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Kasperek D, Colloc T, Edwards D, Longridge N. Drawing parallels between coronectomy and vital pulp treatment. Br Dent J 2024; 236:188. [PMID: 38332081 DOI: 10.1038/s41415-024-7091-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 01/09/2024] [Indexed: 02/10/2024]
Affiliation(s)
- D Kasperek
- Academic Clinical Fellow Dental Core Trainee, Department of Restorative Dentistry, University of Liverpool, Liverpool, UK.
| | - T Colloc
- Clinical Lecturer in Endodontics, Dundee Dental Hospital and Research School, University of Dundee, Dundee, UK.
| | - D Edwards
- School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, UK.
| | - N Longridge
- Senior Clinical Lecturer in Endodontics, Department of Restorative Dentistry, University of Liverpool, Liverpool, UK.
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Sun GY, Edwards DM, Miller SR, Elliott DA, Hamstra DA, Chen AC, Green M, Bryant AK. Association of Proton Pump Inhibitor Use and Severe Pneumonitis in Stage III Non-Small-Cell Lung Cancer Treated with Primary Chemoradiation and Adjuvant Durvalumab. Int J Radiat Oncol Biol Phys 2023; 117:e61. [PMID: 37785836 DOI: 10.1016/j.ijrobp.2023.06.780] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Prior studies have suggested gut microbiome changes induced by long-term acid-reducing medication use could modulate immunotherapy efficacy and toxicity. We assessed the relationship between baseline acid-reducing medication use (proton pump inhibitors [PPI] or H2 antagonists [H2A]) on treatment-related toxicity and efficacy in a large cohort of stage III non-small-cell lung cancer (NSCLC) patients treated with or without immunotherapy. MATERIALS/METHODS Patients with unresectable stage III NSCLC treated with primary concurrent chemoradiation with or without adjuvant durvalumab from 2015 to 2021 were identified in the Veterans Affairs (VA) system. We defined baseline acid-reducing medication use with VA and non-VA pharmacy records in the year prior to radiation start; the number of prescriptions and the cumulative duration of therapy were quantified. Using multivariable Cox models adjusting for potential baseline confounders and stratified by adjuvant durvalumab use, we estimated the association between PPI or H2A use and subsequent severe pneumonitis, progression-free survival, and overall survival. Pneumonitis was determined and graded by manual chart review. RESULTS We included 1994 patients with stage III NSCLC treated with primary chemoradiation, of whom 1005 (50%) received adjuvant durvalumab, 1064 (53%) received any PPI and 1030 (52%) received any H2A. In the overall sample, baseline use of any PPI was associated with increased risk of grade 3-5 pneumonitis (adjusted hazard ratio [aHR] 1.53, 95% CI 1.12-2.10, p = 0.008) and was found to be significant only in durvalumab-treated patients (aHR 1.67, 95% CI 1.10-2.54, p = 0.016), but not for patients treated without durvalumab (aHR 1.34, 95% CI 0.82-2.20, p = 0.2). Higher number of PPI prescriptions were associated with increased risk of severe pneumonitis (aHR 1.38 per 5 prescriptions, 95% CI 1.03-1.85, p = 0.03) and longer duration of PPIs trended toward significance (aHR 1.04 per 90 days, 95% CI 1.00-1.09, p = 0.066). Any PPI use was associated with worse OS in durvalumab-treated patients (aHR 1.30, 95% CI 1.05-1.61, p = 0.016) but not for patients without durvalumab use (aHR 0.99, 95% CI 0.86-1.14, p = 0.9). PPI use had no association with progression-free survival in either cohort. No significant associations between baseline H2A use and pneumonitis, PFS, or OS in either cohort were seen. CONCLUSION PPIs, but not H2As, are associated with increased risk of treatment-related pneumonitis and inferior OS in stage III NSCLC patients treated with chemoradiation and immunotherapy. This association was not observed among patients treated with chemoradiation alone. No association was found between PPI use and cancer progression. Further work is warranted to confirm these findings in other immunotherapy-treated cohorts.
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Affiliation(s)
- G Y Sun
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI; Department of Radiation Oncology, Veterans Affairs Ann Arbor Health System, Ann Arbor, MI
| | - D M Edwards
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI; Department of Radiation Oncology, Veterans Affairs Ann Arbor Health System, Ann Arbor, MI
| | - S R Miller
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI; Department of Radiation Oncology, Veterans Affairs Ann Arbor Health System, Ann Arbor, MI
| | - D A Elliott
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI; Department of Radiation Oncology, Veterans Affairs Ann Arbor Health System, Ann Arbor, MI
| | - D A Hamstra
- Department of Radiation Oncology, Baylor College of Medicine, Houston, TX
| | - A C Chen
- Department of Radiation Oncology, Baylor College of Medicine, Houston, TX; Department of Radiation Oncology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX
| | - M Green
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI; Department of Radiation Oncology, Veterans Affairs Ann Arbor Health System, Ann Arbor, MI
| | - A K Bryant
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI; Department of Radiation Oncology, Veterans Affairs Ann Arbor Health System, Ann Arbor, MI
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3
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Edwards DM, Bryant AK, Sankar K, Dess K, Alseri A, Ramnath N, Green M. Symptomatic Pneumonitis Rates Among Patients with Stage III Non-Small Cell Lung Cancer Receiving Adjuvant Durvalumab. Int J Radiat Oncol Biol Phys 2023; 117:e17. [PMID: 37784776 DOI: 10.1016/j.ijrobp.2023.06.683] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Adjuvant durvalumab after definitive chemoradiation for stage III non-small cell lung cancer (NSCLC) has improved overall survival with low reported pneumonitis rates in clinical trials. However, real-world rates of treatment-associated pneumonitis remain poorly defined. We sought to describe pneumonitis rates among a largest-to-date real-world cohort of stage III NSCLC patients receiving adjuvant durvalumab. MATERIALS/METHODS We performed a retrospective cohort study of patients with stage III NSCLC in the national Veterans Health Administration who received concurrent chemoradiation alone from 2015-2016 or concurrent chemoradiation followed by at least one dose of adjuvant durvalumab from 2017-2021. Incident pneumonitis was defined as new or worsening symptoms, radiographic changes on CT chest, at least one steroid prescription, and a likely diagnosis of pneumonitis by the treating physician within 2 years of the final radiation treatment; severity was graded by CTCAE v4.03 criteria. Pneumonitis events were ascertained by manual chart review assisted by keyword searches and steroid prescription data. Cox regression was used to identify baseline clinical factors associated with Grade 2+ pneumonitis. RESULTS Our cohort included 1,994 patients with stage IIII NSCLC, 989 of whom received concurrent chemoradiation alone and 1005 of whom received adjuvant durvalumab. The overall incidence of symptomatic pneumonitis among patients receiving concurrent chemoradiation alone vs those receiving adjuvant immunotherapy was 6.8% vs 11% (Grade 2, p = 0.0005), 6% vs 8.4% (Grade 3, p = 0.007) and 1.1% vs 1.6% (Grade 5, p = 0.292), respectively. The cumulative incidence of Grade 2-5 pneumonitis at 2 years was 13.8% among patients treated with chemoradiation alone versus 22.1% for patients treated with chemoradiation followed by durvalumab (p ≤0.0001). Of those with Grade 2 pneumonitis, pneumonitis occurred in 85% of patients within one year of receiving radiation, and 84% of those with Grade 3-5 pneumonitis developed pneumonitis within one year. Patients prescribed outpatient steroids for pneumonitis had active prescriptions lasting a mean of 153 days, and among those hospitalized for pneumonitis, ¾ needed supplemental oxygen support. On multivariate analysis, the use of durvalumab is associated with higher risk of Grade 2-5 pneumonitis (HR 1.4, p = 0.004). Current smokers have a 50% risk reduction for Grade 2+ pneumonitis relative to never smokers (p≤0.001). CONCLUSION In this largest-to-date cohort, we found that adjuvant immunotherapy is associated with higher risk of Grade 2+ pneumonitis. The increase in symptomatic pneumonitis associated with durvalumab should spur future work to refine patient selection, balance the risk/benefit of adjuvant immunotherapy, and potentially modify radiation dosimetric constraints to decrease pneumonitis rates.
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Affiliation(s)
- D M Edwards
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - A K Bryant
- Department of Radiation Oncology, Veterans Affairs Ann Arbor Health System, Ann Arbor, MI
| | - K Sankar
- Department of Hematology and Oncology, University of Michigan, Ann Arbor, MI
| | - K Dess
- Veterans Affairs Ann Arbor Health System, Ann Arbor, MI
| | - A Alseri
- Veterans Affairs Ann Arbor Health System, Ann Arbor, MI
| | - N Ramnath
- Department of Hematology and Oncology, University of Michigan, Ann Arbor, MI
| | - M Green
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
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Edwards DM, Hopkins A, Scott A, Mannan R, Cao X, Zhang L, Andren A, Heth JA, Muraszko K, Sagher O, Orringer D, Hollon T, Hervey-Jumper S, Venneti S, Camelo-Piragua S, Al-Holou W, Chinnaiyan A, Lyssiotis CA, Wahl DR. Identification of Excellent Prognosis IDH Wildtype Glioblastomas Using Genomic and Metabolic Profiling. Int J Radiat Oncol Biol Phys 2023; 117:e101. [PMID: 37784627 DOI: 10.1016/j.ijrobp.2023.06.870] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) High grade gliomas (HGGs) are aggressive brain tumors with altered cellular metabolism. HGGs can carry mutations in the tricarboxylic acid (TCA) cycle enzyme isocitrate dehydrogenase 1 (IDH1), conferring distinct biology and improved patient prognosis compared to IDH wildtype (wt) tumors. Using metabolomic analyses of tumor tissue, we previously showed that IDH wt and IDH mutant (IDH mut) tumors have unique metabolomic signatures that correlate with different survival outcomes. Among this cohort of 69 HGG samples, we identified two unique patient tumors that metabolically clustered with IDH mut tumors, but lacked both the IDH mutation and its product 2-hydroxyglutarate. We aimed to discover unique mutations in these two tumors that may impart an IDH mutant-like phenotype in the absence of an IDH1 or IDH2 mutation. MATERIALS/METHODS Whole exome sequencing (WES) was performed on frozen tumor samples from two patients diagnosed as glioblastoma (GBM), IDH wt via Agilent v5 + IncRNA platform. Alignment to the hg38 genome and variant calling were completed using an accelerated implementation of GATK's BWA and MuTect2 algorithms from Sentieon. Variants were filtered based on supporting reads and variant allele thresholds, with synonymous variants and common SNPs removed. High-confidence variants were further filtered by membership in the four KEGG pathways associated with IDH1 and IDH2. Identified variants were corroborated with metabolomics data from the two unique IDH wt tumors compared with classical GBM IDH wt, oligodendrogliomas IDH mut and astrocytomas IDH mut to identify putative drivers of an IDH mutant-like metabolomic phenotype in these unique IDH wt tumors. RESULTS Despite the lack of an IDH mutation, one patient survived 45.6 months and the other patient remains alive at last follow up 64 months post diagnosis, much longer than the 16-18-month median survival typical of patients with GBM IDH wt. WES of outlier IDH wt tumor samples revealed 65 unique mutations in the queried KEGG pathways, of which 34 had a variant allele frequency > = 0.15. These variants were processed in Gprofiler, confirming expected enrichment of the carboxylic acid metabolic biologic process, a functional gene set consisting of TCA genes, among these variants (p = 0.002, 3.6-fold enrichment). Accordingly, metabolite levels of intermediates of the TCA cycle, including malate and isocitrate were decreased in the outlier tumor samples compared to classic GBMs IDH wt (p<0.001). Presence of genetic alterations in key variants of the carboxylic acid metabolic biologic process (including ME1, GYP4F3, PTGIS, PFKL, PSPH, AKR1A1, HK2, NOS1) correlated with improved overall survival among GBM patients in the TCGA (p = 0.04). Laboratory validation of these findings in preclinical GBM models is ongoing. CONCLUSION Disruption of the TCA cycle independent of an IDH mutation is associated with favorable survival in GBM. Pharmacologic inhibition of these pathways may be a promising strategy to improve GBM outcomes.
