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Ryan E, Hannigan A, Grol-Prokopczyk H, May P, Purtill H. Sociodemographic disparities and potential biases in persistent pain estimates: Findings from 5 waves of the Irish Longitudinal Study on Ageing (TILDA). Eur J Pain 2024; 28:754-768. [PMID: 38059524 PMCID: PMC11023795 DOI: 10.1002/ejp.2215] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 11/03/2023] [Accepted: 11/20/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Pain is a prevalent, debilitating condition among older adults. Much evidence on this topic comes from cohort studies, which may be affected by attrition and measurement bias. Little is known about the impact of these biases on pain estimates for European older adults. Additionally, there is a lack of longitudinal research on pain and sociodemographic disparities in Irish older adults. METHODS We analysed data from 8171 participants (aged ≥50 at baseline) across five waves of the Irish Longitudinal Study on Ageing. Longitudinal pain severity and sociodemographic disparities in pain were explored visually and using a latent growth curve model. Using multivariate logistic regression, we examined bias due to attrition at later waves associated with reported pain at Wave 1. Measurement biases due to reporting heterogeneity were assessed by investigating associations between sociodemographic factors and pain-related disability for given pain levels. RESULTS Wave 1 severe pain was associated with increased odds of attrition due to death by Wave 5 (AOR: 1.63, 95% CI: 1.20, 2.19). Not having private health insurance was associated with increased odds of pain-related disability at Wave 1, controlling for pain severity (AOR: 1.37, 95% CI: 1.15, 1.64). These results suggested mortality bias and reporting heterogeneity measurement bias, respectively. Sex, education level, and private health insurance status disparities in pain were observed longitudinally. CONCLUSIONS Mortality bias and reporting heterogeneity measurement bias must be accounted for to improve older adult pain estimates. There is a need for policymakers to address sociodemographic disparities in older adult pain levels. SIGNIFICANCE This study highlights a need to address bias in the estimation of pain in observational studies of older adults. Understanding the sources and extent of these biases is important so that health practices and policies to address pain disparities can be guided by accurate estimates. Women, those with lower educational attainment, and those without private health insurance were found to have the highest pain burden longitudinally, suggesting a need for targeted interventions for these groups in Ireland and internationally.
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Affiliation(s)
- E Ryan
- Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland
| | - A Hannigan
- School of Medicine, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - H Grol-Prokopczyk
- Department of Sociology, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - P May
- Centre for Health Policy and Management, School of Medicine, Trinity College Dublin, Dublin, Ireland
- The Irish Longitudinal Study on Ageing, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - H Purtill
- Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Ageing Research Centre, University of Limerick, Limerick, Ireland
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Madden JM, O'Donovan J, Casey-Bryars M, Sweeney J, Messam LL, McAloon CG, More SJ, Kenny K, Ryan E, Gormley E. The impact of changing the cut-off threshold of the interferon-gamma (IFN-γ) assay for diagnosing bovine tuberculosis in Ireland. Prev Vet Med 2024; 224:106129. [PMID: 38325115 DOI: 10.1016/j.prevetmed.2024.106129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/02/2024] [Accepted: 01/15/2024] [Indexed: 02/09/2024]
Abstract
In Ireland, the interferon-gamma (IFN-γ) assay is routinely used as an ancillary test interpreted in parallel with the single intradermal comparative tuberculin test (SICTT) to maximize the detection of bovine tuberculosis (bTB) infected animals. Up until 2018, a positive test result was recorded in the IFN-γ ELISA assay following whole blood stimulation with purified protein derivative (PPD)-bovine (B), PPD-avian (A) and nil sample (N), using the interpretation criteria, B-N > 50 optical density units (OD), B > 100 and B-A > 0. Following a review of available data, the threshold of the B-A component changed to B-A > 80. As predicting the impact of changing the cut-off thresholds for the IFN-γ test de novo is challenging, the aims of this study were to follow animals that initially tested negative using the new IFN-γ assay interpretation criteria and investigate their future risk of disclosure with bTB, with a focus on animals that otherwise would have been removed when using the older interpretation criteria (0 < B-A ≤ 80). Enrolled animals (n = 28,669 cattle from 527 herds) were followed up for two years (2019-2021), or to point of bTB detection or death. At the end of follow-up, 1151 (4.0%) of enrolled animals were bTB cases. The majority of these cases were diagnosed using SICTT (80.5%). The cumulative number of positive animals that would have been removed if the old cut-off (0 < B-A ≤ 80) was used amounted to 1680 cattle (5.9% of the enrolled cohort). Of these, 127 (7.5%) were diagnosed with bTB during follow-up. In contrast, 1024 of the 1151 cattle which subsequently tested positive during the study period following a negative IFN-γ test would not have been identified with the old or new IFN-γ cut-off criteria. Survival analysis showed that animals that would have been removed under the old interpretation criteria were at increased risk of a positive diagnosis with bTB during follow-up compared to other test negative animals. A newly developed risk prediction model (using a Cox proportional hazard model) showed that age, animal number of SICTT tests, number of inconclusive SICTT tests, B-A (IFN-γ assay), B-N (IFN-γ assay), animals from store herds and the percentage of the rest of the herd that were positive during the breakdown were statistically significantly associated with bTB detection. However, inclusion of the IFN-γ OD variables did not show added value in terms of prediction performance of the model.
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Affiliation(s)
- Jamie M Madden
- Centre for Veterinary Epidemiology and Risk Analysis (CVERA), University College Dublin (UCD), Dublin, Ireland.
| | - Jim O'Donovan
- Department of Agriculture, Food and the Marine, Regional Veterinary Laboratory, Cork, Ireland
| | - Miriam Casey-Bryars
- Centre for Veterinary Epidemiology and Risk Analysis (CVERA), University College Dublin (UCD), Dublin, Ireland
| | - James Sweeney
- Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland
| | - Locksley L Messam
- Section: Herd Health and Animal Husbandry, School of Veterinary Medicine, University College Dublin (UCD), Dublin, Ireland
| | - Conor G McAloon
- Section: Herd Health and Animal Husbandry, School of Veterinary Medicine, University College Dublin (UCD), Dublin, Ireland
| | - Simon J More
- Centre for Veterinary Epidemiology and Risk Analysis (CVERA), University College Dublin (UCD), Dublin, Ireland
| | - Kevin Kenny
- Department of Agriculture, Food and the Marine, Central Veterinary Research Laboratory, Backweston Co., Kildare, Ireland
| | - Eoin Ryan
- Department of Agriculture, Food and the Marine, Ruminant Animal Health Division, Backweston, Co., Kildare, Ireland
| | - Eamonn Gormley
- Tuberculosis Diagnostics and Immunology Research Laboratory, School of Veterinary Medicine, University College Dublin (UCD), Dublin, Ireland
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3
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Madden JM, Casey-Bryars M, More SJ, Barrett D, Gormley E, Ryan E. Investigation of the association between the Enferplex bovine tuberculosis antibody test and the future risk of bovine tuberculosis in irish cattle in infected herds: a pilot field study. Vet Res Commun 2024; 48:555-561. [PMID: 37589815 PMCID: PMC10811095 DOI: 10.1007/s11259-023-10200-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/11/2023] [Indexed: 08/18/2023]
Abstract
The Single Intradermal Comparative Tuberculin Test (SICTT) and the interferon-gamma (IFN-γ) assay are the approved diagnostic tests for bovine tuberculosis (bTB) in Ireland. The aim of this pilot study was to explore if there was any added diagnostic benefit from applying the Enferplex bTB test (an antibody test) in severe bTB herd breakdowns after the removal of cattle that had tested positive to the SICTT and the IFN-γ test. In addition to the normal bTB testing and management protocols, the animals in these herds that tested negative to SICTT and the IFN-γ test were followed forward for a period of two years. All animals were tested by Enferplex at enrolment. The time to subsequent bTB detection (diagnosed with SICTT/IFN-γ tests or detection of visible lesions at routine slaughter) for animals that tested positive or negative to the Enferplex bTB test at the start of the study was compared using Kaplan-Meier survival curves and Cox based survival models. Of the 484 enrolled animals (from 11 herds), 171 (35.3%) and 151 (31.1%) initially tested positive in the Enferplex assay under the high sensitivity and high specificity interpretation settings respectively. The results of the survival analysis showed that there was no difference in the survival time to a positive diagnosis with bTB during the follow-up period between animals initially classified as positive and negative by the Enferplex test. Further research is warranted to explore the potential benefit of using the Enferplex test in other scenarios.
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Affiliation(s)
- Jamie M Madden
- Centre for Veterinary Epidemiology and Risk Analysis (CVERA), University College Dublin, Dublin, Ireland.
| | - Miriam Casey-Bryars
- Centre for Veterinary Epidemiology and Risk Analysis (CVERA), University College Dublin, Dublin, Ireland
| | - Simon J More
- Centre for Veterinary Epidemiology and Risk Analysis (CVERA), University College Dublin, Dublin, Ireland
| | - Damien Barrett
- Ruminant Animal Health Division, Department of Agriculture, Food and the Marine, Backweston, Co. Kildare, Ireland
| | - Eamonn Gormley
- Tuberculosis Diagnostics and Immunology Research Laboratory, School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Eoin Ryan
- Animal Welfare Division, Department of Agriculture, Food and the Marine, Kildare St, Dublin 2, Ireland
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Bennett C, Coughlan S, Hunt K, Butler F, Fanning S, Ryan E, De Gascun C, O'Gorman J. Detection of hepatitis E RNA in pork products at point of retail in Ireland - Are consumers at risk? Int J Food Microbiol 2024; 410:110492. [PMID: 37988969 DOI: 10.1016/j.ijfoodmicro.2023.110492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/09/2023] [Accepted: 11/12/2023] [Indexed: 11/23/2023]
Abstract
Hepatitis E (HEV), a zoonotic virus, is the leading cause of acute viral hepatitis in Europe. The presence of HEV in domestic pigs can result in infections in humans through consumption of pork products which are undercooked or where processing methods are insufficient to inactivate the virus. In Ireland, pork accounts for 34 % of all meat consumption (CSO, 2022) and the prevalence of HEV in products at point of retail has not previously been characterised. A sampling strategy was designed in which high pork content sausages, fresh pork liver and raw fermented sausages were systematically purchased from three types of retailers between May 2018 and March 2019. In total, 200 pork products were tested using a lysing agent to release the HEV from the product for detection. RT-PCR for HEV was performed on samples with an extraction efficiency >1 % (n = 188/200) (94 %). Low level HEV RNA was detected in 9/188 (4.8 %) pork products tested. The highest incidence of HEV RNA was in pork liver where 6/25 (24 %) samples were positive. The concentration of HEV ranged from 0.02 - to 9.4 genome copies/g of pork. Based on these data an exposure assessment was performed which found that if consumers followed advice from the Food Safety Authority of Ireland to achieve core temperatures of 70 °C or higher when cooking, the risk was likely to be negligible.
