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Dossou Etui IM, Stylo M, Davis K, Evers DC, Vera IS, Wood C, Burton MEH. Artisanal and small-scale gold mining and biodiversity: a global literature review. Ecotoxicology 2024:10.1007/s10646-024-02748-w. [PMID: 38713425 DOI: 10.1007/s10646-024-02748-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/06/2024] [Indexed: 05/08/2024]
Abstract
Artisanal and small-scale gold mining (ASGM) is crucial to the livelihoods of close to 20 million people in over 80 countries, including 4-5 million women, mainly in rural areas with limited alternative economic prospects, particularly in developing countries. ASGM is largely informal, which can add to the challenge of addressing negative social and environmental effects including impacts on biodiversity. However, with proper guidance, ASGM can operate in a responsible manner, using cleaner production methods that minimize impacts on human health and the environment. This study presents and analyzes the interactions between ASGM and biodiversity based on new findings from 27 ASGM National Action Plans (NAPs) developed within the framework of Article 7 and Annex C of the Minamata Convention on Mercury, as well as a global literature review of more than 100 publications. In terms of key findings according to the literature reviewed, alongside other human occupation such as agriculture and industrial activities, ASGM also has an impact on the environment and biodiversity. The interrelationship between ASGM and biodiversity, including protected areas, is pervasive at every stage of ASGM operations, from extraction to mine closure, and generates significant impacts on the surrounding ecosystems. These impacts include, in descending order of most reported impacts: deforestation, soil degradation, chemical contamination of aquatic and terrestrial systems, and changes to the turbidity of watercourses. Tropical regions and key species such as amphibians and freshwater fish are among the most affected. Singly or combined, these environmental stressors lead to loss or deterioration of habitat and, by extension, indigenous biodiversity and ecosystem services. In addition, legal, institutional, and regulatory frameworks and related measures, inadequate or non-existent in some cases, may not necessarily support sustainable practices, often resulting in exploited sites abandoned without remediation, reclamation, rehabilitation, or restoration measures. To mitigate such impacts a key recommendation arising from the literature review is to strengthen the integration of the interrelationship between ASGM and biodiversity in the implementation of existing relevant national strategies, including those developed under the NAPs. The global literature review also highlights the importance of a multi-stakeholder, systemic approach combining the use of geospatial analysis, scientific and local knowledge, as well as the adaptation of the relevant frameworks, capacity building, and awareness raising. This approach can inform decision making with a view to developing sustainable initiatives that prevent and reduce the impacts of artisanal and small-scale gold mining on ecosystems, and that preserve biodiversity.
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Affiliation(s)
- Imelda M Dossou Etui
- United Nations Environment Programme, 8-14 Avenue de la Paix CH-1211, Geneva, 10, Switzerland.
- University of Geneva, Faculty of Sciences, Earth and Environment Sciences, Department F.-A. Forel for Environmental and Aquatic Sciences, Environmental Biogeochemistry and Ecotoxicology, 66 Blvd Carl-Vogt, CH 1211, Geneva, Switzerland.
| | - Malgorzata Stylo
- United Nations Environment Programme, 8-14 Avenue de la Paix CH-1211, Geneva, 10, Switzerland
| | - Kenneth Davis
- United Nations Environment Programme, 8-14 Avenue de la Paix CH-1211, Geneva, 10, Switzerland
| | - David C Evers
- Biodiversity Research Institute, 276 Canco Road, Portland, ME, 04103, USA.
| | - I Slaveykova Vera
- University of Geneva, Faculty of Sciences, Earth and Environment Sciences, Department F.-A. Forel for Environmental and Aquatic Sciences, Environmental Biogeochemistry and Ecotoxicology, 66 Blvd Carl-Vogt, CH 1211, Geneva, Switzerland
| | - C Wood
- United Nations Environment Programme, 8-14 Avenue de la Paix CH-1211, Geneva, 10, Switzerland
| | - Mark E H Burton
- Biodiversity Research Institute, 276 Canco Road, Portland, ME, 04103, USA
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Thomas A, Seaton F, Dhiedt E, Cosby BJ, Feeney C, Lebron I, Maskell L, Wood C, Reinsch S, Emmett BA, Robinson DA. Topsoil porosity prediction across habitats at large scales using environmental variables. Sci Total Environ 2024; 922:171158. [PMID: 38387558 DOI: 10.1016/j.scitotenv.2024.171158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/19/2024] [Accepted: 02/19/2024] [Indexed: 02/24/2024]
Abstract
Soil porosity and its reciprocal bulk density are important environmental state variables that enable modelers to represent hydraulic function and carbon storage. Biotic effects and their 'dynamic' influence on such state variables remain largely unknown for larger scales and may result in important, yet poorly quantified environmental feedbacks. Existing representation of hydraulic function is often invariant to environmental change and may be poor in some systems, particularly non-arable soils. Here we assess predictors of total porosity across two comprehensive national topsoil (0-15 cm) data sets, covering the full range of soil organic matter (SOM) and habitats (n = 1385 & n = 2570), using generalized additive mixed models and machine learning. Novel aspects of this work include the testing of metrics on aggregate size and livestock density alongside a range of different particle size distribution metrics. We demonstrate that porosity trends in Great Britain are dominated by biotic metrics, soil carbon and land use. Incorporating these variables into porosity prediction improves performance, paving the way for new dynamic calculation of porosity using surrogate measures with remote sensing, which may help improve prediction in data sparse regions of the world. Moreover, dynamic calculation of porosity could support representation of feedbacks in environmental and Earth System Models. Representing the hydrological feedbacks from changes in structural porosity also requires data and models at appropriate spatial scales to capture conditions leading to near-saturated soil conditions. Classification. Environmental Sciences.
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Affiliation(s)
- A Thomas
- UK Centre for Ecology and Hydrology, Environment Centre Wales, Bangor, UK.
| | - F Seaton
- UK Centre for Ecology and Hydrology, Library Ave, Bailrigg, Lancaster, UK
| | - E Dhiedt
- UK Centre for Ecology and Hydrology, Environment Centre Wales, Bangor, UK
| | - B J Cosby
- UK Centre for Ecology and Hydrology, Environment Centre Wales, Bangor, UK
| | - C Feeney
- UK Centre for Ecology and Hydrology, Environment Centre Wales, Bangor, UK
| | - I Lebron
- UK Centre for Ecology and Hydrology, Environment Centre Wales, Bangor, UK
| | - L Maskell
- UK Centre for Ecology and Hydrology, Library Ave, Bailrigg, Lancaster, UK
| | - C Wood
- UK Centre for Ecology and Hydrology, Library Ave, Bailrigg, Lancaster, UK
| | - S Reinsch
- UK Centre for Ecology and Hydrology, Environment Centre Wales, Bangor, UK
| | - B A Emmett
- UK Centre for Ecology and Hydrology, Environment Centre Wales, Bangor, UK
| | - D A Robinson
- UK Centre for Ecology and Hydrology, Environment Centre Wales, Bangor, UK
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Langhorne C, Wood BJ, Wood C, Henning J, McGowan M, Schull D, Ranjbar S, Gibson JS. Understanding barriers to reducing antimicrobials on Australian dairy farms: A qualitative analysis. Aust Vet J 2024. [PMID: 38342502 DOI: 10.1111/avj.13322] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/21/2024] [Indexed: 02/13/2024]
Abstract
INTRODUCTION Reducing antibiotic use in production animal systems is one strategy which may help to limit the development of antimicrobial resistance. To reduce antimicrobial use in food-producing animals, it is important to first understand how antibiotics are used on farm and what barriers exist to decreasing their use. In dairy production systems, mastitis is one of the most common reasons for administering antimicrobials. Therefore, it is important to understand the motivations and behaviours of dairy farmers in relation to the diagnosis, treatment and prevention of mastitis. MATERIALS AND METHODS In this study, we interviewed a sample of dairy farmers and dairy industry professionals from the major dairying regions of eastern Australia regarding their current practices used to diagnose, treat, and control subclinical and clinical mastitis. Inductive thematic analysis was used to code interview transcripts and identify the recurrent themes. RESULTS Four overarching themes were identified: (1) the challenges associated with the detection and diagnosis of clinical mastitis, including with laboratory culture, (2) the motivations behind treatment decisions for different cases, (3) decisions around dry cow therapy and the role of herd recording, and (4) concerns regarding the development of antimicrobial resistance. DISCUSSION This study identifies several challenges which may limit the ability of Australian dairy farmers to reduce antimicrobial use on farm, such as the need for rapid and reliable diagnostic tests capable of identifying the pathogenic causes of mastitis and the difficulties associated with conducting herd recording for the implementation of selective dry cow therapy. Industry professionals were concerned that farmers were not using individual cow records to aid in treatment decisions, which could result in unnecessary antimicrobial use. The results of this study can act as the basis for future research aimed at assessing these issues across the broader Australian dairy industry.
