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Cheng C, Jenkins A, Holland PR, Wang Z, Dong J, Liu C. Ice shelf basal channel shape determines channelized ice-ocean interactions. Nat Commun 2024; 15:2877. [PMID: 38570489 PMCID: PMC10991488 DOI: 10.1038/s41467-024-47351-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 03/25/2024] [Indexed: 04/05/2024] Open
Abstract
Growing evidence has confirmed the critical role played by basal channels beneath Antarctic ice shelves in both ice shelf stability and freshwater input to the surrounding ocean. Here we show, using a 3D ice shelf-ocean boundary current model, that deeper basal channels can lead to a significant amplification in channelized basal melting, meltwater channeling, and warming and salinization of the channel flow. All of these channelized quantities are also modulated by channel width, with the level of modulation determined by channel height. The explicit quantification of channelized basal melting and the meltwater transport in terms of channel cross-sectional shape is potentially beneficial for the evaluation of ice shelf mass balance and meltwater contribution to the nearshore oceanography. Complicated topographically controlled circulations are revealed to be responsible for the unique thermohaline structure inside deep channels. Our study emphasizes the need for improvement in observations of evolving basal channels and the hydrography inside them, as well as adjacent to the ice front where channelized meltwater emerges.
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Affiliation(s)
- Chen Cheng
- Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Zhuhai, 519080, China.
| | - Adrian Jenkins
- Department of Geography and Environmental Sciences, Faculty of Engineering and Environment, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | | | - Zhaomin Wang
- Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Zhuhai, 519080, China
| | - Jihai Dong
- School of Marine Sciences, Nanjing University of Information Science and Technology, Nanjing, 210044, China
| | - Chengyan Liu
- Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Zhuhai, 519080, China
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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Kugel R, Schaye J, Schaller M, Helly JC, Braspenning J, Elbers W, Frenk CS, McCarthy IG, Kwan J, Salcido J, van Daalen MP, Vandenbroucke B, Bahé YM, Borrow J, Chaikin E, Huško F, Jenkins A, Lacey CG, Nobels FSJ, Vernon I. FLAMINGO: calibrating large cosmological hydrodynamical simulations with machine learning. Mon Not R Astron Soc 2023; 526:6103-6127. [PMID: 37900898 PMCID: PMC10602225 DOI: 10.1093/mnras/stad2540] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/08/2023] [Accepted: 08/12/2023] [Indexed: 10/31/2023]
Abstract
To fully take advantage of the data provided by large-scale structure surveys, we need to quantify the potential impact of baryonic effects, such as feedback from active galactic nuclei (AGN) and star formation, on cosmological observables. In simulations, feedback processes originate on scales that remain unresolved. Therefore, they need to be sourced via subgrid models that contain free parameters. We use machine learning to calibrate the AGN and stellar feedback models for the FLAMINGO (Fullhydro Large-scale structure simulations with All-sky Mapping for the Interpretation of Next Generation Observations) cosmological hydrodynamical simulations. Using Gaussian process emulators trained on Latin hypercubes of 32 smaller volume simulations, we model how the galaxy stellar mass function (SMF) and cluster gas fractions change as a function of the subgrid parameters. The emulators are then fit to observational data, allowing for the inclusion of potential observational biases. We apply our method to the three different FLAMINGO resolutions, spanning a factor of 64 in particle mass, recovering the observed relations within the respective resolved mass ranges. We also use the emulators, which link changes in subgrid parameters to changes in observables, to find models that skirt or exceed the observationally allowed range for cluster gas fractions and the SMF. Our method enables us to define model variations in terms of the data that they are calibrated to rather than the values of specific subgrid parameters. This approach is useful, because subgrid parameters are typically not directly linked to particular observables, and predictions for a specific observable are influenced by multiple subgrid parameters.
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Affiliation(s)
- Roi Kugel
- Leiden Observatory, Leiden University, PO Box 9513, NL-2300 RA Leiden, the Netherlands
| | - Joop Schaye
- Leiden Observatory, Leiden University, PO Box 9513, NL-2300 RA Leiden, the Netherlands
| | - Matthieu Schaller
- Leiden Observatory, Leiden University, PO Box 9513, NL-2300 RA Leiden, the Netherlands
- Lorentz Institute for Theoretical Physics, Leiden University, PO box 9506, NL-2300 RA Leiden, the Netherlands
| | - John C Helly
- Institute for Computational Cosmology, Department of Physics, University of Durham, South Road, Durham DH1 3LE, UK
| | - Joey Braspenning
- Leiden Observatory, Leiden University, PO Box 9513, NL-2300 RA Leiden, the Netherlands
| | - Willem Elbers
- Institute for Computational Cosmology, Department of Physics, University of Durham, South Road, Durham DH1 3LE, UK
| | - Carlos S Frenk
- Institute for Computational Cosmology, Department of Physics, University of Durham, South Road, Durham DH1 3LE, UK
| | - Ian G McCarthy
- Astrophysics Research Institute, Liverpool John Moores University, Liverpool L3 5RF, UK
| | - Juliana Kwan
- Astrophysics Research Institute, Liverpool John Moores University, Liverpool L3 5RF, UK
| | - Jaime Salcido
- Astrophysics Research Institute, Liverpool John Moores University, Liverpool L3 5RF, UK
| | - Marcel P van Daalen
- Leiden Observatory, Leiden University, PO Box 9513, NL-2300 RA Leiden, the Netherlands
| | - Bert Vandenbroucke
- Leiden Observatory, Leiden University, PO Box 9513, NL-2300 RA Leiden, the Netherlands
| | - Yannick M Bahé
- Leiden Observatory, Leiden University, PO Box 9513, NL-2300 RA Leiden, the Netherlands
- Institute of Physics, Laboratory of Astrophysics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Observatoire de Sauverny, CH-1290 Versoix, Switzerland
| | - Josh Borrow
- Institute for Computational Cosmology, Department of Physics, University of Durham, South Road, Durham DH1 3LE, UK
- Department of Physics, Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Evgenii Chaikin
- Leiden Observatory, Leiden University, PO Box 9513, NL-2300 RA Leiden, the Netherlands
| | - Filip Huško
- Institute for Computational Cosmology, Department of Physics, University of Durham, South Road, Durham DH1 3LE, UK
| | - Adrian Jenkins
- Institute for Computational Cosmology, Department of Physics, University of Durham, South Road, Durham DH1 3LE, UK
| | - Cedric G Lacey
- Institute for Computational Cosmology, Department of Physics, University of Durham, South Road, Durham DH1 3LE, UK
| | - Folkert S J Nobels
- Leiden Observatory, Leiden University, PO Box 9513, NL-2300 RA Leiden, the Netherlands
| | - Ian Vernon
- Department of Mathematical Sciences, Durham University, Stockton Road, DH1 3LE Durham, UK
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Pelle T, Greenbaum JS, Dow CF, Jenkins A, Morlighem M. Subglacial discharge accelerates future retreat of Denman and Scott Glaciers, East Antarctica. Sci Adv 2023; 9:eadi9014. [PMID: 37889971 PMCID: PMC10610922 DOI: 10.1126/sciadv.adi9014] [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] [Received: 05/24/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023]
Abstract
Ice shelf basal melting is the primary mechanism driving mass loss from the Antarctic Ice Sheet, yet it is unknown how the localized melt enhancement from subglacial discharge will affect future Antarctic glacial retreat. We develop a parameterization of ice shelf basal melt that accounts for both ocean and subglacial discharge forcing and apply it in future projections of Denman and Scott Glaciers, East Antarctica, through 2300. In forward simulations, subglacial discharge accelerates the onset of retreat of these systems into the deepest continental trench on Earth by 25 years. During this retreat, Denman Glacier alone contributes 0.33 millimeters per year to global sea level rise, comparable to half of the contemporary sea level contribution of the entire Antarctic Ice Sheet. Our results stress the importance of resolving complex interactions between the ice, ocean, and subglacial environments in future Antarctic Ice Sheet projections.
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Affiliation(s)
- Tyler Pelle
- Scripps Institution of Oceanography, University of California, San Diego, La Jolla, CA, USA
| | - Jamin S Greenbaum
- Scripps Institution of Oceanography, University of California, San Diego, La Jolla, CA, USA
| | - Christine F Dow
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, ON, Canada
| | - Adrian Jenkins
- Department of Geography and Environmental Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
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Govind S, Fritzsche M, Jenkins A, Cleveland MH, Vallone PM, Almond N, Morris C, Berry N. Deep Sequencing and Molecular Characterisation of BK Virus and JC Virus WHO International Reference Materials for Clinical Diagnostic Use. Viruses 2023; 15:1289. [PMID: 37376589 DOI: 10.3390/v15061289] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/24/2023] [Accepted: 05/27/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Reactivation of JC and BK polyomaviruses during immunosuppression can lead to adverse clinical outcomes. In renal transplant recipients, BKV-associated nephropathy can result in graft loss, while in patients with autoimmune disorders, prolonged immunomodulatory drug use can cause rare onset of progressive multifocal leukoencephalopathy due to JCV reactivation. In such patients, accurate BK and JC viral load determinations by molecular technologies are important for diagnosis and clinical management; however, comparability across centres requires effective standardisation of diagnostic molecular detection systems. In October 2015, the WHO Expert Committee for Biological Standardisation (ECBS) established the 1st WHO International Standards (ISs) for use as primary-order calibrants for BKV and JCV nucleic acid detection. Two multi-centre collaborative studies confirmed their utility in harmonising agreement across the wide range of BKV and JCV assays, respectively. Previous Illumina-based deep sequence analysis of these standards, however, identified deletions in different regions, including the large T-antigen coding region. Hence, further detailed characterization was warranted. METHODS Comprehensive sequence characterisation of each preparation using short- and long-read next-generation sequencing technologies was performed with additional corroborative independent digital PCR (dPCR) determinations. Potential error rates associated with long-read sequencing were minimised by applying rolling circle amplification (RCA) protocols for viral DNA (circular dsDNA), generating a full validation of sequence identity and composition and delineating the integrity of full-length BK and JC genomes. RESULTS The analysed genomes displayed subpopulations frequently characterised by complex gene re-arrangements, duplications and deletions. CONCLUSIONS Despite the recognition of such polymorphisms using high-resolution sequencing methodologies, the ability of these reference materials to act to enhance assay harmonisation did not appear significantly impacted, based on data generated by the 2015 WHO collaborative studies, but highlights cautionary aspects of IS generation and commutability for clinical molecular diagnostic application.
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Affiliation(s)
- Sheila Govind
- Division of Infectious Disease Diagnostics, National Institute for Biological Standards and Control (NIBSC), South Mimms EN6 3QG, UK
| | - Martin Fritzsche
- Division of Analytical and Biological Sciences, National Institute for Biological Standards and Control (NIBSC), Medicines and Healthcare Product Regulatory Agency (MHRA), South Mimms EN6 3QG, UK
| | - Adrian Jenkins
- Division of Infectious Disease Diagnostics, National Institute for Biological Standards and Control (NIBSC), South Mimms EN6 3QG, UK
| | - Megan H Cleveland
- Applied Genetics Group, National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
| | - Peter M Vallone
- Applied Genetics Group, National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
| | - Neil Almond
- Division of Infectious Disease Diagnostics, National Institute for Biological Standards and Control (NIBSC), South Mimms EN6 3QG, UK
| | - Clare Morris
- Division of Infectious Disease Diagnostics, National Institute for Biological Standards and Control (NIBSC), South Mimms EN6 3QG, UK
| | - Neil Berry
- Division of Infectious Disease Diagnostics, National Institute for Biological Standards and Control (NIBSC), South Mimms EN6 3QG, UK
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Jordan JR, Miles BWJ, Gudmundsson GH, Jamieson SSR, Jenkins A, Stokes CR. Increased warm water intrusions could cause mass loss in East Antarctica during the next 200 years. Nat Commun 2023; 14:1825. [PMID: 37005432 PMCID: PMC10067810 DOI: 10.1038/s41467-023-37553-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 03/22/2023] [Indexed: 04/04/2023] Open
Abstract
The East Antarctic Ice Sheet (EAIS) is currently surrounded by relatively cool water, but climatic shifts have the potential to increase basal melting via intrusions of warm modified Circumpolar Deep Water (mCDW) onto the continental shelf. Here we use an ice sheet model to show that under the current ocean regime, with only limited intrusions of mCDW, the EAIS will likely gain mass over the next 200 years due to the increased precipitation from a warming atmosphere outweighing increased ice discharge due to ice-shelf melting. However, if the ocean regime were to become dominated by greater mCDW intrusions, the EAIS would have a negative mass balance, contributing up to 48 mm of SLE over this time period. Our modelling finds George V Land to be particularly at risk to increased ocean induced melting. With warmer oceans, we also find that a mid range RCP4.5 emissions scenario is likely to result in a more negative mass balance than a high RCP8.5 emissions scenario, as the relative difference between increased precipitation due to a warming atmosphere and increased ice discharge due to a warming ocean is more negative in the mid range RCP4.5 emission scenario.