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Affiliation(s)
- Charlene Bennett
- UCD-National Virus Reference Laboratory, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Suzie Coughlan
- UCD-National Virus Reference Laboratory, University College Dublin, Belfield, Dublin 4, Ireland
| | - Kevin Hunt
- UCD-School of Biosystems and Food Engineering, University College Dublin, Belfield, Dublin 4, Ireland
| | - Francis Butler
- UCD-School of Biosystems and Food Engineering, University College Dublin, Belfield, Dublin 4, Ireland
| | - Séamus Fanning
- UCD-Centre for Food Safety, School of Public Health, Physiotherapy & Sports Science, Belfield, Dublin 4, Ireland
| | - Eoin Ryan
- Central Veterinary Research Laboratory, Department Agriculture Food and the Marine (DAFM), Backweston, Kildare, Ireland
| | - Cillian De Gascun
- UCD-National Virus Reference Laboratory, University College Dublin, Belfield, Dublin 4, Ireland
| | - Joanne O'Gorman
- UCD-National Virus Reference Laboratory, University College Dublin, Belfield, Dublin 4, Ireland
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Ryan E, Breslin P, O'Keeffe J, Byrne AW, Wrigley K, Barrett D. The Irish bTB eradication programme: combining stakeholder engagement and research-driven policy to tackle bovine tuberculosis. Ir Vet J 2023; 76:32. [PMID: 37996956 PMCID: PMC10666303 DOI: 10.1186/s13620-023-00255-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 09/13/2023] [Indexed: 11/25/2023] Open
Abstract
A new Irish bovine tuberculosis (bTB) eradication strategy was launched in 2021. The strategy was formulated following extensive discussions with stakeholders, formal reviews of several aspects of the existing bTB policy and relevant inputs from the latest scientific research projects. A stakeholder discussion body, the TB Forum, had been established in 2018 and this continues under the new strategy, supported by three working groups (scientific, financial and implementation). The strategy sets out actions to address cattle-to-cattle and badger-to-cattle bTB transmission, along with actions to improve farm biosecurity and empower farmers to make their own choices to reduce bTB risk.Large scale vaccination of badgers has been rolled out under the new strategy, with over 20,000 km2 covered by the vaccination programme and 6,586 badgers captured in vaccination areas in 2021. Vaccination efforts have been complemented by intensive communications campaigns, including a web enabled software application ("app") enabling farmers to report the location of badger setts.Cattle which test inconclusive to the tuberculin skin test have been re-tested using a gamma interferon blood test since April 2021, enabling truly infected cattle to be identified more effectively due to the higher sensitivity of this test. An enhanced oversight process has been put in place for herds experiencing extended or repeat bTB breakdowns. Whole genome sequencing is being used to investigate links between breakdowns, with the results supporting operational decision making in case management.Communications, including biosecurity advice, are co-designed with stakeholders, in order to improve their effectiveness. A programme involving veterinary practitioners providing tailored biosecurity bTB advice to their clients was established in 2021 and was rolled out nationally during 2022.A core element of the new strategy is the continual improvement of policies in response to changing bTB risks, informed by scientific research and then implemented with stakeholder consultation.
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Affiliation(s)
- Eoin Ryan
- Department of Agriculture, Food and the Marine, Kildare St, Dublin, 2, Ireland.
| | - Philip Breslin
- Department of Agriculture, Food and the Marine, Kildare St, Dublin, 2, Ireland
| | - James O'Keeffe
- Department of Agriculture, Food and the Marine, Kildare St, Dublin, 2, Ireland
| | - Andrew W Byrne
- Department of Agriculture, Food and the Marine, Kildare St, Dublin, 2, Ireland
| | - Karina Wrigley
- Department of Agriculture, Food and the Marine, Kildare St, Dublin, 2, Ireland
| | - Damien Barrett
- Department of Agriculture, Food and the Marine, Kildare St, Dublin, 2, Ireland
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Duff C, Kennedy L, Ryan E, James J, Binchy A, O'Donovan D. Introducing LISA: Less Invasive Surfactant Administration. Ir Med J 2023; 116:854. [PMID: 37874313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
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Caples M, McCarthy V, Wills T, Goodwin J, McCloskey S, Burton A, Forde M, Erlandsson T, Ryan E, Noonan B. Exploring the Use of an Electronic Competency Assessment Document Using iPad Minis to Assess Clinical Practice Competency in a Preregistration Nursing Program: A Cross-sectional Feasibility Study. Comput Inform Nurs 2023; 41:449-456. [PMID: 36455166 DOI: 10.1097/cin.0000000000000963] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The aim of this study was to explore the feasibility of using iPad minis as a method of completing competency assessment in clinical practice. Digital technology helps to revolutionize all aspects of our lives. The use of digital technologies in clinical practice can facilitate a move toward a more flexible learning environment and enable students to adapt in a rapidly changing, interconnected world. The introduction of electronic clinical booklets in practice placements could facilitate the sharing of clinical information through connected healthcare systems, thus improving the student experience. A cross-sectional design was used in this study. A sample of BSc nursing students (n = 53) and clinically based healthcare professionals (n = 27) (preceptors and clinical placement coordinators) participated in this study. Data were collected using a modified version of Garrett and colleagues' instrument, the System Usability Scale, a demographics questionnaire, and three open-ended questions. There was a significant difference between the students and preceptors/clinical placement coordinators across all items with higher proportions of students (ranging from 66% to 75.5%), indicating that they agreed or strongly agreed with the reliability, ease of use, and effectiveness of the device in assessing their clinical competency (ranging from 11.1% to 40.7%). In addition, the iPad minis were found to be smaller, lighter, and easier to carry than paper-based booklets and encouraged students to access timely online learning resources during placement to help augment their learning. The use of iPad mini to complete the electronic competency assessment document as a replacement for a paper-based system to assess clinical practice is feasible. The introduction of electronic assessment documents should incorporate a robust training plan and standard operating procedures.
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Affiliation(s)
- Maria Caples
- Author Affiliations: School of Nursing and Midwifery, University College Cork (Drs Caples, McCarthy, Wills, Goodwin, Burton, and Noonan and Mr McCloskey); Bons Secours Hospital (Dr Forde); and Marymount University Hospital and Hospice (Mr Erlandsson and Mr Ryan), Cork, Ireland
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Byrne AW, Ronan S, Doyle R, Blake M, Ryan E. Trends and factors associated with dairy calf early slaughter in Ireland, 2018-2022. Front Vet Sci 2023; 10:1178279. [PMID: 37303718 PMCID: PMC10248060 DOI: 10.3389/fvets.2023.1178279] [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: 03/02/2023] [Accepted: 04/24/2023] [Indexed: 06/13/2023] Open
Abstract
Dairy systems require that each cow calves annually to have an efficient milk production cycle. In systems where milk production is maximized, the male offspring from dairy breed sires tend to have poor beef production traits and, therefore, can be of low economic value. Few studies have been published on the factors impacting early slaughtering of calves in peer-reviewed literature. Here we present an analysis of national data on calves slaughtered from 2018 to 2022 in Ireland. Data (Jan 2018-May 2022) on all cattle <6 months of age were collated at a national level and were described at calf-, herd-, and county-levels. These data were statistically analyzed at per-capita slaughter rates (calves/calf born) using negative binomial regression models with an offset. There were 125,260 calves slaughtered early (1.09% of total births) recorded in the dataset from 1,364 birth herds during the study period, of which 94.8% (118,761) were male. 51.7% were classified as Friesian-cross (FRX), 11.5% Friesian (FR) and 32.1% Jersey-cross (JEX). The median age at slaughter was 16 days (Mean: 18.9 days; IQR: 13-22). The median calves/herd slaughtered was 16 (mean: 91.8); median calves/herd/year slaughtered was 21 (mean: 42.0). There was substantial variation in counts of calves slaughtered across herds, years, and counties. Herd calf slaughter rates and per capita calf slaughter rates increased significantly in 2022, with the highest rates over the time series. Calf slaughter rates varied significantly with herd size, year, and major breed (Jersey; JE). Herds which were more recently established tended to have higher calf slaughter rates. Herds that repeatedly slaughtered calves over 2 or more years tended to be larger and slaughtered more calves/herd/year. The slaughtering of calves is not widespread across the dairy industry in Ireland. The distribution of calves slaughtered per herd demonstrate that a small number of herds contributed disproportionately to calf slaughter numbers. Such herds tended to be very large (herd size), more recently established (2016 onwards), and have higher proportions of JE/JEX breed cattle. The outcomes of the present study provide an evidential base for the development of targeted industry-lead interventions with the aim of ending the routine early slaughter of calves.
