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Smith CJ, Scott K, Parrett T, Rao D. An Extremely Rare Variant of Pancreatic Ductal Adenocarcinoma Masquerading as Chronic Pancreatitis. Am J Clin Pathol 2022. [DOI: 10.1093/ajcp/aqac126.117] [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: 11/11/2022] Open
Abstract
Abstract
Introduction/Objective
Primary Pancreatic signet-ring cell carcinoma (PPSRCC) is an extremely rare histologic variant with sparse literature. Herein, we describe a case of PPSRCC in a 75-year-old female with positive family history of pancreatic cancer (47y/o brother). The diagnosis was delayed secondary to diagnostic challenges on initial fine-needle aspiration (FNA).
Methods/Case Report
Diagnosing PPSRCC on FNA can be extremely difficult. Primary, and metastatic neoplasms to the pancreas may exhibit cytomorphological similarities to signet-ring cells, posing diagnostic challenges. Further, sampling of abundant background inflammatory cells during a biopsy can result in incorrect diagnosis of pancreatitis. Given the strong clinical suspicion based on imaging findings, a second FNA was performed which showed few atypical cells suspicious for carcinoma. Subsequently, the patient underwent neoadjuvant chemotherapy and Whipple resection. The tumor morphology is characterized by infiltrating cells with large mucin vacuoles and peripheric nucleus comprising > 50% of the mass lesion with perineural invasion, in a background of chronic inflammation and pancreatic intraepithelial neoplasia, grade III. A diagnosis of PPSRCC was rendered. Notably, lymph nodes (LN) showed no evidence of metastasis.
Results (if a Case Study enter NA)
NA.
Conclusion
Based on limited literature, PPSRCC is considered an aggressive malignancy with low survival rate, because of a high rate of metastasis. However, our case was rather unique given the lack of LN metastasis and the neodjuvant treatment strategy. As of February 2022, <10 cases have been reported with ill-defined characteristics and treatment guidelines.
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Affiliation(s)
- C J Smith
- Pathology , University of Missouri , Columbia, Missouri , United States
| | - K Scott
- Pathology , University of Missouri , Columbia, Missouri , United States
| | - T Parrett
- Pathology , University of Missouri , Columbia, Missouri , United States
| | - D Rao
- Pathology , University of Missouri , Columbia, Missouri , United States
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2
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Smith CJ, Scott K, Rao D. Is the Primary Tumor Site of Ampullary Carcinoma Distinct in the Setting of Morphology Subtype? Am J Clin Pathol 2022. [DOI: 10.1093/ajcp/aqac126.115] [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: 11/11/2022] Open
Abstract
Abstract
Introduction/Objective
Ampullary cancer (AC) are rare and represents only 6% of the malignant periampullary tumors. Two main histologic subtypes of AC are pancreatobiliary (Pb-AC), and intestinal (In-AC). The data on the influencing role of several characteristics associated with AC subtypes on long term outcome is still emerging. Our study aimed to analyze the two subtypes Pb-AC and In-AC regarding their primary tumor site, median overall survival, and associated precursor lesion.
Methods/Case Report
Using the cBioPortal platform and systematic bioinformatical analysis of the Cancer Genome Atlas Baylor College of Medicine Cell Reports, 2016, 133 AC patients were included and analyzed based on their morphology subtype. Of which 62 patients had the intestinal subtype, and 71 had the pancreaticobiliary morphological subtype.
Results (if a Case Study enter NA)
The role of primary tumor site was statistically significant (p-value = 0.01) among subtypes Pb-AC and In-AC (See Figure). Remarkably, the primary tumor site most associated with the pancreaticobiliary subtype was the distal bile duct, and the intestinal subtype was intra-ampullary. Additionally, the precursor lesion identification (absent vs present) was statistically significant among the subtypes (p-value = 0.01). Further, the median overall survival in ampullary carcinoma varied among the morphology of the two subtypes: In-AC (75.56 months, (95% CI: 57.04-NA)) and Pb-AC (27.04 months, (95% CI: 18.29-NA)).
Conclusion
The findings in this study highlight the complex multifactorial role of the two morphological subtypes in AC. Further studies are essential for understanding the underlying tumor site specific molecular signatures leading to subtyping and their impact on prognosis.
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Affiliation(s)
- C J Smith
- Pathology , University of Missouri , Columbia, Missouri , United States
| | - K Scott
- Pathology , University of Missouri , Columbia, Missouri , United States
| | - D Rao
- Pathology , University of Missouri , Columbia, Missouri , United States
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3
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Nicholls Z, Meinshausen M, Lewis J, Smith CJ, Forster PM, Fuglestvedt JS, Rogelj J, Kikstra JS, Riahi K, Byers E. Changes in IPCC Scenario Assessment Emulators Between SR1.5 and AR6 Unraveled. Geophys Res Lett 2022; 49:e2022GL099788. [PMID: 36589268 PMCID: PMC9788315 DOI: 10.1029/2022gl099788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/29/2022] [Accepted: 10/05/2022] [Indexed: 06/17/2023]
Abstract
The IPCC's scientific assessment of the timing of net-zero emissions and 2030 emission reduction targets consistent with limiting warming to 1.5°C or 2°C rests on large scenario databases. Updates to this assessment, such as between the IPCC's Special Report on Global Warming of 1.5°C (SR1.5) of warming and the Sixth Assessment Report (AR6), are the result of intertwined, sometimes opaque, factors. Here we isolate one factor: the Earth System Model emulators used to estimate the global warming implications of scenarios. We show that warming projections using AR6-calibrated emulators are consistent, to within around 0.1°C, with projections made by the emulators used in SR1.5. The consistency is due to two almost compensating changes: the increase in assessed historical warming between SR1.5 (based on AR5) and AR6, and a reduction in projected warming due to improved agreement between the emulators' response to emissions and the assessment to which it is calibrated.
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Affiliation(s)
- Z. Nicholls
- International Institute for Applied System AnalysisIIASALaxenburgAustria
- Climate & Energy CollegeSchool of Geography, Earth and Atmospheric SciencesThe University of MelbourneParkvilleVICAustralia
- Climate ResourceNorthcoteVICAustralia
| | - M. Meinshausen
- Climate & Energy CollegeSchool of Geography, Earth and Atmospheric SciencesThe University of MelbourneParkvilleVICAustralia
- Climate ResourceNorthcoteVICAustralia
| | - J. Lewis
- International Institute for Applied System AnalysisIIASALaxenburgAustria
- Climate & Energy CollegeSchool of Geography, Earth and Atmospheric SciencesThe University of MelbourneParkvilleVICAustralia
- Climate ResourceNorthcoteVICAustralia
| | - C. J. Smith
- International Institute for Applied System AnalysisIIASALaxenburgAustria
- Priestley International Centre for ClimateUniversity of LeedsLeedsUK
| | - P. M. Forster
- Priestley International Centre for ClimateUniversity of LeedsLeedsUK
| | | | - J. Rogelj
- International Institute for Applied System AnalysisIIASALaxenburgAustria
- Centre for Environmental PolicyImperial College LondonLondonUK
- Grantham Institute for Climate Change and the EnvironmentImperial College LondonLondonUK
| | - J. S. Kikstra
- International Institute for Applied System AnalysisIIASALaxenburgAustria
- Centre for Environmental PolicyImperial College LondonLondonUK
- Grantham Institute for Climate Change and the EnvironmentImperial College LondonLondonUK
| | - K. Riahi
- International Institute for Applied System AnalysisIIASALaxenburgAustria
| | - E. Byers
- International Institute for Applied System AnalysisIIASALaxenburgAustria
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Nicholls Z, Meinshausen M, Lewis J, Corradi MR, Dorheim K, Gasser T, Gieseke R, Hope AP, Leach NJ, McBride LA, Quilcaille Y, Rogelj J, Salawitch RJ, Samset BH, Sandstad M, Shiklomanov A, Skeie RB, Smith CJ, Smith SJ, Su X, Tsutsui J, Vega‐Westhoff B, Woodard DL. Reduced Complexity Model Intercomparison Project Phase 2: Synthesizing Earth System Knowledge for Probabilistic Climate Projections. Earths Future 2021; 9:e2020EF001900. [PMID: 34222555 PMCID: PMC8243973 DOI: 10.1029/2020ef001900] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/23/2021] [Accepted: 04/25/2021] [Indexed: 06/13/2023]
Abstract
Over the last decades, climate science has evolved rapidly across multiple expert domains. Our best tools to capture state-of-the-art knowledge in an internally self-consistent modeling framework are the increasingly complex fully coupled Earth System Models (ESMs). However, computational limitations and the structural rigidity of ESMs mean that the full range of uncertainties across multiple domains are difficult to capture with ESMs alone. The tools of choice are instead more computationally efficient reduced complexity models (RCMs), which are structurally flexible and can span the response dynamics across a range of domain-specific models and ESM experiments. Here we present Phase 2 of the Reduced Complexity Model Intercomparison Project (RCMIP Phase 2), the first comprehensive intercomparison of RCMs that are probabilistically calibrated with key benchmark ranges from specialized research communities. Unsurprisingly, but crucially, we find that models which have been constrained to reflect the key benchmarks better reflect the key benchmarks. Under the low-emissions SSP1-1.9 scenario, across the RCMs, median peak warming projections range from 1.3 to 1.7°C (relative to 1850-1900, using an observationally based historical warming estimate of 0.8°C between 1850-1900 and 1995-2014). Further developing methodologies to constrain these projection uncertainties seems paramount given the international community's goal to contain warming to below 1.5°C above preindustrial in the long-term. Our findings suggest that users of RCMs should carefully evaluate their RCM, specifically its skill against key benchmarks and consider the need to include projections benchmarks either from ESM results or other assessments to reduce divergence in future projections.