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Affiliation(s)
- James R Jordan
- Department of Geography and Environmental Sciences, Faculty of Engineering and Environment, Northumbria University, Newcastle upon Tyne, UK.
- Laboratoire de Glaciologie, Université libre de Bruxelles (ULB), Brussels, Belgium.
| | - B W J Miles
- Department of Geography, Durham University, Durham, DH1 3LE, UK
- School of Geosciences, University of Edinburgh, Edinburgh, UK
| | - G H Gudmundsson
- Department of Geography and Environmental Sciences, Faculty of Engineering and Environment, Northumbria University, Newcastle upon Tyne, UK
| | - S S R Jamieson
- Department of Geography, Durham University, Durham, DH1 3LE, UK
| | - A Jenkins
- Department of Geography and Environmental Sciences, Faculty of Engineering and Environment, Northumbria University, Newcastle upon Tyne, UK
| | - C R Stokes
- Department of Geography, Durham University, Durham, DH1 3LE, UK
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van de Wal RSW, Nicholls RJ, Behar D, McInnes K, Stammer D, Lowe JA, Church JA, DeConto R, Fettweis X, Goelzer H, Haasnoot M, Haigh ID, Hinkel J, Horton BP, James TS, Jenkins A, LeCozannet G, Levermann A, Lipscomb WH, Marzeion B, Pattyn F, Payne AJ, Pfeffer WT, Price SF, Seroussi H, Sun S, Veatch W, White K. A High-End Estimate of Sea Level Rise for Practitioners. Earths Future 2022; 10:e2022EF002751. [PMID: 36590252 PMCID: PMC9787942 DOI: 10.1029/2022ef002751] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 09/23/2022] [Accepted: 10/03/2022] [Indexed: 06/17/2023]
Abstract
Sea level rise (SLR) is a long-lasting consequence of climate change because global anthropogenic warming takes centuries to millennia to equilibrate for the deep ocean and ice sheets. SLR projections based on climate models support policy analysis, risk assessment and adaptation planning today, despite their large uncertainties. The central range of the SLR distribution is estimated by process-based models. However, risk-averse practitioners often require information about plausible future conditions that lie in the tails of the SLR distribution, which are poorly defined by existing models. Here, a community effort combining scientists and practitioners builds on a framework of discussing physical evidence to quantify high-end global SLR for practitioners. The approach is complementary to the IPCC AR6 report and provides further physically plausible high-end scenarios. High-end estimates for the different SLR components are developed for two climate scenarios at two timescales. For global warming of +2°C in 2100 (RCP2.6/SSP1-2.6) relative to pre-industrial values our high-end global SLR estimates are up to 0.9 m in 2100 and 2.5 m in 2300. Similarly, for a (RCP8.5/SSP5-8.5), we estimate up to 1.6 m in 2100 and up to 10.4 m in 2300. The large and growing differences between the scenarios beyond 2100 emphasize the long-term benefits of mitigation. However, even a modest 2°C warming may cause multi-meter SLR on centennial time scales with profound consequences for coastal areas. Earlier high-end assessments focused on instability mechanisms in Antarctica, while here we emphasize the importance of the timing of ice shelf collapse around Antarctica. This is highly uncertain due to low understanding of the driving processes. Hence both process understanding and emission scenario control high-end SLR.
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Affiliation(s)
- R. S. W. van de Wal
- Institute for Marine and Atmospheric Research UtrechtUtrecht UniversityTA UtrechtThe Netherlands
- Department of Physical GeographyUtrecht UniversityTA UtrechtThe Netherlands
| | - R. J. Nicholls
- Tyndall Centre for Climate Change ResearchUniversity of East AngliaNorwichUK
| | - D. Behar
- San Francisco Public Utilities CommissionSan FranciscoCAUSA
| | - K. McInnes
- Climate Change Research CentreUNSW AustraliaSydneyNSWAustralia
| | - D. Stammer
- Centrum für Erdsystemforschung und NachhaltigkeitUniversität HamburgHamburgGermany
| | - J. A. Lowe
- Met Office Hadley CentreExeterUK
- Priestley CentreUniversity of LeedsLeedsUK
| | - J. A. Church
- Climate Change Research CentreUNSW AustraliaSydneyNSWAustralia
- Australian Centre for Excellence in Antarctic Science (ACEAS)University of TasmaniaHobartTASAustralia
| | - R. DeConto
- Department of GeosciencesUniversity of Massachusetts‐AmherstAmherstMAUSA
| | - X. Fettweis
- Department of GeographySPHERES Research UnitUniversity of LiègeLiègeBelgium
| | - H. Goelzer
- NORCE Norwegian Research CentreBjerknes Centre for Climate ResearchBergenNorway
| | | | - I. D. Haigh
- School of Ocean and Earth ScienceUniversity of SouthamptonNational Oceanography CentreSouthamptonUK
| | - J. Hinkel
- Adaptation and Social LearningGlobal Climate ForumBerlinGermany
| | - B. P. Horton
- Earth Observatory of SingaporeNanyang Technological UniversitySingaporeSingapore
- Asian School of the EnvironmentNanyang Technological UniversitySingaporeSingapore
| | - T. S. James
- Natural Resources CanadaGeological Survey of CanadaSidneyBCCanada
| | - A. Jenkins
- Department of Geography and Environmental SciencesNorthumbria UniversityNewcastle upon TyneUK
| | - G. LeCozannet
- Coastal Risks and Climate Change UnitRisks and Prevention DivisionBRGMOrléansFrance
| | - A. Levermann
- Potsdam Institute for Climate Impact ResearchPotsdamGermany
- LDEOColumbia UniversityNew YorkNYUSA
- Physics InstituteUniversity of PotsdamPotsdamGermany
| | - W. H. Lipscomb
- Climate and Global Dynamics LaboratoryNational Center for Atmospheric ResearchBoulderCOUSA
| | - B. Marzeion
- Institute of Geography and MARUM ‐ Center for Marine Environmental SciencesUniversity of BremenBremenGermany
| | - F. Pattyn
- Laboratoire de GlaciologieUniversité libre de BruxellesBrusselsBelgium
| | - A. J. Payne
- School of Geographical SciencesUniversity of BristolBristolUK
| | - W. T. Pfeffer
- INSTAAR and Department of Civil, Environmental, Architectural EngineeringUniversity of ColoradoBoulderCOUSA
| | - S. F. Price
- Theoretical DivisionLos Alamos National LaboratoryLos AlamosNMUSA
| | - H. Seroussi
- Thayer School of EngineeringDartmouth CollegeHanoverNHUSA
| | - S. Sun
- Coastal Risks and Climate Change UnitRisks and Prevention DivisionBRGMOrléansFrance
| | - W. Veatch
- US Army Corps of Engineers, HeadquartersWashingtonDCUSA
| | - K. White
- US Department of DefenseOffice of the Deputy Assistant Secretary of Defense (Environment and Energy Resilience)DCWashingtonUSA
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Garozzo D, Rispoli R, Graziano F, Gerardi RM, Grotenhuis A, Jenkins A, Sammons V, Visocchi M, Pinazzo S, Lima R, Martinez F, Emamhadi M, Pedro MT, Shirwari HS, Guedes F, Bhagavatula ID, Shukla DP, Bhat ID, Ojo OA, Tirsit A, Gonzales-Gonzales ME, Luna F, Kretschmer T, Benzel E, Cappelletto B. Women in Neurosurgery: Historical Path to Self-Segregation and Proposal for an Integrated Future. Front Surg 2022; 9:908540. [PMID: 35836607 PMCID: PMC9274114 DOI: 10.3389/fsurg.2022.908540] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/10/2022] [Indexed: 11/17/2022] Open
Abstract
Despite the rising percentage of women accessing the medical profession over the last few decades, surgical specialties are still largely male-dominated; in particular, a remarkable gender disparity is evident in neurosurgery, where only 19% of practitioners are females. Although women may be reluctant to choose a challenging specialty like neurosurgery due to concerns around how to balance family and career, it must be admitted that prejudices against female neurosurgeons have been deeply rooted for long, prompting many to give up and switch track to less demanding subspecialties. Among those who have persisted, many, if not most, have experienced difficulties in career progression and received unequal treatment in comparison with their male counterparts. In 1989, a group of 8 female neurosurgeons founded Women in Neurosurgery (WINS), an organization that aimed to guarantee inclusivity in neurosurgery, encouraging a better and more egalitarian working environment. Thereafter, WINS sessions were regularly promoted at international conferences, offering female neurosurgeons a platform to report issues related to gender discrimination. Over recent years, the mission of WINS sessions in national and international conferences has taken an unexpected deviation; they have progressively become supplementary scientific sessions with only women neurosurgeons as speakers, thus paving the road to a form of self-segregation. This tendency has also resulted in the establishment of sections of only female neurosurgeons within some national societies. Although there remains a faction that fiercely supports the WINS mindset of reserved spaces for women, such segregation is an upsetting prospect for those who believe that science and professionalism have no gender; a growing part of the global neurosurgical community believes that the conception of a “female neurosurgery” and a “male neurosurgery” is misguided and counterproductive and consider the existence of the WINS as anachronistic and no longer necessary.
