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Nicholson-Roberts T, Fletcher T, Rees P, Dickson S, Hinsley D, Bailey M, Lamb L, Ardley C. Ebola virus disease managed with blood product replacement and point of care tests in Sierra Leone. QJM 2015; 108:571-2. [PMID: 25956391 DOI: 10.1093/qjmed/hcv092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rees P, Ardley C, Lamb L, Fletcher T, Bailey M, Dickson S, Nicholson-Roberts T, Hinsley D, Sam H. 132 Targeted Resuscitation Using Echocardiography in a Military Ebola Virus Disease Treatment Unit. Heart 2015. [DOI: 10.1136/heartjnl-2015-308066.132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Lamba M, Wang R, Fletcher T, Alvey C, Kushner J, Stock T. THU0188 Evaluation of Single-dose and Steady-State Pharmacokinetics, Bioavailability and Tolerability of the Modified Release Formulation of Tofacitinib vs the Immediate Release Formulation of Tofacitinib in Healthy Volunteers. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Fowler RA, Fletcher T, Fischer WA, Lamontagne F, Jacob S, Brett-Major D, Lawler JV, Jacquerioz FA, Houlihan C, O'Dempsey T, Ferri M, Adachi T, Lamah MC, Bah EI, Mayet T, Schieffelin J, McLellan SL, Senga M, Kato Y, Clement C, Mardel S, Vallenas Bejar De Villar RC, Shindo N, Bausch D. Caring for critically ill patients with ebola virus disease. Perspectives from West Africa. Am J Respir Crit Care Med 2015; 190:733-7. [PMID: 25166884 DOI: 10.1164/rccm.201408-1514cp] [Citation(s) in RCA: 164] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
The largest ever Ebola virus disease outbreak is ravaging West Africa. The constellation of little public health infrastructure, low levels of health literacy, limited acute care and infection prevention and control resources, densely populated areas, and a highly transmissible and lethal viral infection have led to thousands of confirmed, probable, or suspected cases thus far. Ebola virus disease is characterized by a febrile severe illness with profound gastrointestinal manifestations and is complicated by intravascular volume depletion, shock, profound electrolyte abnormalities, and organ dysfunction. Despite no proven Ebola virus-specific medical therapies, the potential effect of supportive care is great for a condition with high baseline mortality and one usually occurring in resource-constrained settings. With more personnel, basic monitoring, and supportive treatment, many of the sickest patients with Ebola virus disease do not need to die. Ebola virus disease represents an illness ready for a paradigm shift in care delivery and outcomes, and the profession of critical care medicine can and should be instrumental in helping this happen.
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Abstract
From their earliest origins, fishes have developed a suite of adaptations for locomotion in water, which determine performance and ultimately fitness. Even without data from behaviour, soft tissue and extant relatives, it is possible to infer a wealth of palaeobiological and palaeoecological information. As in extant species, aspects of gross morphology such as streamlining, fin position and tail type are optimized even in the earliest fishes, indicating similar life strategies have been present throughout their evolutionary history. As hydrodynamical studies become more sophisticated, increasingly complex fluid movement can be modelled, including vortex formation and boundary layer control. Drag-reducing riblets ornamenting the scales of fast-moving sharks have been subjected to particularly intense research, but this has not been extended to extinct forms. Riblets are a convergent adaptation seen in many Palaeozoic fishes, and probably served a similar hydrodynamic purpose. Conversely, structures which appear to increase skin friction may act as turbulisors, reducing overall drag while serving a protective function. Here, we examine the diverse adaptions that contribute to drag reduction in modern fishes and review the few attempts to elucidate the hydrodynamics of extinct forms.
