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Gunby C, Isham L, Smailes H, Bradbury-Jones C, Damery S, Harlock J, Maxted F, Smith D, Taylor J. Working the Edge: The Emotional Experiences of Commissioning and Funding Arrangements for Service Leaders in the Sexual Violence Voluntary Sector. Violence Against Women 2024; 30:1783-1803. [PMID: 38509824 PMCID: PMC11041076 DOI: 10.1177/10778012241239945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
The specialist voluntary sector plays a crucial role in supporting survivors of sexual violence. However, in England, short-term funding underpins the sector's financial stability. This article examines sector leaders' ways of coping, resisting and being affected by funding practices. Using the concept of edgework, we show how funding and commissioning dynamics push individuals to the edge of service sustainability, job satisfaction, and emotional well-being. We examine how these edges are "worked," for example, by circumventing and remolding the edge. We offer an original way to theorize participants, make visible the emotional toll of service precarity and offer suggestions for support.
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Affiliation(s)
- Clare Gunby
- School of Nursing and Public Health, Manchester Metropolitan University, Manchester, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Louise Isham
- Department of Social Work and Social Care, University of Birmingham, Birmingham, UK
| | - Harriet Smailes
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- School of Criminology, University of Leicester, Leicester, UK
| | | | - Sarah Damery
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jenny Harlock
- Warwick Medical School, University of Warwick, Warwick, UK
| | | | - Deb Smith
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Julie Taylor
- School of Nursing, University of Birmingham, Birmingham, UK
- Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham, UK
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2
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Pocock H, Deakin CD, Lall R, Michelet F, Sun C, Smith D, Hill C, Rai J, Starr K, Brown M, Rodriguez-Bachiller I, Perkins GD. Prehospital optimal shock energy for defibrillation (POSED): A cluster randomised controlled feasibility trial. Resusc Plus 2024; 17:100569. [PMID: 38370312 PMCID: PMC10869912 DOI: 10.1016/j.resplu.2024.100569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/15/2024] [Accepted: 01/25/2024] [Indexed: 02/20/2024] Open
Abstract
Background We explored the feasibility of a large-scale UK ambulance services trial of optimal defibrillation shock energy for out-of-hospital cardiac arrest. The primary objective of this feasibility study was to establish the number of eligible patients and the number recruited. Secondary outcomes were adherence to allocated treatment and data completeness. Methods We conducted a three-arm parallel group cluster randomised controlled feasibility study in a single ambulance service in southern England. Adult patients in out-of-hospital cardiac arrest treated for a shockable rhythm were included. Zoll X series defibrillators (clusters) were randomised to deliver 120-150-200 J, 150-200-200 J, or 200-200-200 J shock strategies. Results Between March 2022 and February 2023, we randomised 38 eligible patients (120-150-200 J (n = 12), 150-200-200 J (n = 10), 200-200-200 J (n = 16)) to the study. The recruitment rate per cluster was 0.07 per month. The median patient age was 71 years (IQR 59-81 years); 79% were male. Twenty-eight cardiac arrests (74%) occurred in a private residence, 29 (76%) were witnessed and 32 (84%) patients received bystander CPR. Treatment adherence was 93% and completeness of clinical and electrical outcomes was 86%. At 30 days, 3/36 (8.3%) patients survived; we were unable to collect survival outcomes for two patients. Defibrillation data collection became difficult when defibrillators became separated from their allocated vehicles. Conclusion We have demonstrated the feasibility of a cluster randomised controlled trial of optimal shock energy for defibrillation in a UK ambulance service. We have identified possible solutions to issues relating to trial design.
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Affiliation(s)
- Helen Pocock
- South Central Ambulance NHS Foundation Trust, Talisman Way, Bicester, Oxfordshire OX26 6HR, UK
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, Warwickshire, UK
| | - Charles D Deakin
- South Central Ambulance NHS Foundation Trust, Talisman Way, Bicester, Oxfordshire OX26 6HR, UK
- University Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton, Hampshire, UK
| | - Ranjit Lall
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, Warwickshire, UK
| | - Felix Michelet
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, Warwickshire, UK
| | - Chu Sun
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, Warwickshire, UK
| | - Deb Smith
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, Warwickshire, UK
| | - Catherine Hill
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, Warwickshire, UK
| | - Jeskaran Rai
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, Warwickshire, UK
| | - Kath Starr
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, Warwickshire, UK
| | - Martina Brown
- South Central Ambulance NHS Foundation Trust, Talisman Way, Bicester, Oxfordshire OX26 6HR, UK
| | | | - Gavin D. Perkins
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, Warwickshire, UK
- University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham B15 2GW, Warwickshire, UK
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Bedston S, Almaghrabi F, Patterson L, Agrawal U, Woolford L, Anand SN, Joy M, Crawford A, Goudie R, Byford R, Abbasizanjani H, Smith D, Laidlaw L, Akbari A, Sullivan C, Bradley DT, Lyons RA, de Lusignan S, Hobbs FR, Robertson C, Sheikh SA, Shi T. Risk of severe COVID-19 outcomes after autumn 2022 COVID-19 booster vaccinations: a pooled analysis of national prospective cohort studies involving 7.4 million adults in England, Northern Ireland, Scotland and Wales. Lancet Reg Health Eur 2024; 37:100816. [PMID: 38162515 PMCID: PMC10757260 DOI: 10.1016/j.lanepe.2023.100816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/17/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024]
Abstract
Background UK COVID-19 vaccination policy has evolved to offering COVID-19 booster doses to individuals at increased risk of severe Illness from COVID-19. Building on our analyses of vaccine effectiveness of first, second and initial booster doses, we aimed to identify individuals at increased risk of severe outcomes (i.e., COVID-19 related hospitalisation or death) post the autumn 2022 booster dose. Methods We undertook a national population-based cohort analysis across all four UK nations through linked primary care, vaccination, hospitalisation and mortality data. We included individuals who received autumn 2022 booster doses of BNT162b2 (Comirnaty) or mRNA-1273 (Spikevax) during the period September 1, 2022 to December 31, 2022 to investigate the risk of severe COVID-19 outcomes. Cox proportional hazard models were used to estimate adjusted hazard ratios (aHR) and 95% confidence intervals (CIs) for the association between demographic and clinical factors and severe COVID-19 outcomes after the autumn booster dose. Analyses were adjusted for age, sex, body mass index (BMI), deprivation, urban/rural areas and comorbidities. Stratified analyses were conducted by vaccine type. We then conducted a fixed-effect meta-analysis to combine results across the four UK nations. Findings Between September 1, 2022 and December 31, 2022, 7,451,890 individuals ≥18 years received an autumn booster dose. 3500 had severe COVID-19 outcomes (2.9 events per 1000 person-years). Being male (male vs female, aHR 1.41 (1.32-1.51)), older adults (≥80 years vs 18-49 years; 10.43 (8.06-13.50)), underweight (BMI <18.5 vs BMI 25.0-29.9; 2.94 (2.51-3.44)), those with comorbidities (≥5 comorbidities vs none; 9.45 (8.15-10.96)) had a higher risk of COVID-19 hospitalisation or death after the autumn booster dose. Those with a larger household size (≥11 people within household vs 2 people; 1.56 (1.23-1.98)) and from more deprived areas (most deprived vs least deprived quintile; 1.35 (1.21-1.51)) had modestly higher risks. We also observed at least a two-fold increase in risk for those with various chronic neurological conditions, including Down's syndrome, immunodeficiency, chronic kidney disease, cancer, chronic respiratory disease, or cardiovascular disease. Interpretation Males, older individuals, underweight individuals, those with an increasing number of comorbidities, from a larger household or more deprived areas, and those with specific underlying health conditions remained at increased risk of COVID-19 hospitalisation and death after the autumn 2022 vaccine booster dose. There is now a need to focus on these risk groups for investigating immunogenicity and efficacy of further booster doses or therapeutics. Funding National Core Studies-Immunity, UK Research and Innovation (Medical Research Council and Economic and Social Research Council), Health Data Research UK, the Scottish Government, and the University of Edinburgh.
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Affiliation(s)
- Stuart Bedston
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health, and Life Science, Swansea University, Swansea, UK
| | - Fatima Almaghrabi
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
| | - Lynsey Patterson
- Centre for Public Health, Queen's University Belfast, Belfast, UK
- Public Health Agency, Belfast, UK
| | - Utkarsh Agrawal
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Lana Woolford
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
| | - Sneha N. Anand
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Anna Crawford
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
| | - Rosalind Goudie
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Rachel Byford
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Hoda Abbasizanjani
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health, and Life Science, Swansea University, Swansea, UK
| | - Deb Smith
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
| | - Lynn Laidlaw
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
| | - Ashley Akbari
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health, and Life Science, Swansea University, Swansea, UK
| | | | - Declan T. Bradley
- Centre for Public Health, Queen's University Belfast, Belfast, UK
- Public Health Agency, Belfast, UK
| | - Ronan A. Lyons
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health, and Life Science, Swansea University, Swansea, UK
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - F.D. Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Chris Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, Scotland, UK
- Public Health Scotland, Glasgow, Scotland, UK
| | - Sir Aziz Sheikh
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
| | - Ting Shi
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
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Baena D, Toor B, Ray LB, Smith D, Kong P, Lopez J, Hoffmann R, Bertram H, Robillard R, Armitage R, Fogel SM. Sleep spindles in adolescents with major depressive disorder. J Affect Disord 2024; 344:535-545. [PMID: 37827259 DOI: 10.1016/j.jad.2023.10.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/26/2023] [Accepted: 10/08/2023] [Indexed: 10/14/2023]
Abstract
Sleep spindle differences in adolescents with major depressive disorder (MDD) compared to healthy adolescents is an ongoing debate. Results mostly indicate decreased sleep spindle activity in adolescents with MDD. Given that sleep spindles predominate NREM and that acutely delaying the sleep period via a "sleep delay challenge" (SDC) increases non-rapid eye movement (NREM) sleep duration, it may be possible to increase spindle density in adolescents with MDD, which may provide a therapeutic benefit to depression symptoms. Here, we examined the impact of a SDC on spindle density and depression symptomology in adolescents with MDD (n = 66) and healthy controls (n = 62) tested across three nights: adaptation, normal sleep, and a SDC night which delayed bedtime by three hours. The results showed that; (1) there was no difference in spindle density between groups on the normal sleep night, (2) following the SDC, both males and females with MDD had a decrease in the frequency of slow spindles, while only females with MDD had an increase in the frequency of fast spindles, (3) acute SDC reduced depression symptoms in both groups, and (4) light sleep on the normal sleep night and slow spindle frequency at SDC predicted an 8 % improvement in depression symptoms, regardless of sex or MDD diagnosis. Taken together, these results suggest that; (a) spindles may be a useful biological marker of depression symptomatology regardless of clinical MDD diagnosis, and (b) that acute SDC may help alleviate depression symptoms in adolescents with MDD.
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Affiliation(s)
- D Baena
- School of Psychology, University of Ottawa, Ottawa K1N 6N5, Canada; Sleep Research Unit, The Royal's Institute of Mental Health Research, Ottawa K1Z 7K4, Canada
| | - B Toor
- School of Psychology, University of Ottawa, Ottawa K1N 6N5, Canada; Sleep Research Unit, The Royal's Institute of Mental Health Research, Ottawa K1Z 7K4, Canada
| | - L B Ray
- School of Psychology, University of Ottawa, Ottawa K1N 6N5, Canada
| | - D Smith
- School of Psychology, University of Ottawa, Ottawa K1N 6N5, Canada; Sleep Research Unit, The Royal's Institute of Mental Health Research, Ottawa K1Z 7K4, Canada
| | - P Kong
- School of Psychology, University of Ottawa, Ottawa K1N 6N5, Canada
| | - J Lopez
- Department of Psychiatry, University of Michigan, MI 48109, USA; Department of Clinical and Diagnostic Sciences, University of Alabama at Birmingham, Birmingham 35294, USA
| | - R Hoffmann
- Department of Psychiatry, University of Michigan, MI 48109, USA
| | - H Bertram
- Department of Psychiatry, University of Michigan, MI 48109, USA
| | - R Robillard
- School of Psychology, University of Ottawa, Ottawa K1N 6N5, Canada; Sleep Research Unit, The Royal's Institute of Mental Health Research, Ottawa K1Z 7K4, Canada
| | - R Armitage
- Department of Psychiatry, University of Michigan, MI 48109, USA
| | - S M Fogel
- School of Psychology, University of Ottawa, Ottawa K1N 6N5, Canada; Sleep Research Unit, The Royal's Institute of Mental Health Research, Ottawa K1Z 7K4, Canada; University of Ottawa Brain & Mind Research Institute, Ottawa K1H 8M5, Canada.