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Affiliation(s)
- D Garozzo
- Department of Neurosurgery, Mediclinic Parkview Hospital, Dubai, UAE
| | - R Rispoli
- SOC Chirurgia Vertebro-Midollare, Azienda Sanitaria Universitaria Friuli Centrale, Presidio Ospedaliero Universitario Santa Maria della Misericordia di Udine, Udine, Italy
| | - F Graziano
- Department of Neurosurgery, ARNAS Garibaldi Hospital, Catania, Italy
| | - R M Gerardi
- Department of Neurosurgery, University Hospital, Palermo, Italy
| | - A Grotenhuis
- Department of Neurosurgery, Radboud UMC, Nijmegen, The Netherlands
| | - A Jenkins
- Department of Neurosurgery, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - V Sammons
- Department of Neurosurgery, North Shore Private Hospital, Sydney, Australia
| | - M Visocchi
- Department of Neurosurgery, Agostino Gemelli IRCCS, Rome, Italy
| | - S Pinazzo
- Department of Neurosurgery, Hospital Maciel, Montevideo, Uruguay
| | - R Lima
- Department of Neurosurgery, Hospital de Clínicas, Montevideo, Uruguay
| | - F Martinez
- Department of Neurosurgery, Hospital de Clínicas, Montevideo, Uruguay
| | - M Emamhadi
- Brachial plexus and peripheral nerve injury center, Guilan University of Medical Sciences, Rasht, Iran
| | - M T Pedro
- Peripheral Nerve Unit, Department of Neurosurgery, BKH Günzburg at Ulm University, Günzburg, Germany
| | - H S Shirwari
- Department of Neurosurgery, Dawodzai Medical Complex, Jalalabad, Afghanistan
| | - F Guedes
- Division of Neurosurgery, Gaffrée e Guinle University Hospital, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - D P Shukla
- Department of Neurosurgery, NIMHANS, Bangalore, India
| | - I D Bhat
- Department of Neurosurgery, RV Astor Hospital Sarakki Jp Nagar, Bengaluru, India
| | - O A Ojo
- Department of Surgery, College of Medicine, University of Lagos, Lagos, Nigeria
| | - A Tirsit
- Department of Neurosurgery, Addis Ababa University, Addis Ababa, Ethiopia
| | - M E Gonzales-Gonzales
- Department of Neurosurgery, Hospital Civil de Guadalajara, Guadalajara, Jalisco, Mexico
| | - F Luna
- Departament of Neurosurgery, Hospital Clínico Regional de Concepción, Universidad de Concepción. Concepcion, Chile
| | - T Kretschmer
- Dept. of Neurosurgery & Neurorestoration, Neurosurgical Intensive Care, Neurooncological Centre (DKG) Klinikum Klagenfurt, Klagenfurt, Austria
| | - E Benzel
- Department of Neurosurgery, Cleveland Clinic, Cleveland, OH, United States of America
| | - B Cappelletto
- SOC Chirurgia Vertebro-Midollare, Azienda Sanitaria Universitaria Friuli Centrale, Presidio Ospedaliero Universitario Santa Maria della Misericordia di Udine, Udine, Italy
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10
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Miles BWJ, Stokes CR, Jamieson SSR, Jordan JR, Gudmundsson GH, Jenkins A. High spatial and temporal variability in Antarctic ice discharge linked to ice shelf buttressing and bed geometry. Sci Rep 2022; 12:10968. [PMID: 35768612 PMCID: PMC9243100 DOI: 10.1038/s41598-022-13517-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/25/2022] [Indexed: 11/09/2022] Open
Abstract
Antarctica's contribution to global mean sea level rise has been driven by an increase in ice discharge into the oceans. The rate of change and the mechanisms that drive variability in ice discharge are therefore important to consider in the context of projected future warming. Here, we report observations of both decadal trends and inter-annual variability in ice discharge across the Antarctic Ice Sheet at a variety of spatial scales that range from large drainage basins to individual outlet glacier catchments. Overall, we find a 37 ± 11 Gt year-1 increase in discharge between 1999 and 2010, but a much smaller increase of 4 ± 8 Gt year-1 between 2010 and 2018. Furthermore, comparisons reveal that neighbouring outlet glaciers can behave synchronously, but others show opposing trends, despite their close proximity. We link this spatial and temporal variability to changes in ice shelf buttressing and the modulating effect of local glacier geometry.
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Affiliation(s)
- Bertie W J Miles
- School of Geosciences, Edinburgh University, Edinburgh, EH8 9XP, UK. .,Department of Geography, Durham University, Durham, DH1 3LE, UK.
| | - Chris R Stokes
- Department of Geography, Durham University, Durham, DH1 3LE, UK
| | | | - Jim R Jordan
- Department of Geography and Environmental Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK.,Laboratoire de Glaciologie, Université Libre de Bruxelles, Brussels, Belgium
| | - G Hilmar Gudmundsson
- Department of Geography and Environmental Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | - Adrian Jenkins
- Department of Geography and Environmental Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
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11
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Abstract
Accurate predictions of basal melt rates on ice shelves are necessary for precise projections of the future behaviour of ice sheets. The computational expense associated with completely resolving the cavity circulation using an ocean model makes this approach unfeasible for multi-century simulations, and parametrizations of melt rates are required. At present, some of the most advanced melt rate parametrizations are based on a one-dimensional approximation to the melt rate that emerges from the theory of subglacial plumes applied to ice shelves with constant basal slopes and uniform ambient ocean conditions; in this work, we present an asymptotic analysis of the corresponding equations in which non-constant basal slopes and typical ambient conditions are imposed. This analysis exploits the small aspect ratio of ice shelf bases, the relatively weak thermal driving and the relative slenderness of the region separating warm, salty water at depth and cold, fresh water at the surface in the ambient ocean. We construct an approximation to the melt rate that is based on this analysis, which shows good agreement with numerical solutions in a wide variety of cases, suggesting a path towards improved predictions of basal melt rates in ice-sheet models.
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Affiliation(s)
| | | | - Adrian Jenkins
- Department of Geography and Environmental Sciences, Northumbria University, Newcastle upon Tyne, UK
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12
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Yoon ST, Lee WS, Nam S, Lee CK, Yun S, Heywood K, Boehme L, Zheng Y, Lee I, Choi Y, Jenkins A, Jin EK, Larter R, Wellner J, Dutrieux P, Bradley AT. Ice front retreat reconfigures meltwater-driven gyres modulating ocean heat delivery to an Antarctic ice shelf. Nat Commun 2022; 13:306. [PMID: 35027549 PMCID: PMC8758661 DOI: 10.1038/s41467-022-27968-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 01/03/2022] [Indexed: 11/09/2022] Open
Abstract
Pine Island Ice Shelf (PIIS) buttresses the Pine Island Glacier, the key contributor to sea-level rise. PIIS has thinned owing to ocean-driven melting, and its calving front has retreated, leading to buttressing loss. PIIS melting depends primarily on the thermocline variability in its front. Furthermore, local ocean circulation shifts adjust heat transport within Pine Island Bay (PIB), yet oceanic processes underlying the ice front retreat remain unclear. Here, we report a PIB double-gyre that moves with the PIIS calving front and hypothesise that it controls ocean heat input towards PIIS. Glacial melt generates cyclonic and anticyclonic gyres near and off PIIS, and meltwater outflows converge into the anticyclonic gyre with a deep-convex-downward thermocline. The double-gyre migrated eastward as the calving front retreated, placing the anticyclonic gyre over a shallow seafloor ridge, reducing the ocean heat input towards PIIS. Reconfigurations of meltwater-driven gyres associated with moving ice boundaries might be crucial in modulating ocean heat delivery to glacial ice. Glacial melt can modify heat transport, and therefore ocean processes, associated with ice front retreat, as revealed by direct observations from the Pine Island Bay region of Antarctica.
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Affiliation(s)
- Seung-Tae Yoon
- School of Earth System Sciences, Kyungpook National University, 80, Daehak-ro, Buk-gu, Daegu, 41566, Republic of Korea
| | - Won Sang Lee
- Division of Glacial Environment Research, Korea Polar Research Institute, Incheon, 21990, Republic of Korea.
| | - SungHyun Nam
- School of Earth and Environmental Sciences/Research Institute of Oceanography, Seoul National University, Gwanak-gu, Seoul, 08826, Republic of Korea.
| | - Choon-Ki Lee
- Division of Glacial Environment Research, Korea Polar Research Institute, Incheon, 21990, Republic of Korea
| | - Sukyoung Yun
- Division of Glacial Environment Research, Korea Polar Research Institute, Incheon, 21990, Republic of Korea
| | - Karen Heywood
- School of Environmental Sciences, University of East Anglia, Norwich, Norfolk, NF4 7TJ, UK
| | - Lars Boehme
- Scottish Oceans Institute, University of St Andrews, Andrews, Fife, KY16 8LB, UK
| | - Yixi Zheng
- School of Environmental Sciences, University of East Anglia, Norwich, Norfolk, NF4 7TJ, UK
| | - Inhee Lee
- Department of Oceanography, Pusan National University, Geumjeong-gu, Busan, 46241, Republic of Korea
| | - Yeon Choi
- School of Earth and Environmental Sciences/Research Institute of Oceanography, Seoul National University, Gwanak-gu, Seoul, 08826, Republic of Korea
| | - Adrian Jenkins
- Department of Geography and Environmental Sciences, Northumbria University, Newcastle-upon-Tyne, NE1 8ST, UK
| | - Emilia Kyung Jin
- Division of Glacial Environment Research, Korea Polar Research Institute, Incheon, 21990, Republic of Korea
| | | | - Julia Wellner
- Department of Earth and Atmospheric Sciences, University of Houston, Houston, TX, 77004, USA
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13
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Curl C, Varma U, Raaijmakers A, Hemphill K, Janssens J, Jenkins A, Mellor K, Delbridge L. Treatment of Type 1 Diabetes With Metformin Reduces Diastolic Dysfunction and Cardiac Lipid Accumulation. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.137] [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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14
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Deitelzweig S, Keshishian A, Kang A, Jenkins A, Atreja N, Schuler P, Jiang J, Lovett K, Yuce H, Lip G. Time at home among nonvalvular atrial fibrillation patients treated with non-vitamin K antagonist oral anticoagulants: an ARISTOPHANES analysis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0574] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Patient-centered outcomes, such as home time, are becoming increasingly important quality-of-life measures. There are limited data on the impact of oral anticoagulants (OACs) on home time among patients with non-valvular atrial fibrillation.
Purpose
This analysis, based on the previously published ARISTOPHANES study, used five US insurance claims databases (CMS Medicare and four commercial databases) to compare home time among NVAF patients who were prescribed non-vitamin K antagonist OACs (NOACs).
Methods
Adult NVAF patients who were newly prescribed apixaban, dabigatran, or rivaroxaban (01JAN2013–30SEP2015) were selected. Time at home was calculated as the number of days from the index date (NOAC prescription) without any of the following: an inpatient, skilled nursing facility (SNF) or nursing facility, hospice, or inpatient rehabilitation facility admission. Time at home and without external AF-related care was defined as days from index date without any events from the home time endpoint or any days with a claim for bleeding, stroke/systemic embolism (S/SE), AF, or an INR test. Time at home and without external AF-related care were measured during the 180 days of follow-up; patients were required to have been alive and have 180 days of follow-up post index. In each database, three 1:1 NOAC-NOAC propensity-score-matched (PSM) cohorts were created before combining the databases. For each NOAC-NOAC matched cohort, Poisson regression was conducted to compare time at home and time at home without external AF-related care.
Results
After PSM, 37,314 apixaban-dabigatran, 107,236 apixaban-rivaroxaban, and 37,693 rivaroxaban-dabigatran patient pairs were created of which 37–44% had 180 days of follow-up available. Across the NOAC cohorts, approximately 21–25% of patients had an admission to a hospital, SNF, nursing facility, rehabilitation center, or hospice during the 180-day follow-up. The time at home was generally consistent between the NOAC cohorts (177 days); however, apixaban patients had 0.5 more days at home compared to rivaroxaban patients. Across all NOAC cohorts, 7–8% had a claim for a S/SE, 11–15% had a claim for bleeding, and 15–22% had an INR test, while 87–89% of all patients had an AF-claim during the 180-day follow-up. Patients prescribed apixaban had 1 more day at home without external AF-related care compared to dabigatran, and 1.5 more days at home without external AF-related care compared to rivaroxaban. Dabigatran had <1 more day at home without external AF-related care compared to rivaroxaban.
Conclusion
Among NVAF patients treated with NOACs, there were small differences in the time at home and time at home without external AF-related care during the first 6 months of NOAC treatment. As NVAF is a chronic condition, it is important to understand the impact of NOAC treatment on these patient-centered outcomes.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Bristol-Myers Squibb Company and Pfizer Inc.
