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Fullam S, Togher Z, Power A, Kennelly L, McHugh JC, O'Dowd S, Tubridy N, Hardiman O, Costigan D, Ryan A, Lefter S, Connolly S, Murphy SM. Late-onset Tay-Sachs disease presenting with a neuromuscular phenotype-a case series. Eur J Neurol 2024; 31:e16069. [PMID: 37754769 DOI: 10.1111/ene.16069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 08/23/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND AND PURPOSE Tay-Sachs disease is a rare and often fatal, autosomal recessive, lysosomal storage disease. Deficiency in β-hexosaminidase leads to accumulation of GM2 ganglioside resulting in neuronal swelling and degeneration. Typical onset is in infancy with developmental regression and early death. Late-onset Tay-Sachs disease (LOTS) is extremely rare, especially in the non-Ashkenazi Jewish population, and is characterized by a more indolent presentation typically encompassing features of cerebellar and anterior horn cell dysfunction in addition to extrapyramidal and neuropsychiatric symptoms. CASES A case series of four unrelated patients of non-Ashkenazi Jewish origin with a predominantly, and in some cases pure, neuromuscular phenotype with evidence of a motor neuronopathy on electromyography is presented. Cerebellar atrophy, reported to be a ubiquitous feature in LOTS, was absent in all patients. CONCLUSION This case series provides evidence to support a pure neuromuscular phenotype in LOTS, which should be considered in the differential diagnosis of anterior horn cell disorders.
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Affiliation(s)
- Sarah Fullam
- Department of Neurology, Tallaght University Hospital, Dublin, Ireland
| | - Zara Togher
- Department of Neurology, Tallaght University Hospital, Dublin, Ireland
| | - Alan Power
- Department of Neurology, Cork University Hospital, Cork, Ireland
| | - Laura Kennelly
- Department of Neurology, St Vincent's University Hospital, Dublin, Ireland
| | - John C McHugh
- Department of Clinical Neurophysiology, Tallaght University Hospital, Dublin, Ireland
| | - Sean O'Dowd
- Department of Neurology, Tallaght University Hospital, Dublin, Ireland
- Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland
| | - Niall Tubridy
- Department of Neurology, St Vincent's University Hospital, Dublin, Ireland
| | - Orla Hardiman
- Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - Donal Costigan
- Department of Clinical Neurophysiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Aisling Ryan
- Department of Neurology, Cork University Hospital, Cork, Ireland
| | - Stela Lefter
- Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - Sean Connolly
- Department of Clinical Neurophysiology, St Vincent's University Hospital, Dublin, Ireland
| | - Sinead M Murphy
- Department of Neurology, Tallaght University Hospital, Dublin, Ireland
- Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland
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2
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Ryan A, Stone RG, Gavin PJ, James A, Walsh M, McMahon CJ. Rheumatic Fever and Rheumatic Heart Disease. Ir Med J 2023; 116:777. [PMID: 37555534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
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Granahan A, Fabre A, Ryan A, Lally A. A rapidly enlarging nonpigmented nodule on the chest wall. Clin Exp Dermatol 2023; 48:426-428. [PMID: 36757909 DOI: 10.1093/ced/llac139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 12/20/2022] [Accepted: 12/28/2022] [Indexed: 01/22/2023]
Abstract
We report a clinicopathological case of a patient with a rapidly enlarging nonpigmented nodule on the chest wall. There was no personal or family history of skin disease or cutaneous malignancy.
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Affiliation(s)
- Aoife Granahan
- Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland
| | - Aurelie Fabre
- Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland
- University College Dublin School of Medicine, Dublin, Ireland
| | - Aisling Ryan
- Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland
| | - Aoife Lally
- Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland
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Peterson K, Ryan A, Antonelli M. Critical Reflection Practice in Nursing Health Care Policy Education. J Nurs Educ 2023; 62:312-315. [PMID: 36701131 DOI: 10.3928/01484834-20230105-01] [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] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND A call to action is in effect for nurses to be change agents and bridge the gaps between the delivery of health care and the social needs of individuals, families, and communities. Response to this charge requires nurses to address long-standing inequity in health care policy and practice realms. METHOD This article describes the creative teaching-learning approach of critical reflection practice as a first step in developing skills and attitude for nurses to do this work. RESULTS Early observations of the effect of critical reflection practice on learners show improved appreciation for the intersection of social, economic, and political dimensions operating in health care policy and practice that influence health inequities. CONCLUSION When nurses engage in a practice of critical reflection, they are more likely to identify offensive social determinants, act to ameliorate disparities, and advance the agenda for health equity. [J Nurs Educ. 2023;62(X):XXX-XXX.].
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Phelan A, Louise D, Alice C, Kent S, Naughton C, Tuohy D, Ryan A, Byrne M. 79 EXPERIENCES OF DIRECTORS OF NURSING IN RESIDENTIAL CARE OF OLDER PEOPLE DURING COVID 19. Age Ageing 2022. [PMCID: PMC9620292 DOI: 10.1093/ageing/afac218.064] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background COVID-19 was a global public health crisis and deaths in the over 65 age group represented a disproportionate number of deaths in older people. In particular, nursing homes experienced clusters of infection and high mortality rates. This paper discusses experiences of care homes’ Directors of Nursing/Persons in Charge (DoN) in their preparedness, management and control of care during COVID-19. Methods A mixed methods approach was used (survey- n=122) and semi-structured interviews (n=20) were conducted with DoNs in private and voluntary older person care homes in the Republic of Ireland. Survey data was analysed using descriptive and inferential statistics. Interviews were analysed using Braun & Clarke's thematic analysis. Results DoNs demonstrated an initial challenge in protecting residents from infection and also managing infection outbreak. However, over time they experienced more effectiveness in managing infection prevention and control as demanded at the level of a pandemic. Fifty percent of respondents experienced an infection outbreak and the data does not demonstrate any significant difference in preparedness and management in care homes which had outbreaks and those who had no outbreaks. Other challenges were related to financial sustainability of their facility while 47% of DoNs were either actively seeking other work, or thinking of leaving their post. In the interviews, the DoNs spoke of persistent concerns with the well-being of the staff and residents and a constant worry about meeting regulatory requirements and ensuring adequate staff cover for residents care needs. Moreover, the DoNs spoke of the difficulties when the media sensationalized poor care leading to a reduction of public confidence in the sector. Conclusion The DoNs were under constant alert and although had acclimatized to high level of infection control and prevention and managing emerging issues, the strain of the pandemic remained evident. Recommendations are given related to care homes and related to system level management for future public health crisis.
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Affiliation(s)
- A Phelan
- Trinity College Dublin , Dublin, Ireland
| | - D Louise
- Trinity College Dublin , Dublin, Ireland
| | - C Alice
- University of Limerick , Limerick, Ireland
| | - S Kent
- Dublin City University , Dublin, Ireland
| | - C Naughton
- University College Dublin , Dublin, Ireland
| | - D Tuohy
- University of Limerick , Limerick, Ireland
| | - A Ryan
- Ulster University , Belfast, Ireland
| | - M Byrne
- Trinity College Dublin , Dublin, Ireland
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Josephy P, Elder R, Allen-Vercoe E, Kelly L, Ryan A, Harvey J, Ackerley D, Keyzers R. S-32-02 Characterization and toxicology of azo dye metabolites. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mehta R, Shardell M, Ryan A, Dong Y, Beamer B, Gallo J, Stuart E, Schuler M, Hochberg M, Rathbun A. POS1138 PERSISTENCY OF DEPRESSIVE SYMPTOMS AND PHYSICAL PERFORMANCE IN KNEE OSTEOARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5250] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundKnee osteoarthritis (OA) is the most prevalent arthritic disorder, characterized by joint paint, which is exacerbated by chronic depressive episodes. Depression in knee OA is also associated with declines in physical activity level and greater disability; however, the impact of persistent depressive symptoms on physical performance remains unclear.ObjectivesTo determine how the persistence of depressive symptoms affects functional capacity in knee OA.MethodsParticipants (n=2,212) were from the Osteoarthritis Initiative cohort and included individuals with radiographic disease (Kellgren-Lawrence grade ≥ 2) and complete data on study measures at baseline. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D; range 0-60) at baseline and the first three follow-up visits. Physical Performance was measured using 20-meter gait speed (meters per second) during follow-up at the first four annual visits. Persistency of depressive symptoms was operationalized as a cumulative exposure using average severity over time. Gait speed was standardized so that outcome estimates could be interpreted in standard deviations. Time-invariant confounders measured at study enrollment included demographic, socioeconomic, and lifestyle factors. Time-varying confounders assessed concurrent to CES-D scores were body mass index, analgesic medications, pain, and other knee OA signs and symptoms. Marginal structural models accounting for time-dependent confounding and selective attrition were the primary method of analysis. The outcome model included all potential statistical interactions between depressive symptoms and follow-up time indicators. Post-estimation linear combinations estimated time-specific effects of time-averaged CES-D scores on standardized gait speed and differences in physical performance between participants with (i.e., CES-D=16) and without (i.e., CES-D=0) depressive symptoms satisfying screening criteria for major depression.ResultsThe interaction between depressive symptoms and time was statistically significant (P=<0.001). Time-specific associations indicated that the largest negative impact of depressive symptoms on physical performance was from baseline through year one (β = -0.0077; 95% CI: -0.0125, 0.0030). However, the effect of persistent depressive symptoms decreased over time and reversed in magnitude and directionality, evidenced by the time-specific associations between time-averaged CES-D scores from baseline through year one and year two and gait speed at year two (β = -0.0033; 95% CI: -0.0084, 0.0019) and year three (β = 0.0014; 95% CI: -0.0046, 0.0074), respectively. Consequently, the strongest negative affect of depressive symptoms on gait speed (β = -0.1232; 95% CI: -0.1998, -0.0473) between participants with and without depressive symptoms satisfying screening criteria for major depression was when depressive symptoms were first measured closest to the initial gait speed assessment.ConclusionIn the contrast to the dose-dependent relationship between chronic depressive episodes and pain in knee OA, study findings imply that the negative effect of depressive symptoms on physical performance decreases over time with increasing depression persistency. These results may reflect diminishing marginal effects, where the largest impact on physical performance in knee OA is during the first depressive episode closest to initial gait speed assessment, especially when averaged against improvement in symptoms over the same duration.AcknowledgementsThe OAI is a public-private partnership comprised of five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. This manuscript was prepared using an OAI public use data set and does not necessarily reflect the opinions or views of the OAI investigators, the NIH, or the private funding partners.Disclosure of InterestsRhea Mehta: None declared, Michelle Shardell: None declared, Alice Ryan: None declared, Yu Dong: None declared, Brock Beamer: None declared, Joseph Gallo: None declared, Elizabeth Stuart: None declared, Megan Schuler: None declared, Marc Hochberg Shareholder of: Dr. Marc C. Hochberg is the President of Rheumcon Corporation., Consultant of: Dr. Marc C. Hochberg receives consulting fees from Bioiberica SA, Bristol-Myers Squibb, Eli Lilly, EMD Serono, Galapagos, IBSA Biotechniq SA, Novartis Pharma AG, Pfizer, Plexxikon, Samumed LLC, Theralogix LLC, and TissueGene Inc., Alan Rathbun: None declared
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Ivanovska A, Mancuso P, Hennessy C, McLoughlin S, Reilly J, Raman S, Dooley C, Ritter T, Ryan A, Kamath R, Levesque M, van Riet D, Barry F, Murphy M. Mesenchymal Stem/Stromal Cells: TRANSCRIPTOME PROFILE OF RETRIEVED MESENCHYMAL STEM/STROMAL CELLS IN A COLLAGENASE INDUCED MURINE OSTEOARTHRITIS MODEL. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00233-x] [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: 11/28/2022]
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9
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Varghese A, Ryan A, Wells C, Li G, Baer D, Parker E, Buko A, Kaza V, Banga A, Bollineni S, Mahan L, Mohanka M, Lawrence A, Joerns J, Torres F, Wait M, Iacono A, Verceles A, Terada L, Terrin M, Timofte I. Post-Transplant Metabolomics Profiles in Patients Undergoing Lung Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Abstract
A 72-year-old woman had a warty growth 'burnt off' with a herbal remedy by a local farmer in rural Ireland. We saw the patient a number of years later in clinic and she brought the specimen with her, which was processed by the pathology department. We report her case and some interesting background information regarding escharotic agents.