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5
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Raman B, McCracken C, Cassar MP, Moss AJ, Finnigan L, Samat AHA, Ogbole G, Tunnicliffe EM, Alfaro-Almagro F, Menke R, Xie C, Gleeson F, Lukaschuk E, Lamlum H, McGlynn K, Popescu IA, Sanders ZB, Saunders LC, Piechnik SK, Ferreira VM, Nikolaidou C, Rahman NM, Ho LP, Harris VC, Shikotra A, Singapuri A, Pfeffer P, Manisty C, Kon OM, Beggs M, O'Regan DP, Fuld J, Weir-McCall JR, Parekh D, Steeds R, Poinasamy K, Cuthbertson DJ, Kemp GJ, Semple MG, Horsley A, Miller CA, O'Brien C, Shah AM, Chiribiri A, Leavy OC, Richardson M, Elneima O, McAuley HJC, Sereno M, Saunders RM, Houchen-Wolloff L, Greening NJ, Bolton CE, Brown JS, Choudhury G, Diar Bakerly N, Easom N, Echevarria C, Marks M, Hurst JR, Jones MG, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Howard LS, Jacob J, Man WDC, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Singh SJ, Thomas DC, Toshner M, Lewis KE, Heaney LG, Harrison EM, Kerr S, Docherty AB, Lone NI, Quint J, Sheikh A, Zheng B, Jenkins RG, Cox E, Francis S, Halling-Brown M, Chalmers JD, Greenwood JP, Plein S, Hughes PJC, Thompson AAR, Rowland-Jones SL, Wild JM, Kelly M, Treibel TA, Bandula S, Aul R, Miller K, Jezzard P, Smith S, Nichols TE, McCann GP, Evans RA, Wain LV, Brightling CE, Neubauer S, Baillie JK, Shaw A, Hairsine B, Kurasz C, Henson H, Armstrong L, Shenton L, Dobson H, Dell A, Lucey A, Price A, Storrie A, Pennington C, Price C, Mallison G, Willis G, Nassa H, Haworth J, Hoare M, Hawkings N, Fairbairn S, Young S, Walker S, Jarrold I, Sanderson A, David C, Chong-James K, Zongo O, James WY, Martineau A, King B, Armour C, McAulay D, Major E, McGinness J, McGarvey L, Magee N, Stone R, Drain S, Craig T, Bolger A, Haggar A, Lloyd A, Subbe C, Menzies D, Southern D, McIvor E, Roberts K, Manley R, Whitehead V, Saxon W, Bularga A, Mills NL, El-Taweel H, Dawson J, Robinson L, Saralaya D, Regan K, Storton K, Brear L, Amoils S, Bermperi A, Elmer A, Ribeiro C, Cruz I, Taylor J, Worsley J, Dempsey K, Watson L, Jose S, Marciniak S, Parkes M, McQueen A, Oliver C, Williams J, Paradowski K, Broad L, Knibbs L, Haynes M, Sabit R, Milligan L, Sampson C, Hancock A, Evenden C, Lynch C, Hancock K, Roche L, Rees M, Stroud N, Thomas-Woods T, Heller S, Robertson E, Young B, Wassall H, Babores M, Holland M, Keenan N, Shashaa S, Price C, Beranova E, Ramos H, Weston H, Deery J, Austin L, Solly R, Turney S, Cosier T, Hazelton T, Ralser M, Wilson A, Pearce L, Pugmire S, Stoker W, McCormick W, Dewar A, Arbane G, Kaltsakas G, Kerslake H, Rossdale J, Bisnauthsing K, Aguilar Jimenez LA, Martinez LM, Ostermann M, Magtoto MM, Hart N, Marino P, Betts S, Solano TS, Arias AM, Prabhu A, Reed A, Wrey Brown C, Griffin D, Bevan E, Martin J, Owen J, Alvarez Corral M, Williams N, Payne S, Storrar W, Layton A, Lawson C, Mills C, Featherstone J, Stephenson L, Burdett T, Ellis Y, Richards A, Wright C, Sykes DL, Brindle K, Drury K, Holdsworth L, Crooks MG, Atkin P, Flockton R, Thackray-Nocera S, Mohamed A, Taylor A, Perkins E, Ross G, McGuinness H, Tench H, Phipps J, Loosley R, Wolf-Roberts R, Coetzee S, Omar Z, Ross A, Card B, Carr C, King C, Wood C, Copeland D, Calvelo E, Chilvers ER, Russell E, Gordon H, Nunag JL, Schronce J, March K, Samuel K, Burden L, Evison L, McLeavey L, Orriss-Dib L, Tarusan L, Mariveles M, Roy M, Mohamed N, Simpson N, Yasmin N, Cullinan P, Daly P, Haq S, Moriera S, Fayzan T, Munawar U, Nwanguma U, Lingford-Hughes A, Altmann D, Johnston D, Mitchell J, Valabhji J, Price L, Molyneaux PL, Thwaites RS, Walsh S, Frankel A, Lightstone L, Wilkins M, Willicombe M, McAdoo S, Touyz R, Guerdette AM, Warwick K, Hewitt M, Reddy R, White S, McMahon A, Hoare A, Knighton A, Ramos A, Te A, Jolley CJ, Speranza F, Assefa-Kebede H, Peralta I, Breeze J, Shevket K, Powell N, Adeyemi O, Dulawan P, Adrego R, Byrne S, Patale S, Hayday A, Malim M, Pariante C, Sharpe C, Whitney J, Bramham K, Ismail K, Wessely S, Nicholson T, Ashworth A, Humphries A, Tan AL, Whittam B, Coupland C, Favager C, Peckham D, Wade E, Saalmink G, Clarke J, Glossop J, Murira J, Rangeley J, Woods J, Hall L, Dalton M, Window N, Beirne P, Hardy T, Coakley G, Turtle L, Berridge A, Cross A, Key AL, Rowe A, Allt AM, Mears C, Malein F, Madzamba G, Hardwick HE, Earley J, Hawkes J, Pratt J, Wyles J, Tripp KA, Hainey K, Allerton L, Lavelle-Langham L, Melling L, Wajero LO, Poll L, Noonan MJ, French N, Lewis-Burke N, Williams-Howard SA, Cooper S, Kaprowska S, Dobson SL, Marsh S, Highett V, Shaw V, Beadsworth M, Defres S, Watson E, Tiongson GF, Papineni P, Gurram S, Diwanji SN, Quaid S, Briggs A, Hastie C, Rogers N, Stensel D, Bishop L, McIvor K, Rivera-Ortega P, Al-Sheklly B, Avram C, Faluyi D, Blaikely J, Piper Hanley K, Radhakrishnan K, Buch M, Hanley NA, Odell N, Osbourne R, Stockdale S, Felton T, Gorsuch T, Hussell T, Kausar Z, Kabir T, McAllister-Williams H, Paddick S, Burn D, Ayoub A, Greenhalgh A, Sayer A, Young A, Price D, Burns G, MacGowan G, Fisher H, Tedd H, Simpson J, Jiwa K, Witham M, Hogarth P, West S, Wright S, McMahon MJ, Neill P, Dougherty A, Morrow A, Anderson D, Grieve D, Bayes H, Fallon K, Mangion K, Gilmour L, Basu N, Sykes R, Berry C, McInnes IB, Donaldson A, Sage EK, Barrett F, Welsh B, Bell M, Quigley J, Leitch K, Macliver L, Patel M, Hamil R, Deans A, Furniss J, Clohisey S, Elliott A, Solstice AR, Deas C, Tee C, Connell D, Sutherland D, George J, Mohammed S, Bunker J, Holmes K, Dipper A, Morley A, Arnold D, Adamali H, Welch H, Morrison L, Stadon L, Maskell N, Barratt S, Dunn S, Waterson S, Jayaraman B, Light T, Selby N, Hosseini A, Shaw K, Almeida P, Needham R, Thomas AK, Matthews L, Gupta A, Nikolaidis A, Dupont C, Bonnington J, Chrystal M, Greenhaff PL, Linford S, Prosper S, Jang W, Alamoudi A, Bloss A, Megson C, Nicoll D, Fraser E, Pacpaco E, Conneh F, Ogg G, McShane H, Koychev I, Chen J, Pimm J, Ainsworth M, Pavlides M, Sharpe M, Havinden-Williams M, Petousi N, Talbot N, Carter P, Kurupati P, Dong T, Peng Y, Burns A, Kanellakis N, Korszun A, Connolly B, Busby J, Peto T, Patel B, Nolan CM, Cristiano D, Walsh JA, Liyanage K, Gummadi M, Dormand N, Polgar O, George P, Barker RE, Patel S, Price L, Gibbons M, Matila D, Jarvis H, Lim L, Olaosebikan O, Ahmad S, Brill S, Mandal S, Laing C, Michael A, Reddy A, Johnson C, Baxendale H, Parfrey H, Mackie J, Newman J, Pack J, Parmar J, Paques K, Garner L, Harvey A, Summersgill C, Holgate D, Hardy E, Oxton J, Pendlebury J, McMorrow L, Mairs N, Majeed N, Dark P, Ugwuoke R, Knight S, Whittaker S, Strong-Sheldrake S, Matimba-Mupaya W, Chowienczyk P, Pattenadk D, Hurditch E, Chan F, Carborn H, Foot H, Bagshaw J, Hockridge J, Sidebottom J, Lee JH, Birchall K, Turner K, Haslam L, Holt L, Milner L, Begum M, Marshall M, Steele N, Tinker N, Ravencroft P, Butcher R, Misra S, Walker S, Coburn Z, Fairman A, Ford A, Holbourn A, Howell A, Lawrie A, Lye A, Mbuyisa A, Zawia A, Holroyd-Hind B, Thamu B, Clark C, Jarman C, Norman C, Roddis C, Foote D, Lee E, Ilyas F, Stephens G, Newell H, Turton H, Macharia I, Wilson I, Cole J, McNeill J, Meiring J, Rodger J, Watson J, Chapman K, Harrington K, Chetham L, Hesselden L, Nwafor L, Dixon M, Plowright M, Wade P, Gregory R, Lenagh R, Stimpson R, Megson S, Newman T, Cheng Y, Goodwin C, Heeley C, Sissons D, Sowter D, Gregory H, Wynter I, Hutchinson J, Kirk J, Bennett K, Slack K, Allsop L, Holloway L, Flynn M, Gill M, Greatorex M, Holmes M, Buckley P, Shelton S, Turner S, Sewell TA, Whitworth V, Lovegrove W, Tomlinson J, Warburton L, Painter S, Vickers C, Redwood D, Tilley J, Palmer S, Wainwright T, Breen G, Hotopf M, Dunleavy A, Teixeira J, Ali M, Mencias M, Msimanga N, Siddique S, Samakomva T, Tavoukjian V, Forton D, Ahmed R, Cook A, Thaivalappil F, Connor L, Rees T, McNarry M, Williams N, McCormick J, McIntosh J, Vere J, Coulding M, Kilroy S, Turner V, Butt AT, Savill H, Fraile E, Ugoji J, Landers G, Lota H, Portukhay S, Nasseri M, Daniels A, Hormis A, Ingham J, Zeidan L, Osborne L, Chablani M, Banerjee A, David A, Pakzad A, Rangelov B, Williams B, Denneny E, Willoughby J, Xu M, Mehta P, Batterham R, Bell R, Aslani S, Lilaonitkul W, Checkley A, Bang D, Basire D, Lomas D, Wall E, Plant H, Roy K, Heightman M, Lipman M, Merida Morillas M, Ahwireng N, Chambers RC, Jastrub R, Logan S, Hillman T, Botkai A, Casey A, Neal A, Newton-Cox A, Cooper B, Atkin C, McGee C, Welch C, Wilson D, Sapey E, Qureshi H, Hazeldine J, Lord JM, Nyaboko J, Short J, Stockley J, Dasgin J, Draxlbauer K, Isaacs K, Mcgee K, Yip KP, Ratcliffe L, Bates M, Ventura M, Ahmad Haider N, Gautam N, Baggott R, Holden S, Madathil S, Walder S, Yasmin S, Hiwot T, Jackson T, Soulsby T, Kamwa V, Peterkin Z, Suleiman Z, Chaudhuri N, Wheeler H, Djukanovic R, Samuel R, Sass T, Wallis T, Marshall B, Childs C, Marouzet E, Harvey M, Fletcher S, Dickens C, Beckett P, Nanda U, Daynes E, Charalambou A, Yousuf AJ, Lea A, Prickett A, Gooptu B, Hargadon B, Bourne C, Christie C, Edwardson C, Lee D, Baldry E, Stringer E, Woodhead F, Mills G, Arnold H, Aung H, Qureshi IN, Finch J, Skeemer J, Hadley K, Khunti K, Carr L, Ingram L, Aljaroof M, Bakali M, Bakau M, Baldwin M, Bourne M, Pareek M, Soares M, Tobin M, Armstrong N, Brunskill N, Goodman N, Cairns P, Haldar P, McCourt P, Dowling R, Russell R, Diver S, Edwards S, Glover S, Parker S, Siddiqui S, Ward TJC, Mcnally T, Thornton T, Yates T, Ibrahim W, Monteiro W, Thickett D, Wilkinson D, Broome M, McArdle P, Upthegrove R, Wraith D, Langenberg C, Summers C, Bullmore E, Heeney JL, Schwaeble W, Sudlow CL, Adeloye D, Newby DE, Rudan I, Shankar-Hari M, Thorpe M, Pius R, Walmsley S, McGovern A, Ballard C, Allan L, Dennis J, Cavanagh J, Petrie J, O'Donnell K, Spears M, Sattar N, MacDonald S, Guthrie E, Henderson M, Guillen Guio B, Zhao B, Lawson C, Overton C, Taylor C, Tong C, Mukaetova-Ladinska E, Turner E, Pearl JE, Sargant J, Wormleighton J, Bingham M, Sharma M, Steiner M, Samani N, Novotny P, Free R, Allen RJ, Finney S, Terry S, Brugha T, Plekhanova T, McArdle A, Vinson B, Spencer LG, Reynolds W, Ashworth M, Deakin B, Chinoy H, Abel K, Harvie M, Stanel S, Rostron A, Coleman C, Baguley D, Hufton E, Khan F, Hall I, Stewart I, Fabbri L, Wright L, Kitterick P, Morriss R, Johnson S, Bates A, Antoniades C, Clark D, Bhui K, Channon KM, Motohashi K, Sigfrid L, Husain M, Webster M, Fu X, Li X, Kingham L, Klenerman P, Miiler K, Carson G, Simons G, Huneke N, Calder PC, Baldwin D, Bain S, Lasserson D, Daines L, Bright E, Stern M, Crisp P, Dharmagunawardena R, Reddington A, Wight A, Bailey L, Ashish A, Robinson E, Cooper J, Broadley A, Turnbull A, Brookes C, Sarginson C, Ionita D, Redfearn H, Elliott K, Barman L, Griffiths L, Guy Z, Gill R, Nathu R, Harris E, Moss P, Finnigan J, Saunders K, Saunders P, Kon S, Kon SS, O'Brien L, Shah K, Shah P, Richardson E, Brown V, Brown M, Brown J, Brown J, Brown A, Brown A, Brown M, Choudhury N, Jones S, Jones H, Jones L, Jones I, Jones G, Jones H, Jones D, Davies F, Davies E, Davies K, Davies G, Davies GA, Howard K, Porter J, Rowland J, Rowland A, Scott K, Singh S, Singh C, Thomas S, Thomas C, Lewis V, Lewis J, Lewis D, Harrison P, Francis C, Francis R, Hughes RA, Hughes J, Hughes AD, Thompson T, Kelly S, Smith D, Smith N, Smith A, Smith J, Smith L, Smith S, Evans T, Evans RI, Evans D, Evans R, Evans H, Evans J. Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study. Lancet Respir Med 2023; 11:1003-1019. [PMID: 37748493 PMCID: PMC7615263 DOI: 10.1016/s2213-2600(23)00262-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/16/2023] [Accepted: 06/30/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. METHODS In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. FINDINGS Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2-6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5-5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4-10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32-4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23-11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. INTERPRETATION After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification. FUNDING UK Research and Innovation and National Institute for Health Research.
