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Bosco A, Di Lorito C, Yang Y, Dunlop M, Booth A, Alexander D, Jones S, Briggs M, Todd C, Burns A. Caregiver experiences of hospice dementia care: a systematic review and meta-ethnography. Aging Ment Health 2024; 28:197-206. [PMID: 37667896 DOI: 10.1080/13607863.2023.2241027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/13/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVES Hospices are regarded as gold standard providers of end-of-life care. The term hospice, however, is broadly used, and can describe a type of care offered in a variety of health care services (e.g. nursing homes). It thus becomes complex for families to decide between services. We aimed to review the evidence around the experience of family carers of people with dementia accessing in-patient hospice settings for end-of-life care. METHOD We registered the review protocol on PROSPERO. We used PerSPE(C)TiF to systematically organise our search strategy. The evidence was reviewed across six databases: PubMed, EMBASE, PsycINFO, ASSIA, ISI Web, and CINAHL. We used meta-ethnography as per the eMERGe guidance for data interpretation. RESULTS Four studies were included. Two third-order constructs were generated through meta-ethnography: expectations of care and barriers to quality of care. We found that carers had expectations of care, and these could change over time. If discussion was not held with hospice staff early on, the carers could experience reduced care quality due to unmatched expectations. Unmatched expectations acted as barriers to care and these were found in terms of carers not feeling adequately supported, and/or having the person discharged from hospice, which would entail increased care responsibility for carers. CONCLUSION In view of an increase in new dementia cases over time and with hospice services being under pressure, integrating palliative care services within community-based models of care is key to reducing the risk of having inadequate and under resourced services for people with dementia.
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Affiliation(s)
- A Bosco
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research, Applied Research Collaboration- Greater Manchester, Manchester, UK
- Manchester Institute for Collaborative Research on Ageing, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | - C Di Lorito
- Department of Primary Care and Population Health, University College London, Centre for Ageing Population Studies, Royal Free Hospital, London, UK
| | - Y Yang
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research, Applied Research Collaboration- Greater Manchester, Manchester, UK
- Manchester Institute for Collaborative Research on Ageing, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | - M Dunlop
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - A Booth
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - D Alexander
- East Cheshire Hospice, Macclesfield, Cheshire, UK
| | - S Jones
- East Cheshire Hospice, Macclesfield, Cheshire, UK
| | - M Briggs
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - C Todd
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research, Applied Research Collaboration- Greater Manchester, Manchester, UK
- Manchester Institute for Collaborative Research on Ageing, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester, UK
| | - A Burns
- Manchester Institute for Collaborative Research on Ageing, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
- Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK
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Bosco A, Di Lorito C, Dunlop M, Booth A, Alexander D, Jones S, Underwood BR, Todd C, Burns A. Experiences of hospice dementia care: A qualitative study of bereaved carers and hospice clinicians. PLoS One 2023; 18:e0286493. [PMID: 37930977 PMCID: PMC10627455 DOI: 10.1371/journal.pone.0286493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/05/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Nearly 50 million people worldwide have dementia and the increasing numbers requiring end-of-life and palliative care, has led to national efforts to define standards of care for this patient group. Little research, however, has been done to date about the experience of hospice care for people with dementia accessing these services. This study explores the views of hospice dementia care for bereaved carers of people with dementia and hospice clinicians. METHODS We used purposive sampling for participant recruitment. Semi-structured qualitative interviews were conducted with bereaved carers and hospice clinical staff. Interviews were audio recorded and the transcriptions were analysed through thematic analysis. A total of 12 participants were interviewed from one service in the Northwest region in the UK. All were female and white British. RESULTS Participants described their experience of hospice dementia care in three main themes: Pre-access to service, roles and responsibility within hospice care, ease and difficulty of last period of end-of-life care. CONCLUSION Rapid response teams delivering hospice home care could represent a better option to inpatient care and may be preferred by patients. This type of service, however, may require joined-up care with other community services, and this type of care needs to be considered and planned. Future studies should evaluate this type of community care.
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Affiliation(s)
- A. Bosco
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Primary Care Unit, University of Cambridge, Cambridge, United Kingdom
- National Institute for Health and Care Research, Applied Research Collaboration- Greater Manchester, Manchester, United Kingdom
| | - C. Di Lorito
- Department of Primary Care and Population Health, Centre for Ageing Population Studies, Royal Free Hospital, University College London, London, United Kingdom
| | - M. Dunlop
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - A. Booth
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - D. Alexander
- East Cheshire Hospice, Macclesfield, Cheshire, United Kingdom
| | - S. Jones
- East Cheshire Hospice, Macclesfield, Cheshire, United Kingdom
| | - B. R. Underwood
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Cambridgeshire and Peterborough NHS Foundation Trust, Windsor Unit, Fulbourn Hospital, Cambridge, United Kingdom
| | - C. Todd
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- National Institute for Health and Care Research, Applied Research Collaboration- Greater Manchester, Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - A. Burns
- Manchester Institute for Collaborative Research on Ageing, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
- Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, United Kingdom
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Raman B, McCracken C, Cassar MP, Moss AJ, Finnigan L, Samat AHA, Ogbole G, Tunnicliffe EM, Alfaro-Almagro F, Menke R, Xie C, Gleeson F, Lukaschuk E, Lamlum H, McGlynn K, Popescu IA, Sanders ZB, Saunders LC, Piechnik SK, Ferreira VM, Nikolaidou C, Rahman NM, Ho LP, Harris VC, Shikotra A, Singapuri A, Pfeffer P, Manisty C, Kon OM, Beggs M, O'Regan DP, Fuld J, Weir-McCall JR, Parekh D, Steeds R, Poinasamy K, Cuthbertson DJ, Kemp GJ, Semple MG, Horsley A, Miller CA, O'Brien C, Shah AM, Chiribiri A, Leavy OC, Richardson M, Elneima O, McAuley HJC, Sereno M, Saunders RM, Houchen-Wolloff L, Greening NJ, Bolton CE, Brown JS, Choudhury G, Diar Bakerly N, Easom N, Echevarria C, Marks M, Hurst JR, Jones MG, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Howard LS, Jacob J, Man WDC, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Singh SJ, Thomas DC, Toshner M, Lewis KE, Heaney LG, Harrison EM, Kerr S, Docherty AB, Lone NI, Quint J, Sheikh A, Zheng B, Jenkins RG, Cox E, Francis S, Halling-Brown M, Chalmers JD, Greenwood JP, Plein S, Hughes PJC, Thompson AAR, Rowland-Jones SL, Wild JM, Kelly M, Treibel TA, Bandula S, Aul R, Miller K, Jezzard P, Smith S, Nichols TE, McCann GP, Evans RA, Wain LV, Brightling CE, Neubauer S, Baillie JK, Shaw A, Hairsine B, Kurasz C, Henson H, Armstrong L, Shenton L, Dobson H, Dell A, Lucey A, Price A, Storrie A, Pennington C, Price C, Mallison G, Willis G, Nassa H, Haworth J, Hoare M, Hawkings N, Fairbairn S, Young S, Walker S, Jarrold I, Sanderson A, David C, Chong-James K, Zongo O, James WY, Martineau A, King B, Armour C, McAulay D, Major E, McGinness J, McGarvey L, Magee N, Stone R, Drain S, Craig T, Bolger A, Haggar A, Lloyd A, Subbe C, Menzies D, Southern D, McIvor E, Roberts K, Manley R, Whitehead V, Saxon W, Bularga A, Mills NL, El-Taweel H, Dawson J, Robinson L, Saralaya D, Regan K, Storton K, Brear L, Amoils S, Bermperi A, Elmer A, Ribeiro C, Cruz I, Taylor J, Worsley J, Dempsey K, Watson L, Jose S, Marciniak S, Parkes M, McQueen A, Oliver C, Williams J, Paradowski K, Broad L, Knibbs L, Haynes M, Sabit R, Milligan L, Sampson C, Hancock A, Evenden C, Lynch C, Hancock K, Roche L, Rees M, Stroud N, Thomas-Woods T, Heller S, Robertson E, Young B, Wassall H, Babores M, Holland M, Keenan N, Shashaa S, Price C, Beranova E, Ramos H, Weston H, Deery J, Austin L, Solly R, Turney S, Cosier T, Hazelton T, Ralser M, Wilson A, Pearce L, Pugmire S, Stoker W, McCormick W, Dewar A, Arbane G, Kaltsakas G, Kerslake H, Rossdale J, Bisnauthsing K, Aguilar Jimenez LA, Martinez LM, Ostermann