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King CE, Kermode A, Saxena G, Carvelli P, Edwards M, Creagh-Brown BC. Postoperative continuous non-invasive cardiac output monitoring on the ward: a feasibility study. J Clin Monit Comput 2020; 35:1349-1356. [PMID: 33094826 PMCID: PMC8542541 DOI: 10.1007/s10877-020-00601-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/29/2020] [Indexed: 12/19/2022]
Abstract
Postoperative hypotension is common (occurring in one third of patients) and is associated with worse clinical outcomes. The LiDCO CNAP (continuous non-invasive arterial pressure) device measures haemodynamics but has not been widely adopted in ward environments. Improved early detection of hypotension by CNAP might guide interventions to improve clinical outcomes. We aimed to find the proportion of patients who tolerated LiDCO CNAP for 12 h postoperatively, to unmask episodes of hypotension detected by continuous monitoring and to characterise the haemodynamic profile at the time of hypotension. In this feasibility study, patients undergoing major elective surgery were continuously postoperatively monitored using CNAP. Haemodynamic data gathered from CNAP, including nSVRI (nominal systemic vascular resistance index), nSVI (nominal stroke volume index), SVV (stroke volume variation) and blood pressure, were analysed using Microsoft Excel and GraphPad Prism 8. 104 patients (age (mean ± sd): 68 ± 14, male (56%)) had CNAP sited postoperatively. 39% tolerated the CNAP device for at least 12 h. Within the 104 patients a mean of 81.2 min of hypotension detected by CNAP was not detected by usual care. The proportion of low/normal/high nSVI was 71%, 27% and 2%, nSVRI was 43%, 17% and 40%, respectively. CNAP monitoring was not tolerated for 12 h in the majority of patients. There were many episodes of hypotension unmasked through continuous monitoring. Based on the advanced haemodynamic data provided it is possible that the underlying cause of a third of postoperative hypotensive episodes is vasodilation rather than hypovolaemia.Trial registry number: NCT04010058 (ClinicalTrials.gov) Date of registration: 08/07/2019.
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McCance W, Jones OAH, Cendón DI, Edwards M, Surapaneni A, Chadalavada S, Wang S, Currell M. Combining environmental isotopes with Contaminants of Emerging Concern (CECs) to characterise wastewater derived impacts on groundwater quality. WATER RESEARCH 2020; 182:116036. [PMID: 32645458 DOI: 10.1016/j.watres.2020.116036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/06/2020] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Abstract
The potential for Wastewater Treatment Plants (WWTPs) to cause adverse impacts to groundwater quality is a major global environmental challenge. Robust and sensitive techniques are required to characterise these impacts, particularly in settings with multiple potential contaminant sources (e.g. agricultural vs. site-derived). Stable (δ2HH2O, δ18OH2O, δ15NNO3, δ18ONO3 and δ13CDIC) and radioactive (3H and 14C) isotopes were used in conjunction with three Contaminants of Emerging Concern (CECs) - carbamazepine, simazine and sulfamethoxazole - to discriminate between multiple potential contamination sources at an Australian WWTP. The radioactive isotope tritium provided a sensitive indicator of recent (post-1990s) leakage, with groundwater activities between 0.68 and 1.83 TU, suggesting WWTP infrastructure (activities between 1.65 and 2.41) acted as a recharge 'window', inputting treated or partially treated effluent to the underlying groundwater system. This was corroborated by water stable isotopes, which showed clear demarcation between δ18OH2O and δ2HH2O in background groundwater (δ18OH2O and δ2HH2O values of approximately -5 and -28‰, respectively) and those associated with on-site wastewater (median δ18OH2O and δ2HH2O values of -1.2 and -7.6‰, respectively), with groundwater down-gradient of the plant plotting on a mixing line between these values. The CECs, particularly the carbamazepine:simazine ratio, provided a means to further distinguish wastewater impacts from other sources, with groundwater down-gradient of the plant reporting elevated ratios (median of 0.98) compared to those up-gradient (median of 0.11). Distinctive CEC ratios in impacted groundwater close to the WWTP (∼3.0) and further down-gradient (2.7-9.3) are interpreted to represent a change in composition over time (i.e., recent vs. legacy contamination), consistent with the site development timeline and possible changes in effluent composition resulting from infrastructure upgrades over time. The data indicate a complex set of co-mingled plumes, reflecting different inputs (in terms of both quantity and concentration) over time. Our approach provides a means to better characterise the nature and timing of wastewater derived impacts on groundwater systems, with significant global implications for site management, potentially allowing more targeted monitoring, management and remedial actions to be undertaken.
