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Butt A, Hayes C, Boland M, Abdulhadi A, Sorenson J, Dowling G, Khalifa M, Keelan S, Giblin K, Downey E, Allen M, Power C, Hill ADK. Effect of the Covid-19 pandemic on breast cancer presentation - a single unit study over 5 years. Ir Med J 2024; 117:912. [PMID: 38446109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
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Carabott MJ, Power C, Widdicombe M, Rough K, Nowak BF, Bott NJ. Dynamics of Cardicola spp. Infection in Ranched Southern Bluefin Tuna: First Observation of C. orientalis at Transfer. Pathogens 2023; 12:1443. [PMID: 38133326 PMCID: PMC10747332 DOI: 10.3390/pathogens12121443] [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: 10/31/2023] [Revised: 11/28/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023] Open
Abstract
Aporocotylid blood flukes Cardicola forsteri and C. orientalis are an ongoing health concern for the Southern Bluefin Tuna (Thunnus maccoyii, SBT) industry, where infections can lead to morbidity and mortality in ranched SBT populations. This study compared blood fluke infection in SBT from two companies during the 2021 ranching season. Both companies administered the same dosage of praziquantel approximately 5 weeks after transfer, feeding with frozen baitfish daily; the only difference in the company's practices was that the pontoons were located 2.5 km apart. Infection severity was measured as prevalence and intensity by quantifying adult C. forsteri in SBT heart and copy numbers of C. forsteri and C. orientalis ITS-2 DNA in SBT heart and gills. Data from the 2018 and 2019 harvests of SBT were used to make comparisons with 2021 harvest data. Cardicola orientalis was detected at transfer and no longer detected after treatment with praziquantel. Cardicola spp. were present in 83% of sampled SBT in 2021. Both companies demonstrated similar patterns of infection, and Company A had higher prevalence and intensity of Cardicola spp. infection. Based on C. forsteri ITS-2 DNA, infection intensity at harvest was significantly greater for both companies in 2021 when compared to 2018 and 2019. Continued monitoring of Cardicola spp. in SBT and improvements in diagnostics contribute to our understanding of Cardicola spp. epizootiology and the detection of changes in treatment efficacy.
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Affiliation(s)
- Melissa J. Carabott
- School of Science, RMIT University, Melbourne, VIC 3083, Australia; (M.J.C.); (C.P.); (M.W.); (B.F.N.)
| | - Cecilia Power
- School of Science, RMIT University, Melbourne, VIC 3083, Australia; (M.J.C.); (C.P.); (M.W.); (B.F.N.)
| | - Maree Widdicombe
- School of Science, RMIT University, Melbourne, VIC 3083, Australia; (M.J.C.); (C.P.); (M.W.); (B.F.N.)
| | - Kirsten Rough
- Australian Southern Bluefin Tuna Industry Association, South Quay Blvd, Port Lincoln, SA 5606, Australia;
| | - Barbara F. Nowak
- School of Science, RMIT University, Melbourne, VIC 3083, Australia; (M.J.C.); (C.P.); (M.W.); (B.F.N.)
| | - Nathan J. Bott
- School of Science, RMIT University, Melbourne, VIC 3083, Australia; (M.J.C.); (C.P.); (M.W.); (B.F.N.)
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Bakal JA, Rivera R, Charlton C, Plitt S, Power C. Evolving etiologies, comorbidities, survival, and costs of care in adult encephalitis. J Neurovirol 2023; 29:605-613. [PMID: 37581843 DOI: 10.1007/s13365-023-01165-9] [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: 03/03/2023] [Revised: 07/10/2023] [Accepted: 07/27/2023] [Indexed: 08/16/2023]
Abstract
Encephalitis is a central nervous system disorder, often caused by infectious agents or aberrant immune responses. We investigated causes, comorbidities, costs, and outcomes of encephalitis in a population-based cohort. ICD-10 codes corresponding to encephalitis were used to identify health services records for all adults from 2004 to 2019. Data were cross-validated for identified diagnoses based on laboratory confirmation using univariate and multivariate statistical analyses. We identified persons with a diagnosis of encephalitis and abnormal cerebrospinal fluid (CSF) results (n = 581) in whom viral genome was detected (n = 315) in a population of 3.2 million adults from 2004 to 2019. Viral genome-positive CSF samples included HSV-1 (n = 133), VZV (n = 116), HSV-2 (n = 34), enterovirus (n = 4), EBV (n = 5), and CMV (n = 3) with the remaining viruses included JCV (n = 12) and HHV-6 (n = 1). The mean Charlson Comorbidity Index (2.0) and mortality rate (37.6%) were significantly higher in the CSF viral genome-negative encephalitis group although the mean costs of care were significantly higher for the CSF viral genome-positive group. Cumulative incidence rates showed increased CSF VZV detection in persons with encephalitis, which predominated in persons over 65 years with a higher mean Charlson index. We detected HSV-2 and VZV more frequently in CSF from encephalitis cases with greater material-social deprivation. The mean costs of care were significantly greater for HSV-1 encephalitis group. Encephalitis remains an important cause of neurological disability and death with a viral etiology in 54.2% of affected adults accompanied by substantial costs of care and mortality. Virus-associated encephalitis is evolving with increased VZV detection, especially in older persons.
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Affiliation(s)
- J A Bakal
- Provincial Research Data Services-Alberta Health Services, Edmonton, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - R Rivera
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - C Charlton
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, AB, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
- Li Ka Shing Institute of Virology, Edmonton, AB, Canada
| | - S Plitt
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, AB, Canada
| | - C Power
- Division of Neurology, Department of Medicine, Medical Research Centre, University of Alberta, 6-11 Heritage, Edmonton, AB, Canada.
- Department of Microbiology, Immunology & Infectious Diseases, University of Calgary, Calgary, AB, Canada.
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Roczkowsky A, Limonta D, Fernandes JP, Branton WG, Clarke M, Hlavay B, Noyce RS, Joseph JT, Ogando NS, Das SK, Elaish M, Arbour N, Evans DH, Langdon K, Hobman TC, Power C. COVID-19 Induces Neuroinflammation and Suppresses Peroxisomes in the Brain. Ann Neurol 2023; 94:531-546. [PMID: 37190821 DOI: 10.1002/ana.26679] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVE Peroxisome injury occurs in the central nervous system (CNS) during multiple virus infections that result in neurological disabilities. We investigated host neuroimmune responses and peroxisome biogenesis factors during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection using a multiplatform strategy. METHODS Brain tissues from coronavirus disease 2019 (COVID-19) (n = 12) and other disease control (ODC) (n = 12) patients, as well as primary human neural cells and Syrian hamsters, infected with a clinical variant of SARS-CoV-2, were investigated by droplet digital polymerase chain reaction (ddPCR), quantitative reverse transcriptase PCR (RT-qPCR), and immunodetection methods. RESULTS SARS-CoV-2 RNA was detected in the CNS of 4 patients with COVID-19 with viral protein (NSP3 and spike) immunodetection in the brainstem. Olfactory bulb, brainstem, and cerebrum from patients with COVID-19 showed induction of pro-inflammatory transcripts (IL8, IL18, CXCL10, NOD2) and cytokines (GM-CSF and IL-18) compared to CNS tissues from ODC patients (p < 0.05). Peroxisome biogenesis factor transcripts (PEX3, PEX5L, PEX11β, and PEX14) and proteins (PEX3, PEX14, PMP70) were suppressed in the CNS of COVID-19 compared to ODC patients (p < 0.05). SARS-CoV-2 infection of hamsters revealed viral RNA detection in the olfactory bulb at days 4 and 7 post-infection while inflammatory gene expression was upregulated in the cerebrum of infected animals by day 14 post-infection (p < 0.05). Pex3 transcript levels together with catalase and PMP70 immunoreactivity were suppressed in the cerebrum of SARS-CoV-2 infected animals (p < 0.05). INTERPRETATION COVID-19 induced sustained neuroinflammatory responses with peroxisome biogenesis factor suppression despite limited brainstem SARS-CoV-2 neurotropism in humans. These observations offer insights into developing biomarkers and therapies, while also implicating persistent peroxisome dysfunction as a contributor to the neurological post-acute sequelae of COVID-19. ANN NEUROL 2023;94:531-546.
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Affiliation(s)
- A Roczkowsky
- Department of Medicine, University of Alberta, Edmonton, AB, USA
| | - D Limonta
- Department of Cell Biology, University of Alberta, Edmonton, AB, USA
- Li Ka Shing Institute of Virology, University of Alberta, Edmonton, AB, USA
| | - J P Fernandes
- Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, AB, USA
| | - W G Branton
- Department of Medicine, University of Alberta, Edmonton, AB, USA
| | - M Clarke
- Department of Medicine, University of Alberta, Edmonton, AB, USA
| | - B Hlavay
- Department of Medicine, University of Alberta, Edmonton, AB, USA
| | - R S Noyce
- Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, AB, USA
| | - J T Joseph
- Department of Pathology, University of Calgary, Calgary, AB, USA
| | - N S Ogando
- Department of Medicine, University of Alberta, Edmonton, AB, USA
| | - S K Das
- Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, AB, USA
| | - M Elaish
- Department of Cell Biology, University of Alberta, Edmonton, AB, USA
| | - N Arbour
- Department of Neuroscience, University of Montreal, and CHUM, Montreal, QC, Canada
| | - D H Evans
- Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, AB, USA
| | - K Langdon
- Department of Pathology, University of Calgary, Calgary, AB, USA
| | - T C Hobman
- Department of Cell Biology, University of Alberta, Edmonton, AB, USA
- Li Ka Shing Institute of Virology, University of Alberta, Edmonton, AB, USA
- Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, AB, USA
| | - C Power
- Department of Medicine, University of Alberta, Edmonton, AB, USA
- Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, AB, USA
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Power C, Carabott M, Widdicombe M, Coff L, Rough K, Nowak B, Bott NJ. Effects of company and season on blood fluke ( Cardicola spp.) infection in ranched Southern Bluefin Tuna: preliminary evidence infection has a negative effect on fish growth. PeerJ 2023; 11:e15763. [PMID: 37520261 PMCID: PMC10377432 DOI: 10.7717/peerj.15763] [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] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Aporocotylid blood flukes Cardicola forsteri and C. orientalis are an ongoing health concern for Southern Bluefin Tuna (SBT), Thunnus maccoyii, ranched in Australia. Therapeutic application of praziquantel (PZQ) has reduced SBT mortalities, however PZQ is not a residual treatment therefore reinfection can occur after the single treatment application. This study documents the epidemiology of Cardicola spp. infection in ranched SBT post treatment over three ranching seasons (2018, 2019 and 2021). Infection prevalence (percentage of SBT affected) and intensity (parasite load) was determined by adult fluke counts from heart, egg counts from gill filaments and the use of specific quantitative polymerase chain reaction (qPCR) for detection of C. forsteri and C. orientalis ITS-2 DNA in SBT hearts and gills. SBT Condition Index decreased as intensity of Cardicola spp. DNA in SBT gills increased, suggesting blood fluke infection had a negative effect on SBT growth (Spearman's r = -0.2426, d.f. = 138, p = 0.0041). Prevalence and intensity of infection indicated PZQ remained highly effective at controlling Cardicola spp. infection in ranched SBT, 10 years after PZQ administration began in this industry. Company A had the highest prevalence and intensity of Cardicola spp. infection in 2018, and Company G had the highest in 2019. No consistent pattern was seen in 2021. Overall, intensity of infection did not increase as ranching duration increased post treatment. Results from this study improve our knowledge of the biology of blood flukes and helps the SBT industry to modify or design new blood fluke management strategies to reduce health risks and improve performance of SBT.