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Lamontagne F, Clément C, Fletcher T, Jacob ST, Fischer WA, Fowler RA. Doing today's work superbly well--treating Ebola with current tools. N Engl J Med 2014; 371:1565-6. [PMID: 25251518 DOI: 10.1056/nejmp1411310] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Marchand L, Nsanganwimana F, Lamy JB, Quintela-Sabaris C, Gonnelli C, Colzi I, Fletcher T, Oustrière N, Kolbas A, Kidd P, Bordas F, Newell P, Alvarenga P, Deletic A, Mench M. Root biomass production in populations of six rooted macrophytes in response to Cu exposure: intra-specific variability versus constitutive-like tolerance. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2014; 193:205-215. [PMID: 25058419 DOI: 10.1016/j.envpol.2014.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 05/18/2014] [Accepted: 07/01/2014] [Indexed: 06/03/2023]
Abstract
Intra-specific variability of root biomass production (RP) of six rooted macrophytes, i.e. Juncus effusus, Phragmites australis, Schoenoplectus lacustris, Typha latifolia, Phalaris arundinacea, and Iris pseudacorus grown from clones, in response to Cu exposure was investigated. Root biomass production varied widely for all these macrophytes in control conditions (0.08 μM) according to the sampling site. Root biomass production of T. latifolia and I. pseudacorus in the 2.5-25 μM Cu range depended on the sampling location but not on the Cu dose in the growth medium. For P. australis, J. effusus, S. lacustris, and P. arundinacea, an intra-specific variability of RP depending on both the sampling location and the Cu-dose was evidenced. This intra-specific variability of RP depending on the sampling location and of Cu-tolerance for these last four species suggests that Cu constitutive tolerance for all rooted macrophytes is not a species-wide trait but it exhibits variability for some species.
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Wang TF, Fiala MA, Cashen AF, Uy GL, Abboud CN, Fletcher T, Wu N, Westervelt P, DiPersio JF, Stockerl-Goldstein KE, Vij R. A phase II study of V-BEAM as conditioning regimen before second auto-SCT for multiple myeloma. Bone Marrow Transplant 2014; 49:1366-70. [DOI: 10.1038/bmt.2014.163] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 06/11/2014] [Accepted: 06/13/2014] [Indexed: 11/09/2022]
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Lamba M, Wang R, Fletcher T, Alvey C, Hazra A, Kushner J, Larmann J, Stock T. THU0143 Pharmacokinetics, Bioavailability and Safety of A Modified Release Once Daily Formulation of Tofacitinib in Healthy Volunteers. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Rees PSC, Ardley C, Bailey M, Dickson S, Fletcher T, Hinsley D, Lamb L, Nicholson-Roberts T. Op GRITROCK: the Royal Navy supports defence efforts to tackle Ebola. JOURNAL OF THE ROYAL NAVAL MEDICAL SERVICE 2014; 100:228-230. [PMID: 25895398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Galovski TE, Blain LM, Chappuis C, Fletcher T. Sex differences in recovery from PTSD in male and female interpersonal assault survivors. Behav Res Ther 2013; 51:247-55. [PMID: 23510841 DOI: 10.1016/j.brat.2013.02.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 12/19/2012] [Accepted: 02/06/2013] [Indexed: 10/27/2022]
Abstract
Men and women differ in exposure to trauma and the development of posttraumatic stress disorder (PTSD); however, research regarding sex differences in recovery from PTSD has been sparse. This study evaluated the treatment response trajectory for 69 male and female interpersonal assault survivors, using a modified Cognitive Processing Therapy (CPT) protocol that allowed survivors to receive up to18 sessions of CPT, with treatment end determined by therapy progress. Few sex differences were observed in trauma history, baseline PTSD and depressive severity, Axis I comorbidity, anger, guilt and dissociation. Women did report more sexual assault in adulthood and elevated baseline guilt cognitions, whereas men reported more baseline anger directed inward. Attrition and total number of sessions did not differ by sex. Over the course of treatment and follow-up, men and women demonstrated similar rates of change in PTSD and depressive symptoms. However, medium effect sizes on both of these primary outcomes at the 3-month follow-up assessment favored women. Several differences in the slope of change emerged on secondary outcomes such that women evidenced more rapid gains on global guilt, guilt cognitions, anger/irritability, and dissociation. Results suggest that male survivors may warrant additional attention to address these important clinical correlates.