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Affiliation(s)
- C Langhorne
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, 4343, Australia
| | - B J Wood
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, 4343, Australia
| | - C Wood
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, 4343, Australia
| | - J Henning
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, 4343, Australia
| | - M McGowan
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, 4343, Australia
| | - D Schull
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, 4343, Australia
| | - S Ranjbar
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, 4343, Australia
| | - J S Gibson
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, 4343, Australia
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Langhorne C, Horsman S, Wood C, Clark R, Price R, Henning J, Grewar JD, Wood BJ, Ranjbar S, McGowan MR, Gibson JS. Bacterial culture and susceptibility test results for clinical mastitis samples from Australia's subtropical dairy region. J Dairy Sci 2024; 107:1151-1163. [PMID: 37769942 DOI: 10.3168/jds.2023-23838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/05/2023] [Indexed: 10/03/2023]
Abstract
This study aimed to identify the pathogens isolated from the milk of cows with clinical mastitis in the subtropical region of Australia and to determine the antimicrobial susceptibility of these bacteria. Thirty dairy herds in the subtropical dairy region were asked to submit milk samples for the first 5 cases of clinical mastitis each month for 12 mo. Samples underwent aerobic culture, and isolates were identified via MALDI-TOF mass spectrometry. Antimicrobial susceptibility was determined for Escherichia coli, Enterococcus spp., Streptococcus agalactiae, Streptococcus uberis, Streptococcus dysgalactiae, Staphylococcus aureus, and non-aureus staphylococci and mammaliicocci (NASM). Between March 2021 and July 2022, 1,230 milk samples were collected. A positive culture result was recorded for 812 (66%) of the milk samples; from these samples, 909 isolates were obtained, including 49 isolates where no identification was possible. The remaining samples were classified as having no growth (16.8%) or as being contaminated (17.2%). The most common isolates with a MALDI-TOF diagnosis (n = 909) were Strep. uberis (23.6%), followed by the NASM group (15.0%). Farms enrolled in the study were in 3 distinct locations within the subtropical dairy region: North Queensland, Southeast Queensland, and Northern New South Wales. Some variation in isolate prevalence occurred between these 3 locations. We found lower odds of a sample being positive for E. coli in North Queensland (odds ratio [OR]: 0.25; 95% confidence interval [CI]: 0.07-0.87) and higher odds in Southeast Queensland (OR: 4.01; 95% CI: 1.96-8.20) compared with the reference, Northern New South Wales. We further found higher odds of Strep. dysgalactiae in North Queensland (OR: 5.69; 95% CI: 1.85-17.54) and Southeast Queensland compared with Northern New South Wales (OR: 3.99; 95% CI: 1.73-9.22). Although some seasonal patterns were observed, season was not significant for any of the analyzed isolates. Farm-level differences in pathogen profiles were obvious. Overall, clinical mastitis pathogens had low levels of resistance to the antimicrobials tested. This research demonstrates that Strep. uberis and the NASM bacterial group are the most common pathogens causing clinical mastitis in the subtropical dairy region. It highlights the importance of understanding pathogenic causes of mastitis at the farm and regional level for targeted control and therapy.
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Affiliation(s)
- Charlotte Langhorne
- School of Veterinary Science, University of Queensland, Gatton, QLD, 4343, Australia.
| | - Sara Horsman
- School of Veterinary Science, University of Queensland, Gatton, QLD, 4343, Australia
| | - Caitlin Wood
- School of Veterinary Science, University of Queensland, Gatton, QLD, 4343, Australia
| | - Rachael Clark
- School of Veterinary Science, University of Queensland, Gatton, QLD, 4343, Australia
| | - Rochelle Price
- School of Veterinary Science, University of Queensland, Gatton, QLD, 4343, Australia
| | - Joerg Henning
- School of Veterinary Science, University of Queensland, Gatton, QLD, 4343, Australia
| | | | - Benjamin J Wood
- School of Veterinary Science, University of Queensland, Gatton, QLD, 4343, Australia
| | - Shahab Ranjbar
- School of Veterinary Science, University of Queensland, Gatton, QLD, 4343, Australia
| | - Michael R McGowan
- School of Veterinary Science, University of Queensland, Gatton, QLD, 4343, Australia
| | - Justine S Gibson
- School of Veterinary Science, University of Queensland, Gatton, QLD, 4343, Australia
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Russell E, Mathews V, Tsiouris J, Wood C, Naidich T. Robert D. Zimmerman, MD. AJNR Am J Neuroradiol 2023; 44:E52-E53. [PMID: 38049987 PMCID: PMC10714851 DOI: 10.3174/ajnr.a8054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
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Langhorne C, Gupta SD, Horsman S, Wood C, Wood BJ, Barker L, Deutscher A, Price R, McGowan MR, Humphris M, Ranjbar S, Henning J, Gibson JS. Bacterial culture and antimicrobial susceptibility results from bovine milk samples submitted to four veterinary diagnostic laboratories in Australia from 2015 to 2019. Front Vet Sci 2023; 10:1232048. [PMID: 37635756 PMCID: PMC10450625 DOI: 10.3389/fvets.2023.1232048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/21/2023] [Indexed: 08/29/2023] Open
Abstract
A 5-year retrospective study was conducted to describe the mastitis-causing organisms isolated from bovine milk samples submitted to four veterinary diagnostic laboratories in Australia. The aim of this study was to identify temporal, geographical, and seasonal patterns of occurrence for the organisms and report the in vitro susceptibility of the most common mastitis-causing pathogens. In total, 22,102 milk samples were submitted between 2015 and 2019. The results were reported as positive growth for at least one significant organism (n = 11,407; 51.6%), no growth (n = 5,782; 26.2%), and mixed/contaminated growth (n = 4,913; 22.2%). Culture results for no growth, gram-negative bacteria, and eukaryotic organisms were combined for each region, and they were accounted for between 23 and 46% of submissions. These results represent a subset of mastitis cases for which the antibiotic treatment may not be warranted. A total of 11,907 isolates were cultured from 11,407 milk samples. The most common isolated organisms were Streptococcus uberis [41.3%; 95% confidence interval (CI): 40.4-42.1%] and Staphylococcus aureus (23.6%; 95% CI: 22.8-24.3%). For S. uberis and S. aureus, there was an association between a positive culture result and the dairy region. All regions except for the Sub-tropical Dairy region were more likely to culture S. uberis compared to the reference, Dairy NSW (P < 0.001). Similarly, for S. aureus, a positive culture result was more likely in all other dairy regions compared to Dairy NSW (P < 0.001). The LISA cluster analysis identified differences between High-High (hotspot) postcodes for S. aureus and S. uberis throughout all the analyzed dairy regions. These results highlight the need for further investigations into specific risk factors, such as environmental factors and herd-level predictors, which may have influenced the observed regional variations. Common mastitis-causing pathogens showed overall good susceptibility to a range of antimicrobials used in the treatment of mastitis. On-going surveillance of mastitis-causing pathogens and their antimicrobial susceptibilities will facilitate targeted mastitis control and treatment programs.
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Affiliation(s)
- Charlotte Langhorne
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Suman Das Gupta
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
- Gulbali Institute, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Sara Horsman
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Caitlin Wood
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Benjamin J. Wood
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Leslie Barker
- Department of Agriculture and Fisheries, Biosecurity Sciences Laboratory, Coopers Plains, QLD, Australia
| | - Ania Deutscher
- NSW Department Primary Industries, Elizabeth Macarthur Agricultural Institute, Menangle, NSW, Australia
| | - Rochelle Price
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Michael R. McGowan
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | | | - Shahab Ranjbar
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Joerg Henning
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Justine S. Gibson
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
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Porter B, Wood C, Belderson P, Manning C, Meadows R, Sanderson K, Hanson S. We care but we're not carers: perceptions and experiences of social prescribing in a UK national community organisation. Perspect Public Health 2023:17579139231185004. [PMID: 37489838 DOI: 10.1177/17579139231185004] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
AIMS (1) To explore how social prescribing referrals impact experiences of existing members of a voluntary and community-based organisation and (2) to describe the processes and relationships associated with joining community and voluntary organisations. METHODS Online survey and qualitative interviews with members of Men's Sheds, a global volunteer-led initiative to address loneliness and social isolation in men. 93 self-selecting Shed members (average age 67 years, 93% male) from across England and Scotland took part in the survey about demographics, joining the Shed, and free-text questions about experiences in the Shed. From the survey participants, 21 Shed members were purposively sampled and interviewed to explore the impact of social prescribing and referrals on the Sheds. RESULTS Participating in the Men's Shed was often associated with a significant change in personal circumstances, and Sheds provided a unique social support space, particularly valuable for men. Key factors around experiences of social prescribing and referral mechanisms were identified. We developed three themes: the experience of joining a Shed, success factors and risks of social prescribing, and 'we care but we're not carers'. CONCLUSIONS The results show that Men's Sheds are a caring organisation, but their members are not trained as professional carers, and men come to the Shed for their own personal reasons. They are concerned about the potential additional responsibilities associated with formal referrals. They encourage the development of relationships and local-level understanding of the essence of Sheds to enable social prescribing. As models of social prescribing grow nationally and internationally, collaboratively working with voluntary and community organisations to develop a mutually beneficial approach is essential for the effectiveness and sustainability of social prescribing in community health.
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Affiliation(s)
- B Porter
- School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK
| | - C Wood
- University of Winchester, Winchester, UK
| | - P Belderson
- Norwich Medical School, University of East Anglia, Norwich, UK
| | | | - R Meadows
- UK Men's Sheds Association, Bristol, UK
| | - K Sanderson
- Professor, School of Health Sciences, University of East Anglia, Norwich, UK
| | - S Hanson
- School of Health Sciences, University of East Anglia, Norwich, UK
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Salami H, Wood C, Ouyang H, Zhao X, Skomski D. Deep learning image analysis models pretrained on daily objects are useful for the preliminary characterization of particulate pharmaceutical samples. Biotechnol Bioeng 2023. [PMID: 37435969 DOI: 10.1002/bit.28488] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/16/2023] [Accepted: 06/24/2023] [Indexed: 07/13/2023]
Abstract
Visible and subvisible particles are a quality attribute in sterile pharmaceutical samples. A common method for characterizing and quantifying pharmaceutical samples containing particulates is imaging many individual particles using high-throughput instrumentation and analyzing the populations data. The analysis includes conventional metrics such as the particle size distribution but can be more sophisticated by interpreting other visual/morphological features. To avoid the hurdles of building new image analysis models capable of extracting such relevant features from scratch, we propose using well-established pretrained deep learning image analysis models such as EfficientNet. We demonstrate that such models are useful as a prescreening tool for high-level characterization of biopharmaceutical particle image data. We show that although these models are originally trained for completely different tasks (such as the classification of daily objects in the ImageNet database), the visual feature vectors extracted by such models can be useful for studying different types of subvisible particles. This applicability is illustrated through multiple case studies: (i) particle risk assessment in prefilled syringe formulations containing different particle types such as silicone oil, (ii) method comparability with the example of accelerated forced degradation, and (iii) excipient influence on particle morphology with the example of Polysorbate 80 (PS80). As examples of agnostic applicability of pretrained models, we also elucidate the application to two high-throughput microscopy methods: microflow and background membrane imaging. We show that different particle populations with different morphological and visual features can be identified in different samples by leveraging out-of-the-box pretrained models to analyze images from each sample.