M, Magtoto MM, Hart N, Marino P, Betts S, Solano TS, Arias AM, Prabhu A, Reed A, Wrey Brown C, Griffin D, Bevan E, Martin J, Owen J, Alvarez Corral M, Williams N, Payne S, Storrar W, Layton A, Lawson C, Mills C, Featherstone J, Stephenson L, Burdett T, Ellis Y, Richards A, Wright C, Sykes DL, Brindle K, Drury K, Holdsworth L, Crooks MG, Atkin P, Flockton R, Thackray-Nocera S, Mohamed A, Taylor A, Perkins E, Ross G, McGuinness H, Tench H, Phipps J, Loosley R, Wolf-Roberts R, Coetzee S, Omar Z, Ross A, Card B, Carr C, King C, Wood C, Copeland D, Calvelo E, Chilvers ER, Russell E, Gordon H, Nunag JL, Schronce J, March K, Samuel K, Burden L, Evison L, McLeavey L, Orriss-Dib L, Tarusan L, Mariveles M, Roy M, Mohamed N, Simpson N, Yasmin N, Cullinan P, Daly P, Haq S, Moriera S, Fayzan T, Munawar U, Nwanguma U, Lingford-Hughes A, Altmann D, Johnston D, Mitchell J, Valabhji J, Price L, Molyneaux PL, Thwaites RS, Walsh S, Frankel A, Lightstone L, Wilkins M, Willicombe M, McAdoo S, Touyz R, Guerdette AM, Warwick K, Hewitt M, Reddy R, White S, McMahon A, Hoare A, Knighton A, Ramos A, Te A, Jolley CJ, Speranza F, Assefa-Kebede H, Peralta I, Breeze J, Shevket K, Powell N, Adeyemi O, Dulawan P, Adrego R, Byrne S, Patale S, Hayday A, Malim M, Pariante C, Sharpe C, Whitney J, Bramham K, Ismail K, Wessely S, Nicholson T, Ashworth A, Humphries A, Tan AL, Whittam B, Coupland C, Favager C, Peckham D, Wade E, Saalmink G, Clarke J, Glossop J, Murira J, Rangeley J, Woods J, Hall L, Dalton M, Window N, Beirne P, Hardy T, Coakley G, Turtle L, Berridge A, Cross A, Key AL, Rowe A, Allt AM, Mears C, Malein F, Madzamba G, Hardwick HE, Earley J, Hawkes J, Pratt J, Wyles J, Tripp KA, Hainey K, Allerton L, Lavelle-Langham L, Melling L, Wajero LO, Poll L, Noonan MJ, French N, Lewis-Burke N, Williams-Howard SA, Cooper S, Kaprowska S, Dobson SL, Marsh S, Highett V, Shaw V, Beadsworth M, Defres S, Watson E, Tiongson GF, Papineni P, Gurram S, Diwanji SN, Quaid S, Briggs A, Hastie C, Rogers N, Stensel D, Bishop L, McIvor K, Rivera-Ortega P, Al-Sheklly B, Avram C, Faluyi D, Blaikely J, Piper Hanley K, Radhakrishnan K, Buch M, Hanley NA, Odell N, Osbourne R, Stockdale S, Felton T, Gorsuch T, Hussell T, Kausar Z, Kabir T, McAllister-Williams H, Paddick S, Burn D, Ayoub A, Greenhalgh A, Sayer A, Young A, Price D, Burns G, MacGowan G, Fisher H, Tedd H, Simpson J, Jiwa K, Witham M, Hogarth P, West S, Wright S, McMahon MJ, Neill P, Dougherty A, Morrow A, Anderson D, Grieve D, Bayes H, Fallon K, Mangion K, Gilmour L, Basu N, Sykes R, Berry C, McInnes IB, Donaldson A, Sage EK, Barrett F, Welsh B, Bell M, Quigley J, Leitch K, Macliver L, Patel M, Hamil R, Deans A, Furniss J, Clohisey S, Elliott A, Solstice AR, Deas C, Tee C, Connell D, Sutherland D, George J, Mohammed S, Bunker J, Holmes K, Dipper A, Morley A, Arnold D, Adamali H, Welch H, Morrison L, Stadon L, Maskell N, Barratt S, Dunn S, Waterson S, Jayaraman B, Light T, Selby N, Hosseini A, Shaw K, Almeida P, Needham R, Thomas AK, Matthews L, Gupta A, Nikolaidis A, Dupont C, Bonnington J, Chrystal M, Greenhaff PL, Linford S, Prosper S, Jang W, Alamoudi A, Bloss A, Megson C, Nicoll D, Fraser E, Pacpaco E, Conneh F, Ogg G, McShane H, Koychev I, Chen J, Pimm J, Ainsworth M, Pavlides M, Sharpe M, Havinden-Williams M, Petousi N, Talbot N, Carter P, Kurupati P, Dong T, Peng Y, Burns A, Kanellakis N, Korszun A, Connolly B, Busby J, Peto T, Patel B, Nolan CM, Cristiano D, Walsh JA, Liyanage K, Gummadi M, Dormand N, Polgar O, George P, Barker RE, Patel S, Price L, Gibbons M, Matila D, Jarvis H, Lim L, Olaosebikan O, Ahmad S, Brill S, Mandal S, Laing C, Michael A, Reddy A, Johnson C, Baxendale H, Parfrey H, Mackie J, Newman J, Pack J, Parmar J, Paques K, Garner L, Harvey A, Summersgill C, Holgate D, Hardy E, Oxton J, Pendlebury J, McMorrow L, Mairs N, Majeed N, Dark P, Ugwuoke R, Knight S, Whittaker S, Strong-Sheldrake S, Matimba-Mupaya W, Chowienczyk P, Pattenadk D, Hurditch E, Chan F, Carborn H, Foot H, Bagshaw J, Hockridge J, Sidebottom J, Lee JH, Birchall K, Turner K, Haslam L, Holt L, Milner L, Begum M, Marshall M, Steele N, Tinker N, Ravencroft P, Butcher R, Misra S, Walker S, Coburn Z, Fairman A, Ford A, Holbourn A, Howell A, Lawrie A, Lye A, Mbuyisa A, Zawia A, Holroyd-Hind B, Thamu B, Clark C, Jarman C, Norman C, Roddis C, Foote D, Lee E, Ilyas F, Stephens G, Newell H, Turton H, Macharia I, Wilson I, Cole J, McNeill J, Meiring J, Rodger J, Watson J, Chapman K, Harrington K, Chetham L, Hesselden L, Nwafor L, Dixon M, Plowright M, Wade P, Gregory R, Lenagh R, Stimpson R, Megson S, Newman T, Cheng Y, Goodwin C, Heeley C, Sissons D, Sowter D, Gregory H, Wynter I, Hutchinson J, Kirk J, Bennett K, Slack K, Allsop L, Holloway L, Flynn M, Gill M, Greatorex M, Holmes M, Buckley P, Shelton S, Turner S, Sewell TA, Whitworth V, Lovegrove W, Tomlinson J, Warburton L, Painter S, Vickers C, Redwood D, Tilley J, Palmer S, Wainwright T, Breen G, Hotopf M, Dunleavy A, Teixeira J, Ali M, Mencias M, Msimanga N, Siddique S, Samakomva T, Tavoukjian V, Forton D, Ahmed R, Cook A, Thaivalappil F, Connor L, Rees T, McNarry M, Williams N, McCormick J, McIntosh J, Vere J, Coulding M, Kilroy S, Turner V, Butt AT, Savill H, Fraile E, Ugoji J, Landers G, Lota H, Portukhay S, Nasseri M, Daniels A, Hormis A, Ingham J, Zeidan L, Osborne L, Chablani M, Banerjee A, David A, Pakzad A, Rangelov B, Williams B, Denneny E, Willoughby J, Xu M, Mehta P, Batterham R, Bell R, Aslani S, Lilaonitkul W, Checkley A, Bang D, Basire D, Lomas D, Wall E, Plant H, Roy K, Heightman M, Lipman M, Merida Morillas M, Ahwireng N, Chambers RC, Jastrub R, Logan S, Hillman T, Botkai A, Casey A, Neal A, Newton-Cox A, Cooper B, Atkin C, McGee C, Welch C, Wilson D, Sapey E, Qureshi H, Hazeldine J, Lord JM, Nyaboko J, Short J, Stockley J, Dasgin J, Draxlbauer K, Isaacs K, Mcgee K, Yip KP, Ratcliffe L, Bates M, Ventura M, Ahmad Haider N, Gautam N, Baggott R, Holden S, Madathil S, Walder S, Yasmin S, Hiwot T, Jackson T, Soulsby T, Kamwa V, Peterkin Z, Suleiman Z, Chaudhuri N, Wheeler H, Djukanovic R, Samuel R, Sass T, Wallis T, Marshall B, Childs C, Marouzet E, Harvey M, Fletcher S, Dickens C, Beckett P, Nanda U, Daynes E, Charalambou A, Yousuf AJ, Lea A, Prickett A, Gooptu B, Hargadon B, Bourne C, Christie C, Edwardson C, Lee D, Baldry E, Stringer E, Woodhead F, Mills G, Arnold H, Aung H, Qureshi IN, Finch J, Skeemer J, Hadley K, Khunti K, Carr L, Ingram L, Aljaroof M, Bakali M, Bakau M, Baldwin M, Bourne M, Pareek M, Soares M, Tobin M, Armstrong N, Brunskill N, Goodman N, Cairns P, Haldar P, McCourt P, Dowling R, Russell R, Diver S, Edwards S, Glover S, Parker S, Siddiqui S, Ward TJC, Mcnally T, Thornton T, Yates T, Ibrahim W, Monteiro W, Thickett D, Wilkinson D, Broome M, McArdle P, Upthegrove R, Wraith D, Langenberg C, Summers C, Bullmore E, Heeney JL, Schwaeble W, Sudlow CL, Adeloye D, Newby DE, Rudan I, Shankar-Hari M, Thorpe M, Pius R, Walmsley S, McGovern A, Ballard C, Allan L, Dennis J, Cavanagh J, Petrie J, O'Donnell K, Spears M, Sattar N, MacDonald S, Guthrie E, Henderson M, Guillen Guio B, Zhao B, Lawson C, Overton C, Taylor C, Tong C, Mukaetova-Ladinska E, Turner E, Pearl JE, Sargant J, Wormleighton J, Bingham M, Sharma M, Steiner M, Samani N, Novotny P, Free R, Allen RJ, Finney S, Terry S, Brugha T, Plekhanova T, McArdle A, Vinson B, Spencer LG, Reynolds W, Ashworth M, Deakin B, Chinoy H, Abel K, Harvie M, Stanel S, Rostron A, Coleman C, Baguley D, Hufton E, Khan F, Hall I, Stewart I, Fabbri L, Wright L, Kitterick P, Morriss R, Johnson S, Bates A, Antoniades C, Clark D, Bhui K, Channon KM, Motohashi K, Sigfrid L, Husain M, Webster M, Fu X, Li X, Kingham L, Klenerman P, Miiler K, Carson G, Simons G, Huneke N, Calder PC, Baldwin D, Bain S, Lasserson D, Daines L, Bright E, Stern M, Crisp P, Dharmagunawardena R, Reddington A, Wight A, Bailey L, Ashish A, Robinson E, Cooper J, Broadley A, Turnbull A, Brookes C, Sarginson C, Ionita D, Redfearn H, Elliott K, Barman L, Griffiths L, Guy Z, Gill R, Nathu R, Harris E, Moss P, Finnigan J, Saunders K, Saunders P, Kon S, Kon SS, O'Brien L, Shah K, Shah P, Richardson E, Brown V, Brown M, Brown J, Brown J, Brown A, Brown A, Brown M, Choudhury N, Jones S, Jones H, Jones L, Jones I, Jones G, Jones H, Jones D, Davies F, Davies E, Davies K, Davies G, Davies GA, Howard K, Porter J, Rowland J, Rowland A, Scott K, Singh S, Singh C, Thomas S, Thomas C, Lewis V, Lewis J, Lewis D, Harrison P, Francis C, Francis R, Hughes RA, Hughes J, Hughes AD, Thompson T, Kelly S, Smith D, Smith N, Smith A, Smith J, Smith L, Smith S, Evans T, Evans RI, Evans D, Evans R, Evans H, Evans J. Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study. Lancet Respir Med 2023; 11:1003-1019. [PMID: 37748493 PMCID: PMC7615263 DOI: 10.1016/s2213-2600(23)00262-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/16/2023] [Accepted: 06/30/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. METHODS In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. FINDINGS Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2-6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5-5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4-10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32-4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23-11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. INTERPRETATION After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification. FUNDING UK Research and Innovation and National Institute for Health Research.
