performed. RESULTS: We identified 10 595 709 patients in The Health Improvement Network of whom 229 164 (2.2%) developed depression and 97 177 (0.9%) developed epilepsy. The median age was 44 years (interquartile range, 32-58 years) for those with depression and 56 years (interquartile range, 43-71 years) for those with epilepsy. Significantly more patients with depression (144 373 [63%] were women, and 84 791 [37%] were men; P < .001) or epilepsy (54 419 [56%] were women, and 42 758 [44%] were men; P < .001) were female. Incident epilepsy was associated with an increased hazard of developing depression (hazard ratio [HR], 2.04 [95% CI, 1.97-2.09]; P < .001), and incident depression was associated with an increased hazard of developing epilepsy (HR, 2.55 [95% CI, 2.49-2.60]; P < .001) There was an incremental hazard according to depression treatment type with lowest risk for those receiving counselling alone (HR, 1.84 [95% CI, 1.30-2.59]; P < .001), an intermediate risk for those receiving antidepressants alone (HR, 3.43 [95% CI, 3.37-3.47]; P < .001), and the highest risk for those receiving both (HR, 9.85 [95% CI, 5.74-16.90]; P < .001). Furthermore, depression mediated the relationship between sex, social deprivation, and Charlson Comorbidity Index with incident epilepsy, accounting for 4.6%, 7.1%, and 20.6% of the total effects of these explanatory variables, respectively. In the Comprehensive Epilepsy Programme, the odds of failing to achieve 1-year seizure freedom were significantly higher for those with depression or treated depression. CONCLUSIONS AND RELEVANCE: Common underlying pathophysiological mechanisms may explain the risk of developing epilepsy following incident depression. Treated depression is associated with worse epilepsy outcomes, suggesting that this may be a surrogate for more severe depression and that severity of depression is associated with severity of epilepsy.
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- 2017
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29. Early Trajectory of Stroke Severity Predicts Long-Term Functional Outcomes in Ischemic Stroke Subjects
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Sajobi, Tolulope T., Menon, Bijoy K., Wang, Meng, Lawal, Oluwaseyi, Shuaib, Ashfaq, Williams, David, Poppe, Alexandre Y., Jovin, Tudor G., Casaubon, Leanne K., Devlin, Thomas, Dowlatshahi, Dar, Fanale, Chris, Lowerison, Mark W., Demchuk, Andrew M., Goyal, Mayank, and Hill, Michael D.
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- 2017
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30. Effect Size Estimates for the ESCAPE Trial: Proportional Odds Regression Versus Other Statistical Methods.
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Sajobi, Tolulope T, Zhang, Yukun, Menon, Bijoy K, Goyal, Mayank, Demchuk, Andrew M, Broderick, Joseph P, and Hill, Michael D
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- 2015
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31. Effect Size Estimates for the ESCAPE Trial.
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Sajobi, Tolulope T., Yukun Zhang, Menon, Bijoy K., Goyal, Mayank, Demchuk, Andrew M., Broderick, Joseph P., and Hill, Michael D.
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- 2015
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32. Analysis of Workflow and Time to Treatment on Thrombectomy Outcome in the Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke (ESCAPE) Randomized, Controlled Trial
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Menon, Bijoy K., Sajobi, Tolulope T., Zhang, Yukun, Rempel, Jeremy L., Shuaib, Ashfaq, Thornton, John, Williams, David, Roy, Daniel, Poppe, Alexandre Y., Jovin, Tudor G., Sapkota, Biggya, Baxter, Blaise W., Krings, Timo, Silver, Frank L., Frei, Donald F., Fanale, Christopher, Tampieri, Donatella, Teitelbaum, Jeanne, Lum, Cheemun, Dowlatshahi, Dar, Eesa, Muneer, Lowerison, Mark W., Kamal, Noreen R., Demchuk, Andrew M., Hill, Michael D., and Goyal, Mayank
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Supplemental Digital Content is available in the text.