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Affiliation(s)
- Hossein Salami
- Analytical Research and Development, Merck & Co. Inc., Rahway, New Jersey, USA
| | - Caitlin Wood
- Analytical Research and Development, Merck & Co. Inc., Rahway, New Jersey, USA
| | - Hanlin Ouyang
- Analytical Research and Development, Merck & Co. Inc., Rahway, New Jersey, USA
| | - Xi Zhao
- Sterile and Specialty Products, Pharmaceutical Sciences & Clinical Supply, Merck & Co. Inc., Rahway, New Jersey, USA
| | - Daniel Skomski
- Analytical Research and Development, Merck & Co. Inc., Rahway, New Jersey, USA
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Marraccini ME, Griffard MKR, Whitcomb CE, Wood C, Griffin DC, Pittleman C, Sartain L. School-based Mental Health Supports During COVID-19: School Professional Perspectives. Psychol Sch 2023; 60:2460-2482. [PMID: 37692888 PMCID: PMC10488322 DOI: 10.1002/pits.22869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 01/15/2023] [Indexed: 01/28/2023]
Abstract
Objective The present study explored the ways school professionals adapted school-based mental health supports and services for remote delivery during the COVID-19 pandemic. Method We surveyed 81 school professionals (e.g., counselors, psychologists, social workers) and conducted in-depth interviews with a subsample of professionals (n=14) to explore their perceptions and experiences of supporting youth with mental health concerns and suicide-related risk during the fall and winter of the 2020-2021 school year. Results Commonly endorsed school-based mental health interventions (e.g., counseling services, checking in), ways of communicating (phone, email), and individuals delivering supports and services to students with suicide-related risk (e.g., counselors, teachers) were identified based on school professional survey responses. Qualitative findings point to facilitators (e.g., specific platforms for connecting with students and families) and barriers (e.g., limited communication) to successful service delivery during COVID-19. Conclusion Findings highlight the creative ways school support professionals adapted to provide school-based mental health supports. Implications for remote school-based mental health services during and following the pandemic are discussed.
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Affiliation(s)
| | | | - Cason E Whitcomb
- Gillings School of Public Health, University of North Carolina at Chapel Hill
| | - Caitlin Wood
- School of Education, University of North Carolina at Chapel Hill
| | - Dana C Griffin
- School of Education, University of North Carolina at Chapel Hill
| | - Cari Pittleman
- School of Education, University of North Carolina at Chapel Hill
| | - Lauren Sartain
- School of Education, University of North Carolina at Chapel Hill
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Gordon LG, Wood C, Tothill RW, Webb PM, Schofield P, Mileshkin L. Healthcare Costs Before and After Diagnosis of Cancer of Unknown Primary Versus Ovarian Cancer in Australia. Pharmacoecon Open 2023; 7:111-120. [PMID: 36253664 PMCID: PMC9929003 DOI: 10.1007/s41669-022-00371-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Little is known about the healthcare resource usage and costs for patients with cancer of unknown primary (CUP). OBJECTIVE The aim of this study was to describe and quantify healthcare resource use and costs in Australia, 6 months prior to and after a diagnosis of CUP, and compare to those of women with ovarian cancer. METHODS Individual-level data combining baseline surveys, clinical records and Medicare Benefits Schedule (MBS) claim records were analysed for 149 patients with CUP and 480 patients with ovarian cancer from two prospective cohort studies. MBS data were aggregated for the period 6 months prior to diagnosis date and 6 months after diagnosis. Data included doctor consultations, pathology, diagnostics, therapeutic procedures, imaging, allied health and medicines. Generalised linear models were used to evaluate the cost differences between CUP and ovarian cancer using gamma family and log link functions. Models were adjusted for age, employment, marital status, surgery, chemotherapy and number of comorbidities. RESULTS The mean healthcare costs in the 6 months prior to diagnosis of CUP were Australian (AU) $3903 versus AU$1327 for ovarian cancer (adjusted cost ratio 2.94, 95% confidence interval [CI] 2.08-4.15). Mean healthcare costs 6 months post-diagnosis were higher for patients with CUP versus ovarian cancer (AU$20,339 vs AU$13,819, adjusted cost ratio 1.47, 95% CI 1.13-1.92). Higher costs for patients with CUP were driven by imaging (AU$1937 vs AU$1387), procedures (AU$5403 vs AU$2702) and prescribed medicines for all conditions (AU$10,111 vs AU$6717). CONCLUSIONS Pre-diagnosis costs for patients with CUP are nearly triple those for ovarian cancer. Six months after diagnosis, healthcare costs for CUP remained higher than for ovarian cancer due to imaging, procedures and medicines.
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Affiliation(s)
- Louisa G Gordon
- QIMR Berghofer Medical Research Institute, Population Health Department, Locked Bag 2000, Royal Brisbane Hospital, Herston, Brisbane, Australia.
- Queensland University of Technology (QUT), School of Nursing, Kelvin Grove, Australia.
- The University of Queensland, School of Medicine, Herston, Brisbane, Australia.
| | - C Wood
- Department of Medical Oncology, Peter MacCallum Cancer Centre and the Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
| | - R W Tothill
- Department of Medical Oncology, Peter MacCallum Cancer Centre and the Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
| | - P M Webb
- QIMR Berghofer Medical Research Institute, Population Health Department, Locked Bag 2000, Royal Brisbane Hospital, Herston, Brisbane, Australia
| | | | - L Mileshkin
- Department of Medical Oncology, Peter MacCallum Cancer Centre and the Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, 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K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, 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Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack 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Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Thurillet S, Bahans C, Wood C, Bougnard S, Labrunie A, Messager V, Toniolo J, Beloni P, Fourcade L. Psychometric properties of a self-assessment fear scale in children aged 4 to 12 years. Scary Scale. J Pediatr Nurs 2022; 65:108-115. [PMID: 35300885 DOI: 10.1016/j.pedn.2022.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/21/2022] [Accepted: 02/23/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Caregivers encounter difficulties differentiating fear and pain experienced by children and tend to interpret what children may feel, often resulting in inadequate pain management. While many pain self-assessment scales are available, there is no validated self-assessment fear scale for children. METHODS The aim of this prospective study was to validate, in children aged 4 to 12 years, the psychometric properties of our scale. In a first part, in a school setting, five exercises were given to 484 children in order to validate the expression of fear, grade the intensity of the faces, the ability to discriminate the faces and the equality of the intervals. The scale's reproducibility was studied by assessing the children's fear in everyday situations at two different time points. In a second part, in a hospital setting, the aim was to test the scale's feasibility. Sixty children admitted to one emergency care department self-assessed their fear with the Scary Scale. FINDINGS The expression of fear was validated by 57.64% (p < 0.0001) of the children in comparison with three other emotions (pain, surprise, sadness).The 7-9 year-olds validated the other properties (gradation, discrimination, equality, reproducibility). The 4-6 year-olds failed to validate the gradation exercise, but succeeded with the others. In the hospital, 95% of children self-assessed their fear using the scale. DISCUSSION Our self-assessment fear scale was validated in children aged 7-12 years specifically and was readily feasible in the hospital. We recommend its use in that age group in every care situation triggering fear. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02675504.
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Affiliation(s)
- S Thurillet
- Pediatric Emergency Department, Mother-Child Hospital, Limoges, France.
| | - C Bahans
- Pediatric Epidemiology Department, Mother-Child Hospital, Limoges, France
| | - C Wood
- Pain Department, Mother-Child Hospital, Limoges, France
| | - S Bougnard
- Pediatric Emergency Department, Mother-Child Hospital, Limoges, France
| | - A Labrunie
- Centre of Epidemiology, Biostatistics and Methodology in Research, Limoges, France
| | - V Messager
- Pediatric Emergency Department, Mother-Child Hospital, Limoges, France
| | - J Toniolo
- University Hospital Centre, Inserm U1094, IRD U270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - P Beloni
- University Hospital Centre, Inserm U1094, IRD U270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - L Fourcade
- Pediatric Surgery Department, Mother-Child Hospital, Limoges, France
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Thomas D, Lan N, Jones C, Raju V, Soon J, Otto J, Wood C, Spencer R, Rankin J, Dwivedi G, Ihdayhid A. Evaluation of a Chest Pain Evaluation Pathway in the Emergency Department Utilising Computed Tomography Coronary Angiography as a First-Line Outpatient Test. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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15
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Noble DJ, Doyle E, Tramonti G, Law AB, Sundaramurthy A, Brush JP, Keanie J, Wood C, Drewell P, Keough W, McLaren DB. Defining Biochemical Cure After Low Dose Rate Prostate Brachytherapy: External Validation of 4-year Prostate-specific Antigen Nadir as a Predictor of 10- and 15-year Disease-free Survival. Clin Oncol (R Coll Radiol) 2021; 34:42-49. [PMID: 34848134 DOI: 10.1016/j.clon.2021.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/06/2021] [Accepted: 11/10/2021] [Indexed: 11/03/2022]
Abstract
AIMS To externally validate a proposed biochemical definition of cure following low dose rate (LDR) brachytherapy for prostate cancer - 4-year post-implant prostate-specific antigen (PSA) ≤0.2 ng/ml - in a UK population, and report the long-term (10- and 15-year) outcomes for patients stratified by National Comprehensive Cancer Network (NCCN) risk groups, through analysis of a large, prospectively collected, single-centre database. MATERIALS AND METHODS All patients treated with LDR brachytherapy for prostate cancer at a single UK centre between 2001 and November 2020 (n = 1142) were eligible; 632 patients met the inclusion criteria for the analysis. The primary end point was disease-free survival (DFS), defined as freedom from clinical, radiological or PSA progression requiring androgen deprivation therapy. Four-year PSA was categorised as ≤0.2, >0.2 to ≤0.5, >0.5 to ≤1.0 and >1.0 ng/ml. Kaplan-Meier analysis to 15 years was undertaken for each group, and sensitivity and specificity of 4-year PSA as a surrogate for long-term cure were calculated. Kaplan-Meier analysis to 15 years was repeated, stratifying patients by NCCN risk groups. RESULTS The median cohort age was 63 years; the median follow-up was 9.1 years (range 3.5-18.7). In total, 248 patients were available for analysis at year 10, 46 at year 15. Sixty-four patients (10.1%) relapsed during the study period. The 10-year DFS for 4-year PSA categories ≤0.2, >0.2 to ≤0.5, >0.5 to ≤1.0 and >1.0 ng/ml (95% confidence intervals) were 97.5% (95.4-99.6), 89.0% (82.4-96.1), 81.5% (70.5-94.2) and 41.8% (29.7-58.9), respectively. The 10-year DFS results for NCCN low, favourable-intermediate and unfavourable-intermediate risk disease were 93.1% (89.6-96.7), 92.1% (87.6-96.9) and 75.9% (67.8-84.9), respectively. CONCLUSIONS Patients with 4-year PSA ≤0.2 ng/ml may be considered cured, and could be discharged to general practitioner follow-up. LDR brachytherapy is an excellent treatment option for patients with low and favourable-intermediate risk prostate cancer, but those with unfavourable-intermediate risk disease should be considered for treatment intensification strategies.