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Andrillon T, Burns A, Mackay T, Windt J, Tsuchiya N. Sleeping while awake: sleep-like slow waves in wakefulness predict modulations of performance and subjective experience. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Robbe P, Ridout KE, Vavoulis DV, Dréau H, Kinnersley B, Denny N, Chubb D, Appleby N, Cutts A, Cornish AJ, Lopez-Pascua L, Clifford R, Burns A, Stamatopoulos B, Cabes M, Alsolami R, Antoniou P, Oates M, Cavalieri D, Gibson J, Prabhu AV, Schwessinger R, Jennings D, James T, Maheswari U, Duran-Ferrer M, Carninci P, Knight SJL, Månsson R, Hughes J, Davies J, Ross M, Bentley D, Strefford JC, Devereux S, Pettitt AR, Hillmen P, Caulfield MJ, Houlston RS, Martín-Subero JI, Schuh A. Whole-genome sequencing of chronic lymphocytic leukemia identifies subgroups with distinct biological and clinical features. Nat Genet 2022; 54:1675-1689. [PMID: 36333502 PMCID: PMC9649442 DOI: 10.1038/s41588-022-01211-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/16/2022] [Indexed: 11/06/2022]
Abstract
The value of genome-wide over targeted driver analyses for predicting clinical outcomes of cancer patients is debated. Here, we report the whole-genome sequencing of 485 chronic lymphocytic leukemia patients enrolled in clinical trials as part of the United Kingdom's 100,000 Genomes Project. We identify an extended catalog of recurrent coding and noncoding genetic mutations that represents a source for future studies and provide the most complete high-resolution map of structural variants, copy number changes and global genome features including telomere length, mutational signatures and genomic complexity. We demonstrate the relationship of these features with clinical outcome and show that integration of 186 distinct recurrent genomic alterations defines five genomic subgroups that associate with response to therapy, refining conventional outcome prediction. While requiring independent validation, our findings highlight the potential of whole-genome sequencing to inform future risk stratification in chronic lymphocytic leukemia.
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Affiliation(s)
- Pauline Robbe
- Department of Oncology, University of Oxford, Oxford, UK
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Kate E Ridout
- Department of Oncology, University of Oxford, Oxford, UK
| | | | - Helene Dréau
- Department of Oncology, University of Oxford, Oxford, UK
| | - Ben Kinnersley
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Nicholas Denny
- Department of Medicine, Medical Research Council Molecular Haematology Unit, Medical Research Council Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Daniel Chubb
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Niamh Appleby
- Department of Oncology, University of Oxford, Oxford, UK
| | - Anthony Cutts
- Department of Oncology, University of Oxford, Oxford, UK
| | - Alex J Cornish
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | | | - Ruth Clifford
- Department of Haematology, University Hospital Limerick, Limerick, Ireland
- Limerick Digital Cancer Research Centre, School of Medicine,University of Limerick, Limerick, Ireland
| | - Adam Burns
- Department of Oncology, University of Oxford, Oxford, UK
| | - Basile Stamatopoulos
- Laboratory of Clinical Cell Therapy, Jules Bordet Institute, ULB Cancer Research Center (U-CRC)- Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Maite Cabes
- Oxford Molecular Diagnostics Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Reem Alsolami
- Department of Medical Laboratory Technology, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | | | - Doriane Cavalieri
- Department of Haematology, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Jane Gibson
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Anika V Prabhu
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Ron Schwessinger
- Department of Medicine, Medical Research Council Molecular Haematology Unit, Medical Research Council Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Daisy Jennings
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | | | | | - Martí Duran-Ferrer
- Biomedical Epigenomics Group, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Piero Carninci
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Human Technopole, Milan, Italy
| | - Samantha J L Knight
- Oxford University Clinical Academic Graduate School, University of Oxford Medical Sciences Division, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Robert Månsson
- Center for Hematology and Regenerative Medicine Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Jim Hughes
- Department of Medicine, Medical Research Council Molecular Haematology Unit, Medical Research Council Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - James Davies
- Department of Medicine, Medical Research Council Molecular Haematology Unit, Medical Research Council Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Mark Ross
- Illumina Cambridge Ltd., Cambridge, UK
| | | | - Jonathan C Strefford
- Cancer Genomics, Cancer Sciences, Faculty of Medicine, Group University of Southampton, Southampton, UK
| | - Stephen Devereux
- King's College Hospital, NHS Foundation Trust, London, UK
- Kings College London, London, UK
| | - Andrew R Pettitt
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | | | - Mark J Caulfield
- Genomics England, London, UK
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Richard S Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - José I Martín-Subero
- Human Technopole, Milan, Italy
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Anna Schuh
- Department of Oncology, University of Oxford, Oxford, UK.
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Harris S, Barkoukis H, McWhorter J, Ricelli O, Burns A, McManus C. Culinary Medicine Education: Curriculum inclusion and Program Director Attitudes, Beliefs and Confidence in ACEND Accredited Programs with a Supervised Practice Component. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.08.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Talluru S, Weiner D, Singh D, Zeng Z, Connor S, Burns A, Smith K, Rozati S. Single-cell RNA sequencing reveals race-based heterogeneity of malignant T-cells and skin microenvironment in patients with cutaneous T-cell lymphoma. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00553-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Goffe K, Wilson J, Gluck T, Brady J, Burns A, Bergbaum C, Petra H, Stewart M, Wilson E. 779 IMPROVING USE OF COORDINATE MY CARE USING A QUALITY IMPROVEMENT APPROACH FOR MEDICAL PATIENTS ADMITTED TO BARNET HOSPITAL. Age Ageing 2022. [DOI: 10.1093/ageing/afac034.779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Coordinate My Care (CMC) is a digital care plan for communicating person-centred urgent and advance care planning. We recognised that it was not being consistently accessed on admission, nor updated on discharge, leading to a risk of ignoring patient wishes and previously clinician-agreed care plans. We used a quality improvement approach to increase use of CMC.
Method
We gathered baseline data on the number of users utilising their account, and explored current practice and barriers. A driver diagram was developed, a Steering Group met regularly, and interventions were tested using Plan, Do, Study, Act. Interventions began in January 2021, including electronic circulation of a guide to gain access to CMC, posters about CMC, departmental teaching, and drop-in training. A Core Group of clinicians repeatedly surveyed 12 medical ward areas and offered on-the-spot troubleshooting. To mitigate effects of staff turnover, we developed e-classroom training for new starters.
Results
53 people attended departmental teaching and drop-ins. The number of users utilising their account each month showed a steady increase, rising from 25 to 42 users. Monthly views of CMC records are increasing, with 167 in May 2021 compared to an average of 105 in the 5 months prior to the project. We have still to examine patient feedback.
Conclusion
Use of CMC is becoming more established. Future actions will concentrate on training (including in the emergency department and during junior doctor changeover), helping clinicians hold conversations, and establishing mentoring. Recording Advance Care Planning on CMC is a final step in a complex process of identifying that a patient may be in the last year of their life, starting conversations and taking actions. It follows that varied and sustained actions are needed to improve this, in order to realise the benefits of person-centred planning for our patients and those caring for them.