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Affiliation(s)
- Z. Nicholls
- Australian‐German Climate & Energy CollegeUniversity of MelbourneParkvilleVICAustralia
- School of Earth SciencesUniversity of MelbourneParkvilleVICAustralia
| | - M. Meinshausen
- Australian‐German Climate & Energy CollegeUniversity of MelbourneParkvilleVICAustralia
- School of Earth SciencesUniversity of MelbourneParkvilleVICAustralia
- Potsdam Institute for Climate Impact ResearchMember of the Leibniz AssociationPotsdamGermany
| | - J. Lewis
- Australian‐German Climate & Energy CollegeUniversity of MelbourneParkvilleVICAustralia
| | - M. Rojas Corradi
- Department of GeophysicsUniversity of ChileSantiagoChile
- Center for Climate and Resilience ResearchCR2SantiagoChile
| | - K. Dorheim
- Pacficic Northwest National LaboratoryRichlandWAUSA
| | - T. Gasser
- International Institute for Applied Systems AnalysisLaxenburgAustria
| | | | - A. P. Hope
- Department of Atmospheric and Oceanic ScienceUniversity of Maryland‐College ParkCollege ParkUSA
| | - N. J. Leach
- Department of PhysicsAtmospheric, Oceanic, and Planetary PhysicsUniversity of OxfordOxfordUK
| | - L. A. McBride
- Department of Chemistry and BiochemistryUniversity of Maryland‐College ParkCollege ParkMDUSA
| | - Y. Quilcaille
- International Institute for Applied Systems AnalysisLaxenburgAustria
| | - J. Rogelj
- International Institute for Applied Systems AnalysisLaxenburgAustria
- Grantham InstituteImperial College LondonLondonUK
| | - R. J. Salawitch
- Department of Atmospheric and Oceanic ScienceUniversity of Maryland‐College ParkCollege ParkUSA
- Department of Chemistry and BiochemistryUniversity of Maryland‐College ParkCollege ParkMDUSA
- Earth System Science Interdisciplinary CenterUniversity of Maryland‐College ParkCollege ParkMDUSA
| | - B. H. Samset
- CICERO Center for International Climate ResearchOsloNorway
| | - M. Sandstad
- CICERO Center for International Climate ResearchOsloNorway
| | | | - R. B. Skeie
- CICERO Center for International Climate ResearchOsloNorway
| | - C. J. Smith
- International Institute for Applied Systems AnalysisLaxenburgAustria
- Priestley International Centre for ClimateUniversity of LeedsLeedsUK
| | - S. J. Smith
- Joint Global Change Research InstitutePacific Northwest National LaboratoryCollege ParkMDUSA
| | - X. Su
- Research Institute for Global Change/Research Center for Environmental Modeling and Application/Earth System Model Development and Application GroupJapan Agency for Marine‐Earth Science and TechnologyYokohamaJapan
| | - J. Tsutsui
- Environmental Science Research LaboratoryCentral Research Institute of Electric Power IndustryAbikoJapan
| | - B. Vega‐Westhoff
- Department of Atmospheric SciencesUniversity of Illinois at Urbana‐ChampaignUrbanaILUSA
| | - D. L. Woodard
- Center for Climate and Resilience ResearchCR2SantiagoChile
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Krishnan S, O’Boyle C, Smith CJ, Hulme S, Allan SM, Grainger JR, Lawrence CB. A hyperacute immune map of ischaemic stroke patients reveals alterations to circulating innate and adaptive cells. Clin Exp Immunol 2021; 203:458-471. [PMID: 33205448 PMCID: PMC7874838 DOI: 10.1111/cei.13551] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 09/29/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 12/24/2022] Open
Abstract
Systemic immune changes following ischaemic stroke are associated with increased susceptibility to infection and poor patient outcome due to their role in exacerbating the ischaemic injury and long-term disability. Alterations to the abundance or function of almost all components of the immune system post-stroke have been identified, including lymphocytes, monocytes and granulocytes. However, subsequent infections have often confounded the identification of stroke-specific effects. Global understanding of very early changes to systemic immunity is critical to identify immune targets to improve clinical outcome. To this end, we performed a small, prospective, observational study in stroke patients with immunophenotyping at a hyperacute time point (< 3 h) to explore early changes to circulating immune cells. We report, for the first time, decreased frequencies of type 1 conventional dendritic cells (cDC1), haematopoietic stem and progenitor cells (HSPCs), unswitched memory B cells and terminally differentiated effector memory T cells re-expressing CD45RA (TEMRA). We also observed concomitant alterations to human leucocyte antigen D-related (HLA-DR), CD64 and CD14 expression in distinct myeloid subsets and a rapid activation of CD4+ T cells based on CD69 expression. The CD69+ CD4+ T cell phenotype inversely correlated with stroke severity and was associated with naive and central memory T (TCM) cells. Our findings highlight early changes in both the innate and adaptive immune compartments for further investigation as they could have implications the development of post-stroke infection and poorer patient outcomes.
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Affiliation(s)
- S. Krishnan
- Geoffrey Jefferson Brain Research CentreFaculty of Biology, Medicine and HealthManchester Academic Health Science CentreUniversity of ManchesterManchesterUK
- Lydia Becker Institute of Immunology and InflammationFaculty of Biology, Medicine and HealthManchester Academic Health Science CentreUniversity of ManchesterManchesterUK
- Division of Infection, Immunity and Respiratory MedicineSchool of Biological SciencesFaculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - C. O’Boyle
- Lydia Becker Institute of Immunology and InflammationFaculty of Biology, Medicine and HealthManchester Academic Health Science CentreUniversity of ManchesterManchesterUK
- Division of Neuroscience and Experimental PsychologySchool of Biological SciencesFaculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - C. J. Smith
- Geoffrey Jefferson Brain Research CentreFaculty of Biology, Medicine and HealthManchester Academic Health Science CentreUniversity of ManchesterManchesterUK
- Lydia Becker Institute of Immunology and InflammationFaculty of Biology, Medicine and HealthManchester Academic Health Science CentreUniversity of ManchesterManchesterUK
- Division of Cardiovascular SciencesUniversity of ManchesterManchester Academic Health Science CentreSalford Royal NHS Foundation TrustSalfordUK
- Manchester Centre for Clinical NeurosciencesSalford Royal NHS Foundation TrustSalfordUK
| | - S. Hulme
- Division of Cardiovascular SciencesUniversity of ManchesterManchester Academic Health Science CentreSalford Royal NHS Foundation TrustSalfordUK
- Manchester Centre for Clinical NeurosciencesSalford Royal NHS Foundation TrustSalfordUK
| | - S. M. Allan
- Geoffrey Jefferson Brain Research CentreFaculty of Biology, Medicine and HealthManchester Academic Health Science CentreUniversity of ManchesterManchesterUK
- Lydia Becker Institute of Immunology and InflammationFaculty of Biology, Medicine and HealthManchester Academic Health Science CentreUniversity of ManchesterManchesterUK
- Division of Neuroscience and Experimental PsychologySchool of Biological SciencesFaculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - J. R. Grainger
- Lydia Becker Institute of Immunology and InflammationFaculty of Biology, Medicine and HealthManchester Academic Health Science CentreUniversity of ManchesterManchesterUK
- Division of Infection, Immunity and Respiratory MedicineSchool of Biological SciencesFaculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - C. B. Lawrence
- Geoffrey Jefferson Brain Research CentreFaculty of Biology, Medicine and HealthManchester Academic Health Science CentreUniversity of ManchesterManchesterUK
- Lydia Becker Institute of Immunology and InflammationFaculty of Biology, Medicine and HealthManchester Academic Health Science CentreUniversity of ManchesterManchesterUK
- Division of Neuroscience and Experimental PsychologySchool of Biological SciencesFaculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
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Keating C, Bolton-Warberg M, Hinchcliffe J, Davies R, Whelan S, Wan AHL, Fitzgerald RD, Davies SJ, Ijaz UZ, Smith CJ. Temporal changes in the gut microbiota in farmed Atlantic cod (Gadus morhua) outweigh the response to diet supplementation with macroalgae. Anim Microbiome 2021; 3:7. [PMID: 33500003 PMCID: PMC7934267 DOI: 10.1186/s42523-020-00065-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 08/20/2020] [Accepted: 11/24/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Aquaculture successfully meets global food demands for many fish species. However, aquaculture production of Atlantic cod (Gadus morhua) is just 2.5% of total market production. For cod farming to be a viable economic venture specific challenges on how to increase growth, health and farming productivity need to be addressed. Feed ingredients play a key role here. Macroalgae (seaweeds) have been suggested as a functional feed supplement with both health and economic benefits for terrestrial farmed animals and fish. The impact of such dietary supplements to cod gut integrity and microbiota, which contribute to overall fish robustness is unknown. The objective of this study was to supplement the diet of juvenile Atlantic cod with macroalgae and determine the impacts on fish condition and growth, gut morphology and hindgut microbiota composition (16S rRNA amplicon sequencing). Fish were fed one of three diets: control (no macroalgal inclusion), 10% inclusion of either egg wrack (Ascophyllum nodosum) or sea lettuce (Ulva rigida) macroalgae in a 12-week trial. RESULTS The results demonstrated there was no significant difference in fish condition, gut morphology or hindgut microbiota between the U. rigida supplemented fish group and the control group at any time-point. This trend was not observed with the A. nodosum treatment. Fish within this group were further categorised as either 'Normal' or 'Lower Growth'. 'Lower Growth' individuals found the diet unpalatable resulting in reduced weight and condition factor combined with an altered gut morphology and microbiome relative to the other treatments. Excluding this group, our results show that the hindgut microbiota was largely driven by temporal pressures with the microbial communities becoming more similar over time irrespective of dietary treatment. The core microbiome at the final time-point consisted of the orders Vibrionales (Vibrio and Photobacterium), Bacteroidales (Bacteroidetes and Macellibacteroides) and Clostridiales (Lachnoclostridium). CONCLUSIONS Our study indicates that U. rigida macroalgae can be supplemented at 10% inclusion levels in the diet of juvenile farmed Atlantic cod without any impact on fish condition or hindgut microbial community structure. We also conclude that 10% dietary inclusion of A. nodosum is not a suitable feed supplement in a farmed cod diet.
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Affiliation(s)
- C Keating
- Department of Microbiology, School of Natural Sciences, National University of Ireland Galway, Galway, H91 TK33, Ireland.
- Water and Environment Group, Infrastructure and Environment Division, James Watt School of Engineering, University of Glasgow, Glasgow, G12 8LT, UK.
| | - M Bolton-Warberg
- Carna Research Station, Ryan Institute, National University of Ireland Galway, Carna, Co, Galway, H91 V8Y1, Ireland
| | - J Hinchcliffe
- Department of Biological and Environmental Sciences, University of Gothenburg, Gothenburg, Sweden
| | - R Davies
- AquaBioTech Group, Central Complex, Naggar Street, Targa Gap, Mosta, G.C, MST 1761, Malta
| | - S Whelan
- Carna Research Station, Ryan Institute, National University of Ireland Galway, Carna, Co, Galway, H91 V8Y1, Ireland
| | - A H L Wan
- Irish Seaweed Research Group, Ryan Institute and School of Natural Sciences, National University of Ireland Galway, Galway, H91 TK33, Ireland
- Aquaculture Nutrition and Aquafeed Research Unit, Carna Research Station, Ryan Institute and School of Natural Sciences, National University of Ireland Galway, Carna, Co, Galway, H91 V8Y1, Ireland
| | - R D Fitzgerald
- Carna Research Station, Ryan Institute, National University of Ireland Galway, Carna, Co, Galway, H91 V8Y1, Ireland
| | - S J Davies
- Department of Animal Production, Welfare and Veterinary Science, Harper Adams University, Newport, Shropshire, TF10 8NB, UK
| | - U Z Ijaz
- Water and Environment Group, Infrastructure and Environment Division, James Watt School of Engineering, University of Glasgow, Glasgow, G12 8LT, UK.
| | - C J Smith
- Department of Microbiology, School of Natural Sciences, National University of Ireland Galway, Galway, H91 TK33, Ireland.