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Affiliation(s)
- D J Noble
- Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK; Edinburgh Cancer Research Centre, MRC Institute of Genetics and Molecular Medicine, Edinburgh, UK
| | - E Doyle
- Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
| | - G Tramonti
- Edinburgh Cancer Research Centre, MRC Institute of Genetics and Molecular Medicine, Edinburgh, UK
| | - A B Law
- Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
| | - A Sundaramurthy
- Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
| | - J P Brush
- Department of Radiology, Western General Hospital, Edinburgh, UK
| | - J Keanie
- Department of Radiology, Western General Hospital, Edinburgh, UK
| | - C Wood
- Department of Oncology Physics, Western General Hospital, Edinburgh, UK
| | - P Drewell
- Department of Oncology Physics, Western General Hospital, Edinburgh, UK
| | - W Keough
- Department of Oncology Physics, Western General Hospital, Edinburgh, UK
| | - D B McLaren
- Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK; Edinburgh Cancer Research Centre, MRC Institute of Genetics and Molecular Medicine, Edinburgh, UK.
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Wood C, Anthony K. DMD - BRAIN. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.159] [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: 11/25/2022]
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17
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Noble D, Doyle E, Tramonti G, Law A, Sundaramurthy A, Brush J, Keanie J, Wood C, Drewell P, Keough W, McLaren D. PD-0809 4-year PSA to predict relapse risk after low dose rate brachytherapy for prostate cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07088-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Shuttleworth C, Everest D, Wood C, Holmes JP. Sympatric cases of squirrelpox in red and grey squirrels. Vet Rec 2021; 188:358. [PMID: 33960446 DOI: 10.1002/vetr.483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Craig Shuttleworth
- School of Natural Sciences, Bangor University, Bangor, Gwynedd, LL57 2UW
| | | | - C Wood
- APHA Weybridge, New Haw, Addlestone, Surrey, KT15 3NB
| | - J P Holmes
- APHA Shrewsbury, Veterinary Investigation Centre, Harlescott, Shrewsbury, Shropshire, SY1 4HD
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Carter H, Wood C. 683 A Quality Improvement Project (QIP) To Increase Compliance with Peri-Operative Antibiotic Guidelines in Colorectal Surgery (CS). Br J Surg 2021. [DOI: 10.1093/bjs/znab134.468] [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: 11/13/2022]
Abstract
Abstract
Introduction
In CS, the correct use of antibiotics is important in order to reduce the risk of surgical site and intra-abdominal infections, whilst balancing risks from overuse of antibiotics. The Commissioning for Quality and Improvement (CQUIN) of 2019/20 identified that antibiotic prophylaxis guideline compliance could be enhanced in CS. This QIP aimed to improve local CS antibiotic prophylaxis and extension guideline compliance.
Method
In December 2019, an educational session was held to highlight the details of the local guideline and prescribing discrepancies. A3 posters of the guideline were created for accessible reference in operating theatres. Perioperative antibiotic prescription data from all colorectal elective cases in January 2020 were extracted and analysed using descriptive methods.
Results
Out of 93 cases in the sample, 70 (75.3%) were compliant with the prophylaxis guideline. However, metronidazole was commonly used in perianal surgery, which is not recommended. 13 cases required extension of the antibiotic course, of which seven were compliant (53.8%). The main issues included: use of agents and course durations which were not indicated; and a lack of antibiotic switch after a pause in therapy.
Conclusions
To further improve compliance with antibiotic guidelines, targeting historic practice, increasing awareness, and making systemic change is required for the next cycle.
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Affiliation(s)
- H Carter
- University College London Hospital, London, United Kingdom
| | - C Wood
- University College London Hospital, London, United Kingdom
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20
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Abdelsalam M, Mecci N, Matin S, Wood C, Karam J, Ahrar K. Abstract No. 587 Magnetic resonance imaging–guided cryoablation of de novo solitary pathologically proven T1a renal tumors. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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De B, Venkatesan A, Msaouel P, Ghia A, Li J, Yeboa D, Nguyen Q, Bishop A, Jonasch E, Shah A, Campbell M, Wang J, Zurita-Saavedra A, Karam J, Wood C, Matin S, Tannir N, Tang C. Definitive Radiotherapy for Oligoprogressive Metastatic Renal Cell Carcinoma as a Strategy to Defer Systemic Therapy Escalation. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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22
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Clark NJ, Tozer S, Wood C, Firestone SM, Stevenson M, Caraguel C, Chaber AL, Heller J, Soares Magalhães RJ. Unravelling animal exposure profiles of human Q fever cases in Queensland, Australia, using natural language processing. Transbound Emerg Dis 2020; 67:2133-2145. [PMID: 32259390 DOI: 10.1111/tbed.13565] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/11/2020] [Accepted: 03/28/2020] [Indexed: 11/28/2022]
Abstract
Q fever, caused by the zoonotic bacterium Coxiella burnetii, is a globally distributed emerging infectious disease. Livestock are the most important zoonotic transmission sources, yet infection in people without livestock exposure is common. Identifying potential exposure pathways is necessary to design effective interventions and aid outbreak prevention. We used natural language processing and graphical network methods to provide insights into how Q fever notifications are associated with variation in patient occupations or lifestyles. Using an 18-year time-series of Q fever notifications in Queensland, Australia, we used topic models to test whether compositions of patient answers to follow-up exposure questionnaires varied between demographic groups or across geographical areas. To determine heterogeneity in possible zoonotic exposures, we explored patterns of livestock and game animal co-exposures using Markov Random Fields models. Finally, to identify possible correlates of Q fever case severity, we modelled patient probabilities of being hospitalized as a function of particular exposures. Different demographic groups consistently reported distinct sets of exposure terms and were concentrated in different areas of the state, suggesting the presence of multiple transmission pathways. Macropod exposure was commonly reported among Q fever cases, even when exposure to cattle, sheep or goats was absent. Males, older patients and those that reported macropod exposure were more likely to be hospitalized due to Q fever infection. Our study indicates that follow-up surveillance combined with text modelling is useful for unravelling exposure pathways in the battle to reduce Q fever incidence and associated morbidity.
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Affiliation(s)
- Nicholas J Clark
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Qld, Australia
| | - Sarah Tozer
- Queensland Centre for Gynaecological Cancer, The University of Queensland, Qld, Australia
| | - Caitlin Wood
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Qld, Australia
| | - Simon M Firestone
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Vic., Australia
| | - Mark Stevenson
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Vic., Australia
| | - Charles Caraguel
- School of Animal and Veterinary Science, The University of Adelaide, Adelaide, SA, Australia
| | - Anne-Lise Chaber
- School of Animal and Veterinary Science, The University of Adelaide, Adelaide, SA, Australia
| | - Jane Heller
- Graham Centre for Agricultural Innovation, School of Animal and Veterinary Sciences, Charles Sturt University, Wagga, NSW, Australia
| | - Ricardo J Soares Magalhães
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Qld, Australia
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Qld, Australia
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Tozer S, Wood C, Si D, Nissen M, Sloots T, Lambert S. The improving state of Q fever surveillance. A review of Queensland notifications, 2003-2017. ACTA ACUST UNITED AC 2020; 44. [PMID: 32536338 DOI: 10.33321/cdi.2020.44.48] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Q fever is a notifiable zoonotic disease in Australia, caused by infection with Coxiella burnetii. This study has reviewed 2,838 Q fever notifications reported in Queensland between 2003 and 2017 presenting descriptive analyses, with counts, rates, and proportions. For this study period, Queensland accounted for 43% of the Australian national Q fever notifications. Enhanced surveillance follow-up of Q fever cases through Queensland Public Health Units was implemented in 2012, which improved the data collected for occupational risk exposures and animal contacts. For 2013-2017, forty-nine percent (377/774) of cases with an identifiable occupational group would be considered high risk for Q fever. The most common identifiable occupational group was agricultural/farming (31%). For the same period, at-risk environmental exposures were identified in 82% (961/1,170) of notifications; at-risk animal-related exposures were identified in 52% (612/1,170) of notifications; abattoir exposure was identified in 7% of notifications. This study has shown that the improved follow-up of Q fever cases since 2012 has been effective in the identification of possible exposure pathways for Q fever transmission. This improved surveillance has highlighted the need for further education and heightened awareness of Q fever risk for all people living in Queensland, not just those in previously-considered high risk occupations.