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Affiliation(s)
- Claire Doyle
- Departments of, Dermatology, St Vincent's University Hospital, Elm Park, Dublin, Ireland
| | - Clare D'Arcy
- Histopathology, St Vincent's University Hospital, Elm Park, Dublin, Ireland
| | - Aisling Ryan
- Departments of, Dermatology, St Vincent's University Hospital, Elm Park, Dublin, Ireland
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11
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Nath LC, Forbes G, Elliott AD, Tomren V, Ryan A, Franklin SH. Application of an electrocardiography device (iECG) for heart rhythm analysis after exercise in Thoroughbred horses. Aust Vet J 2021; 100:114-120. [PMID: 34859419 DOI: 10.1111/avj.13137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/08/2021] [Accepted: 11/14/2021] [Indexed: 12/01/2022]
Abstract
AliveCor is a smartphone electrocardiography device (iECG) providing automated heart rate (HR) and rhythm determination. Atrial fibrillation (AF) in horses often is paroxysmal and rapid ECG acquisition is needed for diagnostic confirmation. iECGs were collected post-race from 15 horses with AF and 64 horses in sinus rhythm (SR). Results of manual assessment were compared to 3 commercial algorithms for HR and rhythm. Agreement between manually derived HR (HRM ) and HR derived by the AliveECG Vet (HRVET ) and Kardia version-1 (KV1 HR) and Kardia advanced (KADV HR) algorithms was quantified by the Bland-Altman limits of agreement test. Agreement between manual rhythm classification and KV1 and KADV algorithms for AF and SR was calculated by the Kappa statistical coefficient. The agreement (bias, 95% limits), between HRM and HRVET was 7.1 BPM (-29 to 43) in AF and -4.2 BPM (-38 to 30) in SR, between HRM and KV1 HR, was -0.3 BPM (-31 to 30) in AF and 0.2 BPM (-3 to 4) in SR, and between HRM and KADV HR was 7.0 BPM (-29 to 43) in AF and 0.2 BPM (-3.9 to 4.2) in SR. Agreement between manual rhythm classification and KV1 was 0.36 (0.13-0.59), and KADV was 0.84 (0.68-0.99). Sensitivity and specificity for identification of AF and SR of the KV1 algorithm were 60, 100% and 83, 100%, respectively, and of KADV was 87, 100% and 93, 100% respectively. The Kardia algorithms improved precision for HR determination in SR but not AF. The advanced algorithm accurately distinguished between AF and SR. The iECG is suitable for recording episodes of AF following exercise.
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Affiliation(s)
- L C Nath
- University of Adelaide, Roseworthy, South Australia, Australia
| | - G Forbes
- Racing Victoria, Flemington, Victoria, Australia
| | - A D Elliott
- University of Adelaide, Adelaide, South Australia, Australia
| | - V Tomren
- Racing Victoria, Flemington, Victoria, Australia
| | - A Ryan
- University of Adelaide, Roseworthy, South Australia, Australia
| | - S H Franklin
- University of Adelaide, Roseworthy, South Australia, Australia
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Tariq S, Stroiescu A, Mannion J, Caples N, O'Callaghan P, O'Reilly M, Ryan A, Owens P. Protection of bone mineral density in heart failure patients:audit on current clinical practice in a busy tertiary care hospital cardiology department in Ireland. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0994] [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: 11/14/2022] Open
Abstract
Abstract
Background
The strong association between heart failure (HF) and osteoporosis is well recognised. Heart failure, due to its multiple risk factors and common pathogenesis with osteoporosis can lead to low bone mineral density (BMD) and increase the risk of fragility fractures. The mortality of HF patients following these fractures is high. Current National Osteoporosis Foundation Guidelines recommend that pharmacological therapy should be reserved for postmenopausal women and men aged 50 years or older who present with a hip or vertebral fracture, where the vertebral fractures may be clinical or identified on a radiograph alone.
Methods
Most HF patients have frequent chest radiographs over their course years. We aimed to audit the prevalence of osteoporosis and current practice of prescribing BMD-protection in patients attending the HF clinic in a busy tertiary care hospital in Ireland. 100 patients attending the clinic in the last one year were randomly selected and clinical, medication and chest radiograph information on this cohort was collected via the hospital electronic information system. All those patients with Radiologist confirmed vertebral compression fractures (VCF) on their plain chest radiographs were audited regarding osteoporosis screening and bone protection prescription.
Results
Due to limited penetration,18 out of 100 chest radiographs were inconclusive,reducing the sample size to 82. 9 out of the remaining 82 patients had radiologist confirmed VCF on their plain chest radiographs whereas 2 patients had VCF incidentally picked up on their lumbar spine x-rays. All patients were aged more than 50. 4 were female and 7 male. Median ejection fraction calculated was 35%. 3 out of 11 were smokers,8 had atrial fibrillation and were on anticoagulation,4 had DM-II and 2 had CKD. 10 were on loop diuretics. Of note,4 patients were on calcium and vitamin D supplements but only 1 patient was on antiresorptive therapy for osteoporosis.
Conclusion
Despite its strong association with heart failure,Osteoporosis remains undertreated in this patient cohort.Due to the significant mortality and morbidity associated with major osteoporotic fractures, doctors should carefully assess and screen heart failure patients for osteoporosis and initiate specific therapy where indicated.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Tariq
- University Hospital Waterford, Cardiology, Waterford, Ireland
| | - A Stroiescu
- University Hospital Waterford, Radiology, Waterford, Ireland
| | - J Mannion
- University Hospital Waterford, Cardiology, Waterford, Ireland
| | - N Caples
- University Hospital Waterford, Cardiology, Waterford, Ireland
| | - P O'Callaghan
- University Hospital Waterford, Cardiology, Waterford, Ireland
| | - M O'Reilly
- University Hospital Waterford, Cardiology, Waterford, Ireland
| | - A Ryan
- University Hospital Waterford, Radiology, Waterford, Ireland
| | - P Owens
- University Hospital Waterford, Cardiology, Waterford, Ireland
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13
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Zabaleta N, Dai W, Bhatt U, Hérate C, Maisonnasse P, Chichester JA, Sanmiguel J, Estelien R, Michalson KT, Diop C, Maciorowski D, Dereuddre-Bosquet N, Cavarelli M, Gallouët AS, Naninck T, Kahlaoui N, Lemaitre J, Qi W, Hudspeth E, Cucalon A, Dyer CD, Pampena MB, Knox JJ, LaRocque RC, Charles RC, Li D, Kim M, Sheridan A, Storm N, Johnson RI, Feldman J, Hauser BM, Contreras V, Marlin R, Tsong Fang RH, Chapon C, van der Werf S, Zinn E, Ryan A, Kobayashi DT, Chauhan R, McGlynn M, Ryan ET, Schmidt AG, Price B, Honko A, Griffiths A, Yaghmour S, Hodge R, Betts MR, Freeman MW, Wilson JM, Le Grand R, Vandenberghe LH. An AAV-based, room-temperature-stable, single-dose COVID-19 vaccine provides durable immunogenicity and protection in non-human primates. Cell Host Microbe 2021; 29:1437-1453.e8. [PMID: 34428428 PMCID: PMC8346325 DOI: 10.1016/j.chom.2021.08.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/12/2021] [Accepted: 08/03/2021] [Indexed: 12/11/2022]
Abstract
The SARS-CoV-2 pandemic has affected more than 185 million people worldwide resulting in over 4 million deaths. To contain the pandemic, there is a continued need for safe vaccines that provide durable protection at low and scalable doses and can be deployed easily. Here, AAVCOVID-1, an adeno-associated viral (AAV), spike-gene-based vaccine candidate demonstrates potent immunogenicity in mouse and non-human primates following a single injection and confers complete protection from SARS-CoV-2 challenge in macaques. Peak neutralizing antibody titers are sustained at 1 year and complemented by functional memory T cell responses. The AAVCOVID vector has no relevant pre-existing immunity in humans and does not elicit cross-reactivity to common AAVs used in gene therapy. Vector genome persistence and expression wanes following injection. The single low-dose requirement, high-yield manufacturability, and 1-month stability for storage at room temperature may make this technology well suited to support effective immunization campaigns for emerging pathogens on a global scale.