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Affiliation(s)
- D M Edwards
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - A Hopkins
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI
| | - A Scott
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - R Mannan
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI
| | - X Cao
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI
| | - L Zhang
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI
| | - A Andren
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI
| | - J A Heth
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI
| | - K Muraszko
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI
| | - O Sagher
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI
| | - D Orringer
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI
| | - T Hollon
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI
| | - S Hervey-Jumper
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI
| | - S Venneti
- Department of Pathology, University of Michigan, Ann Arbor, MI
| | | | - W Al-Holou
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI
| | - A Chinnaiyan
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI
| | - C A Lyssiotis
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI
| | - D R Wahl
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
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Su S, Mayo C, Rosen BS, Covington E, Zhang Z, Bryant AK, Allen SG, Morales Rivera KA, Edwards DM, Takayesu J, Herr DJ, Miller SR, Regan SN, Dykstra MP, Sun GY, Elaimy AL, Mierzwa ML. Use of Explainable AI Algorithm Revealing Longitudinal Changes in Practice Patterns and Toxicity Models. Int J Radiat Oncol Biol Phys 2023; 117:e628. [PMID: 37785877 DOI: 10.1016/j.ijrobp.2023.06.2020] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Dosimetric constraints evolve as clinicians implement practice changes, requiring modeling approaches to be dynamic. We applied a semi-automated explainable artificial intelligence (eAI) algorithm and dashboard visualizations to model dysphagia and xerostomia for head and neck cancer patients. We coupled a large, comprehensive, "real-world" database to the eAI for discovery of features with the strongest combined statistical and machine learning based evidence and to identify clinically actionable thresholds. MATERIALS/METHODS Cohort included 758 patients treated 2017-2021 for HN cancer with conventional fractionation. Features included age, sex, diagnosis, staging, chemotherapy, smoking and alcohol status, BMI, weight loss, re-simulation, DVH curves, PTV and OAR volumes. Patients were scored for toxicity within 2 yrs of RT for dysphagia grade ≥ 3 and xerostomia grade ≥ 2. Bootstrap resampling of thresholds, ROC-AUC, PR-ROC, SN, SP, F1 and diagnostic odds ratio was used to statistically profile strength of evidence for candidate features. XGBoost models with 10-fold cross validation were repeated (n = 20) to identify mean and CIs for statistical measures of predictions. DVH metrics included standard template values and those with highest statistical evidence and low cross correlation with other features. Backward feature selection was used to identify the most relevant feature subset, where the least informative feature is iteratively removed from the model. This workflow was repeated by year and overall. RESULTS Annual incidence of dysphagia averaged 0.13 ± 0.02 overall years. Xerostomia incidence decreased from 0.32 to 0.12 (2017-2021). Box-whisker plots by year showed consistent reductions in standard practice toxicity linked DVH metric values. Median dose to superior constrictors (PCM), contralateral parotid and contralateral submandibular gland (SMG) declined from 2017 to 2021 by 48 to 33 Gy, 17 to 10 Gy, and 28 to 22 Gy respectively. Statistics of XGBoost models of dysphagia for all years were ROC-AUC = 0.72 ± 0.05. Strongest overall years predictors were Oral Cavity (OC) D50%[Gy] < 32, inferior PCM Max [Gy] < 60, contralateral SMG D10%[Gy] < 53 and use of Paclitaxel. Xerostomia models were less predictive with ROC-AUC = 0.65 ± 0.05. Strongest predictors over each year were ipsilateral parotid D30%[Gy] < 35, contralateral SMG D96%[Gy] < 18.4, and overall staging < II. Predictive features varied substantially by year for both, showing the most consistency for SMG doses. For example, OC D50%[Gy] < 27 and contralateral SMG D96%[Gy] < 18 dominated xerostomia model in 2017 but not in 2021 when practice norms shifted to lower doses. CONCLUSION As OAR doses were systematically reduced, statistical and AI models evidence highlighted contralateral SMG dose as important to both dysphagia and xerostomia for clinical practice change. The "real-world" database + eAI + visualization dashboards provided a method for continuous learning as clinical practice changes.
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Affiliation(s)
- S Su
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - C Mayo
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - B S Rosen
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - E Covington
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - Z Zhang
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - A K Bryant
- Department of Radiation Oncology, Veterans Affairs Ann Arbor Health System, Ann Arbor, MI
| | - S G Allen
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | | | - D M Edwards
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - J Takayesu
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - D J Herr
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - S R Miller
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - S N Regan
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - M P Dykstra
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - G Y Sun
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - A L Elaimy
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - M L Mierzwa
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
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Edwards D, Sheehan S, Ingrams D. Unilateral tonsil enlargement in children and adults: is routine histology tonsillectomy warranted? A multi-centre series of 323 patients. J Laryngol Otol 2023; 137:1022-1026. [PMID: 36167605 DOI: 10.1017/s002221512200216x] [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] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study aimed to establish whether histology tonsillectomy is justified for unilateral tonsil enlargement. METHODS A retrospective review was conducted of histology tonsillectomies in three health organisations over five years, with strict exclusion criteria, focusing on benign-appearing unilateral tonsil enlargement. RESULTS Ninety paediatric and 233 adult cases were included. No paediatric cases and five adult cases of malignancy were detected. All malignant cases presented with other symptoms. Using binary logistic regression, a history of rapid unilateral tonsil enlargement was the only factor found to be significantly associated with malignant outcome. Thirty-three per cent of subjectively larger tonsils were smaller on post-operative histological measurement. Of the cases, 12.1 per cent re-presented with post-tonsillectomy bleeding. CONCLUSION The authors recommend avoiding histology tonsillectomy for unilateral tonsil enlargement unless 'red flag' signs of malignancy are present, with particular attention to rapid unilateral tonsil enlargement. This study demonstrated discrepancy between clinical examination findings and true tonsil asymmetry; there may be a role for cross-sectional imaging prior to histology tonsillectomy in high-risk patients.
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Affiliation(s)
- D Edwards
- Department of ENT Surgery, University Hospital of Wales, Cardiff, UK
| | - S Sheehan
- Department of ENT Surgery, Aneurin Bevan University Health Board, Newport, Wales, UK
| | - D Ingrams
- Department of ENT Surgery, Aneurin Bevan University Health Board, Newport, Wales, UK
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Cullington HE, Jiang D, Broomfield SJ, Chung M, Craddock LC, Driver S, Edwards D, Gallacher JM, Jones LL, Koleva T, Martin J, Meakin H, Nash R, Rocca C, Schramm DR, Willmott NS, Vanat ZH. Cochlear implant services for children, young people and adults. Quality standard. Cochlear Implants Int 2023:1-13. [PMID: 37114384 DOI: 10.1080/14670100.2023.2197344] [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: 04/29/2023]
Affiliation(s)
- H E Cullington
- University of Southampton Auditory Implant Service, SO17 1BJ, UK
| | - D Jiang
- Hearing Implant Centre, Guy's and St. Thomas NHS Foundation Trust, London, UK
- Centre for Craniofacial and Regenerative Biology, King's College London, London, UK
| | - S J Broomfield
- West of England Hearing Implant Programme, University Hospitals Bristol and Weston NHS Foundation Trust, UK
| | - M Chung
- Auditory Implant Department, Royal National ENT & Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, UK
| | - L C Craddock
- Midlands Hearing Implant Programme (Adult service), University Hospitals Birmingham NHS Foundation Trust, UK
| | - S Driver
- Hearing Implant Centre, Guy's and St. Thomas NHS Foundation Trust, London, UK
| | - D Edwards
- Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Trust, UK
| | - J M Gallacher
- Scottish Cochlear Implant Program, Crosshouse Hospital, Kilmarnock, UK
| | - L Ll Jones
- North Wales Auditory Implant Service, Betsi Cadwaladr University Health Board, Bodelwyddan, UK
| | - T Koleva
- Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Trust, UK
| | - J Martin
- Cochlear Implant Programme, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK
| | - H Meakin
- Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Trust, UK
| | - R Nash
- Cochlear Implant Programme, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK
| | - C Rocca
- Hearing Implant Centre, Guy's and St. Thomas NHS Foundation Trust, London, UK
| | - D R Schramm
- University of Ottawa Auditory Implant Centre, Ottawa, Canada
| | - N S Willmott
- Auditory Implant Centre, Belfast Health and Social Care Trust, UK
| | - Z H Vanat
- Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Trust, UK
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Edwards D, Rasaiah S, Ahmed S, Breckons M, Stone SJ, Currie CC, Durham J, Whitworth J. The financial and quality of life impact of urgent dental presentations: A cross-sectional study. Int Endod J 2023; 56:697-709. [PMID: 36975836 DOI: 10.1111/iej.13917] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023]
Abstract
AIM This study aimed to: (i) calculate personal financial costs associated with urgent dental attendance; and (ii) investigate the pain-related disability and quality of life impact of dental conditions which result in urgent dental attendance. METHODOLOGY Data were collected from those presenting with urgent dental conditions to an out-of-hours dental service, a dental emergency clinic and five primary care general dental practices across North-East England. A pre-operative questionnaire explored the impact of urgent dental conditions on oral health-related quality of life (OHRQoL) using Oral Health Impact Profile-14 (OHIP-14) and modified Graded Chronic Pain Scale (GCPS). OHIP-14 yields a maximum score of 56, with a higher score indicating a lower OHRQoL. Personal financial costs were summed to provide a total. These included travel, appointment fees, childcare costs, medication use and time away from work. Data were analysed using one-way ANOVA and multivariable modelling. RESULTS In total, 714 participants were recruited. Mean OHIP-14 score was 25.73; 95% CI [24.67, 26.79], GCPS CPI was 71.69; 95% CI [70.09, 73.28] and GCPS interference was 49.56; 95% CI [47.24, 51.87]. Symptomatic irreversible pulpitis was the most frequently managed dental emergency and was associated with the highest mean OHIP-14 score (31.67; 95% CI [30.20, 33.15]). The mean personal financial cost of urgent dental care was £85.81; 95% CI [73.29, 98.33]. Differences in travel time (F[2, 691] = 10.24, p<.001), transport costs (F[2, 698] = 4.92, p=.004), and appointment time (F[2, 74] = 9.40, p<.001) were significant between patients attending an out-of-hours dental service, dental emergency clinic and dental practices for emergency care, with a dental emergency clinic being associated with the highest costs and dental practices the lowest. CONCLUSIONS Diseases of the pulp and associated periapical disease were the most common reason for patients to present for urgent dental care and were the most impactful in terms of OHRQoL and pain in the present sample. Personal financial costs are significant from urgent dental conditions, with centralised services increasing the burden to patients of attending appointments.