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Forslund A, Ensink JHJ, Markussen B, Battilani A, Psarras G, Gola S, Sandei L, Fletcher T, Dalsgaard A. Escherichia coli contamination and health aspects of soil and tomatoes (Solanum lycopersicum L.) subsurface drip irrigated with on-site treated domestic wastewater. WATER RESEARCH 2012; 46:5917-5934. [PMID: 22944202 DOI: 10.1016/j.watres.2012.08.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Revised: 03/06/2012] [Accepted: 08/09/2012] [Indexed: 06/01/2023]
Abstract
Faecal contamination of soil and tomatoes irrigated by sprinkler as well as surface and subsurface drip irrigation with treated domestic wastewater were compared in 2007 and 2008 at experimental sites in Crete and Italy. Wastewater was treated by Membrane Bio Reactor (MBR) technology, gravel filtration or UV-treatment before used for irrigation. Irrigation water, soil and tomato samples were collected during two cropping seasons and enumerated for the faecal indicator bacterium Escherichia coli and helminth eggs. The study found elevated levels of E. coli in irrigation water (mean: Italy 1753 cell forming unit (cfu) per 100 ml and Crete 488 cfu per 100 ml) and low concentrations of E. coli in soil (mean: Italy 95 cfu g(-1) and Crete 33 cfu g(-1)). Only two out of 84 tomato samples in Crete contained E. coli (mean: 2700 cfu g(-1)) while tomatoes from Italy were free of E. coli. No helminth eggs were found in the irrigation water or on the tomatoes from Crete. Two tomato samples out of 36 from Italy were contaminated by helminth eggs (mean: 0.18 eggs g(-1)) and had been irrigated with treated wastewater and tap water, respectively. Pulsed Field Gel Electrophoresis DNA fingerprints of E. coli collected during 2008 showed no identical pattern between water and soil isolates which indicates contribution from other environmental sources with E. coli, e.g. wildlife. A quantitative microbial risk assessment (QMRA) model with Monte Carlo simulations adopted by the World Health Organization (WHO) found the use of tap water and treated wastewater to be associated with risks that exceed permissible limits as proposed by the WHO (1.0 × 10(-3) disease risk per person per year) for the accidental ingestion of irrigated soil by farmers (Crete: 0.67 pppy and Italy: 1.0 pppy). The QMRA found that the consumption of tomatoes in Italy was deemed to be safe while permissible limits were exceeded in Crete (1.0 pppy). Overall the quality of tomatoes was safe for human consumption since the disease risk found on Crete was based on only two contaminated tomato samples. It is a fundamental limitation of the WHO QMRA model that it is not based on actual pathogen numbers, but rather on numbers of E. coli converted to estimated pathogen numbers, since it is widely accepted that there is poor correlation between E. coli and viral and parasite pathogens. Our findings also stress the importance of the external environment, typically wildlife, as sources of faecal contamination.
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Gilbert RS, Nagano Y, Yokota T, Hwan SF, Fletcher T, Lydersen K. Effect of lipids on insect cell growth and expression of recombinant proteins in serum-free medium. Cytotechnology 2012; 22:211-6. [PMID: 22358931 DOI: 10.1007/bf00353941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
The lipid emulsion components of a serum-free insect cell medium were varied and evaluated for effects on cell growth and recombinant protein expression. The growth of High-Five(TM) cells was significantly affected by polyol Pluronic F-68 and Tween-80, but not by lipids. Pluronic was essential for cell growth, while Tween-80 was required to achieve maximum cell densities. A dose response effect was observed for Tween-80 with optimal cell growth at a concentration of 25 mg/l. Cholesterol had a minor effect on cell growth, but was essential for the expression of recombinant proteins. The expression of β-galactosidase (β-gal) was directly affected by cholesterol with optimal expression at a concentration of 5.4 mg/l. Vitamin E, important as an antioxidant to stabilize lipids, did not directly affect recombinant protein expression. Although lipids were not required for cell growth, the presence of lipids were required during the cell growth phase in order to achieve efficient infection with baculovirus. These studies help to define the important components, and range of concentrations, for lipid emulsions which can effectively replace serum in insect cell culture.