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Kitson T, Osborne E, Noble S, Pease N, Alikhan R, Bryant C, Groves T, Wallace R, Walker S, Seddon K, Smith D, Raisanen L, Smith J, Thomas I, Upton L, Casbard A. HIDDEN2: Study protocol for the hospital deep vein thrombosis detection study in patients with cancer receiving palliative care. BMJ Open 2023; 13:e073049. [PMID: 37669841 PMCID: PMC10481726 DOI: 10.1136/bmjopen-2023-073049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 07/27/2023] [Indexed: 09/07/2023] Open
Abstract
INTRODUCTION Medical patients, admitted acutely to hospital, are at risk of venous thromboembolism (VTE). Clinical guidelines advise thromboprophylaxis prophylaxis for those at high risk of VTE. VTE is a common sequela of cancer, but guidelines take little consideration of cancer as an independent risk factor and their utility in palliative care patients is unclear. The hospice inpatient deep vein thrombosis (DVT) detection study (HIDDen) reported a 28% prevalence of asymptomatic iliofemoral DVT in hospice patients of poor performance status (PS) and prognosis, calling into question the utility of thromboprophylaxis in the palliative care setting. However, the majority of cancer inpatients receiving palliative care are admitted to hospital through the acute medical setting, yet their risk factors for VTE may differ from those admitted to hospices. OBJECTIVE To better understand the prevalence and behaviours of VTE in patients with cancer receiving palliative care who are admitted as an acute medical emergency. DESIGN Multicentre, observational cohort study. SETTING Secondary care acute hospitals in South Wales, UK. PATIENTS We plan to recruit 232 patients≥18 years old with a diagnosis of incurable cancer, and/or receiving palliative or best supportive care who are admitted acutely to hospital. Patients will be followed up for a maximum of 6 months following registration. PRIMARY OUTCOME Presence of lower extremity DVT. SECONDARY OUTCOMES Symptom burden attributed to DVT or pulmonary embolism, patient PS, patient demographics and development of new VTE within 90 days of registration. ANALYSIS The study statistical analysis plan will document analysis, methodology and procedures. ETHICS AND DISSEMINATION Ethical approval was obtained from the Wales Research Ethics Committee, reference 22/WA/0037 (IRAS 306352)-the main trial results will be analysed as soon as practically possible and the publication shared with investigators and on sponsor website; applications to access trial data will be subject to sponsor review process.
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Affiliation(s)
- Terri Kitson
- College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Emma Osborne
- College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Simon Noble
- Population Medicine, Cardiff University, Cardiff, UK
| | | | - Raza Alikhan
- University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff, UK
| | - Catherine Bryant
- University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff, UK
| | - Tristan Groves
- University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff, UK
| | | | | | - Kathy Seddon
- Public Involvement, Health and Care Research Wales, Cardiff, UK
| | - Deb Smith
- Public Involvement, Health and Care Research Wales, Cardiff, UK
| | - Lawrence Raisanen
- College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Joanna Smith
- College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Ian Thomas
- College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Laura Upton
- College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Angela Casbard
- College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Harford P, Agaciak M, Looi JCL, Smith D, Allison S, Chan SKW, Bastiampillai T. Urbanisation and Declining Suicide Rates in China Between 2005 and 2017. East Asian Arch Psychiatry 2023; 33:79-88. [PMID: 37771214 DOI: 10.12809/eaap2326] [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: 09/30/2023]
Abstract
BACKGROUND Worldwide suicide rates have declined since 2000s, with China being the primary contributor. This study aimed to investigate whether urbanisation is associated with decreasing suicide rates in China. METHODS Suicide rates and economic indicators of 31 provinces, municipalities, and autonomous regions of China between 2005 and 2017 were analysed. Poisson random intercept models were used to determine associations between suicide rates, urbanicity, sexes, and gross regional product (GRP). RESULTS Between 2005 and 2017, suicide rates in 31 provinces, municipalities, and autonomous regions of China continued to decrease. Urbanicity and GRP were associated with decreased suicide rates among Chinese males and females. An increase in urbanicity by 1% was associated with a 2.2% decrease in suicide rates (p < 0.001). The most urbanised and populous cities (Beijing, Shanghai, Tianjin) had the lowest suicide rates. Urbanicity was associated with a greater decline in suicide rates among females, compared with males. Association between increased urbanicity and reduced suicide rates was independent of GRP. CONCLUSION Urbanisation was associated with declining suicide rates in China; this association was stronger among females than males.
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Affiliation(s)
- P Harford
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - M Agaciak
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - J C L Looi
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University School of Medicine and Psychology, Canberra Hospital, Canberra, ACT, Australia
- Consortium of Australian-Academic Psychiatrists for Independent Policy Research and Analysis (CAPIPRA), Canberra, ACT, Australia
| | - D Smith
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - S Allison
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Consortium of Australian-Academic Psychiatrists for Independent Policy Research and Analysis (CAPIPRA), Canberra, ACT, Australia
| | - S K W Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - T Bastiampillai
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Consortium of Australian-Academic Psychiatrists for Independent Policy Research and Analysis (CAPIPRA), Canberra, ACT, Australia
- Department of Psychiatry, Monash University, Melbourne, VIC, Australia
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Evans REC, Waller J, Nicholson BD, Round T, Gildea C, Smith D, Scott SE. Should we? Could we? Feasibility of interventions to support prevention or early diagnosis of future cancer following urgent referral: A qualitative study. Patient Educ Couns 2023; 112:107757. [PMID: 37099888 DOI: 10.1016/j.pec.2023.107757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 03/30/2023] [Accepted: 04/14/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVE This study investigated perspectives of healthcare professionals (HCPs) on the feasibility of giving additional support to patients after cancer is not found following urgent referral. We sought to understand key facilitators or barriers to offering such support. METHODS A convenience sample of primary and secondary care healthcare professionals (n = 36) participated in semi-structured interviews. Interviews were transcribed verbatim and analysed using Framework Analysis, inductively and deductively, guided by the Theoretical Domains Framework. RESULTS HCPs indicated that support should be offered if proven to be efficacious. It needs to avoid potential negative consequences such as patient anxiety and information overload. HCPs were more hesitant about whether support could feasibly be offered, due to resource restrictions and perceived remit of the urgent pathway for suspected cancer. CONCLUSION HCP support after discharge from urgent cancer referral pathways needs to be resource efficient, developed in collaboration with patients and should have proven efficacy. Development of brief interventions for delivery by a range of staff, and use of technology could mitigate barriers to implementation. PRACTICE IMPLICATIONS Changes to discharge procedures to provide information, endorsement or direction to services could offer much needed support. Additional support would need to overcome logistical challenges and address limited capacity.
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Affiliation(s)
| | | | - Brian D Nicholson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | | | | | | | - Suzanne E Scott
- King's College London, UK; Queen Mary University of London, UK.
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Qi C, Osborne T, Bailey R, Cooper A, Hollinghurst JP, Akbari A, Crowder R, Peters H, Law RJ, Lewis R, Smith D, Edwards A, Lyons RA. Impact of COVID-19 pandemic on incidence of long-term conditions in Wales: a population data linkage study using primary and secondary care health records. Br J Gen Pract 2023; 73:e332-e339. [PMID: 37105743 PMCID: PMC9997656 DOI: 10.3399/bjgp.2022.0353] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 11/25/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has directly and indirectly had an impact on health service provision owing to surges and sustained pressures on the system. The effects of these pressures on the management of long-term or chronic conditions are not fully understood. AIM To explore the effects of COVID-19 on the recorded incidence of 17 long-term conditions. DESIGN AND SETTING This was an observational retrospective population data linkage study on the population of Wales using primary and secondary care data within the Secure Anonymised Information Linkage (SAIL) Databank. METHOD Monthly rates of new diagnosis between 2000 and 2021 are presented for each long-term condition. Incidence rates post-2020 were compared with expected rates predicted using time series modelling of pre-2020 trends. The proportion of annual incidence is presented by sociodemographic factors: age, sex, social deprivation, ethnicity, frailty, and learning disability. RESULTS A total of 5 476 012 diagnoses from 2 257 992 individuals are included. Incidence rates from 2020 to 2021 were lower than mean expected rates across all conditions. The largest relative deficit in incidence was in chronic obstructive pulmonary disease corresponding to 343 (95% confidence interval = 230 to 456) undiagnosed patients per 100 000 population, followed by depression, type 2 diabetes, hypertension, anxiety disorders, and asthma. A GP practice of 10 000 patients might have over 400 undiagnosed long-term conditions. No notable differences between sociodemographic profiles of post- and pre-2020 incidences were observed. CONCLUSION There is a potential backlog of undiagnosed patients with multiple long-term conditions. Resources are required to tackle anticipated workload as part of COVID-19 recovery, particularly in primary care.
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Affiliation(s)
- Cathy Qi
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, Swansea
| | - Tim Osborne
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, Swansea
| | - Rowena Bailey
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, Swansea
| | - Alison Cooper
- Wales COVID-19 Evidence Centre, Division of Population Medicine, Cardiff University, Cardiff
| | - Joe P Hollinghurst
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, Swansea
| | - Ashley Akbari
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, Swansea
| | - Ruth Crowder
- Directorate of Primary Care and Mental Health, Health and Social Services Group, Welsh Government, Cardiff
| | - Holly Peters
- Centre for Medical Education, Cardiff University, Cardiff
| | - Rebecca-Jane Law
- Technical Advisory Cell, Health and Social Services Group, Welsh Government, Cardiff
| | - Ruth Lewis
- North Wales Centre for Primary Care Research, PRIME Centre Wales, Bangor University, Bangor
| | - Deb Smith
- Wales COVID-19 Evidence Centre, Division of Population Medicine, Cardiff University, Cardiff
| | - Adrian Edwards
- Wales COVID-19 Evidence Centre, Division of Population Medicine, Cardiff University, Cardiff
| | - Ronan A Lyons
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, Swansea
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Moazami N, Smith D, Stern J, Kim J, Khalil K, James L, Kowalski H, Bisen S, Bamira D, Saraon T, Reyentovich A, Piper G, Sommer P, Ngai J, Mangiola M, Mehta S, Griesemer A, Ayares D, Narula N, Weldon E, Montgomery R. Two 10-Gene Modified Xenoheart Transplants into Brain Dead Decedents. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1507] [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: 04/05/2023] Open
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Lindsay D, Bates N, Callander E, Johnston K, Carlisle K, Smith D, Evans R, Larkins S. Evaluating the quality and safety of the BreastScreen remote radiology assessment model of service delivery in Australia. J Telemed Telecare 2023; 29:203-210. [PMID: 33283606 DOI: 10.1177/1357633x20975653] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/20/2022]
Abstract
INTRODUCTION Breast cancer is the most commonly diagnosed cancer in Australian women. Given the diverse geography and populations within Australia, the ability to offer a telemedicine-supported breast screening and assessment service may increase access. The aim of this study was to assess clinical outcomes of a telemedicine-based remote radiology assessment service delivery model for detecting breast cancer in regional Australian women compared to the traditional radiologist onsite model. METHODS This study was a pre-post intervention study using de-identified administrative data. Data were collected from seven sites across three health jurisdictions within Australia. There were a total of 21,117 assessment visits, with 10,508 (49.8%) pre- and 10,609 (50.2%) post-remote model implementation. Of the 10,609 post-remote model visits, 3,904 (36.8%) were under the remote model. The main outcome was cancer detection, split into any cancer, any invasive cancer or any small invasive cancer. Timeliness of assessment was also examined. RESULTS After adjusting for multiple factors, there were no statistically significant differences in cancer detection rates between the remote and onsite models (adjusted odds ratio (AOR) = 1.02, 95% CI 0.86-1.19, n.s.). Implementing the remote assessment model had statistically significant positive effects on the timeliness of assessment (AOR = 0.68, 95% CI 0.59-0.77, p < 0.001). DISCUSSION This study found the remote model delivers safe and high-quality assessment services, with equivalent rates of cancer detection and improved timeliness of assessment when compared to the traditional onsite model. Careful monitoring and ongoing evaluation of any health-service model is important for ongoing safety, efficiency and acceptability.