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Affiliation(s)
- K Goffe
- Barnet Hospital, Royal Free London NHS Trust
| | - J Wilson
- Barnet Hospital, Royal Free London NHS Trust
| | - T Gluck
- Barnet Hospital, Royal Free London NHS Trust
| | - J Brady
- Barnet Hospital, Royal Free London NHS Trust
| | - A Burns
- Barnet Hospital, Royal Free London NHS Trust
| | - C Bergbaum
- Barnet Hospital, Royal Free London NHS Trust
| | - H Petra
- Barnet Hospital, Royal Free London NHS Trust
| | - M Stewart
- Barnet Hospital, Royal Free London NHS Trust
| | - E Wilson
- Barnet Hospital, Royal Free London NHS Trust
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Stokes W, Behera M, Jiang R, Gutman D, Huang Z, Burns A, Sebastian N, Sukhatme V, Lowe M, Ramalingam S, Sukhatme V, Moghanaki D. Effect of Antibiotic Therapy on Immunotherapy Outcomes for Non-Small Cell Lung Cancer: Analysis From the Veterans Health Administration. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.10.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Nelson D, Brennan A, Burns A. Calcified Apical Left Ventricular Aneurysm: A Case Study. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Christopher H, Burns A, Josephat E, Makani J, Schuh A, Nkya S. Using DNA testing for the precise, definite, and low-cost diagnosis of sickle cell disease and other Haemoglobinopathies: findings from Tanzania. BMC Genomics 2021; 22:902. [PMID: 34915846 PMCID: PMC8679995 DOI: 10.1186/s12864-021-08220-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background Sickle cell disease (SCD) is an important cause of under-five mortality. Tanzania is the 5th country in the world with the highest births prevalence of SCD individuals. Significant advances in the neonatal diagnosis of SCD using rapid point-of-care testing have been made. However genetic confirmation is still required for positive cases, in uncertain cases, in multiply transfused patients, to resolve compound heterozygosity (Hb S/ β0 Thal or Hb S/ β+ thal) not uncommon in the coastal regions of East Africa and increasingly also for pre-marital counselling and potentially for future curative approaches such as gene therapy. The currently available DNA tests are prohibitively expensive. Here, we describe an easy-to-use, affordable and accurate β-globin sequencing approach that can be easily integrated within existing NBS for SCD and other haemoglobinopathies especially in Low- and Middle-income Countries. Aim To evaluate an affordable DNA technology for the diagnosis of Sickle cell disease and other haemoglobinopathies in a resource-limited setting. Methods Laboratory-based validation study was conducted by Muhimbili University of Health and Allied Sciences and the University of Oxford involving sequencing of the entire β -haemoglobin locus using the Oxford Nanopore MinION platform. A total number of 36 Dried blood spots and whole blood samples were subjected to conventional protein-based methods (isoelectric focusing, HPLC), and/or sequenced by the Sanger method as comparators. Results Sequencing results for SCD using the MinION were 100% concordant with those from the Sanger method. In addition, the long-read DNA sequencing method enabled the resolution of cases with unusual phenotypes which make up 1% of all children in Tanzania. The cost is £11/ sample for consumables, which is cheaper compared to other sequencing platforms. Conclusions This is the first report of a comprehensive single DNA assay as a definitive diagnostic test for SCD and other haemoglobinopathies. The test is fast, precise, accurate and affordable.
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Affiliation(s)
- Heavenlight Christopher
- Sickle cell programme, Department of haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
| | - Adam Burns
- Oxford Molecular Diagnostics Centre, University of Oxford, Oxford, UK
| | - Emmanuel Josephat
- Sickle cell programme, Department of haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Julie Makani
- Sickle cell programme, Department of haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Anna Schuh
- Sickle cell programme, Department of haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Oxford Molecular Diagnostics Centre, University of Oxford, Oxford, UK
| | - Siana Nkya
- Sickle cell programme, Department of haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Department of Biological Sciences, Dar es Salaam University College of Education (DUCE), Dar es Salaam, Tanzania
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13
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Stokes W, Behera M, Jiang R, Gutman D, Huang Z, Giuste F, Burns A, Sebastian N, Ramalingam S, Sukhatme V, Lowe M, Ramalingam S, Sukhatme V, Moghanaki D. P53.08 Concomitant Fibrates and Immunotherapy in Non-Small Cell Lung Cancer Patients in the Veterans Health Administration. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Burns A, Leffler M, Sapp A, Allred A, Kelly E, Doyle S, Uz T, Karaa A. MITOCHONDRIAL DISEASES. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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15
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Eyres M, Lanfredini S, Xu H, Burns A, Blake A, Willenbrock F, Goldin R, Hughes D, Hughes S, Thapa A, Vavoulis D, Hubert A, D'Costa Z, Sabbagh A, Abraham AG, Blancher C, Jones S, Verrill C, Silva M, Soonawalla Z, Maughan T, Schuh A, Mukherjee S, O'Neill E. TET2 Drives 5hmc Marking of GATA6 and Epigenetically Defines Pancreatic Ductal Adenocarcinoma Transcriptional Subtypes. Gastroenterology 2021; 161:653-668.e16. [PMID: 33915173 DOI: 10.1053/j.gastro.2021.04.044] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 03/12/2021] [Accepted: 04/07/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND & AIMS Pancreatic ductal adenocarcinoma (PDAC) is characterized by advanced disease stage at presentation, aggressive disease biology, and resistance to therapy, resulting in an extremely poor 5-year survival rate of <10%. PDAC is classified into transcriptional subtypes with distinct survival characteristics, although how these arise is not known. Epigenetic deregulation, rather than genetics, has been proposed to underpin progression, but exactly why is unclear and is hindered by the technical limitations of analyzing clinical samples. METHODS We performed genome-wide epigenetic mapping of DNA modifications 5-methylcytosine and 5-hydroxymethylcytosine (5hmc) using oxidative bisulfite sequencing from formalin-embedded sections. We identified overlap with transcriptional signatures in formalin-fixed, paraffin-embedded tissue from resected patients, via bioinformatics using iCluster and mutational profiling and confirmed them in vivo. RESULTS We found that aggressive squamous-like PDAC subtypes result from epigenetic inactivation of loci, including GATA6, which promote differentiated classical pancreatic subtypes. We showed that squamous-like PDAC transcriptional subtypes are associated with greater loss of 5hmc due to reduced expression of the 5-methylcytosine hydroxylase TET2. Furthermore, we found that SMAD4 directly supports TET2 levels in classical pancreatic tumors, and loss of SMAD4 expression was associated with reduced 5hmc, GATA6, and squamous-like tumors. Importantly, enhancing TET2 stability using metformin and vitamin C/ascorbic acid restores 5hmc and GATA6 levels, reverting squamous-like tumor phenotypes and WNT-dependence in vitro and in vivo. CONCLUSIONS We identified epigenetic deregulation of pancreatic differentiation as an underpinning event behind the emergence of transcriptomic subtypes in PDAC. Our data showed that restoring epigenetic control increases biomarkers of classical pancreatic tumors that are associated with improved therapeutic responses and survival.
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MESH Headings
- 5-Methylcytosine/analogs & derivatives
- 5-Methylcytosine/metabolism
- Animals
- Antineoplastic Combined Chemotherapy Protocols/pharmacology
- Ascorbic Acid/pharmacology
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Carcinoma, Pancreatic Ductal/drug therapy
- Carcinoma, Pancreatic Ductal/enzymology
- Carcinoma, Pancreatic Ductal/genetics
- Carcinoma, Pancreatic Ductal/pathology
- Cell Differentiation
- Cell Line, Tumor
- DNA Methylation/drug effects
- DNA-Binding Proteins/genetics
- DNA-Binding Proteins/metabolism
- Dioxygenases/genetics
- Dioxygenases/metabolism
- Epigenesis, Genetic/drug effects
- Epigenome
- Epigenomics
- GATA6 Transcription Factor/genetics
- GATA6 Transcription Factor/metabolism
- Gene Expression Profiling
- Gene Expression Regulation, Neoplastic
- Humans
- Metformin/pharmacology
- Mice, Nude
- Mice, Transgenic
- Pancreatic Neoplasms/drug therapy
- Pancreatic Neoplasms/enzymology
- Pancreatic Neoplasms/genetics
- Pancreatic Neoplasms/pathology
- Retrospective Studies
- Smad4 Protein/genetics
- Smad4 Protein/metabolism
- Transcription, Genetic/drug effects
- Transcriptome
- Wnt Signaling Pathway/genetics
- Xenograft Model Antitumor Assays
- Mice
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Affiliation(s)
- Michael Eyres
- Department of Oncology, University of Oxford, Oxford, UK
| | | | - Haonan Xu
- Department of Oncology, University of Oxford, Oxford, UK
| | - Adam Burns
- Department of Oncology, University of Oxford, Oxford, UK
| | - Andrew Blake
- Department of Oncology, University of Oxford, Oxford, UK
| | | | - Robert Goldin
- Centre for Pathology, Imperial College, London, United Kingdom
| | - Daniel Hughes
- Department of Oncology, University of Oxford, Oxford, UK; Department of Hepatobiliary and Pancreatic Surgery, Oxford University Hospitals National Health Service Foundation Trust, Oxford, United Kingdom
| | - Sophie Hughes
- Department of Oncology, University of Oxford, Oxford, UK
| | - Asmita Thapa
- Department of Oncology, University of Oxford, Oxford, UK
| | | | - Aline Hubert
- Department of Oncology, University of Oxford, Oxford, UK
| | | | - Ahmad Sabbagh
- Department of Oncology, University of Oxford, Oxford, UK
| | | | - Christine Blancher
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Stephanie Jones
- Oxford Radcliffe Biobank, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - Clare Verrill
- Nuffield Department of Surgical Sciences and Oxford National Institute for Health Research Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Michael Silva
- Department of Hepatobiliary and Pancreatic Surgery, Oxford University Hospitals National Health Service Foundation Trust, Oxford, United Kingdom
| | - Zahir Soonawalla
- Department of Hepatobiliary and Pancreatic Surgery, Oxford University Hospitals National Health Service Foundation Trust, Oxford, United Kingdom
| | | | - Anna Schuh
- Department of Oncology, University of Oxford, Oxford, UK
| | | | - Eric O'Neill
- Department of Oncology, University of Oxford, Oxford, UK.