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Affiliation(s)
- Cecilia Power
- School of Science, Royal Melbourne Institute of Technology, Melbourne, Victoria, Australia
| | - Melissa Carabott
- School of Science, Royal Melbourne Institute of Technology, Melbourne, Victoria, Australia
| | - Maree Widdicombe
- School of Science, Royal Melbourne Institute of Technology, Melbourne, Victoria, Australia
| | - Lachlan Coff
- School of Science, Royal Melbourne Institute of Technology, Melbourne, Victoria, Australia
| | - Kirsten Rough
- Australian Southern Bluefin Tuna Industry Association, Port Lincoln, South Australia, Australia
| | - Barbara Nowak
- School of Science, Royal Melbourne Institute of Technology, Melbourne, Victoria, Australia
| | - Nathan J. Bott
- School of Science, Royal Melbourne Institute of Technology, Melbourne, Victoria, Australia
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Hlavay BA, Zhuo R, Ogando N, Charlton C, Stapleton JT, Klein MB, Power C. Human pegivirus viremia in HCV/HIV co-infected patients: Direct acting antivirals exert anti-pegivirus effects. J Clin Virol 2023; 162:105445. [PMID: 37043902 DOI: 10.1016/j.jcv.2023.105445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/16/2023] [Accepted: 03/31/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND Human pegivirus (HPgV) is a single-stranded RNA virus that is closely related to hepatitis C virus (HCV). HPgV has also been shown to infect patients with human immunodeficiency virus (HIV). The mechanisms and disease outcomes of HPgV infections are largely unknown, although it has been implicated in both cancer and neurological diseases. There are no established therapies for HPgV. OBJECTIVES To estimate the prevalence of HPgV in a cohort of HCV/HIV co-infected patients undergoing treatment for HCV with direct acting antivirals (DAA) and investigate the effect of DAA therapy on HPgV infection. STUDY DESIGN RNA was extracted from plasma samples collected at time points before, during, and after DAA. HPgV RNA abundance was quantified by droplet digital PCR assays targeting the NS5A and 5'UTR domains and confirmed by RT-qPCR. Clinical, demographic and treatment data were analysed. RESULTS HPgV RNA was detected and quantified in 26 of 100 patients' plasma (26%) before starting DAA. Patients with detectable HPgV were more likely to be male, had higher peak HIV plasma levels, and a history of injection drug use. Patients receiving sofosbuvir/ledipasvir (n = 9) displayed significantly lower HPgV levels at time of DAA completion and had lower post-DAA HPgV rebound levels compared to patients receiving sofosbuvir/velpatasvir (n = 11) although both regimens significantly reduced viremia directly following DAA completion. Sustained suppression of HPgV was also observed among patients (n = 2) receiving pegylated-interferon. CONCLUSIONS HPgV RNA was frequently detected in HCV/HIV co-infected patients and was supressed by DAA and pegylated interferon therapies with sofosbuvir-ledipasvir showing greatest antiviral activity. These findings suggest potential treatment strategies for HPgV infections.
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Affiliation(s)
- B A Hlavay
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - R Zhuo
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, AB, Canada
| | - N Ogando
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - C Charlton
- Laboratory Medicine & Pathology, University of Alberta, Edmonton, AB, Canada; Li Ka Shing Institute of Virology, University of Alberta, Edmonton, AB, Canada; Public Health Laboratory, Alberta Precision Laboratories, Edmonton, AB, Canada
| | - J T Stapleton
- Departments of Internal Medicine and Microbiology, University of Iowa, Iowa City, Iowa, USA
| | - M B Klein
- Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - C Power
- Department of Medicine, University of Alberta, Edmonton, AB, Canada.
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Perret LC, Geoffroy MC, Barr E, Parnet F, Provencal N, Boivin M, O’Donnell KJ, Suderman M, Power C, Turecki G, Ouellet-Morin I. Associations between epigenetic aging and childhood peer victimization, depression, and suicidal ideation in adolescence and adulthood: A study of two population-based samples. Front Cell Dev Biol 2023; 10:1051556. [PMID: 36712964 PMCID: PMC9879289 DOI: 10.3389/fcell.2022.1051556] [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: 09/22/2022] [Accepted: 12/19/2022] [Indexed: 01/13/2023] Open
Abstract
Background: Prior studies indicate that peer victimization (including bullying) is associated with higher risk for depression and suicidal ideation across the life course. However, molecular mechanisms underlying these associations remain unclear. This two-cohort study proposes to test whether epigenetic aging and pace of aging, as well as a DNA methylation marker of responsive to glucocorticoids, are associated to childhood peer victimization and later depressive symptoms, or suicidal ideation. Methods: Cohort 1: Epigenome-wide DNA methylation (EPIC array) was measured in saliva collected when participants were 10.47 years (standard deviation = 0.35) in a subsample of the Quebec Longitudinal Study of Child Development (QLSCD, n = 149 participants), with self-reported peer victimization at 6-8 years, depressive symptoms (mean symptoms, and dichotomized top 30% symptoms) and suicidal ideation at 15-17 years. Cohort 2: Epigenome-wide DNA methylation (EPIC array) was measured in blood collected from participants aged 45.13 years (standard deviation = 0.37) in a subsample of the 1958 British Birth cohort (1958BBC, n = 238 participants) with information on mother-reported peer victimization at 7-11 years, self-reported depressive symptoms at 50 years, and suicidal ideation at 45 years. Five epigenetic indices were derived: three indicators of epigenetic aging [Horvath's pan-tissue (Horvath1), Horvath's Skin-and-Blood (Horvath2), Pediatric-Buccal-Epigenetic age (PedBE)], pace of aging (DunedinPACE), and stress response reactivity (Epistress). Results: Peer victimization was not associated with the epigenetic indices in either cohort. In the QLSCD, higher PedBE epigenetic aging and a slower pace of aging as measured by DunedinPACE predicted higher depressive symptoms scores. In contrast, neither the Horvath1, or Horvath2 epigenetic age estimates, nor the Epistress score were associated with depressive symptoms in either cohort, and none of the epigenetic indices predicted suicidal ideation. Conclusion: The findings are consistent with epigenome-wide and candidate gene studies suggesting that these epigenetic indices did not relate to peer victimization, challenging the hypothesis that cumulative epigenetic aging indices could translate vulnerability to depressive symptoms and suicidal ideation following peer victimization. Since some indices of epigenetic aging and pace of aging signaled higher risk for depressive symptoms, future studies should pursue this investigation to further evaluate the robustness and generalization of these preliminary findings.
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Affiliation(s)
- L. C. Perret
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - M-C. Geoffroy
- Department of Psychiatry, McGill University, Montreal, QC, Canada,Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - E. Barr
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - F. Parnet
- School of Criminology, Research Center of the Montreal Mental Health University Institute, Université de Montréal, Montreal, QC, Canada
| | - N. Provencal
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - M. Boivin
- School of Psychology, Université Laval, Québec City, QC, Canada
| | - K. J. O’Donnell
- Department of Psychiatry, McGill University, Montreal, QC, Canada,Yale Child Study Center, Yale School of Medicine, New Haven, CT, United States,Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, United States,Child and Brain Development Program, CIFAR, Toronto, ON, Canada
| | - M. Suderman
- MRC Integrative Epidemiology Unit, Bristol Medical School, Bristol Population Health Science Institute, Bristol, United Kingdom
| | - C. Power
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - G. Turecki
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - I. Ouellet-Morin
- School of Criminology, Research Center of the Montreal Mental Health University Institute, Université de Montréal, Montreal, QC, Canada,*Correspondence: I. Ouellet-Morin,
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Hennessy G, Boland M, Bambrick M, Crone L, Lloyd A, Abdelwahab S, Downey E, Staunton M, Hambly N, Mhuircheartaigh NN, Kerr J, Power C, Duke D, Hill ADK. Value of long-term follow-up in surgically excised lesions of uncertain malignant potential in the breast – Is 5 years necessary? Clin Breast Cancer 2022; 22:699-704. [DOI: 10.1016/j.clbc.2022.05.009] [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] [Received: 08/26/2021] [Revised: 04/30/2022] [Accepted: 05/29/2022] [Indexed: 11/29/2022]
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Norbury LJ, Shirakashi S, Power C, Nowak BF, Bott NJ. Praziquantel use in aquaculture - Current status and emerging issues. Int J Parasitol Drugs Drug Resist 2022; 18:87-102. [PMID: 35220160 PMCID: PMC8881684 DOI: 10.1016/j.ijpddr.2022.02.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 02/13/2022] [Accepted: 02/17/2022] [Indexed: 12/02/2022]
Abstract
Parasitic diseases are major constraints in fish mariculture. The anthelmintic praziquantel (PZQ) can effectively treat a range of flatworm parasites in a variety of fish species and has potential for broader application than its current use in the global aquaculture industry. In this review we report on PZQ's current use in the aquaculture industry and discuss its efficacy against various flatworm parasites of fish. Routes of PZQ administration are evaluated, along with issues related to palatability, pharmacokinetics and toxicity in fish, while PZQ's effects on non-target species, environmental impacts, and the development of drug-resistance are discussed.
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Affiliation(s)
- Luke J Norbury
- School of Science, STEM College, RMIT University, Bundoora, 3083, Victoria, Australia
| | - Sho Shirakashi
- Aquaculture Research Institute, Kindai University, Wakayama, 649-2211, Japan
| | - Cecilia Power
- School of Science, STEM College, RMIT University, Bundoora, 3083, Victoria, Australia
| | - Barbara F Nowak
- School of Science, STEM College, RMIT University, Bundoora, 3083, Victoria, Australia; Institute for Marine and Antarctic Studies, University of Tasmania, Launceston, 7250, Tasmania, Australia
| | - Nathan J Bott
- School of Science, STEM College, RMIT University, Bundoora, 3083, Victoria, Australia.
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Lloyd A, Abd Elwahab S, Boland M, Elfadul A, Hill A, Power C. Acute complicated appendicitis caused by an ingested toothpick – A case report. Int J Surg Case Rep 2022; 92:106872. [PMID: 35259701 PMCID: PMC8902606 DOI: 10.1016/j.ijscr.2022.106872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/16/2022] [Accepted: 02/22/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction and importance Acute appendicitis is one of the most common presentations to the emergency department, particularly in young adults. A combination of clinical suspicion, inflammatory blood markers and imaging modalities such as ultrasound and CT are used for its definitive diagnosis. Early detection and intervention are paramount to reduce morbidity and mortality. Laparoscopic appendicectomy is the current gold standard in the management of appendicitis, especially if complicated according to EAES guidelines. There are few documented cases in the literature of acute appendicitis secondary to foreign body ingestion. On account of this, there are currently no guidelines for its management. Our literature review highlights the importance of surgical management of foreign body acute appendicitis. Case presentation This case report describes the rare presentation of acute complicated appendicitis caused by an ingested toothpick in a 64 year old woman. The patient was admitted with a 3 day history of lower abdominal pain, localizing to the right iliac fossa with raised inflammatory markers. CT imaging reported acute complicated appendicitis. Laparoscopic appendicectomy was performed during which a toothpick was seen protruding through the appendiceal wall. Post operatively the patient was treated with IV antibiotics for 5 days prior to discharge. Clinical discussion Due to the rare nature of foreign body appendicitis there are no specific guidelines on the respective surgical approach. A literature review showed that in the setting of foreign body appendicitis, surgical intervention is paramount with no scope for conservative management. Conclusion Surgical approach is based on the clinical judgement and skillset of the operating surgeon. Remember foreign body ingestion as a cause of appendicitis Management of foreign body appendicitis is surgical intervention. Open vs laparoscopic approach depends on the surgeons clinical judgement, preference and skillset.
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Power C, Evenden S, Rough K, Webber C, Widdicombe M, Nowak BF, Bott NJ. Prevalence and Intensity of Cardicola spp. Infection in Ranched Southern Bluefin Tuna and a Comparison of Diagnostic Methods. Pathogens 2021; 10:pathogens10101248. [PMID: 34684197 PMCID: PMC8541539 DOI: 10.3390/pathogens10101248] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/24/2021] [Accepted: 09/24/2021] [Indexed: 11/21/2022] Open
Abstract
The parasitic blood flukes Cardicola forsteri and C. orientalis are an ongoing health concern for Southern Bluefin Tuna Thunnus maccoyii (SBT) ranched in Australia. In this study we compared the effect of treatment, company, and ranching year on blood fluke infections in ranched SBT. SBT were sampled during the 2018 and 2019 ranching seasons from praziquantel (PZQ) treated pontoons and untreated pontoons managed by two companies. Severity of infection was diagnosed by several criteria including adult fluke counts from hearts, egg counts from gill filaments and the use of specific quantitative polymerase chain reaction (qPCR) for detection of C. forsteri and C. orientalis ITS-2 DNA in SBT hearts and gills. PZQ treatment remains highly effective against C. forsteri infection. Prevalence and intensity of Cardicola spp. infection was lower in 2019 than 2018 for Company A in treated pontoons at week 12 and week 17 of ranching, and lower for Company A than Company B in untreated pontoons at month 5 of ranching. Results indicate re-infection may be less likely in the environment near Company A pontoons, and consistent years of treatment may have lowered the parasite load in the environment. qPCR demonstrated higher sensitivity when comparing diagnostic methods for C. forsteri in heart, and higher specificity when comparing diagnostic methods for Cardicola spp. in gills. Continuing to monitor blood fluke infections in ranched SBT can help to detect changes in drug efficacy over time and help industry to develop a best practice for treatment.