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Affiliation(s)
- S Deitelzweig
- Ochsner Clinic Foundation, New Orleans, United States of America
| | - A Keshishian
- STATinMED Research, Ann Arbor, United States of America
| | - A Kang
- Bristol-Myers Squibb Company, Lawrenceville, NJ, United States of America
| | - A Jenkins
- Pfizer Ltd, Tadworth, United Kingdom
| | - N Atreja
- Bristol-Myers Squibb Company, Lawrenceville, NJ, United States of America
| | - P Schuler
- Bristol-Myers Squibb Company, Lawrenceville, NJ, United States of America
| | - J Jiang
- Bristol-Myers Squibb Company, Lawrenceville, NJ, United States of America
| | - K Lovett
- STATinMED Research, Ann Arbor, United States of America
| | - H Yuce
- City University of New York, New York, United States of America
| | - G.Y.H Lip
- University of Liverpool, Liverpool, United Kingdom
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15
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Deitelzweig S, Keshishian A, Kang A, Jenkins A, Atreja N, Schuler P, Jiang J, Lovett K, Yuce H, Lip G. Time at home among nonvalvular atrial fibrillation patients treated with non-vitamin K antagonist oral anticoagulants versus warfarin. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0573] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Clinical trials and real-world database studies have shown the benefits of non-vitamin K antagonist oral anticoagulants (NOACs) compared to warfarin; however, measures of functional outcomes are critical in evaluating a patient's quality of life. Previous measures of time spent out of hospital in a home setting and time spent receiving disease-related care among non-valvular atrial fibrillation (NVAF) patients are lacking in the current literature.
Purpose
This analysis was based on the previously published ARISTOPHANES study, and used multiple data sources to evaluate the amount of time spent at a patient's home among NVAF patients who were prescribed NOACs versus warfarin.
Methods
This retrospective observational study used US data from CMS Medicare and four commercial databases to select adult NVAF patients who initiated apixaban, dabigatran, rivaroxaban, or warfarin (01JAN2013–30SEP2015). Time at home and time at home without external AF-related care were measured during the 180 days after the index date (OAC prescription). Time at home was defined as days from index date without any of the following: an inpatient, skilled nursing facility or nursing facility, hospice, or inpatient rehabilitation facility admission. Time at home and without external AF-related care was defined as days away from home and days with a claim for bleeding, stroke/systemic embolism, AF, or an INR test. Each day a claim was observed was counted as one day. In each database, three 1:1 NOAC-warfarin propensity-score-matched (PSM) cohorts were created before pooling the results. After PSM, a subgroup of patients who were alive and had ≥180 days of follow-up was created. Poisson regression was conducted in each NOAC-warfarin matched cohort to compare time at home and time at home without external AF-related care.
Results
After matching, a total of 100,977 apixaban-warfarin, 36,990 dabigatran-warfarin, and 125,068 rivaroxaban-warfarin patient pairs were selected. Of those patients, 38–46% had 180 days of follow-up available. Across treatment cohorts, approximately 75% of patients were at home for the 180-day follow-up. Apixaban, dabigatran, and rivaroxaban patients had 1.3, 0.9, and 0.8 more days at home, respectively, compared to warfarin patients. Patients treated with apixaban had 13.4 more days at home without AF-related care compared to warfarin, while dabigatran and rivaroxaban had 11.6 and 11.7 more days at home without AF-related care compared to warfarin. A greater proportion of warfarin patients than NOAC patients had an INR test (81–82% vs 14–21%), and days with INR testing were the main driver for external AF-related care for warfarin patients.
Conclusion
Among NVAF patients treated with OACs, NOACs were associated with a longer time at home and time at home without external AF-related care compared to warfarin. These results can help inform healthcare providers and patients regarding the impact of NOAC treatment in NVAF patients.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Bristol-Myers Squibb Company and Pfizer Inc.
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Affiliation(s)
- S Deitelzweig
- Ochsner Clinic Foundation, New Orleans, United States of America
| | - A Keshishian
- STATinMED Research, Ann Arbor, United States of America
| | - A Kang
- Bristol-Myers Squibb Company, Lawrenceville, NJ, United States of America
| | - A Jenkins
- Pfizer Ltd, Tadworth, United Kingdom
| | - N Atreja
- Bristol-Myers Squibb Company, Lawrenceville, NJ, United States of America
| | - P Schuler
- Bristol-Myers Squibb Company, Lawrenceville, NJ, United States of America
| | - J Jiang
- Bristol-Myers Squibb Company, Lawrenceville, NJ, United States of America
| | - K Lovett
- STATinMED Research, Ann Arbor, United States of America
| | - H Yuce
- City University of New York, New York, United States of America
| | - G.Y.H Lip
- University of Liverpool, Liverpool, United Kingdom
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16
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Rojas-Villabona A, Magnaye L, Jenkins A, Surash S. Two cases of asymptomatic Teflon granulomas following microvascular decompression mimicking cerebellopontine angle tumours: lessons learnt in the neuro-oncology multidisciplinary team. Ann R Coll Surg Engl 2021; 103:e324-e326. [PMID: 34414772 DOI: 10.1308/rcsann.2021.0030] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We present the cases of two patients with asymptomatic Teflon granulomas which were incidentally found years after microvascular decompression and presented to the neuro-oncology multidisciplinary team as possible cerebellopontine angle tumours. Teflon granulomas can be asymptomatic and they can radiologically resemble cerebellopontine angle tumours. It is important that all relevant information is available to the neuro-oncology multidisciplinary team for adequate assessment and appropriate treatment recommendations.
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Affiliation(s)
| | - L Magnaye
- University of Newcastle, Newcastle Upon Tyne, UK
| | - A Jenkins
- Royal Victoria Infirmary, Newcastle Upon Tyne, UK
| | - S Surash
- Royal Victoria Infirmary, Newcastle Upon Tyne, UK
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17
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Ige TA, Jenkins A, Burt G, Angal-Kalinin D, McIntosh P, Coleman CN, Pistenmaa DA, O'Brien D, Dosanjh M. Surveying the Challenges to Improve Linear Accelerator-based Radiation Therapy in Africa: a Unique Collaborative Platform of All 28 African Countries Offering Such Treatment. Clin Oncol (R Coll Radiol) 2021; 33:e521-e529. [PMID: 34116903 DOI: 10.1016/j.clon.2021.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/22/2021] [Accepted: 05/19/2021] [Indexed: 12/24/2022]
Abstract
Radiation therapy is a critical component for curative and palliative treatment of cancer and is used in more than half of all patients with cancer. Yet there is a global shortage of access to this treatment, especially in Sub-Saharan Africa, where there is a shortage of technical staff as well as equipment. Linear accelerators (LINACs) offer state-of-the-art treatment, but this technology is expensive to acquire, operate and service, especially for low- and middle-income countries (LMICs), and often their harsh environment negatively affects the performance of LINACs, causing downtime. A global initiative was launched in 2016 to address the technology and system barriers to providing radiation therapy in LMICs through the development of a novel LINAC-based radiation therapy system designed for their challenging environments. As the LINAC prototype design phase progressed, it was recognised that additional information was needed from LMICs on the performance of LINAC components, on variables that may influence machine performance and their association, if any, with equipment downtime. Thus, a survey was developed to collect these data from all countries in Africa that have LINAC-based radiation therapy facilities. In order to understand the extent to which these performance factors are the same or different in high-income countries, facilities in Canada, Switzerland, the UK and the USA were invited to participate in the survey, as was Jordan, a middle-income country. Throughout this process, LMIC representatives have provided input on technology challenges in their respective countries. This report presents the method used to conduct this multilevel study of the macro- and microenvironments, the organisation of departments, the technology, the training and the service models that will provide input into the design of a LINAC prototype for a LINAC-based radiation therapy system that will improve access to radiation therapy and thus improve cancer treatment outcomes. It is important to note that new technology should be introduced in a contextual manner so as not to disrupt existing health systems inadvertently, especially with regards to existing staffing, infrastructure and socioeconomic issues. A detailed analysis of data is underway and will be presented in a follow-up report. Selected preliminary results of the study are the observation that LINAC-based facilities in LMICs experience downtime associated with failures in multileaf collimators and vacuum pumps, as well as power instability. Also, that there is a strong association of gross national product per capita with the number of LINACs per population.
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Affiliation(s)
- T A Ige
- National Hospital Abuja, Abuja, Nigeria; University of Abuja, Abuja, Nigeria
| | | | - G Burt
- University of Lancaster, Lancaster, UK
| | | | - P McIntosh
- STFC Daresbury Laboratory, Warrington, UK
| | - C N Coleman
- International Cancer Expert Corps, Washington, DC, USA
| | - D A Pistenmaa
- International Cancer Expert Corps, Washington, DC, USA
| | - D O'Brien
- International Cancer Expert Corps, Washington, DC, USA
| | - M Dosanjh
- University of Oxford, Oxford, UK; International Cancer Expert Corps, Washington, DC, USA; CERN, Geneva, Switzerland.
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18
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Connelly A, Thwaites V, Turnbull H, Neil J, Walker K, Short A, Keast T, Sweeney L, Jenkins A. P.29 Predicting post-delivery anaemia: Development of the MABL table. Int J Obstet Anesth 2021. [DOI: 10.1016/j.ijoa.2021.103027] [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: 10/21/2022]
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19
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Hemphill K, Varma U, Curl C, Raaijmakers H, Bernasochi G, Mellor K, Jenkins A, Delbridge L. Molecular Mechanisms of Cardio-Protection Conferred By Metformin in Type 1 Diabetes. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.090] [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: 11/29/2022]
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20
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Wang J, Bose S, Frenk CS, Gao L, Jenkins A, Springel V, White SDM. Universal structure of dark matter haloes over a mass range of 20 orders of magnitude. Nature 2020; 585:39-42. [PMID: 32879500 DOI: 10.1038/s41586-020-2642-9] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 06/23/2020] [Indexed: 11/09/2022]
Abstract
Cosmological models in which dark matter consists of cold elementary particles predict that the dark halo population should extend to masses many orders of magnitude below those at which galaxies can form1-3. Here we report a cosmological simulation of the formation of present-day haloes over the full range of observed halo masses (20 orders of magnitude) when dark matter is assumed to be in the form of weakly interacting massive particles of mass approximately 100 gigaelectronvolts. The simulation has a full dynamic range of 30 orders of magnitude in mass and resolves the internal structure of hundreds of Earth-mass haloes in as much detail as it does for hundreds of rich galaxy clusters. We find that halo density profiles are universal over the entire mass range and are well described by simple two-parameter fitting formulae4,5. Halo mass and concentration are tightly related in a way that depends on cosmology and on the nature of the dark matter. For a fixed mass, the concentration is independent of the local environment for haloes less massive than those of typical galaxies. Haloes over the mass range of 10-3 to 1011 solar masses contribute about equally (per logarithmic interval) to the luminosity produced by dark matter annihilation, which we find to be smaller than all previous estimates by factors ranging up to one thousand3.
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Affiliation(s)
- J Wang
- Key Laboratory for Computational Astrophysics, National Astronomical Observatories, Chinese Academy of Sciences, Beijing, China. .,School of Astronomy and Space Science, University of Chinese Academy of Sciences, Beijing, China.
| | - S Bose
- Center for Astrophysics
- Harvard and Smithsonian, Cambridge, MA, USA
| | - C S Frenk
- Institute for Computational Cosmology, Department of Physics, Durham University, Durham, UK.
| | - L Gao
- Key Laboratory for Computational Astrophysics, National Astronomical Observatories, Chinese Academy of Sciences, Beijing, China.,School of Astronomy and Space Science, University of Chinese Academy of Sciences, Beijing, China
| | - A Jenkins
- Institute for Computational Cosmology, Department of Physics, Durham University, Durham, UK
| | - V Springel
- Max-Planck-Institut für Astrophysik, Garching, Germany
| | - S D M White
- Max-Planck-Institut für Astrophysik, Garching, Germany.