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16
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Burns A, Ambinder R, Rozati S. 187 Viral reactivation and severe systemic syndromes in post-stem cell transplant patients. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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17
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Eseonu A, Burns A, Rozati S. 380 The role of illness perception in patients with cutaneous t-cell lymphoma. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Costello B, Ross L, Lindqvist A, Brown Z, Hansen D, Stevens W, Burns A, Prior D, Nikpour M, La Gerche A. Significant and Early Cardiac Involvement in Systemic Sclerosis Detected by Cardiac Magnetic Resonance. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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19
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Tran T, Le N, Lo S, Rajaratnam R, Juergens C, Premawardhana U, Shalaby G, Dang V, Vijayarajan V, Al-Falahi Z, Burns A, Johnson R, Hu Q, Sechi R, Narayanan SS. Cardi Bot: A Natural Language Application That Answers Your Cardiology Questions. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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Ross L, Lindqvist A, Hansen D, Brown Z, Costello B, Burns A, Prior D, Stevens W, Nikpour M, La Gerche A. Characterising Breathlessness in Systemic Sclerosis: Peak Exercise Performance is Linked to Workload-Indexed Blood Pressure Response. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Massett HA, McGowan M, Han SH, Watson J, Emmerson K, Burns A, Robinson CW, Hummel A, Silverberg N, Elliott CL, Donley G, Bernard MA. Raising awareness of clinical trials in dementia: A national survey testing concept designs tailored to African American caregivers and individuals at risk. Alzheimers Dement 2020. [DOI: 10.1002/alz.040630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Holly A Massett
- National Institute on Aging/National Institutes of Health Bethesda MD USA
| | - Melissa McGowan
- National Institute on Aging/National Institutes of Health Bethesda MD USA
| | - Sae H Han
- National Institute on Aging/National Institutes of Health Bethesda MD USA
| | - Jennifer Watson
- National Institute on Aging/National Institutes of Health Bethesda MD USA
| | | | | | | | | | - Nina Silverberg
- National Institute on Aging/National Institutes of Health Bethesda MD USA
| | - Cerise L Elliott
- National Institute on Aging/National Institutes of Health Bethesda MD USA
| | - Grayson Donley
- National Institute on Aging/National Institutes of Health Bethesda MD USA
| | - Marie A Bernard
- National Institute on Aging/National Institutes of Health Bethesda MD USA
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22
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McGowan M, Massett HA, Han SH, Watson J, Emmerson K, Burns A, Robinson CW, Hummel A, Silverberg N, Elliott CL, Donley G, Bernard MA. Raising awareness of Alzheimer’s clinical trials: Development of messages tailored to African American caregivers and individuals at risk. Alzheimers Dement 2020. [DOI: 10.1002/alz.040499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Melissa McGowan
- National Institute on Aging/National Institutes of Health Bethesda MD USA
| | - Holly A Massett
- National Institute on Aging/National Institutes of Health Bethesda MD USA
| | - Sae H Han
- National Institute on Aging/National Institutes of Health Bethesda MD USA
| | - Jennifer Watson
- National Institute on Aging/National Institutes of Health Bethesda MD USA
| | | | | | | | | | - Nina Silverberg
- National Institute on Aging/National Institutes of Health Bethesda MD USA
| | - Cerise L Elliott
- National Institute on Aging/National Institutes of Health Bethesda MD USA
| | - Grayson Donley
- National Institute on Aging/National Institutes of Health Bethesda MD USA
| | - Marie A Bernard
- National Institute on Aging/National Institutes of Health Bethesda MD USA
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23
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Hannaway N, Jiang X, Aspray T, Burns A, Ferguson J, Pedley I, Frew J, Azzabi A, Pearson R, Chandler R, Hughes A, Showler H, Bennett A, McMenemin R. 673P Assessing bone health and osteoporotic risk in patients requiring anti androgen therapy for prostate cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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24
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Bullock A, Burns A, Alkozei A, Taylor E, Grandner M, Killgore W. 1083 Nightmares Are Negatively Associated With Immediate Memory And Visuospatial Performance In Individuals With Ptsd. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Disturbing dreams and nightmares are common in individuals with post-traumatic stress disorder (PTSD). At present, little research has investigated the associations between nightmares and cognition in these individuals. However, a robust body of research has shown memory and attention impairments among those with PTSD. The present study sought to investigate the potential relationships between cognitive performance and nightmares in this population.
Methods
Seventy-five individuals (49 female; Mage=31.8, SDage=8.8) were administered the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the PTSD Checklist for the DSM-5 (PCL-5), the Insomnia Severity Index (ISI), the Functional Outcomes of Sleep Questionnaire (FOSQ), the Clinician-Administered PTSD Scale (CAPS), and the Disturbing Dreams and Nightmares Index (DDNSI). Five linear regressions were conducted with index scores on the RBANS subscales (immediate memory, visuospatial/constructional, language, attention, and delayed memory) as the dependent variables and PCL-5, ISI, FOSQ, CAPS symptom class subscales (intrusion, avoidance, cognition, and arousal), and DDNSI scores entered stepwise.
Results
A linear regression revealed that nightmares predicted 15% of the variance in RBANS immediate memory scores (R2 change=.152, β=-.390, p=.003). A second linear regression revealed that nightmares predicted 9.6% of the variance in RBANS visual memory scores (R2 change=.096, β=-.310, p=.019). No other independent variables added to either model. None of the independent variables predicted any variance in language, attention, or delayed memory scores.
Conclusion
Our analysis revealed a unique contribution of nightmares to immediate memory and visuospatial performance in individuals with PTSD. This finding was not better explained by variation in PTSD severity or sleep. Because sleep and dreams are implicated in memory consolidation, one explanation for our finding is that highly distressing trauma-related dreams (i.e. nightmares) may lack the same memory-improving qualities as ordinary dreams. Additionally, given that immediate memory and visuospatial functioning utilize working memory, perhaps nightmares and deficits in working memory share similar mechanisms.
Support
W81XWH-14-1-0570
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Affiliation(s)
| | - A Burns
- University of Arizona, Tucson, AZ
| | | | - E Taylor
- University of Arizona, Tucson, AZ
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25
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Bullock A, Burns A, Taylor E, Grandner M, Miller M, Alkozei A, Killgore W. 1076 Self-referential Language In Trauma Narratives Predicts Shorter Sleep Duration In Women With Ptsd. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The use of self-referential language, defined as first-person singular pronouns (e.g. I, me, my), in trauma narratives has been found to predict post-traumatic stress disorder (PTSD) severity. Additionally, taking a self-immersed perspective correlates with higher blood pressure reactivity than a self-distanced perspective. Given this relationship between self-immersed perspectives and physiological processes, we investigated the relationship between self-referential language and sleep in people with PTSD, as dysfunctional sleep is a major treatment target in this disorder.
Methods
Seventy-five participants (49 females; Mage=31.8, SDage=8.8) meeting DSM-5 criteria for PTSD were administered the PTSD Checklist for the DSM-5 (PCL-5) and the Pittsburg Sleep Quality Index (PSQI). Sleep duration was assessed with the PSQI. Participants provided typed descriptions of their traumatic event, which were then analyzed using the Linguistic Inquiry and Word Count 2015 software to count instances of first-person singular pronouns (“I” words). Linear regression, with PCL-5 scores and “I” words entered stepwise, was used to predict scores on the PSQI sleep duration subscale. Use of “I” words between the sexes was also compared.
Results
For females but not males, PTSD severity significantly predicted sleep duration (R2=.207, p=.001). Additionally, the number of “I” words in the trauma narratives predicted an additional 8% of the variance in sleep duration for females (R2 change=.083, β=.288, p=.029) but not males. Females used significantly more self-referential language in their narratives (M=11.84, SD=8.42) compared to males (M=5.25, SD=6.10, p=.001).
Conclusion
After controlling for PTSD severity, self-referential language in trauma narratives significantly predicted shorter sleep duration in females. While speculative, this finding suggests that treatment approaches for PTSD may benefit from a focus on targeting self-referential processes to improve sleep and PTSD in females but not males. As dysfunctional sleep is a hallmark of PTSD, further investigation into this relationship may illuminate a new treatment avenue for this disorder.
Support
W81XWH-14-1-0570
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Affiliation(s)
| | - A Burns
- University of Arizona, Tucson, AZ
| | - E Taylor
- University of Arizona, Tucson, AZ
| | | | - M Miller
- University of Arizona, Tucson, AZ
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26
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King R, Jecmen D, Mitchell J, Ralston K, Gould J, Burns A, Bullock A, Grandner MA, Alkozei A, Killgore WD. 0081 Habitual Sleep Duration is Negatively Correlated with Emotional Reactivity within the Rostral Anterior Cingulate Cortex in Individuals with PTSD. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Sleep difficulties, such as insomnia, are highly prevalent in individuals with Post-Traumatic Stress Disorder (PTSD). However, sleep deprivation can also increase emotional reactivity to positive (as well as negative) stimuli. While the effects of sleep loss on emotional perception healthy individuals has been documented, it remains unclear how lack of sleep in individuals with PTSD may affect their emotional reactivity to positive stimuli. We hypothesized that lower habitual sleep duration would be associated with greater functional brain activation changes in response to subliminally presented happy faces in brain areas of the reward network, such as the rostral anterior cingulate cortex (rACC).
Methods
Thirty-nine individuals with DSM-5 confirmed PTSD were administered the Pittsburgh Sleep Quality Index (PSQI) as a measure of their average nightly sleep duration over the past month. Participants then underwent fMRI imagining while viewing subliminal presentations of faces displaying happiness, using a backward masked facial affect paradigm to minimize conscious awareness of the expressed emotion. Brain activation to masked happy expressions was regressed against sleep duration in SPM12.
Results
There was a negative correlation between habitual sleep duration and activation within the rACC in response to the masked happy faces (x=14,y=40,z=0; k=102, pFWE-corr= 0.008).