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Male Here RR, Ryan E, Breslin P, Frankena K, Byrne AW. Revisiting the relative effectiveness of slaughterhouses in Ireland to detect tuberculosis lesions in cattle (2014-2018). PLoS One 2022; 17:e0275259. [PMID: 36206240 PMCID: PMC9543943 DOI: 10.1371/journal.pone.0275259] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 09/13/2022] [Indexed: 11/06/2022] Open
Abstract
Slaughterhouse or meat factory surveillance to detect factory lesions (FL) at slaughter is an important part of the bovine tuberculosis (bTB) eradication program in Ireland. The objective of this study was to quantify the effectiveness of Irish slaughterhouses or factories in submitting FL and the proportion of those submitted FL confirmed as being due to bTB in slaughtered cattle, and to identify and quantify the association of risk factors at animal, herd, and factory level with FL submission and confirmation. The data consisted of 6,611,854 animals slaughtered in Irish factories from 2014 to 2018 obtained from the Department of Agriculture, Food and Marine (DAFM), Ireland. Selected risk factors for this study included factory, year and month of slaughter, age, sex, breed, animal movement, ever inconclusive in the standard or severe skin test, herd type, herd size, and bTB history. The association of each risk factor on the FL submission and confirmation risk were analysed with univariable followed by a multivariable logistic regression with herd as random effect. Factories were ranked and compared based on the odds ratio (OR) obtained from the univariable (crude OR) and multivariable (adjusted OR) analysis. The average submission risk of all factories was 20 per 10,000 animals slaughtered, ranging from 1 to 42 per 10,000 animals slaughtered, and the average confirmation risk over all factories was 40.72%, ranging from 0.00 to 61.84%. The odds of submitting and confirming FL as bTB positive were higher in animals over eight years old compared to animals 1–2 years old (OR = 1.91, 95 CI 95% 1.77–2.06 and OR = 4.05, 95% CI 3.17–5.18, respectively), and were higher in animals that ever had inconclusive skin result based on severe interpretation (OR = 2.83, 95% CI 2.44–3.27 and OR = 4.48, 95% CI 2.66–7.54, respectively), animals originating from sucklers herds (OR = 1.08, 95% CI 1.02–1.14 and OR = 1.31, 95% CI 1.11–1.55, respectively), or herds with bTB history in the past three years (OR = 4.46, 95% CI 4.28–4.66 and OR = 319.90, 95% CI 237.98–430.04, respectively). The odds of FL submission and confirmation decreased as the herd size increased (OR = 0.95, 95% CI 0.93–0.96 and OR = 0.82, 95% CI 0.78–0.86, respectively). An inverse relationship of FL submission and confirmation was present for variable sex and inconclusive skin result with standard interpretation, where submission odds were higher in males (OR = 1.05, 95% CI 1.00–1.10) and ever inconclusive animals (OR = 74.24, 95% CI 69.39–79.43), although the confirmation odds were lower (males OR = 0.66, 95% CI 0.56–0.76; ever inconclusive OR = 0.44, 95% CI 0.36–0.54). The crude and adjusted ranking of factories did not differ greatly for FL submission, indicating that factory-related factors may contribute significantly to the submission variation between factories. However, a substantial difference between crude and adjusted confirmation ranking was present which may indicate that animal and herd-related factors were associated to variation in confirmation risk between factories.
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Affiliation(s)
- Rischi Robinson Male Here
- Adaptation Physiology Group, Wageningen University & Research, Wageningen, The Netherlands
- * E-mail: ,
| | - Eoin Ryan
- Ruminant Animal Health Division, Department of Agriculture, Food and the Marine, Backweston Co., Kildare, Ireland
| | - Philip Breslin
- Ruminant Animal Health Division, Department of Agriculture, Food and the Marine, Backweston Co., Kildare, Ireland
| | - Klaas Frankena
- Adaptation Physiology Group, Wageningen University & Research, Wageningen, The Netherlands
| | - Andrew William Byrne
- Department of Agriculture, Food and the Marine, One-Health Scientific Support Unit, National Disease Control Centre (NDCC), Agriculture House, Dublin 2, Ireland
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Palmer S, Williams GA, Brady C, Ryan E, Malczewska K, Bull TJ, Hogarth PJ, Sawyer J. Assessment of the frequency of Mycobacterium bovis shedding in the faeces of naturally and experimentally TB infected cattle. J Appl Microbiol 2022; 133:1832-1842. [PMID: 35729710 PMCID: PMC9544641 DOI: 10.1111/jam.15677] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/05/2022] [Accepted: 06/13/2022] [Indexed: 11/26/2022]
Abstract
Aims To assess the prevalence of Mycobacterium bovis bacilli in faecal samples of tuberculous cattle, and to better understand the risk of environmental dissemination of bovine tuberculosis (TB) through the spreading of manure or slurry. Methods and Results Faecal samples were collected from 72 naturally infected cattle with visible lesions of TB that had reacted to the tuberculin skin test and 12 cattle experimentally infected with M. bovis. These were examined by microbial culture and PCR to assess the presence of M. bovis bacilli. There were no positive cultures from any naturally infected test reactor animal. A single M. bovis colony was cultured from a faecal sample from one of the experimentally infected animals. A single PCR positive result was obtained from the faecal sample of one naturally infected test reactor. Conclusions The prevalence of M. bovis in the faecal samples of TB‐infected cattle was extremely low. Significance and Impact of the Study The results suggest that the risk of spreading TB through the use of slurry or manure as an agricultural fertilizer is lower than that suggested in some historical literature. The results could inform a reconsideration of current risk assessments and guidelines on the disposal of manure and slurry from TB‐infected herds.
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Affiliation(s)
- Si Palmer
- Department of Bacteriology, Animal and Plant Health Agency (Weybridge), Surrey
| | - Gareth A Williams
- Department of Bacteriology, Animal and Plant Health Agency (Weybridge), Surrey
| | - Colm Brady
- Department of Agriculture, Food and the Marine (DAFM), Backweston Campus, Celbridge, Co. Kildare, Ireland
| | - Eoin Ryan
- Department of Agriculture, Food and the Marine (DAFM), Backweston Campus, Celbridge, Co. Kildare, Ireland
| | | | - Tim J Bull
- St. George's, University of London, Cranmer Terrace, London
| | - Philip J Hogarth
- Department of Bacteriology, Animal and Plant Health Agency (Weybridge), Surrey
| | - Jason Sawyer
- Department of Bacteriology, Animal and Plant Health Agency (Weybridge), Surrey
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Murphy KJ, Morera‐Pujol V, Ryan E, Byrne AW, Breslin P, Ciuti S. Habitat availability alters the relative risk of a bovine tuberculosis breakdown in the aftermath of a commercial forest clearfell disturbance. J Appl Ecol 2022. [DOI: 10.1111/1365-2664.14233] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Kilian J. Murphy
- Laboratory of Wildlife Ecology and Behaviour, SBES University College Dublin Ireland
| | - Virginia Morera‐Pujol
- Laboratory of Wildlife Ecology and Behaviour, SBES University College Dublin Ireland
| | - Eoin Ryan
- Ruminant Animal Health Division, Department of Agriculture, Food and the Marine (DAFM), Backweston, Kildare Ireland
| | - Andrew W. Byrne
- One Health Scientific Support Unit, National Disease Control Centre (NDCC), Department of Agriculture, Food and the Marine (DAFM), Dublin Ireland
| | - Philip Breslin
- Ruminant Animal Health Division, Department of Agriculture, Food and the Marine (DAFM), Backweston, Kildare Ireland
| | - Simone Ciuti
- Laboratory of Wildlife Ecology and Behaviour, SBES University College Dublin Ireland
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12
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Frawley E, Cowman M, Cella M, Cohen D, Ryan E, Hallahan B, Bowie C, McDonald C, Fowler D, Wykes T, Donohoe G. Cognitive Remediation and Social Recovery in Early Psychosis (CReSt-R): protocol for a pilot randomised controlled study. Pilot Feasibility Stud 2022; 8:109. [PMID: 35610711 PMCID: PMC9126749 DOI: 10.1186/s40814-022-01064-6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 05/06/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Psychosis, even in its early stages, is associated with significant disability, causing it to be ranked ahead of paraplegia and blindness in those aged 18-35 in terms of years lived with disability. Current pharmacological and psychological interventions intervention have focused primarily on the reduction of positive symptoms (hallucinations and delusions), with little benefit to domains of psychosis such as cognitive difficulties and social and occupational functioning. METHODS/DESIGN The CReSt-R intervention trial is a single center, pilot randomised controlled study based at the National University of Ireland (NUI), Galway. The trial will recruit participants from four clinical sites with assessment and intervention completed by the primary NUI Galway team. The trial will explore the feasibility, acceptability, and effectiveness of a novel psychosocial intervention for early psychosis based on a combined cognitive remediation training and cognitive behavioural therapy approach focused on social recovery. Participants, aged 16-35 within the first 5 years of a diagnosed psychotic disorder, will be recruited from the Children and Adolescent Mental Health Service and the Adult Mental Health Services in the region. DISCUSSION Cognitive remediation training (for improving cognition) and social recovery focused cognitive behavioural therapy, have both separately demonstrated effectiveness. This trial will evaluate the feasibility, acceptability, and explore the efficacy of a treatment approach that combines both approaches as part of an integrated, multicomponent intervention. TRIAL REGISTRATION Cognitive Remediation & Social Recovery in Early Psychosis (CReSt-R): ClincialTrials.gov Identifier NCT04273685. Trial registered Feb 18th, 2020. Last updated April 14th, 2021.
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Affiliation(s)
- E Frawley
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland, Galway, Ireland
| | - M Cowman
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland, Galway, Ireland
| | - M Cella
- Institute of Psychiatry, Psychology & Neuroscience, King's College, London, England
| | - D Cohen
- South Galway Child & Adolescent Mental Health Service, Health Service Executive, Merlin Park Hospital, Galway, Ireland
- Department of Psychiatry, National University of Ireland, Galway, Ireland
| | - E Ryan
- Psychology Service, Adult Mental Health Service, University Hospital Galway, Galway, Ireland
| | - B Hallahan
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland, Galway, Ireland
| | - C Bowie
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - C McDonald
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland, Galway, Ireland
| | - D Fowler
- Department of Psychology, University of Sussex, Brighton, England
| | - T Wykes
- Institute of Psychiatry, Psychology & Neuroscience, King's College, London, England
| | - G Donohoe
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland, Galway, Ireland.
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13
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Bohon J, Gonzalez E, Grace C, Harris CT, Jacobsen B, Kachiguine S, Kim D, MacArthur J, Martinez-McKinney F, Mazza S, Nizam M, Norvell N, Padilla R, Potter E, Prakash T, Prebys E, Ryan E, Schumm BA, Smedley J, Stuart D, Tarka M, Torrecilla IS, Wilder M, Zhu D. Use of diamond sensors for a high-flux, high-rate X-ray pass-through diagnostic. J Synchrotron Radiat 2022; 29:595-601. [PMID: 35510992 PMCID: PMC9070720 DOI: 10.1107/s1600577522003022] [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] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 03/19/2022] [Indexed: 06/14/2023]
Abstract
X-ray free-electron lasers (XFELs) deliver pulses of coherent X-rays on the femtosecond time scale, with potentially high repetition rates. While XFELs provide high peak intensities, both the intensity and the centroid of the beam fluctuate strongly on a pulse-to-pulse basis, motivating high-rate beam diagnostics that operate over a large dynamic range. The fast drift velocity, low X-ray absorption and high radiation tolerance properties of chemical vapour deposition diamonds make these crystals a promising candidate material for developing a fast (multi-GHz) pass-through diagnostic for the next generation of XFELs. A new approach to the design of a diamond sensor signal path is presented, along with associated characterization studies performed in the XPP endstation of the LINAC Coherent Light Source (LCLS) at SLAC. Qualitative charge collection profiles (collected charge versus time) are presented and compared with those from a commercially available detector. Quantitative results on the charge collection efficiency and signal collection times are presented over a range of approximately four orders of magnitude in the generated electron-hole plasma density.