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21
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Hvidsten D, Frafjord K, Gray JS, Henningsson AJ, Jenkins A, Kristiansen BE, Lager M, Rognerud B, Slåtsve AM, Stordal F, Stuen S, Wilhelmsson P. The distribution limit of the common tick, Ixodes ricinus, and some associated pathogens in north-western Europe. Ticks Tick Borne Dis 2020; 11:101388. [PMID: 32122808 DOI: 10.1016/j.ttbdis.2020.101388] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 01/20/2020] [Accepted: 01/26/2020] [Indexed: 11/30/2022]
Abstract
In north-western Europe, the common tick, Ixodes ricinus, is widely established, its distribution appears to be increasing and the spread of tick-borne diseases is of increasing concern. The project 'Flått i Nord' (Ticks in northern Norway) commenced in spring 2009 with the intention of studying the tick's distribution and that of its pathogens in northern Norway. Several methods were used: cloth-dragging, collecting from trapped small mammals, and collecting from pets. Since 2010, the occurrence of ticks in the region of northern Norway was determined directly by cloth-dragging 167 times in 109 separate locations between the latitudes of 64 °N and 70 °N (included seven locations in the northern part of Trøndelag County). The northernmost location of a permanent I. ricinus population was found to be Nordøyvågen (66.2204 °N, 12.59 °E) on the Island of Dønna. In a sample of 518 nymphal and adult ticks, the Borrelia prevalence collected close to this distribution limit varied but was low (1-15 %) compared with the locations in Trøndelag, south of the study area (15-27 %). Five specimens (1 %) were positive for Rickettsia helvetica. The length of the vegetation growing season (GSL) can be used as an approximate index for the presence of established populations of I. ricinus. The present study suggests that the threshold GSL for tick establishment is about 170 days, because the median GSL from 1991 to 2015 was 174-184 days at sites with permanent tick populations, showing a clear increase compared with the period 1961-1990. This apparent manifestation of climate change could explain the northward extension of the range of I. ricinus.
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Affiliation(s)
- D Hvidsten
- University Hospital of North Norway, Department of Microbiology and Infection Control, Tromsø, Norway; Nordland Hospital, Division of Diagnostic Services, Department of Microbiology, Bodø, Norway.
| | - K Frafjord
- UiT The Arctic University of Norway, Tromsø University Museum, Tromsø, Norway
| | - J S Gray
- University College Dublin, Dublin, Ireland
| | - A J Henningsson
- Department of Clinical Microbiology, Jönköping, Region Jönköping County, AND Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - A Jenkins
- University of South-Eastern Norway, Department of Natural Science and Environmental Health, Bø, Norway
| | | | - M Lager
- Department of Clinical Microbiology, Jönköping, Region Jönköping County, AND Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - B Rognerud
- University of Oslo, Department of Geosciences, Oslo, Norway
| | - A M Slåtsve
- Nordland Hospital, Division of Diagnostic Services, Department of Microbiology, Bodø, Norway
| | - F Stordal
- University of Oslo, Department of Geosciences, Oslo, Norway
| | - S Stuen
- Norwegian University of Life Sciences, Faculty of Veterinary Medicine, Section for Small Ruminants Research, Sandnes, Norway
| | - P Wilhelmsson
- Department of Clinical Microbiology, Jönköping, Region Jönköping County, AND Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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22
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Xu D, Jenkins A, Ryan C, Keech A, Brown A, Boffa J, O'Dea K, Bursell SE, Brazionis L. Health-related behaviours in a remote Indigenous population with Type 2 diabetes: a Central Australian primary care survey in the Telehealth Eye and Associated Medical Services Network [TEAMSnet] project. Diabet Med 2019; 36:1659-1670. [PMID: 31385331 DOI: 10.1111/dme.14099] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/03/2019] [Indexed: 12/01/2022]
Abstract
AIM There is a wealth of data concerning the health behaviours of Indigenous Australians, but the health behaviours of Indigenous Australians with diabetes are not systematically documented. At the clinical level, understanding a person's health behaviours can help identify and address barriers to diabetes care and promote good clinical outcomes. METHODS We used a novel survey tool to systematically collect health behaviour data on Smoking, Nutrition, Alcohol consumption, Physical activity and Emotional well-being (SNAPE) from Indigenous Australians with Type 2 diabetes in a remote primary care setting in Alice Springs. RESULTS At least one of the five surveys in the SNAPE tool was completed by 210 participants: 30% male, mean age 52.6 years (range 22.9 - 87.4). Fifty per cent of men and 23% of women were current smokers (P < 0.001). None of the participants reported an adequate intake of vegetables. Only 9.6% reported an adequate fruit intake. Some 49% of men and 32% of women consumed alcohol in the past year (P = 0.022), and 46% of drinkers were considered high-risk or likely-dependent drinkers. On average, participants walked 10 min or more at a time 6.0 days a week and spent 4.8 h sitting on a weekday. Mean adapted Patient Health Questionnaire 9 score was 4.61, with 34% of participants having mild depressive symptoms and 11% having moderate-severe depressive symptoms. CONCLUSIONS Our SNAPE survey tool results present a high-risk, disadvantaged Indigenous population with Type 2 diabetes. More resources will be needed to sustainably implement interventions with the goal of improving health behaviours and subsequent long-term health.
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Affiliation(s)
- D Xu
- National Health and Medical Research Council of Australia Clinical Trials Centre, University of Sydney, Sydney, NSW
- The University of Melbourne, Melbourne, VIC
| | - A Jenkins
- National Health and Medical Research Council of Australia Clinical Trials Centre, University of Sydney, Sydney, NSW
- The University of Melbourne, Melbourne, VIC
| | - C Ryan
- National Health and Medical Research Council of Australia Clinical Trials Centre, University of Sydney, Sydney, NSW
| | - A Keech
- National Health and Medical Research Council of Australia Clinical Trials Centre, University of Sydney, Sydney, NSW
| | - A Brown
- South Australian Health and Medical Research Institute, Adelaide, SA
| | - J Boffa
- Central Australian Aboriginal Congress, Alice Springs, NT, Australia
| | - K O'Dea
- The University of Melbourne, Melbourne, VIC
| | - S E Bursell
- National Health and Medical Research Council of Australia Clinical Trials Centre, University of Sydney, Sydney, NSW
- The University of Melbourne, Melbourne, VIC
- Telehealth Research Institute, University of Hawaii, Hawaii, HI, USA
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23
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Johnsen S, Madsen M, Linder M, Sulo G, Ghanima W, Gislason G, Halvorsen S, Hohnloser SH, Jenkins A, Al-Khalili F, Tell GS, Ehrenstein V. P3470Comparative effectiveness and safety of non-vitamin K oral anticoagulants and warfarin in non-valvular atrial fibrillation - a cohort study in 3 Nordic countries. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0342] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Non-vitamin K oral anticoagulants (NOACs) are an alternative to warfarin in the prevention of stroke in non-valvular atrial fibrillation (NVAF). Nordic countries have high quality of warfarin treatment, making them an especially suitable setting for assessing effectiveness and safety of NOACs against warfarin.
Purpose
The BEYOND Pooled (BEnefit of NOACs studY of nOn-valvular AF patieNts in NorDic countries) study compared risks of ischaemic or haemorrhagic stroke/systemic embolism (S/SE), and risk of bleeding with acute hospitalisation with an overnight stay (bleeding) in NVAF patients treated with apixaban, dabigatran or rivaroxaban, each compared with warfarin treatment.
Methods
A cohort study of treatment-naïve adult NVAF patients dispensed apixaban, dabigatran, rivaroxaban or warfarin was identified from 01 Jan 2013 to 31 Dec 2016. The population and study variables were identified from national registries in Denmark, Norway and Sweden. After 1:1 propensity score (PS) matching for each NOAC-warfarin comparison, individual-level data were pooled across the countries. Cox proportional-hazards regression was used to estimate adjusted hazard ratios (aHRs) of the endpoints.
Results
PS matched NOAC cohort sizes were: apixaban (55,696) dabigatran (28,526) and rivaroxaban (30,701), and the total follow-up in the PS-matched population was 291,171 years (mean 1.3 years). During the follow-up, 35,450 oral anticoagulation (OAC) patients had a S/SE and 38,620 OAC patients had bleeding. Adjusted HRs for the two endpoints are presented in the table. PH assumption has not been formally tested but cum incidence curves did not indicate substantial differences in the effects over time.
Table 1. Adjusted hazard ratios (aHR) of stroke/systemic embolism and bleeding for non-vitamin K oral anticoagulants versus warfarin Endpoint Apixaban vs Warfarin: aHR (95% CI) Dabigatran vs Warfarin: aHR (95% CI) Rivaroxaban vs Warfarin: aHR (95% CI) Stroke/SE 0.93 (0.85–1.03) 0.89 (0.80–1.00) 0.97 (0.88–1.08) Bleeding 0.72 (0.67–0.77) 0.87 (0.80–0.95) 1.12 (1.04–1.20)
Conclusions
Relative to warfarin, apixaban and dabigatran were associated with lower rates of bleeding whereas rivaroxaban was associated with a higher rate. The three NOACs had comparable rates of stroke and systemic embolism relative to warfarin.
Acknowledgement/Funding
This study was funded by the Pfizer/Bristol-Myers Squibb Alliance.
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Affiliation(s)
- S Johnsen
- Aalborg University, Department of Clinical Medicine, Aalborg, Denmark
| | - M Madsen
- Aarhus University Hospital, Department of Clinical Epidemiology, Aarhus, Denmark
| | - M Linder
- Karolinska Institute, Centre for Pharmacoepidemiology, Stockholm, Sweden
| | - G Sulo
- Norwegian Institute of Public Health, Centre for Disease Burden, Bergen, Norway
| | - W Ghanima
- Oestfold Hospital Trust, Department of Hematology, Fredrikstad, Norway
| | - G Gislason
- Gentofte Hospital - Copenhagen University Hospital, Department of Cardiology, Hellerup, Denmark
| | - S Halvorsen
- Ulleval University Hospital, Department of Cardiology, Oslo, Norway
| | - S H Hohnloser
- JW Goethe University, Department of Cardiology, Frankfurt am Main, Germany
| | - A Jenkins
- Pfizer Ltd, Tadworth, United Kingdom
| | - F Al-Khalili
- Sophiahemmets Hospital, Heart, Lung and Allergy Clinic, Stockholm, Sweden
| | - G S Tell
- University of Bergen, Department of Global Public Health and Primary Care, Bergen, Norway
| | - V Ehrenstein
- Aarhus University Hospital, Department of Clinical Epidemiology, Aarhus, Denmark
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24
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Moore J, Raine T, Jenkins A, Livens F, Law K, Morris K, Law G, Yeates S. Decontamination of caesium and strontium from stainless steel surfaces using hydrogels. REACT FUNCT POLYM 2019. [DOI: 10.1016/j.reactfunctpolym.2019.04.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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25
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Jenkins A, Bhuva AN, Hughes AD, Manisty CH, Moon JC, Treibel TA. P432aortic stenosis. the role of aortoseptal angulation as a predictive factor for asymmetrical septal hypertrophy. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez118.019] [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: 11/12/2022] Open
Affiliation(s)
- A Jenkins
- Barts Health NHS Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - A N Bhuva
- Barts Health NHS Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - A D Hughes
- University College London, London, United Kingdom of Great Britain & Northern Ireland
| | - C H Manisty
- Barts Health NHS Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - J C Moon
- Barts Health NHS Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - T A Treibel
- Barts Health NHS Trust, London, United Kingdom of Great Britain & Northern Ireland
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26
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Ferguson D, Hall J, Ham C, Jenkins A, Giles E, Kempster S, Berry N, Almond N. Zika virus: persisting tissue reservoirs and their potential for clinically relevant pathology. Access Microbiol 2019. [DOI: 10.1099/acmi.ac2019.po0522] [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: 11/18/2022] Open
Affiliation(s)
| | - Jo Hall
- NIBSC, South Mimms, United Kingdom
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27
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Pitsika M, Nissen J, Jenkins A, Mitchell P. P4 Spinal cord haemangioblastomas: surgical management and clinical outcome. J Neurol Neurosurg Psychiatry 2019. [DOI: 10.1136/jnnp-2019-abn.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
ObjectivesSpinal haemangioblastomas are rare tumours that can be either sporadic or as part of the CNS expression of Von Hippel Lindau syndrome (VHL). The aim of this study was to identify the characteristics of the haemangioblastomas both in sporadic and in VHL cases and to assess the outcome of the surgical management.MethodsWe retrospectively reviewed all spinal haemangioblastomas that were operated between 2004 and 2017 including clinical letters, MRIs and pathology reports.ResultsA total of 14 patients underwent excision of a spinal haemangioblastoma. Average follow up time was 50 months (range 4–164 months). The location was: medulla n=3, cervical region n=4, thoracic region n=5 and conus n=2. Six patients had VHL (42%) and from those n=5 had more than one lesion. A syrinx was present in n=9 cases (VHL n=6, multiple lesions n=5) and 2 had a syringoperitoneal shunt inserted followed by excision of the haemangioblastoma. In all but one case a total excision was achieved and the syrinx disappeared or improved in 6 cases. A clinical improvement was seen in n=10 patients, in n=2 a deterioration was seen post-operatively and in n=2 new symptoms developed during their follow up from the other lesions. None of the haemangioblastomas that were removed recurred.ConclusionsTotal excision of spinal haemangioblastomas offers a good outcome with possible cure in cases of a single lesion. Patients with VHL present more commonly with multiple lesions and large syrinxes which pose a challenge to the surgical management.