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Lambert NJ, Esmail AA, Edwards M, Ferguson AJ, Schwefel HGL. Random telegraph signal analysis with a recurrent neural network. Phys Rev E 2020; 102:012312. [PMID: 32794998 DOI: 10.1103/physreve.102.012312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/30/2020] [Indexed: 11/07/2022]
Abstract
We use an artificial neural network to analyze asymmetric noisy random telegraph signals, and extract underlying transition rates. We demonstrate that a long short-term memory neural network can outperform other methods, particularly for noisy signals and measurements with limited bandwidths. Our technique gives reliable results as the signal-to-noise ratio approaches one, and over a wide range of underlying transition rates. We apply our method to random telegraph signals generated by quasiparticle poisoning in a superconducting double dot, allowing us to extend our measurement of quasiparticle dynamics to new temperature regimes.
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Gao W, Edwards M, Thompson B, McDonald J, Harris-Tryon T. 752 Diet and the dermal white adipose tissue: Analyzing shifts in the cutaneous lipid landscape in response to dietary change. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Khumsa-Ang K, Edwards M, Rousseau S. General Corrosion of Chromium-Coated Zirconium- and Titanium-Based Alloys in Supercritical Water at 500 °C. JOURNAL OF NUCLEAR ENGINEERING AND RADIATION SCIENCE 2020. [DOI: 10.1115/1.4045387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Abstract
The 300 MWel small Canadian supercritical water-cooled reactor (SCWR), which is a scaled-down version of the original 1200 MWel concept, has a smaller core, uses low enriched uranium fuel instead of a plutonium–thorium fuel, and features a lower (maximum) cladding temperature of 500 °C. The lower cladding temperature may permit the use of different alloys, including zirconium alloys, which had been ruled out as candidates for the Canadian SCWR, whose cladding temperature may reach 850 °C. The potential to use zirconium alloys is exciting because they have a low neutron cross section, which in turn means that fewer neutrons are lost, and the fuel can be used more efficiently. One advantage, for example,, is that the fuel cycle can be lengthened. In this paper, we report on the results of corrosion experiments used to screen zirconium- and titanium-based alloys as well as corrosion-resistant coating materials such as Cr and Al as potential candidates for fuel cladding in the small Canadian SCWR. These experiments were conducted in a refreshed autoclave in deaerated supercritical water at 500 °C and 23.5 MPa. After exposure, the weight gain was measured, and the oxide thickness and the oxide phases were examined. Of all materials, the coated and uncoated Ti-grade 2 and Ti-grade 5 alloys met our screening qualification criteria, however, Al/Cr-coated zirconium coupons showed notable improvement and will be explored further in future testing.
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Brouwers L, de Jongh MAC, de Munter L, Edwards M, Lansink KWW. Prognostic factors and quality of life after pelvic fractures. The Brabant Injury Outcome Surveillance (BIOS) study. PLoS One 2020; 15:e0233690. [PMID: 32525901 PMCID: PMC7289384 DOI: 10.1371/journal.pone.0233690] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/10/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction Pelvic fractures can have long-term consequences for health-related quality of life (HRQoL). The main purpose of this study is to provide insight into short-term HRQoL in the first year after pelvic injury and to identify short-term prognostic factors of decreased outcome. Methods This is a prospective, observational, multicenter, follow-up cohort study in which HRQoL and functional outcomes were assessed during 12-month follow-up of injured adult patients admitted to 1 of 10 hospitals in the county of Noord-Brabant, the Netherlands. The data were collected by self-reported questionnaires at 1 week (including preinjury assessment) and 1, 3, 6 and 12 months after injury. The EuroQoL-5D (EQ-5D), visual analog scale (VAS), Merle d’Aubigné Hip Score (MAHS) and Majeed Pelvic Score (MPS) were used. Multivariable mixed models were used to examine the course of the HRQoL and the prognostic factors for decreased HRQoL and functional outcomes over time. Results A total of 184 patients with pelvic fractures were identified between September 2015–September 2016; the fractures included 71 Tile A, 44 Tile B and 10 Tile C fractures and 59 acetabular fractures. At the pre-injury, 1 week, and 1, 3, 6 and 12 months after injury time points, the mean EQ-5D Index values were 0.90, 0.26, 0.45, 0.66, 0.77 and 0.80, respectively, and the mean EQ-VAS values were 83, 45, 57, 69, 75 and 75, respectively. At 