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Affiliation(s)
- J. Bohon
- Los Alamos National Laboratory, Los Alamos, NM 87545, USA
| | - E. Gonzalez
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - C. Grace
- Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - C. T. Harris
- Sandia National Laboratories, Albuquerque, NM 87123, USA
| | - B. Jacobsen
- SLAC National Accelerator Laboratory, Menlo Park, CA 94025, USA
| | - S. Kachiguine
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - D. Kim
- Los Alamos National Laboratory, Los Alamos, NM 87545, USA
| | - J. MacArthur
- SLAC National Accelerator Laboratory, Menlo Park, CA 94025, USA
| | - F. Martinez-McKinney
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - S. Mazza
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - M. Nizam
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - N. Norvell
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - R. Padilla
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - E. Potter
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - T. Prakash
- Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - E. Prebys
- University of California, Davis, CA 95616, USA
| | - E. Ryan
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - B. A. Schumm
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - J. Smedley
- Los Alamos National Laboratory, Los Alamos, NM 87545, USA
| | - D. Stuart
- University of California, Santa Barbara, CA 93106, USA
| | - M. Tarka
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | | | - M. Wilder
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, USA
| | - D. Zhu
- SLAC National Accelerator Laboratory, Menlo Park, CA 94025, USA
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14
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Clarke A, Byrne AW, Maher J, Ryan E, Farrell F, McSweeney C, Barrett D. Engaging With Farmers to Explore Correlates of Bovine Tuberculosis Risk in an Internationally Important Heritage Landscape: The Burren, in the West of Ireland. Front Vet Sci 2022; 9:791661. [PMID: 35242836 PMCID: PMC8887599 DOI: 10.3389/fvets.2022.791661] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/06/2022] [Indexed: 11/17/2022] Open
Abstract
Bovith recene tuberculosis (bTB) continues to be a pathogen of concern in several countries globally. Analysis of areas that have higher incidences of bTB outbreaks has demonstrated how risk is not equally distributed, and local data collection, analysis and participatory engagement is required to develop tailored approaches. The Burren, an internationally important heritage landscape, has been an area of higher bTB incidence for many years in Ireland, and owing to its unique geology and farming heritage a survey was developed to engage with local farmers to gain greater insight into farming practices and bTB control to inform tailored approaches. The survey gathered data on the farm and animal management approaches being used within the Burren, including local farming techniques like the use of “winterage” (grazing exposed limestone dominated uplands). Thematic analysis of free text responses was undertaken. Quantitative data were then explored using statistical models to assess associations with recent (<3 years) self-reported bTB breakdown risk. There was a high number of responses demonstrating a high degree of willingness to engage on the issue. Thematic analysis suggested that wildlife and its management (culling and vaccination), testing quality, and its impact on the bTB scheme, and pessimism around eradication were important themes. Statistical analysis suggested that increasing bTB risk was primarily related to increasing herd-size and the percentage of herd owner's land inaccessible to those attempting to locate badger setts. There was less evidence for associations relating to the amount of time, or which season (i.e., summer), farmers utilized “winterage”. The results of the study will feed back directly to local bTB management plans and further stakeholder engagement and is an exemplar for local tailoring of national control measures in situations of high incidences of bTB outbreaks in particular areas.
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15
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Barroso P, Breslin P, McGrath G, Madden JM, Tratalos JA, More SJ, Ryan E, Byrne AW, Barrett D. Is there an association between road building and bovine tuberculosis herd risk? A three time-point study in Ireland, 2011-2019. Prev Vet Med 2021; 198:105542. [PMID: 34798305 DOI: 10.1016/j.prevetmed.2021.105542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 10/19/2022]
Abstract
Bovine tuberculosis (bTB) is a chronic infectious disease caused by Mycobacterium bovis which results in a significant economic cost to cattle industries and governments where it is endemic. In Ireland, the European badger is the main wildlife reservoir of infection. In this study, we investigated whether (motorway) road construction was associated with an increased risk of bTB in associated cattle herds. For this study, we considered three observation periods: pre-construction (2011-2014), construction (2015-2017) and post-construction (2018-2019). We selected 1543 herds situated, based on proximity, between >50 m and <5 km of the roadworks, and extracted information about their herd-size, herd-type, inward animal movements, bTB history, and distance to the roadworks. Generalized linear mixed models were performed, whose outcome were whether a herd experienced a bTB breakdown with ≥1 or ≥3 standard reactor/s, respectively. Herds located at a distance of >3 km from the roadworks were found to be at reduced risk of a bTB breakdown over the construction period compared with those situated within 1 km of the roadworks for ≥1 reactor/s (>3 km and construction vs. <1 km: OR: 0.595, 95 % Confidence Interval (CI): 0.354-0.999) or ≥3 reactors (>3 km and construction vs. <1 km: OR: 0.431, 95 % CI: 0.174-1.067). Other previously reported risk factors such as inward movements, herd-size and herd-type were also associated with bTB risk in the final models (≥1 reactor/s and ≥3 reactors). These findings appear to be consistent with bTB breakdowns being a consequence as opposed to coincident to road construction, given the temporal and spatial consistency of the evidence. The potential for badger social group disturbance leading to the spatial spread of infection to cattle herds, as previously described in the United Kingdom, could be a hypothetical mechanism to explain these findings. However, our findings are not consistent with previous Irish studies, including recent work from another road construction project, albeit running alongside and cross over an existing road rather than construction of a new road as in this case, or experiences from national targeted badger removal. Further research is warranted to verify this pattern occurs elsewhere, and the underlying biological mechanism. Until further data are available, we recommend that badgers are vaccinated, as a precautionary measure, in advance of the commencement of major roadworks.
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Affiliation(s)
- Patricia Barroso
- Grupo SaBio, Instituto de Investigación en Recursos Cinegéticos (UCLM-CSIC), Ciudad Real, Spain.
| | - Philip Breslin
- Ruminant Animal Health Division, Department of Agriculture, Food and the Marine (DAFM), Backweston, Co. Dublin, Ireland
| | - Guy McGrath
- Centre for Veterinary Epidemiology and Risk Analysis (CVERA), School of Veterinary Medicine, University College Dublin, Belfield, Dublin D04 W6F6, Ireland
| | - Jamie M Madden
- Centre for Veterinary Epidemiology and Risk Analysis (CVERA), School of Veterinary Medicine, University College Dublin, Belfield, Dublin D04 W6F6, Ireland
| | - Jamie A Tratalos
- Centre for Veterinary Epidemiology and Risk Analysis (CVERA), School of Veterinary Medicine, University College Dublin, Belfield, Dublin D04 W6F6, Ireland
| | - Simon J More
- Centre for Veterinary Epidemiology and Risk Analysis (CVERA), School of Veterinary Medicine, University College Dublin, Belfield, Dublin D04 W6F6, Ireland
| | - Eoin Ryan
- Ruminant Animal Health Division, Department of Agriculture, Food and the Marine (DAFM), Backweston, Co. Dublin, Ireland
| | - Andrew W Byrne
- One Health Scientific Support Unit, National Disease Control Centre (NDCC), Department of Agriculture, Food and the Marine (DAFM), Agriculture House, Dublin 2, Ireland
| | - Damien Barrett
- One Health Scientific Support Unit, National Disease Control Centre (NDCC), Department of Agriculture, Food and the Marine (DAFM), Agriculture House, Dublin 2, Ireland
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16
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Byrne AW, Barrett D, Breslin P, Madden JM, O’Keeffe J, Ryan E. Future Risk of Bovine Tuberculosis ( Mycobacterium bovis) Breakdown in Cattle Herds 2013-2018: A Dominance Analysis Approach. Microorganisms 2021; 9:microorganisms9051004. [PMID: 34066621 PMCID: PMC8148532 DOI: 10.3390/microorganisms9051004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/29/2021] [Accepted: 05/03/2021] [Indexed: 12/03/2022] Open
Abstract
Bovine tuberculosis (bTB) remains a significant endemic pathogen of cattle herds, despite multi-decadal control programmes being in place in several countries. Understanding the risks of future bTB breakdown (BD) and the associated characteristics of herds and index breakdowns could help inform risk categorisation. Such risk categories could then contribute to tailored management and policies. Here, we estimated the future risk of herd BD for the cohort of herds that were derestricted during 2013 in Ireland using multivariable logit regression models, with a dominance analysis approach. One third of herds that were derestricted in 2013 experienced a breakdown during the follow-up five year period (1469/4459; 33%). BD length was a significant predictor of future risk, primarily driven by long BDs > 230 days relative to short BDs < 130 days (OR 95%CI: 1.157–1.851), as was having had a previous BD (OR 95%CI: 1.012–1.366). Herd-size was the dominant predictor of future risk (accounted for 46% of predicted variance), suggesting significant increase in risk of future breakdown with increasing (log) herd-size (OR 95%CI: 1.378–1.609). There was significant spatial variation in future risk across counties, and it was the second most dominant predictor of future risk (25% of predicted variance). The size of index breakdowns was not a strong predictor of future risk over a 5-year period. These findings can inform a risk-based policy development.
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Affiliation(s)
- Andrew W. Byrne
- One-Health Scientific Support Unit, National Disease Control Centre (NDCC), Department of Agriculture, Food and the Marine, Agriculture House, D02 WK12 Dublin 2, Ireland;
- Correspondence: (A.W.B.); (E.R.)
| | - Damien Barrett
- One-Health Scientific Support Unit, National Disease Control Centre (NDCC), Department of Agriculture, Food and the Marine, Agriculture House, D02 WK12 Dublin 2, Ireland;
| | - Philip Breslin
- Ruminant Animal Health Division, Department of Agriculture, Food and the Marine, Backweston Co., W23 X3PH Kildare, Ireland; (P.B.); (J.O.)
| | - Jamie M. Madden
- Centre for Veterinary Epidemiology and Risk Analysis (CVERA), School of Veterinary Medicine, University College Dublin, Belfield, D04 V1W8 Dublin 4, Ireland;
| | - James O’Keeffe
- Ruminant Animal Health Division, Department of Agriculture, Food and the Marine, Backweston Co., W23 X3PH Kildare, Ireland; (P.B.); (J.O.)
| | - Eoin Ryan
- Ruminant Animal Health Division, Department of Agriculture, Food and the Marine, Backweston Co., W23 X3PH Kildare, Ireland; (P.B.); (J.O.)