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Affiliation(s)
- Sarah Tozer
- Centre for Children's Health Research, Queensland Paediatric Infectious Disease Laboratory, Lady Cilento Research Precinct, South Brisbane, Queensland; Children's Health Research Centre, University of Queensland, South Brisbane, Queensland; The University of Queensland, School of Veterinary Science, Gatton, Queensland
| | - Caitlin Wood
- Centre for Children's Health Research, Queensland Paediatric Infectious Disease Laboratory, Lady Cilento Research Precinct, South Brisbane, Queensland; The University of Queensland, School of Veterinary Science, Gatton, Queensland
| | - Damin Si
- Communicable Diseases Branch, Prevention Division, Department of Health, Queensland Government
| | - Michael Nissen
- Children's Health Research Centre, University of Queensland, South Brisbane, Queensland; Director of Scientific Affairs & Public Health, GSK Vaccines Intercontinental, Singapore
| | - Theo Sloots
- Centre for Children's Health Research, Queensland Paediatric Infectious Disease Laboratory, Lady Cilento Research Precinct, South Brisbane, Queensland; Children's Health Research Centre, University of Queensland, South Brisbane, Queensland
| | - Stephen Lambert
- Children's Health Research Centre, University of Queensland, South Brisbane, Queensland
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Affiliation(s)
- Robert C. Atkins
- Department of Nephrology; Monash Medical Center; Clayton, Victoria, Australia
| | - C. Wood
- Department of Nephrology; Monash Medical Center; Clayton, Victoria, Australia
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Wren A, Wood C, Lunney R, Weatherley P. 419 The use of ST/HR Hysteresis as a Diagnostic Tool During Treadmill Exercise Stress Echo. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Billot M, Chaumeil T, Jaglin P, Brun C, Wood C, Tavernier J, Lavallière M, Langlois P, Rigoard P, Perrochon A. Effet d’un programme d’hypno-analgésie de trois semaines sur le contrôle postural de patients obèses douloureux chroniques. Neurophysiol Clin 2019. [DOI: 10.1016/j.neucli.2019.10.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Wood C, Kostkova P, Olufemi O, Soriano D, Ogunsola F, Lefevre-Lewis C, Kpokiri E, Shallcross L. Understanding non-compliance with surgical antibiotic prophylaxis prescribing guidance, in Nigeria. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.088] [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: 11/13/2022] Open
Abstract
Abstract
Background
Antimicrobial Resistance is a prominent worldwide threat that is increasing in low-to-middle income countries. Good antibiotic stewardship (AMS) improves compliance with evidence-based antimicrobial prescribing guidelines but just 4% of LMICs have national AMS initiatives in place and only 15% have national policies. As high as 20-50% of surgical antibiotic prophylaxis prescription in Nigeria is thought to be non-compliant. Behaviour change theories can structure our understanding of why poor compliance occurs and can facilitate development of effective interventions to improve it.
Methods
The Theoretical Domains Framework (TDF; Michie et al. 2009) was used to develop an online survey and interview schedule for focus group discussions. Audio recordings were transcribed and analysed by two researchers using thematic analysis, TDF and the COM-B model of behaviour change (Michie et al. 2010).
Results
60 surgeons (59% male; 43% surgical consultant; 5-10 yrs experience) from Lagos University Teaching Hospital, Lagos University College of Medicine and Niger Delta University Teaching Hospital completed the survey. A sub-group of 14 surgeons (79% male; 86% surgical consultant; 10-15 yrs experience) participated in three focus groups. Whilst compliance with guidance was generally considered desirable, surgeons reported translating guidance to Nigerian practice and context was often difficult, time-consuming and restricted by not having access to recommended antibiotics.
Conclusions
Behaviour change theory can be used to further our understanding of key barriers and facilitators to non-compliance with surgical antibiotic prophylaxis prescribing guidance, amongst surgeons in Nigeria. This presentation will conclude with discussion of how findings from this project are being used to develop a cost-effective, scalable, decision-support smartphone app for prescribing behaviour change.
Key messages
Behaviour change theory can be used effectively to further understanding of barriers and facilitators to Nigerian surgeons’ non-compliance with surgical antibiotic prophylaxis prescribing guidance. We must form a comprehensive understanding of factors (social & environmental) driving non-compliant attitudes and behaviours, before creating interventions to change prescribing behaviour.
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Affiliation(s)
- C Wood
- UCL IRDR Centre for Digital Public Health in Emergencies, University College London, London, UK
| | - P Kostkova
- UCL IRDR Centre for Digital Public Health in Emergencies, University College London, London, UK
| | - O Olufemi
- Lagos University College of Medicine, Lagos University, Lagos, Nigeria
| | - D Soriano
- UCL IRDR Centre for Digital Public Health in Emergencies, University College London, London, UK
| | - F Ogunsola
- Lagos University College of Medicine, Lagos University, Lagos, Nigeria
| | - C Lefevre-Lewis
- UCL Centre for Behaviour Change, University College London, London, UK
| | - E Kpokiri
- Antimicrobial Resistance Centre, LSHTM, London, UK
| | - L Shallcross
- Institute of Health Informatics, University College London, London, UK
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Truffert E, Fournier Charrière E, Treluyer JM, Blanchet C, Cohen R, Gardini B, Haas H, Liard F, Montastruc JL, Nicollas R, Pondaven S, Stahl JP, Wood C, Couloigner V. Guidelines of the French Society of Otorhinolaryngology (SFORL): Nonsteroidal anti-inflammatory drugs (NSAIDs) and pediatric ENT infections. Short version. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:289-294. [PMID: 31420238 DOI: 10.1016/j.anorl.2019.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To present the guidelines of the French Society of Otolaryngology-Head and Neck Surgery concerning the use of non-steroidal anti-inflammatory drugs (NSAIDs) in pediatric ENT infections. METHODS Based on a critical analysis of the medical literature up to November 2016, a multidisciplinary workgroup of 11 practitioners wrote clinical practice guidelines. Levels of evidence were classified according to the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) system: GRADE A, B, C or "expert opinion". The first version of the text was reworked by the workgroup following comments by the 22 members of the reading group. RESULTS The main recommendations are: NSAIDs are indicated at analgesic doses (e.g. 20-30 mg/kg/day for ibuprofen) in combination with paracetamol (acetaminophen) in uncomplicated pediatric ENT infections (acute otitis media, tonsillitis, upper respiratory infections, and maxillary sinusitis) if: o pain is of medium intensity (visual analogue scale (VAS) score 3-5 or "Evaluation Enfant Douleur" (EVENDOL) child pain score 4-7) and insufficiently relieved by first-line paracetamol (residual VAS≥3 or EVENDOL≥4); o pain is moderate to intense (VAS 5-7 or EVENDOL 7-10). When combined, paracetamol and ibuprofen are ideally taken simultaneously every 6h. It is recommended: (1) o not to prescribe NSAIDs in severe or complicated pediatric ENT infections; (2) o to suspend NSAIDs treatment in case of unusual clinical presentation of the infection (duration or symptoms); (3) o not to prescribe NSAIDs for more than 72h.
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Affiliation(s)
- E Truffert
- Service d'ORL, hôpital Necker-Enfants-Malades, AP-HP, 75015 Paris, France
| | - E Fournier Charrière
- CETD, service de pédiatrie, groupe Pédiadol, CHU Bicêtre, AP-HP, 94270 Le Kremlin-Bicêtre, France
| | - J-M Treluyer
- Centre d'investigation clinique, hôpital Necker-Enfants-Malades, AP-HP, 75015 Paris, France
| | - C Blanchet
- Service d'ORL, hôpital-Gui de-Chauliac, CHU de Montpellier, 34295 Montpellier, France
| | - R Cohen
- Service de pédiatre, centre hospitalier intercommunal de Créteil, 94000 Créteil, France
| | - B Gardini
- Clinique Sarrus-Teinturiers, 31300 Toulouse, France
| | - H Haas
- Service des urgences, hôpital CHU Lenval, 06200 Nice, France
| | | | - J-L Montastruc
- Service de pharmacologie clinique, hôpital La Grave, CHU de Toulouse, 31300 Toulouse, France
| | - R Nicollas
- Service d'ORL, CHU La Timone, AP-HM, 13005 Marseille, France
| | - S Pondaven
- Service d'ORL, hôpital Clocheville, CHU de Tours, 37000 Tours, France
| | - J-P Stahl
- Service d'infectiologie, CHU de Grenoble, 38700 Grenoble, France
| | - C Wood
- Service d'algologie, CHU Dupuytren, 87000 Limoges, France
| | - V Couloigner
- Service d'ORL, hôpital Necker-Enfants-Malades, AP-HP, 75015 Paris, France.