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Affiliation(s)
- Nerea Zabaleta
- Grousbeck Gene Therapy Center, Schepens Eye Research Institute, Mass Eye and Ear, Boston, MA, USA; Ocular Genomics Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; The Broad Institute of Harvard and MIT, Cambridge, MA, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA
| | - Wenlong Dai
- Grousbeck Gene Therapy Center, Schepens Eye Research Institute, Mass Eye and Ear, Boston, MA, USA; Ocular Genomics Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; The Broad Institute of Harvard and MIT, Cambridge, MA, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA
| | - Urja Bhatt
- Grousbeck Gene Therapy Center, Schepens Eye Research Institute, Mass Eye and Ear, Boston, MA, USA; Ocular Genomics Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; The Broad Institute of Harvard and MIT, Cambridge, MA, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA
| | - Cécile Hérate
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, France
| | - Pauline Maisonnasse
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, France
| | - Jessica A Chichester
- Gene Therapy Program, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Julio Sanmiguel
- Grousbeck Gene Therapy Center, Schepens Eye Research Institute, Mass Eye and Ear, Boston, MA, USA; Ocular Genomics Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; The Broad Institute of Harvard and MIT, Cambridge, MA, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA
| | - Reynette Estelien
- Grousbeck Gene Therapy Center, Schepens Eye Research Institute, Mass Eye and Ear, Boston, MA, USA; Ocular Genomics Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; The Broad Institute of Harvard and MIT, Cambridge, MA, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA
| | - Kristofer T Michalson
- Gene Therapy Program, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Cheikh Diop
- Grousbeck Gene Therapy Center, Schepens Eye Research Institute, Mass Eye and Ear, Boston, MA, USA; Ocular Genomics Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; The Broad Institute of Harvard and MIT, Cambridge, MA, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA
| | - Dawid Maciorowski
- Grousbeck Gene Therapy Center, Schepens Eye Research Institute, Mass Eye and Ear, Boston, MA, USA; Ocular Genomics Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; The Broad Institute of Harvard and MIT, Cambridge, MA, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA
| | - Nathalie Dereuddre-Bosquet
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, France
| | - Mariangela Cavarelli
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, France
| | - Anne-Sophie Gallouët
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, France
| | - Thibaut Naninck
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, France
| | - Nidhal Kahlaoui
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, France
| | - Julien Lemaitre
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, France
| | - Wenbin Qi
- Novartis Gene Therapies, San Diego, CA, USA
| | | | - Allison Cucalon
- Grousbeck Gene Therapy Center, Schepens Eye Research Institute, Mass Eye and Ear, Boston, MA, USA; Ocular Genomics Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; The Broad Institute of Harvard and MIT, Cambridge, MA, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA
| | - Cecilia D Dyer
- Gene Therapy Program, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - M Betina Pampena
- Gene Therapy Program, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - James J Knox
- Department of Pathology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Regina C LaRocque
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Richelle C Charles
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Dan Li
- Grousbeck Gene Therapy Center, Schepens Eye Research Institute, Mass Eye and Ear, Boston, MA, USA; Ocular Genomics Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; The Broad Institute of Harvard and MIT, Cambridge, MA, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA
| | - Maya Kim
- Grousbeck Gene Therapy Center, Schepens Eye Research Institute, Mass Eye and Ear, Boston, MA, USA; Ocular Genomics Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; The Broad Institute of Harvard and MIT, Cambridge, MA, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA
| | - Abigail Sheridan
- Grousbeck Gene Therapy Center, Schepens Eye Research Institute, Mass Eye and Ear, Boston, MA, USA; Ocular Genomics Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; The Broad Institute of Harvard and MIT, Cambridge, MA, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA
| | - Nadia Storm
- Department of Microbiology and National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, MA 02118, USA
| | - Rebecca I Johnson
- Department of Microbiology and National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, MA 02118, USA
| | - Jared Feldman
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
| | - Blake M Hauser
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
| | - Vanessa Contreras
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, France
| | - Romain Marlin
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, France
| | - Raphaël Ho Tsong Fang
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, France
| | - Catherine Chapon
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, France
| | - Sylvie van der Werf
- Molecular Genetics of RNA Viruses, Department of Virology, Institut Pasteur, CNRS UMR 3569, Université de Paris, Paris, France; National Reference Center for Respiratory Viruses, Institut Pasteur, Paris, France
| | - Eric Zinn
- Grousbeck Gene Therapy Center, Schepens Eye Research Institute, Mass Eye and Ear, Boston, MA, USA; Ocular Genomics Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; The Broad Institute of Harvard and MIT, Cambridge, MA, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA
| | - Aisling Ryan
- Grousbeck Gene Therapy Center, Schepens Eye Research Institute, Mass Eye and Ear, Boston, MA, USA; Ocular Genomics Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; The Broad Institute of Harvard and MIT, Cambridge, MA, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA
| | - Dione T Kobayashi
- Translational Innovation Fund, Mass General Brigham Innovation, Cambridge, MA, USA
| | - Ruchi Chauhan
- Grousbeck Gene Therapy Center, Schepens Eye Research Institute, Mass Eye and Ear, Boston, MA, USA; Ocular Genomics Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; The Broad Institute of Harvard and MIT, Cambridge, MA, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA
| | - Marion McGlynn
- Gene Therapy Program, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Edward T Ryan
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA; Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Aaron G Schmidt
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA; Department of Microbiology, Harvard Medical School, Boston, MA, USA
| | | | - Anna Honko
- Department of Microbiology and National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, MA 02118, USA
| | - Anthony Griffiths
- Department of Microbiology and National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, MA 02118, USA
| | | | | | - Michael R Betts
- Gene Therapy Program, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mason W Freeman
- Center for Computational & Integrative Biology, Department of Medicine, and Translational Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - James M Wilson
- Gene Therapy Program, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Roger Le Grand
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, France.
| | - Luk H Vandenberghe
- Grousbeck Gene Therapy Center, Schepens Eye Research Institute, Mass Eye and Ear, Boston, MA, USA; Ocular Genomics Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; The Broad Institute of Harvard and MIT, Cambridge, MA, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA.
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Ryan A, Crehan E, Khondoker M, Fell M, Curtin R, Johns LC. An emotional regulation approach to psychosis recovery: The Living Through Psychosis group programme. J Behav Ther Exp Psychiatry 2021; 72:101651. [PMID: 33667827 DOI: 10.1016/j.jbtep.2021.101651] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 01/25/2021] [Accepted: 02/15/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Research indicates the value of targeting emotional regulation (ER) skills in psychological interventions for psychosis. These skills can be delivered in a group format, thereby increasing access to therapy. This pilot study examined the acceptability and clinical effects of teaching ER skills in The Living Through Psychosis (LTP) group programme. METHODS Patients with a psychotic illness were offered the LTP programme, comprising eight sessions over four weeks. Measures were completed by 55 participants. Acceptability was assessed by attendance rates and group cohesion. Measures of intervention targets, recovery and clinical outcomes were completed at baseline, pre-group, post-group, and one-month follow-up. RESULTS High group attendance and cohesion support the acceptability of the group. Participants reported less difficulty with ER (Coeff. = -8.29, 95% CI: -13.40 to -3.18, within participant uncontrolled effect size (ES) d = 0.29), increased mindful relating to distressing symptoms (Coeff. = 11.20, 95% CI: 7.02 to 15.38, d = 0.65), and improvements in recovery dimensions (Coeff. = 10.07, 95% CI: 5.6 to 14.54, d = 0.42) from pre-to post-intervention, and maintained at one-month follow-up. Participants' hallucinations and delusions reduced from pre-intervention to follow-up (t(18) = 4.64, p < 0.001; t(18) = 5.34, p < 0.001). There was no change in fear of relapse. LIMITATIONS The uncontrolled, pre-post design precluded blinded assessments, and may have inflated effect sizes. Other factors may have contributed to the improvements. CONCLUSIONS The LTP programme was acceptable to people with psychosis. The preliminary findings indicate the potential utility of teaching ER and mindfulness skills in a brief group programme. Findings require replication in a randomized controlled trial.
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Affiliation(s)
- Aisling Ryan
- School of Psychology, Trinity College Dublin, Ireland; Health Service Executive, Ireland
| | - Edel Crehan
- Department of Psychology, St Patrick's Mental Health Services, Dublin, Ireland
| | | | - Mary Fell
- School of Psychology, Trinity College Dublin, Ireland; Health Service Executive, Ireland
| | - Roisin Curtin
- Department of Psychology, St Patrick's Mental Health Services, Dublin, Ireland
| | - Louise C Johns
- Department of Psychiatry, University of Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK.
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Heijkoop B, Bolton D, Katz D, Ryan A, Epstein J, Appu S. Cystic papillary adenoma of the seminal vesicle – A distinct histological entity. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01082-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Timofte I, Wells C, Hersi K, Ryan A, Varghese A, Vesselinov R, Iacono A, Assadi J, Davis D, Li G, Herr D, Harrington T, Griffith B, Lau C, Krupnick A, Madathil R, Rabin J, Alon G, Parker E, Baer D, Magder L, Terrin M, Verceles A. Nutritional Supplementation and Neuromuscular Electrical Stimulation in Lung Transplant Patients. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Zabaleta N, Dai W, Bhatt U, Chichester JA, Sanmiguel J, Estelien R, Michalson KT, Diop C, Maciorowski D, Qi W, Hudspeth E, Cucalon A, Dyer CD, Pampena MB, Knox JJ, LaRocque RC, Charles RC, Li D, Kim M, Sheridan A, Storm N, Johnson RI, Feldman J, Hauser BM, Zinn E, Ryan A, Kobayashi DT, Chauhan R, McGlynn M, Ryan ET, Schmidt AG, Price B, Honko A, Griffiths A, Yaghmour S, Hodge R, Betts MR, Freeman MW, Wilson JM, Vandenberghe LH. Immunogenicity of an AAV-based, room-temperature stable, single dose COVID-19 vaccine in mice and non-human primates. bioRxiv 2021. [PMID: 33442684 DOI: 10.1101/2021.01.05.422952] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The SARS-CoV-2 pandemic has affected more than 70 million people worldwide and resulted in over 1.5 million deaths. A broad deployment of effective immunization campaigns to achieve population immunity at global scale will depend on the biological and logistical attributes of the vaccine. Here, two adeno-associated viral (AAV)-based vaccine candidates demonstrate potent immunogenicity in mouse and nonhuman primates following a single injection. Peak neutralizing antibody titers remain sustained at 5 months and are complemented by functional memory T-cells responses. The AAVrh32.33 capsid of the AAVCOVID vaccine is an engineered AAV to which no relevant pre-existing immunity exists in humans. Moreover, the vaccine is stable at room temperature for at least one month and is produced at high yields using established commercial manufacturing processes in the gene therapy industry. Thus, this methodology holds as a very promising single dose, thermostable vaccine platform well-suited to address emerging pathogens on a global scale.
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Van Den Heuvel F, Petersson K, Vojnovic B, Hill M, Vella A, Ryan A, Brooke M, Maughan T, Giaccia A. Oxygen Related Factors in FLASH Radiotherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1668] [Citation(s) in RCA: 1] [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: 11/16/2022]
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Squire T, Ryan A, Bernard S. Radioprotective effects of induced astronaut torpor and advanced propulsion systems during deep space travel. Life Sci Space Res (Amst) 2020; 26:105-113. [PMID: 32718676 DOI: 10.1016/j.lssr.2020.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Human metabolic suppression is not a new concept, with 1950s scientific literature and movies demonstrating its potential use for deep space travel (Hock, 1960). An artificially induced state of metabolic suppression in the form of torpor would improve the amount of supplies required and therefore lessen weight and fuel required for missions to Mars and beyond (Choukèr et al., 2019). Transfer habitats for human stasis to Mars have been conceived (Bradford et al., 2018). Evidence suggests that animals, when hibernating, demonstrate relative radioprotection compared to their awake state. Experiments have also demonstrated relative radioprotection in conditions of hypothermia as well as during sleep (Bellesi et al., 2016 and Andersen et al., 2009). Circadian rhythm disrupted cells also appear to be more susceptible to radiation damage compared to those that are under a rhythmic control (Dakup et al., 2018). An induced torpor state for astronauts on deep space missions may provide a biological radioprotective state due to a decreased metabolism and hypothermic conditions. A regular enforced circadian rhythm might further limit DNA damage from radiation. The As Low As Reasonably Achievable (A.L.A.R.A.) radiation protection concept defines time, distance and shielding as ways to decrease radiation exposure. Whilst distance cannot be altered in space and shielding either passively or actively may be beneficial, time of exposure may be drastically decreased with improved propulsion systems. Whilst chemical propulsion systems have superior thrust to other systems, they lack high changes in velocity and fuel efficiency which can be achieved with nuclear or electric based propulsion systems. Radiation toxicity could be limited by reduced transit times, combined with the radioprotective effects of enforced circadian rhythms during a state of torpor or hibernation. OBJECTIVES 1. Investigate how the circadian clock and body temperature may contribute to radioprotection during human torpor on deep space missions. 2. Estimate radiation dose received by astronauts during a transit to Mars with varying propulsion systems. METHODS We simulated three types of conditions to investigate the potential radioprotective effect of the circadian clock and decreased temperature on cells being exposed to radiation such that may be the case during astronaut torpor. These conditions were: - Circadian clock strength: strong vs weak. - Light exposure: dark-dark vs light-dark cycle - Body temperature: 37C vs hypothermia vs torpor. We estimated transit times for a mission to Mars from Earth utilizing chemical, nuclear and electrical propulsion systems. Transit times were generated using the General Mission Analysis Tool (GMAT) and Matlab. These times were then input into the National Aeronautics and Space Administration (NASA) Online Tool for the Assessment of Radiation In Space (OLTARIS) computer simulator to estimate doses received by an astronaut for the three propulsion methods. RESULTS Our simulation demonstrated an increase in radioprotection with decreasing temperature. The greatest degree of radioprotection was shown in cells that maintained a strong circadian clock during torpor. This was in contrast to relatively lower radioprotection in cells with a weak clock during normothermia. We were also able to demonstrate that if torpor weakened the circadian clock, a protective effect could be partially restored by an external drive such as lighting schedules to aid entrainment i.e.: Blue light exposure for periods of awake and no light for rest times For the propulsion simulation, estimated transit times from Earth to Mars were 258 days for chemical propulsion with 165.9mSv received, 209 days for nuclear propulsion with 134.4mSv received and 80 days for electrical propulsion with 51.4mSv received. CONCLUSION A state of torpor for astronauts on deep space missions may not only improve weight, fuel and storage requirements but also provide a potential biological radiation protection strategy. Moreover, maintaining a controlled circadian rhythm during torpor conditions may aid radioprotection. In the not too distant future, propulsion techniques will be improved to limit transit time and hence decrease radiation dose to astronauts. Limiting exposure time and enhancing physiological radioprotection during transit could provide superior radioprotection benefits compared with active and passive radiation shielding strategies alone.