- Correspondence: (A.W.B.); (E.R.)
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17
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Lloyd A, Ryan E, Boland M, Medani S, Elwahab A, Malone C, Sweeney K, Barry K, McLaughlin R, Lowery A, Kerin M. O39: THE HISTOPATHOLOGICAL AND MOLECULAR FEATURES OF BREAST CARCINOMA WITH HIGH-GRADE TUMOUR BUDDING. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Tumour budding (TB) is an adverse histological feature in many cancers. It is thought to represent epithelial-to-mesenchymal transition, a key step in the metastatic process. The role of TB in breast carcinoma (BC) remains unclear.
Aim
To investigate the relationship between TB and other histological and molecular features of BC.
Method
A systematic search was performed to identify studies that compared features of BC based on the presence or absence of high-grade TB. Dichotomous variables were pooled as odds ratios (OR) using the Cochran–Mantel–Haenszel method. Quality assessment of the included studies was performed using the Newcastle-Ottawa scale (NOS).
Result
Seven studies with a total of 1040 patients (high grade TB n=519, 49.9%; low grade TB n=521, 50.1%) were included. A moderate- to high-risk of bias was noted. The median NOS was 7 (range 6-8). High-grade TB was significantly associated with lymph node involvement (OR 2.28, 95% c.i. 1.74 to 2.98, P<0.001) and lymphovascular invasion (OR 3.08, 95% c.i. 2.13 to 4.47, P<0.001). Regarding molecular subtypes, there was an increased likelihood of high-grade TB in oestrogen- (OR 1.66, 95% c.i. 1.21 to 2.29, P=0.002) and progesterone-receptor positive (OR 1.68, 95% c.i. 1.10 to 2.59, P=0.02) tumours. In contrast triple negative breast cancer had a reduced incidence of high-grade TB (OR 0.46, 95% c.i. 0.30 to 0.72, P=0.0006).
Conclusion
High-grade TB is enriched in hormone-positive BC and is associated with known adverse prognostic variables. TB may offer new insights into the metastatic processes of luminal BC.
Take-home message
High-grade TB is enriched in hormone-positive BC and is associated with known adverse prognostic variables. TB may offer new insights into the metastatic processes of luminal BC.
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Affiliation(s)
- A Lloyd
- Royal College of Surgeons Ireland
| | - E Ryan
- Galway University Hospital
| | - M Boland
- Royal College of Surgeons Ireland
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O'Halloran L, Purcell A, Ryan E, O'Doherty J, Troddyn L, Slepanek M, O'Driscoll N, O'Reilly O, Stassen P, Bennett SA, O'Connor R. A snapshot of chronic obstructive pulmonary disease management in general practice in Ireland. Ir J Med Sci 2020; 190:1055-1061. [PMID: 33216315 DOI: 10.1007/s11845-020-02435-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 11/11/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a leading cause of death and disability. Its diagnosis, classification and management are complex. There is a paucity of data on the standard of COPD management in Irish general practice. AIMS We studied whether COPD diagnosis and management was in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. We investigated if patients who were smokers had received smoking cessation advice. We examined whether influenza and pneumococcal vaccination had been given. METHODS Ten general practices affiliated with the Irish Mid-West Specialist Training Programme in General Practice (GP) were searched, to determine which patients had a diagnosis of COPD. A data-collection audit tool was developed using GOLD 2019 guidelines. Results were tabulated in SPSS. Descriptive statistics were used. RESULTS Of 482 patients studied, 91.7% were eligible for free GP care. In 49.4%, the diagnosis of COPD had been made appropriately. In 56.2%, there was no evidence that the stage of COPD had been formally assessed. Of the patients studied, 33.2% were deemed to be receiving appropriate therapy. Smoking status was documented in 99.6% of cases studied and 59.9% were ex-smokers, while 25.9% were current smokers. Appropriate smoking cessation advice had been offered to 71% of eligible patients. Influenza vaccine had been given to 66.2% in the previous 12 months. A total of 53.9% had ever received pneumococcal vaccination. CONCLUSIONS This study provides a comprehensive snapshot of care in Irish general practice for patients with COPD prior to introduction of the Chronic Disease Management programme (CDM).
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Affiliation(s)
- Liam O'Halloran
- Mid-West Specialist Training Programme in General Practice, University of Limerick, Plassey, Limerick, Ireland.
| | - Amy Purcell
- Mid-West Specialist Training Programme in General Practice, University of Limerick, Plassey, Limerick, Ireland
| | - Eoin Ryan
- Mid-West Specialist Training Programme in General Practice, University of Limerick, Plassey, Limerick, Ireland
| | - Jane O'Doherty
- Department of General Practice, School of Medicine, University of Limerick, Plassey, Limerick, Ireland
| | - Louise Troddyn
- Mid-West Specialist Training Programme in General Practice, University of Limerick, Plassey, Limerick, Ireland
| | - Martin Slepanek
- Mid-West Specialist Training Programme in General Practice, University of Limerick, Plassey, Limerick, Ireland
| | - Neil O'Driscoll
- Mid-West Specialist Training Programme in General Practice, University of Limerick, Plassey, Limerick, Ireland
| | - Orlaith O'Reilly
- Mid-West Specialist Training Programme in General Practice, University of Limerick, Plassey, Limerick, Ireland
| | - Paul Stassen
- Mid-West Specialist Training Programme in General Practice, University of Limerick, Plassey, Limerick, Ireland
| | - Sarah Anne Bennett
- Mid-West Specialist Training Programme in General Practice, University of Limerick, Plassey, Limerick, Ireland
| | - Raymond O'Connor
- Mid-West Specialist Training Programme in General Practice, University of Limerick, Plassey, Limerick, Ireland
- Department of General Practice, School of Medicine, University of Limerick, Plassey, Limerick, Ireland
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Byrne AW, Barrett D, Breslin P, Madden JM, O’Keeffe J, Ryan E. Bovine Tuberculosis ( Mycobacterium bovis) Outbreak Duration in Cattle Herds in Ireland: A Retrospective Observational Study. Pathogens 2020; 9:E815. [PMID: 33027882 PMCID: PMC7650827 DOI: 10.3390/pathogens9100815] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/24/2020] [Accepted: 09/24/2020] [Indexed: 11/28/2022] Open
Abstract
Bovine tuberculosis (bTB) outbreaks, caused by Mycobacterium bovis infection, are a costly animal health challenge. Understanding factors associated with the duration of outbreaks, known as breakdowns, could lead to better disease management policy development. We undertook a retrospective observational study (2012-2018) and employed Finite Mixture Models (FMM) to model the outcome parameter, and to investigate how factors were associated with duration for differing subpopulations identified. In addition to traditional risk factors (e.g., herd size, bTB history), we also explored farm geographic area, parcels/farm fragmentation, metrics of intensity via nitrogen loading, and whether herds were designated controlled beef finishing units (CBFU) as potential risk factors for increased duration. The final model fitted log-normal distributions, with two latent classes (k) which partitioned the population into a subpopulation around the central tendency of the distribution, and a second around the tails of the distribution. The latter subpopulation included longer breakdowns of policy interest. Increasing duration was positively associated with recent (<3 years) TB history and the number of reactors disclosed, (log) herd size, beef herd-type relative to other herd types, number of land parcels, area, being designated a CBFU ("feedlot") and having high annual inward cattle movements within the "tails" subpopulation. Breakdown length was negatively associated with the year of commencement of breakdown (i.e., a decreasing trend) and non-significantly with the organic nitrogen produced on the farm (N kg/hectare), a measure of stocking density. The latter finding may be due to confounding effects with herd size and area. Most variables contributed only moderately to explaining variation in breakdown duration, that is, they had moderate size effects on duration. Herd-size and CBFU had greater effect sizes on the outcome. The findings contribute to evidence-based policy formation in Ireland.
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Affiliation(s)
- Andrew W. Byrne
- One-Health Scientific Support Unit, Surveillance, Animal by-products, and TSEs (SAT) Division, Department of Agriculture, Food and the Marine, Agriculture House, Dublin 2 D02 WK12, Ireland;
| | - Damien Barrett
- One-Health Scientific Support Unit, Surveillance, Animal by-products, and TSEs (SAT) Division, Department of Agriculture, Food and the Marine, Agriculture House, Dublin 2 D02 WK12, Ireland;
| | - Philip Breslin
- Ruminant Animal Health Division, Department of Agriculture, Food and the Marine, Backweston, Co. Kildare W23 VW2C, Ireland; (P.B.); (J.O.)
| | - Jamie M. Madden
- Centre for Veterinary Epidemiology and Risk Analysis (CVERA), School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4 D04 W6F6, Ireland;
| | - James O’Keeffe
- Ruminant Animal Health Division, Department of Agriculture, Food and the Marine, Backweston, Co. Kildare W23 VW2C, Ireland; (P.B.); (J.O.)
| | - Eoin Ryan
- Ruminant Animal Health Division, Department of Agriculture, Food and the Marine, Backweston, Co. Kildare W23 VW2C, Ireland; (P.B.); (J.O.)
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20
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Gaudino M, Moreno A, Snoeck CJ, Zohari S, Saegerman C, O'Donovan T, Ryan E, Zanni I, Foni E, Sausy A, Hübschen JM, Meyer G, Chiapponi C, Ducatez MF. Emerging Influenza D virus infection in European livestock as determined in serology studies: Are we underestimating its spread over the continent? Transbound Emerg Dis 2020; 68:1125-1135. [PMID: 32871031 DOI: 10.1111/tbed.13812] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/21/2020] [Accepted: 08/21/2020] [Indexed: 12/24/2022]
Abstract
Influenza D virus (IDV) is a novel orthomyxovirus that was first isolated in 2011 in the United States from a swine exhibiting influenza-like disease. To date, its detection is extended to all continents and in a broad host range: IDV is circulating in cattle, swine, feral swine, camelids, small ruminants and horses. Evidence also suggests a possible species jump to humans, underlining the issue of zoonotic potential. In Europe, serological investigations in cattle have partially allowed the understanding of the virus diffusion in different countries such as Italy, France, Luxembourg and Ireland. The infection is widespread in cattle but limited in other investigated species, consolidating the assumption of cattle as IDV primary host. We hypothesize that commercial livestock trade could play a role in the observed differences in IDV seroprevalence among these areas. Indeed, the overall level of exposure in cattle and swine in destination countries (e.g. Italy) is higher than in origin countries (e.g. France), leading to the hypothesis of a viral shedding following the transportation of young cattle abroad and thus contributing to larger diffusion at countries of destination. IDV large geographic circulation in cattle from Northern to more Southern European countries also supports the hypothesis of a viral spread through livestock trade. This review summarizes available data on IDV seroprevalence in Europe collected so far and integrates unpublished data from IDV European surveillance framework of the last decade. In addition, the possible role of livestock trade and biosecurity measures in this pathogen's spread is discussed.