- Water and Environment Group, Infrastructure and Environment Division, James Watt School of Engineering, University of Glasgow, Glasgow, G12 8LT, UK.
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West RM, Smith CJ, Pavitt SH, Butler CC, Howard P, Bates C, Savic S, Wright JM, Hewison J, Sandoe JAT. 'Warning: allergic to penicillin': association between penicillin allergy status in 2.3 million NHS general practice electronic health records, antibiotic prescribing and health outcomes. J Antimicrob Chemother 2020; 74:2075-2082. [PMID: 31225607 DOI: 10.1093/jac/dkz127] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/26/2019] [Accepted: 02/28/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The prevalence of reported penicillin allergy (PenA) and the impact these records have on health outcomes in the UK general population are unknown. Without such data, justifying and planning enhanced allergy services is challenging. OBJECTIVES To determine: (i) prevalence of PenA records; (ii) patient characteristics associated with PenA records; and (iii) impact of PenA records on antibiotic prescribing/health outcomes in primary care. METHODS We carried out cross-sectional/retrospective cohort studies using patient-level data from electronic health records. Cohort study: exact matching across confounders identified as affecting PenA records. Setting: English NHS general practices between 1 April 2013 and 31 March 2014. Participants: 2.3 million adult patients. Outcome measures: prevalence of PenA, antibiotic prescribing, mortality, MRSA infection/colonization and Clostridioides difficile infection. RESULTS PenA prevalence was 5.9% (IQR = 3.8%-8.2%). PenA records were more common in older people, females and those with a comorbidity, and were affected by GP practice. Antibiotic prescribing varied significantly: penicillins were prescribed less frequently in those with a PenA record [relative risk (RR) = 0.15], and macrolides (RR = 4.03), tetracyclines (RR = 1.91) nitrofurantoin (RR = 1.09), trimethoprim (RR = 1.04), cephalosporins (RR = 2.05), quinolones (RR = 2.10), clindamycin (RR = 5.47) and total number of prescriptions were increased in patients with a PenA record. Risk of re-prescription of a new antibiotic class within 28 days (RR = 1.32), MRSA infection/colonization (RR = 1.90) and death during the year subsequent to 1 April 2013 (RR = 1.08) increased in those with PenA records. CONCLUSIONS PenA records are common in the general population and associated with increased/altered antibiotic prescribing and worse health outcomes. We estimate that incorrect PenA records affect 2.7 million people in England. Establishing true PenA status (e.g. oral challenge testing) would allow more people to be prescribed first-line antibiotics, potentially improving health outcomes.
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Affiliation(s)
- R M West
- Leeds Institute for Health Sciences, University of Leeds, Leeds, UK
| | - C J Smith
- Leeds Institute for Health Sciences, University of Leeds, Leeds, UK
| | - S H Pavitt
- School of Dentistry, University of Leeds, Leeds, UK
| | - C C Butler
- University of Oxford Primary Care Clinical Trials Unit, Oxford, UK
| | - P Howard
- Faculty of Medicine and Health, University of Leeds and Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - S Savic
- Faculty of Medicine and Health, University of Leeds and Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - J M Wright
- Leeds Institute for Health Sciences, University of Leeds, Leeds, UK
| | - J Hewison
- Leeds Institute for Health Sciences, University of Leeds, Leeds, UK
| | - J A T Sandoe
- Faculty of Medicine and Health, University of Leeds and Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Richardson TB, Forster PM, Smith CJ, Maycock AC, Wood T, Andrews T, Boucher O, Faluvegi G, Fläschner D, Hodnebrog Ø, Kasoar M, Kirkevåg A, Lamarque J, Mülmenstädt J, Myhre G, Olivié D, Portmann RW, Samset BH, Shawki D, Shindell D, Stier P, Takemura T, Voulgarakis A, Watson‐Parris D. Efficacy of Climate Forcings in PDRMIP Models. J Geophys Res Atmos 2019; 124:12824-12844. [PMID: 32025453 PMCID: PMC6988499 DOI: 10.1029/2019jd030581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 11/15/2019] [Accepted: 11/16/2019] [Indexed: 05/04/2023]
Abstract
Quantifying the efficacy of different climate forcings is important for understanding the real-world climate sensitivity. This study presents a systematic multimodel analysis of different climate driver efficacies using simulations from the Precipitation Driver and Response Model Intercomparison Project (PDRMIP). Efficacies calculated from instantaneous radiative forcing deviate considerably from unity across forcing agents and models. Effective radiative forcing (ERF) is a better predictor of global mean near-surface air temperature (GSAT) change. Efficacies are closest to one when ERF is computed using fixed sea surface temperature experiments and adjusted for land surface temperature changes using radiative kernels. Multimodel mean efficacies based on ERF are close to one for global perturbations of methane, sulfate, black carbon, and insolation, but there is notable intermodel spread. We do not find robust evidence that the geographic location of sulfate aerosol affects its efficacy. GSAT is found to respond more slowly to aerosol forcing than CO2 in the early stages of simulations. Despite these differences, we find that there is no evidence for an efficacy effect on historical GSAT trend estimates based on simulations with an impulse response model, nor on the resulting estimates of climate sensitivity derived from the historical period. However, the considerable intermodel spread in the computed efficacies means that we cannot rule out an efficacy-induced bias of ±0.4 K in equilibrium climate sensitivity to CO2 doubling when estimated using the historical GSAT trend.
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Affiliation(s)
- T. B. Richardson
- Priestley International Centre for ClimateUniversity of LeedsLeedsUK
| | - P. M. Forster
- Priestley International Centre for ClimateUniversity of LeedsLeedsUK
| | - C. J. Smith
- Priestley International Centre for ClimateUniversity of LeedsLeedsUK
| | - A. C. Maycock
- Priestley International Centre for ClimateUniversity of LeedsLeedsUK
| | - T. Wood
- Priestley International Centre for ClimateUniversity of LeedsLeedsUK
| | | | - O. Boucher
- Institut Pierre‐Simon LaplaceCNRS/Sorbonne UniversitéParisFrance
| | - G. Faluvegi
- NASA Goddard Institute for Space Studies and Center for Climate Systems ResearchColumbia UniversityNew YorkNYUSA
| | - D. Fläschner
- Atmosphere in the Earth SystemMax‐Planck‐Institut für MeteorologieHamburgGermany
| | - Ø. Hodnebrog
- CICERO Center for International Climate and Environmental ResearchOsloNorway
| | - M. Kasoar
- Department of PhysicsImperial College LondonLondonUK
| | - A. Kirkevåg
- Research and Development DepartmentNorwegian Meteorological InstituteOsloNorway
| | | | - J. Mülmenstädt
- Clouds and Global ClimateUniversität LeipzigLeipzigGermany
| | - G. Myhre
- CICERO Center for International Climate and Environmental ResearchOsloNorway
| | - D. Olivié
- Research and Development DepartmentNorwegian Meteorological InstituteOsloNorway
| | - R. W. Portmann
- Earth System Research LaboratoryNational Oceanic and Atmospheric AdministrationBoulderCOUSA
| | - B. H. Samset
- CICERO Center for International Climate and Environmental ResearchOsloNorway
| | - D. Shawki
- Department of PhysicsImperial College LondonLondonUK
| | - D. Shindell
- Earth & Ocean SciencesDuke UniversityDurhamNCUSA
| | - P. Stier
- Atmospheric, Oceanic and Planetary Physics, Department of PhysicsUniversity of OxfordOxfordUK
| | - T. Takemura
- Center for Oceanic and Atmospheric ResearchKyushu UniversityFukuokaJapan
| | | | - D. Watson‐Parris
- Atmospheric, Oceanic and Planetary Physics, Department of PhysicsUniversity of OxfordOxfordUK
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9
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Affiliation(s)
- C. J. Smith
- Department of Chemistry, University of Minnesota, 207 Pleasant Street, SE, Minneapolis, Minnesota 55455, United States
| | - Anna K. Huff
- Department of Chemistry, University of Minnesota, 207 Pleasant Street, SE, Minneapolis, Minnesota 55455, United States
| | - Rebecca M. Ward
- Department of Chemistry, University of Minnesota, 207 Pleasant Street, SE, Minneapolis, Minnesota 55455, United States
| | - Kenneth R. Leopold
- Department of Chemistry, University of Minnesota, 207 Pleasant Street, SE, Minneapolis, Minnesota 55455, United States
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10
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Smith CJ, Huff AK, Zhang H, Mo Y, Leopold KR. A strong dependence of the CH 3 internal rotation barrier on conformation in thioacetic acid: Microwave measurements and an energy decomposition analysis. J Chem Phys 2019; 150:134302. [PMID: 30954056 DOI: 10.1063/1.5087718] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Rotational spectra of thioacetic acid (CH3COSH) have been observed by pulsed-nozzle Fourier transform microwave spectroscopy. Spectroscopic constants are reported for both the syn and anti conformers of the parent species, as well as the 34S and 13C carbonyl isotopologues. Transitions arising from the lowest A and E internal rotor states of the methyl group have been observed and analyzed. Experimental values of the three-fold internal rotation barrier, V3, for the syn and anti conformers of the parent isotopologue are 76.300(12) and 358.056(51) cm-1, respectively, indicating a large effect of the S-H orientation on the CH3 internal rotation potential. M06-2X/6-311+G(d,p) calculations are in good agreement with these results. The block localized energy decomposition method has been applied to understand the origins of this strong dependence of V3 on conformation. The results indicate that π conjugation from the SH to the carbonyl group and steric repulsion between the SH and the methyl group in the anti form are main contributors to the difference.