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Affiliation(s)
- T Squire
- The Canberra Hospital, Department of Radiation Oncology. Garran. Australian Capital Territory, Australia; University of Notre Dame Australia, School of Medicine. Darlinghurst, New South Wales, Australia.
| | - A Ryan
- University of Sydney, Applied and Plasma Physics Research Group. School of Aerospace Mechanical and Mechatronic Engineering, Camperdown, NSW 2006. Australia
| | - S Bernard
- Université de Lyon. CNRS UMR5208 Institut Camille Jordan. Villeurbanne, France & Inria Grenoble, France
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Burnell M, Gentry‐Maharaj A, Glazer C, Karpinskyj C, Ryan A, Apostolidou S, Kalsi J, Parmar M, Campbell S, Jacobs I, Menon U. Serial endometrial thickness and risk of non-endometrial hormone-dependent cancers in postmenopausal women in UK Collaborative Trial of Ovarian Cancer Screening. Ultrasound Obstet Gynecol 2020; 56:267-275. [PMID: 31614036 PMCID: PMC7496247 DOI: 10.1002/uog.21894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/27/2019] [Accepted: 10/02/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Estrogen is a well-established risk factor for various cancers. It causes endometrial proliferation, which is assessed routinely as endometrial thickness (ET) using transvaginal ultrasound (TVS). Only one previous study, restricted to endometrial and breast cancer, has considered ET and the risk of non-endometrial cancer. The aim of this study was to explore the association between baseline and serial ET measurements and nine non-endometrial hormone-sensitive cancers, in postmenopausal women, using contemporary statistical methodology that attempts to minimize the biases typical of endogenous serial data. METHODS This was a cohort study nested within the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). In the ultrasound arm of UKCTOCS, 50639 postmenopausal women, aged 50-74, underwent annual TVS examination, of whom 38 105 had a valid ET measurement, no prior hysterectomy and complete covariate data, and were included in this study. All women were followed up through linkage to national cancer registries. The effect of ET on the risk of six estrogen-dependent cancers (breast, ovarian, colorectal, bladder, lung and pancreatic) was assessed using joint models for longitudinal biomarker and time-to-event data, and Cox models were used to assess the association between baseline ET measurement and these six cancers in addition to liver cancer, gastric cancer and non-Hodgkin's lymphoma (NHL). All models were adjusted for current hormone-replacement therapy (HRT) use, body mass index, age at last menstrual period, parity and oral contraceptive pill use. RESULTS The 38 105 included women had a combined total of 267 567 (median, 8; interquartile range, 5-9) valid ET measurements. During a combined total of 407 838 (median, 10.9) years of follow-up, 1398 breast, 351 endometrial, 381 lung, 495 colorectal, 222 ovarian, 94 pancreatic, 79 bladder, 62 gastric, 38 liver cancers and 52 NHLs were registered. Using joint models, a doubling of ET increased significantly the risk of breast (hazard ratio (HR), 1.21; 95% CI, 1.09-1.36; P = 0.001), ovarian (HR, 1.39; 95% CI, 1.06-1.82; P = 0.018) and lung (HR, 1.25; 95% CI, 1.02-1.54; P = 0.036) cancers. There were no statistically significant associations between ET and the remaining six cancers. CONCLUSION Postmenopausal women with high/increasing ET on TVS are at increased risk of breast, ovarian and lung cancer. It is important that clinicians are aware of these risks, as TVS is a common investigation. © 2019 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- M. Burnell
- MRC CTU, Institute of Clinical Trials and MethodologyUniversity College LondonLondonUK
| | - A. Gentry‐Maharaj
- MRC CTU, Institute of Clinical Trials and MethodologyUniversity College LondonLondonUK
| | - C. Glazer
- Department of Occupational and Environmental MedicineFrederiksberg‐Bispebjerg University HospitalCopenhagenNVDenmark
| | - C. Karpinskyj
- MRC CTU, Institute of Clinical Trials and MethodologyUniversity College LondonLondonUK
| | - A. Ryan
- MRC CTU, Institute of Clinical Trials and MethodologyUniversity College LondonLondonUK
- Department of Women's Cancer, Institute for Women's HealthUniversity College LondonLondonUK
| | - S. Apostolidou
- MRC CTU, Institute of Clinical Trials and MethodologyUniversity College LondonLondonUK
| | - J. Kalsi
- Department of Women's Cancer, Institute for Women's HealthUniversity College LondonLondonUK
| | - M. Parmar
- MRC CTU, Institute of Clinical Trials and MethodologyUniversity College LondonLondonUK
| | | | - I. Jacobs
- Department of Women's Cancer, Institute for Women's HealthUniversity College LondonLondonUK
- University of New South WalesSydneyAustralia
| | - U. Menon
- MRC CTU, Institute of Clinical Trials and MethodologyUniversity College LondonLondonUK
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O'Reilly K, O'Connell P, Ryan A, Ambrosch D, Walshe E, Davoren M, Corvin A, Kennedy HG. Deficit not bias: A quantifiable neuropsychological model of delusions. Schizophr Res 2020; 222:496-498. [PMID: 32507549 DOI: 10.1016/j.schres.2020.05.055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/21/2020] [Accepted: 05/25/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Ken O'Reilly
- The Department of Psychiatry, Trinity College Dublin, Ireland; The National Forensic Mental Health Service, The Central Mental Hospital, Dundrum, Dublin 14, Ireland.
| | - Paul O'Connell
- The Department of Psychiatry, Trinity College Dublin, Ireland; The National Forensic Mental Health Service, The Central Mental Hospital, Dundrum, Dublin 14, Ireland.
| | - Aisling Ryan
- The National Forensic Mental Health Service, The Central Mental Hospital, Dundrum, Dublin 14, Ireland.
| | - Daniellla Ambrosch
- The National Forensic Mental Health Service, The Central Mental Hospital, Dundrum, Dublin 14, Ireland; Department of Psychology, University of Regensburg, Regensburg, Germany.
| | - Eoin Walshe
- The Department of Psychiatry, Trinity College Dublin, Ireland; The National Forensic Mental Health Service, The Central Mental Hospital, Dundrum, Dublin 14, Ireland.
| | - Mary Davoren
- The Department of Psychiatry, Trinity College Dublin, Ireland; The National Forensic Mental Health Service, The Central Mental Hospital, Dundrum, Dublin 14, Ireland.
| | - Aiden Corvin
- The Department of Psychiatry, Trinity College Dublin, Ireland.
| | - Harry G Kennedy
- The Department of Psychiatry, Trinity College Dublin, Ireland; The National Forensic Mental Health Service, The Central Mental Hospital, Dundrum, Dublin 14, Ireland.
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22
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Faivre-Finn C, Brown S, Ryan A, Greystoke A. The UK at the Forefront of Innovative Drug-Radiotherapy Combination Clinical Trials: Introducing the CONCORDE Platform. Clin Oncol (R Coll Radiol) 2020; 32:358-362. [PMID: 32107107 DOI: 10.1016/j.clon.2020.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 01/28/2020] [Indexed: 01/25/2023]
Affiliation(s)
- C Faivre-Finn
- The Christie NHS Foundation Trust/University of Manchester, Manchester, UK.
| | - S Brown
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - A Ryan
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, The Department of Oncology, University of Oxford, Oxford, UK
| | - A Greystoke
- Newcastle University, Newcastle upon Tyne, UK
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O'Brien S, Garvey P, Baker K, Brennan M, Cormican M, Cuddihy J, De Lappe N, Ellard R, Fallon Ú, Irvine N, Murphy S, O'Brien D, O'Connor M, O'Hare C, O'Sullivan MB, Part AM, Rooney P, Ryan A, Waldron G, Ward M, McKeown PJ. Investigation of a foodborne outbreak of Shigella sonnei in Ireland and Northern Ireland, December 2016: the benefits of cross-border collaboration and commercial sales data. Public Health 2020; 182:19-25. [PMID: 32120067 DOI: 10.1016/j.puhe.2020.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 08/27/2019] [Revised: 12/11/2019] [Accepted: 01/09/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To describe a cross-border foodborne outbreak of Shigella sonnei that occurred in Ireland and Northern Ireland (NI) in December 2016 whilst also highlighting the valuable roles of sales data and international collaboration in the investigation and control of this outbreak. STUDY DESIGN A cross-border outbreak control team was established to investigate the outbreak. METHODS Epidemiological, microbiological, and environmental investigations were undertaken. Traditional analytical epidemiological studies were not feasible in this investigation. The restaurant chain provided sales data, which allowed assessment of a possible increased risk of illness associated with exposure to a particular type of heated food product (product A). RESULTS Confirmed cases demonstrated sole trimethoprim resistance: an atypical antibiogram for Shigella isolates in Ireland. Early communication and the sharing of information within the outbreak control team facilitated the early detection of the international dimension of this outbreak. A joint international alert using the European Centre for Disease Control's confidential Epidemic Intelligence Information System for Food- and Waterborne Diseases and Zoonoses (EPIS-FWD) did not reveal further cases outside of the island of Ireland. The outbreak investigation identified that nine of thirteen primary case individuals had consumed product A from one of multiple branches of a restaurant chain located throughout the island of Ireland. Product A was made specifically for this chain in a food production facility in NI. S. sonnei was not detected in food samples from the food production facility. Strong statistical associations were observed between visiting a branch of this restaurant chain between 5 and 9 December 2016 and eating product A and developing shigellosis. CONCLUSIONS This outbreak investigation highlights the importance of international collaboration in the efficient identification of cross-border foodborne outbreaks and the value of using sales data as the analytical component of such studies.