6 and 12 months after injury, 22 and 25% of the MPS < 65 year group, 38 and 47% of the MPS ≥ 65 year group and 34 and 51% of the MAHS group, respectively, reached the maximum score. Pre-injury score, female gender and high Injury Severity Score (ISS) were important prognostic factors for a decreased HRQoL, and the EQ-5D VAS β = 0.43 (95% CI: 0.31 − 0.57), -6.66 (95% CI: -10.90 − -0.43) and -7.09 (95% CI: -6.11 − -5.67), respectively. Discussion Patients with pelvic fractures experience a reduction in their HRQoL. Most patients do not achieve the HRQoL of their pre-injury state within 1 year after trauma. Prognostic factors for decreased HRQoL are a low pre-injury score, high ISS and female gender. We do not recommend using the MAHS and MPS in mid- or long-term follow-up of pelvic fractures because of ceiling effects. Trial registration number NCT02508675.
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LaFaver K, Lang AE, Stone J, Morgante F, Edwards M, Lidstone S, Maurer CW, Hallett M, Dwivedi AK, Espay AJ. Opinions and clinical practices related to diagnosing and managing functional (psychogenic) movement disorders: changes in the last decade. Eur J Neurol 2020; 27:975-984. [DOI: 10.1111/ene.14200] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/03/2020] [Indexed: 11/30/2022]
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Woollard DC, Indyk HE, Angyal G, Borbon J, Chase W, Coors U, Davis P, Edwards M, Ellis C, Gore W, Gossard J, Hischenhuber C, Jagodic M, Kerr M, Kmec D, McMahow A, Myers M, Rajamohan R, Saito K, Sullivan D, Tsalkani N, Walker E, Welton K, Wo C, Zaugg S. Taurine Analysis in Milk and Infant Formulae by Liquid Chromatography: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.4.860] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A collaborative study was conducted on a liquid chromatographic (LC) method for determination of taurine in infant formula and milk powders. Twenty laboratories participated in the analysis of 8 blind duplicates over the range of approximately 3–60 mg/100 g sample. The method involved protein removal, conversion to the dansyl-derivative, and isocratic LC separation with UV and/or fluorescence detection. Following outlier treatment, overall mean RSDR has been estimated at 7.00% for sup. plemented products with a HORRAT value of 1.1. The poorer precision at endogenous levels establishes a lower limit of determination of about 5 mg/100 g. An overall mean RSDr:RSDR value of 0.7 for all products demonstrated acceptable performance.
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Nelson-Sice R, Edwards M, Yogarajah M. A cross-sectional evaluation of health resource use in patients with functional neurological disorders referred to both a tertiary neurology centre and a neuropsychiatry clinic. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mandal A, Nastase A, Lu S, Gennatas S, Anbunathan H, Edwards M, Morris-Rosendahl D, Taylor AN, Rintoul R, Lim E, Popat S, Nicholson A, Bowcock A, Lathrop M, Moffatt M, Cookson W. MA23.11 Analysis of Immune Phenotype Composition in Malignant Pleural Mesothelioma (MPM) Using Bulk RNA Sequencing. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Nastase A, Mandal A, Lu S, Gennatas S, Anbunathan H, Edwards M, Morris-Rosendahl D, Taylor AN, Rintoul R, Lim E, Popat S, Nicholson A, Lathrop M, Bowcock A, Moffatt M, Cookson W. MA23.10 Low Number of Mutations and Frequent Co-Deletions of CDKN2A and IFN Type I Characterize Malignant Pleural Mesothelioma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lu W, Wang Y, Zhang Q, Owen S, Green M, Ni T, Edwards M, Li Y, Zhang L, Harris A, Li JL, Jackson DG, Jiang S. TNF-derived peptides inhibit tumour growth and metastasis through cytolytic effects on tumour lymphatics. Clin Exp Immunol 2019; 198:198-211. [PMID: 31206614 DOI: 10.1111/cei.13340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2019] [Indexed: 01/08/2023] Open
Abstract
Tumour necrosis factor (TNF) is a multi-functional cytokine with profound and diverse effects on physiology and pathology. Identifying the molecular determinants underlying the functions and pathogenic effects of TNF is key to understanding its mechanisms of action and identifying new therapeutic opportunities based on this important molecule. Previously, we showed that some evolutionarily conserved peptides derived from TNF could induce cell death (e.g. apoptosis and/or necrosis), a feature of immune defence mechanisms shared by many vertebrates. In this study, we demonstrated that necrosis-inducing peptide P16 kills human glioblastoma cancer cells and primary human hepatoma or renal cancer cells isolated from patients who had not responded to standard treatments. Importantly, we show that the necrosis-inducing peptide P1516 significantly improves survival by inhibiting tumour metastasis in a 4T1 breast cancer syngeneic