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28
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Ferguson D, Hall J, Ham C, Jenkins A, Giles E, Kempster S, Berry N, Almond N. Zika virus: out of sight but not out of the mind. Viral persistence and host responses within the central and peripheral nervous systems. Access Microbiol 2019. [DOI: 10.1099/acmi.ac2019.po0518] [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: 11/18/2022] Open
Affiliation(s)
| | - Jo Hall
- NIBSC, South Mimms, United Kingdom
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29
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Cao J, Waldman B, O’Connell R, Sullivan D, Gebski V, Marschner I, Scott R, Taskinen M, Simes J, McGill N, Jenkins A, Keech A. Baseline and Short-Term Change in Plasma Uric Acid on Fenofibrate Predict Cardiovascular Risk: A Post Hoc Analysis of FIELD. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.354] [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: 10/26/2022]
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30
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Sivashanmugarajah A, Fulcher J, Sullivan D, Jenkins A, Keech A. A Suggested Clinical Approach for the Diagnosis and Management of ‘Statin Intolerance’. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.343] [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: 10/26/2022]
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31
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Finnigan-Fox G, Allen L, Matlock D, Jenkins A. THE COST CONUNDRUM: NAVIGATING DISCUSSIONS AROUND COST FOR HEART FAILURE MEDICATIONS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2742] [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)
| | - L Allen
- University of Colorado Denver
| | - D Matlock
- University of Colorado School of Medicine
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32
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Farrell LJ, Lo R, Wanford JJ, Jenkins A, Maxwell A, Piddock LJV. Revitalizing the drug pipeline: AntibioticDB, an open access database to aid antibacterial research and development. J Antimicrob Chemother 2018; 73:2284-2297. [DOI: 10.1093/jac/dky208] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L J Farrell
- Institute of Microbiology & Infection, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - R Lo
- School of Biological Sciences, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK
- Department of Biological Chemistry, John Innes Centre, Norwich Research Park, Norwich NR4 7UH, UK
| | - J J Wanford
- Institute of Microbiology & Infection, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - A Jenkins
- British Society for Antimicrobial Chemotherapy, Griffin House, 53 Regent Place, Birmingham B1 3NJ, UK
| | - A Maxwell
- Department of Biological Chemistry, John Innes Centre, Norwich Research Park, Norwich NR4 7UH, UK
| | - L J V Piddock
- Institute of Microbiology & Infection, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
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33
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Tang WW, McGee P, Lachin JM, Li DY, Hoogwerf B, Hazen SL, Nathan D, Zinman B, Crofford O, Genuth S, Brown‐Friday J, Crandall J, Engel H, Engel S, Martinez H, Phillips M, Reid M, Shamoon H, Sheindlin J, Gubitosi‐Klug R, Mayer L, Pendegast S, Zegarra H, Miller D, Singerman L, Smith‐Brewer S, Novak M, Quin J, Genuth S, Palmert M, Brown E, McConnell J, Pugsley P, Crawford P, Dahms W, Gregory N, Lackaye M, Kiss S, Chan R, Orlin A, Rubin M, Brillon D, Reppucci V, Lee T, Heinemann M, Chang S, Levy B, Jovanovic L, Richardson M, Bosco B, Dwoskin A, Hanna R, Barron S, Campbell R, Bhan A, Kruger D, Jones J, Edwards P, Bhan A, Carey J, Angus E, Thomas A, Galprin A, McLellan M, Whitehouse F, Bergenstal R, Johnson M, Gunyou K, Thomas L, Laechelt J, Hollander P, Spencer M, Kendall D, Cuddihy R, Callahan P, List S, Gott J, Rude N, Olson B, Franz M, Castle G, Birk R, Nelson J, Freking D, Gill L, Mestrezat W, Etzwiler D, Morgan K, Aiello L, Golden E, Arrigg P, Asuquo V, Beaser R, Bestourous L, Cavallerano J, Cavicchi R, Ganda O, Hamdy O, Kirby R, Murtha T, Schlossman D, Shah S, Sharuk G, Silva P, Silver P, Stockman M, Sun J, Weimann E, Wolpert H, Aiello L, Jacobson A, Rand L, Rosenzwieg J, Nathan D, Larkin M, Christofi M, Folino K, Godine J, Lou P, Stevens C, Anderson E, Bode H, Brink S, Cornish C, Cros D, Delahanty L, eManbey ., Haggan C, Lynch J, McKitrick C, Norman D, Moore D, Ong M, Taylor C, Zimbler D, Crowell S, Fritz S, Hansen K, Gauthier‐Kelly C, Service F, Ziegler G, Barkmeier A, Schmidt L, French B, Woodwick R, Rizza R, Schwenk W, Haymond M, Pach J, Mortenson J, Zimmerman B, Lucas A, Colligan R, Luttrell L, Lopes‐Virella M, Caulder S, Pittman C, Patel N, Lee K, Nutaitis M, Fernandes J, Hermayer K, Kwon S, Blevins A, Parker J, Colwell J, Lee D, Soule J, Lindsey P, Bracey M, Farr A, Elsing S, Thompson T, Selby J, Lyons T, Yacoub‐Wasef S, Szpiech M, Wood D, Mayfield R, Molitch M, Adelman D, Colson S, Jampol L, Lyon A, Gill M, Strugula Z, Kaminski L, Mirza R, Simjanoski E, Ryan D, Johnson C, Wallia A, Ajroud‐Driss S, Astelford P, Leloudes N, Degillio A, Schaefer B, Mudaliar S, Lorenzi G, Goldbaum M, Jones K, Prince M, Swenson M, Grant I, Reed R, Lyon R, Kolterman O, Giotta M, Clark T, Friedenberg G, Sivitz W, Vittetoe B, Kramer J, Bayless M, Zeitler R, Schrott H, Olson N, Snetselaar L, Hoffman R, MacIndoe J, Weingeist T, Fountain C, Miller R, Johnsonbaugh S, Patronas M, Carney M, Mendley S, Salemi P, Liss R, Hebdon M, Counts D, Donner T, Gordon J, Hemady R, Kowarski A, Ostrowski D, Steidl S, Jones B, Herman W, Martin C, Pop‐Busui R, Greene D, Stevens M, Burkhart N, Sandford T, Floyd J, Bantle J, Flaherty N, Terry J, Koozekanani D, Montezuma S, Wimmergren N, Rogness B, Mech M, Strand T, Olson J, McKenzie L, Kwong C, Goetz F, Warhol R, Hainsworth D, Goldstein D, Hitt S, Giangiacomo J, Schade D, Canady J, Burge M, Das A, Avery R, Ketai L, Chapin J, Schluter M, Rich J, Johannes C, Hornbeck D, Schutta M, Bourne P, Brucker A, Braunstein S, Schwartz S, Maschak‐Carey B, Baker L, Orchard T, Cimino L, Songer T, Doft B, Olson S, Becker D, Rubinstein D, Bergren R, Fruit J, Hyre R, Palmer C, Silvers N, Lobes L, Rath PP, Conrad P, Yalamanchi S, Wesche J, Bratkowksi M, Arslanian S, Rinkoff J, Warnicki J, Curtin D, Steinberg D, Vagstad G, Harris R, Steranchak L, Arch J, Kelly K, Ostrosaka P, Guiliani M, Good M, Williams T, Olsen K, Campbell A, Shipe C, Conwit R, Finegold D, Zaucha M, Drash A, Morrison A, Malone J, Bernal M, Pavan P, Grove N, Tanaka E, McMillan D, Vaccaro‐Kish J, Babbione L, Solc H, DeClue T, Dagogo‐Jack S, Wigley C, Ricks H, Kitabchi A, Chaum E, Murphy M, Moser S, Meyer D, Iannacone A, Yoser S, Bryer‐Ash M, Schussler S, Lambeth H, Raskin P, Strowig S, Basco M, Cercone S, Zinman B, Barnie A, Devenyi R, Mandelcorn M, Brent M, Rogers S, Gordon A, Bakshi N, Perkins B, Tuason L, Perdikaris F, Ehrlich R, Daneman D, Perlman K, Ferguson S, Palmer J, Fahlstrom R, de Boer I, Kinyoun J, Van Ottingham L, Catton S, Ginsberg J, McDonald C, Harth J, Driscoll M, Sheidow T, Mahon J, Canny C, Nicolle D, Colby P, Dupre J, Hramiak I, Rodger N, Jenner M, Smith T, Brown W, May M, Lipps Hagan J, Agarwal A, Adkins T, Lorenz R, Feman S, Survant L, White N, Levandoski L, Grand G, Thomas M, Joseph D, Blinder K, Shah G, Burgess D, Boniuk I, Santiago J, Tamborlane W, Gatcomb P, Stoessel K, Ramos P, Fong K, Ossorio P, Ahern J, Gubitosi‐Klug R, Meadema‐Mayer L, Beck C, Farrell K, Genuth S, Quin J, Gaston P, Palmert M, Trail R, Dahms W, Lachin J, Backlund J, Bebu I, Braffett B, Diminick L, Gao X, Hsu W, Klumpp K, Pan H, Trapani V, Cleary P, McGee P, Sun W, Villavicencio S, Anderson K, Dews L, Younes N, Rutledge B, Chan K, Rosenberg D, Petty B, Determan A, Kenny D, Williams C, Cowie C, Siebert C, Steffes M, Arends V, Bucksa J, Nowicki M, Chavers B, O'Leary D, Polak J, Harrington A, Funk L, Crow R, Gloeb B, Thomas S, O'Donnell C, Soliman E, Zhang Z, Li Y, Campbell C, Keasler L, Hensley S, Hu J, Barr M, Taylor T, Prineas R, Feldman E, Albers J, Low P, Sommer C, Nickander K, Speigelberg T, Pfiefer M, Schumer M, Moran M, Farquhar J, Ryan C, Sandstrom D, Williams T, Geckle M, Cupelli E, Thoma F, Burzuk B, Woodfill T, Danis R, Blodi B, Lawrence D, Wabers H, Gangaputra S, Neill S, Burger M, Dingledine J, Gama V, Sussman R, Davis M, Hubbard L, Budoff M, Darabian S, Rezaeian P, Wong N, Fox M, Oudiz R, Kim L, Detrano R, Cruickshanks K, Dalton D, Bainbridge K, Lima J, Bluemke D, Turkbey E, der Geest ., Liu C, Malayeri A, Jain A, Miao C, Chahal H, Jarboe R, Nathan D, Monnier V, Sell D, Strauch C, Hazen S, Pratt A, Tang W, Brunzell J, Purnell J, Natarajan R, Miao F, Zhang L, Chen Z, Paterson A, Boright A, Bull S, Sun L, Scherer S, Lopes‐Virella M, Lyons T, Jenkins A, Klein R, Virella G, Jaffa A, Carter R, Stoner J, Garvey W, Lackland D, Brabham M, McGee D, Zheng D, Mayfield R, Maynard J, Wessells H, Sarma A, Jacobson A, Dunn R, Holt S, Hotaling J, Kim C, Clemens Q, Brown J, McVary K. Oxidative Stress and Cardiovascular Risk in Type 1 Diabetes Mellitus: Insights From the DCCT/EDIC Study. J Am Heart Assoc 2018. [PMCID: PMC6015340 DOI: 10.1161/jaha.117.008368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background
Hyperglycemia leading to increased oxidative stress is implicated in the increased risk for the development of macrovascular and microvascular complications in patients with type 1 diabetes mellitus.