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Affiliation(s)
- D Edwards
- School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW, UK
| | - S Rasaiah
- School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW, UK
| | - S Ahmed
- Newcastle Hospitals NHS Foundation Trust, Newcastle, Dental Hospital, Richardson Road, NE2 4AZ, UK
| | - M Breckons
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne, NE2 4AX, UK
- NIHR Applied Research Collaboration North East and Cumbria, Newcastle upon Tyne, NE3 3XT, UK
| | - S J Stone
- School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW, UK
| | - C C Currie
- School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW, UK
| | - J Durham
- School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW, UK
| | - J Whitworth
- School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW, UK
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Boden SA, McIntosh RA, Uauy C, Krattinger SG, Dubcovsky J, Rogers WJ, Xia XC, Badaeva ED, Bentley AR, Brown-Guedira G, Caccamo M, Cattivelli L, Chhuneja P, Cockram J, Contreras-Moreira B, Dreisigacker S, Edwards D, González FG, Guzmán C, Ikeda TM, Karsai I, Nasuda S, Pozniak C, Prins R, Sen TZ, Silva P, Simkova H, Zhang Y. Updated guidelines for gene nomenclature in wheat. Theor Appl Genet 2023; 136:72. [PMID: 36952017 PMCID: PMC10036449 DOI: 10.1007/s00122-023-04253-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 10/10/2022] [Indexed: 06/18/2023]
Abstract
Here, we provide an updated set of guidelines for naming genes in wheat that has been endorsed by the wheat research community. The last decade has seen a proliferation in genomic resources for wheat, including reference- and pan-genome assemblies with gene annotations, which provide new opportunities to detect, characterise, and describe genes that influence traits of interest. The expansion of genetic information has supported growth of the wheat research community and catalysed strong interest in the genes that control agronomically important traits, such as yield, pathogen resistance, grain quality, and abiotic stress tolerance. To accommodate these developments, we present an updated set of guidelines for gene nomenclature in wheat. These guidelines can be used to describe loci identified based on morphological or phenotypic features or to name genes based on sequence information, such as similarity to genes characterised in other species or the biochemical properties of the encoded protein. The updated guidelines provide a flexible system that is not overly prescriptive but provides structure and a common framework for naming genes in wheat, which may be extended to related cereal species. We propose these guidelines be used henceforth by the wheat research community to facilitate integration of data from independent studies and allow broader and more efficient use of text and data mining approaches, which will ultimately help further accelerate wheat research and breeding.
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Affiliation(s)
- S. A. Boden
- School of Agriculture, Food and Wine, Waite Research Institute, University of Adelaide, Glen Osmond, SA 5064 Australia
| | - R. A. McIntosh
- School of Life and Environmental Sciences, University of Sydney, Plant Breeding Institute, 107 Cobbitty Road, Cobbitty, NSW 2570 Australia
| | - C. Uauy
- John Innes Centre, Norwich Research Park, Norwich, NR4 7UH UK
| | - S. G. Krattinger
- Plant Science Program, Biological and Environmental Science and Engineering Division, King Abdullah University of Science and Technology, Thuwal, 23955-6900 Saudi Arabia
- The Wheat Initiative, 14195 Berlin, Germany
| | - J. Dubcovsky
- Department of Plant Science, University of California, Davis, CA 95616 USA
- The Wheat Initiative, 14195 Berlin, Germany
| | - W. J. Rogers
- Departamento de Biología Aplicada, Facultad de Agronomía (CIISAS, CIC-BIOLAB AZUL, CONICET-INBIOTEC, CRESCA), Universidad Nacional del Centro de La Provincia de Buenos Aires, Av. República Italia 780, C.C. 47, (7300), Azul, Provincia de Buenos Aires Argentina
- The Wheat Initiative, 14195 Berlin, Germany
| | - X. C. Xia
- Institute of Crop Science, National Wheat Improvement Centre, Chinese Academy of Agricultural Sciences, 12 Zhongguancun South St, Beijing, 100081 China
| | - E. D. Badaeva
- N.I. Vavilov Institute of General Genetics, Russian Academy of Sciences, Moscow, Russia 119991
| | - A. R. Bentley
- International Maize and Wheat Improvement Center (CIMMYT), Apdo Postal 6-641, Mexico, D.F., Mexico
- The Wheat Initiative, 14195 Berlin, Germany
| | - G. Brown-Guedira
- USDA-ARS Plant Science Research, North Carolina State University, William Hall 4114A, Raleigh, NC 27695 USA
- The Wheat Initiative, 14195 Berlin, Germany
| | - M. Caccamo
- NIAB, 93 Lawrence Weaver Road, Cambridge, CB3 0LE UK
- The Wheat Initiative, 14195 Berlin, Germany
| | - L. Cattivelli
- Council for Agricultural Research and Economics (CREA), Research Centre for Genomics and Bioinformatics, Via S. Protaso, 302, 29017 Fiorenzuola d’Arda, PC Italy
- The Wheat Initiative, 14195 Berlin, Germany
| | - P. Chhuneja
- School of Agricultural Biotechnology, Punjab Agricultural University, Ludhiana, 141 004 India
| | - J. Cockram
- NIAB, 93 Lawrence Weaver Road, Cambridge, CB3 0LE UK
- The Wheat Initiative, 14195 Berlin, Germany
| | | | - S. Dreisigacker
- International Maize and Wheat Improvement Center (CIMMYT), Apdo Postal 6-641, Mexico, D.F., Mexico
- The Wheat Initiative, 14195 Berlin, Germany
| | - D. Edwards
- School of Biological Sciences, University of Western Australia, Perth, 6009 Australia
- The Wheat Initiative, 14195 Berlin, Germany
| | - F. G. González
- Instituto Nacional de Tecnología Agropecuaria (INTA), EEA Pergamino, y Centro de Investigaciones y Transferencia del Noroeste de la Provincia de Buenos Aires (CITNOBA, CONICET-UNNOBA-UNSADA), Ruta 32. Km 4.5, CP 2700, Pergamino, Buenos Aires Argentina
- The Wheat Initiative, 14195 Berlin, Germany
| | - C. Guzmán
- Department of Genetics, School of Agricultural and Forest Engineering, Universidad de Córdoba, Córdoba, Spain
- The Wheat Initiative, 14195 Berlin, Germany
| | - T. M. Ikeda
- Agroecosystem and Crop Breeding Group, Western Region Agricultural Research Center, Fukuyama, Hiroshima 721-8514 Japan
- The Wheat Initiative, 14195 Berlin, Germany
| | - I. Karsai
- Centre for Agricultural Research, ELKH, 2462 Martonvasar, Hungary
- The Wheat Initiative, 14195 Berlin, Germany
| | - S. Nasuda
- Laboratory of Plant Breeding, Graduate School of Agriculture, Kyoto University, Kyoto, 606-8224 Japan
| | - C. Pozniak
- Crop Development Centre and Department of Plant Sciences, University of Saskatchewan, 51 Campus Drive, Saskatoon, SK S7N 5A8 Canada
- The Wheat Initiative, 14195 Berlin, Germany
| | - R. Prins
- CenGen Pty Ltd., Worcester, 6850 South Africa
- Department of Genetics, Stellenbosch University, Matieland, 7602 South Africa
| | - T. Z. Sen
- Crop Improvement and Genetics Research Unit, USDA-ARS, 800 Buchanan St, Albany, CA 94710 USA
- The Wheat Initiative, 14195 Berlin, Germany
| | - P. Silva
- Programa Nacional de Cultivos de Secano, Instituto Nacional de Investigación Agropecuaria (INIA), Estación Experimental La Estanzuela, 70006 Colonia, Uruguay
| | - H. Simkova
- Institute of Experimental Botany of the Czech Academy of Sciences, Šlechtitelů 31, 779 00 Olomouc, Czech Republic
| | - Y. Zhang
- State Key Laboratory of Genetic Engineering, Collaborative Innovation Center of Genetics and Development, Institute of Plant Biology, School of Life Sciences, Fudan University, Shanghai, 200438 China
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Davies H, Ahmed SH, Edwards D. Metal vs fibre posts - which is clinically superior for the restoration of endodontically treated teeth? Evid Based Dent 2021; 22:162-163. [PMID: 34916651 DOI: 10.1038/s41432-021-0222-y] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 10/11/2021] [Indexed: 11/09/2022]
Abstract
Data sources Medline/PubMed, Web of Science, Scopus and Cochrane Library databases. Grey literature searches (OpenGrey, ProQuest databases), hand searches in the reference list of eligible studies and relevant journals.Study selection Randomised controlled trials (RCTs) and prospective clinical trials (PCTs) with direct comparisons between metal posts (MPs) and fibre posts (FPs). Trials contained a minimum of ten patients and endodontically treated permanent teeth that had received either single crowns or fixed partial dentures (bridges) and followed up for a minimum of one year. The primary outcome compared the difference in failure rates between FPs and MPs, with subgroup analysis comparing location (anterior/posterior), type of MP (cast post core/preformed MP) and most frequent modes of failure (debond/root fracture).Data extraction and synthesis Study selection, data collection and risk of bias assessments were completed independently by two reviewers. Disagreements were discussed with a third reviewer to reach a consensus. The risk of bias was evaluated using the Cochrane risk of bias tool (RCTs) or the ROBINS-I tool (PCTs). The quality of responses was assessed using the Grading of Recommendations Assessment, Development And Evaluation (GRADE) approach. The meta-analysis (MA) was performed using the Mantel-Haenszel method. Trial heterogeneity was assessed using random- and fixed-effects models. Inter-examiner agreement during the database search and study selection process was checked using the kappa statistic.Results After duplicates were removed, 1,026 articles were assessed and screened by title and abstract. Of these, 21 articles underwent full-text evaluation, with ten articles meeting the eligibility criteria. Eligible studies included six RCTs and four PCTs. A total of 844 endodontically treated teeth (ETT) were restored with intra-radicular posts in 704 participants. Four hundred and fifty-three ETT were restored with FPs and 391 with MPs. The mean age of participants was 42.7 (33.95-55.45) years, with a mean follow-up period of 50.95 (12-154) months. Most studies reported failures during the follow-up period, but the MA revealed no significant difference between FPs and MPs in terms of failure rates (P = 0.39; RR: 0.82 mm; CI: 0.52-1.29). Sub-analysis showed no difference in failure rates between anterior and posterior regions and no difference when comparing FPs to cast post and core vs prefabricated MPs. Root fractures and post debondings were the most common modes of failure, but within these failures, no difference was observed between FPs and MPs.Conclusions No evidence was identified for a difference in failure rates between FPs and MPs. This was independent of the type of MP and position within the arch. Reporting of RCTs and PCTs was variable and further high-quality studies are needed.
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Affiliation(s)
- H Davies
- Restorative Dentistry, Newcastle upon Tyne, UK
| | - S H Ahmed
- Restorative Dentistry, Newcastle upon Tyne, UK
| | - D Edwards
- Restorative Dentistry (Endodontics), Newcastle Dental Hospital, UK
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Gillam TB, Cole J, Gharbi K, Angiolini E, Barker T, Bickerton P, Brabbs T, Chin J, Coen E, Cossey S, Davey R, Davidson R, Durrant A, Edwards D, Hall N, Henderson S, Hitchcock M, Irish N, Lipscombe J, Jones G, Parr G, Rushworth S, Shearer N, Smith R, Steel N. Norwich COVID-19 testing initiative pilot: evaluating the feasibility of asymptomatic testing on a university campus. J Public Health (Oxf) 2021; 43:82-88. [PMID: 33124664 PMCID: PMC7665602 DOI: 10.1093/pubmed/fdaa194] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/01/2020] [Accepted: 10/07/2020] [Indexed: 11/13/2022] Open
Abstract
Background There is a high prevalence of COVID-19 in university-age students, who are returning to campuses. There is little evidence regarding the feasibility of universal, asymptomatic testing to help control outbreaks in this population. This study aimed to pilot mass COVID-19 testing on a university research park, to assess the feasibility and acceptability of scaling up testing to all staff and students. Methods This was a cross-sectional feasibility study on a university research park in the East of England. All staff and students (5625) were eligible to participate. All participants were offered four PCR swabs, which they self-administered over two weeks. Outcome measures included uptake, drop-out rate, positivity rates, participant acceptability measures, laboratory processing measures, data collection and management measures. Results 798 (76%) of 1053 who registered provided at least one swab; 687 (86%) provided all four; 792 (99%) of 798 who submitted at least one swab had all negative results and 6 participants had one inconclusive result. There were no positive results. 458 (57%) of 798 participants responded to a post-testing survey, demonstrating a mean acceptability score of 4.51/5, with five being the most positive. Conclusions Repeated self-testing for COVID-19 using PCR is feasible and acceptable to a university population.