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- 2016
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33. An investigation into the psychosocial effects of the postictal state
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Josephson, Colin B., Engbers, Jordan D.T., Sajobi, Tolulope T., Jette, Nathalie, Agha-Khani, Yahya, Federico, Paolo, Murphy, William, Pillay, Neelan, and Wiebe, Samuel
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- 2016
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34. Time-Dependent Computed Tomographic Perfusion Thresholds for Patients With Acute Ischemic Stroke
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d’Esterre, Christopher D., Boesen, Mari E., Ahn, Seong Hwan, Pordeli, Pooneh, Najm, Mohamed, Minhas, Priyanka, Davari, Paniz, Fainardi, Enrico, Rubiera, Marta, Khaw, Alexander V., Zini, Andrea, Frayne, Richard, Hill, Michael D., Demchuk, Andrew M., Sajobi, Tolulope T., Forkert, Nils D., Goyal, Mayank, Lee, Ting Y., and Menon, Bijoy K.
- Abstract
Supplemental Digital Content is available in the text.
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- 2015
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35. Effect Size Estimates for the ESCAPE Trial
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Sajobi, Tolulope T., Zhang, Yukun, Menon, Bijoy K., Goyal, Mayank, Demchuk, Andrew M., Broderick, Joseph P., and Hill, Michael D.
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Ordinal outcomes, such as modified Rankin Scale (mRS), are the standard primary end points in acute stroke trials. Regression models for assessing treatment efficacy after adjusting for baseline covariates have been developed for continuous, binary, or ordinal end points. There has been no consensus on the best choice of method for analyzing these data.
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- 2015
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36. 33 - Objectively Measured Physical Activity, Sedentary Behaviour and Cardiometabolic Measures in Adults with Type 2 Diabetes: Results from the Canadian Health Measures Survey (2007-2017).
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Booth, Jane E., Leung, Alexander A., Benham, Jamie L., Rabi, Doreen M., Goldfield, Gary S., Sajobi, Tolulope T., and Sigal, Ronald J.
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- 2020
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37. Association of a Shortened Duration of Adjuvant Chemotherapy With Overall Survival Among Individuals With Stage III Colon Cancer
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Boyne, Devon J., Cheung, Winson Y., Hilsden, Robert J., Sajobi, Tolulope T., Batra, Atul, Friedenreich, Christine M., and Brenner, Darren R.
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IMPORTANCE: Several real-world oncology studies have produced findings that contradict those from randomized clinical trials. Such disparities may be associated with methodological shortcomings. OBJECTIVE: To examine the association between a shortened duration of adjuvant chemotherapy among individuals with stage III colon cancer using real-world data. DESIGN, SETTING, AND PARTICIPANTS: This comparative effectiveness study included individuals diagnosed with stage III colon cancer between January 2004 and December 2015 who initiated adjuvant chemotherapy at oncology clinics within the province of Alberta, Canada. Patients were identified through record linkage of various administrative databases and were followed up until September 2017. Eligibility criteria were modeled after those used in the International Duration Evaluation of Adjuvant (IDEA) trial. A target trial emulation and naive observational analysis were conducted. Results from both cohorts were benchmarked against findings from the IDEA trial. Data analysis was conducted from March to December 2020. EXPOSURE: A shortened duration of adjuvant 5-fluorouracil/leucovorin plus oxaliplatin (FOLFOX) or capecitabine plus oxaliplatin (CAPOX) chemotherapy, defined as 3 to 5 months of treatment vs 6 months. MAIN OUTCOMES AND MEASURES: Overall survival assessed via vital statistics. The per-protocol hazard ratio (HR) was estimated using a weighted pooled logistic regression model. Subgroup analyses were conducted by treatment regimen (ie, FOLFOX vs CAPOX) and cancer stage (ie, T1-3 and N1 vs T4 or N2). RESULTS: From an initial cohort of 3086 patients, 485 (16%) were eligible for inclusion in the target trial analysis. The median age was 59 years (range, 19-81 years), and 230 (47%) were women. The maximum follow-up was 11.6 years. Median overall survival was not reached. A total of 90 patients (19%) died. The 5-year Kaplan Meier overall survival estimate was 0.79 (95% CI, 0.75-0.84). Estimates from the trial emulation were similar to those from the IDEA trial. For example, a shortened duration of adjuvant chemotherapy was not associated with overall survival among patients prescribed CAPOX in the IDEA trial (HR, 0.96; 95% CI, 0.85-1.08) or in the trial emulation (HR, 0.96; 95% CI, 0.43-2.14). In contrast, the naive observational analysis suggested that a shortened duration of CAPOX was significantly associated with worse survival (HR, 3.33; 95% CI, 1.04-10.65). CONCLUSIONS AND RELEVANCE: In this study, the explicit emulation of a target trial better approximated results from an analogous well-conducted randomized clinical trial.