Methods and Results
A random subcohort of 349 participants was selected from the
DCCT
/
EDIC
(Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications) cohort. This included 320 controls and 29 cardiovascular disease cases that were augmented with 98 additional known cases to yield a case cohort of 447 participants (320 controls, 127 cases). Biosamples from
DCCT
baseline, year 1, and closeout of
DCCT
, and 1 to 2 years post‐
DCCT
(
EDIC
years 1 and 2) were measured for markers of oxidative stress, including plasma myeloperoxidase, paraoxonase activity, urinary F
2α
isoprostanes, and its metabolite, 2,3 dinor‐8
iso
prostaglandin F
2α
. Following adjustment for glycated hemoblobin and weighting the observations inversely proportional to the sampling selection probabilities, higher paraoxonase activity, reflective of antioxidant activity, and 2,3 dinor‐8
iso
prostaglandin F
2α
, an oxidative marker, were significantly associated with lower risk of cardiovascular disease (−4.5% risk for 10% higher paraoxonase,
P
<0.003; −5.3% risk for 10% higher 2,3 dinor‐8
iso
prostaglandin F
2α
,
P
=0.0092). In contrast, the oxidative markers myeloperoxidase and F
2α
isoprostanes were not significantly associated with cardiovascular disease after adjustment for glycated hemoblobin. There were no significant differences between
DCCT
intensive and conventional treatment groups in the change in all biomarkers across time segments.
Conclusions
Heightened antioxidant activity (rather than diminished oxidative stress markers) is associated with lower cardiovascular disease risk in type 1 diabetes mellitus, but these biomarkers did not change over time with intensification of glycemic control.
Clinical Trial Registration
URL
:
https://www.clinicaltrials.gov
. Unique identifiers:
NCT
00360815 and
NCT
00360893.
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Affiliation(s)
- W.H. Wilson Tang
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH
| | - Paula McGee
- The Biostatistics Center, George Washington University, Rockville, MD
| | - John M. Lachin
- The Biostatistics Center, George Washington University, Rockville, MD
| | - Daniel Y. Li
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | | | - Stanley L. Hazen
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH
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Brazionis L, Jenkins A, Keech A, Ryan C, Brown A, Boffa J, Bursell S. Diabetic retinopathy in a remote Indigenous primary healthcare population: a Central Australian diabetic retinopathy screening study in the Telehealth Eye and Associated Medical Services Network project. Diabet Med 2018; 35:630-639. [PMID: 29405370 DOI: 10.1111/dme.13596] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/30/2018] [Indexed: 01/29/2023]
Abstract
AIM To determine diabetic retinopathy prevalence and severity among remote Indigenous Australians. METHODS A cross-sectional diabetic retinopathy screening study of Indigenous adults with Type 2 diabetes was conducted by locally trained non-ophthalmic retinal imagers in a remote Aboriginal community-controlled primary healthcare clinic in Central Australia and certified non-ophthalmic graders in a retinal grading centre in Melbourne, Australia. The main outcome measure was prevalence of any diabetic retinopathy and sight-threatening diabetic retinopathy. RESULTS Among 301 participants (33% male), gradable image rates were 78.7% (n = 237) for diabetic retinopathy and 83.1% (n = 250) for diabetic macular oedema, and 77.7% (n = 234) were gradable for both diabetic retinopathy and diabetic macular oedema. For the gradable subset, the median (range) age was 48 (19-86) years and known diabetes duration 9.0 (0-24) years. The prevalence of diabetic retinopathy was 47% (n = 110) and for diabetic macular oedema it was 14.4% (n = 36). In the fully gradable imaging studies, sight-threatening diabetic retinopathy prevalence was 16.2% (n = 38): 14.1% (n = 33) for clinically significant macular oedema, 1.3% (n = 3) for proliferative diabetic retinopathy and 0.9% (n = 2) for both. Sight-threatening diabetic retinopathy had been treated in 78% of detected cases. CONCLUSIONS A novel telemedicine diabetic retinopathy screening service detected a higher prevalence of 'any' diabetic retinopathy and sight-threatening diabetic retinopathy in a remote primary care setting than reported in earlier surveys among Indigenous and non-Indigenous populations. Whether the observed high prevalence of diabetic retinopathy was attributable to greater detection, increasing diabetic retinopathy prevalence, local factors, or a combination of these requires further investigation and, potentially, specific primary care guidelines for diabetic retinopathy management in remote Australia. Clinical Trials registration number: Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN 12616000370404.
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Affiliation(s)
- L Brazionis
- Department of Medicine, University of Melbourne, Melbourne, Australia
| | - A Jenkins
- Department of Medicine, University of Melbourne, Melbourne, Australia
- National Health and Medical Research Council of Australia Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - A Keech
- National Health and Medical Research Council of Australia Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - C Ryan
- National Health and Medical Research Council of Australia Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - A Brown
- SAHMRI, University of South Australia, Adelaide, Australia
| | - J Boffa
- Central Australian Aboriginal Congress, Alice Springs, Australia
| | - S Bursell
- National Health and Medical Research Council of Australia Clinical Trials Centre, University of Sydney, Sydney, Australia
- Telehealth Research Unit, University of Hawaii, HI, USA
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Smith JA, Andersen TJ, Shortt M, Gaffney AM, Truffer M, Stanton TP, Bindschadler R, Dutrieux P, Jenkins A, Hillenbrand CD, Ehrmann W, Corr HFJ, Farley N, Crowhurst S, Vaughan DG. Erratum: Corrigendum: Sub-ice-shelf sediments record history of twentieth-century retreat of Pine Island Glacier. Nature 2017; 549:292. [DOI: 10.1038/nature23650] [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: 11/09/2022]
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Kolb I, Stoy WA, Rousseau EB, Moody OA, Jenkins A, Forest CR. Cleaning patch-clamp pipettes for immediate reuse. Sci Rep 2016; 6:35001. [PMID: 27725751 PMCID: PMC5057089 DOI: 10.1038/srep35001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 09/22/2016] [Indexed: 01/19/2023] Open
Abstract
Patch-clamp recording has enabled single-cell electrical, morphological and genetic studies at unparalleled resolution. Yet it remains a laborious and low-throughput technique, making it largely impractical for large-scale measurements such as cell type and connectivity characterization of neurons in the brain. Specifically, the technique is critically limited by the ubiquitous practice of manually replacing patch-clamp pipettes after each recording. To circumvent this limitation, we developed a simple, fast, and automated method for cleaning glass pipette electrodes that enables their reuse within one minute. By immersing pipette tips into Alconox, a commercially-available detergent, followed by rinsing, we were able to reuse pipettes 10 times with no degradation in signal fidelity, in experimental preparations ranging from human embryonic kidney cells to neurons in culture, slices, and in vivo. Undetectable trace amounts of Alconox remaining in the pipette after cleaning did not affect ion channel pharmacology. We demonstrate the utility of pipette cleaning by developing the first robot to perform sequential patch-clamp recordings in cell culture and in vivo without a human operator.
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Affiliation(s)
- I Kolb
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332 USA
| | - W A Stoy
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332 USA
| | - E B Rousseau
- Colleges of Nanoscale Science and Engineering, SUNY Polytechnic Institute, Albany, NY, 12203 USA
| | - O A Moody
- Neuroscience Graduate Program, GDBBS, Emory University, Atlanta, GA, 30322 USA
| | - A Jenkins
- Department of Pharmacology, Emory University School of Medicine, Atlanta, GA, 30322 USA.,Department of Anesthesiology, Emory University, Atlanta, GA, 30322 USA
| | - C R Forest
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta GA, 30332 USA
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Royer P, Weber L, Jenkins A, Sanders J, Gawron L, Turok D. Family planning knowledge and contraceptive use among resettled African refugee women. Contraception 2016. [DOI: 10.1016/j.contraception.2016.07.149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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Royer P, Jenkins A, Weber L, Jackson B, Sanders J, Turok D. Group versus individual contraceptive counseling for resettled African refugee women: a pilot randomized controlled trial. Contraception 2016. [DOI: 10.1016/j.contraception.2016.07.133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Deep brain stimulation for movement disorders is becoming a commonly used procedure. In this article we describe a complication which has not been described previously. Post op intra-cranial air must be considered as a possible complication of DBS insertion and should be on the list of differentials if a patient presents with post operative neurological deficit.
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Affiliation(s)
- M A Hussain
- a Royal Victoria Infirmary , Newcastle Upon Tyne , UK
| | - A Jenkins
- a Royal Victoria Infirmary , Newcastle Upon Tyne , UK
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King E, Yuan J, Kong S, Dunn L, Stocker R, Keech A, Jenkins A, Ng M. Hypoxia Tolerance in Diabetes Mellitus: The Role of Fenofibrate in Facilitating Protective Metabolic Reprogramming. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.205] [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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41
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Manski-Nankervis J, Yates CJ, Blackberry I, Furler J, Ginnivan L, Cohen N, Jenkins A, Vasanthakumar S, Gorelik A, Young D, Best J, O'Neal D. Impact of insulin initiation on glycaemic variability and glucose profiles in a primary healthcare Type 2 diabetes cohort: analysis of continuous glucose monitoring data from the INITIATION study. Diabet Med 2016; 33:803-11. [PMID: 26435033 DOI: 10.1111/dme.12979] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/29/2015] [Indexed: 01/13/2023]
Abstract
AIM To use continuous glucose monitoring to examine the effects of insulin initiation with glargine, with or without glulisine, on glycaemic variability and glycaemia in a cohort of people with Type 2 diabetes receiving maximum oral hypoglycaemic agents in primary healthcare. METHODS We conducted a post hoc analysis of continuous glucose monitoring data from 89 participants at baseline and at 24 weeks after insulin commencement. Indicators of glycaemic variability (standard deviation, J-index and mean amplitude of glycaemic excursion) and glycaemia (HbA1c , mean glucose, area under the glucose-time curve) were assessed. Multi-level regression analysis was used to identify the predictors of change. RESULTS Complete glycaemic variability data were available for 78 participants. Of these participants, 41% were women, their mean (sd) age was 59.2 (10.4) years, the median (interquartile range) diabetes duration was 10.4 (6.5, 13.3) years and the median (interquartile range) baseline HbA1c was 82.5 (71.6, 96.7) mmol/mol [9.7 (8.7, 11.0)%]. At baseline, BMI correlated negatively with standard deviation (r = -0.30) and mean amplitude of glycaemic excursion (r = -0.26), but not with J-index; HbA1c correlated with J-index (r = 0.61) but not with mean amplitude of glycaemic excursion and standard deviation. After insulin initiation the mean (sd) glucose level decreased [from 12.0 (3.0) to 8.5 (1.6) mmol/l; P < 0.001], as did the median (interquartile range) J-index [from 66.9 (47.7, 95.1) to 36.9 (27.6, 49.8) mmol/l; P < 0.001]. Baseline HbA1c correlated with a greater J-index reduction (r = -0.45; P < 0.001). The mean amplitude of glycaemic excursion and standard deviation values were unchanged. The baseline temporal profile, showing elevated postprandial morning glucose levels, was unchanged after insulin initiation, despite an overall reduction in glycaemia. CONCLUSION Insulin initiation reduced hyperglycaemia but did not alter glycaemic variability in adults with Type 2 diabetes receiving maximum oral hypoglycaemic agents. The most significant postprandial excursions were seen in the morning, which identifies prebreakfast as the most effective target for short-acting insulin therapy.