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Affiliation(s)
- Cecilia Power
- School of Science, RMIT University, Bundoora, VIC 3083, Australia; (C.P.); (M.W.); (B.F.N.)
| | - Shannon Evenden
- Australian Southern Bluefin Tuna Industry Association, South Quay Blvd, Port Lincoln, SA 5606, Australia; (S.E.); (K.R.); (C.W.)
| | - Kirsten Rough
- Australian Southern Bluefin Tuna Industry Association, South Quay Blvd, Port Lincoln, SA 5606, Australia; (S.E.); (K.R.); (C.W.)
| | - Claire Webber
- Australian Southern Bluefin Tuna Industry Association, South Quay Blvd, Port Lincoln, SA 5606, Australia; (S.E.); (K.R.); (C.W.)
| | - Maree Widdicombe
- School of Science, RMIT University, Bundoora, VIC 3083, Australia; (C.P.); (M.W.); (B.F.N.)
| | - Barbara F. Nowak
- School of Science, RMIT University, Bundoora, VIC 3083, Australia; (C.P.); (M.W.); (B.F.N.)
| | - Nathan J. Bott
- School of Science, RMIT University, Bundoora, VIC 3083, Australia; (C.P.); (M.W.); (B.F.N.)
- Correspondence:
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12
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Coff L, Abrahams JL, Collett S, Power C, Nowak BF, Kolarich D, Bott NJ, Ramsland PA. Profiling the glycome of Cardicola forsteri, a blood fluke parasitic to bluefin tuna. Int J Parasitol 2021; 52:1-12. [PMID: 34391752 DOI: 10.1016/j.ijpara.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 11/05/2022]
Abstract
Infections by blood flukes (Cardicola spp.) are considered the most significant health issue for ranched bluefin tuna, a major aquaculture industry in Japan and Australia. The host-parasite interfaces of trematodes, namely their teguments, are particularly rich in carbohydrates, which function both in evasion and modulation of the host immune system, while some are primary antigenic targets. In this study, histochemistry and mass spectrometry techniques were used to profile the glycans of Cardicola forsteri. Fluorescent lectin staining of adult flukes indicates the presence of oligomannose (Concanavalin A-reactive) and fucosylated (Pisum sativum agglutinin-reactive) N-glycans. Additionally, reactivity of succinylated wheat germ agglutinin (s-WGA) was localised to several internal organs of the digestive and monoecious reproductive systems. Glycan structures were further investigated with tandem mass spectrometry, which revealed structures indicated by lectin reactivity. While O-glycans from these adult specimens were not detectable by mass spectrometry, several oligomannose, paucimannosidic, and complex-type N-glycans were identified, including some carrying hexuronic acid and many carrying core xylose. This is, to our knowledge, the first glycomic characterisation of a marine platyhelminth, with broader implications for research into other trematodes.
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Affiliation(s)
- Lachlan Coff
- School of Science, STEM College, RMIT University, Bundoora, VIC 3083, Australia
| | - Jodie L Abrahams
- Institute for Glycomics, Griffith University, Southport, QLD 4215, Australia
| | - Simon Collett
- School of Science, STEM College, RMIT University, Bundoora, VIC 3083, Australia
| | - Cecilia Power
- School of Science, STEM College, RMIT University, Bundoora, VIC 3083, Australia
| | - Barbara F Nowak
- School of Science, STEM College, RMIT University, Bundoora, VIC 3083, Australia; Institute for Marine and Antarctic Studies, University of Tasmania, Locked Bag 1370, Launceston, TAS 7250, Australia
| | - Daniel Kolarich
- Institute for Glycomics, Griffith University, Southport, QLD 4215, Australia; ARC Centre of Excellence for Nanoscale BioPhotonics, Griffith University, Southport, QLD 4215, Australia
| | - Nathan J Bott
- School of Science, STEM College, RMIT University, Bundoora, VIC 3083, Australia.
| | - Paul A Ramsland
- School of Science, STEM College, RMIT University, Bundoora, VIC 3083, Australia; Department of Immunology, Monash University, Melbourne, VIC 3004, Australia; Department of Surgery, Austin Health, University of Melbourne, Heidelberg, VIC 3084, Australia.
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13
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Alluqmani M, Roda W, Qqrmli M, Blevins G, Giuliani F, Power C. Differential disease phenotypes and progression in relapsing-remitting multiple sclerosis: comparative analyses of single Canadian and Saudi Arabian clinics. BMC Neurol 2021; 21:295. [PMID: 34311734 PMCID: PMC8314572 DOI: 10.1186/s12883-021-02317-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/02/2021] [Indexed: 12/04/2022] Open
Abstract
Objective Relapsing–remitting multiple sclerosis (RR-MS) phenotypes differ widely although the variables contributing to this heterogeneity remain uncertain. To assess geographic and ethnic effects on RR-MS phenotypes, we investigated RR-MS patients in Canada and Saudi Arabia. Methods A retrospective analysis of patients followed in two MS Clinics was performed in Medina, Saudi Arabia and Edmonton, Canada. Demographic and clinical data were collected for each patient and analyzed using univariable and multivariable statistics. Univariable and multivariable linear regression were used to distinguish the significant clinical and demographic features and neurological systems associated with the change in expanded disability status scale (EDSS) between clinical assessments. Results Patients with treated RR-MS were recruited (n = 51, Saudi; n = 47, Canada) although the disease duration was longer in the Canadian cohort (5.6 ± 2.2 yr.) compared to the Saudi cohort (4.4 ± 1.4 yr.) (P < 0.05), annual relapse rate and EDSS change were higher in the Saudi cohort (P < 0.05). Infratentorial lesion-associated presentation differed (Canada, n = 23; Saudi, n = 13) among groups (P < 0.05). Spinal cord lesions on MRI were more frequently detected in Canadian (n = 23) compared to Saudi (n = 1) patients (P < 0.05). Patients within the Saudi cohort displayed a significantly greater change in Expanded Disability Status Scale (EDSS) between first and second assessments. Conclusions Despite differences in geographic location, ethnicity, and predominance of infratentorial lesions in the Canadian group, the RR-MS phenotypes were similar although the Saudi cohort displayed a more severe disease course. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02317-2.
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Affiliation(s)
- M Alluqmani
- Department of Medicine (Neurology), University of Alberta, 6-11 Heritage Medical Research Centre, Edmonton, AB, Canada.,Department of Medicine, University of Taibah, Medina, Saudi Arabia
| | - W Roda
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, AB, Canada
| | - M Qqrmli
- Department of Medicine, University of Taibah, Medina, Saudi Arabia
| | - G Blevins
- Department of Medicine (Neurology), University of Alberta, 6-11 Heritage Medical Research Centre, Edmonton, AB, Canada
| | - F Giuliani
- Department of Medicine (Neurology), University of Alberta, 6-11 Heritage Medical Research Centre, Edmonton, AB, Canada
| | - C Power
- Department of Medicine (Neurology), University of Alberta, 6-11 Heritage Medical Research Centre, Edmonton, AB, Canada.
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14
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Bakal JA, Charlton CL, Hlavay B, Jansen GH, Svenson LW, Power C. Progressive multifocal leukoencephalopathy and Creutzfeldt-Jakob disease: population-wide incidences, comorbidities, costs of care, and outcomes. J Neurovirol 2021; 27:476-481. [PMID: 33978904 DOI: 10.1007/s13365-021-00983-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/20/2021] [Accepted: 04/27/2021] [Indexed: 10/21/2022]
Abstract
Neurological disorders associated with chronic infections are often progressive as well as challenging to diagnose and manage. Among 4.4 million persons from 2004 to 2019 receiving universal health, progressive multifocal leukoencephalopathy (PML, n = 58) and Creutzfeldt-Jakob disease (CJD, n = 93) cases were identified, revealing stable yearly incidence rates with divergent comorbidities: HIV/AIDS affected 37.8% of PML cases while cerebrovascular disease affected 26.9% of CJD cases. Most CJD cases died within 1 year (73%) although PML cases lived beyond 5 years (34.1%) despite higher initial costs of care. PML and CJD represent important neurological disorders with evolving risk variables and impact on health care.
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Affiliation(s)
- J A Bakal
- Provincial Research Data Services-Alberta Health Services, Edmonton, AB, Canada
| | - C L Charlton
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, AB, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
- Li Ki Sheng Institute of Virology, Edmonton, AB, Canada
| | - B Hlavay
- Department of Medicine, Medical Research Centre, University of Alberta, 6-11 Heritage, Edmonton, AB, Canada
| | - G H Jansen
- Division of Anatomical Pathology, University of Ottawa, Ottawa, ON, Canada
| | - L W Svenson
- Department of Medicine, Medical Research Centre, University of Alberta, 6-11 Heritage, Edmonton, AB, Canada
- Analytics & Performance Reporting Branch, Alberta Health, Edmonton, AB, Canada
- School of Public Health, University of Alberta, Edmonton, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - C Power
- Department of Medicine, Medical Research Centre, University of Alberta, 6-11 Heritage, Edmonton, AB, Canada.
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15
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Eustace AJ, Madden SF, Fay J, Collins DM, Kay EW, Sheehan KM, Furney S, Moran B, Fagan A, Morris PG, Teiserskiene A, Hill AD, Grogan L, Walshe JM, Breathnach O, Power C, Duke D, Egan K, Gallagher WM, O'Donovan N, Crown J, Toomey S, Hennessy BT. The role of infiltrating lymphocytes in the neo-adjuvant treatment of women with HER2-positive breast cancer. Breast Cancer Res Treat 2021; 187:635-645. [PMID: 33983492 PMCID: PMC8197702 DOI: 10.1007/s10549-021-06244-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 04/22/2021] [Indexed: 11/28/2022]
Abstract
Background Pre-treatment tumour-associated lymphocytes (TILs) and stromal lymphocytes (SLs) are independent predictive markers of future pathological complete response (pCR) in HER2-positive breast cancer. Whilst studies have correlated baseline lymphocyte levels with subsequent pCR, few have studied the impact of neoadjuvant therapy on the immune environment. Methods We performed TIL analysis and T-cell analysis by IHC on the pretreatment and ‘On-treatment’ samples from patients recruited on the Phase-II TCHL (NCT01485926) clinical trial. Data were analysed using the Wilcoxon signed-rank test and the Spearman rank correlation. Results In our sample cohort (n = 66), patients who achieved a pCR at surgery, post-chemotherapy, had significantly higher counts of TILs (p = 0.05) but not SLs (p = 0.08) in their pre-treatment tumour samples. Patients who achieved a subsequent pCR after completing neo-adjuvant chemotherapy had significantly higher SLs (p = 9.09 × 10–3) but not TILs (p = 0.1) in their ‘On-treatment’ tumour biopsies. In a small cohort of samples (n = 16), infiltrating lymphocyte counts increased after 1 cycle of neo-adjuvant chemotherapy only in those tumours of patients who did not achieve a subsequent pCR. Finally, reduced CD3 + (p = 0.04, rho = 0.60) and CD4 + (p = 0.01, rho = 0.72) T-cell counts in 'On-treatment' biopsies were associated with decreased residual tumour content post-1 cycle of treatment; the latter being significantly associated with increased likelihood of subsequent pCR (p < 0.01). Conclusions The immune system may be ‘primed’ prior to neoadjuvant treatment in those patients who subsequently achieve a pCR. In those patients who achieve a pCR, their immune response may return to baseline after only 1 cycle of treatment. However, in those who did not achieve a pCR, neo-adjuvant treatment may stimulate lymphocyte influx into the tumour. Supplementary Information The online version contains supplementary material available at 10.1007/s10549-021-06244-1.