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Affiliation(s)
- T Berger Gillam
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK
| | - J Cole
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK
| | - K Gharbi
- Genomics Pipelines, Earlham Institute, Norwich, NR4 7UZ, UK
| | - E Angiolini
- Scientific Training and Education, Earlham Institute, Norwich NR4 7UZ, UK
| | - T Barker
- Genomics Pipelines, Earlham Institute, Norwich, NR4 7UZ, UK
| | - P Bickerton
- Communications, Earlham Institute, Norwich NR4 7UZ, UK
| | - T Brabbs
- Genomics Pipelines, Earlham Institute, Norwich, NR4 7UZ, UK
| | - J Chin
- School of Computing Sciences, University of East Anglia, Norwich NR4 7TJ, UK
| | - E Coen
- John Innes Centre, Norwich NR4 7UH, UK
| | - S Cossey
- Earlham Institute, Norwich NR4 7UZ, UK
| | - R Davey
- Earlham Institute, Norwich NR4 7UZ, UK
| | - R Davidson
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK
| | - A Durrant
- Genomics Pipelines, Earlham Institute, Norwich, NR4 7UZ, UK
| | - D Edwards
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK
| | - N Hall
- Earlham Institute, Norwich NR4 7UZ, UK.,UEA Biosciences, University of East Anglia, Norwich NR4 7TJ, UK
| | - S Henderson
- Genomics Pipelines, Earlham Institute, Norwich, NR4 7UZ, UK
| | - M Hitchcock
- UEA Health and Social Care Partners, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK
| | - N Irish
- Genomics Pipelines, Earlham Institute, Norwich, NR4 7UZ, UK
| | - J Lipscombe
- Genomics Pipelines, Earlham Institute, Norwich, NR4 7UZ, UK
| | - G Jones
- Communications, Earlham Institute, Norwich NR4 7UZ, UK
| | - G Parr
- School of Computing Sciences, University of East Anglia, Norwich NR4 7TJ, UK
| | - S Rushworth
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK
| | - N Shearer
- Genomics Pipelines, Earlham Institute, Norwich, NR4 7UZ, UK
| | - R Smith
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK
| | - N Steel
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK
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Deaton C, Forsyth F, Mant J, Edwards D, Hobbs R, Taylor C, Aziz A, Schiff R, Odone J, Zaman J. Characteristics and health status of patients with and without confirmed HFpEF. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3139] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
Patients with heart failure with preserved ejection fraction (HFpEF) are usually older and multi-morbid and diagnosis can be challenging. The aims of this cohort study were to confirm diagnosis of HFpEF in patients with possible HFpEF recruited from primary care, to compare characteristics and health status between those with and without HFpEF, and to determine factors associated with health status in patients with HFpEF.
Methods
Patients with presumed HFpEF were recruited from primary care practices and underwent clinical assessment and diagnostic evaluation as part of a longitudinal cohort study. Health status was measured by Montreal Cognitive Assessment (MOCA), 6-minute walk test, symptoms, and the Kansas City Cardiomyopathy Questionnaire (KCCQ), and quality of life (QoL) by EQ-5D-5L visual analogue scale (VAS).
Results
151 patients (mean age 78.5±8.6 years, 40% women, mean EF 56% + 9.4) were recruited and 93 (61.6%) were confirmed HFpEF (those without HFpEF had other HF and cardiac diagnoses). Patients with and without HFpEF did not differ by age, MOCA, blood pressure, heart rate, NYHA class, proportion with atrial fibrillation, Charlson Comorbidity Index, or NT-ProBNP levels. Patients with HFpEF were more likely to be women, overweight or obese, frail, and to be more functionally impaired by 6 minute walk distance and gait speed than those without. Although not statistically significant, patients with HFpEF had clinically significant differences (>5 points) on the physical limitations, symptom burden and clinical summary subscales of the KCCQ, but did not differ by other subscales or by EQ-5D-5L VAS (70±17 vs 73±19, p=0.385). More patients with HFpEF reported daytime dyspnoea (63% vs 46%, p=0.035) and fatigue (81% vs 61%, p=0.008), but not other symptoms compared to those without HFpEF. For both groups BMI was moderately negatively correlated with KCCQ subscale scores, and 6 minute walk distance was positively correlated with KCCQ subscales.
Conclusions
Nearly 40% were not confirmed as HFpEF indicating the challenges of diagnosis. Patients with confirmed HFpEF differed by sex, overweight/obesity, frailty, functional impairment, and symptoms but not by age or comorbidities from those without HFpEF. These differences were reflected in some subscale scores of the KCCQ, but not how patients reported their quality of life on the KCCQ QoL subscale and EQ-5D-5L VAS. Older patients with HFpEF reported relatively high QoL despite poor health status by functional impairment, frailty and symptoms.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Institute of Health Research School of Primary Care Research
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Affiliation(s)
- C Deaton
- University of Cambridge, Public Health and Primary Care, Cambridge, United Kingdom
| | - F Forsyth
- University of Cambridge, Public Health and Primary Care, Cambridge, United Kingdom
| | - J Mant
- University of Cambridge, Public Health and Primary Care, Cambridge, United Kingdom
| | - D Edwards
- University of Cambridge, Public Health and Primary Care, Cambridge, United Kingdom
| | - R Hobbs
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - C Taylor
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - A Aziz
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - R Schiff
- Guys and St Thomas Hospital, London, United Kingdom
| | - J Odone
- Guys and St Thomas Hospital, London, United Kingdom
| | - J Zaman
- James Paget University Hospital, Great Yarmouth, United Kingdom
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Elbanna M, Shiue K, Edwards D, Cerra-Franco A, Agrawal N, Hinton J, Mereniuk T, Huang C, Ryan J, Smith J, Aaron V, Burney H, Zang Y, Holmes J, Langer M, Zellars R, Lautenschlaeger T. Impact of Lung Parenchymal-Only Failure on Overall Survival in Early Stage Lung Cancer Patients Treated with Stereotactic Body Radiation Therapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Angadi DS, Edwards D, Melton JTK. Calcium phosphate injection of symptomatic bone marrow lesions of the knee: what is the current clinical evidence? Knee Surg Relat Res 2020; 32:4. [PMID: 32660639 PMCID: PMC7219219 DOI: 10.1186/s43019-019-0013-3] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 10/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic bone marrow lesions (BML) in the weight-bearing portions of the knee are often associated with symptomatic degenerative arthritis resulting in pain and dysfunction. Injection of bone substitute material like calcium phosphate has been described. Whilst some studies have reported encouraging results others have shown limited benefit of this technique. AIM The aim was to collate the available evidence on the injection of calcium phosphate and systematically evaluate the results to answer the questions encountered in clinical decision making: (1) does it provide effective long-lasting pain relief to avoid further surgical intervention? (2) which factors (patient/surgical) significantly influence the outcome? and (3) does it adversely affect the outcomes of subsequent arthroplasty? METHODS A literature search was performed to identify the studies describing the clinical outcomes of calcium phosphate injection for treatment of BML. We evaluated the reported clinical outcomes with respect to pain, function and complications. Isolated case reports and studies with no objective assessment of clinical outcomes were excluded. RESULTS We noted 46 articles in the current literature of which 8 described clinical outcomes of calcium phosphate injection. Mean (plus/minus SD) score on the visual analog scale (VAS) has been reported to improve from 7.90 (± 0.38) to 2.76 (± 0.90), whereas the International Knee Documentation Committee (IKDC) score improved from 30.5 (SD not reported (NR)) to 53.0 (SD NR). Pre and post procedure Short form survey (SF-12) scores were 29.8 (SD NR) and 36.7 (SD NR), respectively. In one study, scores on the Tegner Lysholm knee scoring scale improved in 12 out of 22 patients, whereas the remainder had no change in symptoms. Extravasation of calcium phosphate into the joint was the most common complication, whereas no adverse effect has been reported on subsequent arthroplasty. CONCLUSION Limited data from the published studies would suggest that calcium phosphate injection of BML may potentially improve pain and function. However, no evidence is currently available to clearly identify patient/surgical factors that may influence the long-term outcomes of this procedure. Hence pragmatic, prospective studies with stratified patient cohorts and robust reporting of outcome measures are essential to improve the understanding of the indications and clinical effectiveness of this novel procedure.
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Affiliation(s)
- D S Angadi
- Department of Orthopaedic Surgery, Cheltenham General Hospital, Sandford Road, Cheltenham, Gloucestershire, GL53 7AN, UK.
| | - D Edwards
- Department of Trauma and Orthopaedics, Addenbrookes Hospital, Cambridge, UK
| | - J T K Melton
- Department of Trauma and Orthopaedics, Addenbrookes Hospital, Cambridge, UK
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Zhu Y, Edwards D, Kiddle S, Payne R. Characteristics and outcomes of clusters of multimorbid patients in UK general practice. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.662] [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: 11/12/2022] Open
Abstract
Abstract
Background
Current clinical specialities, guidelines and quality of care metrics are organised around single diseases and treatments of multiple conditions are rarely coordinated, resulting in insufficient or even conflicting care. This study uses large scale English general practice (GP) records to identify and characterise clusters of patients based on their multimorbidity to allow better design of health services and highlight groups that require additional interventions.
Methods
This is a retrospective cohort study that includes multimorbid adult patients (N = 113,211), from a random sample of 391,669 English patients with valid GP records in 2012 where 38 long-term conditions were defined. Latent class analysis, stratified by age groups, was used to identify multimorbidity clusters. Class solutions are validated and associations between multimorbidity clusters, patient characteristics, public health service utilisation and mortality are assessed.
Results
Poor socioeconomic status is associated with clusters with higher service use and mortality risk. Physical-mental health co-morbidity is a major component of multimorbidity across all age strata. The clusters with highest age-stratified mortality risk in under 65 year olds were linked to alcohol and substance misuse, whereas in over 65 year olds they were linked to cardiovascular disease. The largest cluster in the 85+ years strata (58%) has the lowest number of morbidities, a low degree of service use and mortality. Consistency was seen across identification and validation data.
Conclusions
We find a clear distinction between morbidity clusters, both in the prevalence of long term conditions within them, and in their associations with outcomes (service use and mortality). Specific health services and interventions might be more effective when targeted on the distinct types of multimorbidity we have identified, with a particular focus on the morbidity clusters associated with the worst patient outcomes.
Key messages
The first study to derive age stratified multimorbidity clusters from a large GP record system, whose patients are representative of the English population. Knowledge about particularly dangerous clusters of multimorbidity, such as those involving alcohol and drug use in 18–64 years old, and cardiovascular disease in those 65 years or older.