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Fletcher T. Born to be wild? Lancet 2012; 379:395. [PMID: 22305213 DOI: 10.1016/s0140-6736(12)60167-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fremlin G, Baker R, Walters G, Fletcher T. P34 Are nursing staff sufficiently educated and competent in managing patients with a chest drain? Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054c.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Liu Z, Wang Y, Gerig G, Gouttard S, Tao R, Fletcher T, Styner M. Quality Control of Diffusion Weighted Images. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2010; 7628. [PMID: 24353379 DOI: 10.1117/12.844748] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Diffusion Tensor Imaging (DTI) has become an important MRI procedure to investigate the integrity of white matter in brain in vivo. DTI is estimated from a series of acquired Diffusion Weighted Imaging (DWI) volumes. DWI data suffers from inherent low SNR, overall long scanning time of multiple directional encoding with correspondingly large risk to encounter several kinds of artifacts. These artifacts can be too severe for a correct and stable estimation of the diffusion tensor. Thus, a quality control (QC) procedure is absolutely necessary for DTI studies. Currently, routine DTI QC procedures are conducted manually by visually checking the DWI data set in a gradient by gradient and slice by slice way. The results often suffer from low consistence across different data sets, lack of agreement of different experts, and difficulty to judge motion artifacts by qualitative inspection. Additionally considerable manpower is needed for this step due to the large number of images to QC, which is common for group comparison and longitudinal studies, especially with increasing number of diffusion gradient directions. We present a framework for automatic DWI QC. We developed a tool called DTIPrep which pipelines the QC steps with a detailed protocoling and reporting facility. And it is fully open source. This framework/tool has been successfully applied to several DTI studies with several hundred DWIs in our lab as well as collaborating labs in Utah and Iowa. In our studies, the tool provides a crucial piece for robust DTI analysis in brain white matter study.
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Moshammer H, Fletcher T, Heinrich J, Hoek G, Hruba F, Pattenden S, Rudnai P, Slachtova H, Speizer FE, Zlotkowska R, Neuberger M. Gas cooking is associated with small reductions in lung function in children. Eur Respir J 2009; 36:249-54. [DOI: 10.1183/09031936.00102409] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Cleall P, Jones M, Thomas HR, Kapelan Z, Dorini G, Hutchings T, Sinnett D, Swithenbank J, Sharifi V, Fletcher T, Chalabi Z, Vardoulakis S, Tiwary A, Azapagic A. Development of a Software Based Decision Support Platform for Assessing the Impacts of Urban Pollutants. Epidemiology 2009. [DOI: 10.1097/01.ede.0000362772.14787.2f] [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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Carpenter LM, Venables KM, Linsell L, Brooks C, Keegan TJ, Langdon T, Doyle P, Maconochie NES, Fletcher T, Nieuwenhuijsen MJ, Beral V. Mortality and cancer morbidity in a cohort of British military veterans included in chemical warfare agent experiments at Porton Down. Br J Soc Med 2009. [DOI: 10.1136/jech.2009.096719u] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Olsson AC, Fevotte J, Fletcher T, Cassidy A, 't Mannetje A, Zaridze D, Szeszenia-Dabrowska N, Rudnai P, Lissowska J, Fabianova E, Mates D, Bencko V, Foretova L, Janout V, Brennan P, Boffetta P. Occupational exposure to polycyclic aromatic hydrocarbons and lung cancer risk: a multicenter study in Europe. Occup Environ Med 2009; 67:98-103. [DOI: 10.1136/oem.2009.046680] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Carpenter LM, Linsell L, Brooks C, Keegan TJ, Langdon T, Doyle P, Maconochie NES, Fletcher T, Nieuwenhuijsen MJ, Beral V, Venables KM. Cancer morbidity in British military veterans included in chemical warfare agent experiments at Porton Down: cohort study. BMJ 2009; 