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Buono A, Lidbury JA, Wood C, Wilson-Robles H, Dangott LJ, Allenspach K, Suchodolski JS, Steiner JM. Development, analytical validation, and initial clinical evaluation of a radioimmunoassay for the measurement of soluble CD25 concentrations in canine serum. Vet Immunol Immunopathol 2019; 215:109904. [PMID: 31420068 DOI: 10.1016/j.vetimm.2019.109904] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 07/15/2019] [Accepted: 07/23/2019] [Indexed: 12/18/2022]
Abstract
During immune activation, CD25 is expressed by T cells, and its soluble form (sCD25) is released into the extracellular matrix and the bloodstream. In humans, serum sCD25 concentrations are used as a surrogate marker for autoimmune diseases, malignancies, and transplant rejection. However, a canine-specific assay for the measurement of sCD25 in dog serum has not previously been described. Therefore, the aims of this study were to develop and analytically validate a radioimmunoassay to measure sCD25 in canine serum, to establish a reference interval for canine sCD25, and to test the clinical utility of this assay with serum samples for dogs with various diseases. A competitive radioimmunoassay (RIA) was developed and analytically validated. Analytical validation consisted of lower limit of detection (LLOD), dilutional parallelism, spiking recovery, and intra- and inter-assay variability using pooled surplus canine serum samples. A reference interval was established in healthy dogs and serum samples from dogs with various types of neoplasia, IBD, liver disease, suspected pancreatitis, or suspected small intestinal disease and serum samples with an increased C-reactive protein concentration (CRP) were analyzed to test the clinical utility of the assay. LLOD was calculated to be 0.5 ng/mL. The mean (±SD) observed-to-expected ratio (O/E) for serial dilutions was 101.7 ± 14.0%, and the mean (± SD) O/E for spiking recovery was 93.2 ± 4.2%. Coefficients of variation (CVs) for intra-assay variability were ≤12.5% (mean ± SD: 7.5 ± 4.2%), and inter-assay CVs were ≤15.7% (mean ± SD: 11 ± 4.4%). A reference interval (RI) for canine sCD25 of 1.2-4.2 ng/mL was established from a population of 112 clinically healthy dogs. Dogs with neoplasia and dogs with suspected small intestinal disease had decreased concentrations of serum sCD25 when compared to healthy dogs (p < 0.0001, respectively). However, the majority of clinical samples used in this study were within the reference interval. Median concentrations of serum sCD25 were 1.9 ng/mL for healthy dogs. Dogs with cancer, IBD, liver disease, suspected pancreatitis, or suspected small intestinal disease, as well as sera with an increased serum CRP concentration, had median serum sCD25 concentrations of 1.6 ng/mL, 2.1 ng/mL, 2.2 ng/mL, 1.7 ng/mL, 1.5 ng/mL, and 1.8 ng/mL, respectively. Thus, the RIA described here is linear, accurate, precise, and reproducible for measuring sCD25 in canine serum. However, this assay shows little clinical utility of sCD25 as a biomarker for dogs with inflammatory, autoimmune, and/or neoplastic conditions.
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Affiliation(s)
- A Buono
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4474, USA.
| | - J A Lidbury
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4474, USA
| | - C Wood
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843-4474, USA
| | - H Wilson-Robles
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843-4474, USA
| | - L J Dangott
- Protein Chemistry Laboratory, Department of Biochemistry and Biophysics, Texas A&M University, College Station, TX, 77843-2128, USA
| | - K Allenspach
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA, 50011-1134, USA
| | - J S Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4474, USA
| | - J M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4474, USA
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Routledge D, Joyce T, Wood C, Harrison S. PF770 OUTCOMES FOR MELPHALAN-VELCADE BASED AUTOGRAFT IN HIGH RISK MULTIPLE MYELOMA PATIENTS: A SINGLE-CENTRE EXPERIENCE. Hemasphere 2019. [DOI: 10.1097/01.hs9.0000561364.90468.56] [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: 11/25/2022] Open
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Smyth N, Flynn M, Rajcani J, F Hucklebridge M, Thorn L, Wood C, Golding J, Evans P, Clow A. Attenuated cortisol reactivity to psychosocial stress is associated with greater visual dependency in postural control. Psychoneuroendocrinology 2019; 104:185-190. [PMID: 30856424 DOI: 10.1016/j.psyneuen.2019.02.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/21/2019] [Accepted: 02/28/2019] [Indexed: 12/29/2022]
Abstract
Despite known anatomical links between the hypothalamic-pituitary-adrenal (HPA) axis and the vestibular system, there are no studies on the relationship between postural control and HPA axis function. Visual dependence in postural control, often measured by increased postural sway on exposure to visual motion, is an indication of altered visual-vestibular integration with greater weighting towards visual cues for balance. Visual dependence is more common in older age and a range of vestibular and non-vestibular health conditions. The relationship between visual dependence in postural control was investigated in relation to cortisol reactivity to psychosocial stress (using the Trier Social Stress Test for groups: TSST-G), as an index of HPA axis function, in healthy young females. In those who exhibited a cortisol response (>2 nmol/l), a negative relationship between stress-induced cortisol reactivity and visual dependence in postural control was observed, since those with the largest cortisol response showed less visual motion induced postural sway (measured by force platform). This finding in healthy females indicates that subtle non-clinical differences in vestibular function are associated with dysregulated HPA axis activity as indicated by lower cortisol reactivity to psychosocial stress. It adds to the growing body of evidence linking blunted cortisol reactivity to stress to poor homeostatic regulation and potential negative health and behavioural outcomes.
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Affiliation(s)
- N Smyth
- Psychophysiology and Stress Research Group, Psychology, School of Social Sciences, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK.
| | - M Flynn
- Psychophysiology and Stress Research Group, Psychology, School of Social Sciences, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK
| | - J Rajcani
- Department of Psychology, Faculty of Arts, Comenius University, Gondova 2, 81499 Bratislava, Slovakia
| | - M F Hucklebridge
- Psychophysiology and Stress Research Group, Psychology, School of Social Sciences, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK
| | - L Thorn
- Psychophysiology and Stress Research Group, Psychology, School of Social Sciences, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK
| | - C Wood
- Psychophysiology and Stress Research Group, Psychology, School of Social Sciences, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK
| | - J Golding
- Psychophysiology and Stress Research Group, Psychology, School of Social Sciences, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK
| | - P Evans
- Psychophysiology and Stress Research Group, Psychology, School of Social Sciences, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK
| | - A Clow
- Psychophysiology and Stress Research Group, Psychology, School of Social Sciences, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK
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Wood C, Muleme M, Tan T, Bosward K, Gibson J, Alawneh J, McGowan M, Barnes TS, Stenos J, Perkins N, Firestone SM, Tozer S. Validation of an indirect immunofluorescence assay (IFA) for the detection of IgG antibodies against Coxiella burnetii in bovine serum. Prev Vet Med 2019; 169:104698. [PMID: 31311644 DOI: 10.1016/j.prevetmed.2019.104698] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/16/2019] [Accepted: 05/21/2019] [Indexed: 01/07/2023]
Abstract
There is limited knowledge of the true prevalence and distribution of coxiellosis in dairy and beef cattle populations in Australia. For this to occur, apparent prevalence estimates need to be reliably adjusted, accounting for diagnostic sensitivity (DSe) and diagnostic specificity (DSp) of the test used. However, there are few tests available with known diagnostic specifications suitable to inform screening and surveillance activities in the Australian context. We initially modified and optimised a human indirect immunofluorescence assay (IFA) test for the detection of IgG antibodies against phase I and/or phase II Coxiella burnetii in bovine sera and determined an optimal screening dilution cut-off to be 1:160. Direct comparison of the modified IFA with the commercial IDEXX enzyme-linked immunosorbent assay (ELISA) kit (Q Fever Ab Test IDEXX Laboratories, United States of America) was performed by testing 458 serum samples from four distinct cattle populations across the east coast of Australia and New Zealand. Cross classified test results were then analysed using Bayesian latent class modelling, to validate the tests in the absence of a gold standard reference test. Results from this analysis indicate that the IFA, at a 1:160 serum dilution, has an estimated DSe of 73.6% (95% Credible Interval (CrI) 61.1, 85.9) and DSp of 98.2% (95% CrI 95.1, 99.7). The commercial IDEXX ELISA kit was found to have a higher DSe of 87.9% (95% CrI 73.9, 96.4) and similar DSp of 97.7% (95% CrI 93.2, 99.7). Evaluation of the diagnostic performance of the IFA and ELISA methods, specifically for use in cattle will enable more accurate interpretation of prevalence estimates of C. burnetii exposure to be reported for cattle in Australia and other countries.
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Affiliation(s)
- Caitlin Wood
- The University of Queensland, School of Veterinary Science, Gatton, Queensland, 4343, Australia; Centre for Children's Health Research, Queensland Paediatric Infectious Disease Laboratory, Lady Cilento Research Precinct, South Brisbane, Queensland, 4101, Australia.
