Author: "Gwynn OR" / Topic: business.industry - Searchworks@Jio Institute Digital Library Search Results

506 results on '"Gwynn OR"'

1. Overall survival in patients with hormone receptor-positive, HER2-negative, advanced or metastatic breast cancer treated with a cyclin-dependent kinase 4/6 inhibitor plus fulvestrant: a US Food and Drug Administration pooled analysis

Author: Tatiana M. Prowell, Laleh Amiri-Kordestani, Joyce Cheng, Danielle Krol, Erik Bloomquist, Christy L. Osgood, Shenghui Tang, Gwynn Ison, Richard Pazdur, Rajeshwari Sridhara, Jennifer J Gao, Suparna Wedam, Melanie Royce, and Julia A. Beaver
Subjects: Adult, Oncology, medicine.medical_specialty, Receptor, ErbB-2, Population, Breast Neoplasms, Placebo, Breast cancer, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, Humans, Medicine, Neoplasm Metastasis, education, Fulvestrant, Aged, education.field_of_study, United States Food and Drug Administration, business.industry, Proportional hazards model, Hazard ratio, Cyclin-Dependent Kinase 4, Cyclin-Dependent Kinase 6, Middle Aged, medicine.disease, Metastatic breast cancer, United States, Survival Rate, Clinical Trials, Phase III as Topic, Hormonal therapy, Female, Estrogen Receptor Antagonists, Receptors, Progesterone, business, medicine.drug
Abstract: Summary Background Cyclin-dependent kinase 4/6 inhibitors (CDKIs) are oral targeted agents approved for use in combination with endocrine therapy as first-line or second-line treatment of patients with hormone receptor-positive, HER2-negative, advanced or metastatic breast cancer. We previously reported the pooled analyses of progression-free survival in patients in specific clinicopathological subgroups, all of whom received consistent benefit from the addition of a CDKI to hormonal therapy. Here, we report the pooled overall survival results in patients treated with a CDKI and fulvestrant. Methods In this exploratory analysis, we pooled individual patient data from three phase 3 randomised trials of CDKI or placebo in combination with fulvestrant in patients with breast cancer submitted to the US Food and Drug Administration and approved before Aug 1, 2020, in support of marketing applications. All analysed patients were aged at least 18 years, had an Eastern Cooperative Oncology Group performance status of 0–1, had hormone receptor-positive, HER2-negative advanced or metastatic breast cancer, and received at least one dose of CDKI or placebo in combination with fulvestrant. The median overall survival was estimated using Kaplan-Meier methods, and hazard ratios (HRs) with corresponding 95% CIs were estimated using Cox regression models. Patients were analysed collectively, by number of previous lines of systemic endocrine therapy in any disease setting (first-line or endocrine naive vs second-line and later), and in various clinicopathological subgroups of interest. The estimated median overall survival was not reported by group when the pooled population included patients treated across lines of therapy because of potential patient heterogeneity. All results presented are considered exploratory and hypothesis generating. Findings Across the three pooled trials, 1960 patients were randomly assigned between Oct 7, 2013, and June 10, 2016 (12 patients were not treated and 1296 [66%] patients were randomly assigned to CDKI and 652 [33%] to placebo). In all treated patients (n=1948), the estimated HR for overall survival was 0·77 (95% CI 0·68–0·88), with a median follow-up of 43·7 months (IQR 37·8–47·7) and deaths in 935 (48%) of the 1948 patients. The difference in estimated median overall survival was 7·1 months, favouring CDKIs. In patients who received CDKIs or placebo in combination with fulvestrant as first-line systemic endocrine therapy (two trials; n=396), the estimated HR for overall survival was 0·74 (95% CI 0·52–1·07), with a median follow-up of 39·4 months (IQR 37·0–42·2). 123 (31%) of these patients died. The difference in estimated median overall survival could not be calculated because median overall survival was not estimable (95% CI 50·9–not estimable) in the CDKI group and was 45·7 months (95% CI 41·7–not estimable) in the placebo group. In patients who received CDKIs or placebo in combination with fulvestrant as second-line or later systemic endocrine therapy (three trials; n=1552), the estimated HR for overall survival was 0·77 (95% CI 0·67–0·89), with a median follow-up of 45·1 months (95% CI 39·2–48·5). 812 (52%) of these patients died. The difference in estimated median overall survival was 7·0 months, favouring CDKIs. Interpretation The addition of CDKIs to fulvestrant resulted in a consistent overall survival benefit in all pooled patients and within most clinicopathological subgroups of interest. These findings support the existing standard of care of CDKIs plus fulvestrant for the treatment of patients with hormone receptor-positive, HER2-negative, advanced breast cancer. Funding None.
Published: 2021

2. Health Data for New York City Overview: Advancing Health Equity through Policy-Relevant Collaborative Research

Author: Lisa M. Bates, L Hannah Gould, Michele Calvo, R. Charon Gwynn, Francesca Gany, David S. Siscovick, Elizabeth Kelman, Mary Huynh, and Marivel Davila
Subjects: medicine.medical_specialty, Health (social science), Health Equity, business.industry, Public health, Health Policy, Research, Public Health, Environmental and Occupational Health, MEDLINE, Public relations, Health informatics, Health equity, Article, Health data, Urban Studies, Political science, Epidemiology, medicine, Humans, New York City, business
Published: 2021

3. Cognitive impairment in candidates for allogeneic hematopoietic stem cell transplantation

Author: Gwynn D. Long, Sendhilnathan Ramalingam, Nelson J. Chao, Cristina Gasparetto, Lauren Bohannon, Keith M. Sullivan, Patrick Smith, Yen P. Lowder, Taewoong Choi, Alexandra Artica, Meagan Lew, Anthony D. Sung, David A. Rizzieri, Stefanie Sarantopoulos, Richard D. Lopez, Alyssa Pittman, Mitchell E. Horwitz, Jillian C. Thompson, and Kristi Romero
Subjects: Transplantation, medicine.medical_specialty, Hematopoietic cell, business.industry, medicine.medical_treatment, Incidence (epidemiology), Short Physical Performance Battery, Montreal Cognitive Assessment, Hematology, Hematopoietic stem cell transplantation, Neurocognitive Dysfunction, Internal medicine, Medicine, business, Cognitive impairment, Neurocognitive
Abstract: Hematopoietic cell transplant (HCT) is an increasingly common and curative treatment strategy to improve survival among individuals with malignant and nonmalignant diseases, with over one million HCTs having been performed worldwide. Neurocognitive dysfunction is a common and untoward consequence of HCT for many recipients, although few studies have examined the profile of neurocognitive impairments in HCT or their association with clinical features, such as frailty, or the incidence of pre-HCT neurocognitive impairments across all ages, which may influence post-HCT neurocognitive impairments. We examined the pattern and correlates of pre-transplant neurocognitive dysfunction in a prospective sample of adults undergoing HCT. Neurocognition was assessed using the Montreal Cognitive Assessment Battery. Frailty was assessed using the Short Physical Performance Battery. Linear regression analysis was used to examine the associations between neurocognitive performance and frailty. Neurocognitive screening profiles were also examined by partitioning MoCA into domain scores, including Executive Function and Memory. We also examined the associations between neurocognition, frailty, and clinical outcomes, including length of transplant hospitalization and survival. One hundred and ten adults were evaluated across a wide age range (range: 19-75; mean age = 54.7 [SD = 14.1]). Neurocognitive performance tended to fall below published normative levels (mean MoCA = 25.5 [SD = 4.1]), with 17% of participants demonstrating impaired performance compared with medical normative data (MoCA ≤ 22) and 34% exhibiting impaired performance relative to healthy samples (MoCA ≤ 25). Mild impairments (MoCA ≤ 25) were common across age ranges, including middle-aged patients (23% for age < 50; 35% for age 50-60, 41% for age ≥ 60), particularly for items assessing Executive Function. Greater levels of frailty associated with lower neurocognitive screening scores (r = -0.29, P < 0.01) and Executive Functioning (r = -0.24, P < 0.01), whereas greater age was associated with poorer Memory performance only (r = -0.33, P < 0.01). Greater levels of frailty prior to transplant associated with longer length of stay (β = 0.10, P = 0.046), but were not associated with survival. Neurocognitive impairments are common among adults undergoing HCT and the pattern of performance varies by age. Pre-transplant frailty is associated with neurocognitive functioning and may portend worse post-transplant early clinical outcomes.
Published: 2021

4. Pressure to Use HIV Self-Tests Among Men Who Have Sex With Men, United States, 2015–2016

Author: Robin J. MacGowan, Jerris L. Raiford, Pollyanna R Chavez, Craig B. Borkowf, Melanie Gwynn, and Laura Gravens
Subjects: Sexual partner, medicine.medical_specialty, Social Psychology, business.industry, Public health, Public Health, Environmental and Occupational Health, virus diseases, Coercion, Men who have sex with men, law.invention, Health psychology, Infectious Diseases, Harm, Physical abuse, Randomized controlled trial, law, medicine, business, Psychiatry
Abstract: To assess whether pressuring others to use HIV self-tests is prevalent among US men who have sex with men (MSM), we analyzed data from a randomized controlled trial of HIV self-testing. Among 752 online-recruited MSM who received HIV self-tests and responded to a 12-month survey, 8.5% (60/709) reported pressuring someone to use an HIV self-test: 29 pressured a friend, 28 pressured a sexual partner, and 1 pressured a family member. Conversely, 2.1% (15/715) reported being pressured to self-test: 12 by a sexual partner and 3 by a friend. No physical harm was reported. HIV prevention programs that use HIV self-tests to reach populations at risk for HIV may be reassured by our findings because, despite reports of pressure to use HIV self-tests, no physical abuse was reported between sex partners. These programs should, however, include messages emphasizing the voluntary use of HIV self-tests and be prepared to address concerns of persons who have been pressured to use HIV self-tests. This trial is registered at www.clinicaltrials.gov (NCT02067039) and the date of registration is February 5, 2014.
Published: 2021

5. A survey of cetaceans in New Britain, Papua New Guinea

Author: Lisle Gwynn, Olga Belonovich, Jeremy P. Bird, Elizah Nagombi, Wilma B. Mavea, Tracey Boslogo, and Rodney Russ
Subjects: Marine mammal, Ecology, business.industry, Abundance (ecology), Pantropical, Distribution (economics), New guinea, Animal Science and Zoology, Pelagic zone, Biology, business, Ecology, Evolution, Behavior and Systematics
Abstract: A recent assessment of spatial conservation priorities in mega-diverse Papua New Guinea noted a lack of marine data. We surveyed cetaceans in inshore and pelagic waters along the south coast of New Britain island. The total number of cetaceans encountered was 397, attributed to at least 6 species, with spinner dolphins and pantropical spotted dolphins both the most frequently sighted and abundant species. Although diversity and abundance were lower than expected, we hope that by contributing to a national cetacean sightings database this survey will support a growing understanding of marine mammal diversity and distribution within the region.
Published: 2021

6. Bringing safe and effective therapies to premenopausal women with breast cancer: efforts to broaden eligibility criteria

Author: Sara A. Hurvitz, Christy L. Osgood, Preeti Narayan, Laleh Amiri-Kordestani, Jennifer J Gao, Julia A. Beaver, Matthew P. Goetz, Danielle Krol, C.P. Miller, Meredith M. Regan, Erik Bloomquist, L. Mauro, Gwynn Ison, Fatima Cardoso, Brian Booth, C. Hodgdon, Vishal Bhatnagar, Richard Pazdur, and Lola Fashoyin-Aje
Subjects: medicine.medical_specialty, Antineoplastic Agents, Hormonal, business.industry, MEDLINE, Breast Neoplasms, Hematology, medicine.disease, Breast cancer, Premenopause, Oncology, medicine, Humans, Female, Intensive care medicine, business
Published: 2021

7. Monitoring of large B-cell lymphoma and T-zone lymphoma in a dog via flow cytometry

Author: Jennifer L. Granick, Erin N. Burton, Hannah Able, Davis M. Seelig, Claire S. Rosenbaum, and Angela D. Gwynn
Subjects: Male, Pathology, medicine.medical_specialty, Lymphocytosis, 040301 veterinary sciences, T-Lymphocytes, Lymphocyte, Biopsy, Fine-Needle, Population, Immunophenotyping, 0403 veterinary science, 03 medical and health sciences, Dogs, medicine, Animals, Dog Diseases, B-cell lymphoma, education, Lymph node, 030304 developmental biology, 0303 health sciences, education.field_of_study, General Veterinary, business.industry, 04 agricultural and veterinary sciences, Flow Cytometry, medicine.disease, Lymphoma, medicine.anatomical_structure, Brief Reports, Lymph Nodes, Lymphoma, Large B-Cell, Diffuse, CD5, medicine.symptom, business, Generalized lymphadenopathy
Abstract: A 12-y-old, castrated male Pomeranian dog was presented because of mandibular lymph node (LN) enlargement. Physical examination and a complete blood count revealed generalized lymphadenopathy and moderate lymphocytosis. Fine-needle aspirate cytology revealed expansion of medium lymphocytes in the right mandibular LN and expansion of large lymphocytes in the left popliteal LN. Flow cytometry identified 2 aberrant lymphocyte populations in both LNs, namely a CD5+CD45− T-cell population, and a large CD21+ B-cell population. Flow cytometry of the peripheral blood revealed an identical population of aberrant CD45− T cells. The patient was diagnosed with concurrent T-zone lymphoma and leukemia, and B-cell lymphoma. Multi-agent chemotherapy was instituted, and serial clinical and flow cytometric analysis revealed complete remission of the neoplastic B cells, but persistence of the neoplastic T cells and persistent lymphadenopathy. This case affirms the diagnostic value of flow cytometry and reveals a unique limitation of the RECIST criteria.
Published: 2021

8. Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Author: Obbina Abani, Ali Abbas, Fatima Abbas, Mustafa Abbas, Sadia Abbasi, Hakam Abbass, Alfie Abbott, Nabeel Abdallah, Ashraf Abdelaziz, Mohamed Abdelfattah, Bushra Abdelqader, David Abdo, Basir Abdul, Althaf Abdul Rasheed, Ajibode Abdulakeem, Rezan Abdul-Kadir, Amina Abdulle, Abdulfatahi Abdulmumeen, Rasheed Abdul-Raheem, Niyaz Abdulshukkoor, Kula Abdusamad, Yazeed Abed El Khaleq, Mai Abedalla, Abeer Ul Amna Abeer Ul Amna, Katrina Abernethy, Adebanke Aboaba, Hani Abo-Leyah, Ahmed Abou-Haggar, Mahmoud Abouibrahim, Miriam Abraham, Tizzy Abraham, Abraheem Abraheem, Judith Abrams, Hyacinth-John Abu, Ahmed Abu-Arafeh, Syed M Abubacker, Akata Abung, Yaa Aceampong, Amaka Achara, Devikumar Acharya, Sarah Acheampong, Janet Acheson, Andres Acosta, Catherine Acton, Jacqueline Adabie-Ankrah, Sara Adair, Fiona Adam, Matthew Adam, Huzaifa Adamali, Carol Adams, Charlotte Adams, Kate Adams, Lisa Adams, Richard Adams, Tim Adams, Kirsty Adcock, Jemaimah Addai, Ade Adebiyi, Ken Adegoke, Vicki Adell, Debo Ademokun, Sherna Adenwalla, Oluwasegun A Adesemoye, Emmanuel O Adewunmi, Joyce Adeyemi, Rina Adhikary, Gabrielle Adkins, Adnan Adnan, John Aeron-Thomas, Debbie Affleck, Dominic Affron, Carmel Afnan, Muhammad Afridi, Zainab A Aftab, Meenakshi Agarwal, Rachel Agbeko, Chris Agbo, Penny Agent, Sunil Aggarwal, Arameh Aghababaie, Shafana Ahamed Sadiq, Mohamed H Ahammed Nazeer, Humayun Ahmad, Mohammad Ahmad, Syed Ahmad, Asim Ahmed, Bilal Ahmed, Forizuddin Ahmed, Hamze Ahmed, Iram Ahmed, Irshad Ahmed, Khaled Ahmed, Liban Ahmed, Mahin Ahmed, Maria C Ahmed, Muhammad S Ahmed, Naseer Ahmed, Nausheen Ahmed, Osama Ahmed, Rajia A Ahmed, Rizwan Ahmed, Saif Ahmed, Sammiya Ahmed, Sara Ahmed, Sophia Ahmed, Syed Ahmed, Syed Haris Ahmed, Roa Ahmed Ali, Sana Ahmed, Sana Ahmer, Dhiraj Ail, Mark Ainsworth, Giulia Airoldi, Myriam Aissa, Lindianne Aitken, Bini Ajay, Francis Ajeneye, Abdulakeem Ajibode, Ayesha Ajmi, Tahir Akbar, Naim Akhtar, Nasim Akhtar, Nauman Akhtar, Suha Akili, Oludoyinsola Akindolie, Yinka Akinfenwa, Olugbenga Akinkugbe, Ibrahim Akinpelu, Olajide Akinwumiju, Olugbenro Aktinade, Ahmad Al Aaraj, Asma Al Balushi, Majd Al Dakhola, Aladdin Al Swaifi, Eslam Al-Abadi, Narendra Aladangady, Ayaz Alam, Sajid Alam, Abbas Al-Asadi, Karina Al-Asadi, Kyriaki Alatzoglou, Manaf Al-Bayati, Paul Albert, Lorraine Albon, Gemma Alcorn, Stephen Alcorn, Aggie Aldana, David Alderdice, Rayan Aldouri, Jonathan Aldridge, Nicolas Aldridge, Ana Alegria, Alison Alexander, John Alexander, Peter D G Alexander, Charlotte Alford, Julyan Al-Fori, Laith Alghazawi, Bahij Al-Hakim, Shams Al-Hity, Ali Ali, Asad Ali, Fawzia R Ali, Hoodo Ali, Jawad Ali, Mariam Ali, Mohammad Ali, Nayab Ali, Oudai Ali, Sabira Ali, Sakina Ali, Syed Ali, Abid Alina, Fine Aliyuda, Katrin Alizadeh, Maithem Al-Jibury, Saba Al-Juboori, Majid Al-Khalil, Moutaz Alkhusheh, Allameddine Allameddine, Fiona Allan, Rachel Allan, Alison Allanson, Robert Allcock, Beverley Allen, Eireann Allen, Jess Allen, Kerry Allen, Laura Allen, Louise Allen, Poppy Allen, Rebecca Allen, Sam Allen, Sharon Allen, Simon Allen, Kathryn Allison, Bethan Allman, Lynne Allsop, Hassan Al-Moasseb, Magda Al-Obaidi, Lina Alomari, Akram Al-Rabahi, Bahar Al-Ramadhani, Zayneb Al-Saadi, Inji Alshaer, Rustam Al-Shahi Salman, Warkaq Al-Shamkhani, Bashar Al-Sheklly, Sara Altaf, Mary Alvarez, Balaal Alyas, Maysaa Alzetani, Susan Amamou, Noor Amar, Sakkarai Ambalavanan, Sarah-Jayne Ambler, Robert Ambrogetti, Chris Ambrose, Amir Ameen, Kenneth Amenyah, Maria R Amezaga, Allison Amin, Amina Amin, Kanish Amin, Syed Amin, Tara Amin, Amjad Amjad, Neelma Amjad, Mariam Ammoun, Victoria Amosun, Khaled Amsha, Pugh Amy, Atul Anand, Rekha Anand, Samantha Anandappa, Julie Anderson, Kevin Anderson, Laura Anderson, Michelle Anderson, Nicola Anderson, Rachel Anderson, Rory Anderson, Wendy Anderson, Prematie Andreou, Angela Andrews, Antonette Andrews, Jill Andrews, Susan Andrews, Gregory Andrikopoulos, Kanayochukwu Aneke, Andrew Ang, Wan Wei Ang, Tammy Angel, Aramburo Angela, Paola Angelini, Lazarus Anguvaa, Oleg Anichtchik, Millicent Anim-Somuah, Krishnan Aniruddhan, Jessica Annett, Patrick J Anstey, Rebekah Anstey, Alpha Anthony, Aaron Anthony-Pillai, Philip Antill, Zhelyazkova Antonina, Varghese Anu, Muhammad Anwar, George Apostolides, Aristeidis Apostolopoulos, Sarah Appleby, Diane Appleyard, Maia Far Aquino, Bianca Araba, Samuel Aransiola, Mariana Araujo, Emily Arbon, Ann Archer, Denise Archer, Simon Archer, Christian Ardley, Ana-Maria Arias, Ryoki Arimoto, Charlotte Arkley, Charlotte Armah, Ilianna Armata, Adam Armitage, Ceri Armstrong, Maureen Armstrong, Sonia Armstrong, Sylvia Armstrong-Fisher, Philippa Armtrong, Heike Arndt, Clare Arnison-Newgass, David Arnold, Rachael Arnold, Sarah Arnott, Dhawal Arora, Kavan Arora, Pardeep Arora, Rishi Arora, Andrea Arroyo, Arslam Arter, Ayush Arya, Rita Arya, Denisa Asandei, Adeeba Asghar, Catherine Ashbrook-Raby, Glen Ashby, Helen Ashby, Jan Ashcroft, John Ashcroft, Samuel Ashcroft, Deborah Asher, Ayesha Ashfaq, Ben Ashford, Suhail Ashgar, Abdul Ashish, Sally Ashman-Flavell, Sundar Ashok, Abd-El-Aziz Ashour, Muhammad Z Ashraf, Saima Ashraf, Mohammad B Ashraq, Deborah Ashton, Susan Ashton, Andrew Ashworth, Rebecca Ashworth, Arshia Aslam, Harshini Asogan, Abigail Asquith, Atif Asrar, Omar Assaf, Raine Astin-Chamberlain, Richard Athay-Hunt, Deborah Athorne, Billie Atkins, Christopher Atkins, Stacey Atkins, John Atkinson, Vicki Atkinson, Brygitta Atraskiewicz, Claire Atterbury, Abdul Ahmad Attia, Rita Atugonza, Paula Aubrey, Avinash Aujayeb, Aye Chan Thar Aung, Hnin Aung, Kyaw Thu Aung, Ni Aung, Yin Aung, Zaw Myo Aung, Emily Austin, Karen Austin, Abdusshakur Auwal, Miriam Avery, Joanne Avis, Georgina Aviss, Cristina Avram, Paula Avram, Gabriel Awadzi, Atia Awan, Aszad Aya, Eman Ayaz, Amanda Ayers, Jawwad Azam, Mohammed Azharuddin, Ghazala Aziz, N Aziz, Ali Azkoul, Ashaari Azman Shah, Giada Azzopardi, Hocine Azzoug, Fiyinfoluwa Babatunde, Melvin Babi, Babiker Babiker, Gayna Babington, Matthew Babirecki, Marta Babores, Adetona O Babs-Osibodu, Sammy Bacciarelli, Roudi Bachar, Gina Bacon, Jenny Bacon, Bibi Badal, Gurpreet R Badhan, Shreya Badhrinarayanan, Joseph P Bae, Sibel Bafekr Mishamandani, Alice Baggaley, Amy Baggott, Graham Bagley, Dinesh Bagmane, Lynsey Bagshaw, Kasra Bahadori, James Bailey, Katie Bailey, Lindsey Bailey, Liz Bailey, Morgan Bailey, Pippa Bailey, Sarah Bailey, Stephen Bailey, Hamish Baillie, J Kenneth Baillie, Jennifer Bain, Sanchia Baines, Vikram Bains, Aimi Baird, David Baird, Susan Baird, Tracy Baird, Yolanda Baird, Aiysha Bajandouh, Charles Baker, Emma Baker, Evelyn Baker, Johanne Baker, Josephine Baker, Kenneth Baker, Rebecca Baker, Terri-Anne Baker, Victoria Baker, Hugh Bakere, Nawar Bakerly, Michelle Baker-Moffatt, Nauman Bakhtiar, Panos Bakoulas, Julie Balaam, Niranjan Balachandran, Andrea Balan, Theodosios Balaskas, Madhu Balasubramaniam, Alison Balcombe, Alexander Baldwin, Ashley Baldwin, Caron Baldwin, Danielle Baldwin, Rebekah Baldwin-Jones, James Balfour, Gagan Bali, Sonya Balkee, Ceri Ball, Kasia Ballard, Amy Ballinger, Ismael Balluz, Craig Balmforth, Emese Balogh, Amir Baluwala, Gabby Bambridge, Alasdair Bamford, Amy Bamford, Peter Bamford, Adefunke Bamgboye, Elizabeth Bancroft, Hollie Bancroft, Tanya Bancroft, Joyce Banda, Krishna Bandaru, Srini Bandi, Nageswar Bandla, Somaditya Bandyopadhyam, Amit Banerjee, Millie Banerjee, Ritwik Banerjee, Harrison Banks, Lauren Banks, Luke Banks, Paul Banks, Oliver Bannister, Bharat Bansal, Robert Banthorpe, Laura Banton, Mariamma Baptist, Tanya Baqai, Ananya Mouli Baral, Desislava Baramova, Alex Barber, Russel Barber, Emma Barbon, Miriam Barbosa, Monica Barbosa, Jamie Barbour, Alexander Barclay, Claire Barclay, George Bardsley, Stephanie Bareford, Shahedal Bari, Amy Barker, Debbie Barker, Helen Barker, Joseph Barker, Leon Barker, Oliver Barker, Kerry Barker-Williams, Sinha Barkha, Juliana Barla, Gavin Barlow, Richard Barlow, Valerie Barlow, James Barnacle, Alex Barnard, Debi Barnes, Nicky Barnes, Theresa Barnes, Calum Barnetson, Amy Barnett, Matthew Barnett, Ashton Barnett-Vanes, William Barnsley, Andrew Barr, David Barr, Shaney Barratt, Manuella Barrera, Amy Barrett, Fiona Barrett, Jessica Barrett, Joe Barry, Jazz Bartholomew, Claire Bartlett, Georgina Bartlett, Greg Barton, Jill Barton, Lorna Barton, Rachael Barton, Rosaleen Baruah, Sonia Baryschpolec, Archana Bashyal, Betsy Basker, Ayten Basoglu, Gilda Bass, John Bassett, G Bassett, Chris Bassford, Pavinder Bassi, Betsy Bassis, Bengisu Bassoy, Victoria Bastion, Anupam Basumatary, Tristan Bate, Harry J Bateman, Ian Bateman, Kathryn Bateman, Vhairi Bateman, Eleanor Bates, Hayley Bates, Michelle Bates, Simon Bates, Sally Batham, Ana Batista, Amit Batla, Dushyant Batra, Donna Batty, Harry Batty, Thomas Batty, Peter Baughan, Miranda Baum, Carina Bautista, Fareha Bawa, Fatima S Bawani, Simon Bax, Lydia Baxter, Matt Baxter, Nicola Baxter, Zachary Baxter, Hannah Bayes, Charlotte Baylem, Lee Bayliss, Eileen Bays, Farid Bazari, Rohit Bazaz, Ahmad Bazli, Laura Beacham, Wendy Beadles, Philip Beak, Andy Beale, Kirk Beard, Jack Bearpark, Karen Beaumont, Dawn Beaumont-Jewell, Theresa Beaver, Sarah Beavis, Christy Beazley, Sarah Beck, Virginia Beckett, Rosie Beckitt, Heidi Beddall, Seonaid Beddows, Deborah Beeby, Gail Beech, Michelle Beecroft, Sally Beer, Jane Beety, Gabriela Bega, Alison Begg, Susan Begg, Sara Beghini, Ayesha Begum, Salman Begum, Selina Begum, Teresa Behan, Jasmine Beharry, Roya Behrouzi, Jon Beishon, Claire Beith, James Belcher, Holly Belfield, Katherine Belfield, Ajay Belgaumkar, Dina Bell, Gareth Bell, Gill Bell, Gillian Bell, Joshua Bell, Lauren Bell, Louise Bell, Nicholas Bell, Pippa Bell, Stephanie Bell, Jennifer L Bell, Jennifer Bellamu, Mary Bellamy, Arianna Bellini, Amanda Bellis, Fionn Bellis, Lesley Bendall, Naveena Benesh, Nicola Benetti, Leonie Benham, Guy Benison-Horner, Alexander Bennett, Ann Bennett, Caroline Bennett, Christopher Bennett, Gillian Bennett, Ian Bennett, Kristopher Bennett, Lorraine Bennett, Sara Bennett, Karen Bennion, Vivienne Benson, Jane Benstead, Andrew Bentley, Dionne Bentley, James Bentley, Ian Benton, Eva Beranova, Matthew Beresford, Colin Bergin, Malin Bergstrom, Jolanta Bernatoniene, Thomas Berriman, Zoe Berry, Marnie Berwick, Kimberley Best, Ans-Mari Bester, Yvonne Beuvink, Emily Bevan, Sarah Bevins, Tom Bewick, Andrew Bexley, Sonay Beyatli, Fenella Beynon, Arjun Bhadi, Sanjay Bhagani, Shiv Bhakta, Rekha Bhalla, Khushpreet Bhandal, Kulbinder Bhandal, Ashwin Bhandari, Sangam Bhandari, Aashutosh Bhanot, Ravina Bhanot, Sruti Bhaskara, Prashanth Bhat, Nikhil Bhatia, Rahul Bhatnagar, Karan Bhatt, Janki Bhayani, Deepika Bhojwani, Salimuzzaman Bhuiyan, Anna Bibby, Fatima Bibi, Naheeda Bibi, Salma Bibi, Tihana Bicanic, Sarah Bidgood, Julie Bigg, Sarah Biggs, Alphonsa Biju, Andras Bikov, Sophie Billingham, Jessica Billings, Carron Bilton, Teodirico Binas, Martin Binney, Alice Binns, Muhammad BinRofaie, Oliver Bintcliffe, Catherine Birch, Jenny Birch, Louann Birch, Janet Birchall, Katherine Birchall, Sam Bird, Sumedha Bird, Charndip Biring, Mark Birt, Raquel Bisa, Kilanalei Bishop, Linda Bishop, Lisa Bishop, Karen Bisnauthsing, Nibedan Biswas, Sahar Biuk, Karen Blachford, Ethel Black, Helen Black, Karen Black, Mairead Black, Polly Black, Hayley Blackgrove, Bethan Blackledge, Joanne Blackler, Samantha Blackley, Helen Blackman, Stuart Blackmore, Caroline Blackstock, Loraine Blackwood, Francesca Blakemore, Helen Blamey, Alison Bland, Sujata Blane, Simon Blankley, Mary Blanton, Parry Blaxill, Jenny Blaxland, Katie Blaylock, Jane Blazeby, Carol Blears, Natalie Blencowe, Donna Blofield, Ben Bloom, Jack Bloomfield, Angela Bloss, Hannah Bloxham, Louise Blundell, Andrew Blunsum, Mark Blunt, Ian Blyth, Kevin Blyth, Andrew Blythe, Karen Blythe, Marilyn Boampoaa, Boniface Bobie, Karen Bobruk, Pritesh Bodalia, Neena Bodasing, Tanya Bodenham, Sherin Bodh, Gabriele Boehmer, Marta Boffito, Kristyna Bohmova, Sumit Bokhandi, Maria Bokhar, Saba Bokhari, Sakina Bokhari, Syed Owais Bokhari, Ambrose Boles, Sarah Bollington, Sam Bolton, Charlotte Bomken, Charlotte Bond, Hayley Bond, Helena Bond, Stuart Bond, Thomas Bond, Alice Bone, Georgia Boniface, Wendy Bonnert, Lizzy Bonney, Leigh Boorman, Catherine Booth, Joanne Borbone, Cameron Borhani, Naomi Borman, Rachel Borrell, Mamu Boshir, Fiona Bottrill, Laura Bough, Hayley Boughton, Zoe Boult, Miriam Bourke, Stephen Bourke, Michelle Bourne, Rachel Bousfield, Lucy Boustred, Darren Bowen, Kaye Bowen, Alexandra Bowes, Amy Bowes, Philip Bowker, Louise Bowman, Simon Bowman, Rachel Bowmer, Angie Bowring, Geoff Bowyer, Helen Bowyer, Carmel Boyd, Jenny Boyd, Laura Boyd, Maxine Boyd, Namoi Boyle, Pauline Boyle, Rosalind Boyle, Louise Boyles, Osman Bozdag, Leanna Brace, David Brack, Charlotte Brackstone, Rob Bradburn, Jodie Bradder, Barry Bradley, Clare Jane Bradley, Pamela Bradley, Patrick Bradley, Paul Bradley, Joanne Bradley-Potts, Lynne Bradshaw, Sarah Bradshaw, Zena Bradshaw, Rebecca Brady, Shirin Brady, Denise Braganza, Suhail Brailsford, Jill Braithwaite, Marie Branch, Thomas Brankin-Frisby, Jamie Brannigan, Louise Brassington, Sophie Brattan, Fiona Bray, Nancy Bray, Angela Brazier, Manny Brazil, Lucy Brear, Tracy Brear, Stephen Brearey, Laura Bremner, Morwenna Brend, Giovanna Bretland, Chris Brewer, Hannah Bridge, Gavin Bridgwood, Hayley Briggs, Mark Briggs, Sara Brigham, John Bright, Chris Brightling, Lutece Brimfield, Elaine Brinkworth, Robin Brittain-Long, Vianne Britten, Terri Brittin, Lauren Broad, Sarah Broad, Rosie Broadhurst, Andrew Broadley, Marie Broadway, Christopher Brockelsby, Megan Brocken, Tomos Brockley, Andrew Broderick, Mary Brodsky, Fiona Brogan, David Broggio, Liz Brohan, Felicity Brokke, Jacob Brolly, David Bromley, Hannah Brooke-Ball, Verity Brooker, Ceri Brookes, Matthew Brookes, Alison Brooks, Karen Brooks, Nicole Brooks, Philip Brooks, Rachel Brooks, Sophie Brooks, Natalie Broomhead, Chloe Broughton, Nathaniel Broughton, Matt Brouns, Marie Browett, Alison Brown, Ammani Brown, Carly Brown, Catrin Brown, Chloe Brown, Elizabeth Brown, Ellen Brown, Heather Brown, Janet Brown, Louise Brown, Niall Brown, Pauline Brown, Rachel Brown, Richard Brown, Robert Brown, Steven Brown, Tom Brown, Wayne Brown, Bria Browne, Charlotte Browne, Duncan Browne, Mitchell Browne, Stephen Brownlee, Alba Brraka, David Bruce, Johanna Bruce, Michelle Bruce, Wojciech Brudlo, Nigel Brunskill, Alan Brunton, Margaret Brunton, Mandy Bryan, Meera Bryant, April Buazon, Maya Buch, Julie Buchan, Ruaridh Buchan, Alexis Buchanan, Ruaridh Buchanan, Danielle Buche, Amanda Buck, Matthew Buckland, Laura Buckley, Philip Buckley, Sarah Buckley, Carol Buckman, Kathleen Buckmire, George Bugg, Ramadan Bujazia, Marwan Bukhari, Shanze Bukhari, Richard Bulbulia, Alex Bull, Damian Bull, Rhian Bull, Thomas Bull, Naomi Bulteel, Kasun Bumunarachchi, Roneleeh Bungue-Tuble, Caroline Burchett, Dorota Burda, Christy Burden, Thomas G Burden, Mika Burgess, Paula Burgess, Richard Burgess, Sophia Burgess, Paula Burgett, Adrian Burman, Sara Burnard, Caroline Burnett, John Burnett, Amanda Burns, Amy Burns, Collette Burns, James Burns, Karen Burns, Samuel Burns, Sarah Burns, Daniel Burrage, Sadie Burrage, Kate Burrows, Claire Burston, Ben Burton, Fiona Burton, Matthew Burton, Angela Busby, Deborah Butcher, Aaron Butler, Jessica Butler, Joanne Butler, Joshua Butler, Lesley Butler, Peter Butler, Susan Butler, Al-Tahoor Butt, Mohammad M Butt, Sophia Butt, Caryl Butterworth, Nicola Butterworth-Cowin, Robert Buttery, Tom Buttle, Heather Button, Daniel Buttress, Jane Byrne, Wendy Byrne, Victoria Byrne-Watts, Eleanor Byworth, Amanda Cabandugama, Ruth Cade, Anthony Cadwgan, Donna Cairney, James Calderwood, Darren Caldow, Moira Caldwell, Giorgio Calisti, Debbie Callaghan, Jennifer Callaghan, Claire Callens, Donaldson Callum, Caroline Calver, Melissa Cambell-Kelly, Tracey Camburn, David R Cameron, Eleanor Cameron, Fraser Cameron, Sarah Cameron, Sheena Cameron, Christian Camm, Renee F D Cammack, Alison Campbell, Amy Campbell, Barbara Campbell, Bridget Campbell, Debbie Campbell, Helen Campbell, Hilary Campbell, Jonathan Campbell, Mark Campbell, Robyn Campbell, Wynny Campbell, Quentin Campbell Hewson, Julie Camsooksai, Ana Canabarro, Lisa Canclini, Shaula Mae Candido, Janie Candlish, Cielito Caneja, Johnathon Cann, Ruby Cannan, Emma Cannon, Michael Cannon, Petra Cannon, Vivienne Cannons, Jane Cantliff, Ben Caplin, Santino Capocci, Noemi Caponi, Angelika Capp, Anne Capps-Jenner, Thomas Capstick, Ishmael Carboo, Nuria Cardenas, Mary Cardwell, Rachel Carey, Simon Carley, Tammy Carlin, Andrew Carlton, Samantha Carmichael, Mandy Carnahan, Rebecca Carnegie, Charlotte Caroline, Emily Carpenter, Jodi Carpenter, David Carr, Sharon Carr, Anna Carrasco, Samantha Carrington, Zoe Carrington, Paul Carroll, Caroline Carron, Anne Carstairs, Jonathan Carter, Michael Carter, Moira Carter, Paul Carter, Penny Carter, Steven Carter, Simon 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Chandler, Kim J Chandler, Stuart Chandler, Zoe Chandler, Vikki Chandler-Vizard, Sumit Chandra, Navin Chandran, Badrinathan Chandrasekaran, Cherry Chang, Yvonne Chang, Josephine Chaplin, Graeme Chapman, John Chapman, Katie Chapman, Laura Chapman, Lianne Chapman, Polly Chapman, Timothy Chapman, Lucy Chappell, Linda Chapple, Amanda Charalambou, Bethan Charles, Dianne Charlton, Sally Charlton, Kevin Chatar, Calvin Chatha, Ritesh Chaube, Muhammad YN Chaudhary, Iram Chaudhry, Nazia Chaudhuri, Muhammad Chaudhury, Anoop Chauhan, Ruchi S Chauhan, Vipul Chauhan, Nicola Chavasse, Iknam Chaven, Rosanna Chavez, Vipal Chawla, Maria Cheadle, Lindsay Cheater, James Cheaveau, Charlotte Cheeld, Michelle Cheeseman, Fang Chen, Hui Min Chen, Terence Chen, Lok Yin Cheng, Zhihang Cheng, Helen Chenoweth, Chun How Cheong, Shiney Cherian, Suzanne Cherif, Mary Cherrie, Helen Cheshire, Barry Chesterson, Betty Cheung, Chee Kay Cheung, Elaine Cheung, Michelle Cheung, Claire Cheyne, Swati Chhabra, Wei Ling Chia, Eric Chiang, Angela Chiapparino, Rosavic Chicano, Zviedzo A Chikwanha, Sam Chilcott, Phillipa Chimbo, KokWai Chin, Wen Jie Chin, Rumbidzai Chineka, Amol Chingale, Karen Chinn, Vashira Chiroma, Heather Chisem, Claire Chisenga, Ben Chisnall, Carolyn Chiswick, Sunder Chita, Nihil Chitalia, Matthew Chiu, Brenda Chivima, Catherine Chmiel, Soha Choi, Willy Choon Kon Yune, Vandana Choudhary, Sarah Choudhury, Bing-Lun Chow, Fateha Chowdhury, Mahibbur Chowdhury, Shahid Chowdhury, Victoria Christenssen, Peter Christian, Alexander Christides, Fiona Christie, Daniel Christmas, Thereza Christopherson, Mark Christy, Paris Chrysostomou, Yunli Chua, Shabs Chucha, Dip Chudgar, Richard Chudleigh, Srikanth Chukkambotla, Michael E Chukwu, Izu Chukwulobelu, Chi Y Chung, Ben Church, Elaine Church, Sara R Church, David Churchill, Nicole Cianci, Nick Ciccone, Paola Cicconi, Paola Cinardo, Zdenka Cipinova, Bessie Cipriano, Sarah Clamp, Melanie Clapham, Edel Clare, Sarbjit Clare, Andrew Clark, Charlotte Clark, Diane Clark, Felicity Clark, Gabrielle Clark, James Clark, Katherine Clark, Kaylea Clark, Louise Clark, Lucy Clark, Matthew Clark, Patricia Clark, Richard Clark, Thomas Clark, Wendy Clark, Zoe Clark, Andrea Clarke, Heather Clarke, Mark Clarke, Paul Clarke, Robert Clarke, Roseanne Clarke, Samantha Clarke, Sarah Clarke, Sheron Clarke, Tracy Clarke, Andrew Clarkson, Alleyna Claxton, Kate Clay, Elizabeth Clayton, Olivia Clayton, Jill Clayton-Smith, Chris Cleaver, Carlota Clemente de la Torre, Jayne Clements, Suzanne Clements, Francesca Clemons, Lee Clifford, Lynne Clifford, Rachael Clifford, Sarah Clifford, Amelia Clive, Jonathan Clouston, Samantha Clueit, Andrea Clyne, Michelle Coakley, Peter G L Coakley, Tony Coates, Kathryn Cobain, Alexandra Cochrane, Patricia Cochrane, Maeve Cockerell, Helen Cockerill, Shirley Cocks, Rachel Codling, Adam Coe, Samantha Coetzee, David Coey, Danielle Cohen, Jonathan Cohen, Oliver Cohen, Mike Cohn, Louise Coke, Olutoyin Coker, Nicholas Colbeck, Roghan 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Cooper, Chris Cooper, David Cooper, Helen Cooper, Jamie Cooper, Joanne Cooper, Joshua Cooper, Laura Cooper, Lauren Cooper, Nick Cooper, Rowena Cooper, Emma Cooperwaite, Thomas Cope, Sinead Corbet, Carolyn Corbett, John Corcoran, Chris Cordell, Jessica Cordle, Alasdair Corfield, John Corless, Alison Corlett, Joe Cornwell, Michael Cornwell, Diana Corogeanu, Mirella Corredera, Ruth Corrigan, Catherine Corry, Rita Corser, Denise Cosgrove, Tracey Cosier, Patricia Costa, Charlie Coston, Susannah Cotgrove, Zoe Coton, Lisa-Jayne Cottam, Rhiannon Cotter, Donna Cotterill, Alice Cotton, Caroline Cotton, Katy Cotton, Andrew Coull, James Coulson, David Counsell, David Counter, Cherry Coupland, Ellie Courtney, Julia Courtney, Rebecca Cousins, Alexander Cowan, Elena Cowan, Ruth Cowburn, Richard Cowell, Louise Cowen, Steve Cowman, Amanda Cowton, Debra Anne Cox, Ellie Cox, Giles Cox, Karina Cox, Miriam Cox, Karen Coy, Beverly Craig, Victoria Craig, Felicity Craighead, Matthew Cramp, Beverley Crane, 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Davies, Ffyon Davies, Helen Davies, James Davies, Jane Davies, Jeni Davies, Jim Davies, Karen Davies, Kelly Davies, Kim Davies, Louisa Davies, Mark Davies, Matthew Davies, Michelle Davies, Nina Davies, Owen Davies, Patrick Davies, Rachel Davies, Rhys Davies, Ruth Davies, Sarah Davies, Simon Davies, Alison Davis, Gwyneth Davis, Illinos Davis, Julie-Ann Davis, Katherine Davis, Peter Davis, Alexander Davison, Sophia Davison, Mark Davy, Christine Dawe, H Dawe, Mark Dawkins, Danielle Dawson, Elizabeth Dawson, Joy Dawson, Susan Dawson, Tom Dawson, Andrew Daxter, Andrew Day, Helena Day, Jacob Day, Jeremy Day, Lynn Day, Jamie D'Costa, Parijat De, Duneesha de Fonseka, Toni de Freitas, Frederico De Santana Miranda, Eleanor de Sausmarez, Shanika de Silva, Thushan de Silva, Jessica De Sousa, Paulo De Sousa, James de Souza, Anthony de Soyza, Natasha de Vere, Johannes de Vos, Bethan Deacon, Sharon Dealing, Anna Dean, Julie Dean, Katrina Dean, Stephen Dean, Tessa Dean, Jill Deane, James Dear, Effie Dearden, Alison Deary, Catherine Deas, Samuel Debbie, Gabor Debreceni, Vashist Deelchand, Matthew Deeley, Joanne Deery, Emmanuel Defever, Raji Dehulia, Max Deighton, Manuela Del Forno, Arnold Dela Rosa, Lisa Delaney, Amanda Dell, Carrie Demetriou, David DeMets, Jane Democratis, Jacqueline Denham, Emmanuelle Denis, Laura Denley, Craig Denmade, Kathy Dent, Martin Dent, Elise Denton, Tom Denwood, Nishigandh Deole, Darshita Depala, Maria Depante, Randle Derbyshire, Susan Dermody, Amisha Desai, Asmita Desai, Purav Desai, Sanjeev Deshpande, Vai Deshpande, Brendan Devine, Sirjana Devkota, Nicola Dewland, Prakash Dey, Vishal Dey, Rogin Deylami, Jazz Dhaliwal, Kevin Dhaliwal, Jas Dhalliwal, Mandeep Dhanda, Sundip Dhani, Amandeep Dhanoa, Mili Dhar, Devesh Dhasmana, Aman Dhesi, Ekanjali Dhillon, Reiss Dhillon, Pamela Diamond, Priya Dias, Stephanie Diaz, Kayleigh Diaz-Pratt, Debbie Dickerson, Pamela Dicks, Stuart Dickson, Julie Dijo, Sean Dillane, Sarah Diment, Paul Dimitri, Maria Dineen, ThaiHa Dinh, Tri Dinh, Alex Dipper, Laura Dirmantaite, Lisa Ditchfield, Sarah Diver, Lavanya Diwakar, Caroline Dixon, Giles Dixon, Stephen Dixon-Mould, Brice Djeugam, Petr Dlouhy, Laurence Dobbie, Marinela Dobranszky Oroian, Charlotte Dobson, Lee Dobson, Marie Docherty, David Dockrell, James Dodd, Jackie Dodds, Rebecca Dodds, Steve Dodds, Richi Dogra, Erin Doherty, Warren Doherty, Yumiko Doi, Iain Doig, Eleanor Doke, Daniel Dolan, Mark Dolman, Rozzie Dolman, Lisa Donald, Callum Donaldson, Christopher Donaldson, Denise Donaldson, Gillian Donaldson, Kate Donaldson, Joanne Donnachie, Christopher Donnelly, Eilish Donnelly, Ronan Donnelly, Aravindhan Donohoe, Gemma Donohoe, Bryan Donohue, Sinead Donton, Emma Dooks, Grainne Doran, Kane Dorey, Sharon Dorgan, Amanda Dornan, Moonira Dosani, Davinder Dosanjh, Paula Dospinescu, Katie Douglas, Jonathan Douse, Lucy Dowden, Michelle Dower, Kerry Dowling, Sud Dowling, Nicola Downer, Charlotte Downes, Rob Downes, Thomas Downes, Damian Downey, Philippa 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Susie Ferguson, Victoria Ferguson, Denzil Fernandes, Candida Fernandez, Eduardo Fernandez, Maria Fernandez, Sonia Fernandez Lopez, Callum Jeevan Fernando, Ahmed Feroz, Pietro Ferranti, Thais Ferrari Gersogamo, Eleanor Ferrelly, Alexandra Ferrera, Emma Ferriman, Nicholas Fethers, Ben Field, Janet Field, Rebecca Field, Karen Fielder, Lindsey Fieldhouse, Andra Fielding, Julie Fielding, Len Fielding, Sarah Fielding, Asma Fikree, Sarah Ann Filson, Sarah Finbow, Debbie Finch, Joanne Finch, Laurie Finch, Joanne Finden, Natalie Fineman, Lauren Finlayson, Adam Finn, Joanne Finn, Clare Finney, Sofia Fiouni, Jo Fiquet, Dani Fisher, Emily Fisher, James Fisher, Neil Fisher, Meadow Fisher Crisp, Daniel Fishman, Krystofer Fishwick, Lorraine Fitzgerald, Chloe Fitzpatrick-Creamer, Jan Flaherty, Michael Flanagan, Charles Flanders, Cathy Flatters, Julie Fleming, Lucy Fleming, Paul Fleming, William Flesher, Alison Fletcher, Jonathan Fletcher, Lucy Fletcher, Simon Fletcher, Sophie Fletcher, Karen Flewitt, Christopher Flood, Ian Floodgate, Vincent Florence, Sharon Floyd, Kelly Flynn, Rachel Flynn, Sara Flynn, Claire Foden, Adama Fofana, Georgina Fogarty, Claire Foley, Paul Foley, Linda Folkes, Daniela Mock Font, Evodian Fonyonga, Aiwyne Foo, Jane Foo, Andrew Foot, Jayne Foot, Jane Forbes, Jamie Ford, Kathy Ford, Jennifer Foreman, Caroline Fornolles, Adam Forrest, Ellie Forsey, Miranda Forsey, Thomas Forshall, Elliot Forster, Julian Forton, Emily Foster, Joseph Foster, Rachel A Foster, Tracy Foster, Theodora Foukanelli, Angela Foulds, Ian Foulds, Folakemi Fowe, Emily Fowler, Robert Fowler, Stephen Fowler, Caroline Fox, Claire Fox, Daniel Fox, Heather Fox, Jonathan Fox, Lauren Fox, Natalie Fox, Olivia Fox, Simon Fox, Sarah-Jane Foxton, Yasin Fozdar, Rebecca Frake, Alex Francioni, Olesya Francis, Rebecca Francis, Sarah Francis, Theodora Francis-Bacon, Jason Frankcam, Helen Frankland, Gayle Franklin, Jessica Franklin, Darron Franks, Catherine Fraser, Laura Fraser, Sharon Frayling, Martyn Fredlund, Matthew Free, Carol Freeman, Elaine Freeman, Hannah Freeman, Nicola Freeman, Clare Freer, Ian Freestone, Eleanor French, Matthew Frise, Renate Fromson, Claire Froneman, Adam Frosh, John Frost, Victoria Frost, Oliver Froud, Rachel Frowd, Arun Fryatt, Jake Fryer, Janet Fu, Bridget Fuller, Liz Fuller, Neil Fuller, Tracy Fuller, Duncan Fullerton, Jenny Fullthorpe, Carrie Fung, Gayle Fung, Sarah Funnell, John Furness, Charlene Furtado, Andrew Fyfe, Nytianandan G, Elizabeth Gabbitas, Claire Gabriel, Diana Gabriel, Hadiza Gachi, Rose Gad, Joshua Gahir, Sarveen Gajebasia, Katarzyna Gajewska-Knapik, Zacharoula Galani, Christopher Gale, Hugo Gale, Rebecca Gale, Swetha Gali, Karen Galilee, Bernadette Gallagher, Jude Gallagher, Rosie Gallagher, William Gallagher, Joanne Galliford, Catherine Galloway, Chris Galloway, Emma Galloway, Jacqui Galloway, James Galloway, Laura Gamble, Liz Gamble, Brian Gammon, Jaikumar Ganapathi, Ramesh Ganapathy, Kaminiben Gandhi, Sarah Gandhi, Usha Ganesh, 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Kerry Gibbons, Alex Gibson, Bethan Gibson, Kimberley Gibson, Kirsty Gibson, Sian Gibson, Cat Gilbert, Jeanette Gilbert, Joanne Gilbert, Kayleigh Gilbert, Sean Gilchrist, Benjamin Giles, Mandy Gill, Rose Gill, Lynne Gill, Paul Gillen, Annelies Gillesen, Katherine Gillespie, Matt Gillespie, Elizabeth Gillham, Andrew Gillian, Deborah Gilliland, Robert Gillott, Danielle Gilmour, Kate Gilmour, Theodora Giokanini-Royal, Anna Gipson, Joanna Girling, Rhian Gisby, Angelena Gkioni, Aikaterini Gkoritsa, Effrossyni Gkrania-Klotsas, Amy Gladwell, James Glanville, Jessica Glasgow, Susannah Glasgow, Jon Glass, Lynn Glass, Sharon Glaysher, Lisa Gledhill, Ana Glennon, John Glover, Kyle Glover, Jan Glover Bengtsson, Chevanthy Gnanalingam, Julie Goddard, Wendy Goddard, Emily Godden, Jo Godden, Gillian Godding, Emma Godson, Gerry Gogarty, Sukanya Gogoi, Aiky Goh, Rebeca Goiriz, Sriya Gokaraju, Philip Gold, Raphael Goldacre, Arthur Goldsmith, Portia Goldsmith, Darren Gomersall, Lucia Gomez, Raquel Gomez-Marcos, Ali Gondal, Celia Gonzalez, Jack Goodall, Bob Goodenough, Laura Goodfellow, James Goodlife, Camelia Goodwin, Elizabeth Goodwin, Jayne Goodwin, Paula Goodyear, Rajiv Gooentilleke, Sharif Goolam-Hossen, Michelle Goonasekara, Sheila Gooseman, Shameer Gopal, Peter Gordon, Sally Gordon, Hugh Gorick, Caitlin Gorman, Claire Gorman, Stuart Gormely, Diana Gorog, Jan Gorry, Michelle Gorst, Thomas Gorsuch, Jayshreebahen Gosai, Rebecca Gosling, Sally Gosling, Georgina Gosney, Vanessa Goss, Dzintars Gotham, Naomi Gott, Elizabeth Goudie, Amanda Gould, Angela Gould, Susan Gould, Lysander Gourbault, Anna Gouveia, Abha Govind, Sharon Gowans, Girish Gowda, Rohit Gowda, Pauline Gowdy, Hannah Gower, Thomas Gower, Pankaj Goyal, Sunil Goyal, Sushant Goyal, Beverley Graham, Clive Graham, Jane Graham, Jonathan Graham, Justin Graham, Libby Graham, Sharon Graham, Matthew Graham-Brown, Julia Grahamslaw, Gianluca Grana, Tracyanne Grandison, Louis Grandjean, Alison Grant, Ann Grant, David Grant, Matthew Grant, Pauleen Grant, Rhys Gravell, Jenny Graves, Alasdair Gray, Catherine Gray, Georgina Gray, Harriet Gray, Ingrid Gray, Jackie Gray, Karen Gray, Nicola Gray, Sebastian Gray, Alan Grayson, Patricia Grealish, Fiona Greaves, Jack Greaves, Paul Greaves, Charlotte Green, Christopher Green, David Green, Frederick Green, Grace Green, Joel Green, Marie Green, Nicola Green, Stacey Green, Teresa Green, Diarra Greene, Philippa Greenfield, Alan Greenhalgh, Maraneka Greenslade, Daniel Greenwood, Sandra Greer, James Gregory, Jane Gregory, Katie Gregory, Tamsin Gregory, James Gregson, Jill Greig, Julia Greig, Rebecca Grenfell, Teena Grenier, Susan Grevatt, Glaxy Grey, Andrew Gribbin, Amy Gribble, Beverley Grice, Natasha Grieg, Douglas Grieve, Ben Griffin, Denise Griffin, Mel Griffin, Sian Griffith, Alexandra Griffiths, Andrew Griffiths, Daniel Griffiths, David Griffiths, Donna Griffiths, Isabel Griffiths, Mark Griffiths, Nicola Griffiths, Oliver Griffiths, Sarah Griffiths, Sharon Griffiths, Yvonne Griffiths, Sofia Grigoriadou, Steph Grigsby, Paul Grist, Stephen Grist, Evelina Grobovaite, Clarissa Grondin, Rachel Groome, Liliana Grosu, Jenny Grounds, Margaret Grout, Helen Grover, Jayne Groves, Neil Grubb, Julie Grundy, Francesca Guarino, Sharada Gudur, Sharazeq Guettari, Shivang Gulati, Vikas Gulia, Pumali Gunasekera, Malin Gunawardena, Kirun Gunganah, Jessica Gunn, Emma Gunter, Alok Gupta, Atul Gupta, Rajeev Gupta, Richa Gupta, Rishi Gupta, Tarun Gupta, Vineet Gupta, Ankur Gupta-Wright, Victoria Guratsky, Alvyda Gureviciute, Sambasivarao Gurram, Bhawana Gurung, Shraddha Gurung, Hazel Guth, Ruth Habibi, Berkin Hack, Pamela Hackney, Christian Hacon, Aiman Haddad, Denise Hadfield, Michalis Hadjiandreou, Nikolaos Hadjisavvas, Leah Hadzik, Anna Haestier, Nauman Hafiz, Rana Hafiz-Ur-Rehman, Javed Hafsa, Samantha Hagan, Jack W Hague, Rosemary Hague, Kate Haigh, Christina Haines, Scott Hainey, Morton Hair, Brigid Hairsine, Juraj Hajnik, Anne Haldeos, Writaja Halder, Jennie Hale, Carmel Halevy, Paul Halford, William Halford, Alistair Hall, Anthony Hall, Claire