graft mouse model. Because the lymphatic system is an important metastatic route in many cancers, we also tested the effect of TNF-derived peptides on monolayers of primary human lymphatic endothelial cells (hDLEC) and found that they increased junctional permeability by inducing cytoskeletal reorganization, gap junction formation and cell death. Transmission electron microscopy imaging evidence, structural analysis and in-vitro liposome leakage experiments strongly suggest that this killing is due to the cytolytic nature of these peptides. P1516 provides another example of a pro-cytotoxic TNF peptide that probably functions as a cryptic necrotic factor released by TNF degradation. Its ability to inhibit tumour metastasis and improve survival may form the basis of a novel approach to cancer therapy.
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Durno C, Aronson M, Edwards M, Boufett E, Tabori U. A275 COMPREHENSIVE GENOMIC ANALYSIS RESULT IN EARLY DETECTION AND IMPLEMENTATION OF IMMUNE CHECK POINT THERAPY TO IMPROVE SURVIVAL FOR PATIENTS WITH INHERITED REPLICATION REPAIR DEFICIENCY GASTROINTESTINAL CANCERS:REPORT FROM THE INTERNATIONAL REPLICATION REPAIR CONSORTIUM. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Galuppini F, Opocher E, Tabori U, Mammi I, Edwards M, Campbell B, Kelly J, Viel A, Quaia M, Rivieri F, D'Avella D, Arcella A, Giangaspero F, Fassan M, Gardiman MP. Concomitant IDH wild-type glioblastoma and IDH1-mutant anaplastic astrocytoma in a patient with constitutional mismatch repair deficiency syndrome. Neuropathol Appl Neurobiol 2019; 44:233-239. [PMID: 29130549 DOI: 10.1111/nan.12450] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 11/02/2017] [Indexed: 02/01/2023]
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Grocott MPW, Edwards M, Mythen MG, Aronson S. Peri-operative care pathways: re-engineering care to achieve the ‘triple aim’. Anaesthesia 2019; 74 Suppl 1:90-99. [DOI: 10.1111/anae.14513] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2018] [Indexed: 12/11/2022]
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McCance W, Jones OAH, Edwards M, Surapaneni A, Chadalavada S, Currell M. Contaminants of Emerging Concern as novel groundwater tracers for delineating wastewater impacts in urban and peri-urban areas. WATER RESEARCH 2018; 146:118-133. [PMID: 30241045 DOI: 10.1016/j.watres.2018.09.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/16/2018] [Accepted: 09/04/2018] [Indexed: 05/25/2023]
Abstract
Management and treatment of environmental impacts from wastewater treatment plants (WWTPs) is a major, worldwide, sustainability challenge. One issue associated with WWTP operation is the potential for groundwater contamination via leaking or infiltration of wastewater, particularly with inorganic nutrients (ammonia and nitrate) as well as persistent organic compounds. Despite the potential for such contamination to create environmental and health risks, conventional methods, such as the assessment of major ions, nutrients, bacteriological indicators and conventional tracers (such as stable and radiogenic isotopes) are often unable to provide accurate delineation of multiple potential sources of contamination. This is particularly important for WWTPs which often occur in urban, peri-urban or intensively farmed agricultural areas where multiple potential sources (such as livestock, fertilisers, wastewater irrigation, and domestic septic systems) may contribute similar contaminants. This review explores the applicability of promising novel groundwater tracers, such as Contaminants of Emerging Concern (CECs) and isotopic tracers, which can be used in conjunction with conventional tracers (i.e. 'co-tracers') to provide a more definitive assessment of contaminant sources, plume delineation and even (potentially) indicating the age of contamination (e.g., recent vs. legacy). The suitability of the novel groundwater tracers is evaluated according to four key criteria: (i). sufficient presence in raw wastewater and/or treated effluents; (ii) diagnostic of WWTP impacts as opposed to other potential off-site contamination sources; (iii) persistence in the subsurface environment; and (iv) amenable to rapid and sensitive analysis. Further analysis of various classes of CECs along with improved detection limits associated with improvements in analytical methodologies should allow for future application of promising groundwater tracers, providing WWTP operators and regulatory authorities a more definitive toolbox with which to assess groundwater contamination associated with site operations. These include: persistent pharmaceuticals and personal care products (carbamazepine, crotamiton, primidone, atenolol and sulfamethoxazole), artificial sweeteners (acesulfame, sucralose, saccharin and cyclamate) and potentially, certain pesticides (atrazine and simazine).