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Affiliation(s)
- Maria Gaudino
- IHAP, Université de Toulouse, INRAE, ENVT, Toulouse, France
| | - Ana Moreno
- Istituto Zooprofilattico Sperimentale Della Lombardia e dell'Emilia Romagna "Bruno Ubertini", Brescia, Italy
| | - Chantal J Snoeck
- Clinical and Applied Virology Group, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | | | - Claude Saegerman
- Fundamental and Applied Research for Animals and Health (FARAH) Center, University of Liège, Liège, Belgium
| | - Tom O'Donovan
- Central Veterinary Research Laboratory, Celbridge, Co. Kildare, Celbridge, Ireland
| | - Eoin Ryan
- Central Veterinary Research Laboratory, Celbridge, Co. Kildare, Celbridge, Ireland
| | - Irene Zanni
- Istituto Zooprofilattico Sperimentale Della Lombardia e dell'Emilia Romagna "Bruno Ubertini", Parma, Italy
| | - Emanuela Foni
- Istituto Zooprofilattico Sperimentale Della Lombardia e dell'Emilia Romagna "Bruno Ubertini", Parma, Italy
| | - Aurelie Sausy
- Clinical and Applied Virology Group, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Judith M Hübschen
- Clinical and Applied Virology Group, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Gilles Meyer
- IHAP, Université de Toulouse, INRAE, ENVT, Toulouse, France
| | - Chiara Chiapponi
- Istituto Zooprofilattico Sperimentale Della Lombardia e dell'Emilia Romagna "Bruno Ubertini", Parma, Italy
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Byrne AW, Barrett D, Breslin P, Madden JM, O'Keeffe J, Ryan E. Post-mortem surveillance of bovine tuberculosis in Ireland: herd-level variation in the probability of herds disclosed with lesions at routine slaughter to have skin test reactors at follow-up test. Vet Res Commun 2020; 44:131-136. [PMID: 32583301 PMCID: PMC7312117 DOI: 10.1007/s11259-020-09777-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/17/2020] [Indexed: 01/25/2023]
Abstract
Post-mortem surveillance in Ireland discloses skin-test negative cattle with presumptive evidence of infection of Mycobacterium bovis (lesions at routine slaughter (LRS)), the causative agent of bovine tuberculosis (bTB). Laboratory confirmation of lesions has impacts on trade restrictions for herds, therefore if laboratory capacity was diminished, how herds are treated would require an informed risk policy. Here we report the proportion of herds with subsequent evidence of within-herd transmission, based on skin-test results. We assess how herd-size, herd-type, and bTB-history affect the probability of additional reactors at follow-up test using univariable and multivariable random-effects models. The study represents a rapid response to developing an evidential base for policy demands during an extraordinary event, the COVID-19 epidemic in Ireland. A dataset from 2005 to 2019 of breakdowns were collated. Overall, 20,116 breakdowns were initiated by LRS cases. During the index tests of these breakdowns, 3931 revealed ≥1 skin-test reactor animals (19.54%; ≥1 standard reactors: 3827; 19.02%). Increasing herd-size was associated with reactor disclosure on follow-up. For small herds (<33 animals), 11.74% of follow-up tests disclosed ≥1 reactor; 24.63% of follow-up tests from very large herds (>137) disclosed ≥1 reactors. Beef (13.87%) and “other” (13%) herd production types had lower proportion of index tests with reactors in comparison with dairy (28.27%) or suckler (20.48%) herds. Historic breakdown size during the previous 3-years was associated reactor disclosure risk on follow-up. Our results are useful for rapid tailored policy development aimed at identifying higher risk herds.
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Affiliation(s)
- Andrew W Byrne
- One-Health Scientific Support Unit, SAT Division, Department of Agriculture, Food and the Marine, Agriculture House, Dublin 2, Ireland.
| | - Damien Barrett
- One-Health Scientific Support Unit, SAT Division, Department of Agriculture, Food and the Marine, Agriculture House, Dublin 2, Ireland
| | - Philip Breslin
- Ruminant Animal Health Division, Department of Agriculture, Food and the Marine, Backweston, Co. Dublin, Ireland
| | - Jamie M Madden
- Centre for Veterinary Epidemiology and Risk Analysis (CVERA), School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - James O'Keeffe
- Ruminant Animal Health Division, Department of Agriculture, Food and the Marine, Backweston, Co. Dublin, Ireland
| | - Eoin Ryan
- Ruminant Animal Health Division, Department of Agriculture, Food and the Marine, Backweston, Co. Dublin, Ireland
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22
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Ryan E, Bolger T, Barrett MJ, Blackburn C, Okafor I, McNamara R, Molloy EJ. Paediatric Head Injury and Traumatic Brain Injury. Ir Med J 2020; 113:94. [PMID: 32816429] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Aim To determine prevalence of head injury presenting to paediatric emergency departments (PEDs) and characterise by demographics, triage category, disposition neuroimaging or re-attendance. Methods Presentations in 2014 and 2015, with diagnoses of head injury, intracranial bleed, skull fracture including single or re-attendances within 28 days post head injury to all national PEDs, were analysed. Demographics, triage score, imaging rate, admission, mechanisms and representation rate were recorded. Results Head injury was diagnosed in 13,392 of 224,860 (5.9%), median (IQR) age 3.9 (1.4 - 8.3) years. Regionally 3% of children <5 years attend each year. The total admitted/transferred was 10.8% (n=1460). Neuroimaging rate was 4.3% (n= 570). Falls predominated. Sport accounted for 12.2%. Conclusion One in twenty children PED presentations are head injury, over half in preschool children. A sizeable number were symptomatic reflected by admission, transfer, imaging or re-attendance. Observational management was favoured over imaging reflected in the higher admission versus imaging rate.
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Affiliation(s)
- E Ryan
- Paediatrics, Children's Hospital Ireland (CHI) at Tallaght, Tallaght University Hospital, Dublin
- Discipline of Paediatrics, School of Medicine, Trinity College, the University of Dublin
| | - T Bolger
- Paediatrics, Children's Hospital Ireland (CHI) at Tallaght, Tallaght University Hospital, Dublin
| | - M J Barrett
- Emergency Medicine, CHI at Crumlin, Dublin
- Women's & Children's Health, School of Medicine, University College, Dublin
- National Children's Research Centre, Dublin
| | - C Blackburn
- Emergency Medicine, CHI at Crumlin, Dublin
- Women's & Children's Health, School of Medicine, University College, Dublin
| | - I Okafor
- Emergency Medicine, CHI at Temple Street
| | - R McNamara
- Emergency Medicine, CHI at Temple Street
| | - E J Molloy
- Paediatrics, Children's Hospital Ireland (CHI) at Tallaght, Tallaght University Hospital, Dublin
- Discipline of Paediatrics, School of Medicine, Trinity College, the University of Dublin
- Neonatology, CHI at Crumlin, Dublin
- National Children's Research Centre, Dublin
- Neonatology, Coombe Women and Infants' University Hospital, Dublin, Ireland
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Giudice V, Downie L, Lindsay F, Ryan E, MacKay A. Improving the communication of dysphagia recommendations in the inpatient setting. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2019.12.078] [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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Arnold R, Amos D, Lowe H, Elder A, Martin S, Moss S, McMaster K, Juergens C, Ryan E, Larnach G, Adams M. 472 Development of a Rural NSW Cardiac Catheter and Coronary Intervention Service Over 14 Years: Impacts on Service and 30 Day AMI Mortality. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Johnson RL, Jechorek RP, Andrews H, Bautista P, Bird P, Blamey S, Connell E, Cooper C, Cooper WD, Crowley E, Doane C, Elton S, Falkenberg R, Fernandes-Monteiro C, Gharst T, Gonzalez E, Hawes B, Hemming B, High E, Hsu D, Iannucci C, Kora L, Lara A, Lee M, Masanz G, Mattson D, Okolo C, Parra G, Ryan E, Torontali M, Vega H. Evaluation of VIDAS® Listeria species Xpress (LSX) Immunoassay Method for the Detection of Listeria species in Foods: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/94.1.159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
In a multilaboratory study, the effectiveness of an alternative method for rapid screening of Listeria species compared to traditional reference methods was demonstrated in a variety of food products. A collaborative study was conducted to compare the VIDAS® Listeria species Xpress (LSX) method and the standard cultural methods for the detection of Listeria species in foods. Six food types were tested: vanilla ice cream, cheddar cheese, raw ground beef, frozen green beans, deli turkey, and cooked shrimp. Each food, inoculated with a different Listeria strain at two levels and uninoculated test portions, was analyzed by each method. A total of 15 laboratories representing government and industry participated. In this study 1134 tests were analyzed in the statistical analysis. There were 490 positives by the VIDAS LSX method using the sample boiling step, 483 positives by the VIDAS LSX method using the Heat and Go system, and 439 positives by the standard culture methods. Overall, the Chi-square result for the VIDAS LSX method with boiling for all foods was 7.25, indicating a significant statistical difference between the VIDAS method and the standard methods at the 5% confidence. For the VIDAS LSX method with the Heat and Go system, the Chi-square result for all foods was 5.37, indicating a significant statistical difference between the VIDAS LSX assay with the Heat and Go system and the standard methods at the 5% level of significance. In both cases, the VIDAS method was more sensitive than the standard methods. The LSX method detects Listeria species in foods with negative or presumptive positive results in a minimum of 30 h compared to at least 5 days for the cultural methods. Based on the results of this collaborative study, it is recommended that the VIDAS LSX method be adopted as an AOAC Official MethodSM for the detection of Listeria species in dairy products, vegetables, seafood, raw meats and poultry, and processed meats and poultry.