Hall, Elizabeth Hall, Emma Hall, Fiona Hall, Helen Hall, Jennifer Hall, Kathryn Hall, Bill Hall, Jan Hallas, Kyle Hallas, Charles Hallett, Becky-Lee Halls, Heather Halls, Maryam Hamdollah-Zadeh, Bilal Hameed, Imran Hamid, Mohamad Hamie, Bethany Hamilton, Fergus Hamilton, Leigh Hamilton, Nicola Hamilton, Ruth Hamlin, Eleanor Hamlyn, Beatrice Hammans, Shirley Hammersley, Kate Hammerton, Bev Hammond, Leah Hammond, Sara Hammond, Fiona Hammonds, Ibrahim Hamoodi, Karen Hampshire, Elizabeth Hampson, Jude Hampson, Lucy Hampson, Ozan Hanci, Ian Hancock, Sadiyah Hand, Jasmine Handford, Soran Handrean, Sarah Haney, Sheharyar Hanif, E Hanison, Alison Hanlon, Jennifer Hannah, Amy Hannington, Merhej Hannun, Aidan Hanrath, Anita Hanson, Jane Hanson, Kathryn Hanson, Steve Hanson, Helen Hanwell, Mazhar Ul Haq, Ala Haqiqi, Monjurul Haque, Lesley Harden, Zoe Harding, Simon Hardman, Joanna Hardy, Kumar Haresh, Rachel Harford, Beverley Hargadon, Carolyn Hargreaves, Emily Hargreaves, James Hargreaves, Alice Harin, Mohammed Haris, Edward Harlock, Sandra Harlow, Paula Harman, Tracy Harman, Mark Harmer, Muhammad A Haroon, Charlie Harper, Fiona Harper, Heather Harper, Melanie Harper, Peter Harper, Rosemary Harper, Sarah Harrhy, Sian Harrington, Yasmin Harrington-Davies, Jade Harris, Jess Harris, John Harris, Laura Harris, Marie-Clare Harris, Naomi Harris, Nichola Harris, Sophie Harris, Alex Harrison, David Harrison, Julie Harrison, Laura Harrison, Melanie Harrison, Rowan Harrison, Susie Harrison, Thomas Harrison, Wendy Harrison, Elizabeth Harrod, Ciaran Hart, Dominic Hart, Lisa Hartley, Rosemary Hartley, Ruth Hartley, Tom Hartley, William Hartrey, Phillipa Hartridge, Stuart Hartshorn, Heli Harvala, Alice Harvey, Angela Harvey, Max Harvey, Catherine Harwood, Helen Harwood, Brigitte Haselden, Kazi Hashem, Mohammed Hashimm, Tadaaki Hashimoto, Imranullah Hashmi, Sarah Haskins, Zena Haslam, Adil Hassan, Ali Hassan, Wagae UI Hassan, Waqar Ul Hassan, Sapna Hassasing, Jane Hassell, Philip Hassell, Alex Hastings, Bethany Hastings, Janice Hastings, Stephanie Hatch, Jonathan Hatton, Sheryl Haviland, May Havinden-Williams, Stefan Havlik, Daniel B Hawcutt, Kadean Hawes, Liz Hawes, Nicola Hawes, Annie Hawkins, Catherine Hawkins, Nancy Hawkins, Tanya Hawkins, Dan Hawley, Ed Hawley-Jones, Edward Haworth, Cathy Hay, Amna Hayat, Jamal Hayat, Mohamed-Riyal Hayathu, Tamsin Haydon, Anne Hayes, Jonas Hayes, Kate Hayes, Melony Hayes, Vanessa Hayes, Fiona Hayes, Patrick Hayle, Chloe Haylett, Antara Hayman, Melanie Hayman, Matthew Haynes, Richard Haynes, Rachel Hayre, Sarah Haysom, James Hayward, Patrick Haywood, Tracy Hazelton, Phoebe Hazenberg, Zhengmai He, Elizabeth Headon, Carrie Heal, Brendan Healy, Amy Hearn, Angela Heath, Rowan Heath, Diane Heaton, Kerry Hebbron, Gemma Hector, Andy Hedges, Katrine Hedges, Cheryl Heeley, Elaine Heeney, Rajdeep Heire, Ulla Hemmila, Cassie Hemmings, Scott 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Hill, Phoebe Hill, Uta Hill, Annette Hilldrith, Elizabeth Hillerby, Catherine Hillman-Cooper, Elisabeth Hilton, Zoe Hilton, Sarah Hinch, Marcus Hinde, Andrew Hindle, Alice Hindmarsh, Paul Hine, Kim Hinshaw, Clare Hird, Alison Hirst, Jemma Hives, Benson Ho, Michaela Hoare, David Hobden, Gill Hobden, Maria Hobrok, Simon Hobson, Renate Hodge, Simon Hodge, Lesley Hodgen, Holly Hodgkins, Louise Hodgkinson, Sally Hodgkinson, David Hodgson, Helen Hodgson, Luke Hodgson, Sheila Hodgson, Gemma Hodkinson, Kenneth Hodson, Matthew Hogben, Lucy Hogg, Lee Hoggett, Abigail Holborow, Catherine Holbrook, Catherine Holden, Melinda Holden, Thomas Holder, Niels Holdhof, Hannah Holdsworth, Lisa Holland, Maureen Holland, Nicky Holland, Marie Hollands, Elizabeth Holliday, Nina Holling, Gillian Hollis, Laszlo Hollos, Linda Holloway, Simon Holloway, Marcus Hollyer, Amy Holman, Ann Holmes, Benjamin Holmes, Megan Holmes, Raphael Holmes, Rebecca Holmes, Kelly Holroyd, Caroline Holt, Lyndsey Holt, Siobhan Holt, Susie Holt, Alexandra Holyome, Marie Home, Toni Home, Renate Homewood, Kate Hong, Laura Hontoria del Hoyo, Clare Hooper, Sarah Hoosdally, Samantha Hope, Susan Hope, Bridget Hopkins, Peter W Horby, Stephanie Horler, Anil Hormis, Daniel Hornan, Nicola Hornby, Zoey Horne, Latoya Horsford, Megan Horsford, Mark Horsford, Valana Horsham, Alexander Horsley, Ashley Horsley, Elizabeth Horsley, Sarah Horton, Nicola Horton-Turner, Jane Hosea, Toby Hoskins, Muhammad S Hossain, Rashed Hossain, Leanne Hostler, Maxine Hough, Sarah Hough, Brittany Houghton, Catherine Houghton, Iain Houghton, Kathryn Houghton, Rebecca Houlihan, Angela Houston, Hamish Houston, Tawedzegwa Hove, Roseanna Hovvels, Lee How, Laura Howaniec, Laura Howard, Linda Howard, Lucy Howard, Sarah Howard, Stuart Howard, Richard Howard-Griffin, Alison Howarth, Diane Howarth, Serena Howe, Mark Howells, Lyn Howie, Kerry Howlett, Sophie Howlett, Joanne Hoyle, Josh Hrycaiczuk, Naing Zaya Htoon, Su Htwe, Ying Hu, Chiang Ooi Huah Huah, Abby Huckle, Shahzya Huda, Alison Hudak, Lisa Hudig, Alex Hudson, Cara Hudson, Heather Hudson, Peter Hudson, Oli Hudson, Alison Hufton, Connor Huggins, Alistair Hughes, Eithne Hughes, Emma Hughes, Gareth Hughes, Heather Hughes, Luke Hughes, Rachel Hughes, Rebecca Hughes, Samantha Hughes, Stephen Hughes, Vikki Hughes, Wesley Hughes, Lukas Huhn, Ching Hui, Ruth Hulbert, Diana Hull, Grace Hull, Robert Hull, Amanda Hulme, Peter Hulme, Wendy Hulse, George Hulston, Ryan Hum, Laura Humber, Megan Hume, Charlotte Humphrey, Ismay Humphreys, Alasdair Humphries, Joanne Humphries, Lena Hunold, Fiona Hunt, Kristen Hunt, Luke Hunt, Sophie Hunt, Al Hunter, Alexandra Hunter, Isobel Hunter, Karl Hunter, Neil Hunter, George Huntington, Elizabeth Hurditch, Cian Hurley, Katrina Hurley, Mohammed A Husain, Syeda Yusra Husaini, Coralie Huson, Afreen Hussain, Ibraar Hussain, Ifza Hussain, Mohammad Hussain, Muhammad Hussain, Reda Hussain, Sajid Hussain, Samia Hussain, Sanniah Hussain, Wasim Hussain, Yasmin Hussain, Mohammed Hussam El-Din, Raheem Hussein, Rebecca Hussey, Camille Hutchinson, Dorothy Hutchinson, Elizabeth Hutchinson, John Hutchinson, Claire Hutsby, Paula Hutton, Daniella Hydes, Jamie Hyde-Wyatt, Niamh Hynes, Megan Hyslop, Mazen Ibraheim, Abdalla Ibrahim, Ahmed Ibrahim, Asil Ibrahim, Mohamed Ibrahim, Monzeer Ibrahim, Wadah Ibrahim, Adetokunbo I Idowu, Muhammad Idrees, Hina Iftikhar, Mawara Iftikhar, Chukwuemeka Igwe, Mohammad Ijaz, Amaju Ikomi, Clare Iles, Stamatina Iliodromiti, Mary Ilsley, Lorna Ilves, La'ali Imam-Gutierrez, Christopher Imray, Alison Imtiaz, Haider Imtiaz, Claire Ingall, Jack Ingham, Julie Ingham, Rory Ingham, Tejas Ingle, Jennifer Inglis, Anne Ingram, Luke Ingram, Peter Inns, Ken Inweregbu, Andreea A Ionescu, Ana Ionita, Ilian P Iordanov, Anil Ipe, Adil Iqbal, Madiha Iqbal, Mohammed Iqbal, Faisal Iqbal Sait, Jane Ireland, Robert Irons, Mohannad Irshad, Muhammad S Irshad, Janice Irvine, Val Irvine, Pamela Irving, Robert Irving, Mina Ishak, Erica Isherwood, Aminul Islam, Abdurrahman Islim, Ali Ismail, Omar Ismail, Caroline Ison, M'hamedi Israa, Sharon Isralls, Ali Issa, Monica Ivan, Catrina Ivel, Chineze Ivenso, Ashleigh Ivy, Sophie Iwanikiw, Karen Ixer, Menaka Iyer, Mia Iyer, Calum Jack, Amanda Jackson, Anthony Jackson, Ben Jackson, Beth Jackson, Douglas Jackson, Ella Jackson, Hayley Jackson, Helen Jackson, Jane Jackson, Julie Jackson, Karin Jackson, Lauren Jackson, Melanie Jackson, Nicola Jackson, Shane Jackson, Sharon Jackson, Nikita Jacob, Patricia Jacob, Reni Jacob, Nicola Jacques, Terri-Lisa Jacques-Brown, Anisa Jafar, Daniel Jafferji, Ali Jaffery, Chandrashekar Jagadish, Vijay Jagannathan, Sam Jaggard, Mandeep Jagpal, Fernandez R Jaime, Neemisha Jain, Seema Jain, Susan Jain, Sanjay Jaiswal, Danyal Jajbhay, Thomas Jaki, Bintou Jallow, Yusuf Jaly, Sabine Jamal, Zeba Jamal, Yasmin Jameel, Albie James, Christie James, Kate James, Lee James, Linda James, Mark James, Nicholas James, Olivia James, Rebecca James, Ruth James, Tracy James, Jack Jameson, Aaron Jamison, Phoebe Jane, Azara Janmohamed, Sabrina Jansz, Deepa Japp, Lorraine Jappy, Victor Jardim, Catherine Jardine, Emma Jarnell, Ellie Jarvie, Ann Jarvis, Claire Jarvis, Lisa Jarvis, Rosina Jarvis, Patrycja Jastrzebska, Hafsa Javed, Mays Jawad, Lona Jawaheer, Kauky Jawaid, Anu Jayachandran, Dinakaran Jayachandran, Angelina Jayakumar, Deepak Jayaram, Ravi Jayaram, Geeshath Jayasekera, Thilina Jayatilleke, Abi Jayebalan, Saman Jeddi, Vandana Jeebun, Mohammad S Jeelani, Zeynab Jeewa, Emma Jefferson, Katie Jeffery, Helen Jeffrey, Jenni Jeffrey, Rachel Jeffrey, Sue Jeffrey, Nathan Jeffreys, Benjamin Jeffs, Debbie Jegede, Taylor Jemima, Ifan Jenkin, Alison Jenkins, Christopher Jenkins, David Jenkins, Elinor Jenkins, Sarah Jenkins, Sian Jenkins, Stephen Jenkins, Jacqui Jennings, Louise Jennings, Rebecca Jennings, Virginia Jennings, Ellen Jerome, Douglas Jerry, Ellen Jessup-Dunton, Jorge Antonio Jesus Silva, Champa Jetha, Kishan Jethwa, Jeby Jeyachandran, Visuvanathan Jeyakumar, Dharshana Jeyapalan, Shaman Jhanji, Khoo Jian, Zhixin Jiao, Laura Jimenez, Ana Jimenez Gil, Jithin Jith, Teishel Joefield, Navraj Johal, Karine Johannessen, Aisyah Johari, Annie John, Anu John, Navin John, Sarah John, Emma Johns, Margaret Johns, Anne-Marie Johnson, Antoinette Johnson, David Johnson, Emma Johnson, Gillian Johnson, Kathryn Johnson, Katie Johnson, Luke Johnson, Mark Johnson, Nelsonseelan Johnson, Oliver Johnson, Rachel Johnson, Tracy Johnson, Zoe Johnson, Claire Johnston, Janet Johnston, Laura Johnston, Susan Johnston, Victoria Johnston, Dawn Johnstone, Ed Johnstone, Janet Johnstone, Manohar Joishy, Adam Jones, Alistair Jones, Annabel Jones, Ben Jones, Bryony Jones, Carys Jones, Ceri Jones, Charlotte Jones, Christine E Jones, Debra Jones, Emily Jones, Gareth Jones, Geraldine Jones, Hazel Jones, Jac Jones, James Jones, Jamie Jones, Jessica Jones, Jonathon Jones, Julie Jones, Karen Jones, Kate E Jones, Kevin Jones, Laura Jones, Laura M Jones, Lorna Jones, Louise Jones, Mathew Jones, Nicola Jones, Paul Jones, Rhianna Jones, Ruth E Jones, Samantha Jones, Sophie Jones, Stefanie Jones, Steve Jones, Taya Jones, Tim Jones, Tracey Jones, Ramya Jonnalagadda, Rebecca Jordache, Annette Jose, Sanal Jose, Anna Joseph, Joseph Joseph, Rosane Joseph, Sibet Joseph, Dhaara Joshi, Mehul Joshi, Pratichi Joshi, Revati Joshi, Benz Josiah, Tiffany Joyce, Adriel Ju Wen Kwek, Edward Jude, Parminder Judge, Jessica Juhl, Sirisha Jujjavarapu, Mark Juniper, Edmund Juszczak, Deepthi Jyothish, Kasamu Kabiru Dawa, Mark Kacar, Katarina Kacinova, Nikhil Kadam, Rebecca Kahari, Gail Kakoullis, Azad Kala Bhushan, Richard JK Kalayi, Roobala Kaliannan Periyasami, Efthymia Kallistrou, Seika Kalsoom, Elisa Kam, John Kamara, Mohamed Kamara, Ajay Kamath, Prakash Kamath, Ravindra Kamath, Siddharth Arun Kamerkar, Nick Kametas, Musaiwale Kamfose, Arul Kandaswamy, Leia Kane, Osei Kankam, Thogulava Kannan, Abhinav Kant, Vikas Kapil, Ritoo Kapoor, Sonal Kapoor, Sourjya Kar, Janaka Kara, Vasita Kara, Marina Karakantza, Rona Kark, Nicholas Karunaratne, Natashja Kasianczuk, Vidya Kasipandian, Rizwan Kassam, Janarth Kathirgamachelvam, Victoria Katsande, Kulbinder Kaul, Daljit Kaur, Dervinder Kaur, Jasmin Kaur, Jaspreet Kaur, Satvinder Kaur, Zunaira Kausar, Mohammad AA Kawser, Andrea Kay, Sarah Kay, Jossy N Kayappurathu, Callum Kaye, Ahemd Kazeem, Naved Kazi, Sharon Kaznica, Samantha Kearley, Rachel Kearns, Nichola Kearsley, Joanne Keating, John Keating, Liza Keating, Elizabeth Keddie-Gray, Katie Keen, Natalie Keenan, Jonathan Kefas, Stephen Kegg, Laura Keith, Uzoamaka Keke, Tosin Kelani, Joanne Kellett, Jeremy Kellington, Alison Kelly, Conor Kelly, David Kelly, Diane Kelly, Dominic Kelly, Emma Kelly, Laura Kelly, Martin Kelly, Michael Kelly, Rosalind Kelly, Sinead Kelly, Stephen Kelly, Thomas Kelly, Mary Kelly-Baxter, Marketa Keltos, Timothy Kemp, Kelly Kemsley, Alexandra Kendall-Smith, Sarah Kennard, Ann Kennedy, Caroline Kennedy, James Kennedy, Sophie Kennedy-Hay, Julia Kenny, Kelly Kent, Melanie Kent, Lynne Keogan, Alexander Keough, Clement Kerlin, A Kerr, Andrew Kerr, Maria Kerr, Caroline Kerrison, Anthony Kerry, Samantha Kershaw, Helen Kerslake, Ian Kerslake, Helen Kerss, Jocelyn Keshet-Price, Margaret Kevern, Georgina Keyte, Abdul Khadar, Ali Khalid, Muhammad U Khalid, Syed Khalid, Amir Khalil, Asma Khalil, Sijjad Khalil, Abubakar Khan, Ali Khan, Al-Imran Khan, Arham Khan, Asad Khan, Aurangzeb Khan, Burhan Khan, Camran Khan, Fatimah Khan, Kausik Khan, Malik Aamaz Khan, Marria Khan, Mehrunnisha Khan, Mohammad Khan, Mohammed Khan, Nayeem Khan, Omar Khan, Rahe Khan, Rahila Khan, Sabiya Khan, Shabana Khan, Shahul Khan, Shoaib Khan, Tasaduksultan Khan, Waseem Khan, Usman F Khatana, Jibran Khatri, Jyoti Khatri, Hafiza Khatun, Taslima Khatun, Mena Kheia, Jacyntha Khera, Htet Ei Khin, Najaf Khoja, Kiran Khokhar, Jayne Khorsandi, Chloe Khurana, Faith Kibutu, Andrew Kidd, Michelle Kidd, Joe Kidney, Shane Kidney, Will Kieffer, James Kilbane, Caroline Kilby, Eileen Killen, Susan Kilroy, Bomee Kim, Jee Whang Kim, Sarah Kimber, Andy King, Barbara King, Jennifer King, Kirsten King, Rachel King, Sarah King, Tony King, Victoria King, Emily King-Oakley, Laura Kingsmore, Andy King-Venables, Fiona Kinney, Sidra Kiran, Jeremy Kirk, Jodie Kirk, Daniel Kirkbride, Amy Kirkby, Ian Kirker, Emily Kirkham, Gemma Kirkman, Ursula Kirwan, Kelly Kislingbury, Toby Kitching, Laura Kitto, Lauren Kittridge, Sarah Klaczek, Frieder Kleemann, Susan Kmachia, Chris Knapp, Lucy Knibbs, Alicia Knight, Fraser Knight, Marian Knight, Sarah Knight, Steven Knight, Tom Knight, Ellen Knights, Jane Knights, Toby Knights, Martin Knolle, Carol Knott, Charlotte Knowles, Karen Knowles, Laurence Knowles, Emily Knox, Lucy Knox, Oliver Koch, Ronan Kodituwakku, Gouri Koduri, Aisha Koirata, Eirene Kolakaluri, Magdalena Kolodziej, Eirini Kolokouri, Keith Kolsteren, Samantha Kon, Niladri Konar, Mari Kononen, Athanasios Konstantinidis, Hui Fen Koo, Imogen Koopmans, Emmanuela Kopyj, Laura Korcierz, James Korolewicz, George Koshy, Chris Kosmidis, Jalpa Kotecha, Easwari Kothandaraman, Leonidas Koukouflis, Koushan Kouranloo, Rukhsana Kousar'c, Margarita Kousteni, Maja Kovac, Alex Kozak Eskenazia, Kestutis Krasauskas, Raghu Krishnamurthy, Vinodh Krishnamurthy, Manju Krishnan, Hari Krishnan, Suzanne Krizak, Sean Krupej, Agnieszka Kubisz-Pudelko, Soren Kudsk-Iversen, Aurimas Kudzinskas, Chirag Kukadiya, Nainesha Kulkarni, Aditi Kumar, Mayur Kumar, Ramesh Kumar, Ravi Kumar, Rita Kumar, Rupa Kumar, Satish Kumar, Vimal Kumar, Arun Kundu, Heinke Kunst, Amit Kurani, Mohammed Kurdy, Rincy Kurian, Vimal Kurmars, Cameron Kuronen-Stewart, Ranganai S Kusangaya, Vlad Kushakovsky, Mandy Kuunal, Apexa Kuverji, Amma Kyei-Mensah, Thyra Kyere-Diabour, Moe Kyi, Nyan M Kyi, Laura Kyle, Karali-Tsilimpari Kyriaki, Julius Labao, Louise Lacey, Nikki Lack, Emma Ladlow, Heather Lafferty, Shondipon Laha, Sushil Lahane, Clement Lai, James Lai, Emma Laing, Robert Laing, Inez Laing-Faiers, Emily Laity, Michelle Lake, Nicki Lakeman, David Lalloo, Fiona Lalloo, Alison Lam, Fiona Lamb, Lucy Lamb, Thomas Lamb, Nick Lambe, Pauline Lambert, Claudia Lameirinhas, Mohammed KG Lami, Abigail Lamikanra, Holly Lamont, Michal Lamparski, Djillali Lamrani, Christine Lanaghan, Rebecca Lanaway, Ivone Lancona-Malcolm, Julia Lancut, Geraldine Landers, Martin J Landray, Matthew Lane, Nicholas Lane, Alidih Lang, Stephen Lang, Daniel Langer, Margaret Langley, Charles Langoya, Emily Langthorne, Taiya Large, Wojciech Lason, Anna Last, Scott Latham, John Latham-Mollart, Afzal Latheef, Darren Latimer, Nang Latt, Carly-Jane Lattimore, Dawn Lau, Eva Lau, Myra Laurenson, Hou Law, Jennifer Law, Jessica Law, Penny Law, Richard Law, Colin Lawler, Mark Lawley, Emma Lawrence, Jo Lawrence, Neil Lawrence, Ryan Lawrie, Jemima Lawson, Joanne Lawson, Louise Lawson, Rebecca Lawton, Michael Lay, Christine Laycock, Reina Layug, Maria Lazo, Vietland Le, Amelia Lea, William Lea, Ian Leadbitter, Thomas Leahy, Richard Lean, Lorna Leandro, Darren Leaning, Sandra Leason, Christina Leaver, Marie Anne Ledingham, Emma Lee, Hannah Lee, Irish Lee, Judith Lee, Sam Lee, Shi Han Lee, Simon Lee, Sindy Lee, Stephanie Lee, Tracey Lee, Xiang Lee, Diana Lees, Jennifer Lees, Helen Legge, Julian Leggett, Katie Leigh-Ellis, Kevan Leighton, Nicky Leitch, Eleni Lekoudis, Petula Lemessy, Nicholas Lemoine, Joana Lemos, Irina Lenchuk, Katy Leng, Katrina Lennon, Liz Lennon, Isabel Lentell, Kelly Leonard, Wen Leong, Nicky Leopold, Oskar Lepiarczyk, Isla Leslie, Eleni Lester, Joe Leung, Ullrich Leuschner, Emma Levell, Chris Levett, Alice Lewin, Michaela Lewin, Alison Lewis, David Lewis, Dee Lewis, Georgina Lewis, Gillian Lewis, Joanne Lewis, Joseph Lewis, Kathryn Lewis, Keir Lewis, Leon Lewis, Lisa Lewis, Marissa Lewis, Rob Lewis, Robert Lewis, Catherine Lewis-Clarke, Lorraine Lewis-Prosser, Katherine Lewiston, Adam Lewszuk, Penny Lewthwaite, Samantha Ley, Anna Li, Jenny Li, Angela Liao, Victoria Licence, David Lieberman, Susan Liebeschuetz, Nicky Lightfoot, Patrick Lillie, Ben Lim, Carys Lim, Ee Thong Lim, Ivy Lim, Terence Lim, Wei Shen Lim, Wilson Lim, James Limb, Usha Limbu, Christian Linares, Dermot Linden, Gabriella Lindergard, Kate Lindley, Charlotte Lindsay, Emily Lindsay, Max Lindsay, Helen Lindsay-Clarke, Mirella Ling, Claire Lingam, Linette Linkson, Mike Linney, Louise Linsell, Conrad Lippold, George Lipscomb, Karen Lipscomb, Laura Lipskis, Ana Lisboa, Evangeline Lister, Charlotte Little, Jeff Little, Sam Little, Xuedi Liu, Alexandra Liversidge, Jill Livingstone, Daniel K Llanera, Rhiannon Llewellyn, Martin Llewelyn, Adam Lloyd, Aimee Lloyd, Arwel Lloyd, Oliver Lloyd, Richard Lloyd, Su Lo, David Loader, Cristina Lobato, Maria Lobo-Clarke, Lydianne Lock, Sara Lock, Stephen Lock, Angela Locke, Jacqueline Locke, Thomas Locke, Teresa Lockett, Sandy Lockyer, Jeorghino Lodge, Terrence Lodge, Martina Lofthouse, Tracey Lofting, Heather Loftus, Meg Logan, Chloe Logue, Sook Yin Loh, Siddharth Lokanathan, Kaatje Lomme, Emily London, Gabriella Long, Natalie Long, Bev Longhurst, Mark Longshaw, Jennifer Lonnen, Caroline Lonsdale, Laura Looby, Ronda Loosley, Paola Lopez, Paula Lopez, Robert Lord, Stuart Lord, Laura Lordache, Kieron Loregnard, Catherine Lorenzen, Claire Lorimer, Francesco Loro, Rachel Lorusso, Eva Loutraris, Robert Loveless, Maxine Lovell, Angeliki Loverdou, Huw Lovett, Daniel Loveys, Andrew Low, Jen Mae Low, Alastair Lowe, Caroline Lowe, Catherine Lowe, Emily Lowe, Faye Lowe, Michael Lowe, Linda Lowrey, Richard Lowsby, Vicki Lowthorpe, Emma Loxley, Gamu Lubimbi, Alexandra Lubina Solomon, Georgia Lucas, Jacob Lucas, Alice Lucey, Olivia Lucey, Suzanne Luck, H Luke, Jane Luke, Hayley Lund, Apurva Lunia, Muriel Lunn, Ji Luo, Julia Lussier, Cindy Nisha Luximon, Elisa Ly, Barrie Lyell, Elisavet Lyka, Sarah Lymn, Audrey Lynas, Ceri Lynch, Daniel Lynch, Daniella Lynch, Stephen Lynch, Helen Lyon, Rea-Grace Maamari, Hannah Mabb, Louies Mabelin, Jessica Macaro, Angela Macauley, Kateryna Macconaill, Chloe Macdonald, Stuart MacDonald, Tania MacDonald, Claire Macfadyen, James G Macfarlane, Jill Macfarlane, Laura Macfarlane, Cara MacGuigan, Lisa MacInnes, Iain MacIntyre, Jill MacIntyre, Kirsten Mack, Callum Mackay, Euan Mackay, Laura Mackay, Alexander Mackenzie, Matt Mackenzie, Robert MacKenzie Ross, Ami Mackey, Patricia Mackey, Fiona Mackie, Robert Mackie, Carolyn Mackinlay, Claire Mackintosh, Katherine Mackintosh, Sheila MacLennan, Mary Joan MacLeod, Michael Macmahon, Andrew MacNair, Catherine Macphee, Iain Macpherson, Catriona Macrae, Allan MacRaild, Eilidh MacVean, Alannah Madden, Mary Madden, Norman Madeja, Karen Madgwick, Pradeep Madhivathanan, Madhavi Madhusudhana, Harriet Madiyiko, Alpha Madu, Lorraine Madziva, Marion Mafham, Nick Magee, Frederick Magezi, Tim Maggs, Negar Maghsoodi, Christopher Magier, Marios Magriplis, Kathryn Maguire, Natasha Mahabir, Subramanian Mahadevan-Bava, Anjanie Maharajh, Ajit Mahaveer, Bal Mahay, Kanta Mahay, Hibo Mahdi, Thushika Mahendiran, Siva Mahendran, Sarah Maher, Anistta Maheswaran, Shameera Maheswaran, Tina Maheswaran, Parisa Mahjoob-Afag, Ahmed Mahmood, Farhana Mahmood, Waheed Mahmood, Zahra Mahmood, Hager Mahmoud, Ewan Mahony, Luke Mair, Toluwani Majekdunmi, Kesson Majid, Rupert Major, Jaydip Majumdar, Mohammad KH Majumder, Stephen Makin, Marius Malanca, Hannah Malcolm, Flora Malein, Neeraj Malhan, Ayesha Malik, Gulshan Malik, Mohammed Maljk, Paul Mallett, Petrina Mallinder, Georgia Mallison, Louise Mallon, Edward Malone, Gracie Maloney, Edgar Malundas, Madhu Mamman, Irene Man, Kathy Man, Rossana Mancinelli, Marco Mancuso-Marcello, Tracy Manders, Lauren Manderson, Justin Mandeville, Roope Manhas, Carmen Maniero, Ravi Manikonda, Bobby Mann, Jonathan Manning, Lynne Mannion, Katherine Mansi, Katarina Manso, Dina Mansour, Isheunesu T Mapfunde, Predeesh Mappa, Hemant Maraj, Garikayi Marange, Lisa March, Clare Marchand, Neil Marcus, Maria Marecka, Gomathi Margabanthu, Jordi Margalef, Lavinia Margarit, Georgios Margaritopoulos, Mike Margarson, Fernandez M Maria del Rocio, Teresa Maria Pfyl, Victor Mariano, Helen Maria-Osborn, Ashleigh Maric, Grace Markham, John Markham, Maria Marks, Pamela Marks, Elisabeth Marouzet, Arran Marriott, Cheryl Marriott, Nemonie Marriott, Brian Marsden, Karen Marsden, Paul Marsden, Sarah Marsden, Tracy Marsden, Robyn Marsh, Adam Marshall, Andrew Marshall, Gail Marshall, Henry Marshall, Jaimie Marshall, James Marshall, Jenna Marshall, Nicola Marshall, Riley Marshall, Jennifer Marshall, Samantha Marston, Emmeline Martin, Hayley Martin, Hope Martin, Jane Martin, Karen Martin, Kate Martin, Laila Martin, Michael Martin, Noelia Martin, Tim Martin, Winston Martin, Sarah Martin, Tim Martindale, Marcus Martineau, Alexander Martinez, Lauren Martinez, Jose Carlos Martinez Garrido, Juan Martin-Lazaro, Olivia Martins, Lucas Martins Ferreira, Vijay Kumar Maruthamuthu, Gemma Maryan, Roman Mary-Genetu, Sam Maryosh, Vidan Masani, Diego Maseda, Sheila Mashate, 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McAleese, Helinor McAleese, Paul McAlinden, Audrey McAlpine, Graeme McAlpine, Jonathan McAndrew, Hamish McAuley, Sarah McAuliffe, Claire McBrearty, Carole McBride, Erin McBride, Michael McBuigan, James McBurney, Laura McCabe, Amanda McCairn, Martina McCalmont, Jake McCammon, Nicole McCammon, Conor McCann, Alexandra McCarrick, Brendan McCarron, Eoghan McCarthy, Michelle McCarthy, Natalie McCarthy, Sinead McCaughey, Gareth McChlery, Tara McClay, Beverley McClelland, Declan McClintock, Patricia McCormack, Jacqueline McCormick, Wendy McCormick, Paul McCourt, Jame McCrae, Sharon McCready, Allison McCreath, Gordan McCreath, Helen McCreedy, Louise McCreery, Iain J McCullagh, Josephine McCullagh, Liz McCullagh, Megan McCullagh, Conor McCullough, Katherine McCullough, Nicola McCullough, Sarah McCullough, Fiona McCurrach, Rory McDermott, Katharine McDevitt, Helen McDill, Basil McDonald, Claire McDonald, Debbie McDonald, Rob McDonald, Sam McDonald, Damhnaic McDonald, Rowan McDougall, Irene McEleavy, Julie McEnerney, Julie McEntee, Evanna McEvoy, Ruth McEwen, Margaret McFadden, Denise McFarland, Margaret McFarland, Rachel McFarland, Erin McGarry, Lorcan McGarvey, Margaret McGarvey, Clodagh McGettigan, Michael McGettrick, Christopher McGhee, Fiona McGill, Sarah McGinnity, Hannah McGivern, Neil McGlinchey, Phil McGlone, Deborah McGlynn, Claire McGoldrick, Clare McGoldrick, Elizabeth McGough, Margaret McGovern, Brendan McGrath, Amanda McGregor, Annemarie McGregor, Cathryn McGuinness, Heather McGuinness, Sean McGuire, Tara McHugh, Caroline McInnes, Neil McInnes, Karen McIntyre, Mhairi McIntyre, Carolyn McKay, Lorna McKay, Conor P McKeag, Madeleine McKee, Joseph McKeever, Shirley McKenna, Donogh McKeogh, Denise Mckeown, Caroline McKerr, Anthony M McKie, Claire Mckie, Laura Mckie, Gerard McKnight, Heather McLachlan, Andrew McLaren, Barbara McLaren, Nicola McLarty, Maria McLaughlin, James McLay, Mary McLeish, Tina McLennan, Lorna McLintock, Stewart McLure, Amanda McMahon, Anne 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Raj, Pradeep Rajagopalan, Nithy Rajaiah, Arvind Rajasekaran, Aylur Rajasri, Thurkka Rajeswaran, Jyothi Rajeswary, Jeyanthy Rajkanna, Gayathri Rajmohan, Ruth Rallan, David Ralphs, Katherine Ralston, Maximilian Ralston, Matsa Ram, Balaji Ramabhadran, Fathima Ramali, Mohamed Ramali, Athimalaipet Ramanan, Shashikira Ramanna, Maheshi Ramasamy, Dhanishta Ramdin, Jozel Ramirez, Mylah Ramirez, Geshwin Ramnarain, Lidia Ramos, Shanthi Ramraj, Alex Ramshaw, Aleem Rana, Ghulam F Rana, Rehman Rana, Abby Rand, James Rand, Helen Randall, Harpal Randheva, Poonam Ranga, Manmeet Rangar, Harini Rangarajan, Sameer Ranjan, Poormina Ranka, Rajesh Rankhelawon, Haley Ranton, Anita Rao, Sandhya Rao, Sanjay Rao, Deepak Rao, Anuja Rasarathnam, Alia Rashid, Khalid Rashid, Simbisai Ratcliff, Sam Ratcliffe, Sophy Ratcliffe, Sanjeev Rath, Mohmad I Rather, Selina Rathore, Aravinden Ratnakumar, Jonathan Ratoff, Deepa Rattehalli, Jason Raw, Hywel Rawlins, Gautam Ray, Michelle Ray, Adam Raymond-White, Dana Raynard, 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Anand Shah, Bhavni Shah, Momin Shah, Neil Shah, Pallav Shah, Priyank Shah, Qasim Shah, Sarfaraz H Shah, Snehal Shah, Suraj Shah, Syed Shah, Wajid Shah, Saarma Shahad, Sousan Shahi, Sipan Shahnazari, Muhammad Shahzeb, Aisha Shaibu, Zara Shaida, Amina Y Shaikh, Maliha Shaikh, Rajit Shail, Mariya Shaji, Muhammad Shakeel, Korah Shalan, Nadia Shamim, Kazi Shams, Alison Shanahan, Thomas Shanahan, Shaminie Shanmugaranjan, Hamed Sharaf, Muhammad Sharafat, Asir Sharif, Ajay Sharma, Akhilesh Sharma, Ash Sharma, Bhawna Sharma, Mona Sharma, Ojasvi Sharma, Poonam Sharma, Rajeev Sharma, Sanjeev Sharma, Sarkhara Sharma, Shriv Sharma, Sonal Sharma, Alexander Sharp, Charles Sharp, Gemma Sharp, Paula Sharratt, Phoebe Sharratt, Katherine Sharrocks, Emma Sharrod, Christopher Shaw, Daisy Shaw, David Shaw, Deborah Shaw, Joanne Shaw, Jonathan Shaw, Lisa Shaw, Tomos G Shaw, Anna Shawcross, Jill Shawe, Lou Shayler, Khuram Shazad, Sophy Shedwell, Jonathan Sheffield, Zak Shehata, Arshiya Sheik, Asif Sheikh, 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Alexandra Williams, Alison Williams, Angharad Williams, Ava Williams, Carl Williams, Caroline V Williams, Claire Williams, Dewi Williams, Gail Williams, Gemma Williams, Gina Williams, Hannah Williams, James Williams, Jayne Williams, Jennie Williams, John Williams, Joseph Williams, Karen Williams, Kathryn Williams, Marie Williams, Matthew Williams, Patricia Williams, Penny Williams, Rachael Williams, Rupert Williams, Samson Williams, Sarah Williams, Sophie Williams, Tamanna Williams, Annie Williamson, Cath Williamson, Catherine Williamson, Dawn Williamson, James D Williamson, Rachel Williamson, Helen Williamson, Bruce Willian, Elizabeth Willis, Emily Willis, Heather Willis, Herika Willis, Joanna Willis, Laura Willmott, Louise Wills, Lucy Willsher, Catherine Willshire, Francesca Willson, Alison Wilson, Andrea Wilson, Antoinette Wilson, Billy Wilson, Catherine Wilson, Eve Wilson, James Wilson, Karen Wilson, Kate Wilson, Lucinda Wilson, Mark Wilson, Matthew Wilson, Toni Wilson, Evie Wiltsher, Marlar Win, Tin Win, Wut Yee Win Win, Lucinda Winckworth, Laura Winder, Piers Winder, Phillip Windrum, Kerry Winham-Whyte, Helen Winmill, Simon Winn, Carmen Winpenny, Helen Winslow, Helen Winter, Jonathan Winter, Pascal Winter, Barbara Winter-Goodwin, Stephen Wisdom, Matthew Wise, Martin Wiselka, Rebecca Wiseman, Sophie Wiseman, Steven Wishart, Holly Wissett, Eric Witele, Nicholas Withers, Janet Wittes, Donna Wixted, Therese Wodehouse, Will Wolf, Nicola Wolff, Kirsten Wolffsohn, Rebecca Wolf-Roberts, Magda Wolna, Elena Wolodimeroff, Adam Wolstencroft, Alan Wong, Charlotte Wong, Chi-Hung Wong, Edwin Wong, Jessica Sue Yi Wong, Kit Y Wong, Lee Wong, Mei Yin Wong, Nick Wong, Sam Wong, Yun Man Wong, Amanda Wood, Caroline Wood, Carrie Anne Wood, Dianne Wood, Fiona Wood, Hannah Wood, Jennifer Wood, Joe Wood, Julia Wood, Kathryn Wood, Lisa Wood, Louise Wood, Michelle Wood, Stephen Wood, Tracy Wood, Ursula Wood, Katharine Woodall, Rebecca Woodfield, Christopher Woodford, Elizabeth Woodford, Jill Woodford, Luke Woodford, Louise Woodhead, Timothy Woodhead, Philip Woodland, Marc Woodman, Debra Woods, Jane Woods, Katherine Woods, Sarah Woods, Zoe Woodward, Rachel Wookey, Megan Woolcock, Gemma Wooldridge, Rebecca Woolf, Chris Woollard, Christopher Woollard, Louisa Woollen, Emma Woolley, Jade Woolley, Daniel Woosey, Dan Wootton, Joanne Wootton, Daniel Worley, Stephy Worton, Jonathan Wraight, Maria Wray, Tim Wreford-Bush, Joanne Wren, Kim Wren, Lynn Wren, Caroline Wrey Brown, Catherine Wright, Demi Wright, Francesca Wright, Imogen Wright, Lee Wright, Lianne Wright, Pete Wright, Rachel Wright, Rebecca Wright, Stephanie Wright, Tim Wright, Caroline Wroe, Hannah Wroe, Henry Wu, Peishan Wu, Pensee Wu, Jonathan Wubetu, Retno Wulandari, Craig Wyatt, Frederick Wyn-Griffiths, Inez Wynter, Bindhu Xavier, Arnold Xhikola, Zhongyang Xia, Huiyuan Xiao, Masseh Yakubi, May Yan, Freda Yang, Yingjia Yang, Michael Yanney, Woei Lin Yap, Nabil Yaqoob, Naairah Yaqub, Salima Yasmin, Bryan Yates, David Yates, Edward Yates, Helen Yates, Julie Yates, Mark Yates, Charlotte Yearwood Martin, Andrew Yeatman, Khin Yein, Fiona Yelnoorkar, Peter Yew, Kawai Yip, Laura Ylquimiche, Laura Ylquimiche Melly, Inez Ynter, H Yong, Jemma Yorke, Jasmine Youens, Abdel Younes Ibrahim, Eoin Young, Gail Young, Louise Young, Richard Young, Asfand Yousafzar, Sajeda Youssouf, Ahmed Yousuf, Chrissie Yu, Bernard Yung, Daniel Yusef, Said Yusef, Intekhab Yusuf, Anna-Sophia Zafar, Silvia Zagalo, Su Zaher, Aqsa Zahoor, Kareem Zaki, Nabhan Zakir, Kasia Zalewska, Ane Zamalloa, Mohsin Zaman, Raisa Zaman, Shakir Zaman, Julie Zamikula, Louise Zammit, Marie Zammit-Mangion, Lynn Zarb, Esther Zebracki, Daniel Zehnder, Lisa Zeidan, Marian Zelman, Xiaobei Zhao, Dongling Zheng, Doreen Zhu, Madiha Zia, Omar Zibdeh, Rabia Zill-E-Huma, Ei Thankt Zin, Veronica Zindonda, Eleanor Zinkin, Vivian Zinyemba, Christos Zipitis, Arkadiusz Zmierczak, Azam Zubir, Roslin Zuha, Naz Zuhra, Rasha Zulaikha, Sabrina Zulfikar, Carol Zullo, Ana Zuriaga-Alvaro, Will Zuurbier, Sheba Zyengi, and University of St Andrews. School of Medicine
Subjects: Male, Convalescent plasma, medicine.medical_treatment, 030204 cardiovascular system & hematology, Antibodies, Viral, Rate ratio, 0302 clinical medicine, RA0421, RA0421 Public health. Hygiene. Preventive Medicine, Medicine, Hospital Mortality, 030212 general & internal medicine, 11 Medical and Health Sciences, Aged, 80 and over, Medicine(all), Mortality rate, Covid19, Articles, 3rd-DAS, General Medicine, Middle Aged, Hospitals, Treatment Outcome, Female, Open label, Coronavirus Infections, Life Sciences & Biomedicine, RM, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), 03 medical and health sciences, Medicine, General & Internal, SDG 3 - Good Health and Well-being, General & Internal Medicine, Internal medicine, Humans, In patient, Pandemics, COVID-19 Serotherapy, Aged, Mechanical ventilation, Science & Technology, SARS-CoV-2, business.industry, Significant difference, Immunization, Passive, COVID-19, Length of Stay, NIS, R1, Respiration, Artificial, United Kingdom, RM Therapeutics. Pharmacology, RECOVERY Collaborative Group, business
Abstract: Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research.
Published: 2021