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Affiliation(s)
- C J Smith
- Department of Chemistry, University of Minnesota, 207 Pleasant St., SE, Minneapolis, Minnesota 55455, USA
| | - Anna K Huff
- Department of Chemistry, University of Minnesota, 207 Pleasant St., SE, Minneapolis, Minnesota 55455, USA
| | - Huaiyu Zhang
- Institute of Computational Quantum Chemistry, College of Chemistry and Material Science, Hebei Normal University, Shijiazhuang, China
| | - Yirong Mo
- Department of Chemistry, Western Michigan University, 1903 W Michigan Ave., Kalamazoo, Michigan 49008 USA
| | - Kenneth R Leopold
- Department of Chemistry, University of Minnesota, 207 Pleasant St., SE, Minneapolis, Minnesota 55455, USA
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11
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Hernández-Nava E, Mahoney P, Smith CJ, Donoghue J, Todd I, Tammas-Williams S. Additive manufacturing titanium components with isotropic or graded properties by hybrid electron beam melting/hot isostatic pressing powder processing. Sci Rep 2019; 9:4070. [PMID: 30858554 PMCID: PMC6411771 DOI: 10.1038/s41598-019-40722-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 02/20/2019] [Indexed: 11/18/2022] Open
Abstract
A methodology has been demonstrated to consolidate Ti-6Al-4V powder without taking it to the liquid state by novel combination of the electron beam melting additive manufacture and hot isostatic pressing processes. This results in improved static mechanical properties (both strength and yield) in comparison to standard EBM processed material. In addition, the ability to generate microstructurally graded components has been demonstrated by generating a component with a significant change in both microstructure and mechanical properties. This is revealed by the use of electron backscattered diffraction and micro hardness testing to produce maps showing a clear distinction between materials consolidated in different ways. The variation in microstructure and mechanical properties is attributed to the different thermal history experienced by the material at different locations. In particular, it is found that the rapid cooling experienced during EBM leads to a typical fine α lath structure, whereas a more equiaxed α grains generated by diffusion is found in HIP consolidated powder.
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Affiliation(s)
- E Hernández-Nava
- Department of Materials Science and Engineering, University of Sheffield, Sheffield, S1 3JD, UK.
| | - P Mahoney
- Department of Materials Science and Engineering, University of Sheffield, Sheffield, S1 3JD, UK
| | - C J Smith
- Department of Materials Science and Engineering, University of Sheffield, Sheffield, S1 3JD, UK
| | - J Donoghue
- School of Materials, University of Manchester, Manchester, M13 9PL, UK
| | - I Todd
- Department of Materials Science and Engineering, University of Sheffield, Sheffield, S1 3JD, UK
| | - S Tammas-Williams
- Department of Materials Science and Engineering, University of Sheffield, Sheffield, S1 3JD, UK.,Department of Maritime and Mechanical Engineering, Liverpool John Moores University, Liverpool, L3 3AF, UK
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Tsikopoulou I, Moraitis ML, Geropoulos A, Papadopoulou KN, Papageorgiou N, Plaiti W, Smith CJ, Karakassis I, Eleftheriou A. Long-term changes in the structure of benthic communities: Revisiting a sampling transect in Crete after 24 years. Mar Environ Res 2019; 144:9-19. [PMID: 30501903 DOI: 10.1016/j.marenvres.2018.11.008] [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] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/09/2018] [Accepted: 11/15/2018] [Indexed: 06/09/2023]
Abstract
A bathymetric transect in the north coast of Crete first studied in 1989, was revisited 24 years later. Identical sampling design, season, techniques and protocols were followed in both studies in order to minimize bias in the long-term comparisons. This comprehensive macrofaunal dataset (4 stations, 2 sampling seasons, 7 replicates in each study) revealed changes in benthic diversity and community composition between the sampling periods. The recorded changes were higher at the stations located close to the coastal zone. In addition, while benthic communities showed lower total abundance during the recent sampling period, species abundances were more evenly distributed indicating that some species dominated the historical communities. In spite of these changes, the ecological status remained above the threshold values for good ecological status. The results indicated that changes in the benthic community seem to have been driven by local anthropogenic factors and natural variability rather than by large-scale factors such as nutrients influxes in the entire Mediterranean Basin.
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Affiliation(s)
- I Tsikopoulou
- Marine Ecology Laboratory, Department of Biology, University of Crete, GR 70013, Heraklion, Greece.
| | - M L Moraitis
- Marine Ecology Laboratory, Department of Biology, University of Crete, GR 70013, Heraklion, Greece
| | - A Geropoulos
- Marine Ecology Laboratory, Department of Biology, University of Crete, GR 70013, Heraklion, Greece
| | - K N Papadopoulou
- Hellenic Centre for Marine Research, Institute of Marine Biological Resources, GR 71003, Heraklion, Greece
| | - N Papageorgiou
- Marine Ecology Laboratory, Department of Biology, University of Crete, GR 70013, Heraklion, Greece
| | - W Plaiti
- Hellenic Centre for Marine Research Institute of Marine Biology, Biotechnology and Aquaculture, GR 71003, Heraklion, Greece
| | - C J Smith
- Hellenic Centre for Marine Research, Institute of Marine Biological Resources, GR 71003, Heraklion, Greece
| | - I Karakassis
- Marine Ecology Laboratory, Department of Biology, University of Crete, GR 70013, Heraklion, Greece
| | - A Eleftheriou
- Marine Ecology Laboratory, Department of Biology, University of Crete, GR 70013, Heraklion, Greece; Hellenic Centre for Marine Research Institute of Marine Biology, Biotechnology and Aquaculture, GR 71003, Heraklion, Greece
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13
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Huff AK, Mackenzie RB, Smith CJ, Leopold KR. A Perfluorinated Carboxylic Sulfuric Anhydride: Microwave and Computational Studies of CF3COOSO2OH. J Phys Chem A 2019; 123:2237-2243. [DOI: 10.1021/acs.jpca.9b00300] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Anna K. Huff
- Department of Chemistry, University of Minnesota, 207 Pleasant Street, SE, Minneapolis, Minnesota 55455, United States
| | - Rebecca B. Mackenzie
- Department of Chemistry, University of Minnesota, 207 Pleasant Street, SE, Minneapolis, Minnesota 55455, United States
| | - C. J. Smith
- Department of Chemistry, University of Minnesota, 207 Pleasant Street, SE, Minneapolis, Minnesota 55455, United States
| | - Kenneth R. Leopold
- Department of Chemistry, University of Minnesota, 207 Pleasant Street, SE, Minneapolis, Minnesota 55455, United States
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Smith CJ, Kramer RJ, Myhre G, Forster PM, Soden BJ, Andrews T, Boucher O, Faluvegi G, Fläschner D, Hodnebrog Ø, Kasoar M, Kharin V, Kirkevåg A, Lamarque J, Mülmenstädt J, Olivié D, Richardson T, Samset BH, Shindell D, Stier P, Takemura T, Voulgarakis A, Watson‐Parris D. Understanding Rapid Adjustments to Diverse Forcing Agents. Geophys Res Lett 2018; 45:12023-12031. [PMID: 30686845 PMCID: PMC6334512 DOI: 10.1029/2018gl079826] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/10/2018] [Accepted: 10/15/2018] [Indexed: 05/04/2023]
Abstract
Rapid adjustments are responses to forcing agents that cause a perturbation to the top of atmosphere energy budget but are uncoupled to changes in surface warming. Different mechanisms are responsible for these adjustments for a variety of climate drivers. These remain to be quantified in detail. It is shown that rapid adjustments reduce the effective radiative forcing (ERF) of black carbon by half of the instantaneous forcing, but for CO2 forcing, rapid adjustments increase ERF. Competing tropospheric adjustments for CO2 forcing are individually significant but sum to zero, such that the ERF equals the stratospherically adjusted radiative forcing, but this is not true for other forcing agents. Additional experiments of increase in the solar constant and increase in CH4 are used to show that a key factor of the rapid adjustment for an individual climate driver is changes in temperature in the upper troposphere and lower stratosphere.
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Affiliation(s)
- C. J. Smith
- School of Earth and EnvironmentUniversity of LeedsLeedsUK
| | - R. J. Kramer
- Rosenstiel School of Marine and Atmospheric ScienceUniversity of MiamiMiamiFLUSA
| | - G. Myhre
- CICERO Center for International Climate and Environmental Research in OsloOsloNorway
| | - P. M. Forster
- School of Earth and EnvironmentUniversity of LeedsLeedsUK
| | - B. J. Soden
- Rosenstiel School of Marine and Atmospheric ScienceUniversity of MiamiMiamiFLUSA
| | | | - O. Boucher
- Institut Pierre‐Simon Laplace, CNRS/Sorbonne UniversitéParisFrance
| | - G. Faluvegi
- NASA Goddard Institute for Space StudiesNew YorkNYUSA
- Center for Climate Systems ResearchColumbia UniversityNew YorkNYUSA
| | - D. Fläschner
- Max‐Planck‐Institut für MeteorologieHamburgGermany
| | - Ø. Hodnebrog
- CICERO Center for International Climate and Environmental Research in OsloOsloNorway
| | - M. Kasoar
- Department of PhysicsImperial College LondonLondonUK
- Grantham Institute – Climate Change and the EnvironmentImperial College LondonLondonUK
| | - V. Kharin
- Canadian Centre for Climate Modelling and AnalysisVictoriaBritish ColumbiaCanada
| | - A. Kirkevåg
- Norwegian Meteorological InstituteOsloNorway
| | | | - J. Mülmenstädt
- Institute of MeteorologyUniversität LeipzigLeipzigGermany
| | - D. Olivié
- Norwegian Meteorological InstituteOsloNorway
| | - T. Richardson
- School of Earth and EnvironmentUniversity of LeedsLeedsUK
| | - B. H. Samset
- CICERO Center for International Climate and Environmental Research in OsloOsloNorway
| | - D. Shindell
- Nicholas School of the EnvironmentDuke UniversityDurhamNCUSA
| | - P. Stier
- Atmospheric, Oceanic and Planetary Physics, Department of PhysicsUniversity of OxfordOxfordUK
| | | | | | - D. Watson‐Parris
- Atmospheric, Oceanic and Planetary Physics, Department of PhysicsUniversity of OxfordOxfordUK
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15
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Myhre G, Kramer RJ, Smith CJ, Hodnebrog Ø, Forster P, Soden BJ, Samset BH, Stjern CW, Andrews T, Boucher O, Faluvegi G, Fläschner D, Kasoar M, Kirkevåg A, Lamarque J, Olivié D, Richardson T, Shindell D, Stier P, Takemura T, Voulgarakis A, Watson‐Parris D. Quantifying the Importance of Rapid Adjustments for Global Precipitation Changes. Geophys Res Lett 2018; 45:11399-11405. [PMID: 30774164 PMCID: PMC6360531 DOI: 10.1029/2018gl079474] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/09/2018] [Accepted: 10/12/2018] [Indexed: 05/04/2023]
Abstract
Different climate drivers influence precipitation in different ways. Here we use radiative kernels to understand the influence of rapid adjustment processes on precipitation in climate models. Rapid adjustments are generally triggered by the initial heating or cooling of the atmosphere from an external climate driver. For precipitation changes, rapid adjustments due to changes in temperature, water vapor, and clouds are most important. In this study we have investigated five climate drivers (CO2, CH4, solar irradiance, black carbon, and sulfate aerosols). The fast precipitation responses to a doubling of CO2 and a 10-fold increase in black carbon are found to be similar, despite very different instantaneous changes in the radiative cooling, individual rapid adjustments, and sensible heating. The model diversity in rapid adjustments is smaller for the experiment involving an increase in the solar irradiance compared to the other climate driver perturbations, and this is also seen in the precipitation changes.