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Affiliation(s)
- Y Zhu
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - D Edwards
- The Primary Care Unit, University of Cambridge, Cambridge, UK
| | - S Kiddle
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - R Payne
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Edwards D, Cullinan P, Taylor-Robinson D, Schlüter D, Carr S. WS15-3 Exploring the relationship between CFRD treatment and lung function. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30207-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Karlsson I, Traub S, Järås K, Edwards D, Gramming E, Lindell Andersson M, To Y, Mårtensson L, Teige I, Acton G, Dyer M, Radford J, Collins G, Jerkeman M, Frendéus B, McAllister A, Davies A. PHASE 1/2A CLINICAL TRIALS OF BI-1206, A MONOCLONAL ANTIBODY TO FCΓRIIB, ADMINISTERED AS A SINGLE AGENT OR IN COMBINATION WITH RITUXIMAB IN SUBJECTS WITH B-CELL MALIGNANCIES. Hematol Oncol 2019. [DOI: 10.1002/hon.206_2631] [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: 11/09/2022]
Affiliation(s)
- I. Karlsson
- Preclinical Research; BioInvent International AB; Lund Sweden
| | - S. Traub
- Centre for Drug Development; Cancer Research UK; London United Kingdom
| | - K. Järås
- Clinical Development; BioInvent International AB; Lund Sweden
| | - D. Edwards
- Centre for Drug Development; Cancer Research UK; London United Kingdom
| | - E. Gramming
- Clinical Development; BioInvent International AB; Lund Sweden
| | | | - Y. To
- Centre for Drug Development; Cancer Research UK; London United Kingdom
| | - L. Mårtensson
- Preclinical Research; BioInvent International AB; Lund Sweden
| | - I. Teige
- Preclinical Research; BioInvent International AB; Lund Sweden
| | - G. Acton
- Centre for Drug Development; Cancer Research UK; London United Kingdom
| | - M.J. Dyer
- Ernest and Helen Scott Haematological Research Institute; University of Leicester; Leicester United Kingdom
| | - J. Radford
- Institute of Cancer Sciences; University of Manchester; Manchester United Kingdom
| | - G.P. Collins
- Oxford Cancer and Haematology Centre; Churchill Hospital; Oxford United Kingdom
| | - M. Jerkeman
- Department of Oncology; Skane University Hospital; Lund Sweden
| | - B. Frendéus
- Preclinical Research; BioInvent International AB; Lund Sweden
| | - A. McAllister
- Clinical Development; BioInvent International AB; Lund Sweden
| | - A. Davies
- University of Southampton; Cancer Research UK Centre; Southampton United Kingdom
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Levy J, Edwards D, Dilenno N, Dreher P, Lurz K, Zinar C, Belkoff L, Lurz K. 125 Linear Shockwave Tissue Coverage (LTSC) in the Treatment of Erectile Dysfunction (ED). J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Edwards D, Hodson T, Dalton K, Hobson G. P422 Review of CNS cystic fibrosis community service. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30714-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cheng L, Jones A, Kassam K, Pabla R, Patel S, Edwards D, Sadigh P, Tandy R, Kiela G. Recurrent wound dehiscence after neck surgery for metastatic papillary thyroid carcinoma. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Kim JA, Dustin D, Gu G, Corona-Rodriguez A, Edwards D, Coarfa C, Keyomarsi K, Fuqua SA. Abstract PD7-11: Therapeutic strategy for ESR1 mutation driven-endocrine resistance in ER-positive breast cancers. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd7-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Endocrine therapy is used in estrogen receptor (ER)-positive breast cancers, however, 25% of these patients are at risk of distant relapse and the development of acquired endocrine resistance. Recently mutations in the ER gene (ESR1) have been validated to be acquired during the development of endocrine resistance. The most frequent ESR1 mutation, Y537S, promotes ligand-independent ER activity and emerges subclonally during aromatase inhibitor treatment. In this study, we examined the effects of the Y537S ESR1 mutation on cell cycle signaling and therapeutic response to a novel checkpoint inhibitor.
Material and Methods: MCF-7 cells expressing the Y537S ESR1 mutation were generated by CRISPR-Cas9 knock-in techniques. Cells were incubated in steroid deprived conditions. Cell cycle analysis and apoptosis were examined by flow cytometry annnexin-V assays. Proliferation was analyzed by BrdU incorporation. Cell cycle checkpoint kinases were examined by western blot analysis. Cell growth was analyzed using soft agar and MTT assays. Replication stress was identified by RPA32 and gamma-H2AX foci formation assay. For in vivo studies, MCF-7 ESR1 Y537S mutant cells were injected into female athymic nude mice with 17β-estradiol (E2) supplemented water. When tumors reached 350 mm3, tamoxifen (20 mg/kg; s.c.; three times a week), fulvestrant (200 mg/kg; s.c; once a week) and/or PF477736 Chk1 inhibitor (7.5 mg/kg; i.p.; twice a day and twice a week) was treated without E2.
Results: ESR1 Y537S mutant cells accumulated approximately 5 fold in S phase and 1.7 fold in G2/M phase compared to control cells in estrogen-deprived (ED) conditions. BrdU incorporation also increased about 2.5-fold, however, apoptosis was decreased about 60 % compared with wild-type ER parental cells. ESR1 Y537S mutant cells induced significant replication stress, showing increased RPA32 foci together with increased gamma H2AX foci, a marker of DNA double-stranded breaks. ChIP-seq analysis revealed binding sites on ATR and CHEK1 genomic locations. ATR/Chk1-mediated checkpoint signaling was activated in ESR1 Y537S mutant cells, and was repressed with fulvestrant, tamoxifen, or ESR1 siRNA treatment. The Chk1 inhibitor, PF477736, sensitized MCF-7 expressing the ESR1 Y537S mutation to endocrine treatments such as fulvestrant, tamoxifen, and the ER degrader AZD9496 in cell proliferation assays. In MCF-7 ESR1 Y537S mutant xenograft and patient derived mouse models, tamoxifen treatment combined with the Chk1 inhibitor PF477736 repressed primary xenograft tumor doubling times (P=0.038, Wilcoxon test). Treatment of mutant tumors with PF477736 together with fulvestrant significantly inhibited the frequency of distant lung metastases by 80% (P=0.0031, t-test), suggesting that these combinations may be useful in second line treatment of metastatic breast cancer patients resistant to endocrine therapies.
Conclusion: These preclinical results suggest that ESR1 mutant tumors have a therapeutic vulnerability to combination endocrine therapy with cell cycle checkpoint kinase inhibitors. These data demonstrate that this new therapeutic approach may be useful to restore endocrine sensitivity in metastatic breast cancer patients with ESR1 mutation driven-endocrine resistance.
Citation Format: Kim J-A, Dustin D, Gu G, Corona-Rodriguez A, Edwards D, Coarfa C, Keyomarsi K, Fuqua SA. Therapeutic strategy for ESR1 mutation driven-endocrine resistance in ER-positive breast cancers [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD7-11.
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Affiliation(s)
- J-A Kim
- Baylor College of Medicine, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
| | - D Dustin
- Baylor College of Medicine, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
| | - G Gu
- Baylor College of Medicine, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
| | - A Corona-Rodriguez
- Baylor College of Medicine, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
| | - D Edwards
- Baylor College of Medicine, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
| | - C Coarfa
- Baylor College of Medicine, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
| | - K Keyomarsi
- Baylor College of Medicine, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
| | - SA Fuqua
- Baylor College of Medicine, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
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Ramsay J, Hogan C, Courser R, Edwards D, Janevic M, Connell C. COMPARING COMMUNITY-BASED AND EMR RECRUITMENT FOR ENGAGING OLDER MINORITY ADULTS: RESULTS FROM TAKE HEART. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J Ramsay
- University of Michigan School of Public Health
| | - C Hogan
- University of Michigan School of Public Health
| | - R Courser
- University of Michigan School of Public Health
| | - D Edwards
- University of Michigan School of Public Health
| | - M Janevic
- University of Michigan School of Public Health
| | - C Connell
- University of Michigan School of Public Health
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23
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Brazil L, Swampillai A, Mak K, Hackshaw A, Edwards D, Mesiri P, Clifton-Hadley L, Shaffer R, Lewis J, Watts C, Gkogkou P, Chalmers A, Fersht N, Short SC. P01.072 Hydroxychloroquine and short course radiotherapy for elderly patients with glioma: a randomised study. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- L Brazil
- Guys and St Thomas’s Hospital, London, United Kingdom
| | - A Swampillai
- Guys and St Thomas’s Hospital, London, United Kingdom
| | - K Mak
- University College London, London, United Kingdom
| | - A Hackshaw
- University College London, London, United Kingdom
| | - D Edwards
- University College London, London, United Kingdom
| | - P Mesiri
- University College London, London, United Kingdom
| | | | - R Shaffer
- Royal Surrey County Hospital, Guildford, United Kingdom
| | - J Lewis
- Newcastle Hospitals, Newcastle, United Kingdom
| | - C Watts
- University of Birmingham, Birmingham, United Kingdom
| | - P Gkogkou
- Norfolk and Norwich University Hospitals, Norwich, United Kingdom
| | - A Chalmers
- University of Glasgow, Glasgow, United Kingdom
| | - N Fersht
- University College London Hospital, London, United Kingdom
| | - S C Short
- University of Leeds, Leeds, United Kingdom
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24
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Phipps E, McPhedran K, Edwards D, Russell K, O'Connor CM, Morris J, O'Halloran C, Gunn-Moore D. Mycobacterium bovis
tuberculosis in hunting hounds. Vet Rec 2018; 183:356. [DOI: 10.1136/vr.k3962] [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: 11/04/2022]
Affiliation(s)
- E. Phipps
- Public Health England; Wellington House, 133-155 Waterloo Road London SE1 8UG
| | - K. McPhedran
- Public Health England; Wellington House, 133-155 Waterloo Road London SE1 8UG
| | - D. Edwards
- Public Health England; Wellington House, 133-155 Waterloo Road London SE1 8UG
| | - K. Russell
- Public Health England; Wellington House, 133-155 Waterloo Road London SE1 8UG
| | - C. M. O'Connor
- Public Health England; Wellington House, 133-155 Waterloo Road London SE1 8UG
| | - J. Morris
- Public Health England; Wellington House, 133-155 Waterloo Road London SE1 8UG
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25
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Wortman-Jutt S, Edwards D. On the generalizability of post-stroke proportional recovery. Eur J Neurol 2018; 24:e83-e84. [PMID: 29148225 DOI: 10.1111/ene.13408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 07/25/2017] [Indexed: 01/11/2023]
Affiliation(s)
| | - D Edwards
- Non-Invasive Brain Stimulation and Human Motor Control Laboratory, Burke Medical Research Institute, White Plains, NY, USA.,Department of Neurology, Weill Cornell Medicine, NY, USA.,Berenson-Allen Center for Noninvasive Brain Stimulation, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA.,School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
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26
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Ishida T, Wakai E, Hagiwara M, Makimura S, Tada M, Asner D, Casella A, Devaraj A, Edwards D, Prabhakaran R, Senor D, Hartz M, Bhadra S, Fiorentini A, Cadabeschi M, Martin J, Konaka A, Marino A, Atherthon A, Densham C, Fitton M, Ammigan K, Hurh P. Study of the radiation damage effect on Titanium metastable beta alloy by high intensity proton beam. Nuclear Materials and Energy 2018. [DOI: 10.1016/j.nme.2018.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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27
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Li X, Benjamin L, Edwards D, McChesney D. 102 Means to Prevent Microbial Enteric Pathogens Transmission through Animal Food. J Anim Sci 2018. [DOI: 10.1093/jas/sky073.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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28
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Sutton L, Edwards D, McColl M. Outpatient negative pressure dressing therapy for pretibial lacerations in a patient with high anaesthetic risk: a case study. J Wound Care 2017; 26:762-764. [PMID: 29244964 DOI: 10.12968/jowc.2017.26.12.762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pretibial lacerations are a common cause of presentation to accident and emergency departments. The management of these wounds is contentious with a variation in practise between individual institutions. We present the case of a 49-year-old female with a background of pulmonary atresia and associated pulmonary hypertension, who underwent successful outpatient negative pressure wound therapy (NPWT) for three pretibial lacerations. We would propose that this therapy is an effective option for the management of these wounds in independently mobile patients who are at high-risk when under anaesthetic.