338:b655. [PMID: 19318700 PMCID: PMC4984479 DOI: 10.1136/bmj.b655] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To determine cancer morbidity in members of the armed forces who took part in tests of chemical warfare agents from 1941 to 1989. DESIGN Historical cohort study, with cohort members followed up to December 2004. DATA SOURCE Archive of UK government research facility at Porton Down, UK military personnel records, and national death and cancer records. PARTICIPANTS All veterans included in the cohort study of mortality, excluding those known to have died or been lost to follow-up before 1 January 1971 when the UK cancer registration system commenced: 17,013 male members of the UK armed forces who took part in tests (Porton Down veterans) and a similar group of 16,520 men who did not (non-Porton Down veterans). MAIN OUTCOME MEASURES Cancer morbidity in each group of veterans; rate ratios, with 95% confidence intervals, adjusted for age group and calendar period. RESULTS 3457 cancers were reported in the Porton Down veterans compared with 3380 cancers in the non-Porton Down veterans. While overall cancer morbidity was the same in both groups (rate ratio 1.00, 95% confidence interval 0.95 to 1.05), Porton Down veterans had higher rates of ill defined malignant neoplasms (1.12, 1.02 to 1.22), in situ neoplasms (1.45, 1.06 to 2.00), and those of uncertain or unknown behaviour (1.32, 1.01 to 1.73). CONCLUSION Overall cancer morbidity in Porton Down veterans was no different from that in non-Porton Down veterans.
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Venables KM, Brooks C, Linsell L, Keegan TJ, Langdon T, Fletcher T, Nieuwenhuijsen MJ, Maconochie NES, Doyle P, Beral V, Carpenter LM. Mortality in British military participants in human experimental research into chemical warfare agents at Porton Down: cohort study. BMJ 2009; 338:b613. [PMID: 19318699 PMCID: PMC3269894 DOI: 10.1136/bmj.b613] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate any long term effects on mortality in participants in experimental research related to chemical warfare agents from 1941 to 1989. DESIGN Historical cohort study. Data sources Archive of UK government research facility at Porton Down, UK military personnel records, and national death and cancer records. Participants 18,276 male members of the UK armed forces who had spent one or more short periods (median 4 days between first and last test) at Porton Down and a comparison group of 17,600 non-Porton Down veterans followed to 31 December 2004. MAIN OUTCOME MEASURES Mortality rate ratio of Porton Down compared with non-Porton Down veterans and standardised mortality ratio of each veteran group compared with the general population. Both ratios adjusted for age group and calendar period. RESULTS Porton Down veterans were similar to non-Porton Down veterans in year of enlistment (median 1951) but had longer military service (median 6.2 v 5.0 years). After a median follow-up of 43 years, 40% (7306) of Porton Down and 39% (6900) of non-Porton Down veterans had died. All cause mortality was slightly greater in Porton Down veterans (rate ratio 1.06, 95% confidence interval 1.03 to 1.10, P<0.001), more so for deaths outside the UK (1.26, 1.09 to 1.46). Of 12 cause specific groups examined, rate ratios in Porton Down veterans were increased for deaths attributed to infectious and parasitic (1.57, 1.07 to 2.29), genitourinary (1.46, 1.04 to 2.04), circulatory (1.07, 1.01 to 1.12), and external (non-medical) (1.17, 1.00 to 1.37) causes and decreased for deaths attributed to in situ, benign, and unspecified neoplasms (0.60, 0.37 to 0.99). There was no clear relation between type of chemical exposure and cause specific mortality. The mortality in both groups of veterans was lower than that in the general population (standardised mortality ratio 0.88, 0.85 to 0.90; 0.82, 0.80 to 0.84). CONCLUSIONS Mortality was slightly higher in Porton Down than non-Porton Down veterans. With lack of information on other important factors, such as smoking or service overseas, it is not possible to attribute the small excess mortality to chemical exposures at Porton Down.