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Affiliation(s)
- Daniel Lindsay
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Australia.,Menzies School of Health Research, Charles Darwin University, Australia
| | - Nicole Bates
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Australia
| | - Emily Callander
- School of Public Health and Preventive Medicine, Monash University, Australia
| | - Karen Johnston
- College of Medicine and Dentistry, James Cook University, Australia.,Australian Institute of Tropical Health and Medicine, James Cook University, Australia
| | - Karen Carlisle
- College of Medicine and Dentistry, James Cook University, Australia.,Australian Institute of Tropical Health and Medicine, James Cook University, Australia
| | - Deb Smith
- College of Medicine and Dentistry, James Cook University, Australia.,Australian Institute of Tropical Health and Medicine, James Cook University, Australia
| | - Rebecca Evans
- College of Medicine and Dentistry, James Cook University, Australia.,Australian Institute of Tropical Health and Medicine, James Cook University, Australia
| | - Sarah Larkins
- College of Medicine and Dentistry, James Cook University, Australia.,Australian Institute of Tropical Health and Medicine, James Cook University, Australia
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Bamira D, Vainrib A, Saric M, Saraon T, Reyentovich A, Jaffe I, James L, Stern J, Khalil K, Weldon E, Ayares D, Griesemer A, Smith D, Montgomery R, Moazami N. Echocardiographic Evaluation of Two 10-Gene Modified Xenoheart Transplants into Brain Dead Decedents. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1505] [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: 04/05/2023] Open
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Mohsin R, Malouf M, Plit M, Gazibarich G, Smith D, Darley D. Baseline Lung Allograft Dysfunction Provides Risk Stratification for Patients with Chronic Lung Allograft Dysfunction. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1598] [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: 04/05/2023] Open
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Chang S, Piper G, Chan J, Geraci T, Hsiung T, James L, Ngai J, Natalini J, Rudym D, Lesko M, Hussain S, Reyentovich A, Moazami N, Smith D, Angel L. Lung Transplantation Utilizing Donor after Circulatory Death with Normothermic Regional Perfusion. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1027] [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: 04/05/2023] Open
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Herrett E, Tomlin K, Lin LY, Tomlinson LA, Jit M, Briggs A, Marks M, Sandmann F, Parry J, Bates C, Morley J, Bacon S, Butler-Cole B, Mahalingasivam V, Dennison A, Smith D, Gabriel E, Mehrkar A, Goldacre B, Smeeth L, Eggo RMM. Protocol for an OpenSAFELY cohort study collecting patient-reported outcome measures using the TPP Airmid smartphone application and linked big data to quantify the health and economic costs of long COVID (OpenPROMPT). BMJ Open 2023; 13:e071261. [PMID: 36806073 PMCID: PMC9943695 DOI: 10.1136/bmjopen-2022-071261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 01/31/2023] [Indexed: 02/19/2023] Open
Abstract
INTRODUCTION The impact of long COVID on health-related quality of-life (HRQoL) and productivity is not currently known. It is important to understand who is worst affected by long COVID and the cost to the National Health Service (NHS) and society, so that strategies like booster vaccines can be prioritised to the right people. OpenPROMPT aims to understand the impact of long COVID on HRQoL in adults attending English primary care. METHODS AND ANALYSIS We will ask people to participate in this cohort study through a smartphone app (Airmid), and completing a series of questionnaires held within the app. Questionnaires will ask about HRQoL, productivity and symptoms of long COVID. Participants will be asked to fill in the questionnaires once a month, for 90 days. Questionnaire responses will be linked, where possible, to participants' existing health records from primary care, secondary care, and COVID testing and vaccination data. Analysis will take place using the OpenSAFELY data platform and will estimate the impact of long COVID on HRQoL, productivity and cost to the NHS. ETHICS AND DISSEMINATION The Proportionate Review Sub-Committee of the South Central-Berkshire B Research Ethics Committee has reviewed and approved the study and have agreed that we can ask people to take part (22/SC/0198). Our results will provide information to support long-term care, and make recommendations for prevention of long COVID in the future. TRIAL REGISTRATION NUMBER NCT05552612.
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Affiliation(s)
- Emily Herrett
- London School of Hygiene and Tropical Medicine, London, UK
| | - Keith Tomlin
- London School of Hygiene and Tropical Medicine, London, UK
| | - Liang-Yu Lin
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Mark Jit
- London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew Briggs
- London School of Hygiene and Tropical Medicine, London, UK
| | - Michael Marks
- London School of Hygiene and Tropical Medicine, London, UK
- Hospital for Tropical Diseases, London, UK
| | - Frank Sandmann
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Jessica Morley
- Bennett Institute for Applied Data Science, University of Oxford, Oxford, UK
| | - Seb Bacon
- Bennett Institute for Applied Data Science, University of Oxford, Oxford, UK
| | | | | | - Alan Dennison
- Patient and Public Involvement Steering Committee, London, UK
| | - Deb Smith
- Patient and Public Involvement Steering Committee, London, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Ethan Gabriel
- Patient and Public Involvement Steering Committee, London, UK
| | - Amir Mehrkar
- Bennett Institute for Applied Data Science, University of Oxford, Oxford, UK
| | - Ben Goldacre
- Bennett Institute for Applied Data Science, University of Oxford, Oxford, UK
| | - Liam Smeeth
- London School of Hygiene and Tropical Medicine, London, UK
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16
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Lindenmayer DB, Blanchard W, Evans MJ, Beggs R, Lavery T, Florance D, Crane C, Smith D, Siegrist A, Lang E, Scheele BC. Context dependency in interference competition among birds in an endangered woodland ecosystem. DIVERS DISTRIB 2023. [DOI: 10.1111/ddi.13680] [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: 02/16/2023] Open
Affiliation(s)
- D. B. Lindenmayer
- Sustainable Farms, Fenner School of Environment & Society The Australian National University Canberra Australian Capital Territory Australia
| | - W. Blanchard
- Fenner School of Environment & Society The Australian National University Canberra Australian Capital Territory Australia
| | - M. J. Evans
- Fenner School of Environment & Society The Australian National University Canberra Australian Capital Territory Australia
| | - R. Beggs
- Sustainable Farms, Fenner School of Environment & Society The Australian National University Canberra Australian Capital Territory Australia
| | - T. Lavery
- Fenner School of Environment & Society The Australian National University Canberra Australian Capital Territory Australia
| | - D. Florance
- Sustainable Farms, Fenner School of Environment & Society The Australian National University Canberra Australian Capital Territory Australia
| | - C. Crane
- Sustainable Farms, Fenner School of Environment & Society The Australian National University Canberra Australian Capital Territory Australia
| | - D. Smith
- Sustainable Farms, Fenner School of Environment & Society The Australian National University Canberra Australian Capital Territory Australia
| | - A. Siegrist
- Sustainable Farms, Fenner School of Environment & Society The Australian National University Canberra Australian Capital Territory Australia
| | - E. Lang
- Sustainable Farms, Fenner School of Environment & Society The Australian National University Canberra Australian Capital Territory Australia
| | - B. C. Scheele
- Sustainable Farms, Fenner School of Environment & Society The Australian National University Canberra Australian Capital Territory Australia
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17
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Pitts K, Davies M, Burnier C, Kelly M, Farrington K, Smith D, Dimanlig E, DeTata D. Condom evidence in sexual assaults. Pathology 2023. [DOI: 10.1016/j.pathol.2022.12.053] [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: 01/29/2023]
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18
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Colton H, Parker M, Stirrup O, Blackstone J, Loose M, McClure C, Roy S, Williams C, McLeod J, Smith D, Taha Y, Zhang P, Hsu S, Kele B, Harris K, Mapp F, Williams R, Flowers P, Breuer J, Partridge D, de Silva T. Factors affecting turnaround time of SARS-CoV-2 sequencing for inpatient infection prevention and control decision making: analysis of data from the COG-UK HOCI study. J Hosp Infect 2023; 131:34-42. [PMID: 36228768 PMCID: PMC9550290 DOI: 10.1016/j.jhin.2022.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/13/2022] [Accepted: 09/22/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Barriers to rapid return of sequencing results can affect the utility of sequence data for infection prevention and control decisions. AIM To undertake a mixed-methods analysis to identify challenges that sites faced in achieving a rapid turnaround time (TAT) in the COVID-19 Genomics UK Hospital-Onset COVID-19 Infection (COG-UK HOCI) study. METHODS For the quantitative analysis, timepoints relating to different stages of the sequencing process were extracted from both the COG-UK HOCI study dataset and surveys of study sites. Qualitative data relating to the barriers and facilitators to achieving rapid TATs were included from thematic analysis. FINDINGS The overall TAT, from sample collection to receipt of sequence report by infection control teams, varied between sites (median 5.1 days, range 3.0-29.0 days). Most variation was seen between reporting of a positive COVID-19 polymerase chain reaction (PCR) result to sequence report generation (median 4.0 days, range 2.3-27.0 days). On deeper analysis, most of this variability was accounted for by differences in the delay between the COVID-19 PCR result and arrival of the sample at the sequencing laboratory (median 20.8 h, range 16.0-88.7 h). Qualitative analyses suggest that closer proximity of sequencing laboratories to diagnostic laboratories, increased staff flexibility and regular transport times facilitated a shorter TAT. CONCLUSION Integration of pathogen sequencing into diagnostic laboratories may help to improve sequencing TAT to allow sequence data to be of tangible value to infection control practice. Adding a quality control step upstream to increase capacity further down the workflow may also optimize TAT if lower quality samples are removed at an earlier stage.
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Affiliation(s)
- H. Colton
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK,Directorate of Laboratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK,Corresponding author. Address: Department of Infection, Immunity and Cardiovascular Disease, Faculty of Medicine, Dentistry & Health, University of Sheffield, Medical School, Beech Hill Road, Sheffield S10 2RX, UK
| | - M.D. Parker
- Sheffield Biomedical Research Centre, University of Sheffield, Sheffield, UK,Sheffield Bioinformatics Core, University of Sheffield, Sheffield, UK
| | - O. Stirrup
- Institute for Global Health, University College London, London, UK
| | - J. Blackstone
- The Comprehensive Clinical Trials Unit, University College London, London, UK
| | - M. Loose
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - C.P. McClure
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - S. Roy
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, UK
| | - C. Williams
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, UK
| | - J. McLeod
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - D. Smith
- Department of Applied Biology, Cellular and Molecular Sciences/Microbiology Group, Northumbria University, Newcastle, UK
| | - Y. Taha
- Department of Infection and Tropical Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle Upon Tyne, UK
| | - P. Zhang
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - S.N. Hsu
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK,Sheffield Bioinformatics Core, University of Sheffield, Sheffield, UK
| | - B. Kele
- Virology Department, East and South East London Pathology Partnership, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - K. Harris
- Virology Department, East and South East London Pathology Partnership, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - F. Mapp
- Institute for Global Health, University College London, London, UK
| | - R. Williams
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, UK
| | | | - P. Flowers
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - J. Breuer
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, UK
| | - D.G. Partridge
- Directorate of Laboratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - T.I. de Silva
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
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Perrault A, Maltezos A, Pomares F, Smith D, Cross N, Gong K, McCarthy M, McGrath J, Savard J, Schwartz S, Gouin JP, Dang Vu T. Cognitive-behavioral therapy for insomnia reduces sleep duration misperception in chronic insomnia. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.312] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Banerjee S, Boyle DP, Maan A, Majeski R, Kaita R, Smith D, von Hellermann M, Hansen C, Capecchi W, Elliott D. Feasibility study of a high spatial and time resolution beam emission spectroscopy diagnostic for localized density fluctuation measurements in Lithium Tokamak eXperiment-β (LTX-β). Rev Sci Instrum 2022; 93:113523. [PMID: 36461475 DOI: 10.1063/5.0101834] [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] [Received: 06/03/2022] [Accepted: 09/28/2022] [Indexed: 06/17/2023]
Abstract
Trapped electron mode (TEM) is the main source of turbulence predicted for the unique operation regime of a flat temperature profile under low-recycling conditions in the LTX-β tokamak, while ion temperature gradient driven turbulence may also occur with gas fueling from the edge. To investigate mainly TEM scale density fluctuations, a high spatial and time resolution 2D beam emission spectroscopy (BES) diagnostic is being developed. Apart from spatially localized density turbulence measurement, BES can provide turbulence flow and flow shear dynamics. This BES system will be realized using an avalanche photodiode-based camera and narrow band interference filter. The system can acquire data at 2 MHz. Simulations with the Simulation of Spectra (SOS) code indicate that a high signal to noise ratio can be achieved with the proposed system. This will enable sampling the density fluctuations at this high time resolution. The design considerations and system optimization using the SOS code are presented.