Conclusion
Individuals with PTSD who average less sleep at night showed greater emotional reactivity, as indexed by greater functional brain activation changes within an area of the reward network, than individuals who obtained more sleep per night. Future research involving actual sleep duration manipulation will be necessary to determine whether this finding reflects the well-known antidepressant effect of sleep deprivation or a form of greater emotional expression error monitoring among traumatized patients when lacking sleep. Regardless, these findings suggest that insufficient sleep could affect unconsciously perceived emotion in faces and potentially affect social and emotional responses among individuals with PTSD.
Support
US Army Medical Research and Materiel Command: W81XWH-14-1-0570
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Affiliation(s)
- R King
- University of Arizona, Tucson, AZ
| | - D Jecmen
- University of Arizona, Tucson, AZ
| | | | | | - J Gould
- University of Arizona, Tucson, AZ
| | - A Burns
- University of Arizona, Tucson, AZ
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27
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Jiang XY, Atkinson S, Pearson R, Leaning D, Cumming S, Burns A, Azzabi A, Frew J, McMenemin R, Pedley ID. Optimising Radium 223 Therapy for Metastatic Castration-Resistant Prostate Cancer -5-year Real-World Outcome: Focusing on Treatment Sequence and Quality of Life. Clin Oncol (R Coll Radiol) 2020; 32:e177-e187. [PMID: 32448724 DOI: 10.1016/j.clon.2020.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 04/15/2020] [Accepted: 04/22/2020] [Indexed: 01/04/2023]
Abstract
AIMS Real-world evidence of radium 223 (Ra-223) for the treatment of men with metastatic castration-resistant prostate cancer is emerging. In this prospective single-centre service evaluation, we report for the first time in the UK, real-world quality of life (QoL) and survival outcomes, including the sequencing impact, in 228 treated patients. We aim to share our 5-year experience on how to optimise Ra-223 treatment. MATERIALS AND METHODS Patients who received Ra-223 therapy between 2014 and 2018 at the Northern Centre for Cancer Care, Newcastle upon Tyne, UK were included in this evaluation. Demographics, clinical characteristics, blood parameters, treatment sequencing and QoL data using abbreviated Functional Assessment of Cancer Therapy-Prostate questionnaires were prospectively collected and analysed. RESULTS In total, 228 patients were included; median age 72 years (51-87). The medium overall survival was 11.1 months. Overall survival in post-chemotherapy and chemotherapy-naïve patients was 8.1 and 12.3 months, respectively (P = 0.02, hazard ratio 1.52, 95% confidence interval 1.06-2.17); in pre-enzalutamide and post-enzalutamide patients was 11.3 and 10.4 months, respectively (P = 0.65, hazard ratio 0.92, 95% confidence interval 0.63-1.33); in pre-abiraterone and prednisolone and post-abiraterone and prednisolone patients was 11.8 and 10.5 months, respectively (P = 0.08, hazard ratio 0.74, 95% confidence interval 0.51-1.06); in this latter group, the fracture rate was 24% (15/63). QoL post Ra-223 (n = 101 evaluated) showed that pain scores improved in 54%, there was no change in 17% and pain scores worsened in 30% of treated patients. Overall QoL scores showed a similar trend. QoL was not significantly associated with overall survival. CONCLUSIONS Ra-223 palliates pain and improves disease-related QoL in most patients in the real-world setting. Our survival outcome is comparable with other real-world studies. Chemotherapy-naïve patients seemed to have better survival than those who received prior chemotherapy. No significant survival differences were observed between pre- and post-abiraterone and prednisolone or enzalutamide patients. The fracture rate in the post-abiraterone and prednisolone group seemed to be high. Bone health evaluation and protection should be incorporated as standard of care.
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Affiliation(s)
- X Y Jiang
- Northern Centre for Cancer Care, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
| | - S Atkinson
- Department of Nuclear Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - R Pearson
- Northern Institute of Cancer Research, Newcastle University, Newcastle upon Tyne, UK
| | - D Leaning
- Department of Clinical Oncology, James Cook University Hospital, South Tees NHS Trust, Middlesbrough, UK
| | - S Cumming
- Northern Centre for Cancer Care, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - A Burns
- Department of Radiotherapy Information Technology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - A Azzabi
- Northern Centre for Cancer Care, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - J Frew
- Northern Centre for Cancer Care, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - R McMenemin
- Northern Centre for Cancer Care, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - I D Pedley
- Northern Centre for Cancer Care, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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28
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Stevenson EJ, Shannon OM, Minihane AM, Adamson A, Burns A, Hill T, Sniehotta F, Muniz‐Terrera G, Ritchie CW. NuBrain: UK consortium for optimal nutrition for healthy brain ageing. NUTR BULL 2020. [DOI: 10.1111/nbu.12429] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- E. J. Stevenson
- Faculty of Medical Sciences Human Nutrition Research Centre Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK
| | - O. M. Shannon
- Faculty of Medical Sciences Human Nutrition Research Centre Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK
| | - A. M. Minihane
- Norwich Medical School University of East Anglia Norwich UK
| | - A. Adamson
- Faculty of Medical Sciences Human Nutrition Research Centre Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK
| | - A. Burns
- Faculty of Medical and Human Sciences University of Manchester Manchester UK
| | - T. Hill
- Faculty of Medical Sciences Human Nutrition Research Centre Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK
| | - F. Sniehotta
- Faculty of Medical Sciences Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK
| | - G. Muniz‐Terrera
- Centre for Dementia Prevention University of Edinburgh Edinburgh UK
- Centre for Clinical Brain Sciences University of Edinburgh Edinburgh UK
| | - C. W. Ritchie
- Centre for Dementia Prevention University of Edinburgh Edinburgh UK
- Centre for Clinical Brain Sciences University of Edinburgh Edinburgh UK
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Harbin J, Burns A, Davis RI, Indrusiak LS, Bate I, Griffin D. The AirTight Protocol for Mixed Criticality Wireless CPS. ACM Trans Cyber-Phys Syst 2020. [DOI: 10.1145/3362987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This article describes the motivation, design, analysis, and configuration of the criticality-aware multi-hop wireless communication protocol AirTight. Wireless communication has become a crucial part of the infrastructure of many cyber-physical applications. Many of these applications are real-time and also mixed-criticality, in that they have components/subsystems with different consequences of failure. Wireless communication is inevitably subject to levels of external interference. In this article, we represent this interference using a criticality-aware fault model; for each level of temporal interference in the fault model, we guarantee the timing behaviour of the protocol (i.e., we guarantee that packet deadlines are satisfied for certain levels of criticality). Although a new protocol, AirTight is built upon existing standards such as IEEE 802.15.4. A prototype implementation and protocol-accurate simulator have been produced. This article develops a series of schedulability analysis techniques for single-channel and multichannel wireless Cyber-Physical Systems (CPS). Heuristics are specified and evaluated as the starting point of design space exploration. Genetic algorithms are then defined and evaluated to assess their performance in developing schedule tables incorporating multichannel allocations in these systems.
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Affiliation(s)
- J. Harbin
- Department of Computer Science, University of York, UK
| | - A. Burns
- Department of Computer Science, University of York, UK
| | - R. I. Davis
- Department of Computer Science, University of York, UK
| | | | - I. Bate
- Department of Computer Science, University of York, UK
| | - D. Griffin
- Department of Computer Science, University of York, UK
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30
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Pickles R, Atherton P, Turnbull H, Burns A, Iqbal M. Stereotactic ablative radiotherapy (SABR) for non-small cell lung cancer (NSCLC): analysis of T3N0M0 patients. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30100-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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31
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Ashokkumar S, Burns A, MacIsaac A, MacIsaac R, Prior D, La Gerche A, Roberts T. 369 Left Atrial Strain is not Associated With Reduced Exercise Capacity in Diabetes Mellitus Subjects. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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32
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Eyres M, Lanfredini S, Willenbrock F, Thapa A, Blake A, Burns A, Sabbagh A, Abraham A, Maughan T, Soonawalla Z, Schuh A, Mukhergee S, O'Neill E. Abstract PR02: Loss of TET2 activity results in epigenetic instability and drives PDAC molecular subtypes. Cancer Res 2019. [DOI: 10.1158/1538-7445.panca19-pr02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: mRNA datasets have defined two molecular subtypes of pancreatic ductal adenocarcinoma (PDAC), classical and squamous, with distinct clinical characteristics and raising the possibility of subtype specific therapies (Collisson et al., 2019). The aggressive squamous subtype is characterized by poorer patient survival and loss of endodermal differentiation markers GATA6 and PDX1, but neither PDAC subtypes nor metastasis can be explained by genetic mutations alone (Reiter et al., 2018). Conversely, widespread epigenetic reprogramming is associated with progression to more aggressive phenotypes (McDonald et al., 2017), suggesting that aggressive molecular subtype is likely to be epigenetically driven. The role of DNA 5’methylcytosine (5’mc) in PDAC has been previously unclear due to an inability to distinguish this mark from the reciprocal activation mark DNA 5’hydroxymethylcytosine (5’hmC), mediated by Ten-eleven-translocation (TET) enzymes. Moreover, 5’hmc is dynamically regulated during pancreatic differentiation, but a role during PDAC initiation or progression has not been previously addressed.
Methods: PDAC patients who underwent surgical resection at the Churchill Hospital, Oxford (n=146) had FFPE tumor tissue mutation comprehensively profiled by illumina hotspot array (300X), mRNA microarray, and the first epigenetic separation of 5’mc and 5’hmc on FFPE via oxidative bisulphite sequencing (oxBS) and illumina EPIC arrays. iCluster was used to highlight epigenetic PDAC subtypes and compare to existing TCGA datasets. Orthotopic models were employed to test whether the Squamous subtype is defined by 5’hmc loss and if this can be converted to the classical subtype in vivo.