9. Continuing to Broaden Eligibility Criteria to Make Clinical Trials More Representative and Inclusive: ASCO–Friends of Cancer Research Joint Research Statement

Author: Suzanne George, Caroline Schenkel, S. Percy Ivy, Edward S. Kim, Gwynn Ison, Mark Stewart, Patricia A. Spears, Diana Merino Vega, Richard L. Schilsky, Thomas S. Uldrick, Alexander I. Spira, James L. Wade, Andrea Denicoff, Allison Magnuson, Raymond P. Perez, Suanna S. Bruinooge, R. Donald Harvey, Julia A. Beaver, and William D. Tap
Subjects: 0301 basic medicine, Cancer Research, Biomedical Research, Accrual, Population, MEDLINE, Medical Oncology, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Generalizability theory, Patient participation, education, Quality of Health Care, Clinical Trials as Topic, education.field_of_study, business.industry, Test (assessment), Clinical trial, 030104 developmental biology, Oncology, Research Design, 030220 oncology & carcinogenesis, Cancer research, Working group, business
Abstract: Purpose: Restrictive clinical trial eligibility criteria (EC) limit the number of patients who can enroll and potentially benefit from protocol-driven, investigational treatment plans and reduce the generalizability of trial results to the broader population. Following publication of expert stakeholder recommendations for broadening EC in 2017, the American Society of Clinical Oncology (ASCO) and Friends of Cancer Research (Friends) convened working groups to produce additional recommendations and analyze the potential impact on clinical trials using real-world data. Experimental Design: Multistakeholder working groups were appointed by an ASCO-Friends leadership group to propose recommendations for more inclusive EC related to: washout periods, concomitant medications, prior therapies, laboratory reference ranges and test intervals, and performance status. Results: The four working groups, ASCO Board of Directors, and Friends leadership support the recommendations included in this statement to modernize EC related to washout periods, concomitant medications, prior therapies, laboratory references ranges and test intervals, and performance status to make trial populations more inclusive and representative of cancer patient populations. Conclusions: Implementation of the recommendations is intended to result in greater ease of determining patient eligibility. Increased opportunities for patient participation in research will help address longstanding underrepresentation of certain groups in clinical trials and produce evidence that is more informative for a broader patient population. More patients eligible will also likely speed clinical trial accrual. See related commentary by Giantonio, p. 2369
Published: 2021