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Affiliation(s)
- Santanu Banerjee
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - D P Boyle
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - A Maan
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - R Majeski
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - R Kaita
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - D Smith
- Department of Physics, University of Wisconsin, Madison, Wisconsin 53706, USA
| | - M von Hellermann
- Institute for Energy and Climate Research IEK-4, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
| | - C Hansen
- Department of Aeronautics and Astronautics, University of Washington, Seattle, Washington 98195, USA
| | - W Capecchi
- Department of Physics, University of Wisconsin, Madison, Wisconsin 53706, USA
| | - D Elliott
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37830, USA
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21
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Pham A, Smith D, Burr L, Chambers D, Wells T. 470 Role of cloaking antibodies in Burkholderia cepacia complex lung infections. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01160-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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22
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Ritson JP, Kennedy-Blundell O, Croft J, Templeton MR, Hawkins CE, Clark JM, Evans MG, Brazier RE, Smith D, Graham NJD. High frequency UV-Vis sensors estimate error in riverine dissolved organic carbon load estimates from grab sampling. Environ Monit Assess 2022; 194:831. [PMID: 36163406 PMCID: PMC9512721 DOI: 10.1007/s10661-022-10515-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
High frequency ultraviolet - visible (UV-VIS) sensors offer a way of improving dissolved organic carbon (DOC) load estimates in rivers as they can be calibrated to DOC concentration. This is an improvement on periodic grab sampling, or the use of pumped sampling systems which store samples in-field before collection. We hypothesised that the move to high frequency measurements would increase the load estimate based on grab sampling due to systemic under-sampling of high flows. To test our hypotheses, we calibrated two sensors in contrasting catchments (Exe and Bow Brook, UK) against weekly grab sampled DOC measurements and then created an hourly time series of DOC for the two sites. Taking this measurement as a 'true' value of DOC load, we simulated 1,000 grab sampling campaigns at weekly, fortnightly and monthly frequency to understand the likely distribution of load and error estimates. We also performed an analysis of daily grab samples collected using a pumped storage sampling system with weekly collection. Our results show that: a) grab sampling systemically underestimates DOC loads and gives positively skewed distributions of results, b) this under-estimation and positive skew decreases with increasing sampling frequency, c) commonly used estimates of error in the load value are also systemically lowered by the oversampling of low, stable flows due to their dependence on the variance in the flow-weighted mean concentration, and d) that pumped storage systems may lead to under-estimation of DOC and over estimation of specific ultra-violet absorbance (SUVA), a proxy for aromaticity, due to biodegradation during storage.
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Affiliation(s)
- J P Ritson
- School of Environment, Education and Development, The University of Manchester, Oxford Rd, Manchester, M13 9PL, UK.
| | - O Kennedy-Blundell
- School of Environment, Education and Development, The University of Manchester, Oxford Rd, Manchester, M13 9PL, UK
| | - J Croft
- Department of Civil and Environmental Engineering, Imperial College London, South Kensington, London, SW7 2AZ, UK
| | - M R Templeton
- Department of Civil and Environmental Engineering, Imperial College London, South Kensington, London, SW7 2AZ, UK
| | - C E Hawkins
- Department of Geography and Environmental Science, University of Reading, Whiteknights, PO box 227, Reading, RG6 6AB, UK
| | - J M Clark
- Department of Geography and Environmental Science, University of Reading, Whiteknights, PO box 227, Reading, RG6 6AB, UK
| | - M G Evans
- School of Environment, Education and Development, The University of Manchester, Oxford Rd, Manchester, M13 9PL, UK
| | - R E Brazier
- Centre for Resilience in Environment, Water and Waste, Geography, University of Exeter, Exeter, EX44RJ, UK
| | - D Smith
- South West Water, Peninsula House, Rydon Lane, Exeter, EX2 7HR, UK
| | - N J D Graham
- Department of Civil and Environmental Engineering, Imperial College London, South Kensington, London, SW7 2AZ, UK
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Torkington J, Harries R, O'Connell S, Knight L, Islam S, Bashir N, Watkins A, Fegan G, Cornish J, Rees B, Cole H, Jarvis H, Jones S, Russell I, Bosanquet D, Cleves A, Sewell B, Farr A, Zbrzyzna N, Fiera N, Ellis-Owen R, Hilton Z, Parry C, Bradbury A, Wall P, Hill J, Winter D, Cocks K, Harris D, Hilton J, Vakis S, Hanratty D, Rajagopal R, Akbar F, Ben-Sassi A, Francis N, Jones L, Williamson M, Lindsey I, West R, Smart C, Ziprin P, Agarwal T, Faulkner G, Pinkney T, Vimalachandran D, Lawes D, Faiz O, Nisar P, Smart N, Wilson T, Myers A, Lund J, Smolarek S, Acheson A, Horwood J, Ansell J, Phillips S, Davies M, Davies L, Bird S, Palmer N, Williams M, Galanopoulos G, Rao PD, Jones D, Barnett R, Tate S, Wheat J, Patel N, Rahmani S, Toynton E, Smith L, Reeves N, Kealaher E, Williams G, Sekaran C, Evans M, Beynon J, Egan R, Qasem E, Khot U, Ather S, Mummigati P, Taylor G, Williamson J, Lim J, Powell A, Nageswaran H, Williams A, Padmanabhan J, Phillips K, Ford T, Edwards J, Varney N, Hicks L, Greenway C, Chesters K, Jones H, Blake P, Brown C, Roche L, Jones D, Feeney M, Shah P, Rutter C, McGrath C, Curtis N, Pippard L, Perry J, Allison J, Ockrim J, Dalton R, Allison A, Rendell J, Howard L, Beesley K, Dennison G, Burton J, Bowen G, Duberley S, Richards L, Giles J, Katebe J, Dalton S, Wood J, Courtney E, Hompes R, Poole A, Ward S, Wilkinson L, Hardstaff L, Bogden M, Al-Rashedy M, Fensom C, Lunt N, McCurrie M, Peacock R, Malik K, Burns H, Townley B, Hill P, Sadat M, Khan U, Wignall C, Murati D, Dhanaratne M, Quaid S, Gurram S, Smith D, Harris P, Pollard J, DiBenedetto G, Chadwick J, Hull R, Bach S, Morton D, Hollier K, Hardy V, Ghods M, Tyrrell D, Ashraf S, Glasbey J, Ashraf M, Garner S, Whitehouse A, Yeung D, Mohamed SN, Wilkin R, Suggett N, Lee C, Bagul A, McNeill C, Eardley N, Mahapatra R, Gabriel C, Datt P, Mahmud S, Daniels I, McDermott F, Nodolsk M, Park L, Scott H, Trickett J, Bearn P, Trivedi P, Frost V, Gray C, Croft M, Beral D, Osborne J, Pugh R, Herdman G, George R, Howell AM, Al-Shahaby S, Narendrakumar B, Mohsen Y, Ijaz S, Nasseri M, Herrod P, Brear T, Reilly JJ, Sohal A, Otieno C, Lai W, Coleman M, Platt E, Patrick A, Pitman C, Balasubramanya S, Dickson E, Warman R, Newton C, Tani S, Simpson J, Banerjee A, Siddika A, Campion D, Humes D, Randhawa N, Saunders J, Bharathan B, Hay O. Incisional hernia following colorectal cancer surgery according to suture technique: Hughes Abdominal Repair Randomized Trial (HART). Br J Surg 2022; 109:943-950. [PMID: 35979802 PMCID: PMC10364691 DOI: 10.1093/bjs/znac198] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/09/2022] [Accepted: 05/13/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Incisional hernias cause morbidity and may require further surgery. HART (Hughes Abdominal Repair Trial) assessed the effect of an alternative suture method on the incidence of incisional hernia following colorectal cancer surgery. METHODS A pragmatic multicentre single-blind RCT allocated patients undergoing midline incision for colorectal cancer to either Hughes closure (double far-near-near-far sutures of 1 nylon suture at 2-cm intervals along the fascia combined with conventional mass closure) or the surgeon's standard closure. The primary outcome was the incidence of incisional hernia at 1 year assessed by clinical examination. An intention-to-treat analysis was performed. RESULTS Between August 2014 and February 2018, 802 patients were randomized to either Hughes closure (401) or the standard mass closure group (401). At 1 year after surgery, 672 patients (83.7 per cent) were included in the primary outcome analysis; 50 of 339 patients (14.8 per cent) in the Hughes group and 57 of 333 (17.1 per cent) in the standard closure group had incisional hernia (OR 0.84, 95 per cent c.i. 0.55 to 1.27; P = 0.402). At 2 years, 78 patients (28.7 per cent) in the Hughes repair group and 84 (31.8 per cent) in the standard closure group had incisional hernia (OR 0.86, 0.59 to 1.25; P = 0.429). Adverse events were similar in the two groups, apart from the rate of surgical-site infection, which was higher in the Hughes group (13.2 versus 7.7 per cent; OR 1.82, 1.14 to 2.91; P = 0.011). CONCLUSION The incidence of incisional hernia after colorectal cancer surgery is high. There was no statistical difference in incidence between Hughes closure and mass closure at 1 or 2 years. REGISTRATION NUMBER ISRCTN25616490 (http://www.controlled-trials.com).
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Abdul Haris P, Brazil L, Blythe K, Chia K, Hassan S, Loganathan T, Smith D, Swampillai A, Al-Salihi O. P11.30.A Stereotactic Radiosurgery (SRS) for brain metastases in breast cancer: An evaluation of outcomes at a UK tertiary centre. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Brain metastases (BM) occur in approximately 10-30% of patients with breast cancer (BC). Patients with advanced breast cancer are living longer, and the incidence of BM are increasing. Stereotactic Radiosurgery (SRS) has emerged as a strategy to treat BM. We evaluated the outcomes and potential prognostic factors of patients with BM treated with SRS.
Material and Methods
Retrospective review of patients treated with linac-based SRS for BM from BC in a single tertiary centre between August 2017-September 2021. Overall survival (OS), intracranial progression-free survival (IPFS), and prognostic factors were evaluated using Kaplan-Meier analysis, log-rank test, and Cox proportional-hazards model.
Results
76 patients were included in the analysis. Out of these, 56 had first-line local treatment with SRS, either as primary (n=34) or adjuvant to surgery (n=22). Median age was 58 years old (range 37-86), and 88% had PS 0/1. One-year survival rate was 56%.
Median OS and IPFS from SRS was 16 months (95% CI 8-24) and 7 months (95% CI 2-12), respectively. However, there were significant differences in OS (p<0.001) and IPFS (p=0.001) based on molecular subtypes. Patients with triple-negative breast cancer (TNBC) (n=14) had median OS of 7 months (95% CI 2-12), ER+/HER2- (n=22) median OS of 22 months, ER-/HER2+ (n=8) median OS of 4 months (95% CI 0-9), and ER+/HER2+ (n=11) median OS of 36 months. Similar trend was seen with IPFS.
Patients with progressive extracranial disease compared to stable disease had shorter median OS (4 months vs 23 months, HR 2.4, p=0.01) and median IPFS (4 months vs 13 months, HR 2, p=0.03). Age ≥65 years was associated with shorter median OS (4 vs 23 months, HR 2.3, p=0.02). Patients with ≥4 brain metastases had shorter IPFS (4 months vs 11 months, HR 2.4, p=0.012), but no significant difference in OS. Volume of metastases did not affect outcome in this series.
30% of patients progressed intracranially after first-line SRS. 94 % had out-of-field recurrences, and 6% in-field recurrences. 59% had further SRS, 12 % WBRT, 6% surgery, and 23% had no further local treatment.
26 patients had second-line local treatment with SRS after first-line SRS (n=9), WBRT (n=9), or surgery +/- WBRT (n=8). There were no significant differences in outcome based on the modality of first-line local treatment.
Conclusion
SRS is an effective treatment for BM from BC. There were significant differences in survival based on age, molecular subtypes, and extracranial disease status.
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Affiliation(s)
- P Abdul Haris
- Guy's and St Thomas' NHS Trust , London , United Kingdom
| | - L Brazil
- Guy's and St Thomas' NHS Trust , London , United Kingdom
| | - K Blythe
- Guy's and St Thomas' NHS Trust , London , United Kingdom
- Department of Medical Physics, Guy's and St Thomas' NHS Trust , London , United Kingdom
| | - K Chia
- Guy's and St Thomas' NHS Trust , London , United Kingdom
| | - S Hassan
- Guy's and St Thomas' NHS Trust , London , United Kingdom
| | - T Loganathan
- Guy's and St Thomas' NHS Trust , London , United Kingdom
| | - D Smith
- Guy's and St Thomas' NHS Trust , London , United Kingdom
| | - A Swampillai
- Guy's and St Thomas' NHS Trust , London , United Kingdom
| | - O Al-Salihi
- Guy's and St Thomas' NHS Trust , London , United Kingdom
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Smith LC, Chakraborty D, Lourdsamy D, McIntyre D, Smith D. P12.11.B The role of miRNAs in glioma in response to hypoxia. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Hypoxia, low oxygen, is a microenvironment that promotes tumour progression, particularly in gliomas. The regulation of many biological processes are maintained by miRNAs. The hypoxia status of glioma cells effects the regulation of processes by affecting the expression of individual miRNAs.The aims of this study is identifying significant miRNAs that are either under or overexpressed in hypoxia compared to normoxia in glioma cells and further exploring the effect of hypoxia on miR-92a-3p and miR-149-5p in gliomas on the apoptotic and cellular senescence pathways.