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Affiliation(s)
- A J Eustace
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland.
| | - S F Madden
- Data Science Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - J Fay
- Department of Histopathology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - D M Collins
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - E W Kay
- Department of Histopathology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - K M Sheehan
- Department of Histopathology, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - S Furney
- Department of Physiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - B Moran
- Conway Institute, University College Dublin, Dublin, Ireland
| | - A Fagan
- Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - P G Morris
- Department of Medical Oncology, Beaumont Hospital, Dublin, Ireland
| | | | - A D Hill
- Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - L Grogan
- Department of Medical Oncology, Beaumont Hospital, Dublin, Ireland
| | - J M Walshe
- Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland
| | - O Breathnach
- Department of Medical Oncology, Beaumont Hospital, Dublin, Ireland
| | - C Power
- Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - D Duke
- Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - K Egan
- Cancer Clinical Trials and Research Unit, Beaumont Hospital, Dublin, Ireland
| | - W M Gallagher
- Conway Institute, University College Dublin, Dublin, Ireland
| | - N O'Donovan
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - J Crown
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland.,Cancer Trials Ireland, Dublin, Ireland
| | - S Toomey
- Medical Oncology Group, Department of Molecular Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - B T Hennessy
- Cancer Trials Ireland, Dublin, Ireland.,Medical Oncology Group, Department of Molecular Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
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16
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Keelan S, Sorensen J, Downey E, Hegarty A, Nelson T, Duke D, Power C, Hill A. O30: EVALUATION OF AXILLARY LYMPH NODE METASTATIC BURDEN BY PREOPERATIVE ULTRASOUND. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Sentinel lymph node biopsy (SLNB) is the gold standard for determining axillary nodal status. There is growing interest in using preoperative axillary ultrasound (AUS) as a non-invasive means of assessing the axilla. However, AUS has limited sensitivity and is subject to operator dependency. This study aimed to quantify axillary nodal burden in preoperative AUS.
Method
This retrospective study used an institutional database of all primary invasive breast carcinomas from 2006–2019. Those with pathologically proven axillary metastatic disease were included. Patients were considered in two groups, low nodal burden/LNB(1-2LN) and high nodal burden/HNB(≥3LN) based on total positive lymph node count(SLNB+ALND). Preoperative AUS reports were assessed to determine those suspicious for axillary metastasis.
Result
Of the 347 patients (n=349 axillae), 77.9% had LNB and 22.1% had HNB. In patients with LNB, 228(83.8%) had a normal AUS versus 44(16.2%) suspicious AUS. In those with HNB 60(77.9%) had normal AUS findings versus 17(22.1%) suspicious findings. On multivariate analysis Nottingham Grade-3 was associated with suspicious AUS findings (p=0.02). However, receptor status, SLN macro-metastasis and extra-nodal extension were not associated with abnormal AUS.
Conclusion
As the surgical approach to the axilla becomes increasingly conservative, detection of axillary involvement by non-invasive means is an area of increasing research. In this cohort, AUS did not reliably identify patients with axillary metastasis. These results highlight the challenges in accurately assessing the axilla using preoperative AUS, which may result in axillary undertreatment if used as an alternative to surgical staging.
Take-home message
As the surgical approach to the axilla becomes increasingly conservative, detection of axillary involvement by non-invasive means is an area of increasing research. This study highlights the challenges in accurately assessing the axilla using preoperative AUS, which may result in axillary undertreatment if used as an alternative to surgical staging.
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Affiliation(s)
- S Keelan
- Department of Surgery, Royal College of Surgeons in Ireland, Department of Surgery, 123 St Stephen's Green, Dublin, D02 YN77
| | - J Sorensen
- Royal College of Surgeons in Ireland, Department of Surgery, Healthcare Outcomes Research Centre (HORC), Beaux Lane House, Mercer Street Lower, Dublin 2
| | - E Downey
- Department of Surgery, Royal College of Surgeons in Ireland, Department of Surgery, 123 St Stephen's Green, Dublin, D02 YN77
| | - A Hegarty
- Department of Surgery, Royal College of Surgeons in Ireland, Department of Surgery, 123 St Stephen's Green, Dublin, D02 YN77
| | - T Nelson
- Department of Surgery, Royal College of Surgeons in Ireland, Department of Surgery, 123 St Stephen's Green, Dublin, D02 YN77
| | - D Duke
- Beaumont Hospital P.O. Box 1297, Beaumont Road, Dublin 9, Ireland
| | - C Power
- Beaumont Hospital P.O. Box 1297, Beaumont Road, Dublin 9, Ireland
| | - A Hill
- Department of Surgery, Royal College of Surgeons in Ireland, Department of Surgery, 123 St Stephen's Green, Dublin, D02 YN77
- Beaumont Hospital P.O. Box 1297, Beaumont Road, Dublin 9, Ireland
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Patel PG, Keen P, McManus H, Duck T, Callander D, Selvey C, Power C, Gray RT, Knight V, Asselin J, Read P, Johnson K, Bavinton BR, Bowden VJ, Grulich AE, Guy R. Increased targeted HIV testing and reduced undiagnosed HIV infections among gay and bisexual men. HIV Med 2021; 22:605-616. [PMID: 33876526 DOI: 10.1111/hiv.13102] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 07/13/2020] [Revised: 02/17/2021] [Accepted: 02/24/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To evaluate the impact of government HIV strategies that aimed to increase HIV testing uptake and frequency among gay and bisexual men (GBM) in New South Wales (NSW), Australia. DESIGN We analysed HIV testing data from existing passive and sentinel surveillance systems between 2010 and 2018. METHODS Six indicators were measured: (1) state-wide total HIV laboratory tests; (2) number of GBM attending publicly-funded clinics; (3) 12-monthly testing uptake; (4) annual testing frequency; (5) HIV testing with a STI diagnosis; and (6) HIV positivity. Mathematical modelling was used to estimate (7) the proportion of men with undiagnosed HIV. Indicators were stratified by Australian vs. overseas-born. RESULTS Overall, 43,560 GBM attended participating clinics (22,662 Australian-born, 20,834 overseas-born) from 2010-2018. Attendees increased from 5,186 in 2010 to 16,507 in 2018. There were increasing trends (p<0.001 for all) in testing uptake (83.9% to 95.1%); testing with a STI diagnosis (68.7% to 94.0%); annual HIV testing frequency (1.4 to 2.7); and a decreasing trend (p<0.01) in HIV positivity (1.7% to 0.9%).Increases in testing were similar in Australian-born and overseas-born GBM. However, there were decreasing trends in the estimated undiagnosed HIV proportion overall (9.5% to 7.7%) and in Australian-born GBM (7.1% to 2.8%), but an increasing trend in overseas-born GBM (15.3% to 16.9%) (p<0.001 for all).
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Affiliation(s)
- P G Patel
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - P Keen
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - H McManus
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - T Duck
- New South Wales Ministry of Health, Sydney, NSW, Australia
| | - D Callander
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.,New York University Spatial Epidemiology Lab, School of Medicine, New York University, New York, NY, USA
| | - C Selvey
- Health Protection NSW, Sydney, Australia
| | - C Power
- New South Wales Ministry of Health, Sydney, NSW, Australia
| | - R T Gray
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - V Knight
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.,Sydney Sexual Health Centre, Sydney, NSW, Australia
| | - J Asselin
- Burnet Institute, Melbourne, NSW, Australia
| | - P Read
- Kirketon Road Centre, Kings Cross, NSW, Australia
| | | | - B R Bavinton
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - V J Bowden
- Health Protection NSW, Sydney, Australia
| | - A E Grulich
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - R Guy
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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Cheng C, Gomez D, McCombe JA, Smyth P, Giuliani F, Blevins G, Baker GB, Power C. Disability progression in multiple sclerosis is associated with plasma neuroactive steroid profile. Neurol Sci 2021; 42:5241-5247. [PMID: 33829329 DOI: 10.1007/s10072-021-05203-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 03/17/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Neuroactive steroids (NASs) exert multiple biological effects on development and inflammation. The effects of NASs on disease progression in multiple sclerosis (MS) are uncertain, prompting analyses of NAS profiles during the transition from clinically isolated syndrome (CIS) to relapsing-remitting (RR) MS. METHODS Subjects with CIS or RRMS and healthy controls (HCs) were recruited; demographic and clinical data as well as disability scores measured by the Expanded Disability Status Scale (EDSS) were recorded. Matched plasma NAS and amino acid (AA) concentrations were measured. RESULTS HC (n = 17), CIS (n = 31), and RRMS (n = 33) groups showed similar ages and sex distribution although disability scores were higher in the RRMS group. The conversion rate of CIS to RRMS group was 51.6% (n = 16) during a mean follow-up period of 1.85 years. The RRMS group showed significantly higher mean allopregnanolone, aspartate, and taurine concentrations with lower epiallopregnanolone concentrations than CIS patients, and higher L-serine-O-phosphate and lower alanine, arginine, and glutamine concentrations than the HC group. Among CIS and RRMS groups, multivariate hierarchical regressions revealed that higher concentrations of plasma tetrahydrodeoxycorticosterone (THDOC) may predict disability worsening. CONCLUSIONS RRMS and CIS patients exhibited differing concentrations of both NASs and AAs in plasma while both THDOC and pregnanolone might serve as biomarkers of disability worsening.
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Affiliation(s)
- C Cheng
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - D Gomez
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - J A McCombe
- Department of Medicine (Neurology), HMRC 6-11, University of Alberta, Edmonton, AB, Canada
| | - P Smyth
- Department of Medicine (Neurology), HMRC 6-11, University of Alberta, Edmonton, AB, Canada
| | - F Giuliani
- Department of Medicine (Neurology), HMRC 6-11, University of Alberta, Edmonton, AB, Canada
| | - G Blevins
- Department of Medicine (Neurology), HMRC 6-11, University of Alberta, Edmonton, AB, Canada
| | - G B Baker
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - C Power
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada. .,Department of Medicine (Neurology), HMRC 6-11, University of Alberta, Edmonton, AB, Canada.
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19
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O'Brien MMC, Hannigan O, Power C, Lawlor B, Robinson D. Family members' attitudes towards telling the patient with Alzheimer's disease their diagnosis: a 20-year repeat study. Eur Geriatr Med 2021; 12:881-885. [PMID: 33609267 DOI: 10.1007/s41999-021-00464-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 01/30/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE Exploring family members' attitudes to an Alzheimer's disease diagnosis compared to that of a study 20 years prior by Maguire et al. (BMJ 313:529-530, 1996). METHODS The survey was a replica of that completed 20 years prior in the same department by Maguire et al. (BMJ 313:529-530, 1996). With ethics approval and consent, family members were surveyed regarding their attitudes towards a dementia diagnosis. Completed by doctors with 100 consecutive respondents accompanying patients to scheduled memory clinic appointments. Themes were generated, results compiled and compared to the previous study. RESULTS Respondents are now over four times more likely to favour disclosure over non-disclosure to a patient (chi-squared 68.142, p < 0.0001). A substantial decrease is evident in those listing fear of evoking a negative reaction. Accordingly, there is an increase in those referring to the benefits of disclosure. CONCLUSION The emerged theme was that of autonomy versus paternalism, with attitude shift reflecting that patient privacy is an established patient right, taking precedence over paternalistic preferences.
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Affiliation(s)
- M M C O'Brien
- Memory Clinic, Mercer's Institute for Research on Ageing, St. James's Hospital, James's Street, Dublin 8., Dublin, Ireland.
| | - O Hannigan
- Memory Clinic, Mercer's Institute for Research on Ageing, St. James's Hospital, James's Street, Dublin 8., Dublin, Ireland
| | - C Power
- Memory Clinic, Mercer's Institute for Research on Ageing, St. James's Hospital, James's Street, Dublin 8., Dublin, Ireland
| | - B Lawlor
- Mercer's Institute for Research on Ageing, St. James's Hospital, James's Street, Dublin 8., Dublin, Ireland
| | - D Robinson
- Mercer's Institute for Research on Ageing, St. James's Hospital, James's Street, Dublin 8., Dublin, Ireland
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20
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Christiansen C, Castillo-Fernandez JE, Domingo-Relloso A, Zhao W, El-Sayed Moustafa JS, Tsai PC, Maddock J, Haack K, Cole SA, Kardia SLR, Molokhia M, Suderman M, Power C, Relton C, Wong A, Kuh D, Goodman A, Small KS, Smith JA, Tellez-Plaza M, Navas-Acien A, Ploubidis GB, Hardy R, Bell JT. Novel DNA methylation signatures of tobacco smoking with trans-ethnic effects. Clin Epigenetics 2021; 13:36. [PMID: 33593402 PMCID: PMC7888173 DOI: 10.1186/s13148-021-01018-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/24/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Smoking remains one of the leading preventable causes of death. Smoking leaves a strong signature on the blood methylome as shown in multiple studies using the Infinium HumanMethylation450 BeadChip. Here, we explore novel blood methylation smoking signals on the Illumina MethylationEPIC BeadChip (EPIC) array, which also targets novel CpG-sites in enhancers. METHOD A smoking-methylation meta-analysis was carried out using EPIC DNA methylation profiles in 1407 blood samples from four UK population-based cohorts, including the MRC National Survey for Health and Development (NSHD) or 1946 British birth cohort, the National Child Development Study (NCDS) or 1958 birth cohort, the 1970 British Cohort Study (BCS70), and the TwinsUK cohort (TwinsUK). The overall discovery sample included 269 current, 497 former, and 643 never smokers. Replication was pursued in 3425 trans-ethnic samples, including 2325 American Indian individuals participating in the Strong Heart Study (SHS) in 1989-1991 and 1100 African-American participants in the Genetic Epidemiology Network of Arteriopathy Study (GENOA). RESULTS Altogether 952 CpG-sites in 500 genes were differentially methylated between smokers and never smokers after Bonferroni correction. There were 526 novel smoking-associated CpG-sites only profiled by the EPIC array, of which 486 (92%) replicated in a meta-analysis of the American Indian and African-American samples. Novel CpG sites mapped both to genes containing previously identified smoking-methylation signals and to 80 novel genes not previously linked to smoking, with the strongest novel signal in SLAMF7. Comparison of former versus never smokers identified that 37 of these sites were persistently differentially methylated after cessation, where 16 represented novel signals only profiled by the EPIC array. We observed a depletion of smoking-associated signals in CpG islands and an enrichment in enhancer regions, consistent with previous results. CONCLUSION This study identified novel smoking-associated signals as possible biomarkers of exposure to smoking and may help improve our understanding of smoking-related disease risk.