Results: Compared to healthy tissue, PDAC tumors demonstrate loss of 5’hmC at genes critical for pancreatic development and associated with PDAC progression, including MAPK signaling and TP53 targets. 5’hmC was preferentially lost in aggressive molecular subtypes (squamous) compared to the classical subtypes and was associated with SMAD4 mutations and reduced TET2. Overexpression of TET2 in squamous tumor cells restored 5’hmc and the expression of classical associated genes (e.g., GATA6 and PDX1), suggesting that 5’hmC is a master epigenetic regulator of PDAC molecular subtypes. Notably, we find TET2 stability is regulated by glucose levels, implying the widespread hypoglycemia seen in PDAC patients may contribute to progression of aggressive subtypes through loss of 5’hmC. Concomitantly, as metformin and vitamin C independently enhance endogenous TET2 activity, we find that this combination acts synergistically on squamous tumors to increase 5’hmC and expression of a classical-subtype phenotype, suggesting subtype switching is achievable in vitro and in vivo.
Conclusion: These results identify 5’hmC as a regulator of molecular subtype that can be targeted in vivo using well-tolerated drugs.
This abstract is also being presented as Poster A39.
Citation Format: Michael Eyres, Simone Lanfredini, Frances Willenbrock, Asmita Thapa, Andrew Blake, Adam Burns, Ahmad Sabbagh, Aswin Abraham, Timothy Maughan, Zahir Soonawalla, Anna Schuh, Somnath Mukhergee, Eric O'Neill. Loss of TET2 activity results in epigenetic instability and drives PDAC molecular subtypes [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Advances in Science and Clinical Care; 2019 Sept 6-9; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2019;79(24 Suppl):Abstract nr PR02.
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Affiliation(s)
| | | | | | | | | | - Adam Burns
- University of Oxford, Oxford, United Kingdom
| | | | | | | | | | - Anna Schuh
- University of Oxford, Oxford, United Kingdom
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Vargyas LD, Walls GE, Bramstedt WR, Eilrich GL, Bennett O, Burns A, Bushway R, Byington J, Denomme M, Fox D, Helfant L, Kennedy D, Ripley B, Schetter J, Schultz W. Simultaneous Determination of Chlorothalonil and Hexachlorobenzene in Technical and Formulated Materials by Capillary Gas Chromatography: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/83.5.1047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A collaborative study was conducted for the capillary gas chromatographic (GC) method for the simultaneous determination of the fungicide chlorothalonil (CTL) and the accompanying impurity, hexachlorobenzene (HCB), in technical and formulated materials. The method calls for the dissolution of technical and dry formulations of CTL and HCB from the aqueous flowable formulation. The 10 participating laboratories were asked to analyze the samples by adhering to the method as closely as their instrumentation and data systems allowed, and to note any deviations from the method. Collaborators were asked to prepare the standards and samples, set up the capillary GC systems, analyze the samples, and calculate the results. CTL produced reproducibility relative standard deviations (RSDR) of 0.4–2.5 (active ingredient concentrations ranged from approximately 52 to 98% by weight). HCB produced RSDR values of 5.2–22% (HCB concentrations were 0.02–0.04% by weight). The method was adopted First Action by AOAC INTERNATIONAL.
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Affiliation(s)
| | | | | | - Gary L Eilrich
- ISK Biosciences Corporation, 5966 Heisley Rd, Mentor, OH 44060
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Sartorius N, Semrau M, Burns A, Lobo A, Rikkert MO, Robert P, Stoppe G. Staging of care for people with dementia: A global effort. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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35
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Pearson R, Jiang X, Atkinson S, Cumming S, Burns A, Frew J, McMenemin R, Pedley I, Azzabi A. EP-1584 Radium-223 treatment in Metastatic Prostate Cancer: Prognostic Factors: Real-world Outcome. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32004-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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36
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Goodfellow M, Burns A. Relation between facial fractures and socioeconomic deprivation in the north east of England. Br J Oral Maxillofac Surg 2019; 57:255-259. [PMID: 30898455 DOI: 10.1016/j.bjoms.2018.11.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 11/21/2018] [Indexed: 11/28/2022]
Abstract
Patients with a low socioeconomic status suffer disproportionately from trauma, and have a high incidence of mandibular fractures. To explore how deprivation affects the incidence of facial fractures in the north east of England, we reviewed 1096 patients who were admitted to the oral and maxillofacial surgical (OMFS) unit at Sunderland Royal Hospital for treatment of a facial fracture between December 2013 and December 2017. Levels of socioeconomic deprivation, which were obtained from postcodes and the UK Government Open Data Communities database, were compared with a random sample of deprivation data from the catchment area of our hospital. Patients with nasal and mandibular fractures were more likely to be socioeconomically deprived than those in the catchment area of our hospital (p = 0.006 and p < 0.001, respectively), but this was not the case in those with malar/maxillary or orbital floor fractures (p = 0.184 and p = 0.641, respectively). The incidence of fractures that were caused by assault was not associated with increased socioeconomic deprivation (p = 0.241). Patients of low socioeconomic status were more likely to have been under the influence of a substance when the injury occurred (p = 0.014). There is a strong association between socioeconomic deprivation and facial fractures. OMFS departments should therefore be as accessible as possible to patients from more disadvantaged backgrounds, given their greater risk of injury.
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Affiliation(s)
- M Goodfellow
- School of Medical Education, The Faculty of Medical Sciences, Cookson Building, Newcastle University, NE2 4HH, United Kingdom.
| | - A Burns
- Department of Oral & Maxillofacial Surgery, Sunderland Royal Hospital, Kayll Road, Sunderland, SR4 7TP, United Kingdom
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37
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Iqbal M, Pickles R, Mackenzie L, Burns A, Turnbull H, Atherton P. Experience of stereotactic ablative radiotherapy (SABR) in early stage non-small cell lung cancer (NSCLC): an analysis of treatment response and survival outcome. Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30221-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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38
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Turner A, Burns A, Colling B, Leppänen J. Applications of Serpent 2 Monte Carlo Code to ITER Neutronics Analysis. Fusion Science and Technology 2018. [DOI: 10.1080/15361055.2018.1489660] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A. Turner
- UK Atomic Energy Authority (CCFE), Culham Science Centre, Abingdon, Oxon OX14 3DB, United Kingdom
| | - A. Burns
- UK Atomic Energy Authority (CCFE), Culham Science Centre, Abingdon, Oxon OX14 3DB, United Kingdom
| | - B. Colling
- UK Atomic Energy Authority (CCFE), Culham Science Centre, Abingdon, Oxon OX14 3DB, United Kingdom
| | - J. Leppänen
- VTT Technical Research Centre of Finland, Kivimiehetie 3, Espoo FI-02150, Finland
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39
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Coyle CE, Mutchler JE, Shea E, Burns A. AGE-FRIENDLY BOSTON’S INCLUSIONARY APPROACH TO IMPLEMENTING ACTION. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C E Coyle
- University of Massachusetts Boston, Boston, Massachusetts, United States
| | - J E Mutchler
- Gerontology Department, University of Massachusetts Boston, Boston, MA, USA
| | - E Shea
- City of Boston’s Commisison on Affairs of the Elderly, Boston, MA, USA
| | - A Burns
- City of Boston’s Commisison on Affairs of the Elderly, Boston, MA, USA
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40
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Bui C, Coyle C, Shea E, Burns A. ENGAGING OLDER RESIDENTS THROUGH A CIVIC ACADEMY IN AGE-FRIENDLY BOSTON. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C Bui
- University of Massachusetts Boston
| | - C Coyle
- University of Massachusetts Boston
| | - E Shea
- Commission of Affairs of the Elderly
| | - A Burns
- Commission on Affairs of the Elderly
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41
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Gaines B, Xu P, Burns A, Shea E, Coyle C, Mutchler J. BARRIERS TO EMPLOYMENT AMONG OLDER ADULTS: AN ACTION ITEM OF THE AGE-FRIENDLY BOSTON INITIATIVE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- B Gaines
- University of Massachusetts Boston
| | - P Xu
- University of Massachusetts Boston
| | - A Burns
- Commission on Affairs of the Elderly
| | - E Shea
- Commission of Affairs of the Elderly
| | - C Coyle
- University of Massachusetts Boston
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42
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Maguire D, McMillan D, Stefanowicz F, Burns A, Ross D, Talwar D. The effect of thiamine and/or magnesium supplementation on thiamine, magnesium, lactate and erythrocyte transketolase activity in patients presenting to the emergency department with alcohol withdrawal syndrome. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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43
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Gupta P, Mohamed A, Patel P, Burns A, Saeed M, Lane D, Seidu S, Khunti K. High rates of non-adherence to antidiabetic, antihypertensive and lipid lowering treatment in patients with type 2 diabetes revealed liquid chromatography-tandem mass spectrometry (lc-ms/ms) urine analysis. ATHEROSCLEROSIS SUPP 2018. [DOI: 10.1016/j.atherosclerosissup.2018.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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44
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Mohamed AA, Gupta P, Patel P, Burns A, Saeed M, Lane D, Seidu S, Khunti K. P6187High rates of non-adherence to antidiabetic, antihypertensive and lipid lowering treatment in patients with Type 2 diabetes revealed by liquid chromatography-tandem mass spectrometry urine analysis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A A Mohamed
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - P Gupta
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - P Patel
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - A Burns
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - M Saeed
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - D Lane
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - S Seidu
- University of Leicester, Leicester, United Kingdom
| | - K Khunti
- University of Leicester, Leicester, United Kingdom
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45
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Stamatopoulos B, Smith T, Crompot E, Pieters K, Clifford R, Mraz M, Robbe P, Burns A, Timbs A, Bruce D, Hillmen P, Meuleman N, Mineur P, Firescu R, Maerevoet M, De Wilde V, Efira A, Philippé J, Verhasselt B, Offner F, Sims D, Heger A, Dreau H, Schuh A. The Light Chain IgLV3-21 Defines a New Poor Prognostic Subgroup in Chronic Lymphocytic Leukemia: Results of a Multicenter Study. Clin Cancer Res 2018; 24:5048-5057. [PMID: 29945996 DOI: 10.1158/1078-0432.ccr-18-0133] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 03/07/2018] [Accepted: 06/22/2018] [Indexed: 11/16/2022]
Abstract
Purpose: Unmutated (UM) immunoglobulin heavy chain variable region (IgHV) status or IgHV3-21 gene usage is associated with poor prognosis in chronic lymphocytic leukemia (CLL) patients. Interestingly, IgHV3-21 is often co-expressed with light chain IgLV3-21, which is potentially able to trigger cell-autonomous BCR-mediated signaling. However, this light chain has never been characterized independently of the heavy chain IgHV3-21.Experimental Design: We performed total RNA sequencing in 32 patients and investigated IgLV3-21 prognostic impact in terms of treatment-free survival (TFS) and overall survival (OS) in 3 other independent cohorts for a total of 813 patients. IgLV3-21 presence was tested by real-time PCR and confirmed by Sanger sequencing.Results: Using total RNA sequencing to characterize 32 patients with high-risk CLL, we found a high frequency (28%) of IgLV3-21 rearrangements. Gene set enrichment analysis revealed that these patients express higher levels of genes responsible for ribosome biogenesis and translation initiation (P < 0.0001) as well as MYC target genes (P = 0.0003). Patients with IgLV3-21 rearrangements displayed a significantly shorter TFS and OS (P < 0.05), particularly those with IgHV mutation. In each of the three independent validation cohorts, we showed that IgLV3-21 rearrangements-similar to UM IgHV status-conferred poor prognosis compared with mutated IgHV (P < 0.0001). Importantly, we confirmed by multivariate analysis that this was independent of IgHV mutational status or subset #2 stereotyped receptor (P < 0.0001).Conclusions: We have demonstrated for the first time that a light chain can affect CLL prognosis and that IgLV3-21 light chain usage defines a new subgroup of CLL patients with poor prognosis. Clin Cancer Res; 24(20); 5048-57. ©2018 AACR.