Material and Methods
A range of glioma cells were used for screening including primary cell lines: GIN28 and GIN31; low-grade cell lines: LGG19 and LGG24; paediatric cell line: SF188 and commercially available glioblastoma cell line U87. These cells were culture at both 1% (hypoxia) and 20% (normoxia) oxygen levels. Screening of miRNAs was achieved by quantitative polymerase chain reaction (qPCR) using miRNA specific primers. Knockdowns/in were achieved by transfecting with miR-92a-3p and miR-149-5p mimics and inhibitors. Caspase-glo assay was used to assess the effect of hypoxia on apoptosis.
Results
miRNA 92a-3p and miR-149-5p were found to be downregulated and upregulated respectively in primary gliomas cells in hypoxia compared to normoxia. These particular miRNAs are also found to have multiple targets in apoptosis and cellular senescence.
Conclusion
The screening of 90 miRNAs among the different categories of gliomas highlighted multiple miRNAs that were significant in hypoxia compared to normoxia. Using primary cell lines have identified hypoxia-affected miRNAs in glioblastomas. This discovery will increase our knowledge and understanding of the hypoxia effect on miRNAs which may aid and direct targeted therapy to conquer hypoxia in glioblastomas.
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Affiliation(s)
- L C Smith
- University of Nottingham , Nottingham , United Kingdom
| | | | - D Lourdsamy
- University of Nottingham , Nottingham , United Kingdom
| | - D McIntyre
- University of Nottingham , Nottingham , United Kingdom
| | - D Smith
- University of Nottingham , Nottingham , United Kingdom
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Butler GL, Davis TR, Brooks SG, Bowen C, Cameron LM, Rowland SJ, Smith D, St Vincent Welch J, Carpenter-Bundhoo L. Combining bio-telemetry and underwater imagery to elucidate the reproductive behaviour of a large, long-lived Australian freshwater teleost. J Environ Manage 2022; 317:115298. [PMID: 35617858 DOI: 10.1016/j.jenvman.2022.115298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/02/2022] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
Murray cod Maccullochella peelii (Mitchell) have a key ecological role in ensuring the health of Australia's largest inland waterway, but many aspects surrounding its reproductive strategies in the wild are unknown. From 2015 to 2019 within the Northern Murray-Darling Basin, Australia, we used a combination of bio-telemetry and underwater imagery to quantify the behaviour of Murray cod across their breeding cycle in a natural riverine environment. In most years, breeding behaviour including nest site selection was observed from early-August and spawning from late-August through to late-October, which is considerably earlier than previously reported. There was a positive correlation between the onset of breeding behaviour and week-of-year, and spawning was correlated with moon-phase. Whilst some nesting sites were amongst woody debris and in hollow logs, the majority were located in shallow water on hard substrate underneath undercuts along the riverbank edge. Nests were frequently established in isolated and disconnected pools with little or no measurable flow, suggesting that river hydraulics is not a key component driving spawning of Murray cod across at least some areas of its range. Larvae were observed actively swimming and controlling their position within and near nests and used a scatter tactic when dispersing. We also established that disturbing nesting Murray cod had a negative impact on egg and larval survival. We suggest a review of current regulations to safeguard the long-term conservation of the species across all sections of its range.
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Affiliation(s)
- G L Butler
- NSW Department of Primary Industries (Fisheries), Grafton, NSW, Australia; Australian Rivers Institute, Griffith University, 170 Kessels Road, Nathan, Qld, 4111, Australia.
| | - T R Davis
- NSW Department of Primary Industries (Fisheries), Grafton, NSW, Australia
| | - S G Brooks
- Department of Agriculture and Fisheries, Brisbane, Qld, Australia
| | - C Bowen
- NSW Department of Primary Industries (Fisheries), Grafton, NSW, Australia
| | - L M Cameron
- NSW Department of Primary Industries (Fisheries), Grafton, NSW, Australia
| | - S J Rowland
- NSW Department of Primary Industries (Fisheries), Grafton, NSW, Australia
| | - D Smith
- Department of Agriculture and Fisheries, Brisbane, Qld, Australia
| | - J St Vincent Welch
- NSW Department of Primary Industries (Fisheries), Grafton, NSW, Australia
| | - L Carpenter-Bundhoo
- NSW Department of Primary Industries (Fisheries), Grafton, NSW, Australia; Australian Rivers Institute, Griffith University, 170 Kessels Road, Nathan, Qld, 4111, Australia
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Aguilar-Arevalo AA, Alves DSM, Biedron S, Boissevain J, Borrego M, Chavez-Estrada M, Chavez A, Conrad JM, Cooper RL, Diaz A, Distel JR, D'Olivo JC, Dunton E, Dutta B, Elliott A, Evans D, Fields D, Greenwood J, Gold M, Gordon J, Guarincerri E, Huang EC, Kamp N, Kelsey C, Knickerbocker K, Lake R, Louis WC, Mahapatra R, Maludze S, Mirabal J, Moreno R, Neog H, deNiverville P, Pandey V, Plata-Salas J, Poulson D, Ray H, Renner E, Schaub TJ, Shaevitz MH, Smith D, Sondheim W, Szelc AM, Taylor C, Thompson WH, Thornton RT, Tripathi M, Van Berg R, Van de Water RG, Verma S, Walker K. First Leptophobic Dark Matter Search from the Coherent-CAPTAIN-Mills Liquid Argon Detector. Phys Rev Lett 2022; 129:021801. [PMID: 35867467 DOI: 10.1103/physrevlett.129.021801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 05/17/2022] [Indexed: 06/15/2023]
Abstract
We report the first results of a search for leptophobic dark matter (DM) from the Coherent-CAPTAIN-Mills (CCM) liquid argon (LAr) detector. An engineering run with 120 photomultiplier tubes (PMTs) and 17.9×10^{20} protons on target (POT) was performed in fall 2019 to study the characteristics of the CCM detector. The operation of this 10-ton detector was strictly light based with a threshold of 50 keV and used coherent elastic scattering off argon nuclei to detect DM. Despite only 1.5 months of accumulated luminosity, contaminated LAr, and nonoptimized shielding, CCM's first engineering run has already achieved sensitivity to previously unexplored parameter space of light dark matter models with a baryonic vector portal. With an expected background of 115 005 events, we observe 115 005+16.5 events which is compatible with background expectations. For a benchmark mediator-to-DM mass ratio of m_{V_{B}}/m_{χ}=2.1, DM masses within the range 9 MeV≲m_{χ}≲50 MeV are excluded at 90% C. L. in the leptophobic model after applying the Feldman-Cousins test statistic. CCM's upgraded run with 200 PMTs, filtered LAr, improved shielding, and 10 times more POT will be able to exclude the remaining thermal relic density parameter space of this model, as well as probe new parameter space of other leptophobic DM models.
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Affiliation(s)
| | - D S M Alves
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S Biedron
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - J Boissevain
- Bartoszek Engineering, Aurora, Illinois 60506, USA
| | - M Borrego
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | | | - A Chavez
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J M Conrad
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - R L Cooper
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - A Diaz
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - J R Distel
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J C D'Olivo
- Universidad Nacional Autónoma de México, CDMX 04510, México
| | - E Dunton
- Columbia University, New York, New York 10027, USA
| | - B Dutta
- Texas A&M University, College Station, Texas 77843, USA
| | - A Elliott
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
| | - D Evans
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D Fields
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - J Greenwood
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
| | - M Gold
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - J Gordon
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
| | - E Guarincerri
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - E C Huang
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - N Kamp
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - C Kelsey
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - K Knickerbocker
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - R Lake
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
| | - W C Louis
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - R Mahapatra
- Texas A&M University, College Station, Texas 77843, USA
| | - S Maludze
- Texas A&M University, College Station, Texas 77843, USA
| | - J Mirabal
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - R Moreno
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
| | - H Neog
- Texas A&M University, College Station, Texas 77843, USA
| | - P deNiverville
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - V Pandey
- University of Florida, Gainesville, Florida 32611, USA
| | - J Plata-Salas
- Universidad Nacional Autónoma de México, CDMX 04510, México
| | - D Poulson
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - H Ray
- University of Florida, Gainesville, Florida 32611, USA
| | - E Renner
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - T J Schaub
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - M H Shaevitz
- Columbia University, New York, New York 10027, USA
| | - D Smith
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
| | - W Sondheim
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - A M Szelc
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - C Taylor
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - W H Thompson
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - R T Thornton
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M Tripathi
- University of Florida, Gainesville, Florida 32611, USA
| | - R Van Berg
- Bartoszek Engineering, Aurora, Illinois 60506, USA
| | - R G Van de Water
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S Verma
- Texas A&M University, College Station, Texas 77843, USA
| | - K Walker
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
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Forde H, Davenport C, Rochfort KD, Wallace RG, Durkan E, Agha A, Thompson CJ, Tormey WT, O'Gorman DJ, Cummins PM, Smith D. Serum OPG/TRAIL ratio predicts the presence of cardiovascular disease in people with type 2 diabetes mellitus. Diabetes Res Clin Pract 2022; 189:109936. [PMID: 35662613 DOI: 10.1016/j.diabres.2022.109936] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/28/2022] [Accepted: 05/30/2022] [Indexed: 11/19/2022]
Abstract
AIMS Cardiovascular disease (CVD) is the leading cause of mortality in type 2 diabetes mellitus (T2DM). Epidemiological studies suggest serum Osteoprotegrin (OPG)/Tumour-necrosis-factor-related-apoptosis-inducing- ligand (TRAIL) ratio may be a useful marker of cardiovascular risk. This study aimed to compare serum levels of TRAIL, OPG and OPG/TRAIL ratio in people with T2DM, with and without a history of CVD, and controls; and to determine which of these indices, if any, predict cardiovascular risk. METHODS In this single centre observational study of 133 participants, people with T2DM, with and without a history of a cardiovascular event in the last 5 years, were recruited along with a control cohort without T2DM or CVD. Demographic information and anthropometric measurements were recorded. Blood samples were taken and OPG and TRAIL were measured using ELISA. RESULTS People with T2DM and CVD had higher OPG/TRAIL ratios compared to controls or those with a new diagnosis of T2DM. After adjustment for potential confounding factors, OPG/TRAIL ratio was significantly associated with the presence of CVD in people with T2DM and an OPG/TRAIL ratio cut-off > 38.6 predicted the presence of CVD in this cohort with a sensitivity of 80% and specificity of 82%. CONCLUSION This study suggests that OPG/TRAIL ratio may have a role as a biomarker of CVD in people with T2DM.
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Affiliation(s)
- H Forde
- Department of Endocrinology, Beaumont Hospital and RCSI Medical School, Beaumont, Dublin 9, Ireland; School of Biotechnology, Dublin City University, Glasnevin, Dublin 9, Ireland.
| | - C Davenport
- Department of Endocrinology, Beaumont Hospital and RCSI Medical School, Beaumont, Dublin 9, Ireland; School of Biotechnology, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - K D Rochfort
- School of Nursing, Psychotherapy, and Community Health, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - R G Wallace
- School of Biotechnology, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - E Durkan
- School of Health and Human Performance, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - A Agha
- Department of Endocrinology, Beaumont Hospital and RCSI Medical School, Beaumont, Dublin 9, Ireland
| | - C J Thompson
- Department of Endocrinology, Beaumont Hospital and RCSI Medical School, Beaumont, Dublin 9, Ireland
| | - W T Tormey
- Department of Chemical Pathology, Beaumont Hospital, Beaumont, Dublin 9, Ireland
| | - D J O'Gorman
- School of Health and Human Performance, Dublin City University, Glasnevin, Dublin 9, Ireland; National Institute for Cellular Biotechnology, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - P M Cummins
- School of Biotechnology, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - D Smith
- Department of Endocrinology, Beaumont Hospital and RCSI Medical School, Beaumont, Dublin 9, Ireland
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Williamson S, Dennison L, Greenwell K, Denison-Day J, Mowbray F, Richards-Hall S, Smith D, Bradbury K, Ainsworth B, Little P, Geraghty AWA, Yardley L. Using nasal sprays to prevent respiratory tract infections: a qualitative study of online consumer reviews and primary care patient interviews. BMJ Open 2022; 12:e059661. [PMID: 35772824 PMCID: PMC9247325 DOI: 10.1136/bmjopen-2021-059661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Nasal sprays could be a promising approach to preventing respiratory tract infections (RTIs). This study explored lay people's perceptions and experiences of using nasal sprays to prevent RTIs to identify barriers and facilitators to their adoption and continued use. DESIGN Qualitative research. Study 1 thematically analysed online consumer reviews of an RTI prevention nasal spray. Study 2 interviewed patients about their reactions to and experiences of a digital intervention that promotes and supports nasal spray use for RTI prevention (reactively: at 'first signs' of infection and preventatively: following possible/probable exposure to infection). Interview transcripts were analysed using thematic analysis. SETTING Primary care, UK. PARTICIPANTS 407 online customer reviews. 13 purposively recruited primary care patients who had experienced recurrent infections and/or had risk factors for severe infections. RESULTS Both studies identified various factors that might influence nasal spray use including: high motivation to avoid RTIs, particularly during the COVID-19 pandemic; fatalistic views about RTIs; beliefs about alternative prevention methods; the importance of personal recommendation; perceived complexity and familiarity of nasal sprays; personal experiences of spray success or failure; tolerable and off-putting side effects; concerns about medicines; and the nose as unpleasant and unhygienic. CONCLUSIONS People who suffer disruptive, frequent or severe RTIs or who are vulnerable to RTIs are interested in using a nasal spray for prevention. They also have doubts and concerns and may encounter problems. Some of these may be reduced or eliminated by providing nasal spray users with information and advice that addresses these concerns or helps people overcome difficulties.