| | - Michael Muleme
- The University of Melbourne, Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, Parkville Victoria, 3010, Australia
| | - Tabita Tan
- The University of Melbourne, Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, Parkville Victoria, 3010, Australia
| | - Katrina Bosward
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, 2570, Australia
| | - Justine Gibson
- The University of Queensland, School of Veterinary Science, Gatton, Queensland, 4343, Australia
| | - John Alawneh
- The University of Queensland, School of Veterinary Science, Gatton, Queensland, 4343, Australia
| | - Michael McGowan
- The University of Queensland, School of Veterinary Science, Gatton, Queensland, 4343, Australia
| | - Tamsin S Barnes
- The University of Queensland, School of Veterinary Science, Gatton, Queensland, 4343, Australia; The University of Queensland, Queensland Alliance for Agriculture and Food Innovation, Gatton, Queensland, 4343, Australia
| | - John Stenos
- Australian Rickettsial Reference Laboratory, Bellarine Street, University Hospital Geelong, Victoria, 3220 Australia
| | - Nigel Perkins
- The University of Queensland, School of Veterinary Science, Gatton, Queensland, 4343, Australia
| | - Simon M Firestone
- The University of Melbourne, Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, Parkville Victoria, 3010, Australia
| | - Sarah Tozer
- Centre for Children's Health Research, Queensland Paediatric Infectious Disease Laboratory, Lady Cilento Research Precinct, South Brisbane, Queensland, 4101, Australia
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Girgis D, Gibson D, Wood C, Subramaniam S, Bobinskas A. Radiographic study to assess the reliability of the gillies approach for biopsy of the superficial temporal artery. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mwaiselage J, Lidenge S, Ngowi J, Haynatzki G, Wood C, West J. Differential Immune Responses in Epidemic and Endemic Tanzanian Kaposi Sarcoma Patients. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.81800] [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: 11/20/2022] Open
Abstract
Background: Mechanisms underlying Kaposi sarcoma (KS) development are unclear. The high incidence of KS in HIV-1+ individuals implicates immune dysregulation in epidemic KS (EpKS) development. In African endemic KS (EnKS), the immune response is uncharacterized. Aim: The aim was to assess a comparative quantification between newly diagnosed Tanzanian EpKS and EnKS patients, and asymptomatic controls. We also report the first comparison of KSHV NAb prevalence and titer between EpKS and EnKS patients. Methods: To compare innate and adaptive immune responses, we recruited histologically confirmed Tanzanian EpKS and EnKS patients, as well as noncancer controls. After differential detection of KSHV nucleic acids in tissues, neutralizing antibody (NAb), levels of cytokines/chemokines, and T-cell differentiation subsets were quantified. The Mann-Whitney U-test was used to assess median differences between groups. All tests were 2-tailed and P-values < 0.05 were considered significant. Results: A total of 180 patients have been recruited in this study. In addition, a comparable 25 EpKS and 10 EnKS as well as 10 noncancer controls were recruited for this study. KSHV was significantly more frequently detected in EpKS patients than in EnKS. While all EpKS, and some EnKS patients mounted NAb responses, the EpKS patients had higher prevalence and titer of NAb compared with EnKS patients ( P = 0.001). Levels of the cytokines IP-10 and IL-10 were higher in EpKS vs EnKS patients ( P = 0.006 and P = 0.005 respectively), whereas, IL-4 was lower in EpKS vs EnKS patients ( P = 0.004). The levels of all 14 cytokines/chemokines measured were comparable between EnKS patients and HIV− controls ( P < .05 ). The distribution of CD4+ and CD8+ T-cells was similar between EpKS and EnKS such as naive and effector T-cells were depleted while central memory T-cells were elevated in both KS forms. Conclusion: The detection of similar abnormalities in T-cell differentiation subsets in both EpKS and EnKS as compared with controls, suggests that KSHV-induced T-cell dysfunction plays a major role in the disease, and that HIV-1 coinfection is only exacerbating and accelerating KSHV pathogenesis and KS development.
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Affiliation(s)
- J.D. Mwaiselage
- Ocean Road Cancer Institute, Cancer Prevention Services, Dar es Salaam, United Republic of Tanzania
| | - S. Lidenge
- Ocean Road Cancer Institute, Academic and Research, Dar es Salaam, United Republic of Tanzania
| | - J.R. Ngowi
- Ocean Road Cancer Institute, Cancer Prevention Services, Dar es Salaam, United Republic of Tanzania
| | - G. Haynatzki
- University of Nebraska Medical Center, College of Public Health, Omaha, NE
| | - C. Wood
- University of Nebraska - Lincoln, Center for Virology, Lincoln, NE
| | - J. West
- University of Nebraska - Lincoln, Center for Virology, Lincoln, NE
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Iddles E, Macleod A, Wood C, Alex V, Saldanha J. WhatsAppTM with surgical training? Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abdelsalam M, Sabir S, Kusin S, Karam J, Matin S, Wood C, Ahrar K. 3:18 PM Abstract No. 242 Long-term follow-up of image-guided thermal ablation for pathologically proven T1a renal tumors: radiofrequency ablation or cryoablation. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
Subjective perceptions of mental and physical energy were measured by the use of visual analogue scales (VAS) over the course of a week in a group of normal volunteers. These variables were found to correlate, highly both with one another and with assessments of vigour and fatigue measured with a standard adjectival format. In addition, high correlations were found with a measure of positive affect. These five variables also displayed characteristic patterns of diurnal variation. Physical and mental energy, vigour and positive affect were highest in the morning, falling progressively and significantly over the day. In contrast, fatigue showed the opposite pattern. Extraversion showed positive correlations with physical and mental energy, vigour and positive affect, and negative correlations with fatigue and negative affect, most being significant (P less than 0.05). Conversely, neuroticism showed a negative correlation with the first four energy variables but was positively related to fatigue and negative affect, most correlations again being significant. Physical and mental energy, vigour and positive affect also showed a positive correlation (P less than 0.01) with a measure of happiness. It is concluded that VAS-derived ratings of physical and mental energy are reliable indicators of self-perceived vigour and fatigue. They are easy to record and show sufficient short-term stability to be used in more extensive studies both of well-being and of its physiological correlates.
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Affiliation(s)
- C Wood
- Department of Biological Anthropology, University of Oxford
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Affiliation(s)
- S E Prance
- Department of General Practice, St Mary's Hospital Medical School, Lisson Grove Health Centre, London
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Abstract
In an attempt to assess whether there are any characteristics which a majority of ordinary people regard as life-affirming or life-denying, a questionnaire was given to a pilot group of 167 respondents, representing three different age and social categories. Five life-affirming and five life-denying characteristics were mentioned by more than 10% of respondents. Of the former, Drive, Sociability, Happiness and Optimism were endorsed by 15–20%. Of the latter, Unsociability and Poor Coping were mentioned by 22%, making them distinctly more frequent than the following categories of Pessimism, Lack of Drive and Unhappiness (11–14%). It is suggested that a number of these subjectively determined characteristics, which the general public perceive as being life-affirming or denying, do indeed influence physical or mental health, illness or illness behaviour. It may therefore be of value to utilize this set of public perceptions in future programmes of health education.
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Parker SG, Reid TH, Boulton R, Wood C, Sanders D, Windsor A. Proposal for a national triage system for the management of ventral hernias. Ann R Coll Surg Engl 2018; 100:106-110. [PMID: 28869388 PMCID: PMC5838688 DOI: 10.1308/rcsann.2017.0158] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2017] [Indexed: 01/26/2023] Open
Abstract
Ventral hernia disease is becoming increasingly prevalent and complex. Subspecialisation for patients with challenging conditions requiring surgery has been shown to improve postoperative outcomes. Worldwide, there is an emergence of specialist hernia centres using new and innovative techniques to repair large and complicated ventral hernias. After a national meeting of hernia experts, we present an algorithm to be used as a national triage system for patients with ventral hernias, with the aim of ensuring that patients are operated on by the most appropriate surgeon. Evidence-based clinical risk factors and ventral hernia parameters are used for risk stratification and patient triage. We hope that this algorithm will guide future ventral hernia management in the UK.
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Affiliation(s)
- S G Parker
- Department of Colorectal Surgery and Abdominal Wall Reconstruction, University College London Hospital , London , UK
| | - T H Reid
- Department of Colorectal Surgery and Abdominal Wall Reconstruction, University College London Hospital , London , UK
| | - R Boulton
- Department of Colorectal Surgery and Abdominal Wall Reconstruction, University College London Hospital , London , UK
| | - C Wood
- Department of Colorectal Surgery and Abdominal Wall Reconstruction, University College London Hospital , London , UK
| | - D Sanders
- Department of Colorectal Surgery and Abdominal Wall Reconstruction, University College London Hospital , London , UK
| | - Ajc Windsor
- Department of Colorectal Surgery and Abdominal Wall Reconstruction, University College London Hospital , London , UK
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Liu Z, Fang Q, Zuo J, Minhas V, Wood C, Zhang T. The world‐wide incidence of Kaposi's sarcoma in the
HIV
/
AIDS
era. HIV Med 2018; 19:355-364. [DOI: 10.1111/hiv.12584] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Z Liu
- Department of Epidemiology School of Public Health Fudan University Shanghai China
- Key Laboratory of Public Health Safety (Fudan University) Ministry of Education Shanghai China
| | - Q Fang
- Department of Epidemiology School of Public Health Fudan University Shanghai China
- Key Laboratory of Public Health Safety (Fudan University) Ministry of Education Shanghai China
| | - J Zuo
- Department of Epidemiology School of Public Health Fudan University Shanghai China
- Key Laboratory of Public Health Safety (Fudan University) Ministry of Education Shanghai China
| | - V Minhas
- Nebraska Center of Virology and the School of Biological Sciences University of Nebraska‐Lincoln Lincoln NE USA
| | - C Wood
- Nebraska Center of Virology and the School of Biological Sciences University of Nebraska‐Lincoln Lincoln NE USA
| | - T Zhang
- Department of Epidemiology School of Public Health Fudan University Shanghai China
- Key Laboratory of Public Health Safety (Fudan University) Ministry of Education Shanghai China
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Ryan T, Taylor E, Morris C, Wood C, Chieng D, Sanfilippo F, Haseler L, Shetty S, Rankin J, Dwivedi G, Yong G. Do Opportunistic Radiological Markers of Frailty on Pre–Transcatheter Aortic Valve Implantation Computed Tomography Predict Outcomes? Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ryan T, Taylor E, Morris C, Gahungu N, Wood C, Sanfilippo F, Haseler L, Shetty S, Rankin J, Yong G, Dwivedi G. Are There Any Echocardiographic or Clinical Markers of Adverse Outcome in Patients Undergoing Transcatheter Aortic Valve Implantation for Low-Gradient Aortic Stenosis? Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
An interim goal of the NHS National Cancer Plan is that, by 2005, patients with cancer should be treated within one month of diagnosis and within two months from urgent general practitioner referral. Preoperative radiotherapy for rectal cancer reduces the risk of local recurrence and may translate into improved patient survival. We conducted a prospective audit of existing waiting times for preoperative radiotherapy experienced by 65 patients with rectal cancer referred to the Christie Cancer Centre, Manchester, UK, between May and November 2002. The median time between referral from the surgeon to the start of radiotherapy was 40 days (range 11-85). Only 4 patients (6%) received radiotherapy within 28 days of referral by the surgeon. 62 patients (95%) underwent surgery within 14 days of completing radiotherapy. Delays in the provision of preoperative radiotherapy were primarily due to shortages of radiography staff and equipment. Lack of such infrastructure will prove a major stumbling block to achieving the targets of the NHS Cancer Plan.
