Publications by authors named "Fagan M"

The MEK inhibitor selumetinib induces objective responses and provides clinical benefit in children with neurofibromatosis type 1 (NF1) and inoperable plexiform neurofibromas (PNs). To evaluate whether similar outcomes were possible in adult patients, in whom PN growth is generally slower than in pediatric patients, we conducted an open-label phase 2 study of selumetinib in adults with NF1 PNs. The study was designed to evaluate objective response rate (primary objective), tumor volumetric responses, patient-reported outcomes and pharmacodynamic effects in PN biopsies.

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Introduction: Musculoskeletal (MSK) injury can negatively affect service members by compromising job performance and readiness. These injuries can impact the service member's physical health, functional abilities, and quality of life (QoL). Rehabilitation therapies for MSK injuries can reduce these impacts.

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Individuals with hematologic malignancy have increased risk of latent tuberculosis infection (LTBI) reactivation and (SS) dissemination. However, screening prior to chemotherapy or corticosteroids is not routine. We conducted a LTBI and SS screening intervention amongst patients with hematologic malignancies.

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Background: Maternal mortality remains high in sub-Saharan Africa, with little progress made in the last 20 years. The provision of emergency obstetric care has been shown to have the greatest effect in reducing maternal mortality in countries with high maternal mortality ratios, especially when paired with an emergency transport service. Integrate Health has partnered with the Togolese Ministry of Health to improve maternal and child health via the integration of a free ambulance service into a pre-existing primary care model.

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Article Synopsis
  • * The study highlights that natural regeneration of forests is more efficient and less costly than tree planting in degraded areas, analyzing the spatial distribution of natural forests from 2000 to 2016 to identify potential for regeneration.
  • * It estimates that around 215 million hectares, mainly in countries like Brazil, Indonesia, China, Mexico, and Colombia, could naturally regenerate, potentially sequestering 23.4 billion tons of carbon over 30 years—emphasizing the importance of targeting these areas for effective restoration efforts.
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  • This study critically tested the relationship between bone internal structure and strength, specifically focusing on various microanatomical features and their effects on bone resistance to compression.
  • Utilizing finite element analyses on humerus models from a white rhinoceros, the research identified how specific features, like cortex thickening and trabecular bone compactness, contribute to bone strength.
  • The findings suggest that while certain microanatomical changes can compensate for each other, the combined negative effects of two detrimental changes significantly outweigh their individual impacts, enhancing the understanding of bone adaptation and its implications for studying fossil specimens and skeletal evolution. *
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Muscle spindle abundance is highly variable in vertebrates, but the functional determinants of this variation are unclear. Recent work has shown that human leg muscles with the lowest abundance of muscle spindles primarily function to lengthen and absorb energy, while muscles with a greater spindle abundance perform active-stretch-shorten cycles with no net work, suggesting that muscle spindle abundance may be underpinned by muscle function. Compared with other mammalian muscles, the digastric muscle contains the lowest abundance of muscle spindles and, therefore, might be expected to generate substantial negative work.

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Introduction: Patient-reported outcome measures (PROMs) are validated and standardised questionnaires that capture patients' own reports of their symptoms, functioning and well-being. PROMs can facilitate communication between patients and clinicians, reduce symptom burden, enhance quality of life and inform health service re-design. We aim to determine the acceptability of PROMs and the preferred timing of PROM completion in New South Wales (NSW) at the point of care, facilitated by the Health Outcomes and Patient Experiences (HOPE) platform.

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Traumatic brain injury (TBI) is a leading cause of death and disability in pediatric patients and often results in delayed neural development and altered connectivity, leading to lifelong learning, memory, behavior, and motor function deficits. Induced pluripotent stem cell-derived neural stem cells (iNSCs) may serve as a novel multimodal therapeutic as iNSCs possess neuroprotective, regenerative, and cell-replacement capabilities post-TBI. In this study, we evaluated the effects of iNSC treatment on cellular, tissue, and functional recovery in a translational controlled cortical impact TBI piglet model.

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  • The study focuses on early detection of peripheral nerve sheath tumors (PNST) associated with neurofibromatosis type 1 (NF1) using a cell-free DNA (cfDNA) fragmentomic approach, which can improve clinical decision-making and treatment outcomes.
  • Researchers isolated cfDNA from plasma samples of 101 NF1 patients and 21 healthy controls, employing whole-genome sequencing and analyzing various fragmentomic signatures to differentiate between benign, premalignant, and malignant tumors.
  • Results showed that fragmentomic methods successfully distinguished atypical neurofibromas (premalignant) from benign forms and malignant PNST, offering potential for non-invasive diagnostics and better management of NF1-related tumors.*
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: To examine trends in self-reported psychological distress among Canadian postsecondary students between 2020 and 2023. : Using data collected from postsecondary students ( = 103,936) through the Canadian Campus Wellbeing Survey (CCWS), multilevel regression models were fitted to determine how distress levels, as measured by the Kessler Psychological Distress Scale, differed across six-time points of the CCWS. Across the cycles, students reported high levels of distress (mean across cycles = 26.