10. Impact of Broadening Trial Eligibility Criteria for Patients with Advanced Non–Small Cell Lung Cancer: Real-World Analysis of Select ASCO-Friends Recommendations

Author: George Anthony Komatsoulis, Suanna S. Bruinooge, Whitney Rhodes, Gwynn Ison, Richard L. Schilsky, Edward J. Stepanski, Elizabeth Garrett-Mayer, Robert S. Miller, Wendy S. Rubinstein, Edward S. Kim, Sean Khozin, Caroline Schenkel, R. Donald Harvey, Thomas S. Uldrick, and Li Chen
Subjects: 0301 basic medicine, Cancer Research, medicine.medical_specialty, business.industry, MEDLINE, Cancer, Renal function, medicine.disease, External validity, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Oncology, 030220 oncology & carcinogenesis, Internal medicine, Cohort, Medicine, Non small cell, Patient participation, business, Lung cancer
Abstract: Purpose: Cancer clinical trials often accrue slowly or miss enrollment targets. Strict eligibility criteria are a major reason. Restrictive criteria also limit opportunities for patient participation while compromising external validity of trial results. We examined the impact of broadening select eligibility criteria on characteristics and number of patients eligible for trials, using recommendations of the American Society of Clinical Oncology (ASCO) and Friends of Cancer Research. Experimental Design: A retrospective, observational analysis used electronic health record data from ASCO’s CancerLinQ Discovery database. Study cohort included patients with advanced non–small cell lung cancer treated from 2011 to 2018. Patients were grouped by traditional criteria [no brain metastases, no other malignancies, and creatinine clearance (CrCl) ≥ 60 mL/minute] and broadened criteria (including brain metastases, other malignancies, and CrCl ≥ 30 mL/minute). Results: The analysis cohort included 10,500 patients. Median age was 68 years, and 73% of patients were White. Most patients had stage IV disease (65%). A total of 5,005 patients (48%) would be excluded from trial participation using the traditional criteria. The broadened criteria, however, would allow 98% of patients (10,346) to be potential participants. Examination of patients included by traditional criteria (5,495) versus those added (4,851) by broadened criteria showed that the number of women, patients aged 75+ years, and those with stage IV cancer was significantly greater using broadened criteria. Conclusions: This analysis of real-world data demonstrated that broadening three common eligibility criteria has the potential to double the eligible patient population and include trial participants who are more representative of those encountered in practice. See related commentary by Giantonio, p. 2369
Published: 2021

11. Modernizing Clinical Trial Eligibility Criteria: Recommendations of the ASCO–Friends of Cancer Research Prior Therapies Work Group

Author: Gwynn Ison, Raymond U. Osarogiagbon, Tithi Biswas, Madison M. Wempe, Sol Atienza, Diana Merino Vega, James L. Wade, Peter De Porre, Jamie N. Holloway, Richard L. Schilsky, Suparna Wedam, Edward S. Kim, Lola Fashoyin-Aje, and David S. Hong
Subjects: Cancer Research, medicine.medical_specialty, Mechanism (biology), business.industry, Beneficence, MEDLINE, Clinical trial, 03 medical and health sciences, 0302 clinical medicine, Prior Therapy, Oncology, 030220 oncology & carcinogenesis, medicine, Clinical endpoint, 030212 general & internal medicine, Patient participation, Intensive care medicine, business, Scientific validity
Abstract: Purpose: Restrictive eligibility criteria induce differences between clinical trial and “real-world” treatment populations. Restrictions based on prior therapies are common; minimizing them when appropriate may increase patient participation in clinical trials. Experimental Design: A multi-stakeholder working group developed a conceptual framework to guide evaluation of prevailing practices with respect to using prior treatment as selection criteria for clinical trials. The working group made recommendations to minimize restrictions based on prior therapies within the boundaries of scientific validity, patient centeredness, distributive justice, and beneficence. Recommendations: (i) Patients are eligible for clinical trials regardless of the number or type of prior therapies and without requiring a specific therapy prior to enrollment unless a scientific or clinically based rationale is provided as justification. (ii) Prior therapy (either limits on number and type of prior therapies or requirements for specific therapies before enrollment) could be used to determine eligibility in the following cases: a) the agents being studied target a specific mechanism or pathway that could potentially interact with a prior therapy; b) the study design requires that all patients begin protocol-specified treatment at the same point in the disease trajectory; and c) in randomized clinical studies, if the therapy in the control arm is not appropriate for the patient due to previous therapies received. (iii) Trial designers should consider conducting evaluation separately from the primary endpoint analysis for participants who have received prior therapies. Conclusions: Clinical trial sponsors and regulators should thoughtfully reexamine the use of prior therapy exposure as selection criteria to maximize clinical trial participation. See related commentary by Giantonio, p. 2369
Published: 2021

12. Ultrasound-guided Intralesional Injection of Talimogene laherparepvec (Imlygic) for Advanced Melanoma: Technical Note on a Preliminary Experience

Author: Kaleigh Burke, Lauren M. B. Burke, Frances A. Collichio, David W. Ollila, Hyeon Yu, Morgan E Gwynn, Paula Landman Rn, and Raphael J. Louie
Subjects: medicine.medical_specialty, business.industry, Melanoma, Ultrasound, Technical note, medicine.disease, Ultrasound guided, 030218 nuclear medicine & medical imaging, Surgery, 03 medical and health sciences, 0302 clinical medicine, medicine, Radiology, Nuclear Medicine and imaging, In patient, Cardiology and Cardiovascular Medicine, business, Complication, Talimogene laherparepvec, Advanced melanoma
Abstract: To evaluate the safety and feasibility of ultrasound-guided intralesional injection of Talimogene laherparepvec (Imlygic, T-VEC) in patients with advanced non-palpable melanoma. Fourteen consecutive patients (mean age, 67.9 years ± 13.0; range, 40–88; 12 males) with unresectable, locally advanced melanoma underwent ultrasound-guided intralesional injections of T-VEC (July 2016–March 2020) into subcutaneous lesions. Tumor response to the injection was evaluated at the last follow-up. Technical success and complication rates were recorded. The T-VEC injection was technically successful in all patients with all lesions successfully punctured (100%). The mean number of lesions, injection cycles, and injection volumes were 4.1 ± 2.6 (1–9), 6.5 ± 3.0 (3–12), and 2.6 mL ± 1.4 (1–4 mL), respectively. During the follow-up period (mean, 21.0 months ± 13.4; range 1–43.6 months), complete remission, partial remission, persistent disease, and disease progression were observed in 6 (42.9%), 3 (21.4%), 1 (7.1%), and 4 (28.6%) patients, respectively. Post-treatment symptoms observed in 9 patients (64.3%), including fever (n = 2), fatigue (n = 1), headache (n = 1), pain (n = 1), mouth sores (n = 1), and flu-like symptoms (n = 3). No injection-related complications occurred in all procedures. Intralesional injection of T-VEC for non-palpable metastases under ultrasound guidance is safe and feasible in patients with advanced melanoma.
Published: 2021

13. Connecting Primary Care Providers in Free Clinics with Specialists Via Telehealth: A Pilot Program with Three Miami Clinics

Author: Sarah E. Stumbar, Alan L. Wells, Lisa Gwynn, Lisa Bard Levine, Michael Maurer, and Frederick Anderson
Subjects: 2019-20 coronavirus outbreak, Primary Health Care, business.industry, Health Personnel, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), education, Public Health, Environmental and Occupational Health, Pilot Projects, Primary care, Telehealth, Miami, medicine.disease, Telemedicine, Health care delivery, medicine, Humans, Pilot program, Medical emergency, Quality of care, business, health care economics and organizations, Specialization
Abstract: The Medical Alumni Volunteer Expert Network (MAVEN) Project (MP) in Miami, Florida piloted primary care provider (PCP)-specialist telehealth consults in three clinics for the uninsured. Preliminary findings suggest telehealth consults may improve quality of care, provider knowledge, and confidence, and may represent innovative health care delivery for the uninsured.
Published: 2021

14. A Safe Mobilisation Program to Improve Functional Mobility and Reduce Fall Risks in Cognitively Impaired Older Adults with Higher Level Gait Disorders: A Pilot Study

Author: Nicholas Mills, Josephine Gwynn, Weihong Zhang, Lindy Clemson, Elizabeth Harper, Alexander Harry Beveridge, and Lee-Fay Low
Subjects: medicine.medical_specialty, Spaced retrieval, business.industry, Cognitive Neuroscience, Tinetti test, Psychological intervention, Pilot Projects, Cognition, Gait, Psychiatry and Mental health, Quality of life (healthcare), Physical medicine and rehabilitation, Errorless learning, Quality of Life, Humans, Medicine, Accidental Falls, Geriatrics and Gerontology, business, Postural Balance, Aged, Balance (ability)
Abstract: Background: The association between gait and cognition, and their combined impact on postural stability may underlie the increased fall risk in older adults with dementia. However, there are few interventions to improve functional mobility and reduce fall risks in people with cognitive impairment. Objectives: This study aims to investigate the feasibility and acceptability of a Safe Mobilisation Program for cognitively impaired older adults with higher level gait disorders. It also explores the potential effectiveness of the program on mobility and fall risks. Methods: Fifteen community-dwelling older adults participated in a 3-week pre-post intervention study. They were trained to take steady steps in transfers and mobilization using errorless learning and spaced retrieval teaching techniques. Results: The intervention program was feasible, all the participants completed the program and were able to mobilize safely. The program was acceptable and participants reported an increase in safety awareness, improvement in confidence while transferring and mobilising, and better quality of life. There was a trend of improvement in Falls Efficacy Scale-international (FES-I), 360° turn and Tinetti Performance Oriented Mobility Assessment (POMA), which may indicate improvement in balance and mobility. Conclusion: The Safe Mobilisation Program was feasible and acceptable in older adults with cognitive impairment and gait disorders and warrants further evaluation.
Published: 2021