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Affiliation(s)
- Sian Williamson
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Laura Dennison
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Kate Greenwell
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - James Denison-Day
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Fiona Mowbray
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Samantha Richards-Hall
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Deb Smith
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Katherine Bradbury
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Ben Ainsworth
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Department of Psychology, University of Bath, Bath, UK
| | - Paul Little
- Primary Care and Population Science, University of Southampton, Southampton, UK
| | - Adam W A Geraghty
- Primary Care and Population Science, University of Southampton, Southampton, UK
| | - Lucy Yardley
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- School of Health Sciences, University of Bristol, Bristol, UK
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31
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Williams MR, Welikhe P, Bos J, King K, Akland M, Augustine D, Baffaut C, Beck EG, Bierer A, Bosch DD, Boughton E, Brandani C, Brooks E, Buda A, Cavigelli M, Faulkner J, Feyereisen G, Fortuna A, Gamble J, Hanrahan B, Hussain M, Kohmann M, Kovar J, Lee B, Leytem A, Liebig M, Line D, Macrae M, Moorman T, Moriasi D, Nelson N, Ortega-Pieck A, Osmond D, Pisani O, Ragosta J, Reba M, Saha A, Sanchez J, Silveira M, Smith D, Spiegal S, Swain H, Unrine J, Webb P, White K, Wilson H, Yasarer L. P-FLUX: A phosphorus budget dataset spanning diverse agricultural production systems in the United States and Canada. J Environ Qual 2022; 51:451-461. [PMID: 35373848 DOI: 10.1002/jeq2.20351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 03/22/2022] [Indexed: 06/14/2023]
Abstract
Quantifying spatial and temporal fluxes of phosphorus (P) within and among agricultural production systems is critical for sustaining agricultural production while minimizing environmental impacts. To better understand P fluxes in agricultural landscapes, P-FLUX, a detailed and harmonized dataset of P inputs, outputs, and budgets, as well as estimated uncertainties for each P flux and budget, was developed. Data were collected from 24 research sites and 61 production systems through the Long-term Agroecosystem Research (LTAR) network and partner organizations spanning 22 U.S. states and 2 Canadian provinces. The objectives of this paper are to (a) present and provide a description of the P-FLUX dataset, (b) provide summary analyses of the agricultural production systems included in the dataset and the variability in P inputs and outputs across systems, and (c) provide details for accessing the dataset, dataset limitations, and an example of future use. P-FLUX includes information on select site characteristics (area, soil series), crop rotation, P inputs (P application rate, source, timing, placement, P in irrigation water, atmospheric deposition), P outputs (crop removal, hydrologic losses), P budgets (agronomic budget, overall budget), uncertainties associated with each flux and budget, and data sources. Phosphorus fluxes and budgets vary across agricultural production systems and are useful resources to improve P use efficiency and develop management strategies to mitigate environmental impacts of agricultural systems. P-FLUX is available for download through the USDA Ag Data Commons (https://doi.org/10.15482/USDA.ADC/1523365).
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Affiliation(s)
- M R Williams
- National Soil Erosion Research Laboratory, USDA-ARS, West Lafayette, IN, USA
| | - P Welikhe
- National Soil Erosion Research Laboratory, USDA-ARS, West Lafayette, IN, USA
- Dep. of Agronomy, Purdue Univ., West Lafayette, IN, USA
| | - J Bos
- National Soil Erosion Research Laboratory, USDA-ARS, West Lafayette, IN, USA
| | - K King
- Soil Drainage Research Unit, USDA-ARS, Columbus, OH, USA
| | - M Akland
- Dep. of Plant and Soil Sciences, Univ. of Kentucky, Lexington, KY, USA
| | - D Augustine
- Rangeland Resources Research Unit, USDA-ARS, Fort Collins, CO, USA
| | - C Baffaut
- Cropping Systems and Water Quality Research Unit, USDA-ARS, Columbia, MO, USA
| | - E G Beck
- Kentucky Geological Survey, Univ. of Kentucky, Henderson, KY, USA
| | - A Bierer
- Northwest Irrigation and Soils Research Lab, USDA-ARS, Kimberly, ID, USA
| | - D D Bosch
- Southeast Watershed Research Laboratory, USDA-ARS, Tifton, GA, USA
| | - E Boughton
- Buck Island Ranch, Archbold Biological Station, Lake Placid, FL, USA
| | - C Brandani
- Dep. of Animal and Range Science, New Mexico State Univ., Las Cruces, NM, USA
| | - E Brooks
- Dep. of Soil and Water Resources, Univ. of Idaho, Moscow, ID, USA
| | - A Buda
- Systems and Watershed Management Research Unit, USDA-ARS, University Park, PA, USA
| | - M Cavigelli
- Sustainable Agricultural Systems Laboratory, USDA-ARS, Beltsville, MD, USA
| | - J Faulkner
- Dep. of Plant and Soil Science, Univ. of Vermont, Burlington, VT, USA
| | - G Feyereisen
- Soil and Water Management Unit, USDA-ARS, St. Paul, MN, USA
| | - A Fortuna
- Grazinglands Research Laboratory, USDA-ARS, El Reno, OK, USA
| | - J Gamble
- Soil and Water Management Unit, USDA-ARS, St. Paul, MN, USA
| | - B Hanrahan
- Soil Drainage Research Unit, USDA-ARS, Columbus, OH, USA
| | - M Hussain
- W.K. Kellogg Biological Station, Michigan State Univ., Hickory Corners, MI, USA
| | - M Kohmann
- Range Cattle Research and Education Center, Univ. of Florida, Ona, FL, USA
| | - J Kovar
- Agroecosystems Management Research, USDA-ARS, Ames, IA, USA
| | - B Lee
- Dep. of Plant and Soil Sciences, Univ. of Kentucky, Lexington, KY, USA
| | - A Leytem
- Northwest Irrigation and Soils Research Lab, USDA-ARS, Kimberly, ID, USA
| | - M Liebig
- Northern Great Plains Research Laboratory, USDA-ARS, Mandan, ND, USA
| | - D Line
- Dep. of Crop and Soil Sciences, North Carolina State Univ., Raleigh, NC, USA
| | - M Macrae
- Dep. of Geography and Environmental Management, Univ. of Waterloo, Waterloo, ON, Canada
| | - T Moorman
- Agroecosystems Management Research, USDA-ARS, Ames, IA, USA
| | - D Moriasi
- Grazinglands Research Laboratory, USDA-ARS, El Reno, OK, USA
| | - N Nelson
- Dep. of Agronomy, Kansas State Univ., Manhattan, KS, USA
| | - A Ortega-Pieck
- Dep. of Soil and Water Resources, Univ. of Idaho, Moscow, ID, USA
| | - D Osmond
- Dep. of Crop and Soil Sciences, North Carolina State Univ., Raleigh, NC, USA
| | - O Pisani
- Southeast Watershed Research Laboratory, USDA-ARS, Tifton, GA, USA
| | - J Ragosta
- USDA-ARS, Jornada Experimental Range, Las Cruces, NM, USA
| | - M Reba
- USDA-ARS, Delta Water Management Research Unit, Arkansas State Univ., Jonesboro, AR, USA
| | - A Saha
- Buck Island Ranch, Archbold Biological Station, Lake Placid, FL, USA
| | - J Sanchez
- Range Cattle Research and Education Center, Univ. of Florida, Ona, FL, USA
| | - M Silveira
- Range Cattle Research and Education Center, Univ. of Florida, Ona, FL, USA
| | - D Smith
- Grassland, Soil and Water Research Laboratory, USDA-ARS, Temple, TX, USA
| | - S Spiegal
- USDA-ARS, Jornada Experimental Range, Las Cruces, NM, USA
| | - H Swain
- Buck Island Ranch, Archbold Biological Station, Lake Placid, FL, USA
| | - J Unrine
- Dep. of Plant and Soil Sciences, Univ. of Kentucky, Lexington, KY, USA
| | - P Webb
- Dep. of Crop, Soil, and Environmental Sciences, Univ. of Arkansas, Fayetteville, AR, USA
| | - K White
- Sustainable Agricultural Systems Laboratory, USDA-ARS, Beltsville, MD, USA
| | - H Wilson
- Science and Technology Branch, Brandon Research and Development Centre, Agriculture and Agri-Food Canada, Brandon, MB, Canada
| | - L Yasarer
- National Sedimentation Laboratory, USDA-ARS, Oxford, MS, USA
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Birs A, Kadosh B, Flattery E, Hong K, Adler E, Xia Y, Aslam S, Razzouk L, Smith D, Moazam N, Reyentovich A, Gidea C. Cardiac Allograft Vasculopathy in Heart Transplant Recipients from Hepatitis C Viremic Donors, Data from Two Large Academic Transplant Centers. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.215] [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] Open
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33
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Ramachandran A, Siddiqui E, Reyentovich A, Lonze B, Saraon T, Rao S, Katz S, Goldberg R, Kadosh B, DiVita M, Cruz J, Carillo J, Smith D, Moazami N, Gidea C. Transplant Outcomes in Hearts with Moderate to Severe Left Ventricular Hypertrophy After the 2018 OPTN/UNOS Allocation Changes. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1690] [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: 10/18/2022] Open
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34
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Benmore CJ, Benmore SR, Edwards AD, Shrader CD, Bhat MH, Cherry BR, Smith P, Gozzo F, Shi C, Smith D, Yarger JL, Byrn SR, Weber JKR. A High Energy X-ray Diffraction Study of Amorphous Indomethacin. J Pharm Sci 2022; 111:818-824. [PMID: 34890631 PMCID: PMC11064786 DOI: 10.1016/j.xphs.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 11/18/2022]
Abstract
Amorphous pharmaceuticals often possess a wide range of molecular conformations and bonding arrangements. The x-ray pair distribution function (PDF) method is a powerful technique for the characterization of variations in both intra-molecular and inter-molecular packing arrangements. Here, the x-ray PDF of amorphous Indomethacin is shown to be particularly sensitive to the preferred orientations of the chlorobenzyl ring found in isomers in the crystalline state. In some cases, the chlorobenzyl ring has no preferred torsional angle in the amorphous form, while in others evidence of distinct isomer orientations are observed. Amorphous samples with no preferred torsion angles of the chlorobenzyl ring are found to favor enhanced inter-molecular hydrogen bonding, and this is reflected in the intensity of the first sharp diffraction peak. These significant variations in structure rule out amorphous Indomethacin as a possible standard for x-ray PDF measurements. At high humidity, time resolved PDF's for >40 h reveal water molecules forming hydrogen bonds with Indomethacin molecules. A simple linear hydrogen bond model indicates that water molecules in the wet amorphous form have similar hydrogen bond strengths to those found between Indomethacin dimers or chains in the dry amorphous form.
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Affiliation(s)
- C J Benmore
- X-Ray Science Division, Advanced Photon Source, Argonne National Laboratory, Argonne, IL 60439, United States of America; Arizona State University, Tempe, AZ 85281, United States of America.