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Affiliation(s)
- S O'Brien
- HSE-Health Protection Surveillance Centre, Dublin, Ireland; Department of Public Health HSE-NW, Sligo, Ireland.
| | - P Garvey
- HSE-Health Protection Surveillance Centre, Dublin, Ireland
| | - K Baker
- Food Standards Agency Northern Ireland, Belfast, Northern Ireland, Ireland
| | - M Brennan
- Food Safety Authority of Ireland, Dublin, Ireland
| | - M Cormican
- National Salmonella, Shigella and Listeria Reference Laboratory, Galway, Ireland
| | - J Cuddihy
- Department of Public Health HSE-SE, Kilkenny, Ireland
| | - N De Lappe
- National Salmonella, Shigella and Listeria Reference Laboratory, Galway, Ireland
| | - R Ellard
- Food Safety Authority of Ireland, Dublin, Ireland
| | - Ú Fallon
- Department of Public Health HSE-Midlands, Co Offaly, Ireland
| | - N Irvine
- Public Health Agency Northern Ireland, Belfast, Northern Ireland, UK
| | - S Murphy
- Environmental Health Department, Newry, Mourne & Down District Council, Northern Ireland, UK
| | - D O'Brien
- HSE Environmental Health Service Dublin Specialist Section, Dublin, Ireland
| | - M O'Connor
- Department of Public Health HSE-E, Dublin, Ireland
| | - C O'Hare
- Department of Public Health HSE-SE, Kilkenny, Ireland
| | | | - A M Part
- HSE Environmental Health Service Dublin Mid Leinster, Dublin, Ireland
| | - P Rooney
- Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
| | - A Ryan
- Department of Public Health HSE-NW, Sligo, Ireland
| | - G Waldron
- Public Health Agency Northern Ireland, Belfast, Northern Ireland, UK
| | - M Ward
- Department of Public Health HSE-E, Dublin, Ireland
| | - P J McKeown
- HSE-Health Protection Surveillance Centre, Dublin, Ireland
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Ryan A, Bates E, Danson S, Das T, Fisher P, Hatton M, Lee C, Young R, Taylor F, Marshall R. Outcomes of patients in South Yorkshire with advanced non-small-cell lung cancer treated with second-line atezolizumab following induction with chemotherapy. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30153-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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O’Reilly K, O’Connell P, O’Sullivan D, Corvin A, Sheerin J, O’Flynn P, Donohoe G, McCarthy H, Ambrosh D, O’Donnell M, Ryan A, Kennedy HG. Moral cognition, the missing link between psychotic symptoms and acts of violence: a cross-sectional national forensic cohort study. BMC Psychiatry 2019; 19:408. [PMID: 31856762 PMCID: PMC6921589 DOI: 10.1186/s12888-019-2372-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 11/26/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND People with schizophrenia are ten times more likely to commit homicide than a member of the general population. The relationship between symptoms of schizophrenia and acts of violence is unclear. There has also been limited research on what determines the seriousness and form of violence, such as reactive or instrumental violence. Moral cognition may play a paradoxical role in acts of violence for people with schizophrenia. Thoughts which have moral content arising from psychotic symptoms may be a cause of serious violence. METHOD We investigated if psychotic symptoms and moral cognitions at the time of a violent act were associated with acts of violence using a cross-sectional national forensic cohort (n = 55). We examined whether moral cognitions were associated with violence when controlling for neurocognition and violence proneness. We explored the association between all psychotic symptoms present at the time of the violent act, psychotic symptoms judged relevant to the violent act and moral cognitions present at that time. Using mediation analysis, we examined whether moral cognitions were the missing link between symptoms and the relevance of symptoms for violence. We also investigated if specific moral cognitions mediated the relationship between specific psychotic symptoms, the seriousness of violence (including homicide), and the form of violence. RESULTS Psychotic symptoms generally were not associated with the seriousness or form of violence. However, specific moral cognitions were associated with the seriousness and form of violence even when controlling for neurocognition and violence proneness. Specific moral cognitions were associated with specific psychotic symptoms present and relevant to violence. Moral cognitions mediated the relationship between the presence of specific psychotic symptoms and their relevance for violence, homicide, seriousness of violence, and the form of violence. CONCLUSIONS Moral cognitions including the need to reduce suffering, responding to an act of injustice or betrayal, the desire to comply with authority, or the wish to punish impure or disgusting behaviour, may be a key mediator explaining the relationship between psychotic symptoms and acts of violence. Our findings may have important implications for risk assessment, treatment and violence prevention.
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Affiliation(s)
- Ken O’Reilly
- 0000 0004 0616 8533grid.459431.eNational Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland ,0000 0004 1936 9705grid.8217.cDepartment of Psychiatry, Trinity College, Dublin, Ireland
| | - Paul O’Connell
- 0000 0004 0616 8533grid.459431.eNational Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland ,0000 0004 1936 9705grid.8217.cDepartment of Psychiatry, Trinity College, Dublin, Ireland
| | - Danny O’Sullivan
- 0000 0004 0616 8533grid.459431.eNational Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
| | - Aiden Corvin
- 0000 0004 1936 9705grid.8217.cDepartment of Psychiatry, Trinity College, Dublin, Ireland
| | - James Sheerin
- 0000 0004 0616 8533grid.459431.eNational Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
| | - Padraic O’Flynn
- 0000 0004 0616 8533grid.459431.eNational Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
| | - Gary Donohoe
- 0000 0004 0488 0789grid.6142.1Department of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Hazel McCarthy
- 0000 0004 0616 8533grid.459431.eNational Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
| | - Daniela Ambrosh
- 0000 0001 2190 5763grid.7727.5Department of Psychology, University of Regensburg, Regensburg, Germany
| | - Muireann O’Donnell
- 0000 0004 0616 8533grid.459431.eNational Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
| | - Aisling Ryan
- 0000 0004 0616 8533grid.459431.eNational Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
| | - Harry G. Kennedy
- 0000 0004 0616 8533grid.459431.eNational Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland ,0000 0004 1936 9705grid.8217.cDepartment of Psychiatry, Trinity College, Dublin, Ireland
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Bates T, Ryan A, Schoeffler K, Ayoub R, Onyiego S, Sims G, Shah U. Safeguarding Against Prescription Drug Misuse: Educational Resources to Properly Secure and Dispose of Medication. Res Social Adm Pharm 2019. [DOI: 10.1016/j.sapharm.2019.08.014] [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: 10/25/2022]
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Hudson A, Brown S, Chalmers A, Dive C, Franks K, Hanna G, Hannaway N, Harrow S, Haswell T, Hiley C, Hinsley S, Krebs M, Murden G, Reed S, Ryan A, Sebag-Montefiore D, Shaw P, Smith A, Walls G, Young R, Faivre-Finn C, Greystoke A. P2.01-08 Clinical Trial in Progress: CONCORDE - A Phase 1B Study of Novel Agents in Combination with Conventional Radiotherapy in NSCLC. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1352] [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: 10/25/2022]
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Puckrein G, Xu L, Ryan A, Campbell K, Balu S. Abstract P5-15-06: Potential Medicare beneficiary out-of-pocket cost reductions through use of biosimilar filgrastim-sndz over reference filgrastim among breast cancer patients: A simulation model analysis. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-15-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Rationale & Objective: Granulocyte colony-stimulating factors (G-CSFs) are utilized to decrease the incidence of febrile neutropenia (FN) in patients with cancers undergoing chemotherapy treatments. In 2015 biosimilar filgrastim-sndz was the first biosimilar to be approved and launched in the US market. Limited data exists in ascertaining the impact of biosimilars on patient out-of-pocket (OOP) expenditures. The objective of this simulation model was to estimate potential OOP cost savings through use of filgrastim-sndz over reference filgrastim from a Medicare breast cancer patient perspective.
Methods: An Excel simulation analysis was conducted among breast cancer patients treated with biosimilar filgrastim-sndz or the branded reference filgrastim (identified through HCPCS codes). Data from the 2016 Medicare Limited Data Set (5% sample of the carrier file) was used to populate the model. The payment calculation worksheet within the Medicare carrier file was used to calculate the average Medicare payment to the provider and the average beneficiary OOP responsibility per claim of either filgrastim-sndz or reference filgrastim. The average OOP reduction per claim for a filgrastim-sndz beneficiary relative to a reference filgrastim beneficiary was multiplied to a hypothetical FN prevalent population of 100,000 beneficiaries (average of 10 claims per beneficiary) to estimate the potential OOP savings.
Results: Data for 616 filgrastim-sndz and 1,064 reference filgrastim claims were used to populate the model. The average Medicare allowed charge amount per claim for a filgrastim-sndz beneficiary was $362.8 versus $406.9 for a reference filgrastim beneficiary, while corresponding average Medicare payments to the provider were $284.1 and $316.9, respectively. On an average, OOP responsibility for a filgrastim-sndz beneficiary was lower compared to a reference filgrastim beneficiary ($72.9 versus $82.5) leading to a cost saving per claim of $9.60. When extrapolated to 100,000 beneficiaries (1,000,000 claims), the overall cost saving was projected to be around $9.6 million.
Conclusions: Our simulation model estimated a potential OOP Medicare breast cancer beneficiary saving of around $9.6 million, based on a hypothetical population of 100,000 FN beneficiaries, with the use of biosimilar filgrastim-sndz over reference filgrastim. Further real-world analyses are required to evaluate the true cost saving potential from a breast cancer patient perspective with the use of biosimilars over reference biologics.
Citation Format: Puckrein G, Xu L, Ryan A, Campbell K, Balu S. Potential Medicare beneficiary out-of-pocket cost reductions through use of biosimilar filgrastim-sndz over reference filgrastim among breast cancer patients: A simulation model analysis [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-15-06.