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Affiliation(s)
- G. Myhre
- CICERO Center for International Climate ResearchOsloNorway
| | - R. J. Kramer
- Rosenstiel School of Marine and Atmospheric ScienceUniversity of MiamiMiamiFLUSA
| | - C. J. Smith
- School of Earth and EnvironmentUniversity of LeedsLeedsUK
| | - Ø. Hodnebrog
- CICERO Center for International Climate ResearchOsloNorway
| | - P. Forster
- School of Earth and EnvironmentUniversity of LeedsLeedsUK
| | - B. J. Soden
- Rosenstiel School of Marine and Atmospheric ScienceUniversity of MiamiMiamiFLUSA
| | - B. H. Samset
- CICERO Center for International Climate ResearchOsloNorway
| | - C. W. Stjern
- CICERO Center for International Climate ResearchOsloNorway
| | | | - O. Boucher
- Institut Pierre‐Simon LaplaceCNRS/Sorbonne UniversitéParisFrance
| | - G. Faluvegi
- NASA Goddard Institute for Space StudiesNew YorkNYUSA
- Center for Climate Systems ResearchColumbia UniversityNew YorkNYUSA
| | - D. Fläschner
- Max‐Planck‐Institut für MeteorologieHamburgGermany
| | - M. Kasoar
- Department of PhysicsImperial College LondonLondonUK
- Grantham Institute‐Climate Change and the EnvironmentImperial College LondonLondonUK
| | - A. Kirkevåg
- Norwegian Meteorological InstituteOsloNorway
| | | | - D. Olivié
- Norwegian Meteorological InstituteOsloNorway
| | - T. Richardson
- School of Earth and EnvironmentUniversity of LeedsLeedsUK
| | - D. Shindell
- Nicholas School of the EnvironmentDuke UniversityDurhamNCUSA
| | - P. Stier
- Atmospheric, Oceanic & Planetary Physics, Department of PhysicsUniversity of OxfordOxfordUK
| | - T. Takemura
- Research Institute for Applied MechanicsKyushu UniversityFukuokaJapan
| | | | - D. Watson‐Parris
- Atmospheric, Oceanic & Planetary Physics, Department of PhysicsUniversity of OxfordOxfordUK
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Teh WH, Smith CJ, Barlas RS, Wood AD, Bettencourt-Silva JH, Clark AB, Metcalf AK, Bowles KM, Potter JF, Myint PK. Impact of stroke-associated pneumonia on mortality, length of hospitalization, and functional outcome. Acta Neurol Scand 2018; 138:293-300. [PMID: 29749062 DOI: 10.1111/ane.12956] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Stroke-associated pneumonia (SAP) is common and associated with adverse outcomes. Data on its impact beyond 1 year are scarce. MATERIALS AND METHODS This observational study was conducted in a cohort of stroke patients admitted consecutively to a tertiary referral center in the east of England, UK (January 2003-April 2015). Logistic regression models examined inpatient mortality and length of stay (LOS). Cox regression models examined longer-term mortality at predefined time periods (0-90 days, 90 days-1 year, 1-3 years, and 3-10 years) for SAP. Effect of SAP on functional outcome at discharge was assessed using logistic regression. RESULTS A total of 9238 patients (mean age [±SD] 77.61 ± 11.88 years) were included. SAP was diagnosed in 1083 (11.7%) patients. The majority of these cases (n = 658; 60.8%) were aspiration pneumonia. After controlling for age, sex, stroke type, Oxfordshire Community Stroke Project (OCSP) classification, prestroke modified Rankin scale, comorbidities, and acute illness markers, mortality estimates remained significant at 3 time periods: inpatient (OR 5.87, 95%CI [4.97-6.93]), 0-90 days (2.17 [1.97-2.40]), and 91-365 days (HR 1.31 [1.03-1.67]). SAP was also associated with higher odds of long LOS (OR 1.93 [1.67-2.22]) and worse functional outcome (OR 7.17 [5.44-9.45]). In this cohort, SAP did not increase mortality risk beyond 1 year post-stroke, but it was associated with reduced mortality beyond 3 years. CONCLUSIONS Stroke-associated pneumonia is not associated with increased long-term mortality, but it is linked with increased mortality up to 1 year, prolonged LOS, and poor functional outcome on discharge. Targeted intervention strategies are required to improve outcomes of SAP patients who survive to hospital discharge.
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Affiliation(s)
- W. H. Teh
- Institute of Applied Health Sciences; School of Medicine; Medical Sciences and Nutrition; University of Aberdeen; Aberdeen UK
| | - C. J. Smith
- Greater Manchester Comprehensive Stroke Centre; Manchester Academic Health Science Centre; Salford Royal NHS Foundation Trust; Salford UK
- Faculty of Biology; Medicine and Health; University of Manchester; Manchester UK
| | - R. S. Barlas
- Institute of Applied Health Sciences; School of Medicine; Medical Sciences and Nutrition; University of Aberdeen; Aberdeen UK
| | - A. D. Wood
- Institute of Applied Health Sciences; School of Medicine; Medical Sciences and Nutrition; University of Aberdeen; Aberdeen UK
| | - J. H. Bettencourt-Silva
- Institute of Applied Health Sciences; School of Medicine; Medical Sciences and Nutrition; University of Aberdeen; Aberdeen UK
- Stroke Research Group; Norwich Cardiovascular Research Group; Norwich Research Park; Norwich UK
| | - A. B. Clark
- Norwich Medical School; University of East Anglia; Norwich UK
| | - A. K. Metcalf
- Stroke Research Group; Norwich Cardiovascular Research Group; Norwich Research Park; Norwich UK
- Stroke Services; Norfolk and Norwich University Hospitals NHS Foundation Trust; Norwich UK
| | - K. M. Bowles
- Norwich Medical School; University of East Anglia; Norwich UK
- Stroke Research Group; Norwich Cardiovascular Research Group; Norwich Research Park; Norwich UK
| | - J. F. Potter
- Norwich Medical School; University of East Anglia; Norwich UK
- Stroke Research Group; Norwich Cardiovascular Research Group; Norwich Research Park; Norwich UK
| | - P. K. Myint
- Institute of Applied Health Sciences; School of Medicine; Medical Sciences and Nutrition; University of Aberdeen; Aberdeen UK
- Stroke Research Group; Norwich Cardiovascular Research Group; Norwich Research Park; Norwich UK
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Keating C, Hughes D, Mahony T, Cysneiros D, Ijaz UZ, Smith CJ, O'Flaherty V. Cold adaptation and replicable microbial community development during long-term low-temperature anaerobic digestion treatment of synthetic sewage. FEMS Microbiol Ecol 2018; 94:5004848. [PMID: 29846574 PMCID: PMC5995215 DOI: 10.1093/femsec/fiy095] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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] [Received: 05/18/2018] [Accepted: 05/24/2018] [Indexed: 11/12/2022] Open
Abstract
The development and activity of a cold-adapting microbial community was monitored during low-temperature anaerobic digestion (LtAD) treatment of wastewater. Two replicate hybrid anaerobic sludge bed-fixed-film reactors treated a synthetic sewage wastewater at 12°C, at organic loading rates of 0.25-1.0 kg chemical oxygen demand (COD) m-3 d-1, over 889 days. The inoculum was obtained from a full-scale anaerobic digestion reactor, which was operated at 37°C. Both LtAD reactors readily degraded the influent with COD removal efficiencies regularly exceeding 78% for both the total and soluble COD fractions. The biomass from both reactors was sampled temporally and tested for activity against hydrolytic and methanogenic substrates at 12°C and 37°C. Data indicated that significantly enhanced low-temperature hydrolytic and methanogenic activity developed in both systems. For example, the hydrolysis rate constant (k) at 12°C had increased 20-30-fold by comparison to the inoculum by day 500. Substrate affinity also increased for hydrolytic substrates at low temperature. Next generation sequencing demonstrated that a shift in a community structure occurred over the trial, involving a 1-log-fold change in 25 SEQS (OTU-free approach) from the inoculum. Microbial community structure changes and process performance were replicable in the LtAD reactors.