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Affiliation(s)
- J Manski-Nankervis
- Department of General Practice, University of Melbourne, Carlton, Vic., Australia
| | - C J Yates
- Department of Medicine, University of Melbourne, Melbourne, Vic., Australia
- Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, Vic., Australia
| | - I Blackberry
- Department of General Practice, University of Melbourne, Carlton, Vic., Australia
- La Trobe University, Wodonga, Vic., Australia
| | - J Furler
- Department of General Practice, University of Melbourne, Carlton, Vic., Australia
| | - L Ginnivan
- Department of General Practice, University of Melbourne, Carlton, Vic., Australia
| | - N Cohen
- Baker IDI Heart and Diabetes Institute, Melbourne, Vic., Australia
| | - A Jenkins
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - S Vasanthakumar
- Monash Medical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Vic., Australia
| | - A Gorelik
- Melbourne EpiCentre, Royal Melbourne Hospital, University of Melbourne, Parkville, Vic., Australia
| | - D Young
- Department of General Practice, University of Melbourne, Carlton, Vic., Australia
| | - J Best
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - D O'Neal
- Department of Medicine, St Vincent's Hospital, University of Melbourne, Fitzroy, Vic., Australia
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De Ron P, Dremier S, Winlow P, Jenkins A, Hanon E, Nogueira da Costa A. Correlating behaviour and gene expression endpoints in the dopaminergic system after modafinil administration in mouse. Eur Neuropsychopharmacol 2016; 26:729-40. [PMID: 26875113 DOI: 10.1016/j.euroneuro.2016.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 01/18/2016] [Accepted: 01/25/2016] [Indexed: 10/22/2022]
Abstract
The mechanisms of action of modafinil continue to be poorly characterised and its potential for abuse in preclinical models remains controverted. The aim of this study was to further elucidate the mechanism of action of modafinil, through a potential behavioural and molecular association in the mouse. A conditioned place preference (CPP) paradigm was implemented to investigate the rewarding properties of modafinil. Whole genome expression and qRT-PCR analysis were performed on the ventral tegmental area (VTA), nucleus accumbens (NAC) and prefrontal cortex (PFC) of modafinil-treated and control animals. Modafinil administration (65 mg/kg) induced an increase in locomotor activity, an increase in the change of preference for the drug paired side after a conditioning period as well as changes to gene expression profiles in the VTA (120 genes), NAC (23 genes) and PFC (19 genes). A molecular signature consisting of twelve up-regulated genes was identified as common to the three brain regions. Multiple linear correlation analysis showed a strong correlation (R(2)>0.70) between the behavioural and molecular endpoints in the three brain regions. We show that modafinil had a concomitant effect on CPP, locomotor activity, and up-regulation of interferon-γ (IFN-γ) regulated genes (Gbp2, Gbp3, Gbp10, Cd274, Igtp), while correlating the latter set of genes with behaviour changes evaluated through the CPP. A potential association can be proposed based on the dysregulation of p47 family genes and Gbp family of IFN-γ induced GTPases. In conclusion, these findings suggest a link between the behavioural and molecular events in the context of modafinil administration.
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Affiliation(s)
- P De Ron
- Non-Clinical Development, UCB Biopharma SPRL, Belgium
| | - S Dremier
- Non-Clinical Development, UCB Biopharma SPRL, Belgium
| | - P Winlow
- Non-Clinical Development, UCB Biopharma SPRL, Belgium
| | - A Jenkins
- Non-Clinical Development, UCB Biopharma SPRL, Belgium
| | - E Hanon
- CNS Research, UCB Biopharma SPRL, Belgium
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Xu S, Alexander K, Bryant W, Cohen N, Craig ME, Forbes M, Fulcher G, Greenaway T, Harrison N, Holmes-Walker DJ, Howard G, Jackson J, Jenkins A, Kamp M, Kaye J, Sinha A, Stranks S, O'Neal D, Colman P. Healthcare professional requirements for the care of adult diabetes patients managed with insulin pumps in Australia. Intern Med J 2015; 45:86-93. [PMID: 25370368 DOI: 10.1111/imj.12619] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [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: 07/10/2014] [Accepted: 10/22/2014] [Indexed: 01/16/2023]
Abstract
BACKGROUND Healthcare professional (HCP) time supporting insulin pump therapy (IPT) has not been documented, yet it is important in planning and allocating resources for effective care. AIM This study aims to determine HCP time spent in IPT patient care to inform resource planning for optimal IPT delivery. METHODS Twenty-four Australian adult IPT-experienced institutions (14 government funded, seven private, three both) collected data between April 2012 and January 2013 prospectively, including: patient demographics, HCP classification, purpose of HCP-patient interaction, interaction mode and HCP time with the patient. A subset of patients was tracked from pre-pump education until stable on IPT. RESULTS Data on 2577 HCP-adult patient interactions (62% face-to-face, 29% remote, 9% administrative) were collected over 12.2 ± 6.4 weeks for 895 patients; age 35.4 ± 14.2 years; 67% female; 99% type 1 diabetes, representing 25% of all IPT patients of the institutions. Time (hours) spent on IPT interactions per centre per week were: nurses 5.4 ± 2.8, dietitians 0.4 ± 0.2 and doctors 1.0 ± 0.5. IPT starts accounted for 48% of IPT interaction time. The percentage of available diabetes clinic time spent on outpatient IPT interactions was 20.4%, 4.6% and 2.7% for nurses, dietitians and doctors respectively. Fifteen patients tracked from pre-pump to stabilisation over 11.8 ± 4.5 weeks, required a median (range) of 9.2 (3.0-20.9), 2.4 (0.5-6.0) and 1.8 (0.5-5.4) hours per patient from nurses, dietitians and doctors respectively. CONCLUSIONS IPT patient care represents a substantial investment in HCP time, particularly for nurses. Funding models for IPT care need urgent review to ensure this now mainstream therapy integrates well into healthcare resources.
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Affiliation(s)
- S Xu
- St Vincent's Hospital, Melbourne, Victoria, Australia
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Lebrun R, Jenkins A, Dussaux A, Locatelli N, Tsunegi S, Grimaldi E, Kubota H, Bortolotti P, Yakushiji K, Grollier J, Fukushima A, Yuasa S, Cros V. Understanding of Phase Noise Squeezing Under Fractional Synchronization of a Nonlinear Spin Transfer Vortex Oscillator. Phys Rev Lett 2015; 115:017201. [PMID: 26182117 DOI: 10.1103/physrevlett.115.017201] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Indexed: 06/04/2023]
Abstract
We investigate experimentally the synchronization of vortex based spin transfer nano-oscillators to an external rf current whose frequency is at multiple integers, as well as at an integer fraction, of the oscillator frequency. Through a theoretical study of the locking mechanism, we highlight the crucial role of both the symmetries of the spin torques and the nonlinear properties of the oscillator in understanding the phase locking mechanism. In the locking regime, we report a phase noise reduction down to -90 dBc/Hz at 1 kHz offset frequency. Our demonstration that the phase noise of these nanoscale nonlinear oscillators can be tuned and eventually lessened, represents a key achievement for targeted radio frequency applications using spin torque devices.
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Affiliation(s)
- R Lebrun
- Unité Mixte de Physique CNRS/Thales and Université Paris Sud, 1 Avenue Fresnel, 91767 Palaiseau, France
| | - A Jenkins
- Unité Mixte de Physique CNRS/Thales and Université Paris Sud, 1 Avenue Fresnel, 91767 Palaiseau, France
| | - A Dussaux
- Unité Mixte de Physique CNRS/Thales and Université Paris Sud, 1 Avenue Fresnel, 91767 Palaiseau, France
| | - N Locatelli
- Unité Mixte de Physique CNRS/Thales and Université Paris Sud, 1 Avenue Fresnel, 91767 Palaiseau, France
| | - S Tsunegi
- Unité Mixte de Physique CNRS/Thales and Université Paris Sud, 1 Avenue Fresnel, 91767 Palaiseau, France
- National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Umezono, Tsukuba, Ibaraki 305-8568, Japan
| | - E Grimaldi
- Unité Mixte de Physique CNRS/Thales and Université Paris Sud, 1 Avenue Fresnel, 91767 Palaiseau, France
| | - H Kubota
- National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Umezono, Tsukuba, Ibaraki 305-8568, Japan
| | - P Bortolotti
- Unité Mixte de Physique CNRS/Thales and Université Paris Sud, 1 Avenue Fresnel, 91767 Palaiseau, France
| | - K Yakushiji
- National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Umezono, Tsukuba, Ibaraki 305-8568, Japan
| | - J Grollier
- Unité Mixte de Physique CNRS/Thales and Université Paris Sud, 1 Avenue Fresnel, 91767 Palaiseau, France
| | - A Fukushima
- National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Umezono, Tsukuba, Ibaraki 305-8568, Japan
| | - S Yuasa
- National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Umezono, Tsukuba, Ibaraki 305-8568, Japan
| | - V Cros
- Unité Mixte de Physique CNRS/Thales and Université Paris Sud, 1 Avenue Fresnel, 91767 Palaiseau, France
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Benedict A, Ishak J, Gal P, Proskorovsky I, Cappelleri J, Everiss T, Jones H, Hughes R, Jenkins A. THU0207 Comparative Analysis of the Effectiveness of anti-TNF Therapies in Non-Radiographic Axial Spondyloarthritis Using Novel Statistical Techniques: Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Rowley D, Jenkins A, Aucharaz K, Urquhart T, Demack S. Do community based activity days benefit childhood cancer patients? Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1218] [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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47
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King E, Chen S, Yuan J, Jenkins A, Keech A, Ng M. The role of fenofibrate in metabolic reprogramming in hyperglycaemia and hypoxia. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.188] [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]
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Chen S, King E, Yuan J, Jenkins A, Keech A, Ng M. Effects of fenofibrate on hypoxia tolerance in diabetes and associated molecular mechanisms. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.016] [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]
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Yuan J, Rajamani K, King E, Bursill C, Lecce L, Jenkins A, Keech A, Ng M. Fenofibrate rescues diabetes-related impairment of ischaemia-mediated angiogenesis by a PPARα independent pathway. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.004] [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]
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Jenkins A, Wilkinson JV, Akeroyd MA, Broom MA. Distractions during critical phases of anaesthesia for caesarean section: an observational study. Anaesthesia 2014; 70:543-8. [DOI: 10.1111/anae.12979] [Citation(s) in RCA: 17] [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] [Accepted: 11/14/2014] [Indexed: 11/29/2022]
Affiliation(s)
- A. Jenkins
- Department of Anaesthesia; Princess Royal Maternity Hospital; Glasgow Royal Infirmary; Glasgow UK
| | - J. V. Wilkinson
- Department of Anaesthesia; Princess Royal Maternity Hospital; Glasgow Royal Infirmary; Glasgow UK
| | - M. A. Akeroyd
- MRC Institute of Hearing Research (Scottish Section); Glasgow Royal Infirmary; Glasgow UK
| | - M. A. Broom
- Department of Anaesthesia; Princess Royal Maternity Hospital; Glasgow Royal Infirmary; Glasgow UK
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