Publications by authors named "Emma Lee"

Background: There are few realistic and accessible laparoscopic pyeloplasty training models. The aim of this study is to develop a functional training model through user-centered design that depicts the pathological features of pelvicoureteric junction obstruction (PUJO).

Methods: Realistic patient-matched anatomical models of the kidney, renal pelvis, and ureter were created based on segmentations of computed tomography (CT) scans of a paediatric patient with PUJO who underwent laparoscopic pyeloplasty.

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Introduction: Chronic hepatitis D virus (HDV) is associated with rapid progression to severe liver disease. Co-infection with HDV and hepatitis B virus is likely underdiagnosed due to challenges in diagnostic test availability and standardization. With new HDV antiviral options, HDV RNA quantification is essential for understanding the patient response to treatment.

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Importance: Extubation Advisor (EA) is a novel software tool that generates a synoptic report for each Spontaneous Breathing Trial (SBT) conducted to inform extubation decision-making.

Objectives: To assess bedside EA implementation, perceptions of utility, and identify barriers and facilitators of use.

Design, Setting And Participants: We conducted a phase I mixed-methods interventional study in three mixed intensive care unit (ICUs) in two academic hospitals.

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Background: Blastomycosis is a pulmonary disease caused by Blastomyces spp., a group of pathogenic dimorphic fungi endemic to a number of geographic regions, specifically Manitoba and northwestern Ontario, Canada. Immunosuppression is a major risk factor affecting disease susceptibility, yet host immunity is not well understood.

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Oral contraceptive (OC) use can increase resting blood pressure (BP) in females as well as contribute to greater activation of group III/IV afferents during upper body exercise. It is unknown, however, whether an exaggerated BP response occurs during lower limb exercise in OC users. We sought to elucidate the group III/IV afferent activity-mediated BP and heart rate responses while performing lower extremity tasks during early and late follicular phases in young, healthy females.

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Despite increasing scale-up of antiretroviral therapy (ART) coverage, challenges related to adherence and HIV drug resistance (HIVDR) remain. The high cost of HIVDR surveillance is a persistent challenge with implementation in resource-constrained settings. Dried blood spot (DBS) specimens have been demonstrated to be a feasible alternative to plasma or serum for HIVDR genotyping and are more suitable for lower resource settings.

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The COVID-19 pandemic put families in the United States under financial stress. The federal government's largest response in 2021 was the American Rescue Plan Act, which temporarily expanded the Child Tax Credit (CTC) into a large, unconditional child allowance providing monthly payments to families with children. This study investigates consumption responses to the CTC expansion using anonymized mobile-location data and debit/credit card data that track visits and spending at 1.

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Article Synopsis
  • * Conducted between 2020 and 2023, the research involved patients with invasive breast cancer from both an underserved hospital and a cancer center, analyzing data collected through a social needs screening tool.
  • * Results showed that 76% of patients with access to city-funded mammograms underwent screening, but those at the underserved hospital were more likely to be diagnosed at a later stage of cancer.
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Sleep disturbance, one of the most common menopausal symptoms, contributes to autonomic dysfunction and is linked to hypertension and cardiovascular risk. Longitudinal studies suggest that hyperreactivity of blood pressure (BP) to a stressor can predict the future development of hypertension. It remains unknown if postmenopausal females who experience sleep disturbance (SDG) demonstrate greater hemodynamic and sympathetic neural hyperreactivity to a stressor.

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  • Cystathionine- -synthase (CBS)-pair domain transporters (CNNMs) are important for regulating magnesium levels in the body by transporting magnesium ions and affecting a specific ion channel (TRPM7).
  • The study presents the crystal structure of the extracellular part of tapeworm CNNM4, revealing it forms a dimer with specific molecular structures and sites for sugar molecules.
  • Mutations in the extracellular domain of human CNNM4 hinder its dimerization, and a similar mutation in mouse CNNM2 negatively affects its ability to transport magnesium in cells.
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Background: Older adults are commonly prescribed long-term benzodiazepines for anxiety and insomnia despite evidence of risks and limited evidence of long-term benefits. Recent quality measures and guidelines have recommended benzodiazepine deprescribing, yet there is little real-world data on clinic-based deprescribing programs.

Methods: We developed a benzodiazepine deprescribing quality improvement program for older adults at a large US academic medical center.

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Cystathionine-β-synthase (CBS)-pair domain divalent metal cation transport mediators (CNNMs) are an evolutionarily conserved family of magnesium transporters. They promote efflux of Mg ions on their own and influx of divalent cations when expressed with the transient receptor potential ion channel subfamily M member 7 (TRPM7). Recently, ADP-ribosylation factor-like GTPase 15 (ARL15) has been identified as CNNM-binding partner and an inhibitor of divalent cation influx by TRPM7.

