Publications by authors named "J. Pitt"
Purpose: The purpose of the current study was to gain insight on augmentative and alternative communication (AAC) interface designs for children with cortical visual impairment (CVI). Children with CVI frequently require AAC and specific interface supports, and customization may be necessary to support access and use of speech-generating devices.
Method: A focus group methodology was selected to gain feedback from vision professionals on helpful AAC features for children with CVI.
Aims: This post hoc analysis aimed to assess the efficacy and safety of the non-steroidal mineralocorticoid receptor antagonist finerenone by baseline diuretic use in FIDELITY, a pre-specified pooled analysis of the phase III trials FIDELIO-DKD and FIGARO-DKD.
Methods And Results: Eligible patients with type 2 diabetes (T2D) and chronic kidney disease (CKD; urine albumin-to-creatinine ratio [UACR] ≥30-<300 mg/g and estimated glomerular filtration rate [eGFR] ≥25-≤90 ml/min/1.73 m, or UACR ≥300-≤5000 mg/g and eGFR ≥25 ml/min/1.
Background: An initial decline in estimated glomerular filtration rate (eGFR) often leads to reluctance to continue life-saving therapies in patients with heart failure (HF).
Objectives: The goal of this study was to describe the association between initial decline in eGFR and subsequent clinical outcomes in patients randomized to placebo or finerenone.
Methods: In this prespecified analysis of FINEARTS-HF (Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients with Heart Failure), we examined the association between initial decline in eGFR (≥15%) from randomization to 1 month and subsequent outcomes in patients assigned to finerenone or placebo.
Background: In response to the opioid epidemic, prescribing guidelines and statewide surgical opioid management programs were initiated in 2018-19. This analysis aims to document the sustainability of a regional opioid stewardship consortium through the pandemic and beyond.
Study Design: From September 2019 through August 2023, 15 NSQIP hospitals in two states gathered opioid-specific variables on patients undergoing 12 procedures.
Background: Hypertension is common in patients with heart failure with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF), and current guidelines recommend treating systolic blood pressure (SBP) to a target <130 mm Hg. However, data supporting treatment to this target are limited. Additionally, pulse pressure (PP), a marker of aortic stiffness, has been associated with increased risk of cardiovascular events, but its prognostic impact in HFpEF has not been extensively studied.
View Article and Find Full Text PDFHigh shear wet granulation (HSWG) is widely used in tablet manufacturing mainly because of its advantages in improving flowability, powder handling, process run time, size distribution, and preventing segregation. In-line process analytical technology measurements are essential in capturing detailed particle dynamics and presenting real-time data to uncover the complexity of the HSWG process and ultimately for process control. This study is to find relationships between Lenterra in-line measurements and granule properties and tablet properties.
View Article and Find Full Text PDFBackground: Obesity is associated with excessive adipocyte-derived aldosterone secretion, independent of the classical renin-angiotensin-aldosterone cascade, and mineralocorticoid receptor antagonists may be more effective in patients with heart failure (HF) and obesity.
Objectives: This study sought to examine the effects of the nonsteroidal mineralocorticoid receptor antagonist finerenone compared with placebo, according to body mass index (BMI) in FINEARTS-HF (FINerenone trial to investigate Efficacy and sAfety superioR to placebo in paTientS with Heart Failure).
Methods: A total of 6,001 patients with HF with NYHA functional class II, III, and IV, a left ventricular ejection fraction of ≥40%, evidence of structural heart disease, and elevated natriuretic peptide levels were randomized to finerenone or placebo.
Article Synopsis
- The study aims to use machine learning clustering to categorize distinct patient types among those with ischaemic heart failure and reduced ejection fraction (HFrEF) to improve personalized treatment approaches.
- Analysis of 8,591 HFrEF patients revealed five unique clusters based on clinical and biological traits, with varying risks for hospitalization and death, highlighting the need for tailored management strategies.
- The findings indicate that specific clusters correlate with different outcomes, suggesting that treatments like mineralocorticoid receptor antagonists may be more beneficial for certain patient groups, ultimately enhancing patient care in the future.
Total Knee Replacements (TKRs) are a commonly used treatment to help patients suffering from severely damaged knee joints, which is normally brought on by osteoarthritis. The aim of the surgery is to reduce pain and regain function of the joint, however, some of these implants fail prematurely with implant wear being one of the main factors of failure. Computational analysis is an efficient tool that can provide an in-depth insight on the evolution of wear, before utilising experimental techniques which are time-consuming and costly.
View Article and Find Full Text PDFSpironolactone, a steroidal mineralocorticoid receptor antagonist (MRA), has been used to treat patients with heart failure (HF) for more than half a century. Spironolactone improved outcomes in patients with severely symptomatic HF with reduced ejection fraction, and later, eplerenone expanded the benefits to patients with mildly symptomatic HF with reduced ejection fraction and myocardial infarction complicated by HF. Spironolactone reduced HF events in some patients with HF with preserved ejection fraction, but the results were not generalizable to all patients with HF with preserved ejection fraction.
View Article and Find Full Text PDFArticle Synopsis
- - Timothy syndrome, caused by variants in the CACNA1C gene, was originally recognized for its cardiac symptoms (long QT syndrome) and physical abnormalities (syndactyly), but more recent research has unveiled a wider range of symptoms associated with different CACNA1C variants.
- - A survey was conducted with parents of Timothy syndrome patients to gather information on various symptoms, grouping participants by genetic type and initial diagnosis to compare their conditions.
- - The study found that patients commonly show both cardiac and extra-cardiac symptoms, such as neurodevelopmental issues and respiratory problems, regardless of their classification, indicating that the current understanding of "non-syndromic" cases may not fully capture the complexity of the disease.