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Affiliation(s)
- G Puckrein
- National Minority Quality Forum, Washington, DC; Sandoz Inc., Princeton
| | - L Xu
- National Minority Quality Forum, Washington, DC; Sandoz Inc., Princeton
| | - A Ryan
- National Minority Quality Forum, Washington, DC; Sandoz Inc., Princeton
| | - K Campbell
- National Minority Quality Forum, Washington, DC; Sandoz Inc., Princeton
| | - S Balu
- National Minority Quality Forum, Washington, DC; Sandoz Inc., Princeton
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McKanna T, Ryan A, Krinshpun S, Kareht S, Marchand K, Grabarits C, Ali M, McElheny A, Gardiner K, LeChien K, Hsu M, Saltzman D, Stosic M, Martin K, Benn P. Fetal fraction-based risk algorithm for non-invasive prenatal testing: screening for trisomies 13 and 18 and triploidy in women with low cell-free fetal DNA. Ultrasound Obstet Gynecol 2019; 53:73-79. [PMID: 30014528 PMCID: PMC6587793 DOI: 10.1002/uog.19176] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 06/13/2018] [Accepted: 07/10/2018] [Indexed: 05/09/2023]
Abstract
OBJECTIVE To identify pregnancies at increased risk for trisomy 13, trisomy 18 or triploidy attributable to low fetal fraction (FF). METHODS A FF-based risk (FFBR) model was built using data from more than 165 000 singleton pregnancies referred for single-nucleotide polymorphism (SNP)-based non-invasive prenatal testing (NIPT). Based on maternal weight and gestational age (GA), FF distributions for normal, trisomy 13, trisomy 18 and triploid pregnancies were constructed and used to adjust prior risks for these abnormalities. A risk cut-off of ≥ 1% was chosen to define pregnancies at high risk for trisomy 13, trisomy 18 or triploidy (high FFBR score). The model was evaluated on an independent blinded set of pregnancies for which SNP-based NIPT did not return a result, and for which pregnancy outcome information was gathered retrospectively. RESULTS The evaluation cohort comprised 1148 cases, of which approximately half received a high FFBR score. Compared with rates expected based on maternal age (MA) and GA, cases with a high FFBR score had a significantly increased rate of trisomy 13, trisomy 18 or triploidy combined (5.7% vs 0.7%; P < 0.001) and also of unexplained pregnancy loss (14.7% vs 10.4%; P < 0.001). For cases that did not receive a high FFBR score, the incidence of a chromosomal abnormality or pregnancy loss was not significantly different from that expected based on MA and GA. In this study cohort, the sensitivity of the FFBR model for detection of trisomy 13, trisomy 18 or triploidy was 91.4% (95% CI, 76.9-98.2%) with a positive predictive value of 5.7% (32/564; 95% CI, 3.9-7.9%). CONCLUSIONS For pregnancies with a FF too low to receive a result on standard NIPT, the FFBR algorithm identified a subset of cases at increased risk for trisomy 13, trisomy 18 or triploidy. For the remainder of cases, the risk of a fetal chromosomal abnormality was unchanged from that expected based on MA and GA. © 2018 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
| | | | | | | | - K. Marchand
- Beth Israel Deaconess Medical CenterBostonMAUSA
| | - C. Grabarits
- Vanderbilt University Medical CenterNashvilleTNUSA
| | - M. Ali
- Weill Cornell MedicineNew YorkNYUSA
| | - A. McElheny
- St Louis University School of MedicineSt LouisMOUSA
| | | | | | - M. Hsu
- Northshore University Health SystemChicagoILUSA
| | - D. Saltzman
- Icahn School of Medicine at Mount SinaiNew YorkNYUSA
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Ryan A, Penney S, Meyer J, Dewar B. THE ‘MY HOME LIFE’ LEADERSHIP SUPPORT AND COMMUNITY DEVELOPMENT PROGRAMME. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.685] [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: 11/12/2022] Open
Affiliation(s)
- A Ryan
- Ulster University, Londonderry, England, United Kingdom
| | - S Penney
- Ulster University, Northern Irel
| | - J Meyer
- City University, London, Engl
| | - B Dewar
- University of the West of Scotland, Scotl
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Rathbun A, Gallo J, Stuart E, Shardell M, Gruber-Baldini A, Orwig D, Ryan A, Magaziner J. DEPRESSIVE SYMPTOM SUBTYPES IN OLDER ADULTS AFTER HIP FRACTURE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1893] [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: 11/12/2022] Open
Affiliation(s)
| | - J Gallo
- Johns Hopkins Bloomberg School of Public Health
| | - E Stuart
- Johns Hopkins Bloomberg School of Public Health
| | | | | | - D Orwig
- Department of Epidemiology & Public Health University of Maryland School of Medicine
| | - A Ryan
- University of Maryland School of Medicine
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O’Cearbhaill R, Wolfer A, Disilvestro P, O’Malley D, Sabbatini P, Shohara L, Schwarzenberger P, Ricciardi T, Macri M, Ryan A, Venhaus R, Bryan J, Wong P, Homicsko K, Kandalaft L, Rusakiewicz S, Harari A, Monk B, Coukos G. A phase I/II study of chemo-immunotherapy with durvalumab (durva) and pegylated liposomal doxorubicin (PLD) in platinum-resistant recurrent ovarian cancer (PROC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy285.153] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Akram F, Fuchs D, Daue M, Nijjar G, Ryan A, Benros ME, Okusaga O, Baca‐Garcia E, Brenner LA, Lowry CA, Ryan KA, Pavlovich M, Mitchell BD, Snitker S, Postolache TT. Association of plasma nitrite levels with obesity and metabolic syndrome in the Old Order Amish. Obes Sci Pract 2018; 4:468-476. [PMID: 30338117 PMCID: PMC6180710 DOI: 10.1002/osp4.290] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 06/01/2018] [Accepted: 06/07/2018] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Plasma nitrite is a metabolite of nitric oxide and reflects endogenous nitric oxide synthase (NOS) activity. Although plasma nitrites were previously linked with obesity and metabolic syndrome (MetS), the direction of association remains inconsistent, possibly due to sample heterogeneity. In a relatively homogeneous population, we hypothesized that nitrite levels will be positively associated with overweight/obesity and MetS. METHODS Fasting nitrite levels were measured in 116 Old Order Amish (78% women). We performed age-and-sex-adjusted ancovas to compare nitrite levels between three groups (a) overweight/obese(-)MetS(-), (b) overweight/obese(+)MetS(-) and (c) overweight/obese(+)MetS)(+). Multivariate linear regressions were conducted on nitrite associations with continuous metabolic variables, with successive adjustments for demographics, body mass index, C-reactive protein and neopterin. RESULTS Nitrite levels were higher in the obese/overweight(+)MetS(+) group than in the other two groups (p < 0.001). Nitrites were positively associated with levels of triglycerides (p < 0.0001), total cholesterol (p = 0.048), high-density lipoprotein/cholesterol ratio (p < 0.0001) and fasting glucose (p < 0.0001), and negatively correlated with high-density lipoprotein-cholesterol (p < 0.0001). These associations were robust to adjustments for body mass index and inflammatory markers. CONCLUSION Further investigation of the connection between obesity/MetS and plasma nitrite levels may lead to novel dietary and pharmacological approaches that ultimately may contribute to reducing the increasing burden of obesity, MetS and cardiovascular morbidity and mortality.
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Affiliation(s)
- F. Akram
- Mood and Anxiety ProgramUniversity of Maryland, School of MedicineBaltimoreMDUSA
- Psychiatry Residency Training ProgramSt. Elizabeth's HospitalWashingtonDCUSA
| | - D. Fuchs
- Division of Biological Chemistry, BiocenterInnsbruck Medical UniversityInnsbruckAustria
| | - M. Daue
- Division of Endocrinology, Diabetes and Nutrition, Department of MedicineUniversity of Maryland, School of MedicineBaltimoreMDUSA
| | - G. Nijjar
- Mood and Anxiety ProgramUniversity of Maryland, School of MedicineBaltimoreMDUSA
| | - A. Ryan
- Department of Veterans AffairsVISN 5 Mental Illness Research Education and Clinical Center (MIRECC)BaltimoreMDUSA
| | - M. E. Benros
- Mental Health Centre CopenhagenCopenhagen University HospitalCopenhagenDenmark
| | - O. Okusaga
- Michael E DeBakey VA Medical CenterHoustonTXUSA
- Department of Psychiatry and Behavioral SciencesBaylor College of MedicineHoustonTXUSA
| | - E. Baca‐Garcia
- Department of Psychiatry, Fundación Jimenez Diaz HospitalAutónoma University, Centro de Investigacion en Red Salud MentalMadridSpain
| | - L. A. Brenner
- Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC)Denver Veterans Affairs Medical Center (VAMC)DenverCOUSA
- Department of Physical Medicine & Rehabilitation and Center for NeuroscienceUniversity of Colorado Anschutz Medical CampusAuroraCO80045USA
- Military and Veteran Microbiome: Consortium for Research and Education (MVM‐CoRE)DenverCO80220USA
- Department of Integrative Physiology and Center for NeuroscienceUniversity of Colorado BoulderBoulderCO80309USA
| | - C. A. Lowry
- Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC)Denver Veterans Affairs Medical Center (VAMC)DenverCOUSA
- Department of Physical Medicine & Rehabilitation and Center for NeuroscienceUniversity of Colorado Anschutz Medical CampusAuroraCO80045USA
- Military and Veteran Microbiome: Consortium for Research and Education (MVM‐CoRE)DenverCO80220USA
- Department of Integrative Physiology and Center for NeuroscienceUniversity of Colorado BoulderBoulderCO80309USA
| | - K. A. Ryan
- Program for Personalized and Genomic Medicine, Division of Endocrinology, Diabetes and Nutrition, Department of MedicineUniversity of Maryland, School of MedicineBaltimoreMDUSA
| | - M. Pavlovich
- Division of Endocrinology, Diabetes and Nutrition, Department of MedicineUniversity of Maryland, School of MedicineBaltimoreMDUSA
| | - B. D. Mitchell
- Division of Endocrinology, Diabetes and Nutrition, Department of MedicineUniversity of Maryland, School of MedicineBaltimoreMDUSA
- Program for Personalized and Genomic Medicine, Division of Endocrinology, Diabetes and Nutrition, Department of MedicineUniversity of Maryland, School of MedicineBaltimoreMDUSA
| | - S. Snitker
- Division of Endocrinology, Diabetes and Nutrition, Department of MedicineUniversity of Maryland, School of MedicineBaltimoreMDUSA
| | - T. T. Postolache
- Mood and Anxiety ProgramUniversity of Maryland, School of MedicineBaltimoreMDUSA
- Department of Veterans AffairsVISN 5 Mental Illness Research Education and Clinical Center (MIRECC)BaltimoreMDUSA
- Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC)Denver Veterans Affairs Medical Center (VAMC)DenverCOUSA
- Department of Physical Medicine & Rehabilitation and Center for NeuroscienceUniversity of Colorado Anschutz Medical CampusAuroraCO80045USA
- Military and Veteran Microbiome: Consortium for Research and Education (MVM‐CoRE)DenverCO80220USA
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Grace RF, Cohen J, Egan S, Wells T, Witherspoon B, Ryan A, Salek SS, Bodie S, Klaassen RJ. The burden of disease in pyruvate kinase deficiency: Patients’ perception of the impact on health-related quality of life. Eur J Haematol 2018; 101:758-765. [DOI: 10.1111/ejh.13128] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 06/20/2018] [Indexed: 01/19/2023]
Affiliation(s)
- Rachael F. Grace
- Pediatric Hematology/Oncology; Dana-Farber/Boston Children's Cancer and Blood Disorders Center; Boston Massachusetts
| | | | - Shayna Egan
- Endpoint Outcomes; Boston Massachusetts
- Endpoint Outcomes; Long Beach California
| | - Ted Wells
- Endpoint Outcomes; Boston Massachusetts
- Endpoint Outcomes; Long Beach California
| | - Brooke Witherspoon
- Endpoint Outcomes; Boston Massachusetts
- Endpoint Outcomes; Long Beach California
| | - Aisling Ryan
- Endpoint Outcomes; Boston Massachusetts
- Endpoint Outcomes; Long Beach California
| | - Sam S. Salek
- School of Life and Medical Sciences; University of Hertfordshire; Hatfield UK
- Institute for Medicines Development; Cardiff UK
| | - Susan Bodie
- Agios Pharmaceuticals, Inc.; Cambridge Massachusetts
| | - Robert J. Klaassen
- Division of Hematology/Oncology; Children's Hospital of Eastern Ontario; Ottawa ON Canada
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Ryan A, Cruz S, Miller R, Kristeleit R. PARP inhibitor (PARPi) monotherapy treatment in non-BRCA and/or non-serous gynaecological cancers. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy314.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Hwang S, van Nooten F, Wells T, Ryan A, Crawford B, Evans C, English M. Neuropathic pain: A patient-centred approach to measuring outcomes. Health Expect 2018; 21:774-786. [PMID: 29656511 PMCID: PMC6117483 DOI: 10.1111/hex.12673] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Neuropathic pain (NP) is a complex, chronic pain state initiated by a primary lesion or dysfunction of the nervous system and presents as a variety of symptoms across multiple disease states. OBJECTIVE To develop a patient-centred conceptual model of symptoms and impacts in subjects with diabetic peripheral neuropathy (DPN) or post-herpetic neuralgia (PHN) that can inform the measurement strategy in clinical trials. METHOD Thirty subjects with DPN or PHN participated in in-person interviews which were performed until saturation was achieved. Transcripts were analysed in ATLAS.ti. RESULTS Interviews were completed with DPN subjects (United States, n = 10; Japan, n = 10) and PHN subjects (United States, n = 5; Japan, n = 5). Numbness and tingling were frequently reported symptoms in the DPN population while itchiness and hypersensitivity were predominant in PHN. Both populations experienced burning and ache/soreness with similar frequency. DPN subjects experienced pain primarily in their lower extremity (eg feet, ankles), while PHN subjects experienced pain primarily in the chest and back. Impacts reported by DPN subjects included difficulty walking, sleep disturbance and climbing stairs. Impacts in PHN subjects included sleep disturbance, avoidance of physical contact, being angry/frustrated and being sad/depressed. Overall, concepts in Japan were not qualitatively different from the United States. Conceptual models of NP were generated based on the concepts elicited. CONCLUSIONS This research highlights core concepts to measure from the patient's perspective. Moreover, it enables the assessment of existing measures, the possible modification of these measures, or if a new NP measure with improved sensitivity and responsiveness is merited.