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  • The study compares outcomes for non-small-cell lung cancer (NSCLC) patients classified as pT4 by the AJCC7 and AJCC8 criteria, highlighting differences in tumor size and characteristics.
  • It found that patients categorized under AJCC7 had worse perioperative outcomes, such as higher 90-day mortality rates, and were more likely to have lymph node involvement and metastasis.
  • Despite these differences, long-term survival rates were similar, indicating the complexity of the AJCC8 classification and suggesting a need for ongoing adjustments in future cancer classifications.
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  • Menopause symptoms can be severely disruptive, and the popularity of menopausal hormone therapy (MHT) has dropped since the Women's Health Initiative study raised concerns about its safety.
  • A survey of 508 peri- and postmenopausal women revealed that they often use complementary and integrative therapies (CIT) like exercise and mind-body therapies, often based on advice from physicians and research studies, to manage symptoms like sleep disturbances and anxiety.
  • The results highlighted a correlation between education level and the choice of therapies, suggesting the need for more research focused on diverse populations and a personalized healthcare approach that takes into account individual needs and preferences.
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The COVID-19 pandemic has proved unique in both its unpredictability and the extent to which it has continued to impact on daily life since March 2020. Among the immunosuppressed population the challenges of the COVID-19 pandemic are cumulative to the ever-present challenges of living with a long-term condition. This prospective longitudinal study explored patterns of concern experienced by 467 British parents caring for an immunosuppressed child during the first 2 years of the COVID-19 pandemic and related this to parental mental wellbeing.

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Cystathionine-β-synthase (CBS)-pair domain divalent metal cation transport mediators (CNNMs) are an evolutionarily conserved family of magnesium transporters. They promote efflux of Mg ions on their own or uptake of divalent cations when coupled to the transient receptor potential ion channel subfamily M member 7 (TRPM7). Recently, ADP-ribosylation factor-like GTPase 15 (ARL15) has been identified as CNNM binding partner and an inhibitor of divalent cation influx by TRPM7.

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Background: Patients often have high expectations for recovery after critical illness, but the impact of these expectations on subsequent quality of life (QoL) after serious illnesses has not been evaluated empirically.

Research Question: Among adult survivors of acute respiratory failure (ARF), are met vs unmet expectations for health associated with self-reported QoL 6 months after discharge?

Study Design And Methods: This was a prospective longitudinal cohort study enrolling consecutive adult patients with ARF managed in ICUs at five academic medical centers. At hospital discharge, we evaluated participants' expected health 6 months in the future via a visual analog scale (VAS; range, 0-100), with higher scores representing better expected health.

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Importance: The dramatic rise in use of telehealth accelerated by COVID-19 created new telehealth-specific challenges as patients and clinicians adapted to technical aspects of video visits.

Objective: To evaluate a telehealth patient navigator pilot program to assist patients in overcoming barriers to video visit access.

Design, Setting, And Participants: This quality improvement study investigated visit attendance outcomes among those who received navigator outreach (intervention group) compared with those who did not (comparator group) at 2 US academic primary care clinics during a 12-week study period from April to July 2021.

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Single-parent families have historically faced greater economic precarity relative to other family types in the United States. We investigate how and whether those disparities widened after the onset of the COVID-19 pandemic. Using data on exposure to school and childcare center closures, unemployment, poverty, food hardship, and frequent worrying among single-parent families versus two-parent families throughout 2020 and 2021, we find that the challenges that single parents faced prior to the pandemic generally magnified after the arrival of COVID-19.

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Background: The uncertainties surrounding the COVID-19 pandemic have been associated with increased parental concern. The aim of this study is to explore if this increased level of concern is associated with certain individual/household characteristics or if parents adapted to the ever-changing realities of the COVID-19 pandemic over time.

Methods: This prospective study explored COVID-19 concern trajectories and associated family characteristics of 765 UK parents caring for an immunosuppressed child during the first 18 months of the pandemic using growth mixture modelling.

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Cardiovascular disease (CVD), the leading cause of death among US adults, is more prevalent in menopausal females compared with age-matched males. Vasomotor symptoms of menopause (VMS; hot flashes/flushes and night sweats) are common among females undergoing menopausal transition and have been associated with elevated blood pressure (BP) and increased CVD risk. Autonomic dysregulation of BP has been posited as a contributing factor to the elevated CVD risk in menopausal females with VMS.

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Discussion of patient expectations for recovery is a component of intensive care unit (ICU) follow-up clinics. However, few studies have formally evaluated recovery-related expectations of ICU survivors. To estimate the prevalence of unmet expectations for recovery 6 months after hospital discharge among adult survivors of acute respiratory failure (ARF).

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