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Affiliation(s)
- Basile Stamatopoulos
- Laboratory of Clinical Cell Therapy, Jules Bordet Institute, ULB-Research Cancer Center (U-CRC), Université Libre de Bruxelles (ULB), Brussels, Belgium. .,Molecular Diagnostic Centre, Oxford University Hospitals, Oxford, United Kingdom.,Nuffield Department of Laboratory Sciences, University of Oxford, Oxford, United Kingdom
| | - Thomas Smith
- Computational Genomics Analysis and Training Program, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - Emerence Crompot
- Laboratory of Clinical Cell Therapy, Jules Bordet Institute, ULB-Research Cancer Center (U-CRC), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Karlien Pieters
- Laboratory of Clinical Cell Therapy, Jules Bordet Institute, ULB-Research Cancer Center (U-CRC), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Ruth Clifford
- Molecular Diagnostic Centre, Oxford University Hospitals, Oxford, United Kingdom.,Nuffield Department of Laboratory Sciences, University of Oxford, Oxford, United Kingdom
| | - Marek Mraz
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Brno, Czech Republic.,Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Pauline Robbe
- Molecular Diagnostic Centre, Oxford University Hospitals, Oxford, United Kingdom.,Nuffield Department of Laboratory Sciences, University of Oxford, Oxford, United Kingdom
| | - Adam Burns
- Molecular Diagnostic Centre, Oxford University Hospitals, Oxford, United Kingdom.,Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Adele Timbs
- Molecular Diagnostic Centre, Oxford University Hospitals, Oxford, United Kingdom
| | - David Bruce
- Molecular Diagnostic Centre, Oxford University Hospitals, Oxford, United Kingdom.,Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Peter Hillmen
- St. James' Institute of Oncology, St James' University Hospital, Leeds, United Kingdom
| | | | - Philippe Mineur
- Department of Hemato-Oncology, Grand Hôpital de Charleroi, Charleroi, Belgium
| | - Radu Firescu
- Hematology Department, CHU Ambroise Paré, Mons, Belgium
| | - Marie Maerevoet
- Hematology Department, Jules Bordet Institute, Brussels, Belgium.,Hematology Department, Hôpital Erasme (ULB), Brussels, Belgium
| | | | - André Efira
- Department of Hemato-oncology, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium
| | - Jan Philippé
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Bruno Verhasselt
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Fritz Offner
- Department of Internal Medicine, Hematology, Ghent University Hospital, Ghent, Belgium
| | - David Sims
- Computational Genomics Analysis and Training Program, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - Andreas Heger
- Computational Genomics Analysis and Training Program, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - Hélène Dreau
- Molecular Diagnostic Centre, Oxford University Hospitals, Oxford, United Kingdom
| | - Anna Schuh
- Molecular Diagnostic Centre, Oxford University Hospitals, Oxford, United Kingdom.,Department of Oncology, University of Oxford, Oxford, United Kingdom
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Klintman J, Barmpouti K, Knight SJL, Robbe P, Dreau H, Clifford R, Ridout K, Burns A, Timbs A, Bruce D, Antoniou P, Sosinsky A, Becq J, Bentley D, Hillmen P, Taylor JC, Caulfield M, Schuh AH. Clinical-grade validation of whole genome sequencing reveals robust detection of low-frequency variants and copy number alterations in CLL. Br J Haematol 2018; 182:412-417. [DOI: 10.1111/bjh.15406] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 04/09/2018] [Indexed: 01/02/2023]
Affiliation(s)
- Jenny Klintman
- Molecular Diagnostic Centre; Department of Oncology; University of Oxford; Oxford UK
| | - Katerina Barmpouti
- Molecular Diagnostic Centre; Department of Oncology; University of Oxford; Oxford UK
- Oxford University Hospitals; Oxford UK
| | - Samantha J. L. Knight
- NIHR Biomedical Research Centre; Oxford and Wellcome Trust Centre for Human Genetics; University of Oxford; Oxford UK
- Oxford Biomedical Research Centre; Oxford UK
| | - Pauline Robbe
- Molecular Diagnostic Centre; Department of Oncology; University of Oxford; Oxford UK
- Nuffield Department of Laboratory Sciences; University of Oxford; Oxford UK
| | - Hélène Dreau
- Molecular Diagnostic Centre; Department of Oncology; University of Oxford; Oxford UK
- Oxford University Hospitals; Oxford UK
| | - Ruth Clifford
- Molecular Diagnostic Centre; Department of Oncology; University of Oxford; Oxford UK
- Nuffield Department of Laboratory Sciences; University of Oxford; Oxford UK
- Haematology Department; University Hospital Limerick; Limerick Ireland
| | - Kate Ridout
- Molecular Diagnostic Centre; Department of Oncology; University of Oxford; Oxford UK
| | - Adam Burns
- Molecular Diagnostic Centre; Department of Oncology; University of Oxford; Oxford UK
| | | | - David Bruce
- Molecular Diagnostic Centre; Department of Oncology; University of Oxford; Oxford UK
- Oxford University Hospitals; Oxford UK
| | | | | | | | | | - Peter Hillmen
- St James’ Institute of Oncology; St James’ University Hospital; Leeds UK
| | - Jenny C. Taylor
- NIHR Biomedical Research Centre; Oxford and Wellcome Trust Centre for Human Genetics; University of Oxford; Oxford UK
- Oxford Biomedical Research Centre; Oxford UK
| | - Mark Caulfield
- Haematology Department; University Hospital Limerick; Limerick Ireland
| | - Anna H. Schuh
- Molecular Diagnostic Centre; Department of Oncology; University of Oxford; Oxford UK
- Oxford University Hospitals; Oxford UK
- Oxford Biomedical Research Centre; Oxford UK
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47
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Dunn K, Hamilton B, Burns A. Support device for percutaneous endoscopic gastrostomy tube. Br J Oral Maxillofac Surg 2018; 56:346-347. [DOI: 10.1016/j.bjoms.2018.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 02/06/2018] [Indexed: 10/17/2022]
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Förstl H, Howard R, Burns A, Levy R. ‘The Strange Mental State of an Old Man who thought he would be Slaughtered’–An Early Report of Dementia with Delusion (1785). J R Soc Med 2018; 84:432-4. [PMID: 1865454 PMCID: PMC1293338 DOI: 10.1177/014107689108400717] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- H Förstl
- Section of Old Age Psychiatry, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London
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Burns A, Alsolami R, Becq J, Stamatopoulos B, Timbs A, Bruce D, Robbe P, Vavoulis D, Clifford R, Cabes M, Dreau H, Taylor J, Knight SJL, Mansson R, Bentley D, Beekman R, Martín-Subero JI, Campo E, Houlston RS, Ridout KE, Schuh A. Whole-genome sequencing of chronic lymphocytic leukaemia reveals distinct differences in the mutational landscape between IgHV mut and IgHV unmut subgroups. Leukemia 2017; 32:573. [PMID: 29160863 PMCID: PMC5808063 DOI: 10.1038/leu.2017.311] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Affiliation(s)
- E. Reynish
- Stirling University, Stirling, United Kingdom
- ICHOM Dementia Working Group, London, United Kingdom,
| | - A. Burns
- ICHOM Dementia Working Group, London, United Kingdom,
| | - C. Roberts
- ICHOM Dementia Working Group, London, United Kingdom,
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