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Affiliation(s)
- C Christiansen
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | | | - A Domingo-Relloso
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, USA
- Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Carlos III Health Institute, Madrid, Spain
- Department of Statistics and Operative Research, University of Valencia, Valencia, Spain
| | - W Zhao
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, USA
| | - J S El-Sayed Moustafa
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - P-C Tsai
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
- Department of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan
- Genomic Medicine Research Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - J Maddock
- MRC Unit for Lifelong Health and Ageing, Institute of Cardiovascular Science, University College London, London, UK
| | - K Haack
- Population Health Program, Texas Biomedical Research Institute, San Antonio, USA
| | - S A Cole
- Population Health Program, Texas Biomedical Research Institute, San Antonio, USA
| | - S L R Kardia
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, USA
| | - M Molokhia
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | - M Suderman
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - C Power
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - C Relton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - A Wong
- MRC Unit for Lifelong Health and Ageing, Institute of Cardiovascular Science, University College London, London, UK
| | - D Kuh
- MRC Unit for Lifelong Health and Ageing, Institute of Cardiovascular Science, University College London, London, UK
| | - A Goodman
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, London, UK
| | - K S Small
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - J A Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, USA
| | - M Tellez-Plaza
- Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - A Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, USA
| | - G B Ploubidis
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, London, UK
| | - R Hardy
- MRC Unit for Lifelong Health and Ageing, Institute of Cardiovascular Science, University College London, London, UK
| | - J T Bell
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.
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Widdicombe M, Power C, Van Gelderen R, Nowak BF, Bott NJ. Relationship between Southern Bluefin Tuna, Thunnus maccoyii, melanomacrophage centres and Cardicola spp. (Trematoda: Aporocotylidae) infection. Fish Shellfish Immunol 2020; 106:859-865. [PMID: 32898655 DOI: 10.1016/j.fsi.2020.09.004] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/03/2020] [Indexed: 06/11/2023]
Abstract
Southern Bluefin Tuna (SBT), Thunnus maccoyii, is ranched off Port Lincoln, South Australia and is Australia's second largest economic finfish aquaculture industry. The biggest threats to SBT health identified by the industry are the blood flukes Cardicola forsteri and C. orientalis (Trematoda: Aporocotylidae). Melanomacrophage centres (MMCs) are aggregations of pigmented macrophage like cells present in spleen, kidney and liver of teleost fish. The aim of this study was to quantify MMCs in SBT anterior kidney, liver and spleen to investigate changes in relation to Cardicola spp. Infection. Samples were collected at the end of ranching from pontoons where SBT were treated with PZQ and pontoons with untreated SBT. SBT MMC percentage of surface area cover was highest in SBT spleen and lowest in the liver. Significant positive correlations were identified between SBT MMC area and SBT size in all three organs (p < 0.05). MMC area and parasite infection showed significant positive correlations in the kidney and spleen for Cardicola spp. gill egg counts, and in the kidney for C. forsteri DNA from SBT hearts and gills (p < 0.05). MMCs area increased with increased intensity of Cardicola spp. Infection and MMCs have the potential to be used as an indicator to assess health effects that Cardicola spp. have on SBT.
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Affiliation(s)
- Maree Widdicombe
- Centre for Environmental Sustainability and Remediation, School of Science, RMIT University, Bundoora, 3083, Victoria, Australia
| | - Cecilia Power
- Centre for Environmental Sustainability and Remediation, School of Science, RMIT University, Bundoora, 3083, Victoria, Australia
| | - Rebecca Van Gelderen
- Centre for Environmental Sustainability and Remediation, School of Science, RMIT University, Bundoora, 3083, Victoria, Australia
| | - Barbara F Nowak
- Centre for Environmental Sustainability and Remediation, School of Science, RMIT University, Bundoora, 3083, Victoria, Australia
| | - Nathan J Bott
- Centre for Environmental Sustainability and Remediation, School of Science, RMIT University, Bundoora, 3083, Victoria, Australia.
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Power C, Nowak BF, Cribb TH, Bott NJ. Bloody flukes: a review of aporocotylids as parasites of cultured marine fishes. Int J Parasitol 2020; 50:743-753. [DOI: 10.1016/j.ijpara.2020.04.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/14/2020] [Accepted: 04/18/2020] [Indexed: 01/09/2023]
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23
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Minich JJ, Power C, Melanson M, Knight R, Webber C, Rough K, Bott NJ, Nowak B, Allen EE. The Southern Bluefin Tuna Mucosal Microbiome Is Influenced by Husbandry Method, Net Pen Location, and Anti-parasite Treatment. Front Microbiol 2020; 11:2015. [PMID: 32983024 PMCID: PMC7476325 DOI: 10.3389/fmicb.2020.02015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/30/2020] [Indexed: 12/19/2022] Open
Abstract
Aquaculture is the fastest growing primary industry worldwide. Marine finfish culture in open ocean net pens, or pontoons, is one of the largest growth areas and is currently the only way to rear high value fish such as bluefin tuna. Ranching involves catching wild juveniles, stocking in floating net pens and fattening for 4 to 8 months. Tuna experience several parasite-induced disease challenges in culture that can be mitigated by application of praziquantel (PZQ) as a therapeutic. In this study, we characterized the microbiome of ranched southern Bluefin Tuna, Thunnus maccoyii, across four anatomic sites (gill, skin, digesta, and anterior kidney) and evaluated environmental and pathological factors that influence microbiome composition, including the impact of PZQ treatment on microbiome stability. Southern bluefin tuna gill, skin, and digesta microbiome communities are unique and potentially influenced by husbandry practices, location of pontoon growout pens, and treatment with the antiparasitic PZQ. There was no significant relationship between the fish mucosal microbiome and incidence or abundance of adult blood fluke in the heart or fluke egg density in the gill. An enhanced understanding of microbiome diversity and function in high-value farmed fish species such as bluefin tuna is needed to optimize fish health and improve aquaculture yield. Comparison of the bluefin tuna microbiome to other fish species, including Seriola lalandi (yellowtail kingfish), a common farmed species from Australia, and Scomber japonicus (Pacific mackerel), a wild caught Scombrid relative of tuna, showed the two Scombrids had more similar microbial communities compared to other families. The finding that mucosal microbial communities are more similar in phylogenetically related fish species exposes an opportunity to develop mackerel as a model for tuna microbiome and parasite research.
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Affiliation(s)
- Jeremiah J. Minich
- Marine Biology Research Division, Scripps Institution of Oceanography, University of California, San Diego, La Jolla, CA, United States
| | - Cecilia Power
- Centre for Environmental Sustainability and Remediation, School of Science, RMIT University, Bundoora, VIC, Australia
| | - Michaela Melanson
- Marine Biology Research Division, Scripps Institution of Oceanography, University of California, San Diego, La Jolla, CA, United States
| | - Rob Knight
- Department of Pediatrics, School of Medicine, University of California, San Diego, La Jolla, CA, United States
- Department of Computer Science and Engineering, University of California, San Diego, La Jolla, CA, United States
- Department of Bioengineering, University of California, San Diego, La Jolla, CA, United States
- Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA, United States
| | - Claire Webber
- Australian Southern Bluefin Tuna Industry Association, Port Lincoln, SA, Australia
| | - Kirsten Rough
- Australian Southern Bluefin Tuna Industry Association, Port Lincoln, SA, Australia
| | - Nathan J. Bott
- Centre for Environmental Sustainability and Remediation, School of Science, RMIT University, Bundoora, VIC, Australia
| | - Barbara Nowak
- Centre for Environmental Sustainability and Remediation, School of Science, RMIT University, Bundoora, VIC, Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS, Australia
| | - Eric E. Allen
- Marine Biology Research Division, Scripps Institution of Oceanography, University of California, San Diego, La Jolla, CA, United States
- Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA, United States
- Division of Biological Sciences, University of California, San Diego, La Jolla, CA, United States
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24
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Power C, Williams C, Brown A. Does childbirth experience affect infant behaviour? Exploring the perceptions of maternity care providers. Midwifery 2019; 78:131-139. [PMID: 31437757 DOI: 10.1016/j.midw.2019.07.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 05/22/2019] [Accepted: 07/30/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE High levels of childbirth interventions are known to increase risk of health complications for mother and infant, alongside having a negative impact upon maternal wellbeing. However less is understood about how childbirth experience may affect infant behaviour (e.g. how calm or unsettled an infant is). This study explores maternity care provider perceptions of how and why childbirth experience may affect infant behaviour. DESIGN A qualitative semi-structured interview study. SETTING Bristol, Swansea and West Wales, UK. PARTICIPANTS 18 maternity care providers. MEASUREMENTS AND FINDINGS A semi-structured interview schedule was developed to explore maternity care providers' perceptions of how maternal experience of childbirth could influence infant behaviour. Findings highlighted how maternity care providers perceived childbirth experience to sometimes impact positively or negatively on infant behaviour. A calmer birth and postnatal experience was believed to lead to a calmer infant, whilst physical and emotional stress was associated with more challenging infant behaviours such as crying and being unsettled. Pathways were perceived to be direct (pain and stress during birth might physiologically affect the infant) and indirect (birth was perceived to affect maternal wellbeing and subsequently her interactions with her baby). However, postnatal factors such as skin to skin, postnatal environment and emotional support were believed to mediate these impacts. KEY CONCLUSIONS Birth experience was considered to affect infant behaviour. Promoting as positive a birth experience as possible, including postnatal care, was viewed as significant in supporting positive infant behaviours. Maternity care providers believed this could help facilitate bonding, attachment, and mother-infant wellbeing in the postnatal period. IMPLICATIONS FOR PRACTICE The findings highlight maternity care providers' views concerning supporting normal birth and protecting emotional wellbeing during birth and postnatally. Where interventions are necessary, ensuring a calm environment, and enabling normal postnatal behaviours such as skin to skin and breastfeeding were perceived as important. Midwives, it was claimed, need time to nurture mothers alongside providing physical care. LIMITATIONS Participants were self-selecting and might therefore have been biased.
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Affiliation(s)
- C Power
- Department of Public Health, Policy and Social Sciences, Swansea University, Wales, UK
| | - C Williams
- Department of Psychology, Swansea University, Wales, UK
| | - A Brown
- Department of Public Health, Policy and Social Sciences, Swansea University, Wales, UK; Centre for Lactation, Infant Feeding and Translation (LIFT), Swansea University, Wales, UK.