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Affiliation(s)
- L Sutton
- Otolarygology Specialist, Head and Neck Centre, University College London Hospitals NHS Trust, London, UK; UCL Cancer Institute, University College London, London, UK
| | - D Edwards
- Lead Nurse, Burns and Plastic Surgery, Plastic Surgery Department, The Royal London Hospital, Barts Health NHS Trust, London, UK
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29
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French GCA, Stürup M, Rizzuto S, van Wyk JH, Edwards D, Dolan RW, Wintner SP, Towner AV, Hughes WOH. The tooth, the whole tooth and nothing but the tooth: tooth shape and ontogenetic shift dynamics in the white shark Carcharodon carcharias. J Fish Biol 2017; 91:1032-1047. [PMID: 28815588 DOI: 10.1111/jfb.13396] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 01/20/2017] [Accepted: 07/18/2017] [Indexed: 06/07/2023]
Abstract
Results from this study of the white shark Carcharodon carcharias include measurements obtained using a novel photographic method that reveal significant differences between the sexes in the relationship between tooth cuspidity and shark total length, and a novel ontogenetic change in male tooth shape. Males exhibit broader upper first teeth and increased distal inclination of upper third teeth with increasing length, while females do not present a consistent morphological change. Substantial individual variation, with implications for pace of life syndrome, was present in males and tooth polymorphism was suggested in females. Sexual differences and individual variation may play major roles in ontogenetic changes in tooth morphology in C. carcharias, with potential implications for their foraging biology. Such individual and sexual differences should be included in studies of ontogenetic shift dynamics in other species and systems.
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Affiliation(s)
- G C A French
- School of Life Sciences, University of Sussex, Brighton, BN1 9QG, U.K
| | - M Stürup
- School of Life Sciences, University of Sussex, Brighton, BN1 9QG, U.K
| | - S Rizzuto
- Department of Botany and Zoology, Stellenbosch University, Stellenbosch, 7600, South Africa
| | - J H van Wyk
- Department of Botany and Zoology, Stellenbosch University, Stellenbosch, 7600, South Africa
| | - D Edwards
- Dyer Island Conservation Trust, Kleinbaai, South Africa
| | - R W Dolan
- Dyer Island Conservation Trust, Kleinbaai, South Africa
| | - S P Wintner
- KwaZulu-Natal Sharks Board and Biomedical Resource Unit, University of KwaZulu-Natal, Durban, 4000, South Africa
| | - A V Towner
- Dyer Island Conservation Trust, Kleinbaai, South Africa
| | - W O H Hughes
- School of Life Sciences, University of Sussex, Brighton, BN1 9QG, U.K
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30
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Edwards D. P15: DRUG REPORTING ACCURACY AND COMPLETENESS IS DEPENDENT ON THOSE WHO ARE INVESTED IN NEGATIVE OUTCOMES OF ADVERSE DRUG REACTIONS. Intern Med J 2017. [DOI: 10.1111/imj.15_13578] [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: 11/27/2022]
Affiliation(s)
- D Edwards
- Clinical Nurse, Allergy/Clinical Immunology Unit and Post Anaesthetic Care Unit, Flinders Medical Centre; South Australia Australia
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31
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Affiliation(s)
- CJ Deutsch
- Clinical Fellow in Plastic Surgery, Department of Plastic Surgery, Royal London Hospital, London E1 1BB
| | - DM Edwards
- Clinical Nurse Specialist, Department of Plastic Surgery, Royal London Hospital, London
| | - S Myers
- Consultant Plastic Surgeon and Senior Clinical Lecturer in Plastic Surgery, Department of Plastic Surgery, Royal London Hospital, London
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32
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Edwards D, Eltbogen R, Nöldner M. P-04-004 Stress-induced female sexual dysfunction: Beneficial effect of the Rhodiola rosea extract Rosalin® (WS® 1375). J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.03.240] [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: 10/19/2022]
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33
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Ruffini G, Fox M, Santarnecchi E, Miranda P, Edwards D, Wendling F, Pascual-Leone A. Modeling, targeting and optimizing multichannel transcranial current stimulation (tCS). Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.01.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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34
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Slagboom M, Kargo M, Edwards D, Sørensen AC, Thomasen JR, Hjortø L. Herd characteristics influence farmers’ preferences for trait improvements in Danish Red and Danish Jersey cows. ACTA AGR SCAND A-AN 2017. [DOI: 10.1080/09064702.2016.1277550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M. Slagboom
- Department of Molecular Biology and Genetics, Center for Quantitative Genetics and Genomics, Aarhus University, Tjele, Denmark
| | - M. Kargo
- Department of Molecular Biology and Genetics, Center for Quantitative Genetics and Genomics, Aarhus University, Tjele, Denmark
- SEGES Cattle, Aarhus N, Denmark
| | - D. Edwards
- Department of Molecular Biology and Genetics, Center for Quantitative Genetics and Genomics, Aarhus University, Tjele, Denmark
| | - A. C. Sørensen
- Department of Molecular Biology and Genetics, Center for Quantitative Genetics and Genomics, Aarhus University, Tjele, Denmark
| | | | - L. Hjortø
- Department of Molecular Biology and Genetics, Center for Quantitative Genetics and Genomics, Aarhus University, Tjele, Denmark
- SEGES Cattle, Aarhus N, Denmark
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35
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Slagboom M, Kargo M, Edwards D, Sørensen A, Thomasen J, Hjortø L. Organic dairy farmers put more emphasis on production traits than conventional farmers. J Dairy Sci 2016; 99:9845-9856. [DOI: 10.3168/jds.2016-11346] [Citation(s) in RCA: 20] [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: 04/22/2016] [Accepted: 08/08/2016] [Indexed: 11/19/2022]
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36
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Abduljalil K, Edwards D, Barnett A, Rose RH, Cain T, Jamei M. A Tutorial on Pharmacodynamic Scripting Facility in Simcyp. CPT Pharmacometrics Syst Pharmacol 2016; 5:455-65. [PMID: 27393710 PMCID: PMC5036420 DOI: 10.1002/psp4.12102] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 06/30/2016] [Accepted: 07/02/2016] [Indexed: 02/05/2023]
Affiliation(s)
- K Abduljalil
- Simcyp Limited (a Certara Company), Blades Enterprise Centre, Sheffield, UK.
| | - D Edwards
- Simcyp Limited (a Certara Company), Blades Enterprise Centre, Sheffield, UK
| | - A Barnett
- Simcyp Limited (a Certara Company), Blades Enterprise Centre, Sheffield, UK
| | - R H Rose
- Simcyp Limited (a Certara Company), Blades Enterprise Centre, Sheffield, UK
| | - T Cain
- Simcyp Limited (a Certara Company), Blades Enterprise Centre, Sheffield, UK
| | - M Jamei
- Simcyp Limited (a Certara Company), Blades Enterprise Centre, Sheffield, UK
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37
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Hopkinson JB, Milton R, King A, Edwards D. People with dementia: what is known about their experience of cancer treatment and cancer treatment outcomes? A systematic review. Psychooncology 2016; 25:1137-1146. [PMID: 27246507 DOI: 10.1002/pon.4185] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [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: 12/31/2015] [Revised: 05/27/2016] [Accepted: 05/27/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The objective of the study is to report a systematic review of what is currently known about the experience of cancer treatment and cancer treatment in adults with dementia. METHODS The analytic plan and inclusion/exclusion criteria were specified in advance of the search process in a protocol. Searches were conducted in MEDLINE, CINAHL, PsycINFO and the Cochrane Library for publications about people with cancer and a pre-existing dementia. Limits were English language; 2000 to 12/2015; adults; >18 years old. The search identified 5214 titles and abstracts that were assessed against eligibility criteria and 101 were selected for full-text examination by two researchers who agreed inclusion of nine papers, extracted data independently then conducted a content analysis and narrative synthesis. RESULTS Nine studies conducted in four resource rich countries were included in the review. These studies evidence that when compared with other cancer patients, those with dementia are diagnosed at a later stage, receive less treatment, are more likely to experience complications from treatment and have poorer survival. The experience of supportive care and preferences of people with dementia receiving cancer services and cancer treatment have not been investigated. Research into how the cancer team manage the particular needs of people with dementia and their family members has been limited to one study that reported how a cancer team managed the particular needs of seven people with dementia. CONCLUSION Further work is needed to establish practice guidelines for the management of cancer in people with dementia. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- J B Hopkinson
- School of Healthcare Sciences, Cardiff University, Cardiff, UK.
| | - R Milton
- School of Medicine, Cardiff University, Cardiff, UK
| | - A King
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - D Edwards
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
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38
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Sundaresh A, Gasparoli L, Mangolini M, Edwards D, Hubank M, Brooks T, Bartram J, Goulden N, Ancliff P, de Boer J, Williams O. Aberrant transcriptional pathways in t(12;21) Acute Lymphoblastic Leukemia. Klin Padiatr 2016. [DOI: 10.1055/s-0036-1582489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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39
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Iglesias-Bartolome R, Edwards D, Molinolo A, Brooks S, Doci C, Abusleme L, Moutsopoulos N, Gutkind J, Morasso M. 711 The molecular anatomy of human oral and cutaneous wound healing. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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40
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Edwards D, Kumar V, Nöldner M. P-01-051 Stress-induced sexual dysfunction in rodents and humans: the Rhodiola rosea extract WS® 1375 shows clinical promise. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.03.201] [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: 10/21/2022]
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41
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Edwards DM. The absence of intraband scattering in a consistent theory of Gilbert damping in pure metallic ferromagnets. J Phys Condens Matter 2016; 28:086004. [PMID: 26837050 DOI: 10.1088/0953-8984/28/8/086004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Damping of magnetization dynamics in a ferromagnetic metal, arising from spin-orbit coupling, is usually characterised by the Gilbert parameter α. Recent calculations of this quantity, using a formula due to Kambersky, find that it is infinite for a perfect crystal owing to an intraband scattering term which is of third order in the spin-orbit parameter ξ. This surprising result conflicts with recent work by Costa and Muniz who study damping numerically by direct calculation of the dynamical transverse susceptibility in the presence of spin-orbit coupling. We resolve this inconsistency by following the approach of Costa and Muniz for a slightly simplified model where it is possible to calculate α analytically. We show that to second order in ξ one retrieves the Kambersky result for α, but to higher order one does not obtain any divergent intraband terms. The present work goes beyond that of Costa and Muniz by pointing out the necessity of including the effect of long-range Coulomb interaction in calculating damping for large ξ. A direct derivation of the Kambersky formula is given which shows clearly the restriction of its validity to second order in ξ so that no intraband scattering terms appear. This restriction has an important effect on the damping over a substantial range of impurity content and temperature. The experimental situation is discussed.
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Affiliation(s)
- D M Edwards
- Department of Mathematics, Imperial College London, London SW7 2BZ, UK
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42
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Zheng ZY, Bu W, Tian L, Fan C, Gao X, Zhang X, Yu C, Wang H, Liao YH, Li Y, Lewis MT, Edwards D, Zwaka TP, Hilsenbeck SG, Medina D, Perou CM, Creighton CJ, Zhang XH, Chang EC. Abstract P2-06-11: Wild type N-Ras, overexpressed in basal-like breast cancer, promotes tumor formation by inducing IL8 secretion via JAK2 activation. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p2-06-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
"Basal-like" breast cancer (BLBC) is a very aggressive subtype of breast cancer. BLBC has very poor prognosis — median time to distant recurrence is just 2.6 years vs. 5 years overall, and survival time from diagnosis of distant metastatic disease is 9 months vs. 22 months. BLBC tumors usually do not express ER, Her2, or progesterone receptor. As such, they cannot be treated by the current targeted therapies, which target these molecules. What drive the formation and progression of BLBCs is largely unclear.