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- 2021
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38. Hippocampal atrophy and cognitive function in transient ischemic attack and minor stroke patients over three years
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Barber, Philip, Nestor, Sean M., Wang, Meng, Wu, Pauline, UrsenbachMunir, JakeAmlish, Gupta, Rani, Tariq, Sana, Smith, Eric E., Frayne, Richard, Black, Sandra, Sajobi, Tolulope T., and Coutts, Shelagh B
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Transient ischemic attack (TIA) and minor ischemic stroke (IS) is associated with a increased risk of late life dementia. In this study we aim to study the extent to which the rates of hippocampal atrophy in TIA/IS differ from healthy controls, and how they are correlated to neuropsychological measurements.
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- 2021
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39. 33 - Objectively Measured Physical Activity, Sedentary Behaviour and Cardiometabolic Measures in Adults with Type 2 Diabetes: Results from the Canadian Health Measures Survey (2007-2017)
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Booth, Jane E., Leung, Alexander A., Benham, Jamie L., Rabi, Doreen M., Goldfield, Gary S., Sajobi, Tolulope T., and Sigal, Ronald J.
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- 2020
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40. Effects of Nutritional Prehabilitation, With and Without Exercise, on Outcomes of Patients Who Undergo Colorectal Surgery: A Systematic Review and Meta-analysis.
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Gillis, Chelsia, Buhler, Katherine, Bresee, Lauren, Carli, Francesco, Gramlich, Leah, Culos-Reed, Nicole, Sajobi, Tolulope T., and Fenton, Tanis R.
- Abstract
Background & Aims Although there have been meta-analyses of the effects of exercise-only prehabilitation on patients undergoing colorectal surgery, little is known about the effects of nutrition-only (oral nutritional supplements with and without counseling) and multimodal (oral nutritional supplements with and without counseling and with exercise) prehabilitation on clinical outcomes and patient function after surgery. We performed a systemic review and meta-analysis to determine the individual and combined effects of nutrition-only and multimodal prehabilitation compared with no prehabilitation (control) on outcomes of patients undergoing colorectal resection. Methods We searched Medline, EMBASE, CINAHL, CENTRAL, and ProQuest for cohort and randomized controlled studies of adults awaiting colorectal surgery who received at least 7 days of nutrition prehabilitation with or without exercise. We performed a random-effects meta-analysis to estimate the pooled risk ratio for categorical data and the weighted mean difference for continuous variables. The primary outcome was length of hospital stay; the secondary outcome was recovery of functional capacity based on results of a 6-minute walk test. Results We identified 9 studies (5 randomized controlled studies and 4 cohort studies) composed of 914 patients undergoing colorectal surgery (438 received prehabilitation and 476 served as controls). Receipt of any prehabilitation significantly decreased days spent in the hospital compared with controls (weighted mean difference of length of hospital stay = −2.2 days; 95% confidence interval = −3.5 to −0.9). Only 3 studies reported on functional outcomes but could not be pooled owing to methodologic heterogeneity. In the individual studies, multimodal prehabilitation significantly improved results of the 6-minute walk test at 4 and 8 weeks after surgery compared with standard Enhanced Recovery Pathway care and at 8 weeks compared with standard Enhanced Recovery Pathway care with added rehabilitation. The 4 observational studies had a high risk of bias. Conclusions In a systematic review and meta-analysis, we found that nutritional prehabilitation alone or combined with an exercise program significantly decreased length of hospital stay by 2 days in patients undergoing colorectal surgery. There is some evidence that multimodal prehabilitation accelerated the return to presurgical functional capacity. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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41. Trajectories of Health-Related Quality of Life in Coronary Artery Disease
- Author
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Sajobi, Tolulope T., Wang, Meng, Awosoga, Oluwagbohunmi, Santana, Maria, Southern, Danielle, Liang, Zhiying, Galbraith, Diane, Wilton, Stephen B., Quan, Hude, Graham, Michelle M., James, Matthew T., Ghali, William A., Knudtson, Merrill L., and Norris, Colleen
- Abstract
Supplemental Digital Content is available in the text.
- Published
- 2018
- Full Text
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