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Affiliation(s)
- C Keating
- Microbiology, School of Natural Sciences and Ryan Institute, National University of Ireland, Galway, Ireland
| | - D Hughes
- Microbiology, School of Natural Sciences and Ryan Institute, National University of Ireland, Galway, Ireland
| | - T Mahony
- Microbiology, School of Natural Sciences and Ryan Institute, National University of Ireland, Galway, Ireland
| | - D Cysneiros
- Microbiology, School of Natural Sciences and Ryan Institute, National University of Ireland, Galway, Ireland
| | - U Z Ijaz
- Infrastructure and Environment, School of Engineering, University of Glasgow, Rankine Building, 79-85 Oakfield Avenue, Glasgow, G12 8LT, UK
| | - C J Smith
- Microbiology, School of Natural Sciences and Ryan Institute, National University of Ireland, Galway, Ireland
| | - V O'Flaherty
- Microbiology, School of Natural Sciences and Ryan Institute, National University of Ireland, Galway, Ireland
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Affiliation(s)
- C. J. Smith
- Department of Chemistry, University of Minnesota, 207 Pleasant Street, SE, Minneapolis, Minnesota 55455, United States
| | - Anna K. Huff
- Department of Chemistry, University of Minnesota, 207 Pleasant Street, SE, Minneapolis, Minnesota 55455, United States
| | - Rebecca B. Mackenzie
- Department of Chemistry, University of Minnesota, 207 Pleasant Street, SE, Minneapolis, Minnesota 55455, United States
| | - Kenneth R. Leopold
- Department of Chemistry, University of Minnesota, 207 Pleasant Street, SE, Minneapolis, Minnesota 55455, United States
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19
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Samset BH, Sand M, Smith CJ, Bauer SE, Forster PM, Fuglestvedt JS, Osprey S, Schleussner CF. Climate Impacts From a Removal of Anthropogenic Aerosol Emissions. Geophys Res Lett 2018; 45:1020-1029. [PMID: 32801404 PMCID: PMC7427631 DOI: 10.1002/2017gl076079] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Limiting global warming to 1.5 or 2.0°C requires strong mitigation of anthropogenic greenhouse gas (GHG) emissions. Concurrently, emissions of anthropogenic aerosols will decline, due to coemission with GHG, and measures to improve air quality. However, the combined climate effect of GHG and aerosol emissions over the industrial era is poorly constrained. Here we show the climate impacts from removing present-day anthropogenic aerosol emissions and compare them to the impacts from moderate GHG-dominated global warming. Removing aerosols induces a global mean surface heating of 0.5-1.1°C, and precipitation increase of 2.0-4.6%. Extreme weather indices also increase. We find a higher sensitivity of extreme events to aerosol reductions, per degree of surface warming, in particular over the major aerosol emission regions. Under near-term warming, we find that regional climate change will depend strongly on the balance between aerosol and GHG forcing.
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Affiliation(s)
- B. H. Samset
- CICERO Center for International Climate and Environmental Research, Oslo, Norway
| | - M. Sand
- CICERO Center for International Climate and Environmental Research, Oslo, Norway
| | - C. J. Smith
- School of Earth and Environment, University of Leeds, Leeds, UK
| | - S. E. Bauer
- NASA Goddard Institute for Space Studies and Columbia Earth Institute, New York, NY, USA
| | - P. M. Forster
- School of Earth and Environment, University of Leeds, Leeds, UK
| | - J. S. Fuglestvedt
- CICERO Center for International Climate and Environmental Research, Oslo, Norway
| | - S. Osprey
- National Centre for Atmospheric Science and Department of Physics, University of Oxford, Oxford, UK
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20
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Smith CJ, Huff AK, Mackenzie RB, Leopold KR. Observation of Two Conformers of Acrylic Sulfuric Anhydride by Microwave Spectroscopy. J Phys Chem A 2017; 121:9074-9080. [DOI: 10.1021/acs.jpca.7b09833] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C. J. Smith
- Department of Chemistry, University of Minnesota, 207 Pleasant St., SE, Minneapolis, Minnesota 55455, United States
| | - Anna K. Huff
- Department of Chemistry, University of Minnesota, 207 Pleasant St., SE, Minneapolis, Minnesota 55455, United States
| | - Rebecca B. Mackenzie
- Department of Chemistry, University of Minnesota, 207 Pleasant St., SE, Minneapolis, Minnesota 55455, United States
| | - Kenneth R. Leopold
- Department of Chemistry, University of Minnesota, 207 Pleasant St., SE, Minneapolis, Minnesota 55455, United States
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21
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Mackenzie RB, Dewberry CT, Cornelius RD, Smith CJ, Leopold KR. Multidimensional Large Amplitude Dynamics in the Pyridine–Water Complex. J Phys Chem A 2017; 121:855-860. [DOI: 10.1021/acs.jpca.6b11255] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Rebecca B. Mackenzie
- Department
of Chemistry, University of Minnesota, 207 Pleasant Street, SE, Minneapolis, Minnesota 55455, United States
| | - Christopher T. Dewberry
- Department
of Chemistry and Biochemistry, Kettering University, 1700 University Avenue, Flint, Michigan 48504, United States
| | - Ryan D. Cornelius
- Department
of Chemistry and Biochemistry, St. Cloud State University, 720 Fourth Avenue South, St. Cloud, Minnesota 56301, United States
| | - C. J. Smith
- Department
of Chemistry, University of Minnesota, 207 Pleasant Street, SE, Minneapolis, Minnesota 55455, United States
| | - Kenneth R. Leopold
- Department
of Chemistry, University of Minnesota, 207 Pleasant Street, SE, Minneapolis, Minnesota 55455, United States
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Abstract
Patients with cardiac failure require careful evaluation to determine the precise nature of the cause of their illness. Genetic causes of dilated cardiomyopathy are well known but inherited conditions may lead to unexpected consequences through intermediate mechanisms not readily recognised as a feature of the inherited disorder. We describe a case of dilated cardiomyopathy resulting from prolonged hypocalcaemia due to previously undiagnosed hypoparathyroidism resulting from DiGeorge Syndrome and describe the features of this case and the treatment of hypoparathyroidism.
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Affiliation(s)
- A Jamieson
- A Jamieson, Medical Unit, St John's Hospital, Howden S Road, Livingston EH54 6PP, UK. Email
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Al-Yasiri AY, Khoobchandani M, Cutler CS, Watkinson L, Carmack T, Smith CJ, Kuchuk M, Loyalka SK, Lugão AB, Katti KV. Mangiferin functionalized radioactive gold nanoparticles (MGF-198AuNPs) in prostate tumor therapy: green nanotechnology for production, in vivo tumor retention and evaluation of therapeutic efficacy. Dalton Trans 2017; 46:14561-14571. [DOI: 10.1039/c7dt00383h] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We report here production of MGF-198AuNPs and its application for prostate tumor therapy.
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Affiliation(s)
- A. Y. Al-Yasiri
- Nuclear Science and Engineering Institute (NSEI)
- University of Missouri
- Columbia
- USA
| | - M. Khoobchandani
- Department of Radiology
- Institute of Green Nanotechnology
- University of Missouri
- One Hospital Drive
- Columbia
| | - C. S. Cutler
- Nuclear Science and Engineering Institute (NSEI)
- University of Missouri Research Reactor (MURR)
- University of Missouri
- Columbia
- USA
| | - L. Watkinson
- Harry S. Truman Memorial Veterans Hospital
- University of Missouri
- One Hospital Drive
- Columbia
- USA
| | - T. Carmack
- Harry S. Truman Memorial Veterans Hospital
- University of Missouri
- One Hospital Drive
- Columbia
- USA
| | - C. J. Smith
- Department of Radiology
- Harry S. Truman Memorial Veterans Hospital
- University of Missouri
- One Hospital Drive
- Columbia
| | - M. Kuchuk
- University of Missouri Research Reactor (MURR)
- University of Missouri
- One Hospital Drive
- Columbia
- USA
| | - S. K. Loyalka
- Nuclear Science and Engineering Institute (NSEI)
- University of Missouri
- Columbia
- USA
| | - A. B. Lugão
- Nuclear and Energy Research Institute – IPEN/CNEN/Sao Paulo
- Brazil
| | - K. V. Katti
- Nuclear Science and Engineering Institute (NSEI)
- Department of Radiology
- Institute of Green Nanotechnology
- University of Missouri Research Reactor (MURR)
- Harry S. Truman Memorial Veterans Hospital
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Smith CJ, Ryckman KK, Barnabei VM, Howard BV, Isasi CR, Sarto GE, Tom SE, Van Horn LV, Wallace RB, Robinson JG. The impact of birth weight on cardiovascular disease risk in the Women's Health Initiative. Nutr Metab Cardiovasc Dis 2016; 26:239-245. [PMID: 26708645 PMCID: PMC4788544 DOI: 10.1016/j.numecd.2015.10.015] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 10/14/2015] [Accepted: 10/29/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Cardiovascular disease (CVD) is among the leading causes of morbidity and mortality worldwide. Traditional risk factors predict 75-80% of an individual's risk of incident CVD. However, the role of early life experiences in future disease risk is gaining attention. The Barker hypothesis proposes fetal origins of adult disease, with consistent evidence demonstrating the deleterious consequences of birth weight outside the normal range. In this study, we investigate the role of birth weight in CVD risk prediction. METHODS AND RESULTS The Women's Health Initiative (WHI) represents a large national cohort of post-menopausal women with 63,815 participants included in this analysis. Univariable proportional hazards regression analyses evaluated the association of 4 self-reported birth weight categories against 3 CVD outcome definitions, which included indicators of coronary heart disease, ischemic stroke, coronary revascularization, carotid artery disease and peripheral arterial disease. The role of birth weight was also evaluated for prediction of CVD events in the presence of traditional risk factors using 3 existing CVD risk prediction equations: one body mass index (BMI)-based and two laboratory-based models. Low birth weight (LBW) (<6 lbs.) was significantly associated with all CVD outcome definitions in univariable analyses (HR = 1.086, p = 0.009). LBW was a significant covariate in the BMI-based model (HR = 1.128, p < 0.0001) but not in the lipid-based models. CONCLUSION LBW (<6 lbs.) is independently associated with CVD outcomes in the WHI cohort. This finding supports the role of the prenatal and postnatal environment in contributing to the development of adult chronic disease.
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Affiliation(s)
- C J Smith
- University of Iowa Department of Epidemiology, College of Public Health, 145 N. Riverside Drive, Iowa City, IA, 52242, USA
| | - K K Ryckman
- University of Iowa Department of Epidemiology, College of Public Health, 145 N. Riverside Drive, Iowa City, IA, 52242, USA
| | - V M Barnabei
- University at Buffalo, Department of Obstetrics and Gynecology, 219 Bryant Street, Buffalo, NY, 14221, USA
| | - B V Howard
- Medstar Health Research Institute, Hyattsville, MD, USA; Georgetown/Howard Universities Center for Clinical and Translational Research, USA
| | - C R Isasi
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, USA
| | - G E Sarto
- University of Wisconsin, Department of Obstetrics and Gynecology, Madison, WI, USA
| | - S E Tom
- University of Maryland, School of Pharmacy, Baltimore, MD, USA
| | - L V Van Horn
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - R B Wallace
- University of Iowa Department of Epidemiology, College of Public Health, 145 N. Riverside Drive, Iowa City, IA, 52242, USA
| | - J G Robinson
- University of Iowa Department of Epidemiology, College of Public Health, 145 N. Riverside Drive, Iowa City, IA, 52242, USA.