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Affiliation(s)
| | - Floortje van Nooten
- Astellas Pharma B.V.LeidenNetherlands
- Present address:
Dompé Farmaceutici S.p.A.MilanItaly
| | | | | | - Bruce Crawford
- IMS Japan K.K.TokyoJapan
- Present address:
Bruce Crawford, inVentiv HealthTokyoJapan
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Trembling PM, Apostolidou S, Gentry-Maharaj A, Parkes J, Ryan A, Tanwar S, Burnell M, Menon U, Rosenberg WM. Association between skirt size and chronic liver disease in post-menopausal women: a prospective cohort study within the United Kingdom Trial of Ovarian Cancer Screening (UKCTOCS). BMC Public Health 2018; 18:409. [PMID: 29587697 PMCID: PMC5870222 DOI: 10.1186/s12889-018-5308-x] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 03/13/2018] [Indexed: 11/25/2022] Open
Abstract
Background We investigated the association between self-reported skirt size (SS) and change in SS, and incidence of chronic liver disease (CLD) in a prospective cohort study of women recruited to the UKCTOCS trial. Methods Women recruited to UKCTOCS in England without documented CLD self-reported their current UK SS during trial participation and were asked to recall their SS when aged in 20s (via completion of a questionnaire 3–5 years after recruitment). Participants were followed up via electronic health record linkage and hazard ratios (HR) calculated for incident liver-related events (LRE). Results Three hundred twenty-two (0.3%) of 94,124 women experienced a first LRE. Compared to SS ≤ 16, rates of LRE were higher in the SS ≥ 18 groups (both when aged in 20s and at questionnaire completion). Event rates were higher if there was no change in SS or an increase in SS, compared to a decrease in SS. In the models adjusted for potential confounders, HRs for LRE were higher in the groups of women reporting SS ≥ 18 both when aged in 20s (HR = 1.39 (95% CI; 0.87–2.23)) and at questionnaire completion (HR = 1.37 (95% CI; 1.07–1.75)). Compared to a decrease in SS, HRs were higher in the no change (HR = 1.78 (95% CI; 0.95–3.34)) and increase (HR = 1.80 (95% CI; 1.01–3.21)) groups. Conclusion CLD is associated with high SS and an increase in SS over time. These data suggest SS can be used in simple public health messages about communicating the risk of liver disease. Trial Registration UKCTOCS is registered as an International Standard Randomised Controlled Trial, number ISRCTN22488978. Registered 06/04/2000. Electronic supplementary material The online version of this article (10.1186/s12889-018-5308-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- P M Trembling
- Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK.
| | - S Apostolidou
- Gynaecological Cancer Research Centre, Department of Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - A Gentry-Maharaj
- Gynaecological Cancer Research Centre, Department of Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - J Parkes
- Public Health Sciences and Medical Statistics, Faculty of Medicine, University of Southampton, Southampton, UK
| | - A Ryan
- Gynaecological Cancer Research Centre, Department of Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - S Tanwar
- Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK
| | - M Burnell
- Gynaecological Cancer Research Centre, Department of Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - U Menon
- Gynaecological Cancer Research Centre, Department of Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - W M Rosenberg
- Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK
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Stott W, Campbell S, Franchini A, Blyuss O, Zaikin A, Ryan A, Jones C, Gentry‐Maharaj A, Fletcher G, Kalsi J, Skates S, Parmar M, Amso N, Jacobs I, Menon U. Sonographers' self-reported visualization of normal postmenopausal ovaries on transvaginal ultrasound is not reliable: results of expert review of archived images from UKCTOCS. Ultrasound Obstet Gynecol 2018; 51:401-408. [PMID: 28796383 PMCID: PMC5888153 DOI: 10.1002/uog.18836] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 07/28/2017] [Accepted: 08/01/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE In the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS), self-reported visualization rate (VR) of the ovaries by the sonographer on annual transvaginal sonographic (TVS) examinations was a key quality control (QC) metric. The objective of this study was to assess self-reported VR using expert review of a random sample of archived images of TVS examinations from UKCTOCS, and then to develop software for measuring VR automatically. METHODS A single expert reviewed images archived from 1000 TVS examinations selected randomly from 68 931 TVS scans performed in UKCTOCS between 2008 and 2011 with ovaries reported as 'seen and normal'. Software was developed to identify the exact images used by the sonographer to measure the ovaries. This was achieved by measuring caliper dimensions in the image and matching them to those recorded by the sonographer. A logistic regression classifier to determine visualization was trained and validated using ovarian dimensions and visualization data reported by the expert. RESULTS The expert reviewer confirmed visualization of both ovaries (VR-Both) in 50.2% (502/1000) of the examinations. The software identified the measurement image in 534 exams, which were split 2:1:1 providing training, validation and test data. Classifier mean accuracy on validation data was 70.9% (95% CI, 70.0-71.8%). Analysis of test data (133 exams) provided a sensitivity of 90.5% (95% CI, 80.9-95.8%) and specificity of 47.5% (95% CI, 34.5-60.8%) in detecting expert confirmed visualization of both ovaries. CONCLUSIONS Our results suggest that, in a significant proportion of TVS annual screens, the sonographers may have mistaken other structures for normal ovaries. It is uncertain whether or not this affected the sensitivity and stage at detection of ovarian cancer in the ultrasound arm of UKCTOCS, but we conclude that QC metrics based on self-reported visualization of normal ovaries are unreliable. The classifier shows some potential for addressing this problem, though further research is needed. © 2017 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- W. Stott
- Women's CancerUCL EGA Institute for Women's HealthLondonUK
| | | | - A. Franchini
- London School of Hygiene and Tropical MedicineLondonUK
| | - O. Blyuss
- Women's CancerUCL EGA Institute for Women's HealthLondonUK
| | - A. Zaikin
- Women's CancerUCL EGA Institute for Women's HealthLondonUK
| | - A. Ryan
- Women's CancerUCL EGA Institute for Women's HealthLondonUK
| | - C. Jones
- Women's CancerUCL EGA Institute for Women's HealthLondonUK
| | | | - G. Fletcher
- Women's CancerUCL EGA Institute for Women's HealthLondonUK
| | - J. Kalsi
- Women's CancerUCL EGA Institute for Women's HealthLondonUK
| | - S. Skates
- Biostatistics CenterMassachusetts General HospitalBostonMAUSA
| | - M. Parmar
- Medical Research Council Clinical Trials Unit at UCLLondonUK
| | - N. Amso
- School of Medicine, College of Biomedical and Life SciencesCardiff UniversityCardiffUK
| | - I. Jacobs
- Women's CancerUCL EGA Institute for Women's HealthLondonUK
- University of New South Wales, SydneyAustralia
| | - U. Menon
- Women's CancerUCL EGA Institute for Women's HealthLondonUK
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Dunkel B, Ryan A, Haggett E, Knowles EJ. Atypical myopathy in the South‐East of England: Clinicopathological data and outcome in hospitalised horses. EQUINE VET EDUC 2018. [DOI: 10.1111/eve.12895] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- B. Dunkel
- Department of Clinical Science and Services The Royal Veterinary College North Mymms Hertfordshire UK
| | - A. Ryan
- Department of Clinical Science and Services The Royal Veterinary College North Mymms Hertfordshire UK
| | - E. Haggett
- Rossdales Equine Hospital and Diagnostic Centre Newmarket Suffolk UK
| | - E. J. Knowles
- Bell Equine Veterinary Clinic Mereworth Maidstone Kent UK
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Martin K, Iyengar S, Kalyan A, Lan C, Simon AL, Stosic M, Kobara K, Ravi H, Truong T, Ryan A, Demko ZP, Benn P. Clinical experience with a single-nucleotide polymorphism-based non-invasive prenatal test for five clinically significant microdeletions. Clin Genet 2017; 93:293-300. [PMID: 28696552 DOI: 10.1111/cge.13098] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [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: 05/17/2017] [Accepted: 06/30/2017] [Indexed: 01/06/2023]
Abstract
Single-nucleotide polymorphism (SNP)-based non-invasive prenatal testing (NIPT) can currently predict a subset of submicroscopic abnormalities associated with severe clinical manifestations. We retrospectively analyzed the performance of SNP-based NIPT in 80 449 referrals for 22q11.2 deletion syndrome and 42 326 referrals for 1p36, cri-du-chat, Prader-Willi, and Angelman microdeletion syndromes over a 1-year period, and compared the original screening protocol with a revision that reflexively sequenced high-risk calls at a higher depth of read. The prevalence of these microdeletion syndromes was also estimated in the referral population. The positive predictive value of the original test was 15.7% for 22q11.2 deletion syndrome, and 5.2% for the other 4 disorders combined. With the revised protocol, these values increased to 44.2% for 22q11.2 and 31.7% for the others. The 0.33% false-positive rate (FPR) for 22q11.2 deletion syndrome decreased to 0.07% with the revised protocol. Similarly, the FPR for the other 4 disorders combined decreased from 0.56% to 0.07%. Minimal prevalences were estimated to be 1 in 1255 for 22q11.2 deletion syndrome and 1 in 1464 for 1p36, cri-du-chat, and Angelman syndromes combined. Our results show that these microdeletions are relatively common in the referral population, and that the performance of SNP-based NIPT is improved with high-depth resequencing.
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Affiliation(s)
- K Martin
- Natera, Inc., San Carlos, California
| | - S Iyengar
- Natera, Inc., San Carlos, California
| | - A Kalyan
- Natera, Inc., San Carlos, California
| | - C Lan
- Natera, Inc., San Carlos, California
| | - A L Simon
- Natera, Inc., San Carlos, California
| | - M Stosic
- Natera, Inc., San Carlos, California
| | - K Kobara
- Natera, Inc., San Carlos, California
| | - H Ravi
- Natera, Inc., San Carlos, California
| | - T Truong
- Natera, Inc., San Carlos, California
| | - A Ryan
- Natera, Inc., San Carlos, California
| | - Z P Demko
- Natera, Inc., San Carlos, California
| | - P Benn
- Department of Genetics and Genome Sciences, University of Connecticut Health Center, Farmington, Connecticut
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Purcell-Milton F, Visheratina AK, Kuznetsova VA, Ryan A, Orlova AO, Gun'ko YK. Impact of Shell Thickness on Photoluminescence and Optical Activity in Chiral CdSe/CdS Core/Shell Quantum Dots. ACS Nano 2017; 11:9207-9214. [PMID: 28820937 DOI: 10.1021/acsnano.7b04199] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Core/shell quantum dots (QDs) are of high scientific and technological importance as these nanomaterials have found a number of valuable applications. In this paper, we have investigated the dependence of optical activity and photoluminescence upon CdS shell thickness in a range of core-shell structured CdSe/CdS QDs capped with chiral ligands. For our study, five samples of CdSe/CdS were synthesized utilizing successive ion layer adsorption and reaction to vary the thickness of the CdS shell from 0.5 to 2 nm, upon a 2.8 nm diameter CdSe core. Following this, a ligand exchange of the original aliphatic ligands with l- and d-cysteine was carried out, inducing a chiroptical response in these nanostructures. The samples were then characterized using circular dichroism, photoluminescent spectroscopy, and fluorescence lifetime spectroscopy. It has been found that the induced chiroptical response was inversely proportional to the CdS shell thickness and showed a distinct evolution in signal, whereas the photoluminescence of our samples showed a direct relationship to shell thickness. In addition, a detailed study of the influence of annealing time on the optical activity and photoluminescence quantum yield was performed. From our work, we have been able to clearly illustrate the approach and strategies that must be used when designing optimal photoluminescent optically active CdSe/CdS core-shell QDs.