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Traumatic brain injury (TBI), a significant global health issue, is affecting ∼69 million annually. To better understand TBI's impact on brain function and assess the efficacy of treatments, this study uses a novel temporal-spatial cross-group approach with a porcine model, integrating resting-state functional magnetic resonance imaging (rs-fMRI) for temporal and arterial spin labeling for spatial information. Our research used 18 four-week-old pigs divided into three groups: TBI treated with saline (SLN, = 6), TBI treated with fecal microbial transplant (FMT, = 6), and a sham group (sham, = 6) with only craniectomy surgery as the baseline.

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Many Canadians use nicotine products such as cigarettes and e-cigarettes. A particular subpopulation of concern is post-secondary students given they have a higher prevalence of use. Many correlates of cigarette smoking and e-cigarette use have been identified.

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Introduction: Urologists observed reduced cancer consultations and surgeries during the SARS-CoV-2 pandemic, raising concern about treatment delays. Testicular cancer serves as a particularly sensitive marker of this phenomenon, as the clinical stage of testicular cancer at presentation is predictive of cancer-specific survival. We aimed to investigate whether COVID-related restrictions to primary care access resulted in increased incidence of metastatic germ cell testis cancer.

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Heavy animals incur large forces on their limb bones, due to the transmission of body weight and ground reaction forces, and the contractions of the various muscles of the limbs. This is particularly true for rhinoceroses, the heaviest extant animals capable of galloping. Several studies have examined their musculoskeletal system and the forces their bones incur, but no detailed quantification has ever been attempted.

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Introduction: Osteoarthritis (OA) commonly occurs following anterior cruciate ligament reconstruction (ACLR), affecting over 50 % of patients within 10-15 years post-ACLR. The Hoffa-synovitis of the infrapatellar fat pad (IPFP) has been implicated as a major contributor to OA pathogenesis. While MRI is typically used to evaluate the IPFP, it is cost-prohibitive for routine screening.

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Objective: Chronic inflammation and altered walking biomechanics are common after ACL reconstruction (ACLR) and contribute to the development of osteoarthritis. Clinically accessible techniques are needed to monitor inflammation (ultrasound-assessed effusion-synovitis) and walking biomechanics (force-measuring insoles), and they must improve the translation of these assessments and determine whether inflammation and walking biomechanics are related in patients after ACLR. This study aimed to determine the association between ultrasound-detected knee effusion-synovitis and limb loading asymmetries during walking in patients 1-5 years post-ACLR.

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Pediatric traumatic brain injury (TBI) often induces significant disability in patients, including long-term motor deficits. Early detection of injury severity is key in determining a prognosis and creating appropriate intervention and rehabilitation plans. However, conventional magnetic resonance imaging (MRI) scans, such as T2 Weighted (T2W) sequences, do not reliably assess the extent of microstructural white matter injury.

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The material properties of some bones are known to vary with anatomical location, orientation and position within the bone (e.g., cortical and trabecular bone).

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Introduction: Renal cell carcinoma (RCC) is often associated with significant morbidity and mortality, with overall survival contingent on multiple factors - most importantly, disease stage at diagnosis. Disruptions in healthcare delivery during the COVID-19 pandemic have resulted in various reported diagnostic and treatment delays, which have had detrimental impacts on malignancies such as RCC.

Methods: Surgically managed cases of RCC at our center were identified using a retrospective chart review of all nephrectomies conducted from March 1, 2018, to February 28, 2023.

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Introduction: Musculoskeletal (MSK) injury is an inherent risk for military personnel that can potentially impact job performance, productivity, and military readiness. Evidence is needed to show the efficacy of nonpharmacological, self-managed therapies to reduce MSK symptoms at common injury sites that are feasible for use during expeditionary operations and home stations. This systematic review and meta-analysis identified, summarized, and synthesized available evidence from randomized and non-randomized trials on the effectiveness of self-managed, home-use therapies to improve pain, muscle strength, and physical performance in military personnel with MSK injuries, when compared to controls.

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Article Synopsis
  • Early detection of neurofibromatosis type 1 (NF1) associated tumors can improve clinical decision-making and potentially reduce severe outcomes.
  • A new study employed a cell-free DNA (cfDNA) fragmentomic method, successfully differentiating between benign, pre-malignant, and malignant peripheral nerve sheath tumors (PNST) in NF1 patients.
  • This innovative approach allows non-invasive diagnosis and could significantly enhance the management of NF1-associated tumors, helping to differentiate conditions like atypical neurofibromas from more severe malignancies.
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Background: Calls to action addressing the interconnections between physical (in)activity and the climate crisis are increasing. The current study aimed to investigate public support for policy actions that potentially have co-benefits for physical activity promotion and climate change mitigation.

Methods: In 2023, a survey through the Angus Reid Forum was completed by 2507 adults living in Canada.

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