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Keegan TJ, Walker SAS, Brooks C, Langdon T, Linsell L, Maconochie NES, Doyle P, Fletcher T, Nieuwenhuijsen MJ, Carpenter LM, Venables KM. Exposures Recorded for Participants in the UK Chemical Warfare Agent Human Research Programme, 1941–1989. ANNALS OF OCCUPATIONAL HYGIENE 2009; 53:83-97. [PMID: 19131404 DOI: 10.1093/annhyg/men040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Antova T, Pattenden S, Brunekreef B, Heinrich J, Rudnai P, Forastiere F, Luttmann-Gibson H, Grize L, Katsnelson B, Moshammer H, Nikiforov B, Slachtova H, Slotova K, Zlotkowska R, Fletcher T. Exposure to indoor mould and children's respiratory health in the PATY study. J Epidemiol Community Health 2008. [PMID: 18621956 DOI: 10.1136/jech.2007.06589662/8/708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Living in a damp or mouldy home reportedly damages children's respiratory health, yet mould appears not to be a prominent risk factor in the public's perception. Analyses of data on over 58,000 children from the Pollution and the Young (PATY) study are presented. In this collaboration, researchers from 12 cross-sectional studies pooled their data to assess the effects of air quality on a spectrum of children's respiratory disorders. METHOD Original studies were conducted in Russia, North America and 10 countries in Eastern and Western Europe. Pooled analyses were restricted to children aged 6-12 years. Associations between visible mould reported in the household and a spectrum of eight respiratory and allergic symptoms were estimated within each study. Logistic regressions were used, controlling for individual risk factors and for study area. Heterogeneity between study-specific results and mean effects (allowing for heterogeneity) were estimated using meta-analysis. RESULTS Visible mould was reported by 13.9% of respondents in Russia, increasing to 39.1% in North America. Positive associations between exposure to mould and children's respiratory health were seen with considerable consistency across studies and across outcomes. Confounder-adjusted combined ORs ranged from 1.30 (95% CI 1.22 to 1.39) for "nocturnal cough" to 1.50 (1.31 to 1.73) for "morning cough". Evidence of stronger effects in more crowded households was statistically significant for only asthma and sensitivity to inhaled allergens. No consistent interactions between mould and age, sex or parental smoking were found. CONCLUSION Indoor mould exposure was consistently associated with adverse respiratory health outcomes in children living in these diverse countries.
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Antova T, Pattenden S, Brunekreef B, Heinrich J, Rudnai P, Forastiere F, Luttmann-Gibson H, Grize L, Katsnelson B, Moshammer H, Nikiforov B, Slachtova H, Slotova K, Zlotkowska R, Fletcher T. Exposure to indoor mould and children's respiratory health in the PATY study. J Epidemiol Community Health 2008; 62:708-14. [PMID: 18621956 DOI: 10.1136/jech.2007.065896] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Living in a damp or mouldy home reportedly damages children's respiratory health, yet mould appears not to be a prominent risk factor in the public's perception. Analyses of data on over 58,000 children from the Pollution and the Young (PATY) study are presented. In this collaboration, researchers from 12 cross-sectional studies pooled their data to assess the effects of air quality on a spectrum of children's respiratory disorders. METHOD Original studies were conducted in Russia, North America and 10 countries in Eastern and Western Europe. Pooled analyses were restricted to children aged 6-12 years. Associations between visible mould reported in the household and a spectrum of eight respiratory and allergic symptoms were estimated within each study. Logistic regressions were used, controlling for individual risk factors and for study area. Heterogeneity between study-specific results and mean effects (allowing for heterogeneity) were estimated using meta-analysis. RESULTS Visible mould was reported by 13.9% of respondents in Russia, increasing to 39.1% in North America. Positive associations between exposure to mould and children's respiratory health were seen with considerable consistency across studies and across outcomes. Confounder-adjusted combined ORs ranged from 1.30 (95% CI 1.22 to 1.39) for "nocturnal cough" to 1.50 (1.31 to 1.73) for "morning cough". Evidence of stronger effects in more crowded households was statistically significant for only asthma and sensitivity to inhaled allergens. No consistent interactions between mould and age, sex or parental smoking were found. CONCLUSION Indoor mould exposure was consistently associated with adverse respiratory health outcomes in children living in these diverse countries.
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