15. Tracking cancer patients during COVID-19 using structured outcomes and keywords

Author: Catherine Urch, Phawan Hurhangee, Rowan Wathes, Gareth Gwynn, and Katherine van Ree
Subjects: medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), business.industry, COVID-19 rapid report, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Cancer, medicine.disease, Increased risk, Emergency medicine, Health care, medicine, Tracking (education), business
Abstract: For the duration of COVID-19, cancer pathways will be affected by the significant loss of elective capacity and increased risk of COVID-19-related morbidity and mortality for cancer patients. Imperial College Healthcare NHS Trust (ICHT) has developed a simple, effective MDT recording process, using keywords, to support the tracking of patients who require treatment prioritisation, repeated clinical/MDT reviews and/or need adjustments to their treatment. Following implementation in April, the percentage of MDT outcomes with keywords recorded was 79% in June and 77% for the first two weeks of July. Analysis of the 3,680 MDT outcomes with at least one key word recorded showed that 96% had the ‘intention to proceed’ recorded. For 59% patients, the decision was to ‘proceed’, 5% patients are being monitored, 3% patients have been deferred and 29% were ‘closed’. While this process adds time to busy MDTs, we hypothesise that it will support the tracking and safety-netting of thousands of cancer patients whose care has been affected by the pandemic. The process could easily be implemented in other trusts and adapted for other specialties.
Published: 2020

16. U.S. FDA Drug Approvals for Gynecological Malignancies - A Decade in Review

Author: Mirat Shah, Daniel L. Suzman, Mallorie H. Fiero, Danielle Krol, Amna Ibrahim, Laleh Amiri-Kordestani, Soma Ghosh, Christina Brus, Gwynn Ison, Tatiana M. Prowell, Shenghui Tang, Reena Philip, Sakar Wahby, Melanie Royce, Shaily Arora, Tara Berman, Julia A. Beaver, Jennifer J Gao, Preeti Narayan, Richard Pazdur, Suparna Wedam, Erik Bloomquist, and Christy L. Osgood
Subjects: Cancer Research, medicine.medical_specialty, business.industry, Genital Neoplasms, Female, United States Food and Drug Administration, Center of excellence, Antineoplastic Agents, Article, United States, Priority review, Clinical trial, Food and drug administration, Oncology, Drug development, Family medicine, medicine, Drug approval, Humans, Accelerated approval, Female, business, Objective response, Drug Approval
Abstract: Over the last decade, there has been tremendous progress in the treatment of patients with gynecologic cancers with a changing therapy landscape. This summary provides an overview of U.S. Food and Drug Administration (FDA) approvals for gynecologic cancers from 2010 to 2020, totaling 17 new indications. For each of the approved indications, endpoints, trial design, results, and regulatory considerations are outlined. Among these 17 indications, six received accelerated approval (AA) and 11 received regular approval (RA). As of September 2021, of the six AA, three have subsequently demonstrated clinical benefit resulting in conversion to RA and the remaining three have ongoing clinical trials that have not yet reported results. Approval decisions for these 17 indications were supported by primary efficacy endpoints of progression-free survival (n = 10), objective response rate (n = 6), and overall survival (n = 1) and showed a favorable benefit–risk profile. Among the 17 indications, 15 received priority review and three applications participated in one or more novel Oncology Center of Excellence initiatives, including Real Time Oncology Review, Assessment Aid, and Project Orbis. Current FDA thinking on drug development opportunities and regulatory initiatives currently under way will be discussed.
Published: 2022

17. Spatial co‐localisation of extreme weather events: a clear and present danger

Author: Dylan Gwynn-Jones, Rosalind Dodd, Theodoros Economou, Adrian Hines, David A. Robinson, Ian Harris, Dan Hollis, David R. Chadwick, John Scullion, and David L. Jones
Subjects: 0106 biological sciences, Ecological stability, Land use, Event (computing), business.industry, Ecology, Climate, Climate Change, 010604 marine biology & hydrobiology, Environmental resource management, Land management, 010603 evolutionary biology, 01 natural sciences, Ecosystem services, Extreme weather, Meteorology and Climatology, Geography, Extreme Weather, Agricultural productivity, Resilience (network), business, Weather, Ecosystem, Ecology, Evolution, Behavior and Systematics
Abstract: Extreme weather events have become a dominant feature of the narrative surrounding changes in global climate with large impacts on ecosystem stability, functioning and resilience; however, understanding of their risk of co‐occurrence at the regional scale is lacking. Based on the UK Met Office’s long‐term temperature and rainfall records, we present the first evidence demonstrating significant increases in the magnitude, direction of change and spatial co‐localisation of extreme weather events since 1961. Combining this new understanding with land‐use data sets allowed us to assess the likely consequences on future agricultural production and conservation priority areas. All land‐uses are impacted by the increasing risk of at least one extreme event and conservation areas were identified as the hotspots of risk for the co‐occurrence of multiple event types. Our findings provide a basis to regionally guide land‐use optimisation, land management practices and regulatory actions preserving ecosystem services against multiple climate threats.
Published: 2020

18. Phase I dose escalation study of naive T-cell depleted donor lymphocyte infusion following allogeneic stem cell transplantation

Author: Nelson J. Chao, Zhiguo Li, Mitchell E. Horwitz, Stefanie Sarantopoulos, Anthony D. Sung, Benny J. Chen, Cristina Gasparetto, Krista Rowe Nichols, Richard D. Lopez, Barbara Waters-Pick, David A. Rizzieri, Ko K. Maung, Ian Barak, Gwynn D. Long, Keith M. Sullivan, Yubin Kang, and Ashley Morris Engemann
Subjects: Transplantation, medicine.medical_specialty, biology, Naive T cell, business.industry, CD3, medicine.medical_treatment, Lymphocyte, Hematology, Hematopoietic stem cell transplantation, Gastroenterology, Donor lymphocyte infusion, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Internal medicine, medicine, biology.protein, Stem cell, Adverse effect, business, 030215 immunology
Abstract: Prophylactic donor lymphocyte infusions (DLI) are used to augment post-transplant immune recovery to reduce both infectious complications and disease recurrence. Preclinical studies implicate the naive T-cell subset as the primary driver of graft-versus-host disease (GvHD). In this phase I dose escalation study, we assessed the safety of a DLI that was depleted of CD45RA+ naive T cells. Sixteen adult patients received a prophylactic DLI at a median of 113 days (range 76–280 days) following an HLA-identical, non-myeloablative allogeneic hematopoietic stem cell transplantation. Three patients each received the naive T-cell depleted DLI with a CD3+ dose of 1 × 105/kg, 1 × 106/kg, and 5 × 106/kg. The maximum dose of 1 × 107/kg was expanded to 7 patients. No dose-limiting grade III/IV acute GvHD or adverse events attributable to the DLI were observed at any dose level. One patient developed grade 2 acute GvHD of skin and upper intestines, and another developed moderate chronic GvHD of the lungs following the DLI. With a median follow-up of 2.8 years, 2-year progression-free and overall survival is 50.0% and 68.8%, respectively. In conclusion, these data suggest that a DLI that has been depleted of CD45RA+ naive T cells is feasible and carries a low risk of acute or chronic GvHD.
Published: 2020

19. Principles of Medical and Surgical Treatment of Cerebral Palsy

Author: Shenandoah Robinson, Eric M. Chin, Hilary Gwynn, and Alexander H. Hoon
Subjects: medicine.medical_specialty, Movement disorders, business.industry, Cerebral Palsy, Individualized treatment, Treatment options, Limiting, medicine.disease, Article, Cerebral palsy, 03 medical and health sciences, Dysgenesis, 0302 clinical medicine, Physical medicine and rehabilitation, Humans, Medicine, 030212 general & internal medicine, Neurology (clinical), medicine.symptom, Child, business, Surgical treatment, 030217 neurology & neurosurgery, Motor disability
Abstract: Cerebral palsy is the most common cause of childhood motor disability, affecting 2 to 3/1000 children worldwide. Clinical abnormalities in tone, posture, and movement are the result of brain dysgenesis or injury early in life, and impairment varies in type, distribution, and in severity. The underlying brain disorder may also lead to other associated neurologic and systemic impairments. Variability in functional impairments, which can change during development, necessitates an individualized treatment plan. Treatment options are primarily symptomatic and directed toward optimizing independence, function, and/or ease of care-while limiting side effects. New promising disease-preventing and modifying treatments are emerging.
Published: 2020

20. Perspectives on Rabbinic Constructions of Gendered Bodies

Author: Gwynn Kessler
Subjects: Literature, History, business.industry, Judaism, business, Talmud
Published: 2020

21. CLO20-049: Retrospective Study of Safety and Toxicity Profile Comparison for Propylene Glycol-Free Melphalan (Evomela®) and Generic Melphalan

Author: Kelly Corbet, Yubin Kang, Gwynn D. Long, David A. Rizzieri, Ko K. Maung, Nelson J. Chao, Mitchell E. Horwitz, Ashley Morris Engemann, Cristina Gasparetto, Taewoong Choi, Anthony D. Sung, Stefanie Sarantopoulos, Richard D. Lopez, and Keith M. Sullivan
Subjects: Melphalan, Oncology, business.industry, medicine, Retrospective cohort study, Pharmacology, business, Toxicity profile, medicine.drug
Published: 2020

22. 39 A Model of Gait and Falls in Older Adults with Dementia

Author: Weihong Zhang, Josephine Gwynn, Nicholas Mills, Michael Schwenk, Lindy Clemson, and Lee-Fay Low
Subjects: Aging, medicine.medical_specialty, Neurology, business.industry, Cognition, Falls in older adults, General Medicine, Fall risk, medicine.disease, Gait (human), Physical medicine and rehabilitation, Gait training, Medicine, Dementia, Geriatrics and Gerontology, business, Fall prevention
Abstract: Background Older people with cognitive impairment are at increased risk of falls; however, fall prevention strategies have limited success in reducing fall risks in this population (Fernando E, Fraser M, Hendriksen J et al. Physiotherapy Canada. 2017; 69: 161–170). We aim to present a model of factors contributing to gait and falls in older adults with dementia. Methods The model was developed based on an in-depth review of literature on fall risk factors particularly in people with dementia, and the relationship between cognition and gait, and their joint impact on risk of falls. Results Cognitive and motor functions are closely related as they share neuroanatomy (Rosso AL, Studenski SA, Chen WG et al. J Gerontol A Biol Sci Med Sci. 2013; 68: 1379–1386). This close relationship has been confirmed by imaging, observational and interventional studies. Executive function is the cognitive domain most commonly associated with gait dysfunction (Cohen JA, Verghese J, Zwerling JL. Maturitas. 2016; 93: 73-77). The sub-domains of executive function(Sachdev PS, Blacker D, Blazer DG et al. Neurology. 2014; 10: 634-642) - attention, sensory integration and motor planning affect risk of falls through gait dysfunction; whereas other non-gait associated sub-domains of executive function - cognitive flexibility, judgement and inhibitory control affect risk of falls through risk taking behaviour. Conclusion Gait, cognition and falls are closely related. The comoridity and interaction between gait abnormality and cognitive impairment may be the underlying mechanism behind the high prevalence of falls in older adults with dementia. Gait and cognitive assessment with particular focus on executive function, should be integrated in fall risk screening. Assessment results should inform interventions developed by a multidisciplinary team and may include strategies such as customised gait training and behavioural modulation. A comprehensive multidisciplinary approach could be more effective in reducing fall risks in older adults with dementia.
Published: 2019

23. Characterization of changes in medication complexity using a modified scoring tool

Author: Daniel Anderson, Andrea Sikora Newsome, Morgan E Gwynn, and Jennifer L. Waller
Subjects: medicine.medical_specialty, Critical Illness, health care facilities, manpower, and services, Pharmacist, Pharmacy, 030204 cardiovascular system & hematology, Pharmacists, Resource Allocation, 03 medical and health sciences, Patient safety, 0302 clinical medicine, Pharmacotherapy, Chart review, medicine, Humans, Hospital Mortality, 030212 general & internal medicine, Retrospective Studies, Patient Care Team, Pharmacology, business.industry, Critically ill, Health Policy, Length of Stay, Patient Acuity, Patient Discharge, Intensive Care Units, Research Design, Models, Organizational, Emergency medicine, Observational study, Pharmacy Service, Hospital, business
Abstract: Purpose The purpose of this study was to characterize dynamic changes in medication regimen complexity over time in critically ill adults and to validate a modified version of the medication regimen complexity–intensive care unit (MRC-ICU) scoring tool. Summary A single-center, retrospective, observational chart review was conducted with a primary aim of assessing changes in medication regimen complexity over time, as measured by both the 39-item MRC-ICU scoring tool and a modified version (the mMRC-ICU) containing just 17 items. Secondary aims included validation of the mMRC-ICU and exploration of relationships between medication regimen complexity and ICU length of stay (LOS), inpatient mortality, and patient acuity. Adults admitted to a medical ICU from November 2016 through June 2017 were included. The medication regimens of a total of 130 patients were scored in order to test, modify, and validate the MRC-ICU and mMRC-ICU tools. The modified tool was validated by evaluating correlation of mMRC-ICU scores with MRC-ICU scores and with patient outcomes including patient acuity, ICU LOS, and inpatient mortality. mMRC-ICU scores were collected at 24 and 48 hours after admission and at ICU discharge to evaluate changes over time. Significant changes in medication regimen complexity over time were observed, with the highest scores observed at 24 hours after admission. Conclusion Medication regimen complexity may provide valuable insights into pharmacist activity and resource allocation. Further validation of the MRC-ICU and mMRC-ICU scoring tools in other critically ill populations and at external sites is required.
Published: 2019

24. One size does not fit all – a realist review of screening for asymptomatic atrial fibrillation in Indigenous communities in Australia, Canada, New Zealand and United States

Author: Stavros Stavrakis, John Skinner, Katrina Poppe, Boe Rambaldini, Anna Rolleston, Maja-Lisa Løchen, Kylie Gwynne, Lis Neubeck, Josephine Gwynn, S Nahdi, and Ben Freedman
Subjects: medicine.medical_specialty, business.industry, Family medicine, medicine, Atrial fibrillation, medicine.symptom, Cardiology and Cardiovascular Medicine, medicine.disease, business, Asymptomatic, Indigenous
Abstract: Background/Introduction Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and it is increasing in prevalence and incidence globally. True prevalence is underestimated because silent/asymptomatic AF is frequent and under-detected, but can cause stroke. Guidelines recommend opportunistic screening for AF in patients aged ≥65 years old. A growing body of evidence from hospital and community-based studies in Australia, New Zealand, Canada and United States indicates this age limit is lower for Indigenous people. Screening for AF meets the World Health Organisation (WHO) criteria for successful routine screening, yet little is known about successful implementation of AF screening in Indigenous communities in developed countries. Purpose The aim of this study is to use a realist approach to identify what works, how, for whom and under what circumstances for AF screening of Indigenous communities in Australia, Canada, New Zealand and United States. Methods In the realist review, eight databases were searched for studies targeted at AF screening in Indigenous communities. Realist analysis was used to identify context-mechanism-outcome configurations across 11 included records (reporting on 5 studies). Snowball referencing and grey literature were used to iteratively incorporate evidence to enhance the refined programme theory that was the product of the realist analysis. Results The realist review included studies using multiple screening strategies such as using tools to increase screening, using different screening environments and training screeners to provide culturally centred care. The realist analysis identified a number of mechanisms that can improve AF screening in Indigenous communities. The contextual factors enabling AF screening programs in Indigenous communities include wider community engagement, opportunistic non-clinical settings, using portable and easy to use devices, increasing knowledge, motivation and confidence in screening amongst Indigenous healthcare workers as well as improving follow-up protocols for abnormal results tailored to screen setting. Barriers to effective AF screening include time-poor working environments, conflicting cultural issues, navigating communication of abnormal results and logistical issues with device use (Figure 1). Conclusion(s) Since the life-course risk for AF in Indigenous population is different, a modified screening strategy needs to be put in place. This realist review provides lessons learned for successful implementation of AF screening programs for Indigenous communities. In order to tackle the gap in cardiovascular burden in Indigenous people, this study calls for action to develop AF screening guidelines for Indigenous populations and provides a guide for policy makers about timely and effective AF screening programs for Indigenous communities. Funding Acknowledgement Type of funding sources: None.
Published: 2021

25. Female Sex is Associated with Improved Long-Term Survival Following Allogeneic Hematopoietic Stem Cell Transplant

Author: Taewoong Choi, Nelson J. Chao, Gwynn D. Long, Cristina Gasparetto, Haesu Jin, Stefanie Sarantopoulos, Richard D. Lopez, Yi Ren, Felicia Cao, Prioty Islam, Anthony D. Sung, David A. Rizzieri, Mitchell E. Horwitz, Helen Tang, and Lauren Bohannon
Subjects: Male, medicine.medical_specialty, Multivariate analysis, medicine.medical_treatment, Population, Graft vs Host Disease, Hematopoietic stem cell transplantation, Disease, Article, Internal medicine, Immunology and Allergy, Medicine, Humans, Transplantation, Homologous, education, Survival analysis, Retrospective Studies, Transplantation, education.field_of_study, Performance status, business.industry, Hematopoietic Stem Cell Transplantation, Cell Biology, Hematology, Tissue Donors, Child, Preschool, Life expectancy, Molecular Medicine, Female, business
Abstract: BACKGROUND: Life expectancy for long-term survivors of allogeneic hematopoietic stem cell transplant (alloHSCT), defined as those living ≥5 years post-transplant, is significantly lower compared to that of the age-matched general population despite a relatively low primary disease relapse rate >2 years post-transplant. Among several factors, patient sex is increasingly recognized as a prognostic indicator of long-term survival. OBJECTIVE: We examined the influence of patient sex and donor-recipient sex matching on overall survival in a landmark analysis of long-term survivors. STUDY DESIGN: Using our institutional database supplemented with individual patient record review, we retrospectively investigated the relative influence of recipient sex and donor-recipient sex matching on outcomes of long-term survivors receiving alloHSCT between 1994 – 2014. RESULTS: Over this 20-year period, 247 met inclusion criteria for analysis; males and females had similar demographic and treatment characteristics. However, significantly more deaths after the 5-year landmark occurred in male recipients. Interestingly, donor sex did not have a significant impact on overall survival in multivariate analysis, and differences in overall survival of donor-recipient sex pairs was driven by recipient sex. In addition to recipient sex, only cGVHD retained significance as a covariate with impact on overall survival in multivariate analysis. Men experienced slightly higher, but non-significant, rates and increased severity of cGVHD, and a greater percentage of cGVHD-related mortality as compared to females. CONCLUSION: In this long-term survival analysis of alloHSCT adult patients, one of the only to include follow-up to 15 years, our results show that women survive significantly longer than men irrespective of their age at transplant. This outcome is independent of other common pre-transplant prognostic indicators such as donor sex or performance status at transplant. Inferior survival for males is consistent with survival outcomes described in transplant literature. Gathering evidence suggests a biologic basis for long-term sex-determined outcomes, possibly due to differing rates or severity of cGVHD or sustained alloimmune tolerance in females. Larger studies are warranted to validate these retrospective clinical results.
Published: 2021

26. Pisa Syndrome and Aripiprazole

Author: Connor Smith, Jean-Pierre Lindenmayer, and Naomi Gwynn
Subjects: Psychiatry and Mental health, medicine.medical_specialty, Text mining, business.industry, medicine, MEDLINE, Pharmacology (medical), Aripiprazole, Psychiatry, business, medicine.drug
Published: 2019

27. Impact of lower motor neurone facial palsy on oro-motor function and its remediation

Author: Ruben Kannan, Catriona Neville, Charles Nduka, Tamsin Gwynn, and Vanessa Venables
Subjects: Adult, Male, medicine.medical_specialty, Visual analogue scale, medicine.medical_treatment, Facial Paralysis, Facial Muscles, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Prospective Studies, 030223 otorhinolaryngology, Prospective cohort study, Physical Therapy Modalities, Motor Neurons, Palsy, Rehabilitation, business.industry, medicine.disease, Facial paralysis, Masticatory force, Surgery, Facial Expression, Distress, Treatment Outcome, 030220 oncology & carcinogenesis, Cohort, Quality of Life, Physical therapy, Mastication, Female, business, Follow-Up Studies
Abstract: Summary Introduction Lower motor neurone facial paralysis (LMNFP) is often viewed by the general public and wider non-facial palsy fraternity as a cosmetic issue rather than a functional one. In this article, we sought to determine the severity and frequency of oro-motor dysfunction in LMNFP and assess the benefits of physical therapy and rehabilitation in this cohort. Patients and methods A prospective study at our institute was conducted for a one-year period (2015–2016), involving adult patients with LMNFP with significant oro-motor dysfunction. The exclusion criteria were (i) pre-existing oro-motor dysfunction, (ii) within six months of facial palsy onset. The assessment tools used were (i) The Facial Disability Index (FDI), (ii) IPREDD or Inventory of Patient-Reported Eating and Drinking Dysfunction for mastication and (iii) a bespoked Visual Analogue Scale (VAS) based on focus group discussions. Results Of the 183 new clinic referrals, FDI identified that 14% of patients with LMNFP had significant oro-motor dysfunction. IPREDD analysis showed that 74% of this cohort had masticatory problems, while the VAS indicated significant oro-motor dysfunction as well in those with LMNFP. Following speech and facial therapy, IPREDD-focused symptoms were reduced from 74% to 43% (shown to be significant), while VAS similarly showed a significant reduction in symptoms (two-tailed, paired Student's t-test p Discussion Oro-motor function is a significant sequel of facial paralysis. Facial rehabilitation, both physical and psychological, can help reduce patients’ distress and improve oro-motor function, without the need for surgical intervention in the first instance.
Published: 2019