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Šantrić Milicević M, Vasić M, Edwards M, Sanchez C, Fellows J. Strengthening public health institutes: an assessment of workforce requirements in Serbia. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky218.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Pompili C, Edwards M, Hasegawa S, Yoshino I, Chida M, Novoa N, Brunelli A, Bhandari P, Naunheim K, Backhus L. P2.15-21 Post Resection Lung Cancer Surveillance: Comparisons of Practice Between STS, ESTS and JACS Members. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Paccou J, D'Angelo S, Rhodes A, Curtis EM, Raisi-Estabragh Z, Edwards M, Walker-Bone K, Cooper C, Petersen SE, Harvey NC. Prior fragility fracture and risk of incident ischaemic cardiovascular events: results from UK Biobank. Osteoporos Int 2018; 29:1321-1328. [PMID: 29479646 PMCID: PMC6015763 DOI: 10.1007/s00198-018-4426-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 02/06/2018] [Indexed: 11/25/2022]
Abstract
In the large UK Biobank population-based cohort, we found that amongst men, but not women, prior fragility fracture was associated with increased risk of admission with ischaemic heart disease. INTRODUCTION We aimed to investigate the relationship between prior fracture and risk of incident ischaemic cardiovascular events in a UK population-based cohort. METHODS UK Biobank is a large prospective cohort comprising 502,637 men and women aged 40-69 years, with detailed baseline assessment. History of fracture was self-reported, and details of hospital admissions for ischaemic heart disease (IHD) (ICD-10:I20-I25) were obtained through linkage to UK Hospital Episode Statistics. Cox proportional hazards models were used to investigate the prospective relationships between prior fracture and hospital admission for men and women, controlling for age, BMI, smoking, alcohol, educational level, physical activity, systolic blood pressure, calcium and vitamin D use, ankle spacing-width, heel BUA and HRT use (women). RESULTS Amongst men, a fragility fracture (hip, spine, wrist or arm fracture resulting from a simple fall) within the previous 5 years was associated with a 35% increased risk of IHD admission (fully adjusted HR 1.35; 95%CI 1.00, 1.82; p = 0.047), with the relationship predominantly driven by wrist fractures. Associations with hospitalisation for angina in men were similar in age-adjusted models [HR1.54; 95%CI: 1.03, 2.30), p = 0.037], but did not remain statistical significant after full adjustment [HR 1.64; 95%CI: 0.88, 3.07); p = 0.121]. HRs for admission with angina were lower in women, and neither age- nor fully adjusted relationships attained statistical significance. CONCLUSIONS Prior fragility fracture is an independent risk factor for incident ischaemic cardiovascular events in men. Further work may clarify whether this association is causal or represents shared risk factors, but these findings are likely to be of value in risk assessment of both osteoporosis and cardiovascular disease.