Ras GTPases are best known for mediating growth factor signaling. Oncogenic mutations in the RAS genes, K-RAS in particular, are found in more than 30% of human tumors. Surprisingly, oncogenic RAS mutations are rare in breast cancer. However, we found that wild-type N-RAS is overexpressed in BLBCs, possibly partly via promoter demethylation, but not in other breast cancer subtypes. Repressing N-RAS inhibits transformation and tumor growth, while overexpressing it enhances these processes even in preinvasive BLBC cells. In contrast, in breast cancer cells of other subtypes, repressing N-RAS expression does not affect growth and transforming activities. We identified N-Ras-responsive genes, most of which encode chemokines and cytokines, e.g., IL8. High expression levels of these N-Ras-responsive genes as well as of N-RAS itself in tumors correlate with poor patient outcome. N-Ras, but not K-Ras, induces IL8 by binding and activating the cytoplasmic pool of JAK2; IL8 then acts on both the cancer cells and stromal fibroblasts.
In conclusion, N-Ras drives BLBC by promoting transformation in epithelial cells, which may in turn remodel the tumor microenvironment to create a proinvasive state. Although oncogenic mutations affecting RAS are common in many other human cancers, tumorigenesis in an important subset of breast cancers is driven instead by increasing activity of wild-type N-Ras. Thus, to fully assess the impact of Ras on tumorigenesis, the role of wild-type as well as mutant Ras proteins must be carefully examined.
Citation Format: Zheng Z-Y, Bu W, Tian L, Fan C, Gao X, Zhang X, Yu C, Wang H, Liao Y-H, Li Y, Lewis MT, Edwards D, Zwaka TP, Hilsenbeck SG, Medina D, Perou CM, Creighton CJ, Zhang XH, Chang EC. Wild type N-Ras, overexpressed in basal-like breast cancer, promotes tumor formation by inducing IL8 secretion via JAK2 activation. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-06-11.
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Affiliation(s)
- Z-Y Zheng
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
| | - W Bu
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
| | - L Tian
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
| | - C Fan
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
| | - X Gao
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
| | - X Zhang
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
| | - C Yu
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
| | - H Wang
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
| | - Y-H Liao
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
| | - Y Li
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
| | - MT Lewis
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
| | - D Edwards
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
| | - TP Zwaka
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
| | - SG Hilsenbeck
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
| | - D Medina
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
| | - CM Perou
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
| | - CJ Creighton
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
| | - XH Zhang
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
| | - EC Chang
- Baylor College of Medicine; University of North Carolina-Chapel Hill; National Taiwan University Hospital
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Abstract
Vaginal dryness is a common condition that is particularly prevalent during and after the menopause, and is one of the symptoms of vulvovaginal atrophy/genitourinary syndrome of menopause. The impact of vaginal dryness on interpersonal relationships, quality of life, daily activities, and sexual function can be significant, but is frequently underestimated. Furthermore, barriers exist to treatment-seeking, and this condition is often underreported and undertreated. Greater education about vaginal dryness and the range of available treatments is essential to encourage more women to seek help for this condition. Personal lubricants and moisturizers are effective at relieving discomfort and pain during sexual intercourse for women with mild to moderate vaginal dryness, particularly those who have a genuine contraindication to estrogen, or who choose not to use estrogen. However, there is a distinction between lubricants and moisturizers, and notable differences between commercially available products. Women should be advised to choose a product that is optimally balanced in terms of both osmolality and pH, and is physiologically most similar to natural vaginal secretions. A series of recommendations for the use of vaginal lubricants and moisturizers, either on their own or in combination with systemic or topical hormone replacement therapy, is presented.
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Affiliation(s)
- D Edwards
- a Claridges Barn , Charlbury Road, Chipping Norton , Oxon , UK
| | - N Panay
- b Queen Charlotte's & Chelsea Hospital and Chelsea & Westminster Hospital, and Honorary Senior Lecturer, Imperial College , London , UK
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Forbes VE, Brain R, Edwards D, Galic N, Hall T, Honegger J, Meyer C, Moore DRJ, Nacci D, Pastorok R, Preuss TG, Railsback SF, Salice C, Sibly RM, Tenhumberg B, Thorbek P, Wang M. Assessing pesticide risks to threatened and endangered species using population models: Findings and recommendations from a CropLife America Science Forum. Integr Environ Assess Manag 2015; 11:348-354. [PMID: 25655086 DOI: 10.1002/ieam.1628] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 10/29/2014] [Accepted: 01/20/2015] [Indexed: 06/04/2023]
Abstract
This brief communication reports on the main findings and recommendations from the 2014 Science Forum organized by CropLife America. The aim of the Forum was to gain a better understanding of the current status of population models and how they could be used in ecological risk assessments for threatened and endangered species potentially exposed to pesticides in the United States. The Forum panelists' recommendations are intended to assist the relevant government agencies with implementation of population modeling in future endangered species risk assessments for pesticides. The Forum included keynote presentations that provided an overview of current practices, highlighted the findings of a recent National Academy of Sciences report and its implications, reviewed the main categories of existing population models and the types of risk expressions that can be produced as model outputs, and provided examples of how population models are currently being used in different legislative contexts. The panel concluded that models developed for listed species assessments should provide quantitative risk estimates, incorporate realistic variability in environmental and demographic factors, integrate complex patterns of exposure and effects, and use baseline conditions that include present factors that have caused the species to be listed (e.g., habitat loss, invasive species) or have resulted in positive management action. Furthermore, the panel advocates for the formation of a multipartite advisory committee to provide best available knowledge and guidance related to model implementation and use, to address such needs as more systematic collection, digitization, and dissemination of data for listed species; consideration of the newest developments in good modeling practice; comprehensive review of existing population models and their applicability for listed species assessments; and development of case studies using a few well-tested models for particular species to demonstrate proof of concept. To advance our common goals, the panel recommends the following as important areas for further research and development: quantitative analysis of the causes of species listings to guide model development; systematic assessment of the relative role of toxicity versus other factors in driving pesticide risk; additional study of how interactions between density dependence and pesticides influence risk; and development of pragmatic approaches to assessing indirect effects of pesticides on listed species.
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Affiliation(s)
- V E Forbes
- School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - R Brain
- Syngenta Crop Protection, Greensboro, North Carolina, USA
| | - D Edwards
- BASF Corporation, Research Triangle Park, North Carolina, USA
| | - N Galic
- School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - T Hall
- Bayer CropScience, Research Triangle Park, North Carolina, USA
| | | | - C Meyer
- ARCADIS, Lakewood, Colorado, USA
| | - D R J Moore
- Intrinsik Environmental Sciences (US), New Gloucester, Maine
| | - D Nacci
- USEPA, Narragansett, Rhode Island
| | - R Pastorok
- Integral Consulting, Woodinville, Washington, USA
| | - T G Preuss
- Bayer CropScience AG, Monheim am Rhein, Germany
| | - S F Railsback
- Department of Mathematics, Humboldt State University, Arcata, California, USA
| | - C Salice
- Towson University, Environmental Science and Studies Program, Towson, Maryland, USA
| | - R M Sibly
- School of Biological Sciences, University of Reading, Reading, UK
| | - B Tenhumberg
- School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - P Thorbek
- Syngenta, Jealott's Hill International Research Centre, Bracknell, UK
| | - M Wang
- WSC Scientific GmbH, Heidelberg, Germany
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Wood P, Gill M, Edwards D, Clifton P, Bullock C, Aldington D. Clinical and microbiological evaluation of epidural and regional anaesthesia catheters in injured UK military personnel. J ROY ARMY MED CORPS 2015; 162:261-5. [PMID: 26076913 DOI: 10.1136/jramc-2015-000439] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 05/10/2015] [Indexed: 11/03/2022]
Abstract
INTRODUCTION The adoption of regional and epidural analgesia in UK military personnel injured in action during Op HERRICK increased from 2008, in line with structural and environmental developments in the UK medical treatment facility. Historically, there have been concerns that invasive analgesic techniques could carry an increased risk of infection, due to the mechanism of injury and the environmental conditions in which the injuries were sustained. Consequently, the epidural and continuous peripheral nerve blockade (CPNB) catheters that were inserted in UK military personnel during a 33-month period of Op HERRICK were clinically and microbiologically examined, after subsequent admission to the University Hospitals Birmingham (UHB) NHS Trust. METHODS Data on epidural and CPNB insertions were collected via the specialist pain service at UHB over the study period, including de novo and replacement insertions performed in both Afghanistan and the UK. Patients were regularly reviewed and relevant clinical concerns were documented in patients' case notes as necessary. The anatomical site, duration of placement and the results of microbiological culture of the epidural and CPNB catheter tips were all recorded. RESULTS Overall, 236 catheters were assessed, of which 151 catheter tips (64%) were cultured (85 epidural, 66 CPNB). Of these, 48 grew bacteria (34% of cultured epidurals and 29% of cultured CPNB). There was no difference between the colonisation rates of epidurals inserted in Afghanistan and the UK. Only one infection related to a misplaced epidural catheter was confirmed. CONCLUSIONS With the exception of the epidural (34%) and proximal sciatic (42%) catheters, these figures, in a military cohort characterised by significant injury scores, are consistent with those reported for civilian surgical patients. The results strongly support the expansion of regional analgesia during Op HERRICK from 2008 onwards. The outcomes suggest a possible translation into civilian major trauma practice.
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Affiliation(s)
- Paul Wood
- Department of Anaesthetics, Queen Elizabeth Hospital, Birmingham, UK
| | - M Gill
- Department of Microbiology, Queen Elizabeth Hospital, Birmingham, UK
| | - D Edwards
- Queen Elizabeth Hospital, Birmingham, UK
| | - P Clifton
- Wellington Medical Practice, Shropshire, UK
| | - C Bullock
- Department of Anaesthetics, Russells Hall Hospital Dudley, West Midlands, UK
| | - D Aldington
- Department of Anaesthetics, Hampshire Hospitals Foundation Trust, Winchester, Hampshire, UK
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Swat MJ, Moodie S, Wimalaratne SM, Kristensen NR, Lavielle M, Mari A, Magni P, Smith MK, Bizzotto R, Pasotti L, Mezzalana E, Comets E, Sarr C, Terranova N, Blaudez E, Chan P, Chard J, Chatel K, Chenel M, Edwards D, Franklin C, Giorgino T, Glont M, Girard P, Grenon P, Harling K, Hooker AC, Kaye R, Keizer R, Kloft C, Kok JN, Kokash N, Laibe C, Laveille C, Lestini G, Mentré F, Munafo A, Nordgren R, Nyberg HB, Parra-Guillen ZP, Plan E, Ribba B, Smith G, Trocóniz IF, Yvon F, Milligan PA, Harnisch L, Karlsson M, Hermjakob H, Le Novère N. Pharmacometrics Markup Language (PharmML): Opening New Perspectives for Model Exchange in Drug Development. CPT Pharmacometrics Syst Pharmacol 2015; 4:316-9. [PMID: 26225259 PMCID: PMC4505825 DOI: 10.1002/psp4.57] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 05/06/2015] [Indexed: 12/02/2022] Open
Abstract
The lack of a common exchange format for mathematical models in pharmacometrics has been a long-standing problem. Such a format has the potential to increase productivity and analysis quality, simplify the handling of complex workflows, ensure reproducibility of research, and facilitate the reuse of existing model resources. Pharmacometrics Markup Language (PharmML), currently under development by the Drug Disease Model Resources (DDMoRe) consortium, is intended to become an exchange standard in pharmacometrics by providing means to encode models, trial designs, and modeling steps.