28. Feasibility and acceptability of opportunistic screening to detect atrial fibrillation in Aboriginal adults

Author: Monica Lawrence, Rona Macniven, Ben Freedman, Josephine Gwynn, Kylie Gwynne, Kerry Taylor, Hiroko Fujimoto, Heather Finlayson, Sandy Hamilton, Boe Rambaldini, Norman Dulvari, Graham Bolton, Daryl C. Wright, and Sandra C. Thompson
Subjects: Adult, Male, Rural Population, medicine.medical_specialty, Native Hawaiian or Other Pacific Islander, rural and remote health, Urban Population, Referral, 030309 nutrition & dietetics, indigenous health, Enabling Factors, Qualitative property, Rural Health, Interviews as Topic, Electrocardiography, 03 medical and health sciences, 0302 clinical medicine, Atrial Fibrillation, Humans, Mass Screening, Medicine, 030212 general & internal medicine, Opportunistic screening, Qualitative Research, 0303 health sciences, business.industry, screening, lcsh:Public aspects of medicine, Public health, Australia, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Atrial fibrillation, Patient Acceptance of Health Care, medicine.disease, Mobile Applications, primary health care, Family medicine, Community health, Feasibility Studies, Community setting, Female, business, Cell Phone
Abstract: Objective: Examine the feasibility and acceptability of an electrocardiogram (ECG) attached to a mobile phone (iECG) screening device for atrial fibrillation (AF) in Aboriginal Controlled Community Health Services (ACCHS) and other community settings. Methods: Semi‐structured interviews were conducted with ACCHS staff in urban, rural and remote communities in three Australian states/territories. Quantitative and qualitative questions identified the enabling factors and barriers for staff and Aboriginal patients' receptiveness to the device. Mean quantitative scores and their standard deviation were calculated in Microsoft Excel and qualitative questions were thematically analysed. Results: Eighteen interviews were conducted with 23 staff across 11 ACCHS. Quantitative data found staff were confident in providing iECG screening and managing the referral pathway, and thought the process was beneficial for patients. Qualitative data highlighted the usefulness of the device to undertake opportunistic screening and acceptability in routine practice, and provided opportunities to engage patients in education around AF. Conclusion: The iECG device was well accepted within ACCHSs and was feasible to use to screen for AF among Aboriginal patients. Implications for public health: The device can be used in clinical and community settings to screen Aboriginal people for atrial fibrillation to help reduce rates of stroke and other cardiovascular diseases.
Published: 2019

29. Leisure Experiences and Social Support Systems of Latino Students With DACA Status

Author: Willaim Haller, Gwynn M. Powell, C. Austin Langley, Toni Liechty, and Denise M. Anderson
Subjects: Gerontology, 050402 sociology, Higher education, Population, lcsh:LB5-3640, Social support, Mentorship, 0504 sociology, 0502 economics and business, Developmental and Educational Psychology, Deferred Action for Childhood Arrivals, latino, Life-span and Life-course Studies, education, Recreation, education.field_of_study, daca, business.industry, 05 social sciences, lcsh:Theory and practice of education, Snowball sampling, Access to Higher Education, Psychology, business, leisure experiences, 050212 sport, leisure & tourism
Abstract: The purpose of this study was to gain a better understanding of the leisure experiences of undocumented Latino young adults with Deferred Action for Childhood Arrivals (DACA) status in order to note any potential links between leisure experience and success in reaching higher education. This population faces a unique set of challenges in their transition to adulthood and their pursuit of and access to higher education. Research suggests that 3 common factors among undocumented young adults who have been successful in reaching higher education are extra-familial mentors, positive social supports, and supplementary educational programming. This study used these 3 factors and the principles of contact theory to examine leisure experiences of undocumented young adults with DACA status. Qualitative semi-structured interviews were conducted with 7 young adults with DACA status who were enrolled in higher education. The data were transcribed verbatim and analyzed thematically. Due to the difficulty accessing this population, snowball sampling was used beginning with a volunteer database from a local Hispanic Alliance. The results support previous literature that has identified constraints this population faces when striving for higher education, as well as the capacity of populations that experience disadvantages for leisure constraint negotiation. The findings show leisure and recreational pursuits support the development of the above mentioned 3-factor support system, helpful in reaching higher education, from previous literature and document a severe drop off of both leisure and recreation participation after high school graduation. Limitations of the study and implications for practice and future research are discussed.
Published: 2019

30. Making space for Aboriginal and Torres Strait Islander community health workers in health promotion

Author: Kathleen P. Conte, Karen Gillham, Nicole Turner, Claudia E. Koller, and Josephine Gwynn
Subjects: Adult, Male, Native Hawaiian or Other Pacific Islander, Health (social science), community health promotion, media_common.quotation_subject, Health Promotion, Aboriginal health, Space (commercial competition), Indigenous, Health care, Situated, Health Services, Indigenous, Humans, participation, Sociology, Child, indigenous, Empowerment, media_common, Community Health Workers, Operationalization, business.industry, Australia, Public Health, Environmental and Occupational Health, Middle Aged, Public relations, Health equity, Health promotion, empowerment, Female, Rural Health Services, Diet, Healthy, business, Perspectives
Abstract: Despite a clear need, ‘closing the gap’ in health disparities for Aboriginal and Torres Strait Islander communities (hereafter, respectfully referred to as Aboriginal) continues to be challenging for western health care systems. Globally, community health workers (CHWs) have proven effective in empowering communities and improving culturally appropriate health services. The global literature on CHWs reflects a lack of differentiation between the types of roles these workers carry out. This in turn impedes evidence syntheses informing how different roles contribute to improving health outcomes. Indigenous CHW roles in Australia are largely operationalized by Aboriginal Health Workers (AHWs)—a role situated primarily within the clinical health system. In this commentary, we consider whether the focus on creating professional AHW roles, although important, has taken attention away from the benefits of other types of CHW roles particularly in community-based health promotion. We draw on the global literature to illustrate the need for an Aboriginal CHW role in health promotion; one that is distinct from, but complementary to, that of AHWs in clinical settings. We provide examples of barriers encountered in developing such a role based on our experiences of employing Aboriginal health promoters to deliver evidence-based programmes in rural and remote communities. We aim to draw attention to the systemic and institutional barriers that persist in denying innovative employment and engagement opportunities for Aboriginal people in health.
Published: 2019

31. Development and validation of a medication regimen complexity scoring tool for critically ill patients

Author: Andrea Sikora Newsome, Margaret O. Poisson, Morgan E Gwynn, and Jennifer L. Waller
Subjects: Adult, Male, medicine.medical_specialty, Medication Therapy Management, Critical Illness, Pharmacy, Pharmacists, Severity of Illness Index, 030226 pharmacology & pharmacy, 03 medical and health sciences, Patient safety, Professional Role, 0302 clinical medicine, Pharmacotherapy, Humans, Medicine, Hospital Mortality, 030212 general & internal medicine, Aged, Retrospective Studies, Pharmacology, business.industry, Health Policy, Process Assessment, Health Care, Discriminant validity, Middle Aged, Patient Acuity, Intensive Care Units, Medication regimen, Convergent validity, Emergency medicine, Polypharmacy, Female, Observational study, Pharmacy Service, Hospital, business
Abstract: PurposeThe purpose of this study was to develop and validate a novel medication regimen complexity–intensive care unit (MRC-ICU) scoring tool in critically ill patients and to correlate MRC with illness severity and patient outcomes.MethodsThis study was a single-center, retrospective observational chart review of adults admitted to the medical ICU (MICU) between November 2016 and June 2017. The primary aim was the development and internal validation of the MRC-ICU scoring tool. Secondary aims included external validation of the MRC-ICU and exploration of relationships between medication regimen complexity and patient outcomes. Exclusion criteria included a length of stay of less than 24 hours in the MICU, active transfer, or hospice orders at 24 hours. A total of 130 patient medication regimens were used to test, modify, and validate the MRC-ICU tool.ResultsThe 39-line item medication regimen complexity scoring tool was validated both internally and externally. Convergent validity was confirmed with total medications (p < 0.0001). Score discriminant validity was confirmed by lack of association with age (p = 0.1039) or sex (p = 0.7829). The MRC-ICU score was significantly associated with ICU length of stay (p = 0.0166), ICU mortality (p = 0.0193), and patient acuity (p < 0.0001).ConclusionThe MRC-ICU scoring tool was validated and found to correlate with length of stay, inpatient mortality, and patient acuity.
Published: 2019

32. Establishing Expert, Multi-Disciplinary, Peer-Reviewed Consensus to Lead a Paradigm Shift in Optimal Blood Glucose Management

Author: Tim Warren, Adam Lester-George, Kaushal Kansagra, Douglas A. Robertson, Naresh Kanumilli, Simon Gwynn, Charlotte McMurray, Richard Chudleigh, and Carol Jairam
Subjects: Consensus, Monitoring, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, 030209 endocrinology & metabolism, 030204 cardiovascular system & hematology, computer.software_genre, 03 medical and health sciences, 0302 clinical medicine, Glycemic control, Nursing, Internal Medicine, medicine, Blood glucose, BGM, Empowerment, health care economics and organizations, media_common, Original Research, Blood glucose monitoring, Multi disciplinary, medicine.diagnostic_test, business.industry, Type 2 diabetes, Glucose management, Type 1 diabetes, Paradigm shift, business, computer, Patient education, Data integration
Abstract: Introduction The National Health Service (NHS) in the UK appears unclear on how blood glucose monitoring (BGM) should be used to support diabetes patient care and empowerment, and local interpretation of NICE guidance on the availability of devices varies widely. An expert group of clinicians and commissioners considered BGM in terms of access, guidance, resources, data integration, patient education, and patient choice. Methods The group generated a series of questions on BGM into a 38-statement questionnaire using Delphi methodology. This was circulated to clinicians involved in diabetes management across the UK, receiving 222 responses. Results From the questionnaire, 35 of the 38 statement responses showed > 66% consensus, with 26 of these achieving > 90% agreement. Conclusion The expert group reviewed the responses and made recommendations based on the clear professional consensus demonstrated. These included the need to use new technology and data integration and that wider factors, including patient choice rather than cost alone, should inform formulary inclusion of BGM equipment. Funding LifeScan U.K. Ltd.
Published: 2019

33. Collection Creation as Collection Management: Libraries as Publishers and Implications for Collection Development

Author: Tiffany N. Henry, Anna R. Craft, and David Gwynn
Subjects: business.industry, Process (engineering), Strategy and Management, 05 social sciences, 050301 education, Library science, Content creation, Library and Information Sciences, Open educational resources, Collection development, Metadata, Publishing, Political science, 0509 other social sciences, Digital scholarship, 050904 information & library sciences, business, 0503 education, Digitization
Abstract: Digital collections, institutional repositories, open educational resources, open access publishing, and new forms of digital scholarship are all ways in which academic libraries are growing their collections from the inside out as well as making this content widely available to other libraries and users. This article will explore national and global trends in library-enabled publishing and content creation, focusing on the kinds of collections being published by libraries, the ways that metadata can bring these collections together for improved access, and the role of consortia in the process.
Published: 2019

34. Presurgical Assessment Using Telemedicine Technology: Impact on Efficiency, Effectiveness, and Patient Experience of Care

Author: Janeen Duckworth, Kristin L. Rising, Frank D. Sites, Venus Gwynn, Margaret Mullen-Fortino, and Judd E. Hollander
Subjects: Adult, Telemedicine, animal structures, 020205 medical informatics, animal diseases, MEDLINE, Health Informatics, 02 engineering and technology, Efficiency, Organizational, Technology impact, Patient safety, fluids and secretions, Patient satisfaction, Health Information Management, Patient experience, 0202 electrical engineering, electronic engineering, information engineering, Humans, Medicine, Retrospective Studies, Diagnostic Tests, Routine, business.industry, Retrospective cohort study, General Medicine, Middle Aged, Surgical procedures, medicine.disease, body regions, Patient Satisfaction, Preoperative Period, cardiovascular system, Medical emergency, business
Abstract: Preadmission testing (PAT) before surgical procedures ensures patient safety and decreases last minute case cancellations.PAT before surgery improves efficiency for the health system; however, the process is often inconvenient for the patient. We sought to determine the impact of telemedicine on the presurgical assessment.We performed a retrospective review comparing patients who participated in telemedicine-based PAT to patients who had a routine, on-site PAT. Our outcomes aligned with National Quality Forum recommended domains for telehealth measures: access (time spent in evaluation), experience (patient satisfaction), and effectiveness (case cancellation rate).There were 7,803 people evaluated; 361 with telemedicine and 7,442 without telemedicine. Compared with those not using telemedicine, the telemedicine group spent less time in the PAT by 24 min (95% confidence interval, 21.4-26.5), and had no case cancellations (0% vs. 1.1%; 95% confidence interval for the difference, 0.028-1.25%). Patient experience showed high rates of satisfaction with telemedicine.We found that using telemedicine for PAT had benefits in terms of access, patient experience, and effectiveness, the three domains recommended for use in telehealth quality measures by the National Quality Forum. The improvements in evaluation times are beneficial for both patients and providers.PAT utilizing telemedicine reduced overall patient time in the PAT and improved patient satisfaction without increasing the operative case cancellation rate.
Published: 2019

35. Post-Tenure Pathways: Individualized Careers in Higher Education

Author: Daniel L. Dustin, Dorothy L. Schmalz, Mary G. Parr, Kelly S. Bricker, and Gwynn M. Powell
Subjects: Medical education, ComputingMilieux_THECOMPUTINGPROFESSION, Higher education, business.industry, 05 social sciences, 050301 education, General Medicine, GeneralLiterature_MISCELLANEOUS, Mentorship, 0502 economics and business, ComputingMilieux_COMPUTERSANDEDUCATION, Job satisfaction, ComputingMethodologies_GENERAL, business, Psychology, 0503 education, Phd students, Recreation, 050212 sport, leisure & tourism, Career counseling, Tourism, Career development
Abstract: Promotion with tenure is often the ultimate goal for PhD students who choose to pursue a career in higher education. Extensive mentorship is provided for tenure-track faculty to smooth the ...
Published: 2019

36. Surviving and Thriving in Graduate School

Author: Gwynn M. Powell, Jill Sturts, Mariela Fernandez, Lincoln R. Larson, Joey Gray, and Lauren N. Duffy
Subjects: Medical education, ComputingMilieux_THECOMPUTINGPROFESSION, Higher education, business.industry, Professional development, Socialization, Self-concept, General Medicine, Thriving, Sociology, business, Recreation, Tourism, Career development
Abstract: Graduate school is critical period of professional development in the lives of aspiring scholars, presenting a number of challenges and opportunities. Synthesizing insights from an online survey of...
Published: 2019

37. Getting Started on the Tenure Track: Challenges and Strategies for Success

Author: Joey Gray, Jill Sturts, Mariela Fernandez, Gwynn M. Powell, Lincoln R. Larson, and Lauren N. Duffy
Subjects: Higher education, business.industry, 05 social sciences, Professional development, Academic freedom, 050301 education, General Medicine, Public relations, Track (rail transport), Job security, Scholarship, Political science, 0502 economics and business, Faculty development, business, 0503 education, 050212 sport, leisure & tourism, Career development
Abstract: Tenure-track positions at institutions of higher education are often highly coveted because they offer job stability, academic freedom, and higher pay. Despite this allure, the academic car...
Published: 2019

38. The Academic Job Search: Steps for Success

Author: Gwynn M. Powell, Mariela Fernandez, Kelsie Roberts, Lauren N. Duffy, Joey Gray, Lincoln R. Larson, and Jill Sturts
Subjects: Higher education, business.industry, 05 social sciences, Professional development, 050301 education, General Medicine, Public relations, Quality of working life, Job security, 0502 economics and business, Specialization (functional), Job satisfaction, business, Psychology, 0503 education, Recreation, 050212 sport, leisure & tourism, Career development
Abstract: The complex and uncertain academic job search is often a terrifying prospect for aspiring recreation and leisure scholars. New doctoral candidates are eager for meaningful lived experiences and use...
Published: 2019

39. Rationale and design for eHealth Familias Unidas Primary Care: A drug use, sexual risk behavior, and STI preventive intervention for hispanic youth in pediatric primary care clinics

Author: Lisa Gwynn, Hilda Pantin, Guillermo Prado, Lourdes Forster, Nicole S. Torres, Meera Nagarsheth, Lourdes M. Rojas, Monica Bahamon, Yannine Estrada, C. Hendricks Brown, and Audrey Y. Ofir
Subjects: Male, medicine.medical_specialty, Adolescent, Substance-Related Disorders, Cost effectiveness, Cost-Benefit Analysis, Sexual Behavior, education, Sexually Transmitted Diseases, Ethnic group, Psychological intervention, Pediatrics, Article, 03 medical and health sciences, Risk-Taking, 0302 clinical medicine, Intervention (counseling), medicine, eHealth, Humans, Pharmacology (medical), 030212 general & internal medicine, Child, Family Health, 030505 public health, Primary Health Care, Unsafe Sex, Social work, business.industry, Hispanic or Latino, General Medicine, Mental health, Telemedicine, Health equity, Family medicine, Female, 0305 other medical science, business
Abstract: Family-based behavioral interventions are efficacious and effective in preventing drug use and sexual risk behaviors; unfortunately, they have not been evaluated and disseminated in pediatric primary care practice, where they can have a significant impact. There is an increased focus on integrating parenting interventions into primary care to reduce health disparities among ethnic minorities such as Hispanics. Although Hispanic youth demonstrate higher levels of drug use and sexual risk behaviors than their non-Hispanic counterparts, few parenting interventions are available for Hispanic youth, and none have been delivered specifically to Hispanic adolescents in primary care. Therefore, this manuscript describes the rationale and design of an Internet-based, family-centered, Hispanic-specific, evidence-based prevention intervention, eHealth Familias Unidas Primary Care. Hispanic adolescents (n = 456) and their care givers will be recruited from pediatric primary care clinics in South Florida and randomized to: eHealth Familias Unidas Primary Care or prevention as usual. The intervention will be delivered by trained interns, clinic volunteers, social workers, mental health counselors, students, and nurses. Outcomes will be measured at baseline and 6, 12, 24, and 36 months post-baseline. This study will determine whether the intervention, compared to prevention as usual, is effective in reducing drug use, unprotected sex, and STI incidence in Hispanic youth through the improvement of family functioning. Additionally, we will determine the cost effectiveness of delivering eHealth Familias Unidas within primary care settings. The effectiveness of eHealth Familias Unidas Primary Care will further inform the need to integrate effective behavioral health interventions into primary care settings.
Published: 2019

40. Interventions to Improve Gait in Older Adults with Cognitive Impairment: A Systematic Review

Author: Lee-Fay Low, Weihong Zhang, Lindy Clemson, and Josephine Gwynn
Subjects: Cognitive Intervention, medicine.medical_specialty, business.industry, education, Psychological intervention, Flexibility (personality), Cognition, Context (language use), medicine.disease, Cognitive training, 03 medical and health sciences, 0302 clinical medicine, Gait (human), Physical medicine and rehabilitation, 030502 gerontology, Medicine, Dementia, Geriatrics and Gerontology, 0305 other medical science, business, 030217 neurology & neurosurgery
Abstract: Objectives To review intervention programs that measure gait to investigate what features of the intervention may contribute to improving gait in older adults with cognitive impairment or dementia. Design Systematic review using Medline, Cinahl, Scopus, PsychInfo, Amed, Embase, Web of Science, and PubMed for original research published in English between January 1, 2000, and July 23, 2018, to identify interventional controlled trials. Narrative synthesis was undertaken. Results Of 6,379 citations, 36 articles met inclusion criteria. Interventions were categorized as medication or medical devices (8 studies), exercise (19 studies), and exercise plus cognitive training (9 studies). Antidementia medication may improve gait variability in people with Alzheimer's disease. Exercise programs focusing on strength and balance training, especially when combined with functional mobility training, improve gait in people with mild cognitive impairment or dementia. Exercise plus cognitive training programs combining strength and balance training, functional mobility training, and training on attention and executive function also improve gait. Conlusion Physical and cognitive factors affect gait performance, and both should be addressed in intervention programs. Physical exercises including functional mobility training, especially walking, have better results than physical programs with only static, resistance, and flexibility training. Cognitive intervention should be concomitant with physical exercises rather than separate, with a focus on attention and executive function. Combining physical training with cognitive training in a functional context may assist older adults with cognitive impairment generalize from training to everyday activity. J Am Geriatr Soc 67:381–391, 2019.
Published: 2018

41. What does ‘routine post-op neuro obs’ really mean? Establishing a guideline

Author: Amelia Swift, Katie Holland, Claire Lynch, and Chloe Gwynn
Subjects: medicine.medical_specialty, Phrase, 030504 nursing, business.industry, General surgery, food and beverages, Guideline, Neurological observations, 03 medical and health sciences, 0302 clinical medicine, medicine, 030212 general & internal medicine, Neurology (clinical), Neurosurgery, Post operative, 0305 other medical science, business, General Nursing
Abstract: Background: Neurosurgery carries a risk of post-operative deterioration that can be detected using neurological observations (NO). NO are frequently requested by surgeons using the phrase ‘routine post-op neuro obs’. There is no agreed definition of what this means. Aims: To identify the range of possible interpretations of the phrase ‘routine post-op neuro obs’ by nurses and surgeons. Method: National policy analysis, literature review, notes audit and survey methods were used to identify national and local practice. Data were analysed descriptively using Excel. Findings: Two out of 15 policies contained observation guidance. Fifteen surgeons used five terms to describe post-operative observations. ‘Routine’ was used to describe observation frequency anywhere between every 15 minutes and every 4 hours. Nurses varied in their interpretation, and frequency was based on clinical judgement. Conclusion: Post-operative instructions and nursing practice vary. There is a need and desire for clear evidence-based guidelines to ensure consistency and patient safety.
Published: 2018

42. Decreased Mortality in 1-Year Survivors of Umbilical Cord Blood Transplant vs. Matched Related or Matched Unrelated Donor Transplant in Patients with Hematologic Malignancies