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25
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Balcom EF, Roda WC, Cohen EA, Li MY, Power C. HIV-1 persistence in the central nervous system: viral and host determinants during antiretroviral therapy. Curr Opin Virol 2019; 38:54-62. [PMID: 31390580 DOI: 10.1016/j.coviro.2019.06.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/03/2019] [Accepted: 06/05/2019] [Indexed: 02/07/2023]
Abstract
Despite remarkable therapeutic advances in the past two decades, the elimination of human immunodeficiency virus type 1 (HIV-1) from latent reservoirs constitutes a major barrier to eradication and preventing neurological disease associated with HIV/AIDS. Invasion of the central nervous system (CNS) by HIV-1 occurs early in infection, leading to viral infection and productive persistence in brain macrophage-like cells (BMCs) including resident microglia and infiltrating macrophages. HIV-1 persistence in the brain and chronic neuroinflammation occur despite effective treatment with antiretroviral therapy (ART). This review examines the evidence from clinical studies, in vivo and in vitro models for HIV-1 CNS persistence, as well as therapeutic considerations in targeting latent CNS reservoirs.
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Affiliation(s)
- E F Balcom
- Department of Medicine (Neurology), University of Alberta, Edmonton, AB, Canada
| | - W C Roda
- Department of Mathematical & Statistical Sciences, University of Alberta, Edmonton, AB, Canada
| | - E A Cohen
- Departments of Microbiology and Immunology, University of Montreal, Montreal Clinical Research Institute, Montreal, QC, Canada
| | - M Y Li
- Department of Mathematical & Statistical Sciences, University of Alberta, Edmonton, AB, Canada
| | - C Power
- Department of Medicine (Neurology), University of Alberta, Edmonton, AB, Canada.
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26
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Li L, Pinto Pereira SM, Power C. Childhood maltreatments, child-to-adult BMI and cardiometabolic disease risk in mid-adulthood. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky213.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- L Li
- University College London Great Ormond Street Institute of Child Health, London, UK
| | - SM Pinto Pereira
- University College London Great Ormond Street Institute of Child Health, London, UK
| | - C Power
- University College London Great Ormond Street Institute of Child Health, London, UK
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27
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Nüesch E, Dale C, Palmer TM, White J, Keating BJ, van Iperen EP, Goel A, Padmanabhan S, Asselbergs FW, Verschuren WM, Wijmenga C, Van der Schouw YT, Onland-Moret NC, Lange LA, Hovingh GK, Sivapalaratnam S, Morris RW, Whincup PH, Wannamethe GS, Gaunt TR, Ebrahim S, Steel L, Nair N, Reiner AP, Kooperberg C, Wilson JF, Bolton JL, McLachlan S, Price JF, Strachan MW, Robertson CM, Kleber ME, Delgado G, März W, Melander O, Dominiczak AF, Farrall M, Watkins H, Leusink M, Maitland-van der Zee AH, de Groot MC, Dudbridge F, Hingorani A, Ben-Shlomo Y, Lawlor DA, Amuzu A, Caufield M, Cavadino A, Cooper J, Davies TL, Drenos F, Engmann J, Finan C, Giambartolomei C, Hardy R, Humphries SE, Hypponen E, Kivimaki M, Kuh D, Kumari M, Ong K, Plagnol V, Power C, Richards M, Shah S, Shah T, Sofat R, Talmud PJ, Wareham N, Warren H, Whittaker JC, Wong A, Zabaneh D, Davey Smith G, Wells JC, Leon DA, Holmes MV, Casas JP. Adult height, coronary heart disease and stroke: a multi-locus Mendelian randomization meta-analysis. Int J Epidemiol 2018; 45:1927-1937. [PMID: 25979724 PMCID: PMC5841831 DOI: 10.1093/ije/dyv074] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2015] [Indexed: 11/12/2022] Open
Abstract
Background: We investigated causal effect of completed growth, measured by adult height, on coronary heart disease (CHD), stroke and cardiovascular traits, using instrumental variable (IV) Mendelian randomization meta-analysis. Methods: We developed an allele score based on 69 single nucleotide polymorphisms (SNPs) associated with adult height, identified by the IBCCardioChip, and used it for IV analysis against cardiovascular risk factors and events in 21 studies and 60 028 participants. IV analysis on CHD was supplemented by summary data from 180 height-SNPs from the GIANT consortium and their corresponding CHD estimates derived from CARDIoGRAMplusC4D. Results: IV estimates from IBCCardioChip and GIANT-CARDIoGRAMplusC4D showed that a 6.5-cm increase in height reduced the odds of CHD by 10% [odds ratios 0.90; 95% confidence intervals (CIs): 0.78 to 1.03 and 0.85 to 0.95, respectively],which agrees with the estimate from the Emerging Risk Factors Collaboration (hazard ratio 0.93; 95% CI: 0.91 to 0.94). IV analysis revealed no association with stroke (odds ratio 0.97; 95% CI: 0.79 to 1.19). IV analysis showed that a 6.5-cm increase in height resulted in lower levels of body mass index (P < 0.001), triglycerides (P < 0.001), non high-density (non-HDL) cholesterol (P < 0.001), C-reactive protein (P = 0.042), and systolic blood pressure (P = 0.064) and higher levels of forced expiratory volume in 1 s and forced vital capacity (P < 0.001 for both). Conclusions: Taller individuals have a lower risk of CHD with potential explanations being that taller people have a better lung function and lower levels of body mass index, cholesterol and blood pressure.
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Affiliation(s)
- Eveline Nüesch
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,CTU Bern, Department of Clinical Research and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Caroline Dale
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Tom M Palmer
- Warwick Medical School, University of Warwick, Coventry, UK.,Department of Mathematics and Statistics, Lancaster University, Lancaster, UK
| | - Jon White
- UCL Genetics Institute, Department of Genetics, Evolution and Environment, University College London, London, UK
| | - Brendan J Keating
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Surgery.,Division of Genetics, University of Pennsylvania, Philadelphia
| | - Erik Pa van Iperen
- Department of Biostatistics, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.,Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, The Netherlands
| | - Anuj Goel
- Wellcome Trust Centre for Human Genetics and Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Sandosh Padmanabhan
- Institute of Cardiovascular and Medical Sciences, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart and Lungs, University Medical Centre Utrecht, Utrecht, The Netherlands.,Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, The Netherlands.,Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK
| | | | | | | | | | | | - Leslie A Lange
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - G K Hovingh
- Department of Vascular Medicine, Academic Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Suthesh Sivapalaratnam
- Department of Vascular Medicine, Academic Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Richard W Morris
- Department of Primary Care & Population Health, University College London, London, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's, University of London, London, UK
| | - Goya S Wannamethe
- Department of Primary Care & Population Health, University College London, London, UK
| | - Tom R Gaunt
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Shah Ebrahim
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Laura Steel
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nikhil Nair
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Alexander P Reiner
- Department of Epidemiology, University of Washington, Seattle, WA, USA / Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - James F Wilson
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.,MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Jennifer L Bolton
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Stela McLachlan
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Jacqueline F Price
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | | | - Christine M Robertson
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Marcus E Kleber
- Fifth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Graciela Delgado
- Fifth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Winfried März
- Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetolgy, and Rheumatology), Mannheim Medical Faculty, University of Heidelberg, Germany, Synlab Academy, Synlab Services GmbH, Mannheim and Augsburg, Germany, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria
| | | | - Anna F Dominiczak
- Institute of Cardiovascular and Medical Sciences, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Martin Farrall
- Wellcome Trust Centre for Human Genetics and Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Hugh Watkins
- Wellcome Trust Centre for Human Genetics and Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Maarten Leusink
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anke H Maitland-van der Zee
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Mark Ch de Groot
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frank Dudbridge
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Aroon Hingorani
- Department of Epidemiology and Public Health, University College London Medical School, London, UK
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Debbie A Lawlor
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - D Zabaneh
- UCLEB, London, Edinburgh and Bristol, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Jonathan C Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK
| | - David A Leon
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Department of Community Medicine, Arctic University of Norway, UiT
| | - Michael V Holmes
- Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK.,Department of Surgery and Clinical Epidemiology Unit, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Juan P Casas
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK
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28
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Geoffroy MC, Gunnell D, Clark C, Power C. Are early-life antecedents of suicide mortality associated with psychiatric disorders and suicidal ideation in midlife? Acta Psychiatr Scand 2018; 137:116-124. [PMID: 29270976 DOI: 10.1111/acps.12844] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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] [Accepted: 11/22/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To establish whether previously identified early-life antecedents of suicide mortality (i.e. low birthweight, younger maternal age, higher birth order, externalizing problems and adversities) are associated with proximal psychiatric disorders and suicidal ideation, which are themselves associated with an increased risk of suicide. METHODS Participants were from the 1958 British birth-cohort (N = 8905) with information on prenatal/childhood experiences and the Clinical Interview Schedule-Revised at age 45 years. Outcomes were as follows: any internalizing disorder (anxiety disorder/depressive episode), depressive episode, alcohol use disorder and suicidal ideation. RESULTS After adjustment, higher birth order (Ptrend = 0.043), younger maternal age (Ptrend = 0.017) and increased number of childhood adversities (Ptrend = 0.026) were associated with an increased risk of internalizing disorders. For example, the OR (95% CI) in fourth- or later-born children was 1.48 (1.06-2.07) and for young maternal age (<19 years) was 1.31 (0.89-1.91). Effect sizes were similar in magnitude for depressive episode and suicidal ideation, although associations did not reach conventional significance levels. No associations were found for low birthweight and externalizing problems (in males) and investigated outcomes. CONCLUSION Associations for younger maternal age, higher birth order and adversities with adult internalizing disorders suggest that psychiatric disorders may be on the pathway linking some early-life factors and suicide.
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Affiliation(s)
- M-C Geoffroy
- Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - D Gunnell
- Department of Population Health Sciences and National Institute of Health Research Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - C Clark
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - C Power
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK
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Hooks T, McCarthy O, Power C, Macken-Walsh Á. A co-operative business approach in a values-based supply chain: A case study of a beef co-operative. Journal of Co-operative Organization and Management 2017. [DOI: 10.1016/j.jcom.2017.10.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
BACKGROUND Childhood adversity predicts adolescent suicidal ideation but there are few studies examining whether the risk of childhood adversity extends to suicidal ideation in midlife. We hypothesized that childhood adversity predicts midlife suicidal ideation and this is partially mediated by adolescent internalizing disorders, externalizing disorders and adult exposure to life events and interpersonal difficulties. METHOD At 45 years, 9377 women and men from the UK 1958 British Birth Cohort Study participated in a clinical survey. Childhood adversity was prospectively assessed at the ages of 7, 11 and 16 years. Suicidal ideation at midlife was assessed by the depressive ideas subscale of the Revised Clinical Interview Schedule. Internalizing and externalizing disorders were measured by the Rutter scales at 16 years. Life events, periods of unemployment, partnership separations and alcohol dependence were measured through adulthood. RESULTS Illness in the household, paternal absence, institutional care, parental divorce and retrospective reports of parental physical and sexual abuse predicted suicidal ideation at 45 years. Three or more childhood adversities were associated with suicidal ideation at 45 years [odds ratio (OR) 4.31, 95% confidence interval (CI) 2.67-6.94]. Psychological distress at 16 years partially mediated the associations of physical abuse (OR 3.41, 95% CI 2.29-5.75), sexual abuse (OR 4.99, 95% CI 2.90-11.16) with suicidal ideation. Adult life events partially mediated the association of parental divorce (OR 6.34, 95% CI -7.16 to 36.75) and physical (OR 9.59, 95% CI 4.97-27.88) and sexual abuse (OR 6.59, 95% CI 2.40-38.36) with suicidal ideation at 45 years. CONCLUSIONS Adversity in childhood predicts suicidal ideation in midlife, partially mediated by adolescent internalizing and externalizing disorders, adult life events and interpersonal difficulties. Understanding the pathways from adversity to suicidal ideation can inform suicide prevention and the targeting of preventive interventions.