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Affiliation(s)
- MJ Swat
- EMBL-European Bioinformatics Institute, Wellcome Trust Genome CampusHinxton, Cambridgeshire, UK
| | | | - SM Wimalaratne
- EMBL-European Bioinformatics Institute, Wellcome Trust Genome CampusHinxton, Cambridgeshire, UK
| | | | | | - A Mari
- National Research Council, Institute of Biomedical EngineeringPadova, Italy
| | - P Magni
- Dipartimento di Ingegneria Industriale e dell'Informazione, Università degli Studi di PaviaPavia, Italy
| | - MK Smith
- Global Clinical Pharmacology, PfizerSandwich, UK
| | - R Bizzotto
- INSERM, IAME, UMR 1137, Paris, France, University Paris Diderot, IAME, UMR 1137Sorbonne Paris Cité, Paris, France
| | - L Pasotti
- Dipartimento di Ingegneria Industriale e dell'Informazione, Università degli Studi di PaviaPavia, Italy
| | - E Mezzalana
- Dipartimento di Ingegneria Industriale e dell'Informazione, Università degli Studi di PaviaPavia, Italy
| | - E Comets
- INSERM, IAME, UMR 1137, Paris, France, University Paris Diderot, IAME, UMR 1137Sorbonne Paris Cité, Paris, France
| | - C Sarr
- Advanced Quantitative Sciences (AQS), NovartisBasel, Switzerland
| | - N Terranova
- Merck Institute for Pharmacometrics, Merck SeronoLausanne, Switzerland
| | | | - P Chan
- Global Clinical Pharmacology, PfizerSandwich, UK
| | - J Chard
- Mango SolutionsChippenham, Wiltshire, UK
| | | | - M Chenel
- SGS Exprimo NV, Mechelen, Belgium, Clinical Pharmacokinetics and Pharmacometrics, Institut de Recherches Internationales ServierSuresnes, France
| | - D Edwards
- Simcyp (a Certara company)Sheffield, UK
| | - C Franklin
- CPMS Technology and DevelopmentSouthall, UK
| | - T Giorgino
- National Research Council, Institute of Biomedical EngineeringPadova, Italy
| | - M Glont
- EMBL-European Bioinformatics Institute, Wellcome Trust Genome CampusHinxton, Cambridgeshire, UK
| | - P Girard
- Merck Institute for Pharmacometrics, Merck SeronoLausanne, Switzerland
| | - P Grenon
- CHIME, University College LondonLondon, UK
| | - K Harling
- Department of Pharmaceutical Biosciences, Uppsala UniversityUppsala, Sweden
| | - AC Hooker
- Department of Pharmaceutical Biosciences, Uppsala UniversityUppsala, Sweden
| | - R Kaye
- Mango SolutionsChippenham, Wiltshire, UK
| | - R Keizer
- Department of Pharmaceutical Biosciences, Uppsala UniversityUppsala, Sweden
| | - C Kloft
- Freie Universtitaet Berlin, Germany, Institute of Pharmacy, Department of Clinical Pharmacy and BiochemistryBerlin, Germany
| | - JN Kok
- Leiden Institute of Advanced Computer Science (LIACS), Leiden UniversityLeiden, The Netherlands
| | - N Kokash
- Leiden Institute of Advanced Computer Science (LIACS), Leiden UniversityLeiden, The Netherlands
| | - C Laibe
- EMBL-European Bioinformatics Institute, Wellcome Trust Genome CampusHinxton, Cambridgeshire, UK
| | - C Laveille
- SGS Exprimo NV, Mechelen, Belgium, Clinical Pharmacokinetics and Pharmacometrics, Institut de Recherches Internationales ServierSuresnes, France
| | - G Lestini
- INSERM, IAME, UMR 1137, Paris, France, University Paris Diderot, IAME, UMR 1137Sorbonne Paris Cité, Paris, France
| | - F Mentré
- INSERM, IAME, UMR 1137, Paris, France, University Paris Diderot, IAME, UMR 1137Sorbonne Paris Cité, Paris, France
| | - A Munafo
- Merck Institute for Pharmacometrics, Merck SeronoLausanne, Switzerland
| | - R Nordgren
- Department of Pharmaceutical Biosciences, Uppsala UniversityUppsala, Sweden
| | - HB Nyberg
- Mango SolutionsChippenham, Wiltshire, UK
- Department of Pharmaceutical Biosciences, Uppsala UniversityUppsala, Sweden
| | - ZP Parra-Guillen
- Freie Universtitaet Berlin, Germany, Institute of Pharmacy, Department of Clinical Pharmacy and BiochemistryBerlin, Germany
| | - E Plan
- Department of Pharmaceutical Biosciences, Uppsala UniversityUppsala, Sweden
| | - B Ribba
- Inria Grenoble - Rhône-AlpesGrenoble, France
| | - G Smith
- Scientific Computing Group, Cyprotex Discovery LimitedMacclesfield, Crewe, UK
| | - IF Trocóniz
- Department of Pharmacy and Pharmaceutical Technology, University of NavarraPamplona, Spain
| | - F Yvon
- EMBL-European Bioinformatics Institute, Wellcome Trust Genome CampusHinxton, Cambridgeshire, UK
| | - PA Milligan
- Global Clinical Pharmacology, PfizerSandwich, UK
| | - L Harnisch
- Global Clinical Pharmacology, PfizerSandwich, UK
| | - M Karlsson
- Department of Pharmaceutical Biosciences, Uppsala UniversityUppsala, Sweden
| | - H Hermjakob
- EMBL-European Bioinformatics Institute, Wellcome Trust Genome CampusHinxton, Cambridgeshire, UK
| | - N Le Novère
- EMBL-European Bioinformatics Institute, Wellcome Trust Genome CampusHinxton, Cambridgeshire, UK
- Babraham Institute, Babraham Research CampusCambridge, UK
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Bassim CW, Fassil H, Mays JW, Edwards D, Baird K, Steinberg SM, Cowen EW, Naik H, Datiles M, Stratton P, Gress RE, Pavletic SZ. Oral disease profiles in chronic graft versus host disease. J Dent Res 2015; 94:547-54. [PMID: 25740857 DOI: 10.1177/0022034515570942] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
At least half of patients with chronic graft-versus-host-disease (cGVHD), the leading cause of morbidity and non-relapse mortality after allogeneic stem cell transplantation, have oral manifestations: mucosal lesions, salivary dysfunction, and limited mouth-opening. cGVHD may manifest in a single organ or affect multiple organ systems, including the mouth, eyes, and the skin. The interrelationship of the 3 oral manifestations of cGVHD with each other and with the specific manifestations of extraoral cGVHD has not been studied. In this analysis, we explored, in a large group of patients with cGVHD, the potential associations between: (1) oral mucosal disease and erythematous skin disease, (2) salivary gland dysfunction and lacrimal gland dysfunction, and (3) limited mouth-opening and sclerotic skin cGVHD. Study participants, enrolled in a cGVHD Natural History Protocol (NCT00331968, n = 212), underwent an oral examination evaluating: (1) mucosal cGVHD [NIH Oral Mucosal Score (OMS)], (2) salivary dysfunction (saliva flow and xerostomia), and (3) maximum mouth-opening measurement. Parameters for dysfunction (OMS > 2, saliva flow ≤ 1 mL/5 min, mouth-opening ≤ 35 mm) were analyzed for association with skin cGVHD involvement (erythema and sclerosis, skin symptoms), lacrimal dysfunction (Schirmer's tear test, xerophthalmia), Lee cGVHD Symptom Scores, and NIH organ scores. Oral mucosal disease (31% prevalence) was associated with skin erythema (P < 0.001); salivary dysfunction (11% prevalence) was associated with lacrimal dysfunction (P = 0.010) and xerostomia with xerophthalmia (r = 0.32, P = 0.001); and limited mouth-opening (17% prevalence) was associated with skin sclerosis (P = 0.008) and skin symptoms (P = 0.001). There was no association found among these 3 oral cGVHD manifestations. This analysis supports the understanding of oral cGVHD as 3 distinct diseases: mucosal lesions, salivary gland dysfunction, and mouth sclerosis. Clear classification of oral cGVHD as 3 separate manifestations will improve clinical diagnosis, observational research data collection, and the definitions of outcome measures in clinical trials.
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Affiliation(s)
- C W Bassim
- National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, USA
| | - H Fassil
- Experimental Transplantation and Immunology Branch, National Cancer Institute, NIH, Bethesda, MD, USA Tufts University School of Dental Medicine, Boston, MA, USA
| | - J W Mays
- National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, USA
| | - D Edwards
- National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, USA
| | - K Baird
- Pediatric Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, USA
| | - S M Steinberg
- Biostatistics and Data Management Section, Office of the Clinical Director, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD, USA
| | - E W Cowen
- Dermatology Branch, National Cancer Institute, NIH, Bethesda, MD, USA
| | - H Naik
- Dermatology Branch, National Cancer Institute, NIH, Bethesda, MD, USA
| | - M Datiles
- National Eye Institute, NIH, Bethesda, MD, USA
| | - P Stratton
- Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD, USA
| | - R E Gress
- Experimental Transplantation and Immunology Branch, National Cancer Institute, NIH, Bethesda, MD, USA
| | - S Z Pavletic
- Experimental Transplantation and Immunology Branch, National Cancer Institute, NIH, Bethesda, MD, USA
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Killington MJ, Speck K, Kahlbaum J, Fabian J, Edwards D, Stobie J. Quality-of-life for individuals with a vestibular impairment following an acquired brain injury (ABI); the clients' perspective. Brain Inj 2015; 29:490-500. [PMID: 25615883 DOI: 10.3109/02699052.2014.995226] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE To investigate how a vestibular deficit following an acquired brain injury (ABI) affects an individuals' quality-of-life. RESEARCH DESIGN A qualitative exploratory design. PARTICIPANTS Nine community dwelling individuals who experienced significant symptoms and limitations as a result of their vestibular deficits. METHODS The individuals participated in face-to-face interviews with open ended questions. Data was analysed initially using a case study research approach, exploring the experience for each individual and then cross-case analysis to determine common themes for the group with the assistance of nVivo 10 qualitative analysis software. RESULTS Thematic analysis determined four main themes arising from the interviews; (1) validation, (2) definitive diagnosis is more difficult amongst an array of ABI symptoms, (3) vestibular adaptation is more difficult in the presence of an ABI and (4) emotional and social. CONCLUSION Individuals who suffer a brain injury and experience vestibular symptoms as part of their overall presentation are not diagnosed in a timely manner, with individuals, their families, associates and even health professionals feeling uncertain of the legitimacy of their reported symptoms. It is important that all patients who experience an acquired brain injury are screened for vestibular impairment and, if necessary, receive vestibular rehabilitation including explanation and education.
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Affiliation(s)
- M J Killington
- South Australian Brain Injury Rehabilitation Services, Hampstead Rehabilitation Centre, Royal Adelaide Hospital , Northfield , Australia
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49
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Edwards DM. A smooth polaron-molecule crossover in a Fermi system. J Phys Condens Matter 2013; 25:425602. [PMID: 24077394 DOI: 10.1088/0953-8984/25/42/425602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The problem of a single down-spin particle interacting with a Fermi sea of up-spin particles is of current interest in the field of cold atoms. The Hubbard model, appropriate to atoms in an optical lattice potential, is considered in parallel with a gas model. As the strength of an attractive short-range interaction is increased there is a crossover from 'polaron' behaviour, in which the Fermi sea is weakly perturbed, to 'molecule' behaviour in which the down-spin particle is bound to a single up-spin particle. It is shown that this is a smooth crossover, not a sharp transition as claimed by many authors.
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Affiliation(s)
- D M Edwards
- Department of Mathematics, Imperial College London, London SW7 2BZ, UK
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50
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Aldington D, Small C, Edwards D, Ralph J, Woods P, Jagdish S, Moore RA. A survey of post-amputation pains in serving military personnel. J ROY ARMY MED CORPS 2013; 160:38-41. [DOI: 10.1136/jramc-2013-000069] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [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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