Author: Taewoong Choi, Anne Britt, Yi Ren, Matthew S. Kelly, Lauren Bohannon, David A. Rizzieri, Alexandra Artica, Cristina Gasparetto, Gwynn D. Long, Sin-Ho Jung, Sharareh Siamakpour-Reihani, Stefanie Sarantopoulos, Vinay K. Giri, Nelson J. Chao, Helen Tang, Richard D. Lopez, Prioty Islam, Mitchell E. Horwitz, Meagan Lew, Anthony D. Sung, and Kristin Page
Subjects: Oncology, Adult, medicine.medical_specialty, medicine.medical_treatment, Disease, Hematopoietic stem cell transplantation, Umbilical cord, Article, hemic and lymphatic diseases, Internal medicine, medicine, Immunology and Allergy, Humans, Transplantation, Homologous, Survivors, Child, Retrospective Studies, Transplantation, Acute leukemia, business.industry, Hazard ratio, Retrospective cohort study, Cell Biology, Hematology, Fetal Blood, Log-rank test, surgical procedures, operative, medicine.anatomical_structure, Hematologic Neoplasms, Molecular Medicine, Cord Blood Stem Cell Transplantation, business, Unrelated Donors
Abstract: Allogeneic hematopoietic stem cell transplantation (HCT) has the potential to cure hematologic malignancies but is associated with significant morbidity and mortality. Although deaths during the first year after transplantation are often attributable to treatment toxicities and complications, death after the first year may be due to sequelae of accelerated aging caused by cellular senescence. Cytotoxic therapies and radiation used in cancer treatments and conditioning regimens for HCT can induce aging at the molecular level; HCT patients experience time-dependent effects, such as frailty and aging-associated diseases, more rapidly than people who have not been exposed to these treatments. Consistent with this, recipients of younger cells tend to have decreased markers of aging and improved survival, decreased graft-versus-host disease, and lower relapse rates. Given that umbilical cord blood (UCB) is the youngest donor source available, we studied the outcomes after the first year of UCB transplantation versus matched related donor (MRD) and matched unrelated donor (MUD) transplantation in patients with hematologic malignancies over a 20-year period. In this single-center, retrospective study, we examined the outcomes of all adult patients who underwent their first allogeneic HCT through the Duke Adult Bone Marrow Transplant program from January 1, 1996, to December 31, 2015, to allow for at least 3 years of follow-up. Patients were excluded if they died or were lost to follow-up before day 365 after HCT, received an allogeneic HCT for a disease other than a hematologic malignancy, or received cells from a haploidentical or mismatched adult donor. UCB recipients experienced a better unadjusted overall survival than MRD/MUD recipients (log rank P = .03, median overall survival: UCB not reached, MRD/MUD 7.4 years). After adjusting for selected covariates, UCB recipients who survived at least 1 year after HCT had a hazard of death that was 31% lower than that of MRD/MUD recipients (hazard ratio, 0.69; 95% confidence interval, 0.47-0.99; P = .049). This trend held true in a subset analysis of subjects with acute leukemia. UCB recipients also experienced lower rates of moderate or severe chronic graft-versus-host disease (GVHD) and nonrelapse mortality, and slower time to relapse. UCB and MRD/MUD recipients experienced similar rates of grade 2-4 acute GVHD, chronic GHVD, secondary malignancy, and subsequent allogeneic HCT. UCB is already widely used as a donor source in pediatric HCT; however, adult outcomes and adoption have historically lagged behind in comparison. Recent advancements in UCB transplantation such as the implementation of lower-intensity conditioning regimens, double unit transplants, and ex vivo expansion have improved early mortality, making UCB an increasingly attractive donor source for adults; furthermore, our findings suggest that UCB may actually be a preferred donor source for mitigating late effects of HCT.
Published: 2021

43. Talking about the 'r' word: a right to a health system that is free of racism

Author: Shawn Wilson, Donna Hartz, Boe Rambaldini, John Skinner, Janine Mohamed, Josephine Gwynn, Donna Murray, Carmen Parter, and Tom Calma
Subjects: Native Hawaiian or Other Pacific Islander, Parliament, media_common.quotation_subject, Public policy, Resistance (psychoanalysis), Racism, Indigenous, 1117 Public Health and Health Services, Life Expectancy, Dismissal, Political science, Health Services, Indigenous, Humans, Healthcare Disparities, Health policy, media_common, business.industry, Health Policy, Public Health, Environmental and Occupational Health, Australia, Public relations, Models, Theoretical, Oceanic Ancestry Group, Life expectancy, Public Health, business, Delivery of Health Care
Abstract: Australia's local, state, territory and federal governments have agreed that the 10-year life expectancy gap between Indigenous and non-Indigenous Australians will be closed by 2031. However, annual Closing the Gap reports tabled by the various prime ministers in the Australian Parliament (for the past 12 years) have consistently indicated that the life expectancy gap continues to widen. Australia has seen more than three decades of government policies since the landmark 1989 National Aboriginal health strategy. What has been missing from these policy commitments is the genuine enactment of the knowledges that are held by Indigenous Australians relating to their cultural ways of being, knowing and doing. Privileging Indigenous knowledges, cultures and voices must be front and centre in developing, designing and implementing policies and programs. The sharing of power, provision of resources, culturally informed reflective policy making, and program design are critical elements. In this paper, we provide a conceptual model of practice, working at the cultural interface where knowledges are valued and innovations can occur. This model of practice is where knowledges and cultures can co-exist, and it could be the answer to Closing the Gap in life expectancy by 2031. Despite a growing willingness and need to consider these models, there remains a deep-seated resistance to identifying and addressing institutional and systemic racism and racist attitudes, including unconscious biases held by individuals. Further, western non-Indigenous worldviews of ways of being, knowing and doing continue to dominate the decisions and actions of governments - and consequentially dominate public health policies and practices. There is an unacceptable standard approach, for and about Indigenous health instead of with Indigenous peoples, resulting in the neglectful dismissal of Indigenous knowledges and Indigenous cultures of ways of being, knowing and doing.
Published: 2021

44. An Examination of Miami-Dade County Public-School Vaccination Compliance Utilizing GIS Mapping

Author: Lisa Gwynn and Carly G. Muller
Subjects: Vaccination, medicine.medical_specialty, business.industry, Family medicine, Pediatrics, Perinatology and Child Health, Medicine, Miami, business, Compliance (psychology)
Published: 2021

45. Improving Standardized Screening for E-Cigarette and Vaping Use Among Adolescents

Author: Lawrence B Friedman, Marcela Nur, Carolyn M. Kienstra, Michael Maurer, Prasanth Narahari, Lisa Gwynn, Nina Hein, Cristina Matheus, and Liz Bayes-Santos
Subjects: Nicotine, medicine.medical_specialty, business.industry, Family medicine, Pediatrics, Perinatology and Child Health, medicine, Product (category theory), Lung injury, business, Tobacco product, medicine.drug
Abstract: Background: Electronic Cigarettes (e-cigarettes, EC) constitute the number one vehicle for tobacco product use by adolescents in the United States since 2014. Data from 2019 suggests that 27.5% of high school students reported using EC within the preceding 30 days, but only 37% recognized the presence of nicotine in it. Users of EC are at risk of developing E-cigarette or vaping product use-associated lung injury (EVALI) a life-threatening complication. Although the AAP recommends screening, education and cessation counseling for EC use, only 14% of physicians do it. Physicians using Electronic Health …
Published: 2021

46. Enablers and Barriers to Accessing Healthcare Services for Aboriginal People in New South Wales, Australia

Author: Katrina Ward, Robyn Martin, Susannah Tobin, Kylie Gwynne, Donna Taylor, Yvonne Dimitropoulos, Kate Hunter, Michelle Lincoln, Heather Finlayson, Rona Macniven, Rachael Moir, Davida Nolan-Isles, Tim Agius, and Josephine Gwynn
Subjects: Native Hawaiian or Other Pacific Islander, Inequality, Cultural safety, Health, Toxicology and Mutagenesis, media_common.quotation_subject, lcsh:Medicine, Article, Indigenous, 03 medical and health sciences, 0302 clinical medicine, Nursing, Health care, Health Services, Indigenous, Humans, 030212 general & internal medicine, indigenous, Health policy, media_common, communication, business.industry, 030503 health policy & services, allergology, lcsh:R, Public Health, Environmental and Occupational Health, Australia, first nations, health policy, trust, Health Services, primary health care, Snowball sampling, health services administration, health services accessibility, Sustainable Services, Business, New South Wales, Thematic analysis, 0305 other medical science
Abstract: Background: Australia’s healthcare system is complex and fragmented which can create challenges in healthcare, particularly in rural and remote areas. Aboriginal people experience inequalities in healthcare treatment and outcomes. This study aimed to investigate barriers and enablers to accessing healthcare services for Aboriginal people living in regional and remote Australia. Methods: Semi-structured interviews were conducted with healthcare delivery staff and stakeholders recruited through snowball sampling. Three communities were selected for their high proportion of Aboriginal people and diverse regional and remote locations. Thematic analysis identified barriers and enablers. Results: Thirty-one interviews were conducted in the three communities (n = 5 coastal, n = 13 remote, and n = 13 border) and six themes identified: (1) Improved coordination of healthcare services, (2) Better communication between services and patients, (3) Trust in services and cultural safety, (4) Importance of prioritizing health services by Aboriginal people, (5) Importance of reliable, affordable and sustainable services, (6) Distance and transport availability. These themes were often present as both barriers and enablers to healthcare access for Aboriginal people. They were also present across the healthcare system and within all three communities. Conclusions: This study describes a pathway to better healthcare outcomes for Aboriginal Australians by providing insights into ways to improve access.
Published: 2021

47. Overall Survival in Patients with Hormone Receptor-Positive, HER2-Negative Advanced or Metastatic Breast Cancer Treated with a CDK 4/6 Inhibitor Plus Fulvestrant: A U.S. Food and Drug Administration Pooled Analysis

Author: Gwynn Ison, Rajeshwari Sridhara, Melanie E Royce, Tatiana M. Prowell, Shenghui Tang, Erik Bloomquist, Joyce Cheng, Laleh Amiri-Kordestani, Christy Osgood, Suparna Wedam, Jennifer J. Gao, Danielle Krol, Richard Pazdur, and Julia A. Beaver
Subjects: Oncology, medicine.medical_specialty, Fulvestrant, business.industry, Proportional hazards model, Hazard ratio, medicine.disease, Placebo, Metastatic breast cancer, Breast cancer, Interquartile range, Internal medicine, medicine, Hormonal therapy, business, medicine.drug
Abstract: Background: Cyclin dependent kinase 4/6 inhibitors (CDKIs) are oral targeted agents approved for use in combination with endocrine therapy as 1st or 2nd line treatment of hormone-receptor positive (HR+), human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer. We previously reported the pooled analyses of progression-free survival (PFS) of patients in certain clinicopathological subgroups, all of whom received consistent benefit from the addition of a CDKI to hormonal therapy. Here, we report the pooled overall survival (OS) results in patients treated with a CDKI and fulvestrant. Methods: We pooled individual patient data (n=1948) from three phase III randomized breast cancer trials of CDKI in combination with fulvestrant submitted to the US Food and Drug Administration (FDA) in support of marketing applications. All analyzed patients received at least one dose of CDKI or placebo in combination with fulvestrant. The median OS was estimated using Kaplan-Meier (KM) methods, and hazard ratios (HR) with corresponding 95% confidence intervals (CIs) were estimated using Cox regression models. Patients were analyzed collectively, by number of prior lines of systemic endocrine therapy in any disease setting (1st-line or endocrine naive vs. 2nd -line and later), and in various clinicopathologic subgroups of interest. Findings: In all pooled patients (n=1948), the estimated OS HR was 0∙77 (95% CI 0∙68-0∙88), with a median follow-up of 43∙7 months (interquartile range, (IQR): 37∙8, 47∙7) and deaths in 48% of patients. The difference in estimated median OS was 7∙1 months, favoring CDKIs. In patients who were endocrine therapy naive and received CDKIs as 1st -line systemic endocrine therapy (2 trials, n=396), the estimated OS HR was 0∙74 (95% CI 0∙52-1∙07), with a median follow-up of 39∙4 months (IQR: 37∙0, 42∙2) and deaths in 31% of patients. The median OS difference could not be calculated, since median OS was not reached on CDKI arm. In patients who received CDKIs as 2nd-line or later systemic endocrine therapy (3 trials, n=1552), the estimated OS HR was 0∙77 (95% CI 0∙67-0∙89), with a median follow-up of 45∙1 months (IQR: 39∙2, 48∙5) and deaths in 52% of patients. The median OS difference was 7∙0 months, favoring CDKIs. Additional subgroup analyses of OS by progesterone receptor status, site of metastases, breast cancer histology, ECOG performance status, race, and de novo metastatic presentation all favored adding CDKI to fulvestrant. Patients with de novo metastatic disease (n=470, OS HR 0∙91 [95% CI 0∙68-1∙21]) and Asian patients (n=394, OS HR 0∙95 [95% CI 0∙81-1∙60]) appeared to benefit relatively less from the addition of CDKI to fulvestrant. Although the estimated OS HR appeared to favor fulvestrant alone in patients age < 40 [HR 1∙5 (95% CI 0∙75-3∙02)], this result must be interpreted with caution, given the small sample size (n=89) and correspondingly wide confidence interval. Evaluation of other age subgroups showed results in favor of the addition of CDKI to fulvestrant. All results presented are considered exploratory and hypothesis-generating. Interpretation: Addition of CDKIs to fulvestrant appears to confer a consistent overall survival benefit across all pooled patients and within most clinicopathological subgroups of interest. Funding: None. Declaration of Interest: All authors declare no competing interests. Ethical Approval: All patients in the included trials were required to provide informed written consent, and all trials had institutional review board or ethical approval.
Published: 2021

48. A phase 2 trial of the somatostatin analog pasireotide to prevent GI toxicity and acute GVHD in allogeneic hematopoietic stem cell transplant

Author: Jami Brown, Cristina Gasparetto, Sendhilnathan Ramalingam, Taewoong Choi, Stefanie Sarantopoulos, Jeff Sheng, Richard D. Lopez, Andrew B. Nixon, Antonio L.C. Gomes, Lauren Bohannan, Janet L. Huebner, Virginia B. Kraus, Anthony D. Sung, Alexander B. Sibley, Gwynn D. Long, Marcel R.M. van den Brink, Olga Ilkayeva, Sharareh Siamakpour-Reihani, David A. Rizzieri, Nelson J. Chao, Li Ma, Jing Lyu, Michael J. Muehlbauer, Jonathan U. Peled, Thomas R. Spitzer, Daniel C. Parker, Mitchell E. Horwitz, James R. Bain, and Yi Ren
Subjects: Male, Transplantation Conditioning, Gastrointestinal Diseases, Physiology, medicine.medical_treatment, Peptide Hormones, Graft vs Host Disease, Hematopoietic stem cell transplantation, Disease, Toxicology, Pathology and Laboratory Medicine, Gastroenterology, Biochemistry, chemistry.chemical_compound, Immune Physiology, Medicine and Health Sciences, Blood and Lymphatic System Procedures, Medicine, Immune Response, Bone Marrow Transplantation, Innate Immune System, Multidisciplinary, Hematopoietic Stem Cell Transplantation, Genomics, Middle Aged, Combined Modality Therapy, Medical Microbiology, Hematologic Neoplasms, Toxicity, Cytokines, Tumor necrosis factor alpha, Female, medicine.symptom, Somatostatin, Research Article, Adult, medicine.medical_specialty, Science, Immunology, Inflammation, Surgical and Invasive Medical Procedures, Microbial Genomics, Microbiology, Signs and Symptoms, Internal medicine, Genetics, Humans, Transplantation, Homologous, Metabolomics, Survival rate, Transplantation, business.industry, Interleukins, Biology and Life Sciences, Molecular Development, Pasireotide, Hormones, Metabolism, chemistry, Immune System, Microbiome, Calprotectin, Clinical Medicine, business, Biomarkers, Developmental Biology
Abstract: Background Allogeneic hematopoietic stem cell transplantation (HCT) is an often curative intent treatment, however it is associated with significant gastrointestinal (GI) toxicity and treatment related mortality. Graft-versus-host disease is a significant contributor to transplant-related mortality. We performed a phase 2 trial of the somatostatin analog pasireotide to prevent gastrointestinal toxicity and GVHD after myeloablative allogeneic HCT. Methods Patients received 0.9mg pasireotide every 12 hours from the day prior to conditioning through day +4 after HCT (or a maximum of 14 days). The primary outcomes were grade 3–4 gastrointestinal toxicity through day 30 and acute GVHD. Secondary outcomes were chronic GVHD, overall survival and relapse free survival at one year. Stool and blood samples were collected from before and after HCT for analyses of stool microbiome, local inflammatory markers, and systemic inflammatory and metabolic markers. Results were compared with matched controls. Results Twenty-six patients received pasireotide and were compared to 52 matched contemporaneous controls using a 1–2 match. Grade 3–4 GI toxicity occurred in 21 (81%) patients who received pasireotide and 35 (67%) controls (p = 0.33). Acute GVHD occurred in 15 (58%) patients in the pasireotide group and 28 (54%) controls (p = 0.94). Chronic GVHD occurred in 16 patients in the pasireotide group (64%) versus 22 patients in the control group (42%) (p = 0.12). Overall survival at 1 year in the pasireotide group was 63% (95% CI: 47%,86%) versus 82% (95% CI: 72%, 93%) in controls (log-rank p = 0.006). Relapse-free survival rate at one year was 40% (95% CI: 25%, 65%) in the pasireotide group versus 78% (95% CI: 68%, 91%) in controls (log-rank p = 0.002). After controlling for the effect of relevant covariates, patients in the pasireotide group had attenuated post-HCT loss of microbial diversity. Analysis of systemic inflammatory markers and metabolomics demonstrated feasibility of such analyses in patients undergoing allogeneic HCT. Baseline level and pre-to-post transplant changes in several inflammatory markers (including MIP1a, MIP1b, TNFa, IL8Pro, and IL6) correlated with likelihood of survival. Conclusions Pasireotide did not prevent gastrointestinal toxicity or acute GVHD compared to contemporaneous controls. Pasireotide was associated with numerically higher chronic GVHD and significantly decreased OS and RFS compared to contemporaneous controls. Pasireotide may provide a locally protective effect in the stool microbiome and in local inflammation as measured by stool calprotectin, stool beta-defensin, and stool diversity index.
Published: 2020

49. A Retrospective Analysis of Blood Lead Levels in Newly Arrived Immigrant Children, Miami-Dade County, Florida, 2013-2016

Author: Ashley Barash, Tulay Koru-Sengul, Lisa Gwynn, and Devina J. Dave
Subjects: Male, Adolescent, media_common.quotation_subject, Immigration, Ethnic group, Emigrants and Immigrants, Zip code, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Retrospective analysis, Medicine, Humans, 030212 general & internal medicine, Young adult, Child, Poverty, media_common, Retrospective Studies, 030505 public health, medicine.diagnostic_test, business.industry, Research, Public Health, Environmental and Occupational Health, Miami, Lead, Child, Preschool, Florida, Blood lead level, Female, 0305 other medical science, business, Demography
Abstract: Objective The Centers for Disease Control and Prevention’s (CDC’s) recommendation for blood lead level (BLL) screening of refugee children is to test new arrivals aged 6 months to 16 years. No such recommendations exist for testing immigrant children. Our objective was to provide evidence in support of creating lower age-specific guidelines for BLL screening for newly arrived immigrant populations to reduce the burden of unnecessary BLL testing. Methods We conducted a 3-year (2013-2016) retrospective analysis of BLLs of 1349 newly arrived immigrant children, adolescents, and young adults aged 3-19 who visited the University of Miami Pediatric Mobile Clinic in Miami, Florida. We obtained capillary samples and confirmed values >5 μg/dL via venous sample. The primary outcome was BLL in μg/dL. The main predictor variable was age. We further adjusted regression models by poverty level, sex, and ethnicity. Results Of 15 patients with a BLL that warranted further workup and a lead level of concern, 9 were aged 3-5 and 6 were aged 6-11. None of the adolescent and young adult patients aged 12-19 had a lead level of concern. Nearly half of the patients (n = 658, 48.8%) lived in zip codes of middle to high levels of poverty. Conclusion This study provides evidence to support the creation of lower age-specific guidelines for BLL screening among newly arrived immigrant children and adolescents. Future studies should elucidate appropriate age ranges for BLL testing based on epidemiologic evidence, such as age and country of origin.
Published: 2020

50. Chlorhexidine Gluconate Bathing Reduces the Incidence of Bloodstream Infections in Adults Undergoing Inpatient Hematopoietic Cell Transplantation

Author: Kristin G. Kegerreis, Antonio L.C. Gomes, Li Ma, David A. Rizzieri, Mitchell E. Horwitz, Yvonne M. Mowery, Gwynn D. Long, Sin-Ho Jung, Stefanie Sarantopoulos, Yi Ren, Erica Lobaugh-Jin, Vinay K. Giri, Richard D. Lopez, Marcel R.M. van den Brink, Deborah H. Allen, Nelson J. Chao, Martha Lassiter, Lauren Bohannon, Elizabeth Sito, Jennifer L. Saullo, Julia A. Messina, Morris Greenberg, Anita Matthews, Jonathan U. Peled, Anthony D. Sung, Cristina Gasparetto, Tessa M. Andermann, and Taewoong Choi
Subjects: Adult, medicine.medical_specialty, Bathing, medicine.drug_class, medicine.medical_treatment, Hematopoietic stem cell transplantation, Article, Antiseptic, Internal medicine, Sepsis, Chlorhexidine gluconate, medicine, Immunology and Allergy, Humans, Prospective Studies, Prospective cohort study, Adverse effect, Transplantation, Cross Infection, Inpatients, business.industry, Incidence (epidemiology), Incidence, Chlorhexidine, Hematopoietic Stem Cell Transplantation, Cell Biology, Hematology, Molecular Medicine, business, human activities
Abstract: BACKGROUND: Bloodstream infections (BSIs) occur in 20-45% of inpatient autologous and allogeneic hematopoietic cell transplant (HCT) patients. Daily bathing with the antiseptic chlorhexidine gluconate (CHG) has been shown to reduce the incidence of BSIs in critically ill patients although very few studies include HCT patients or have evaluated the impact of compliance on effectiveness. METHODS: We conducted a prospective cohort study with historical controls to assess the impact of CHG bathing on the rate of BSIs and gut microbiota composition among adults undergoing inpatient HCT at the Duke University Medical Center. We present one year of data without CHG bathing (2016) and two years of data when CHG was used on the HCT unit (2017-2018). Because not all patients adhered to CHG, patients were grouped into four categories by rate of daily CHG usage: High (>75%), Medium (50-75%), Low (1-49%), and None (0%). RESULTS: Among 192 patients, univariate trend analysis demonstrated that increased CHG usage was associated with decreased incidence of clinically-significant BSI, defined as any BSI requiring treatment by the medical team (High-8% BSI, Medium-15.2%, Low-15.6%, No CHG-30.3%, p=0.003), laboratory-confirmed BSI (LCBI, p=0.03), central line-associated BSI (CLABSI, p=0.04), and mucosal barrier injury BSI (MBI-LCBI, p=0.002), Multivariate analysis confirmed a significant effect of CHG bathing on clinically-significant BSI (p=0.023) and mucosal barrier injury BSI (MBI-LCBI, p=0.007), without consistently impacting gut microbial diversity. Benefits of CHG bathing were most pronounced with >75% daily usage, and there were no adverse effects attributable to CHG. CONCLUSIONS: Adherence to daily CHG bathing significantly decreases the rate of bloodstream infection following HCT.
Published: 2020

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