Background: Mineralocorticoid receptor antagonists have been shown to reduce mortality in patients after myocardial infarction with congestive heart failure. Whether routine use of spironolactone is beneficial after myocardial infarction is uncertain.
Methods: In this multicenter trial with a 2-by-2 factorial design, we randomly assigned patients with myocardial infarction who had undergone percutaneous coronary intervention to receive either spironolactone or placebo and either colchicine or placebo.
Article Synopsis
- The study investigates the safety and efficacy of finerenone in treating heart failure, focusing on differences between men and women.
- Conducted as part of the FINEARTS-HF trial, it included over 6000 participants aged 40 and older across multiple countries.
- Results show that finerenone significantly reduces the risk of combined cardiovascular death and heart failure events in both sexes, with women experiencing slightly better outcomes on average.
Article Synopsis
- Finerenone, a nonsteroidal mineralocorticoid receptor antagonist, improved outcomes for heart failure patients in the FINEARTS-HF trial but led to elevated serum potassium levels.
- The study aimed to analyze the frequency of abnormal serum potassium levels (<3.5 mmol/L and >5.5 mmol/L) and the impact of finerenone treatment compared to placebo on patient outcomes.
- Results showed that participants taking finerenone experienced significantly higher potassium levels over time, with increased risk of levels >5.5 mmol/L and reduced risk of levels <3.5 mmol/L, indicating a notable effect of the drug on potassium regulation.
Article Synopsis
- * The FINEARTS-HF trial compared the effectiveness of finerenone, a nonsteroidal mineralocorticoid receptor antagonist, against a placebo, measuring primary outcomes like cardiovascular death and HF worsening events.
- * Results showed that lower KCCQ Total Symptom Scores (TSS) indicated a higher risk of adverse events, but finerenone significantly reduced event risks across all KCCQ TSS tertiles, suggesting it may improve outcomes for patients with varying levels of symptom severity.
Background: Finerenone has kidney-protective effects in patients with chronic kidney disease with type 2 diabetes, but effects on kidney outcomes in patients with heart failure with and without diabetes and/or chronic kidney disease are not known.
Objectives: The purpose of this study was to examine the effects of finerenone on kidney outcomes in FINEARTS-HF (Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients With Heart Failure), a randomized trial of finerenone vs placebo among patients with heart failure with mildly reduced or preserved ejection fraction.
Methods: We explored the effects of finerenone on the secondary outcome of a sustained ≥50% estimated glomerular filtration rate (eGFR) decline or kidney failure (sustained eGFR decline <15 mL/min/1.
Background: Bladder dysfunction entails overactive bladder (OAB) defined as symptoms of urinary urgency, frequency, and/or nocturia with or without incontinence if there is no obvious pathology or infection or lower urinary tract symptoms that includes recognized causes of bladder dysfunction.
Methods: Literature search.
Results: Symptoms of OAB are reported in about 15% of the adult US population.
Introduction: Postoperative recovery of children is difficult to gauge by parents after hospital discharge. Consumer wearable devices (CWD) generate valid and near real-time pulse rate data, integer pulse rate variability (PRVi), that can serve as digital biomarkers for the onset of complications during post-discharge recovery. This study sought to explore whether pediatric patients with surgical complications after appendectomy exhibited a CWD-derived PRVi trajectory that differs from the normative PRVi recovery trajectory.
View Article and Find Full Text PDFUsing proton-proton collision data corresponding to an integrated luminosity of collected by the CMS experiment at , the decay is observed for the first time, with a statistical significance exceeding 5 standard deviations. The relative branching fraction, with respect to the decay, is measured to be , where the first uncertainty is statistical, the second is systematic, and the third is related to the uncertainties in and .
View Article and Find Full Text PDFA search for collective effects inside jets produced in proton-proton collisions is performed via correlation measurements of charged particles using the CMS detector at the CERN LHC. The analysis uses data collected at a center-of-mass energy of sqrt[s]=13 TeV, corresponding to an integrated luminosity of 138 fb^{-1}. Jets are reconstructed with the anti-k_{T} algorithm with a distance parameter of 0.
View Article and Find Full Text PDFArticle Synopsis
- - The study focused on improving surgical quality for thyroid cancer by selecting 10 specific quality indicators and identifying areas for quality improvement at the state level.
- - A team of experts found significant gaps in care: over 34% of patients didn’t have preoperative cytology, 50% with small cancers underwent unnecessary extensive surgeries, and nearly 20% lacked follow-up and surveillance plans post-surgery.
- - The findings suggest that implementing a dedicated quality improvement program for thyroid cancer could enhance surgical care quality and provide a model for similar initiatives in other regions.
Context: Little is known about how patients' emotions impact the choice between hemi- and total thyroidectomy (TT) for low-risk thyroid cancer (LR-TC) and how these emotions change after treatment.
Objective: To investigate thyroid cancer-specific fear and worry both before and after treatment of LR-TC with hemi- or TT.
Methods: This prospective cohort study enrolled adults with confirmed or likely LR-TC at 15 institutions.
Article Synopsis
- Thyroid hormones are frequently prescribed in the U.S., especially to older adults, where misuse and overtreatment pose risks like heart and bone issues.
- The study involved interviews with 19 healthcare professionals about the challenges and supports for deprescribing thyroid hormones in older patients, analyzing responses through a structured framework.
- Key barriers included patient anxiety and misinformation, and systemic issues like time constraints and lack of knowledge among doctors; facilitators were strong communication and trust between patients and their physicians.