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Affiliation(s)
- S. A. Stansfeld
- Centre for Psychiatry,
Wolfson Institute of Preventive Medicine, Barts and the
London School of Medicine and Dentistry, Queen Mary University of
London, London EC1M 6BQ, UK
| | - C. Clark
- Centre for Psychiatry,
Wolfson Institute of Preventive Medicine, Barts and the
London School of Medicine and Dentistry, Queen Mary University of
London, London EC1M 6BQ, UK
| | - M. Smuk
- Centre for Psychiatry,
Wolfson Institute of Preventive Medicine, Barts and the
London School of Medicine and Dentistry, Queen Mary University of
London, London EC1M 6BQ, UK
| | - C. Power
- Population, Policy and
Practice, University College London,
Institute of Child Health, 30 Guilford
Street, London WC1N 1EH, UK
| | - T. Davidson
- Centre for Gambling Research,
School of Sociology, Beryl Rawson Building,
The Australian National University,
Acton, ACT 2601, Australia
| | - B. Rodgers
- School of Demography, The
Australian National University, Acton, ACT
2601, Australia
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Branton WG, Lu JQ, Surette MG, Holt RA, Lind J, Laman JD, Power C. Brain microbiota disruption within inflammatory demyelinating lesions in multiple sclerosis. Sci Rep 2016; 6:37344. [PMID: 27892518 PMCID: PMC5125007 DOI: 10.1038/srep37344] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 10/26/2016] [Indexed: 12/14/2022] Open
Abstract
Microbial communities reside in healthy tissues but are often disrupted during disease. Bacterial genomes and proteins are detected in brains from humans, nonhuman primates, rodents and other species in the absence of neurological disease. We investigated the composition and abundance of microbiota in frozen and fixed autopsied brain samples from patients with multiple sclerosis (MS) and age- and sex-matched nonMS patients as controls, using neuropathological, molecular and bioinformatics tools. 16s rRNA sequencing revealed Proteobacteria to be the dominant phylum with restricted diversity in cerebral white matter (WM) from MS compared to nonMS patients. Both clinical groups displayed 1,200–1,400 bacterial genomes/cm3 and low bacterial rRNA:rDNA ratios in WM. RNAseq analyses showed a predominance of Proteobacteria in progressive MS patients’ WM, associated with increased inflammatory gene expression, relative to a broader range of bacterial phyla in relapsing-remitting MS patients’ WM. Although bacterial peptidoglycan (PGN) and RNA polymerase beta subunit immunoreactivities were observed in all patients, PGN immunodetection was correlated with demyelination and neuroinflammation in MS brains. Principal component analysis revealed that demyelination, PGN and inflammatory gene expression accounted for 86% of the observed variance. Thus, inflammatory demyelination is linked to an organ-specific dysbiosis in MS that could contribute to underlying disease mechanisms.
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Affiliation(s)
- W G Branton
- Department of Medicine, University of Alberta, Edmonton AB Canada.,Department of Laboratory Medicine &Pathology, University of Alberta, Edmonton AB Canada
| | - J Q Lu
- Department of Laboratory Medicine &Pathology, University of Alberta, Edmonton AB Canada.,Department of Psychiatry, University of Alberta, Edmonton AB Canada
| | - M G Surette
- Department of Medicine, McMaster University, Hamilton ON Canada
| | - R A Holt
- Genome Sciences Centre, Vancouver BC, Canada
| | - J Lind
- Department of Neurosciences, Section of Medical Physiology, Faculty of Medical Sciences, University Medical Center Groningen, University of Groningen, Groningen Netherlands
| | - J D Laman
- Multiple Sclerosis Centre, University of Alberta, Edmonton AB Canada
| | - C Power
- Department of Medicine, University of Alberta, Edmonton AB Canada.,Department of Laboratory Medicine &Pathology, University of Alberta, Edmonton AB Canada.,Department of Neurosciences, Section of Medical Physiology, Faculty of Medical Sciences, University Medical Center Groningen, University of Groningen, Groningen Netherlands
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Pinto Pereira SM, Li L, Power C. Child maltreatment and living standards in mid-adulthood: findings from the 1958 British birth cohort. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw172.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pinto Pereira SM, Li L, Power C. OP04 Associations between child maltreatment and mid-adulthood labour market participation, living standards and social mobility: findings from a British birth cohort. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mackey LM, Blake C, Power C, Casey MB, Hearty C, Victory R, Fullen BM. Abstract PR326. Anesth Analg 2016. [DOI: 10.1213/01.ane.0000492722.73851.fd] [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: 11/05/2022]
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Li L, Pinto Pereira S, Power C. P32 Childhood maltreatment and biomarkers for cardiometabolic disease in mid-adulthood: associations and potential explanations. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.131] [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: 11/04/2022]
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Skirka S, Power C, Nadeem M, Greally P. Which Factors are Important in Determining the Length of Stay in Bronchiolitis? Ir Med J 2016; 109:379. [PMID: 27685826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Power C, Bates H, Healy M, Gleeson P, Greene E. Cognitive screening in the acute hospital: Preliminary findings from a cognitive screening program in a university-affiliated, tertiary-referral hospital with 6-month interval outcomes. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
IntroductionCognitive impairment impacts on patient outcomes [1] but is under-recognised in acute hospitals [2]. Data on rates and degree of impairment among hospital inpatients remain sparse. This information is vital for strategic planning of health services as the European population ages.ObjectivesTo examine the rates and degree of cognitive impairment among patients aged 65 and older who were admitted to an acute general hospital and to assess its impact on patient outcomes.MethodsAll patients aged over 65 who were admitted over a 2-week period were invited to participate. Those who met the inclusion criteria were screened for delirium then underwent a cognitive screening battery. Normative values for age and level of education were obtained from the TILDA study [3]. Demographic and outcome data were obtained from medical records.ResultsOne hundred and forty-eight patients underwent cognitive screening. Thirty-nine over 148 (26%) met the DSM-IV criteria for dementia of whom only 16 (41%) had a previously-documented impairment. Thirty over 148 (20%) had evidence of cognitive impairment that did not meet criteria for dementia, only 3 (10%) of whom were previously documented. Seventy-three over 148 (49%) were normal. Six over 148 (4%) were not classifiable. The impact of cognitive status on length of hospital stay, number of readmissions in 6 months and discharge destination was investigated. Impact on length of stay was significant (P = 0.017) but significance was not achieved against number of readmissions or discharge destination.ConclusionsCognitive impairment is pervasive and under-recognised in the acute hospital and impacts on length of hospital stay. Longer interval analysis is necessary to investigate further implications.References 1–3 available upon request.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Maddock J, Cavadino A, Power C, Hyppönen E. 25-hydroxyvitamin D, APOE ɛ4 genotype and cognitive function: findings from the 1958 British birth cohort. Eur J Clin Nutr 2014; 69:505-8. [PMID: 25293430 DOI: 10.1038/ejcn.2014.201] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 07/30/2014] [Accepted: 08/26/2014] [Indexed: 12/16/2022]
Abstract
Both high and low vitamin D statuses have been associated with lower memory function. Apolipoprotein E (APOE) ɛ4 alleles have been associated with reduced memory function, and separately with higher vitamin D concentrations. This report aims to examine if the presence of APOE ɛ4 alleles contributes to the relationship between vitamin D and memory function. A total of 4848 (46% female) participants from the 1958 British birth cohort had information on APOE genotypes and completed memory tests at 50 years, where 4644 also had 25-hydroxyvitamin D (25(OH)D) concentrations measured at 45 years. Both low and high 25(OH)D concentrations were associated with lower memory function after adjustment for number of APOE ɛ4 alleles (P curvature=0.02). There was evidence of interaction between APOE ɛ4 and 25(OH)D, suggesting the association between 25(OH)D concentrations and memory function is different for those with two APOE ɛ4 alleles compared with those with zero or one APOE ɛ4 alleles (recessive model P interaction=0.01). Among participants with two APOE ɛ4 alleles, higher 25(OH)D concentrations were associated with higher memory function, whereas in others, memory scores were slightly lower for individuals with higher versus lower concentrations. Further studies are required to replicate these findings.
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Affiliation(s)
- J Maddock
- Population, Policy and Practice, UCL Institute of Child Health, London, UK
| | - A Cavadino
- Population, Policy and Practice, UCL Institute of Child Health, London, UK
| | - C Power
- Population, Policy and Practice, UCL Institute of Child Health, London, UK
| | - E Hyppönen
- 1] Population, Policy and Practice, UCL Institute of Child Health, London, UK [2] School of Population Health, Sansom Institute, University of South Australia, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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Abstract
BACKGROUND An unhealthy body mass index (BMI) has been associated with depression but the direction of association is uncertain. Our aim was to estimate the co-morbidity and direction of association between BMI and depressive symptoms at several ages, from childhood to mid-adulthood. METHOD The data were from 18,558 individuals born in 1 week in March 1958, in England, Scotland and Wales, with follow-up at ages 7, 11, 16, 23, 33, 42, 45 and 50 years. Depression (scores>or=90th percentile) was identified from child/adolescent (teacher questionnaires) and adult (self-complete questionnaires and clinical interview) measures. BMI (kg/m2) measured in child/adolescence and adulthood was classified as underweight, normal, overweight or obese. RESULTS In cross-sectional analyses, obesity and underweight (not overweight) from 11 to 45 years were associated respectively with 1.3-2.1 and 1.5-2.3 times the risk of depression compared with normal weight. Using the time-lagged generalized estimating equation (GEE) approach, we tested (a) whether underweight or obesity at prior ages (7 to 45 years) predicted subsequent risk of depression (11 to 50 years), adjusting for baseline depression; and (b) whether depression at prior ages (7 to 42 years) predicted subsequent risk of underweight or obesity (11 to 45 years), adjusting for baseline BMI. In longitudinal analyses, underweight predicted subsequent depression in both sexes [odds ratio (OR) 1.25, 95% confidence interval (CI) 1.11-1.40] and depression predicted subsequent underweight in males only (OR 1.84, 95% CI 1.52-2.23). Obesity predicted subsequent depressive symptoms in females only (OR 1.34, 95% CI 1.14-1.56), but depression did not predict obesity. CONCLUSIONS Clinicians should consider screening routinely for depression patients with unhealthy BMI, namely underweight and obesity, and vice versa.
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Affiliation(s)
- M-C Geoffroy
- Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health,University College London,UK
| | - L Li
- Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health,University College London,UK
| | - C Power
- Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health,University College London,UK
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Pinto Pereira SM, Li L, Power C. PP73 Childhood influences on adult (33–50y) physical inactivity in the 1958 British birth cohort. Br J Soc Med 2014. [DOI: 10.1136/jech-2014-204726.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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van Veldhoven K, Pinto Pereira S, Li L, Power C. PP69 Multiple risk behaviours and adult body mass index in the 1958 British birth cohort. Br J Soc Med 2014. [DOI: 10.1136/jech-2014-204726.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Paul AM, Branton WG, Walsh JG, Polyak MJ, Lu JQ, Baker GB, Power C. GABA transport and neuroinflammation are coupled in multiple sclerosis: regulation of the GABA transporter-2 by ganaxolone. Neuroscience 2014; 273:24-38. [PMID: 24814730 DOI: 10.1016/j.neuroscience.2014.04.037] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 04/15/2014] [Accepted: 04/17/2014] [Indexed: 10/25/2022]
Abstract
Interactions between neurotransmitters and the immune system represent new prospects for understanding neuroinflammation and associated neurological disease. GABA is the chief inhibitory neurotransmitter but its actions on immune pathways in the brain are unclear. In the present study, we investigated GABAergic transport in conjunction with neuroinflammation in models of multiple sclerosis (MS). Protein and mRNA levels of γ-amino butyric acid transporter 2 (GAT-2) were examined in cerebral white matter from MS and control (Non-MS) patients, in cultured human macrophages, microglia and astrocytes, and in spinal cords from mice with and without experimental autoimmune encephalomyelitis (EAE) using western blotting, immunocytochemistry and quantitative real-time polymerase chain reaction (qRT-PCR). GABA levels were measured by HPLC. The GAT-2's expression was increased in MS patients' (n=6) white matter, particularly in macrophage lineage cells, compared to Non-MS patients (n=6) (p<0.05). Interferon-γ (IFN-γ) stimulation of human macrophage lineage cells induced GAT-2 expression and reduced extracellular GABA levels (p<0.05) but soluble GABA treatment suppressed HLA-DRα, GAT-2 and XBP-1/s expression in stimulated macrophage lineage cells (p<0.05). Similarly, the synthetic allopregnanolone analog, ganaxolone (GNX), repressed GAT-2, JAK-1 and STAT-1 expression in activated macrophage lineage cells (p<0.05). In vivo GNX treatment reduced Gat-2, Cd3ε, MhcII, and Xbp-1/s expression in spinal cords following EAE induction (p<0.05), which was correlated with improved neurobehavioral outcomes and reduced neuroinflammation, demyelination and axonal injury. These findings highlight altered GABAergic transport through GAT-2 induction during neuroinflammation. GABA transport and neuroinflammation are closely coupled but regulated by GNX, pointing to GABAergic pathways as therapeutic targets in neuroinflammatory diseases.
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Affiliation(s)
- A M Paul
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - W G Branton
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - J G Walsh
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - M J Polyak
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - J-Q Lu
- Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, AB, Canada
| | - G B Baker
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - C Power
- Department of Medicine, University of Alberta, Edmonton, AB, Canada; Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, AB, Canada.