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Beudel M, Zutt R, Meppelink AM, Little S, Elting JW, Stelten BML, Edwards M, Tijssen MAJ. Improving neurophysiological biomarkers for functional myoclonic movements. Parkinsonism Relat Disord 2018; 51:3-8. [PMID: 29653908 PMCID: PMC6022215 DOI: 10.1016/j.parkreldis.2018.03.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 03/08/2018] [Accepted: 03/28/2018] [Indexed: 11/29/2022]
Abstract
Introduction Differentiating between functional jerks (FJ) and organic myoclonus can be challenging. At present, the only advanced diagnostic biomarker to support FJ is the Bereitschaftspotential (BP). However, its sensitivity is limited and its evaluation subjective. Recently, event related desynchronisation in the broad beta range (13–45 Hz) prior to functional generalised axial (propriospinal) myoclonus was reported as a possible complementary diagnostic marker for FJ. Here we study the value of ERD together with a quantified BP in clinical practice. Methods Twenty-nine patients with FJ and 16 patients with cortical myoclonus (CM) were included. Jerk-locked back-averaging for determination of the ‘classical’ and quantified BP, and time-frequency decomposition for the event related desynchronisation (ERD) were performed. Diagnostic gain, sensitivity and specificity were obtained for individual and combined techniques. Results We detected a classical BP in 14/29, a quantitative BP in 15/29 and an ERD in 18/29 patients. At group level we demonstrate that ERD in the broad beta band preceding a jerk has significantly higher amplitude in FJ compared to CM (respectively −0.14 ± 0.13 and +0.04 ± 0.09 (p < 0.001)). Adding ERD to the classical BP achieved an additional diagnostic gain of 53%. Furthermore, when combining ERD with quantified and classical BP, an additional diagnostic gain of 71% was achieved without loss of specificity. Conclusion Based on the current findings we propose to the use of combined beta ERD assessment and quantitative BP analyses in patients with a clinical suspicion for all types of FJ with a negative classical BP. Differentiating between functional jerks and organic myoclonus is often difficult. The sensitivity of a positive bereitschaftspotential for diagnosing FJ is low. FJ are preceded by event related desynchronisation (ERD) in the beta band. Combining beta ERD and BP improves diagnosing FJ. The ERD method is of special relevance in possible FJ patients with a negative BP.
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Backhus L, Bhandari P, Pompili C, Brunelli A, Novoa N, Naunheim K, Edwards M. OA 04.06 Surgeon Practices for Post Resection Lung Cancer Surveillance: Comparisons of STS and ESTS Members. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Wong L, Kontogeorgis A, Brett L, Edwards M, Wilkinson S, Ware J, Morris-Rosendahl D, Homfray T, Till J. 61Prevalence and spectrum of genetic variants in a single-centre cohort of Brugada syndrome. Europace 2017. [DOI: 10.1093/europace/eux283.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Chua I, Edwards M, Liu J, Out MS, Spellenberg M, O’Donnell J. P30: CLINICAL VALIDATION OF A COMPONENT-BASED MULTI-PARAMETER LINE BLOT TEST FOR PEANUT ALLERGY. Intern Med J 2017. [DOI: 10.1111/imj.30_13578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Woodcock BA, Bullock JM, Shore RF, Heard MS, Pereira MG, Redhead J, Ridding L, Dean H, Sleep D, Henrys P, Peyton J, Hulmes S, Hulmes L, Sárospataki M, Saure C, Edwards M, Genersch E, Knäbe S, Pywell RF. Country-specific effects of neonicotinoid pesticides on honey bees and wild bees. Science 2017; 356:1393-1395. [DOI: 10.1126/science.aaa1190] [Citation(s) in RCA: 409] [Impact Index Per Article: 58.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 05/22/2017] [Indexed: 11/02/2022]
Abstract
Neonicotinoid seed dressings have caused concern world-wide. We use large field experiments to assess the effects of neonicotinoid-treated crops on three bee species across three countries (Hungary, Germany, and the United Kingdom). Winter-sown oilseed rape was grown commercially with either seed coatings containing neonicotinoids (clothianidin or thiamethoxam) or no seed treatment (control). For honey bees, we found both negative (Hungary and United Kingdom) and positive (Germany) effects during crop flowering. In Hungary, negative effects on honey bees (associated with clothianidin) persisted over winter and resulted in smaller colonies in the following spring (24% declines). In wild bees (Bombus terrestris and Osmia bicornis), reproduction was negatively correlated with neonicotinoid residues. These findings point to neonicotinoids causing a reduced capacity of bee species to establish new populations in the year following exposure.
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Nguyen L, Whitehall J, Edwards M. Accuracy of clinical coding for febrile seizures and implications for activity-based funding. Intern Med J 2017. [DOI: 10.1111/imj.11_13462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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