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Achhra AC, Mocroft A, Reiss P, Sabin C, Ryom L, de Wit S, Smith CJ, d'Arminio Monforte A, Phillips A, Weber R, Lundgren J, Law MG. Short-term weight gain after antiretroviral therapy initiation and subsequent risk of cardiovascular disease and diabetes: the D:A:D study. HIV Med 2015. [PMID: 26216031 DOI: 10.1111/hiv.12294] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of the study was to assess the impact of the gain in body mass index (BMI) observed immediately after antiretroviral therapy (ART) initiation on the subsequent risk of cardiovascular disease (CVD) and diabetes. METHODS We analysed data from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) cohort study. Outcomes were development of (i) CVD (composite of myocardial infarction/stroke/coronary procedure) and (ii) diabetes. The main exposure variable was change in BMI from ART initiation (pre-ART) to 1 year after initiation (continuous variable) in treatment-naïve individuals initiating ART with no history of CVD or diabetes (for respective outcomes). BMI [weight (kg)/(height (m))(2)] was categorized as underweight (< 18.5), normal (18.5-25), overweight (25-30) and obese (> 30). Poisson regression models were fitted stratified for each pre-ART BMI category to allow for category-specific estimates of incidence rate ratio (IRR). Models were adjusted for pre-ART BMI and CD4 count, key known risk factors (time-updated where possible) and calendar year. RESULTS A total of 97 CVD events occurred in 43,982 person-years (n = 9321) and 125 diabetes events in 43,278 person-years (n = 9193). In fully adjusted analyses for CVD, the IRR/unit gain in BMI (95% confidence interval) in the first year of ART, by pre-ART BMI category, was: underweight, 0.90 (0.60-1.37); normal, 1.18 (1.05-1.33); overweight, 0.87 (0.70-1.10), and obese, 0.95 (0.71-1.28) (P for interaction = 0.04). For diabetes, the IRR/unit gain in BMI was 1.11 (95% confidence interval 1.03 to 1.21), regardless of pre-ART BMI (P for interaction > 0.05). CONCLUSIONS Short-term gain in BMI following ART initiation appeared to increase the longer term risk of CVD, but only in those with pre-ART BMI in the normal range. It was also associated with increased risk of diabetes regardless of pre-ART BMI.
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Affiliation(s)
- A C Achhra
- Kirby Institute, UNSW Australia, Sydney, NSW, Australia
| | - A Mocroft
- Research Department of Infection & Population Health, University College London, London, UK
| | - P Reiss
- Division of Infectious Diseases and Department of Global Health, University of Amsterdam, Amsterdam, The Netherlands
| | - C Sabin
- Research Department of Infection & Population Health, University College London, London, UK
| | - L Ryom
- University of Copenhagen, Copenhagen, Denmark
| | - S de Wit
- Infectious Diseases Department, Saint-Pierre University Hospital, Brussels, Belgium
| | - C J Smith
- Research Department of Infection & Population Health, University College London, London, UK
| | | | - A Phillips
- Research Department of Infection & Population Health, University College London, London, UK
| | - R Weber
- University Hospital in Zurich, Zurich, Switzerland
| | - J Lundgren
- Rigshospitalet & University of Copenhagen, Copenhagen, Denmark
| | - M G Law
- Kirby Institute, UNSW Australia, Sydney, NSW, Australia
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Saunders P, Goodman AL, Smith CJ, Marshall N, O'Connor JL, Lampe FC, Johnson MA. Does gender or mode of HIV acquisition affect virological response to modern antiretroviral therapy (ART)? HIV Med 2015; 17:18-27. [PMID: 26140659 DOI: 10.1111/hiv.12272] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Previous UK studies have reported disparities in HIV treatment outcomes for women. We investigated whether these differences persist in the modern antiretroviral treatment (ART) era. METHODS A single-centre cohort analysis was carried out. We included in the study all previously ART-naïve individuals at our clinic starting triple ART from 1 January 2006 onwards with at least one follow-up viral load (VL). Time to viral suppression (VS; first viral load < 50 HIV-1 RNA copies/mL), virological failure (VF; first of two consecutive VLs > 200 copies/mL more than 6 months post-ART) and treatment modification were estimated using standard survival methods. RESULTS Of 1086 individuals, 563 (52%) were men whose risk for HIV acquisition was sex with other men (MSM), 207 (19%) were men whose risk for HIV acquisition was sex with women (MSW) and 316 (29%) were women. Median pre-ART CD4 count and time since HIV diagnosis in these groups were 298, 215 and 219 cells/μL, and 2.3, 0.3 and 0.3 years, respectively. Time to VS was comparable between groups, but women [adjusted hazard ratio (aHR) 2.32; 95% confidence interval (CI) 1.28-4.22] and MSW (aHR 3.28; 95% CI 1.91-5.64) were at considerably higher risk of VF than MSM. Treatment switches and complete discontinuation were also more common among MSW [aHR 1.38 (95% CI 1.04-1.81) and aHR 1.73 (95% CI 0.97-3.16), respectively] and women [aHR 1.87 (95% CI 1.43-2.46) and aHR 3.20 (95% CI 2.03-5.03), respectively] than MSM. CONCLUSIONS Although response rates were good in all groups, poorer virological outcomes for women and MSW have persisted into the modern ART era. Factors that might influence the differences include socioeconomic status and mental health disorders. Further interventions to ensure excellent response rates in women and MSW are required.
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Affiliation(s)
- P Saunders
- Royal Free London NHS Foundation Trust, London, UK
| | - A L Goodman
- Royal Free London NHS Foundation Trust, London, UK.,Department of Infection and Immunity, University College London, London, UK
| | - C J Smith
- Research Department of Infection and Population Health, University College London, London, UK
| | - N Marshall
- Royal Free London NHS Foundation Trust, London, UK
| | - J L O'Connor
- Research Department of Infection and Population Health, University College London, London, UK
| | - F C Lampe
- Research Department of Infection and Population Health, University College London, London, UK
| | - M A Johnson
- Royal Free London NHS Foundation Trust, London, UK
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27
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Zhang S, Li W, Smith CJ, Musa H. Cereal-Derived Arabinoxylans as Biological Response Modifiers: Extraction, Molecular Features, and Immune-Stimulating Properties. Crit Rev Food Sci Nutr 2015; 55:1035-52. [DOI: 10.1080/10408398.2012.705188] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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28
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Ryckman KK, Spracklen CN, Smith CJ, Robinson JG, Saftlas AF. Maternal lipid levels during pregnancy and gestational diabetes: a systematic review and meta-analysis. BJOG 2015; 122:643-51. [PMID: 25612005 DOI: 10.1111/1471-0528.13261] [Citation(s) in RCA: 233] [Impact Index Per Article: 25.9] [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: 11/04/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND Lipid levels during pregnancy in women with gestational diabetes mellitus (GDM) have been extensively studied; however, it remains unclear whether dyslipidaemia is a potential marker of preexisting insulin resistance. OBJECTIVE To evaluate the relationship between lipid measures throughout pregnancy and GDM. SEARCH STRATEGY We searched PubMed-MedLine and SCOPUS (inception until January 2014) and reference lists of relevant studies. SELECTION CRITERIA Publications describing original data with at least one raw lipid (total cholesterol, high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], or triglyceride) measurement during pregnancy in women with GDM and healthy pregnant controls were retained. DATA COLLECTION AND ANALYSIS Data extracted from 60 studies were pooled and weighted mean difference (WMD) in lipid levels was calculated using random effects models. Meta-regression was also performed to identify sources of heterogeneity. MAIN RESULTS Triglyceride levels were significantly elevated in women with GDM compared with those without GDM (WMD 30.9, 95% confidence interval [95% CI] 25.4-36.4). This finding was consistent in the first, second and third trimesters of pregnancy. HDL-C levels were significantly lower in women with GDM compared with those without GDM in the second (WMD -4.6, 95% CI -6.2 to -3.1) and third (WMD -4.1, 95% CI -6.5 to -1.7) trimesters of pregnancy. There were no differences in aggregate total cholesterol or LDL-C levels between women with GDM and those without insulin resistance. AUTHOR'S CONCLUSIONS Our meta-analysis shows that triglycerides are significantly elevated among women with GDM compared with women without insulin resistance and this finding persists across all three trimesters of pregnancy.
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Affiliation(s)
- K K Ryckman
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA
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29
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Nelson MD, Trojanowski NF, George-Raizen JB, Smith CJ, Yu CC, Fang-Yen C, Raizen DM. The neuropeptide NLP-22 regulates a sleep-like state in Caenorhabditis elegans. Nat Commun 2014; 4:2846. [PMID: 24301180 PMCID: PMC3867200 DOI: 10.1038/ncomms3846] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 10/30/2013] [Indexed: 11/09/2022] Open
Abstract
Neuropeptides play central roles in the regulation of homeostatic behaviors such as sleep and feeding. Caenorhabditis elegans displays sleep-like quiescence of locomotion and feeding during a larval transition stage called lethargus and feeds during active larval and adult stages. Here we show that the neuropeptide NLP-22 is a regulator of Caenorhabditis elegans sleep-like quiescence observed during lethargus. nlp-22 shows cyclical mRNA expression in synchrony with lethargus; it is regulated by LIN-42, an orthologue of the core circadian protein PERIOD; and it is expressed solely in the two RIA interneurons. nlp-22 and the RIA interneurons are required for normal lethargus quiescence, and forced expression of nlp-22 during active stages causes anachronistic locomotion and feeding quiescence. Optogenetic stimulation of RIA interneurons has a movement-promoting effect, demonstrating functional complexity in a single neuron type. Our work defines a quiescence-regulating role for NLP-22 and expands our knowledge of the neural circuitry controlling Caenorhabditis elegans behavioral quiescence.
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Affiliation(s)
- M D Nelson
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
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30
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Anastasopoulou A, Mytilineou C, Lefkaditou E, Dokos J, Smith CJ, Siapatis A, Bekas P, Papadopoulou KN. Diet and feeding strategy of blackmouth catshark Galeus melastomus. J Fish Biol 2013; 83:1637-1655. [PMID: 24298955 DOI: 10.1111/jfb.12269] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Diet and feeding strategy of the blackmouth catshark Galeus melastomus in the deep waters of the eastern Ionian Sea were investigated. Sampling was carried out using experimental bottom longline fishing at depths ranging from 300 to 855 m in summer and autumn 2010. Diet variability with fish size, season, area, sex and depth zone was tested and only season was found to significantly affect the diet of the species. Of the 870 stomachs examined, only 1·4% were empty. Cumulative prey curves showed that the sample sizes were adequate to describe the main prey items of the diet for both seasons. Prey identified belonged primarily to three major groups: fishes, cephalopods and dendrobranchiatan and caridean shrimps. In autumn, the above three major groups were found as principal prey, whereas in summer cephalopods followed by fishes were the principal prey and shrimps were found as secondary prey. SIMPER analysis indicated high dissimilarity between seasons and highlighted that Sepiolidae, Myctophidae, fishes, cephalopods, shrimps and other crustaceans contributed to seasonal differences in the diet of G. melastomus. The prey diversity index was higher in autumn than in summer. A high dietary overlap was observed between the two seasons. Galeus melastomus behaved as an opportunistic predator with a variety of unimportant prey in its diet. Feeding strategy indicated that G. melastomus holds a generalist niche with a considerable specialization at the individual level. This strategy seems to be an adaptation to a food-scarce environment, as typified in deep-water habitats.