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Abstract
BACKGROUND We aimed to elucidate early antecedents of suicide including possible mediation by early child development. METHOD Using the 1958 birth cohort, based on British births in March 1958, individuals were followed up to adulthood. We used data collected at birth and at age 7 years from various informants. Suicides occurring up to 31 May 2009 were identified from linked national death certificates. Multivariable Cox proportional hazard models were used to investigate risk factors. RESULTS Altogether 12399 participants (n = 44 suicides) had complete data. The strongest prenatal risk factors for suicide were: birth order, with risk increasing in later-born children [p trend = 0.063, adjusted hazard ratio (HR)], e.g. for fourth- or later-born children [HR = 2.27, 95% confidence interval (CI) 0.90-5.75]; young maternal age (HR = 1.18, 95% CI 0.34-4.13 for ⩽19 years and HR = 0.41, 95% CI 0.19-0.91 for >29 years, p trend = 0.034); and low (<2.5 kg) birth weight (HR = 2.48, 95% CI 1.03-5.95). The strongest risk factors at 7 years were externalizing problems in males (HR = 2.96, 95% CI 1.03-8.47, p trend = 0.050) and number of emotional adversities (i.e. parental death, neglected appearance, domestic tension, institutional care, contact with social services, parental divorce/separation and bullying) for which there was a graded association with risk of suicide (p trend = 0.033); the highest (HR = 3.12, 95% CI 1.01-9.62) was for persons with three or more adversities. CONCLUSIONS Risk factors recorded at birth and at 7 years may influence an individual's long-term risk of suicide, suggesting that trajectories leading to suicide have roots in early life. Some factors are amenable to intervention, but for others a better understanding of causal mechanisms may provide new insights for intervention to reduce suicide risk.
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Affiliation(s)
- M-C Geoffroy
- MRC Centre of Epidemiology for Child Health/Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK
| | - D Gunnell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - C Power
- MRC Centre of Epidemiology for Child Health/Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK
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Vimaleswaran KS, Power C, Hyppönen E. Interaction between vitamin D receptor gene polymorphisms and 25-hydroxyvitamin D concentrations on metabolic and cardiovascular disease outcomes. Diabetes Metab 2014; 40:386-9. [PMID: 24582179 DOI: 10.1016/j.diabet.2014.01.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 01/24/2014] [Accepted: 01/26/2014] [Indexed: 12/18/2022]
Abstract
AIM 25-hydroxyvitamin D (25OHD) concentrations have been shown to be associated with major clinical outcomes, with a suggestion that individual risk may vary according to common genetic differences in the vitamin D receptor (VDR) gene. Hence, we tested for the interactions between two previously studied VDR polymorphisms and 25OHD on metabolic and cardiovascular disease-related outcomes in a large population-based study. METHODS Interactions between two previously studied VDR polymorphisms (rs7968585 and rs2239179) and 25OHD concentrations on metabolic and cardiovascular disease-related outcomes such as obesity- (body mass index, waist circumference, waist-hip ratio (WHR)), cardiovascular- (systolic and diastolic blood pressure), lipid- (high- and low-density lipoprotein, triglycerides, total cholesterol), inflammatory- (C-reactive protein, fibrinogen, insulin growth factor-1, tissue plasminogen activator) and diabetes- (glycated haemoglobin) related markers were examined in the 1958 British Birth cohort (n up to 5160). Interactions between each SNP and 25OHD concentrations were assessed using linear regression and the likelihood ratio test. RESULTS After Bonferroni correction, none of the interactions reached statistical significance except for the interaction between the VDR SNP rs2239179 and 25OHD concentrations on waist-hip ratio (WHR) (P=0.03). For every 1nmol/L higher 25OHD concentrations, the association with WHR was stronger among those with two major alleles (-4.0%, P=6.26e(-24)) compared to those with either one or no major alleles (-2.3%, P≤8.201e(-07), for both) of the VDR SNP rs2239179. CONCLUSION We found no evidence for VDR polymorphisms acting as major modifiers of the association between 25OHD concentrations and cardio-metabolic risk. Interaction between VDR SNP rs2239179 and 25OHD on WHR warrants further confirmation.
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Affiliation(s)
- K S Vimaleswaran
- Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK; Hugh Sinclair Unit of Human Nutrition, Department of Food & Nutritional Sciences, School of Chemistry, Food & Pharmacy, University of Reading, England RG6 6AP, UK.
| | - C Power
- Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK
| | - E Hyppönen
- Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK; School of Population Health, Sansom Institute for Health Research, University of South Australia; South Australian Health and Medical Research Institute, Adelaide, Australia
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Reinke SN, Broadhurst DI, Sykes BD, Baker GB, Catz I, Warren KG, Power C. Metabolomic profiling in multiple sclerosis: insights into biomarkers and pathogenesis. Mult Scler 2014; 20:1396-400. [DOI: 10.1177/1352458513516528] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Metabolomics enables the provision of sensitive bio-markers of disease. We performed 800 MHz 1H-nuclear magnetic resonance (NMR) spectroscopic analyses of cerebrospinal fluid (CSF) specimens to identify biomarkers of multiple sclerosis (MS), yielding reproducible detection of 15 metabolites from MS ( n=15) and non-MS ( n=17) patients. Mean levels of choline, myo-inositol and threonate were increased, whereas 3-hydroxybutyrate, citrate, phenylalanine, 2-hydroxyisovalerate and mannose were decreased in MS-derived CSF ( p<0.05), suggesting alterations to energy and phospholipid metabolism. Multivariate hierarchal cluster analysis indicated a high correlation within the metabolite profiles, significantly clustering samples into the two clinical groups, which was corroborated using principal components analysis. CSF metabolomics have the capacity to yield quantitative biomarkers and insights into the pathogenesis of MS.
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Affiliation(s)
- SN Reinke
- Department of Medicine, University of Alberta, Canada
| | - DI Broadhurst
- Department of Medicine, University of Alberta, Canada
| | - BD Sykes
- Department of Biochemistry, University of Alberta, Canada
| | - GB Baker
- Department of Psychiatry, University of Alberta, Canada
| | - I Catz
- Department of Medicine, University of Alberta, Canada
| | - KG Warren
- Department of Medicine, University of Alberta, Canada
| | - C Power
- Department of Medicine, University of Alberta, Canada
- Department of Psychiatry, University of Alberta, Canada
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Power C, Pereira SMP, Law C, Ki M. OP39 Are Adverse Effects of Obesity on Cardiovascular Risk Factors Modifiable: the Role of Physical Activity and Sedentary Behaviour in Mid-Life in the 1958 British Cohort. Br J Soc Med 2013. [DOI: 10.1136/jech-2013-203126.39] [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: 11/04/2022]
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Pereira SMP, Geoffroy MC, Power C. PP67 Psychological Health and Physical Activity from Adolescence To Mid-Adulthood: Evidence of Bi-Directional Associations in the 1958 British Birth Cohort. Br J Soc Med 2013. [DOI: 10.1136/jech-2013-203126.161] [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: 11/04/2022]
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Power C, Danaher M, Sayers R, O'Brien B, Clancy C, Furey A, Jordan K. Investigation of the migration of triclabendazole residues to milk products manufactured from bovine milk, and stability therein, following lactating cow treatment. J Dairy Sci 2013; 96:6223-32. [PMID: 23932132 DOI: 10.3168/jds.2013-7016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 06/29/2013] [Indexed: 11/19/2022]
Abstract
Triclabendazole (TCB) is a flukicide used in the treatment of liver fluke in cattle; however, its use is currently prohibited in lactating dairy cows. In this study, following administration of 10% Fasinex (triclabendazole, Novartis Animal Health UK Ltd., Camberley, UK) the milk of 6 animals was used to manufacture dairy products, to ascertain if TCB residues in milk migrate into dairy products. The detection limit of the ultra-high-performance liquid chromatography-tandem mass spectrometry method used was 0.67 μg/kg. The highest concentrations of TCB residue measured, within the individual cow milk yield, was 1,529 ± 244 µg/kg (n=6), on d 2 posttreatment. Days 2 and 23 posttreatment represented high and low residue concentrations, respectively. At each of these 2 time points, the milk was pooled into 2 independent aliquots and refrigerated. Milk products, including cheese, butter, and skim milk powder were manufactured using pasteurized and unpasteurized milk from each aliquot. The results for high residue milks demonstrated that TCB residues concentrated in the cheese by a factor of 5 (5,372 vs. 918 µg/kg for cheese vs. milk) compared with the starting milk. Residue concentrations are the sum of TCB and its metabolites, expressed as keto-TCB. Residues were concentrated in the butter by a factor of 9 (9,177 vs. 1,082 μg/kg for butter vs. milk) compared with the starting milk. For milk, which was separated to skim milk and cream fractions, the residues were concentrated in the cream. Once skim milk powder was manufactured from the skim milk fraction, the residue in powder was concentrated 15-fold compared with the starting skim milk (7,252 vs. 423 µg/kg for powder vs. skim milk), despite the high temperature (185 °C) required during powder manufacture. For products manufactured from milk with low residue concentrations at d 23 posttreatment, TCB residues were detected in butter, cheese, and skim milk powder, even though there was no detectable residue in the milk used to manufacture these products. Triclabendazole residues were concentrated in some milk products (despite manufacturing treatments), exceeding residue levels in the starting milk and, depending on the storage conditions, may be relatively stable over time.
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Affiliation(s)
- C Power
- Food Safety Department, Teagasc Food Research Centre, Fermoy, Co. Cork, Ireland; Team Elucidate, Department of Chemistry, Cork Institute of Technology, Bishopstown, Cork, Ireland
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Webber CA, Salame J, Luu GLS, Acharjee S, Ruangkittisakul A, Martinez JA, Jalali H, Watts R, Ballanyi K, Guo GF, Zochodne DW, Power C. Nerve growth factor acts through the TrkA receptor to protect sensory neurons from the damaging effects of the HIV-1 viral protein, Vpr. Neuroscience 2013; 252:512-25. [PMID: 23912036 DOI: 10.1016/j.neuroscience.2013.07.046] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 06/30/2013] [Accepted: 07/22/2013] [Indexed: 01/19/2023]
Abstract
Distal sensory polyneuropathy (DSP) with associated neuropathic pain is the most common neurological disorder affecting patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Viral protein R (Vpr) is a neurotoxic protein encoded by HIV-1 and secreted by infected macrophages. Vpr reduces neuronal viability, increases cytosolic calcium and membrane excitability of cultured dorsal root ganglion (DRG) sensory neurons, and is associated with mechanical allodynia in vivo. A clinical trial with HIV/AIDS patients demonstrated that nerve growth factor (NGF) reduced the severity of DSP-associated neuropathic pain, a problem linked to damage to small diameter, potentially NGF-responsive fibers. Herein, the actions of NGF were investigated in our Vpr model of DSP and we demonstrated that NGF significantly protected sensory neurons from the effects of Vpr. Footpads of immunodeficient Vpr transgenic (vpr/RAG1(-/-)) mice displayed allodynia (p<0.05), diminished epidermalinnervation (p<0.01) and reduced NGF mRNA expression (p<0.001) compared to immunodeficient (wildtype/RAG1(-/-)) littermate control mice. Compartmented cultures confirmed recombinant Vpr exposure to the DRG neuronal perikarya decreased distal neurite extension (p<0.01), whereas NGF exposure at these distal axons protected the DRG neurons from the Vpr-induced effect on their cell bodies. NGF prevented Vpr-induced attenuation of the phosphorylated glycogen synthase-3 axon extension pathway and tropomyosin-related kinase A (TrkA) receptor expression in DRG neurons (p<0.05) and it directly counteracted the cytosolic calcium burst caused by Vpr exposure to DRG neurons (p<0.01). TrkA receptor agonist indicated that NGFacted through the TrkA receptor to block the Vpr-mediated decrease in axon outgrowth in neonatal and adult rat and fetal human DRG neurons (p<0.05). Similarly, inhibiting the lower affinity NGF receptor, p75, blocked Vpr's effect on DRG neurons. Overall, NGF/TrkA signaling or p75 receptor inhibition protects somatic sensory neurons exposed to Vpr, thus laying the groundwork for potential therapeutic options for HIV/AIDS patients suffering from DSP.
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Affiliation(s)
- C A Webber
- Division of Anatomy, University of Alberta, Edmonton, Alberta T6G 2H7, Canada.
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