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Affiliation(s)
- S E Duff
- Department of Surgery, Christie Hospital NHS Trust, Manchester M20 4BX, UK.
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Delafontaine A, Presedo A, Mohamed D, Lopes D, Wood C, Alberti C. Equimolar mixture of nitroux oxyde and oxygen during post-operative physiotherapy in patients with cerebral palsy: A randomized, double-blind, placebo-controlled study. Eur J Pain 2017; 21:1657-1667. [PMID: 28726270 DOI: 10.1002/ejp.1071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND The administration of an equimolar mixture of nitrous oxide and oxygen (N2O) is recommended during painful procedures. However, the evaluation of its use during physiotherapy after surgery has not been reported, although pain may hamper physiotherapy efficiency. This study investigated whether the use of N2O improves the efficacy of post-operative physiotherapy after multilevel surgery in patients with cerebral palsy. METHOD It was a randomized 1:1, double-blind, placebo-controlled study. All patients had post-operative physiotherapy starting the day after surgery. Patients received either N2O or placebo gas during the rehabilitation sessions. All patients had post-operative pain management protocol, including pain medication as needed for acute pain. The primary objective was to reach angles of knee flexion of 110° combined with hip extension of 10°, with the patient lying prone, within six or less physiotherapy sessions. Secondary evaluation criteria were the number of sessions required to reach the targeted angles, the session-related pain intensity and the analgesics consumption for managing post-operative pain. RESULTS Sixty-four patients were enrolled. Targeted angles were achieved more often in the N2O group (23 of 32, 72%, vs. Placebo: 13/ of 32, 41%; p = 0.01). CONCLUSION The administration of N2O during post-operative physiotherapy can help to achieve more quickly an improved range of motion, and, although not significant in our study, to alleviate the need for pain medication. Further studies evaluating the administration of N2O in various settings are warranted. SIGNIFICANCE During this randomized placebo-controlled double-blind study, children receiving nitrous oxide and oxygen (N2O) achieved more often the targeted range of motion during physiotherapy sessions after multilevel surgery. Compared to placebo, nitrous oxide and oxygen (N2O) enabled a better management of acute pain related to physiotherapy procedures.
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Affiliation(s)
- A Delafontaine
- AP-HP, Hôpital Robert Debré, Service de Chirurgie Orthopédique, Paris, France
| | - A Presedo
- AP-HP, Hôpital Robert Debré, Service de Chirurgie Orthopédique, Paris, France
| | - D Mohamed
- AP-HP, Hôpital Robert-Debré, URC- UEC, Paris, France
| | - D Lopes
- AP-HP, Hôpital Robert Debré, Service de Chirurgie Orthopédique, Paris, France
| | - C Wood
- Centre de la Douleur Chronique, CHU Dupuytren, Limoges, France
| | - C Alberti
- AP-HP, Hôpital Robert-Debré, URC- UEC, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, UMR-S1123, ECEVE, Paris, France.,INSERM, U1123 and CIC-1426, ECEVE, Paris, France
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Cope EV, Sultana N, Masson EA, Allen BJ, Oboh A, Wilkinson L, Wood C, Lindow SW. Neonatal outcomes following planned preterm delivery in diabetic mothers. J Neonatal Perinatal Med 2017; 10:25-31. [PMID: 28282822 DOI: 10.3233/npm-915148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Women with diabetes may need elective preterm delivery due to pregnancy or diabetes related complications. The aim of this study was to describe the neonatal outcomes arising from elective preterm delivery in diabetic women. METHOD Suitable patients were identified by the obstetric team at Hull Royal Infirmary Women and Children's Hospital and data was extracted from their case notes. 45 diabetic women with planned preterm delivery were identified within a set time frame, resulting in 48 babies. RESULTS Of the 48 babies born, 47 survived. 36 out of 48 were delivered via caesarean section. Gestational ages ranged from 29+3 to 36+6 weeks, and 24 out of 48 (50%) had a birth weight greater than the 90th centile for gestational age.34 out of the 48 babies experienced some form of neonatal complication and were admitted to the neonatal unit. The median duration of stay in the neonatal unit was 7 days. 14 of the surviving neonates suffered from respiratory distress, although only 4 required surfactant therapy to regain respiratory function. However, the incidence of serious neonatal complications in those born after 34 weeks was shown to be low. CONCLUSIONS Elective preterm delivery after 34 weeks had little effect on overall neonatal outcome. Therefore it could be proposed that elective preterm delivery after 34 weeks gestation may be an acceptable option in diabetic women if there are maternal or obstetric complications.
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Affiliation(s)
- E V Cope
- Hull York Medical School, Women and Childrens' Hospital, Hull Royal Infirmary, Hull,UK
| | - N Sultana
- Hull York Medical School, Women and Childrens' Hospital, Hull Royal Infirmary, Hull,UK
| | - E A Masson
- Department Diabetes and Endocrinology, Women and Childrens' Hospital, Hull Royal Infirmary, Hull, UK
| | - B J Allen
- Department Diabetes and Endocrinology, Women and Childrens' Hospital, Hull Royal Infirmary, Hull, UK
| | - A Oboh
- Department Obstetrics Gynaecology, Women and Childrens' Hospital, Hull Royal Infirmary, Hull, UK
| | - L Wilkinson
- Department Diabetes and Endocrinology, Women and Childrens' Hospital, Hull Royal Infirmary, Hull, UK
| | - C Wood
- Department Paediatrics, Women and Childrens' Hospital, Hull Royal Infirmary, Hull, UK
| | - S W Lindow
- Hull York Medical School, Women and Childrens' Hospital, Hull Royal Infirmary, Hull,UK
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Ward J, Wood C, Rouch K, Pienkowski D, Malluche HH. Stiffness and strength of bone in osteoporotic patients treated with varying durations of oral bisphosphonates. Osteoporos Int 2016; 27:2681-2688. [PMID: 27448808 DOI: 10.1007/s00198-016-3661-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 06/02/2016] [Indexed: 10/21/2022]
Abstract
UNLABELLED Apparent modulus and failure stress of trabecular bone structure from 45 women with osteoporosis treated with bisphosphonates for varying durations were studied using finite element analyses and statistical modeling. Following adjustments for patient age and bone volume, increasing bisphosphonate treatment duration for up to 7.3 years was associated with treatment-time-dependent increases in bone apparent modulus and failure stress. Treatment durations exceeding 7.3 years were associated with time-dependent decreases in apparent modulus and failure stress from the peak values observed. INTRODUCTION The purpose of this study was to clarify the relationship between bisphosphonate (BP) treatment duration and human bone quality. This study quantified changes in the apparent modulus and failure stress of trabecular bone biopsied from patients with osteoporosis who were treated with BPs for widely varying durations. METHODS Forty-five iliac crest bone samples were obtained from women with osteoporosis who were continuously treated with oral BPs for varying periods of up to 16 years. Micro-CT imaging was used to develop three-dimensional virtual models of the trabecular bone from these samples. Apparent modulus and failure stress of these virtual models were determined using finite element analyses (FEA). Polynomial regression and cubic splines, adjusted for relevant (age and BV/TV) covariates, were used to statistically model the data and quantify the relationships between BP treatment duration and apparent modulus or failure stress. RESULTS Second-order polynomial models were needed to relate apparent modulus or failure stress to BP treatment duration. These models showed that these bone quality parameters (a) increased with increasing BP treatment duration up to approximately 7.3 years, (b) reached a maximum at this (~7.3 years) time, and then (c) declined with BP treatment durations exceeding ~7.3 years. A similar result was obtained by modeling with cubic splines. CONCLUSIONS Changes in FEA-derived apparent stiffness and failure stress are attributable to changes in trabecular bone structure, which in turn are related to the duration of BP treatment. These relationships are evident even after adjustments are made in the statistical models for changes in age and BV/TV. According to these models, increases in trabecular bone apparent stiffness and failure stress linked to BPs cease and appear to reverse after approximately 7.3 years of treatment. Conclusions regarding optimal BP therapy duration await study of additional bone quality parameters.
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Affiliation(s)
- J Ward
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA
| | - C Wood
- Department of Statistics, University of Kentucky, Lexington, KY, USA
| | - K Rouch
- Department of Mechanical Engineering, University of Kentucky, Lexington, KY, USA
| | - D Pienkowski
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA
| | - H H Malluche
- Division of Nephrology, Bone and Mineral Metabolism, University of Kentucky, Lexington, KY, USA.
- Division of Nephrology, Bone & Mineral Metabolism, University of Kentucky Chandler Medical Center, 800 Rose Street, MN-564, Lexington, KY, 40536-0298, USA.
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Hetherington MM, Wood C, Lyburn S. Response to Energy Dilution in the Short Term: Evidence of Nutritional Wisdom in Young Children? Nutr Neurosci 2016; 3:321-9. [DOI: 10.1080/1028415x.2000.11747329] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
An ongoing study of mother-to-child human herpes virus-8 (HHV-8) transmission in Zambian women ( n = 3160) allowed us to examine the association of medical injections with HIV serostatus while simultaneously accounting for other factors known to be correlated with HIV prevalence. Multi-method data collection included structured interviews, medical record abstraction, clinical examinations, and biological measures. Medically administered intramuscular or intravenous injections in the past five years (but not blood transfusions) were overwhelmingly correlated with HIV prevalence, exceeding the contribution of sexual behaviours in a multivariable logistic regression. Statistically significant associations with HIV also were found for some demographic variables, sexual behaviours, alcohol use, and sexually transmitted diseases (STD). The results confirmed that iatrogenic needle exposure, sexual behaviour, demographic factors, substance use, and STD history are all implicated in Zambian women's HIV+ status. However, the disproportionate association of medical injection history with HIV highlights the need to investigate further and prospectively the role of health-care injection in sub-Saharan Africa's HIV epidemic.
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Affiliation(s)
- J S St Lawrence
- Centers for Disease Control and Prevention, Atlanta, GA, USA.
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