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26
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O'Donovan T, Donohoe L, Ducatez MF, Meyer G, Ryan E. Seroprevalence of influenza D virus in selected sample groups of Irish cattle, sheep and pigs. Ir Vet J 2019; 72:11. [PMID: 31687130 PMCID: PMC6820949 DOI: 10.1186/s13620-019-0150-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/16/2019] [Indexed: 11/28/2022] Open
Abstract
Influenza D virus (IDV) is a new member of the Orthomyxoviridae family. It was first reported in swine in 2011 and isolated from bovine samples received for routine respiratory disease diagnosis in Ireland during 2014–2016. The goal of this study was to determine the seroprevalence in selected populations of IDV in cattle, pigs and sheep. Results showed a high prevalence of IDV in cattle sampled at slaughter (94.6%) or for diagnostic reasons (64.9%), whereas prevelance in samples taken for diagnostic reasons from sheep (4.5%) and pigs (5.8%) was much lower. This study suggests that IDV is widespread in Irish cattle.
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Affiliation(s)
- Tom O'Donovan
- Central Veterinary Research Laboratory, Celbridge, Co. Kildare Ireland
| | - Leah Donohoe
- Central Veterinary Research Laboratory, Celbridge, Co. Kildare Ireland
| | | | | | - Eoin Ryan
- 3Ruminant Animal Health Division, Department of Agriculture, Food and the Marine, Celbridge, Ireland
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27
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Cacciottolo TM, Perikari A, van der Klaauw A, Henning E, Stadler LKJ, Keogh J, Farooqi IS, Tenin G, Keavney B, Ryan E, Budd R, Bewley M, Coelho P, Rumsey W, Sanchez Y, McCafferty J, Dockrell D, Walmsley S, Whyte M, Liu Y, Choy MK, Tenin G, Abraham S, Black G, Keavney B, Ford T, Stanley B, Good R, Rocchiccioli P, McEntegart M, Watkins S, Eteiba H, Shaukat A, Lindsay M, Robertson K, Hood S, McGeoch R, McDade R, Sidik N, McCartney P, Corcoran D, Collison D, Rush C, McConnachie A, Touyz R, Oldroyd K, Berry C, Gazdagh G, Diver L, Marshall J, McGowan R, Ahmed F, Tobias E, Curtis E, Parsons C, Maslin K, D'Angelo S, Moon R, Crozier S, Gossiel F, Bishop N, Kennedy S, Papageorghiou A, Fraser R, Gandhi S, Prentice A, Inskip H, Godfrey K, Schoenmakers I, Javaid MK, Eastell R, Cooper C, Harvey N, Watt ER, Howden A, Mirchandani A, Coelho P, Hukelmann JL, Sadiku P, Plant TM, Cantrell DA, Whyte MKB, Walmsley SR, Mordi I, Forteath C, Wong A, Mohan M, Palmer C, Doney A, Rena G, Lang C, Gray EH, Azarian S, Riva A, Edwards H, McPhail MJW, Williams R, Chokshi S, Patel VC, Edwards LA, Page D, Miossec M, Williams S, Monaghan R, Fotiou E, Santibanez-Koref M, Keavney B, Badat M, Mettananda S, Hua P, Schwessinger R, Hughes J, Higgs D, Davies J. Scientific Business Abstracts of the 113th Annual Meeting of the Association of Physicians of Great Britain and Ireland. QJM 2019; 112:724-729. [PMID: 31505685 DOI: 10.1093/qjmed/hcz175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - A Perikari
- University of Cambridge Metabolic Research Laboratories
| | | | - E Henning
- University of Cambridge Metabolic Research Laboratories
| | - L K J Stadler
- University of Cambridge Metabolic Research Laboratories
| | - J Keogh
- University of Cambridge Metabolic Research Laboratories
| | - I S Farooqi
- University of Cambridge Metabolic Research Laboratories
| | - G Tenin
- From University of Manchester
| | | | - E Ryan
- Department of Respiratory Medicine, Centre for Inflammation Research, University of Edinburgh
| | - R Budd
- Department of Infection Immunity and Cardiovascular Disease, The Florey Institute for Host-Pathogen Interactions, University of Sheffield
| | - M Bewley
- Department of Infection Immunity and Cardiovascular Disease, The Florey Institute for Host-Pathogen Interactions, University of Sheffield
| | - P Coelho
- Department of Respiratory Medicine, Centre for Inflammation Research, University of Edinburgh
| | - W Rumsey
- Stress and Repair Discovery Performance Unit, Respiratory Therapy Area
| | - Y Sanchez
- Stress and Repair Discovery Performance Unit, Respiratory Therapy Area
| | - J McCafferty
- Department of Respiratory Medicine, Centre for Inflammation Research, University of Edinburgh
| | - D Dockrell
- Department of Respiratory Medicine, Centre for Inflammation Research, University of Edinburgh
| | - S Walmsley
- Department of Respiratory Medicine, Centre for Inflammation Research, University of Edinburgh
| | - M Whyte
- Department of Respiratory Medicine, Centre for Inflammation Research, University of Edinburgh
| | - Y Liu
- From the University of Manchester
| | - M-K Choy
- From the University of Manchester
| | - G Tenin
- From the University of Manchester
| | | | - G Black
- From the University of Manchester
| | | | - T Ford
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | | | - R Good
- Golden Jubilee National Hospital
| | - P Rocchiccioli
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - M McEntegart
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | | | - H Eteiba
- Golden Jubilee National Hospital
| | | | | | | | - S Hood
- Golden Jubilee National Hospital
| | | | - R McDade
- Golden Jubilee National Hospital
| | - N Sidik
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - P McCartney
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - D Corcoran
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - D Collison
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - C Rush
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | | | - R Touyz
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
| | - K Oldroyd
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - Colin Berry
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - G Gazdagh
- School of Medicine, Dentistry & Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow
| | - L Diver
- West of Scotland Regional Genetics Service, Laboratory Medicine Building, Queen Elizabeth University Hospital
| | - J Marshall
- Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow
| | - R McGowan
- West of Scotland Regional Genetics Service, Laboratory Medicine Building, Queen Elizabeth University Hospital
| | - F Ahmed
- Developmental Endocrinology Research Group, Royal Hospital for Children, University of Glasgow
| | - E Tobias
- Academic Unit of Medical Genetics and Clinical Pathology, Laboratory Medicine Building, Queen Elizabeth University Hospital, University of Glasgow
| | - E Curtis
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - C Parsons
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - K Maslin
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - S D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - R Moon
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - S Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - F Gossiel
- Academic Unit of Bone Metabolism, University of Sheffield
| | - N Bishop
- Academic Unit of Child Health, University of Sheffield
| | - S Kennedy
- Nuffield Department of Women's & Reproductive Health, John Radcliffe Hospital, University of Oxford
| | - A Papageorghiou
- Nuffield Department of Women's & Reproductive Health, John Radcliffe Hospital, University of Oxford
| | - R Fraser
- Department of Obstetrics and Gynaecology, Sheffield Hospitals NHS Trust, University of Sheffield
| | - S Gandhi
- Department of Obstetrics and Gynaecology, Sheffield Hospitals NHS Trust, University of Sheffield
| | | | - H Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - K Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - I Schoenmakers
- Department of Medicine, Faculty of Medicine and Health Sciences, University of East Anglia
| | - M K Javaid
- NIHR Oxford Biomedical Research Centre, University of Oxford
| | - R Eastell
- Academic Unit of Bone Metabolism, University of Sheffield
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - N Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | | | - A Howden
- School of Life Sciences, University of Dundee
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - E H Gray
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
| | - S Azarian
- Institute of Hepatology, Foundation for Liver Research
| | - A Riva
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
| | - H Edwards
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
| | - M J W McPhail
- School of Immunology and Microbial Sciences, King's College London
- Institute of Liver Studies & Transplantation, King's College Hospital
| | - R Williams
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
| | - S Chokshi
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
| | - V C Patel
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
- Institute of Liver Studies & Transplantation, King's College Hospital
| | - L A Edwards
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
| | - D Page
- University of Manchester
- Manchester Metropolitan University
| | - M Miossec
- Manchester Metropolitan University
- University of Newcastle
| | | | | | | | | | | | - M Badat
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital
| | - S Mettananda
- Department of Paediatrics, Faculty of Medicine, University of Kelaniya
| | - P Hua
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital
| | - R Schwessinger
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital
| | - J Hughes
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital
| | - D Higgs
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital
| | - J Davies
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital
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Alarcon P, Brouwer A, Venkatesh D, Duncan D, Dovas CI, Georgiades G, Monne I, Fusaro A, Dan A, Śmietanka K, Ragias V, Breed AC, Chassalevris T, Goujgoulova G, Hjulsager CK, Ryan E, Sánchez A, Niqueux E, Tammiranta N, Zohari S, Stroud DA, Savić V, Lewis NS, Brown IH. Comparison of 2016-17 and Previous Epizootics of Highly Pathogenic Avian Influenza H5 Guangdong Lineage in Europe. Emerg Infect Dis 2019; 24:2270-2283. [PMID: 30457528 PMCID: PMC6256410 DOI: 10.3201/eid2412.171860] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
We analyzed the highly pathogenic avian influenza (HPAI) H5 epizootic of 2016-17 in Europe by epidemiologic and genetic characteristics and compared it with 2 previous epizootics caused by the same H5 Guangdong lineage. The 2016-17 epizootic was the largest in Europe by number of countries and farms affected and greatest diversity of wild birds infected. We observed significant differences among the 3 epizootics regarding region affected, epidemic curve, seasonality, and outbreak duration, making it difficult to predict future HPAI epizootics. However, we know that in 2005-06 and 2016-17 the initial peak of wild bird detections preceded the peak of poultry outbreaks within Europe. Phylogenetic analysis of 2016-17 viruses indicates 2 main pathways into Europe. Our findings highlight the need for global surveillance of viral changes to inform disease preparedness, detection, and control.
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29
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Clegg TA, Doyle M, Ryan E, More SJ, Gormley E. Characteristics of Mycobacterium bovis infected herds tested with the interferon-gamma assay. Prev Vet Med 2019; 168:52-59. [PMID: 31097123 DOI: 10.1016/j.prevetmed.2019.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 04/12/2019] [Accepted: 04/12/2019] [Indexed: 01/09/2023]
Abstract
The IFN-γ (interferon gamma) assay is used in Ireland as an ancillary diagnostic test to the single intradermal comparative tuberculin test (SICTT) to maximise the detection of Mycobacterium bovis infected animals (bTB) in cattle herds. Understanding the relationships between herd and animal risk factors and IFN-γ test results is critical to enable the development and evaluation of policy measures on how best to use the test. In this study, we set out to characterise Irish herds with IFN-γ test positive animals in terms of herd size, number of SICTT reactors and number of IFN-γ positive tests, and to evaluate the IFN-γ test in terms of the test cut-off values. The results showed that larger herds with more SICTT reactors were likely to have more IFN-γ positives in the herd, and herds with an IFN-γ test positive animal that was also positive for bTB lesions at post-mortem had higher numbers of IFN-γ positive animals in the herd. Raising the cut-off values for the IFN-γ test only marginally decreased the combined sensitivity of the IFN-γ and the SICTT for diagnosis of bTB lesioned animals. The analysis has provided valuable information on the performance of the IFN-γ test as it is used under current bTB infection levels in Ireland.