| | - S R Benmore
- Materials Development, Inc., Arlington Heights, IL 60004, United States of America
| | - A D Edwards
- Arizona State University, Tempe, AZ 85281, United States of America
| | - C D Shrader
- Arizona State University, Tempe, AZ 85281, United States of America
| | - M H Bhat
- Arizona State University, Tempe, AZ 85281, United States of America
| | - B R Cherry
- Arizona State University, Tempe, AZ 85281, United States of America
| | - P Smith
- Improved Pharma, West Lafayette, IN 47906, United States of America
| | - F Gozzo
- Excelsus Structural Solutions, Park Innovaare, 5234 Villigen, Switzerland
| | - C Shi
- Data Science Consulting, Tiger Analytics, Santa Clara, CA 95054
| | - D Smith
- Improved Pharma, West Lafayette, IN 47906, United States of America; Department of Industrial and Physical Pharmacy, Purdue University, West Lafayette, IN 47906, United States of America
| | - J L Yarger
- Arizona State University, Tempe, AZ 85281, United States of America
| | - S R Byrn
- Improved Pharma, West Lafayette, IN 47906, United States of America; Department of Industrial and Physical Pharmacy, Purdue University, West Lafayette, IN 47906, United States of America
| | - J K R Weber
- X-Ray Science Division, Advanced Photon Source, Argonne National Laboratory, Argonne, IL 60439, United States of America; Materials Development, Inc., Arlington Heights, IL 60004, United States of America
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Lampert S, Chen D, Burger I, Barber D, Poole V, Smith D, Kouba A, Kouba C. 21 Saving salamanders with sonograms: tracking follicular development with ultrasonography in a variety of caudate species. Reprod Fertil Dev 2021; 34:244-245. [PMID: 35231273 DOI: 10.1071/rdv34n2ab21] [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: 11/23/2022] Open
Affiliation(s)
- S Lampert
- Mississippi State University, Starkville, MS, USA
| | - D Chen
- Mississippi State University, Starkville, MS, USA
| | - I Burger
- Mississippi State University, Starkville, MS, USA
| | - D Barber
- Fort Worth Zoo, Fort Worth, TX, USA
| | - V Poole
- Fort Worth Zoo, Fort Worth, TX, USA
| | - D Smith
- North Carolina Zoo, Asheboro, NC, USA
| | - A Kouba
- Mississippi State University, Starkville, MS, USA
| | - C Kouba
- Mississippi State University, Starkville, MS, USA
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36
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Burger I, Chen LD, Barber D, Poole V, Smith D, Kouba A, Kouba C. 18 All aboard the polar express: transferability of a cryopreservation protocol between anuran species. Reprod Fertil Dev 2021; 34:243. [PMID: 35231383 DOI: 10.1071/rdv34n2ab18] [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: 11/23/2022] Open
Affiliation(s)
- I Burger
- Mississippi State University, Mississippi State, MS, USA
| | - L D Chen
- Mississippi State University, Mississippi State, MS, USA
| | - D Barber
- Fort Worth Zoo, Fort Worth, TX, USA
| | - V Poole
- Fort Worth Zoo, Fort Worth, TX, USA
| | - D Smith
- North Carolina Zoo, Asheboro, NC, USA
| | - A Kouba
- Mississippi State University, Mississippi State, MS, USA
| | - C Kouba
- Mississippi State University, Mississippi State, MS, USA
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Kass S, Smith D, Gor R, Mama S. Robotic Approach to Ectopic Endometriosis in a Patient with Duplicated Ureters. J Minim Invasive Gynecol 2021. [DOI: 10.1016/j.jmig.2021.09.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Fraser-Pitt D, Dolan S, Smith D, O’Neil D. 431: Antivirulence activities of cysteamine and protection from Pseudomonas toxicity in the Galleria mellonella model. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01855-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ampil F, Sin A, Smith D, Richards T. Is Noninvasive Stereotactic Radiosurgery for Skull Base Meningiomas With Carotid Artery Involvement Supported by Long-Term Clinical Outcomes? Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1512] [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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Martin M, Giraud N, Capdepont M, Sarrade C, Viaouet A, Smith D, Terrebonne E, Frulio N, Rullier A, Denost Q, Rullier E, Vendrely V. Morbidité chirurgicale sévère après une chimioradiothérapie néoadjuvante en technique conformationnelle tridimensionnelle comparée à la modulation d’intensité pour l’adénocarcinome rectal localement évolué. Cancer Radiother 2021. [DOI: 10.1016/j.canrad.2021.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Little J, Ahmad S, Skwarski M, Smith D, Taylor B, Vasiliadou I, Vivekanandan S. MA06.02 Impact of Heart and Lung Radiation Dose and Lymphopenia on Non-Small Cell Lung Cancer Outcomes. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Girard N, Mazieres J, Otto J, Lena H, Lepage C, Egenod T, Smith D, Madelaine J, Gérinière L, El Hajbi F, Ferru A, Clément-Duchêne C, Madroszyk A, Desrame J, Morin F, Langlais A, Michel P, Louvet C, Westeel V, Walter T. LBA41 Nivolumab (nivo) ± ipilimumab (ipi) in pre-treated patients with advanced, refractory pulmonary or gastroenteropancreatic poorly differentiated neuroendocrine tumors (NECs) (GCO-001 NIPINEC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Dolly S, Russell B, Moss C, Tsotra E, Gousis C, Roca J, Sita-Lumsden A, Khan M, Josephs D, Zaki K, Smith D, Michalarea V, Kristeleit R, Enting D, Flanders L, Lei M, Sawyer E, Spicer J, Ross P, Montes A, Van Hemelrijick M. 1608P The impact of COVID-19 on the delivery of systemic anti-cancer treatment at Guy’s Cancer Centre. Ann Oncol 2021. [PMCID: PMC8454366 DOI: 10.1016/j.annonc.2021.08.1601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Martin M, Giraud N, Capdepont M, Sarrade C, Viaouet A, Smith D, Terrebonne E, Frulio N, Rullier A, Denost Q, Rullier E, Vendrely V. PO-1244 Severe surgical morbidity after chemoradiotherapy conformational-3D versus IMRT for rectal cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07695-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Osborn DPJ, Favarato G, Lamb D, Harper T, Johnson S, Lloyd-Evans B, Marston L, Pinfold V, Smith D, Kirkbride JB, Weich S. Readmission after discharge from acute mental healthcare among 231 988 people in England: cohort study exploring predictors of readmission including availability of acute day units in local areas. BJPsych Open 2021; 7:e136. [PMID: 34275509 PMCID: PMC8329766 DOI: 10.1192/bjo.2021.961] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND In the UK, acute mental healthcare is provided by in-patient wards and crisis resolution teams. Readmission to acute care following discharge is common. Acute day units (ADUs) are also provided in some areas. AIMS To assess predictors of readmission to acute mental healthcare following discharge in England, including availability of ADUs. METHOD We enrolled a national cohort of adults discharged from acute mental healthcare in the English National Health Service (NHS) between 2013 and 2015, determined the risk of readmission to either in-patient or crisis teams, and used multivariable, multilevel logistic models to evaluate predictors of readmission. RESULTS Of a total of 231 998 eligible individuals discharged from acute mental healthcare, 49 547 (21.4%) were readmitted within 6 months, with a median time to readmission of 34 days (interquartile range 10-88 days). Most variation in readmission (98%) was attributable to individual patient-level rather than provider (trust)-level effects (2.0%). Risk of readmission was not associated with local availability of ADUs (adjusted odds ratio 0.96, 95% CI 0.80-1.15). Statistically significant elevated risks were identified for participants who were female, older, single, from Black or mixed ethnic groups, or from more deprived areas. Clinical predictors included shorter index admission, psychosis and being an in-patient at baseline. CONCLUSIONS Relapse and readmission to acute mental healthcare are common following discharge and occur early. Readmission was not influenced significantly by trust-level variables including availability of ADUs. More support for relapse prevention and symptom management may be required following discharge from acute mental healthcare.
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Affiliation(s)
- David P J Osborn
- Division of Psychiatry, University College London, and Camden and Islington NHS Foundation Trust, UK
| | | | - Danielle Lamb
- Division of Psychiatry, University College London, UK
| | - Terri Harper
- Department of Primary Care and Population Health, University College London, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, and Camden and Islington NHS Foundation Trust, UK
| | | | - Louise Marston
- Department of Primary Care and Population Health, University College London, UK
| | | | | | | | - Scott Weich
- Mental Health Research Unit, Sheffield University, UK
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André T, Shiu K, Kim T, Jensen B, Jensen L, Punt C, Smith D, Garcia-Carbonero R, Alcaide García J, Gibbs P, De la Fouchardière C, Rivera Herrero F, Elez E, Bendell J, Le D, Yoshino T, Zhong W, Fogelman D, Marinello P, Diaz L. O-8 Final overall survival for the phase 3 KN177 study: Pembrolizumab versus chemotherapy in microsatellite instability-high/mismatch repair deficient metastatic colorectal cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.012] [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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Rai AT, Deib G, Smith D, Boo S. Teleproctoring for Neurovascular Procedures: Demonstration of Concept Using Optical See-Through Head-Mounted Display, Interactive Mixed Reality, and Virtual Space Sharing-A Critical Need Highlighted by the COVID-19 Pandemic. AJNR Am J Neuroradiol 2021; 42:1109-1115. [PMID: 33707282 PMCID: PMC8191671 DOI: 10.3174/ajnr.a7066] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/11/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND PURPOSE Physician training and onsite proctoring are critical for safely introducing new biomedical devices, a process that has been disrupted by the pandemic. A teleproctoring concept using optical see-through head-mounted displays with a proctor's ability to see and, more important, virtually interact in the operator's visual field is presented. MATERIALS AND METHODS Test conditions were created for simulated proctoring using a bifurcation aneurysm flow model for WEB device deployment. The operator in the angiography suite wore a Magic Leap-1 optical see-through head-mounted display to livestream his or her FOV to a proctor's computer in an adjacent building. A Web-based application (Spatial) was used for the proctor to virtually interact in the operator's visual space. Tested elements included the quality of the livestream, communication, and the proctor's ability to interact in the operator's environment using mixed reality. A hotspot and a Wi-Fi-based network were tested. RESULTS The operator successfully livestreamed the angiography room environment and his FOV of the monitor to the remotely located proctor. The proctor communicated and guided the operator through the procedure over the optical see-through head-mounted displays, a process that was repeated several times. The proctor used mixed reality and virtual space sharing to successfully project images, annotations, and data in the operator's FOV for highlighting any device or procedural aspects. The livestream latency was 0.71 (SD, 0.03) seconds for Wi-Fi and 0.86 (SD, 0.3) seconds for the hotspot (P = .02). The livestream quality was subjectively better over the Wi-Fi. CONCLUSIONS New technologies using head-mounted displays and virtual space sharing could offer solutions applicable to remote proctoring in the neurointerventional space.
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Affiliation(s)
- A T Rai
- From the Department of Interventional Neuroradiology (A.T.R., G.D., S.B.), Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, West Virginia
| | - G Deib
- From the Department of Interventional Neuroradiology (A.T.R., G.D., S.B.), Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, West Virginia
| | - D Smith
- West Virginia University Reed College of Media (D.S.), Morgantown, West Virginia
| | - S Boo
- From the Department of Interventional Neuroradiology (A.T.R., G.D., S.B.), Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, West Virginia
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Patterson B, Smith D, Telford A, Tana A, Johnstone D, Davidson R, Martineau AR. Vitamin D deficiency predicts latent TB reactivation independent of preventive therapy: a longitudinal study. Int J Tuberc Lung Dis 2021; 24:916-921. [PMID: 33156758 DOI: 10.5588/ijtld.19.0605] [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] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Vitamin D deficiency is associated with progression of latent tuberculosis (TB) infection to active disease. The impact of preventive therapy on this association is unknown.METHOD: Serum 25-hydroxyvitamin D (25(OH)D) levels were retrospectively linked to adults diagnosed with latent TB between April 2010 and January 2019 in a hospital in London, UK. Individuals in the cohort who progressed to active TB were identified by matching to a national notification register. A logistic regression model was used to examine baseline vitamin D deficiency and use of preventive therapy with subsequent incidence of TB disease.RESULTS: Of 1509 latently infected individuals with 3902 patient-years of follow-up, 687 (45.5%) were identified as vitamin D deficient and 691 (45.8%) individuals had a LTBI regimen prescribed. There were 29 (1.9%) instances of TB reactivation. On multivariate analysis, profound (<25 nmol/L) vitamin D deficiency (aHR 5.68, 95%CI 2.18-14.82; P = 0.0003) and the absence of preventive therapy (aHR 3.84, 95%CI 1.46-10.08; P = 0.006) were associated with progression to active TB disease. There was no evidence that preventive therapy modified the association between vitamin D status and TB reactivation.CONCLUSION: Our results show an independent association between vitamin D deficiency and progression from latent TB infection to active disease.
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Affiliation(s)
- B Patterson
- Infectious Diseases Department, Northwick Park Hospital, London
| | - D Smith
- Infectious Diseases Department, Northwick Park Hospital, London
| | - A Telford
- Infectious Diseases Department, Northwick Park Hospital, London
| | - A Tana
- Infectious Diseases Department, Northwick Park Hospital, London
| | - D Johnstone
- Infectious Diseases Department, Northwick Park Hospital, London
| | - R Davidson
- Infectious Diseases Department, Northwick Park Hospital, London
| | - A R Martineau
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Toy B, Emmarco A, Lester L, Lohan-Mullens M, Ottoson E, Garofalo T, Saputo M, Moazami N, Kon Z, Smith D. Rapid ECMO Training for Nurses in Response to the COVID-19 Pandemic. J Heart Lung Transplant 2021. [PMCID: PMC7979362 DOI: 10.1016/j.healun.2021.01.445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Purpose From March 17th to April 29th, our ECMO Program placed 30 adult patients on venovenous extracorporeal membrane oxygenation (VV-ECMO) for management of coronavirus disease 2019 (COVID-19). This acute increase in volume placed a strain on our available ECMO-competent nursing staff. Although perfusionists function as our ECMO specialists, our critical care nurses provide continuous circuit monitoring and respond to emergencies. Because of the need to increase the number of ECMO-competent nurses, on March 27th a focused, two-hour COVID-ECMO training course was implemented. Methods We retrospectively reviewed the number of ECMO care hours provided by our nursing staff and separated the nursing staff into two cohorts. Group A consisted of nurses who had undergone ECMO training prior to the pandemic (n=126). Group B consisted of nurses whose initial ECMO training occurred during the pandemic (N=145). We then compared the number of nursing hours provided by each cohort before and after training. Results From March 27th to May 4th, 145 nurses completed training, increasing our total number of ECMO-competent nurses from 126 to 271 (115% increase). From March 17th to June 30th, 20,677 ECMO care hours were provided. Pre-training, all 634 care hours were 100% provided by Group A nurses. Post-training, 20,043 care hours were provided, consisting of 39% Group A nursing coverage and 61% Group B nursing coverage. There were no differences in nursing related ECMO-emergencies between the two groups. At the conclusion of the surge, 28 out of 30 (93%) patients survived ECMO and 26 out of 29 patients (90%) survived to hospital discharge. One patient has a pending hospital disposition. Conclusion Rapid implementation of an abbreviated ECMO education program for nurses is feasible. It met the time-sensitive needs of the COVID-19 pandemic and provided safe nursing coverage to patients requiring ECMO.
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Wainstein E, Da Lozzo A, Beveraggi E, Dietrich A, Smith D, Montagne J, Orazi M, Svetliza G. Native Lung Complications in Single Lung Transplant Recipients. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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