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Affiliation(s)
- A Anastasopoulou
- Hellenic Centre for Marine Research, Institute of Marine Biological Resources and Inland Waters, 46.7 km Athens Sounio, Mavro Lithari, P. O. Box 712, 19013 Anavissos, Attica, Greece
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31
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Mytilineou C, Tsagarakis K, Bekas P, Anastasopoulou A, Kavadas S, Machias A, Haralabous J, Smith CJ, Petrakis G, Dokos J, Kapandagakis A. Spatial distribution and life-history aspects of blackspot seabream Pagellus bogaraveo (Osteichthyes: Sparidae). J Fish Biol 2013; 83:1551-1575. [PMID: 24298951 DOI: 10.1111/jfb.12271] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Spatial distribution and life history aspects of Pagellus bogaraveo in the eastern Ionian Sea were investigated using the data from 13 different studies carried out in the area from 1983 to 2010. The spatial patterns of the abundance, biomass and mean size showed that the species inhabits the shallow waters of the shelf (<170 m depth) as juveniles up to a certain size (<180 mm total length, LT ), moving to deeper waters of the slope (mainly 400-500 m depth) as adults. The spatial pattern of abundance indicated a continuous distribution of the species in deep waters, with hot-spot areas of high values, whereas in shallow waters distribution was more discontinuous, with higher concentrations of juveniles in estuaries and brackish waters. The study of biological aspects of the species revealed (1) a difference in the increase in mass between males and females, (2) protandrous hermaphroditism, accompanied by the presence of primary females and males that do not change sex, (3) a sex ratio in favour of females >250 mm LT , (4) the presence of hermaphrodites between 200 and 370 mm, (5) a long reproduction period from June to March, (6) a size at first maturity around 300 mm and (7) a diet composition of adults based mainly on fishes, and also on opportunistic behaviour in the food scarce environment of deep waters. The results suggest that the species' distribution and feeding strategies are the most appropriate for the oligotrophic eastern Ionian waters and that these conditions result in smaller sizes of the species in the east Mediterranean Sea compared to the west basin and the east Atlantic Ocean, with implications for the growth and reproductive biology of the species.
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Affiliation(s)
- Ch Mytilineou
- Hellenic Centre for Marine Research, 46.7 km Athens-Sounio, P. O. Box 1712, 19013 Anavissos Attica, Greece
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Affiliation(s)
- C J Smith
- Research Department of Infection and Population Health, UCL, Royal Free Campus, London, NW3 2PF, UK.
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Wienhoff BE, Prasanphanich AF, Lane SR, Nanda PK, Bandari RP, Sieckman GL, Smith CJ. Synthesis and Selective Radiolabeling Strategies for Production of [90Y-DOTA-βala-K-64Cu-NOTA-BBN(7–14) NH2] Conjugate; A Dual Negatron/Positron Emitting Radioligand. ACTA ACUST UNITED AC 2012. [DOI: 10.1080/15533174.2012.731120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- B. E. Wienhoff
- a Department of Radiology , University of Missouri School of Medicine , Columbia , Missouri , USA
| | - A. F. Prasanphanich
- b Department of Biomedical Engineering , Georgia Institute of Technology and Emory University School of Medicine , Atlanta , Georgia , USA
| | - S. R. Lane
- a Department of Radiology , University of Missouri School of Medicine , Columbia , Missouri , USA
| | - P. K. Nanda
- a Department of Radiology , University of Missouri School of Medicine , Columbia , Missouri , USA
| | - R. P. Bandari
- a Department of Radiology , University of Missouri School of Medicine , Columbia , Missouri , USA
| | - G. L. Sieckman
- c Research Division , Harry S. Truman Memorial Veterans’ Hospital , Columbia , Missouri , USA
| | - C. J. Smith
- a Department of Radiology , University of Missouri School of Medicine , Columbia , Missouri , USA
- c Research Division , Harry S. Truman Memorial Veterans’ Hospital , Columbia , Missouri , USA
- d The Missouri University Research Reactor , Columbia , Missouri , USA
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Thakker DH, Cullinan P, Hubbard R, Smith CJ, MacNeill SJ. P273 Asthma: Is It as Predictable as the Seasons? Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Affiliation(s)
- C J Smith
- Research Department of Infection and Population Health, UCL, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
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37
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Di Napoli M, Godoy DA, Campi V, Masotti L, Smith CJ, Parry Jones AR, Hopkins SJ, Slevin M, Papa F, Mogoanta L, Pirici D, Popa Wagner A. C-reactive protein in intracerebral hemorrhage: Time course, tissue localization, and prognosis. Neurology 2012; 79:690-9. [DOI: 10.1212/wnl.0b013e318264e3be] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Smith CJ. Type I and Type II errors: what are they and why do they matter? Phlebology 2012; 27:199-200. [DOI: 10.1258/phleb.2012.012j04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- C J Smith
- Research Department of Infection and Population Health, UCL, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
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Affiliation(s)
- C. J. Smith
- Joint UKBTS/HPA Professional Advisory Committee (JPAC) Manager, NHS Blood and Transplant, Sheffield, UK E‐mail:
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40
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Affiliation(s)
- C J Smith
- Research Department of Infection and Population Health, UCL, Rowland Hill Street, LondonNW3 2PF, UK
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41
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Affiliation(s)
- C J Smith
- Research Department of Infection and Population Health, UCL, London NW3 2PF, UK.
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42
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Affiliation(s)
- C J Smith
- Research Department of Infection and Population Health, UCL, Rowland Hill Street, London NW3 2PF, UK.
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43
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Affiliation(s)
- C J Smith
- Research Department of Infection and Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK.
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44
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Affiliation(s)
- C J Smith
- Research Department of Infection and Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK.
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45
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Smith CJ. Repeated measurements on individuals. Phlebology 2011; 26:313-4. [DOI: 10.1258/phleb.2011.011j05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- C J Smith
- Research Department of Infection and Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
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Abstract
Abstract
The utilization of positron emission tomography (PET) is increasing due to its superior imaging quality and its ability to be used for in vivo quantification. Radionuclides that decay by positron emission can be attached to the same chelators used for radiotherapy applications in diagnosis and staging. One such isotope is 68Ga (T
1/2 = 68 min), which can be obtained from a long-lived generator by decay of the parent 68Ge (T
1/2 = 270.8 d). The availability of 68Ga from a generator plus its ability to be stably incorporated with a variety of chelates hold promise for expanding PET utilization to facilities unable to afford their own cyclotron. In collaboration with researchers at the University of Missouri, we have developed and evaluated peptides that target the melanocortin-1 receptor and the gastrin-releasing peptide (GRP) receptor for peptide guided imaging and the rapy. The melanocortin-1 receptor is an attractive target for peptide guided melanoma imaging and therapy. The limited number of receptors per cell, approximately 900–5000, requires high specific activity radiolabeled peptide ligands to prevent target saturation and ensure optimal cellular uptake. GRP receptors are over-expressed by a variety of human cancers such as breast, lung, pancreatic and prostate tumors, and due to bombesin's toxicity, it is necessary to label it in high specific activity. Results are presented on NOTA and DOTA bifunctionalized α-MSH and bombesin peptides, highlighting the differences in specific activity, preparation time and in vivo characteristics.
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Smith CJ. Systemic inflammation and fatal versus non-fatal coronary events. Heart 2011; 97:1455. [DOI: 10.1136/heartjnl-2011-300561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Smith CJ. Systematic reviews and meta-analyses. Phlebology 2011; 26:271-3. [DOI: 10.1258/phleb.2011.011j04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- C J Smith
- Research Department of Infection and Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
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Murray M, Hogg RS, Lima VD, May MT, Moore DM, Abgrall S, Bruyand M, D'Arminio Monforte A, Tural C, Gill MJ, Harris RJ, Reiss P, Justice A, Kirk O, Saag M, Smith CJ, Weber R, Rockstroh J, Khaykin P, Sterne JAC. The effect of injecting drug use history on disease progression and death among HIV-positive individuals initiating combination antiretroviral therapy: collaborative cohort analysis. HIV Med 2011; 13:89-97. [PMID: 21819529 DOI: 10.1111/j.1468-1293.2011.00940.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND We examined whether determinants of disease progression and causes of death differ between injecting drug users (IDUs) and non-IDUs who initiate combination antiretroviral therapy (cART). METHODS The ART Cohort Collaboration combines data from participating cohort studies on cART-naïve adults from cART initiation. We used Cox models to estimate hazard ratios for death and AIDS among IDUs and non-IDUs. The cumulative incidence of specific causes of death was calculated and compared using methods that allow for competing risks. RESULTS Data on 6269 IDUs and 37 774 non-IDUs were analysed. Compared with non-IDUs, a lower proportion of IDUs initiated cART with a CD4 cell count <200 cells/μL or had a prior diagnosis of AIDS. Mortality rates were higher in IDUs than in non-IDUs (2.08 vs. 1.04 per 100 person-years, respectively; P<0.001). Lower baseline CD4 cell count, higher baseline HIV viral load, clinical AIDS at baseline, and later year of cART initiation were associated with disease progression in both groups. However, the inverse association of baseline CD4 cell count with AIDS and death appeared stronger in non-IDUs than in IDUs. The risk of death from each specific cause was higher in IDUs than non-IDUs, with particularly marked increases in risk for liver-related deaths, and those from violence and non-AIDS infection. CONCLUSION While liver-related deaths and deaths from direct effects of substance abuse appear to explain much of the excess mortality in IDUs, they are at increased risk for many other causes of death, which may relate to suboptimal management of HIV disease in these individuals.
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Affiliation(s)
- M Murray
- Division of Infectious Diseases, University of British Columbia, Vancouver, British Columbia, Canada
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Affiliation(s)
- C J Smith
- Research Department of Infection and Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, UK
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