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Affiliation(s)
- Finn Purcell-Milton
- School of Chemistry and CRANN, University of Dublin , Trinity College, Dublin 2, Ireland
| | | | - Vera A Kuznetsova
- School of Chemistry and CRANN, University of Dublin , Trinity College, Dublin 2, Ireland
- ITMO University , St. Petersburg 197101, Russia
| | - Aisling Ryan
- School of Chemistry and CRANN, University of Dublin , Trinity College, Dublin 2, Ireland
| | | | - Yurii K Gun'ko
- School of Chemistry and CRANN, University of Dublin , Trinity College, Dublin 2, Ireland
- ITMO University , St. Petersburg 197101, Russia
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Kuznetsova V, Visheratina A, Ryan A, Martynenko I, Loudon A, Maguire C, Purcell-Milton F, Orlova A, Baranov A, Fedorov A, Prina-Mello A, Volkov Y, Gun'Ko Y. Enantioselective cytotoxicity of ZnS:Mn quantum dots in A549 cells. Chirality 2017; 29:403-408. [DOI: 10.1002/chir.22713] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 03/22/2017] [Accepted: 04/05/2017] [Indexed: 12/13/2022]
Affiliation(s)
| | - A.K. Visheratina
- Optical Physics and Modern Natural Science; ITMO University; Saint Petersburg Russia
| | - A. Ryan
- Chemistry School, Trinity College Dublin; Dublin Ireland
| | - I.V. Martynenko
- Optical Physics and Modern Natural Science; ITMO University; Saint Petersburg Russia
| | - A. Loudon
- Chemistry School, Trinity College Dublin; Dublin Ireland
| | - C.M. Maguire
- Clinical Medicine, School of Medicine; Trinity College Dublin; Dublin Ireland
| | | | - A.O. Orlova
- Optical Physics and Modern Natural Science; ITMO University; Saint Petersburg Russia
| | - A.V. Baranov
- Optical Physics and Modern Natural Science; ITMO University; Saint Petersburg Russia
| | - A.V. Fedorov
- Optical Physics and Modern Natural Science; ITMO University; Saint Petersburg Russia
| | - A. Prina-Mello
- Clinical Medicine, School of Medicine; Trinity College Dublin; Dublin Ireland
| | - Y. Volkov
- Clinical Medicine, School of Medicine; Trinity College Dublin; Dublin Ireland
| | - Y.K. Gun'Ko
- Chemistry School, Trinity College Dublin; Dublin Ireland
- Optical Physics and Modern Natural Science; ITMO University; Saint Petersburg Russia
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Gentry-Maharaj A, Karpinskyj C, Glazer C, Burnell M, Bailey K, Apostolidou S, Ryan A, Lanceley A, Fraser L, Jacobs I, Hunter MS, Menon U. Prevalence and predictors of complementary and alternative medicine/non-pharmacological interventions use for menopausal symptoms within the UK Collaborative Trial of Ovarian Cancer Screening. Climacteric 2017; 20:240-247. [PMID: 28326899 PMCID: PMC5448394 DOI: 10.1080/13697137.2017.1301919] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 01/26/2017] [Accepted: 02/19/2017] [Indexed: 12/04/2022]
Abstract
OBJECTIVES The negative publicity about menopausal hormone therapy (MHT) has led to increased use of complementary and alternative medicines (CAM) and non-pharmacological interventions (NPI) for menopausal symptom relief. We report on the prevalence and predictors of CAM/NPI among UK postmenopausal women. METHOD Postmenopausal women aged 50-74 years were invited to participate in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). A total of 202 638 women were recruited and completed a baseline questionnaire. Of these, 136 020 were sent a postal follow-up-questionnaire between September 2006 and May 2009 which included ever-use of CAM/NPI for menopausal symptom relief. Both questionnaires included MHT use. RESULTS A total of 88 430 (65.0%) women returned a completed follow-up-questionnaire; 22 206 (25.1%) reported ever-use of one or more CAM/NPI. Highest use was reported for herbal therapies (43.8%; 9725/22 206), vitamins (42.6%; 9458/22 206), lifestyle approaches (32.1%; 7137/22 206) and phytoestrogens (21.6%; 4802/22 206). Older women reported less ever-use of herbal therapies, vitamins and phytoestrogens. Lifestyle approaches, aromatherapy/reflexology/acupuncture and homeopathy were similar across age groups. Higher education, Black ethnicity, MHT or previous oral contraceptive pill use were associated with higher CAM/NPI use. Women assessed as being less hopeful about their future were less likely to use CAM/NPI. CONCLUSION One in four postmenopausal women reported ever-use of CAM therapies/NPI for menopausal symptom relief, with lower use reported by older women. Higher levels of education and previous MHT use were positive predictors of CAM/NPI use. UKCTOCS Trial registration: ISRCTN22488978.
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Affiliation(s)
- A. Gentry-Maharaj
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
| | - C. Karpinskyj
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
| | - C. Glazer
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
- Department of Occupational and Environmental Medicine, Bispebjerg - Frederiksberg Hospital, Institute of Public Health, University of CopenhagenCopenhagenDenmark
| | - M. Burnell
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
| | - K. Bailey
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
| | - S. Apostolidou
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
| | - A. Ryan
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
| | - A. Lanceley
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
| | - L. Fraser
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
| | - I. Jacobs
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
- UNSW AustraliaSydneyAustralia
- Centre for Women's Health, Institute of Human Development, University of ManchesterManchesterUK
| | - M. S. Hunter
- Department of Psychology, Institute of Psychiatry, Guy’s Campus, King's College LondonLondonUK
| | - U. Menon
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
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Ryan A, MacHale D, Cohen Y. George Boole and Childhood Mortality in the Cork Union Workhouse. Ir Med J 2017; 110:503. [PMID: 28657280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- A Ryan
- Department of Neonatology, Cork University Maternity Hospital
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - D MacHale
- School of Mathematical Sciences, University College Cork (UCC), Ireland
| | - Y Cohen
- Chartered Accountant, Declan O'Connell & Co, Cork, Ireland
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da Silva RAG, Churchward CP, Karlyshev AV, Eleftheriadou O, Snabaitis AK, Longman MR, Ryan A, Griffin R. The role of apolipoprotein N-acyl transferase, Lnt, in the lipidation of factor H binding protein of Neisseria meningitidis strain MC58 and its potential as a drug target. Br J Pharmacol 2016; 174:2247-2260. [PMID: 27784136 DOI: 10.1111/bph.13660] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 10/06/2016] [Accepted: 10/13/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND PURPOSE The level of cell surface expression of the meningococcal vaccine antigen, Factor H binding protein (FHbp) varies between and within strains and this limits the breadth of strains that can be targeted by FHbp-based vaccines. The molecular pathway controlling expression of FHbp at the cell surface, including its lipidation, sorting to the outer membrane and export, and the potential regulation of this pathway have not been investigated until now. This knowledge will aid our evaluation of FHbp vaccines. EXPERIMENTAL APPROACH A meningococcal transposon library was screened by whole cell immuno-dot blotting using an anti-FHbp antibody to identify a mutant with reduced binding and the disrupted gene was determined. KEY RESULTS In a mutant with markedly reduced binding, the transposon was located in the lnt gene which encodes apolipoprotein N-acyl transferase, Lnt, responsible for the addition of the third fatty acid to apolipoproteins prior to their sorting to the outer membrane. We provide data indicating that in the Lnt mutant, FHbp is diacylated and its expression within the cell is reduced 10 fold, partly due to inhibition of transcription. Furthermore the Lnt mutant showed 64 fold and 16 fold increase in susceptibility to rifampicin and ciprofloxacin respectively. CONCLUSION AND IMPLICATIONS We speculate that the inefficient sorting of diacylated FHbp in the meningococcus results in its accumulation in the periplasm inducing an envelope stress response to down-regulate its expression. We propose Lnt as a potential novel drug target for combination therapy with antibiotics. LINKED ARTICLES This article is part of a themed section on Drug Metabolism and Antibiotic Resistance in Micro-organisms. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.14/issuetoc.
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Affiliation(s)
- R A G da Silva
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Kingston upon Thames, UK
| | - C P Churchward
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Kingston upon Thames, UK
| | - A V Karlyshev
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Kingston upon Thames, UK
| | - O Eleftheriadou
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Kingston upon Thames, UK
| | - A K Snabaitis
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Kingston upon Thames, UK
| | - M R Longman
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Kingston upon Thames, UK
| | - A Ryan
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Kingston upon Thames, UK
| | - R Griffin
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Kingston upon Thames, UK
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Daly L, Bhuachalla ÉN, Cushen S, Power D, O'Reilly S, McEneaney P, O'Mahony D, Bambury R, Ryan A. Malnutrition in 822 Irish cancer patients undergoing chemotherapy: prevalence and impact on quality of life and survival. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw390.15] [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: 11/13/2022] Open
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Daly L, Ní Bhuachalla É, Cushen S, Power D, MacEneaney P, O'Donovan F, Ryan A. MON-P066: Malnutrition and Body Composition Predicts Poor Quality of Life and Reduced Survival in Ambulatory Oncology Patients Receiving Chemotherapy: A Cross Sectional Study of 820 Patients. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30700-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Healy L, Doyle S, Ni Buchalla E, Cushen S, Murphy T, Ryan A, Ravi N, Reynolds J. OR43: Double Blinded, Placebo Controlled Eicosapentaenoic Acid (EPA) Enriched Enteral Nutrition in the Surgical Treatment of Oesophageal Cancer Patients. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30282-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Naicker P, Khonga M, Wojno J, Bamford C, Ntuli S, Oladokun R, Eley B, Ryan A, Gardiner S, Sooka A, Smith A, Keddy K. Five-year review of non-typhoidal salmonella meningitis in Cape Town, 2010 - 2015. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.736] [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] Open
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O'Neill C, McCaughan E, Semple CJ, Ryan A. Fathers' experiences of living with cancer: a phenomenological study. Eur J Cancer Care (Engl) 2016; 27. [PMID: 27001026 DOI: 10.1111/ecc.12492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2016] [Indexed: 10/22/2022]
Abstract
There is a paucity of knowledge about fathers' experiences of cancer. This study explored the experiences of fathers diagnosed and living with cancer while also having parental responsibility for children. A hermeneutic phenomenological approach guided the study. Data were generated through 22 in-depth interviews with 10 fathers throughout Northern Ireland. The findings evidenced that fathers' identities are challenged and frequently re-shaped by the cancer experience, in many cases leading to an improved lifestyle behaviour. Heightened engagement with their children can provide a protective effect from the illness. On the other hand a lack of involvement led to frustration and low mood. The findings also demonstrated that father/child relationships were adversely affected by the social complexities that exist in the variances and diversity of fathers parenting roles and status. This knowledge contributes to our understanding of the complex relationships of fathers in non-traditional roles. It extends our understanding of how, when stereotyped gendered roles are ascribed to fathers it can impact on a fathers' ability to fulfil the traditional breadwinner's role. This is knowledge that will inform health care professionals and enable them to provide gendered-sensitive care that takes account of the masculine psychological responses that can shape the cancer experience.
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Affiliation(s)
- C O'Neill
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - E McCaughan
- Institute of Nursing & Health Research, University of Ulster, Coleraine, Northern Ireland
| | - C J Semple
- South Eastern Health and Social Care Trust, Cancer Services Ulster Hospital, Belfast, Northern Ireland
| | - A Ryan
- Institute of Nursing and Health Research, University of Ulster, Coleraine, Northern Ireland
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