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Affiliation(s)
- T A Clegg
- Centre for Veterinary Epidemiology and Risk Analysis, UCD School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
| | - M Doyle
- Tuberculosis Diagnostics and Immunology Research Laboratory, School of Veterinary Medicine, University College Dublin, UCD, Belfield, Dublin 4, Ireland.
| | - E Ryan
- Department of Agriculture, Food & the Marine, Backweston, Co. Kildare, Ireland.
| | - S J More
- Centre for Veterinary Epidemiology and Risk Analysis, UCD School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
| | - E Gormley
- Tuberculosis Diagnostics and Immunology Research Laboratory, School of Veterinary Medicine, University College Dublin, UCD, Belfield, Dublin 4, Ireland.
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McGovern M, Morrissey P, Ryan E. Can Early Changes in Vital signs Predict Duration of Antibiotic Therapy in Suspected Neonatal Sepsis? Ir Med J 2019; 112:909. [PMID: 31241276] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Aims Suspected sepsis remains a leading causes of Neonatal Intensive Care Unit admission, with infants often receiving 48-72 hours of empirical antibiotic therapy. Early in treatment it is difficult to predict infants who will require prolonged antibiotic therapy. Our aim was to assess if vital sign measurements in the initial period of treatment can predict those neonates requiring prolonged antibiotic therapy in term and late-preterm infants. Methods Data was retrospectively collected over 1 year on neonates admitted to our institute for antibiotics. Infants were classified as standard (<48hours duration) or prolonged (>48hours duration) antibiotic therapy. Results Respiratory rate on admission and 12 hours after initiation of therapy correlated significantly with duration of antibiotic therapy and infants requiring prolonged therapy were more likely to have one or more abnormal vital signs 12 hours after initiation of treatment (p<0.05). Conclusion Respiratory rate shows a weak positive correlation with antibiotic duration. Infants requiring prolonged therapy were more likely to have abnormal vital signs 12 hours after initiating antibiotic therapy. Changes in vital signs maybe useful in detecting infants who will require prolonged antibiotic therapy.
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Affiliation(s)
- M McGovern
- Department of Paediatrics and Neonatology University College Hospital Galway
- Academic Department of Paediatrics, National University of Ireland, Galway
| | - P Morrissey
- Department of Paediatrics and Neonatology University College Hospital Galway
- Academic Department of Paediatrics, National University of Ireland, Galway
| | - E Ryan
- Department of Paediatrics and Neonatology University College Hospital Galway
- Academic Department of Paediatrics, National University of Ireland, Galway
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Kyne S, Donohue S, Ryan E. Management of Acute Wheeze in a Paediatric Emergency Department. Ir Med J 2019; 112:923. [PMID: 31245965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- S Kyne
- Department of Paediatrics, University Hospital Galway, Ireland
| | - S Donohue
- Department of Paediatrics, University Hospital Galway, Ireland
| | - E Ryan
- Department of Paediatrics, University Hospital Galway, Ireland
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Ryan E, Poole C. EP-2211 Impact of virtual learning environment on students’ satisfaction, engagement, recall and retention. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32631-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Smith A, Ryan E, O’Keeffe D, O’Donovan D. Meconium Ileus in Two Irish Newborns: The Presenting Feature of Cystic Fibrosis. Ir Med J 2019; 112:901. [PMID: 30932447] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Introduction Meconium Ileus (MI) is the presenting feature of CF in approximately 10-15% of cases. This report outlines the clinical presentation, imaging and management of two neonates with MI and subsequent diagnosis of Cystic Fibrosis (CF). Methods A retrospective chart review was performed to evaluate the clinical course of two neonates with MI. Results Case 1 and 2 presented clinically with signs of abdominal obstruction. Subsequent laparotomies confirmed MI. MI is strongly associated with CF and CF is the most common genetically inherited disease in Ireland. Genetic testing was positive for a homozygous ∆ F508 mutation in both case 1 and 2, securing a diagnosis of MI secondary to CF. Conclusion Our cases highlight that all infants born in Ireland with MI should be considered as CF positive until proven otherwise.
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Affiliation(s)
- A Smith
- Department of Neonatology, University Hospital, Galway
| | - E Ryan
- Department of Neonatology, University Hospital, Galway
| | - D O’Keeffe
- Department of Radiology, University Hospital Galway
| | - D O’Donovan
- Department of Neonatology, University Hospital, Galway
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Ring SC, Purfield DC, Good M, Breslin P, Ryan E, Blom A, Evans RD, Doherty ML, Bradley DG, Berry DP. Variance components for bovine tuberculosis infection and multi-breed genome-wide association analysis using imputed whole genome sequence data. PLoS One 2019; 14:e0212067. [PMID: 30763354 PMCID: PMC6375599 DOI: 10.1371/journal.pone.0212067] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 01/25/2019] [Indexed: 11/18/2022] Open
Abstract
Bovine tuberculosis (bTB) is an infectious disease of cattle generally caused by Mycobacterium bovis, a bacterium that can elicit disease humans. Since the 1950s, the objective of the national bTB eradication program in Republic of Ireland was the biological extinction of bTB; that purpose has yet to be achieved. Objectives of the present study were to develop the statistical methodology and variance components to undertake routine genetic evaluations for resistance to bTB; also of interest was the detection of regions of the bovine genome putatively associated with bTB infection in dairy and beef breeds. The novelty of the present study, in terms of research on bTB infection, was the use of beef breeds in the genome-wide association and the utilization of imputed whole genome sequence data. Phenotypic bTB data on 781,270 animals together with imputed whole genome sequence data on 7,346 of these animals' sires were available. Linear mixed models were used to quantify variance components for bTB and EBVs were validated. Within-breed and multi-breed genome-wide associations were undertaken using a single-SNP regression approach. The estimated genetic standard deviation (0.09), heritability (0.12), and repeatability (0.30) substantiate that genetic selection help to eradicate bTB. The multi-breed genome-wide association analysis identified 38 SNPs and 64 QTL regions associated with bTB infection; two QTL regions (both on BTA23) identified in the multi-breed analysis overlapped with the within-breed analyses of Charolais, Limousin, and Holstein-Friesian. Results from the association analysis, coupled with previous studies, suggest bTB is controlled by an infinitely large number of loci, each having a small effect. The methodology and results from the present study will be used to develop national genetic evaluations for bTB in the Republic of Ireland. In addition, results can also be used to help uncover the biological architecture underlying resistance to bTB infection in cattle.
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Affiliation(s)
- S. C. Ring
- Teagasc, Animal and Grassland Research and Innovation Centre, Moorepark, Fermoy, Co. Cork, Ireland
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - D. C. Purfield
- Teagasc, Animal and Grassland Research and Innovation Centre, Moorepark, Fermoy, Co. Cork, Ireland
| | - M. Good
- Department of Agriculture, Food and the Marine, Dublin 2, Ireland
| | - P. Breslin
- Department of Agriculture, Food and the Marine, Dublin 2, Ireland
| | - E. Ryan
- Department of Agriculture, Food and the Marine, Dublin 2, Ireland
| | - A. Blom
- Irish Cattle Breeding Federation, Highfield House, Bandon, Co. Cork, Ireland
| | - R. D. Evans
- Irish Cattle Breeding Federation, Highfield House, Bandon, Co. Cork, Ireland
| | - M. L. Doherty
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - D. G. Bradley
- Smurfit Institute of Genetics, University of Dublin, Trinity College, Dublin, Ireland
| | - D. P. Berry
- Teagasc, Animal and Grassland Research and Innovation Centre, Moorepark, Fermoy, Co. Cork, Ireland
- * E-mail:
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Feehan S, Fox E, Greene J, Ryan E. Determine whether having a specified weigh day improves compliance with patient weighing and MUST screening guidelines on admission and one week post-admission in an acute hospital? Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2018.12.077] [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: 10/27/2022]
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Abstract
We detected influenza D virus in 18 nasal swab samples from cattle in Ireland that were clinically diagnosed with respiratory disease. Specimens were obtained from archived samples received for routine diagnosis during 2014–2016. Sequencing showed that viruses from Ireland clustered with virus sequences obtained in Europe within the D/swine/OK/1334/2011 clade.
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Allen WL, Dunne PD, McDade S, Scanlon E, Loughrey M, Coleman H, McCann C, McLaughlin K, Nemeth Z, Syed N, Jithesh P, Arthur K, Wilson R, Coyle V, McArt D, Murray GI, Samuel L, Nuciforo P, Jimenez J, Argiles G, Dienstmann R, Tabernero J, Messerini L, Nobili S, Mini E, Sheahan K, Ryan E, Johnston PG, Van Schaeybroeck S, Lawler M, Longley DB. Transcriptional subtyping and CD8 immunohistochemistry identifies poor prognosis stage II/III colorectal cancer patients who benefit from adjuvant chemotherapy. JCO Precis Oncol 2018; 2018. [PMID: 30088816 PMCID: PMC6040635 DOI: 10.1200/po.17.00241] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Purpose Transcriptomic profiling of colorectal cancer (CRC) has led to the identification of four consensus molecular subtypes (CMS1 to 4) that have prognostic value in stage II and III disease. More recently, the Colorectal Cancer Intrinsic Subtypes (CRIS) classification system has helped to define the biology specific to the epithelial component of colorectal tumors; however, the clinical value of these classification systems in the prediction of response to standard-of-care adjuvant chemotherapy remains unknown. Patients and Methods Using samples from four European sites, we assembled a novel cohort of patients with stage II and III CRC (n = 156 samples) and performed transcriptomic profiling and targeted sequencing and generated a tissue microarray to enable integrated multiomics analyses. We also accessed data from two published cohorts of patients with stage II and III CRC: GSE39582 and GSE14333 (n = 479 and n = 185 samples, respectively). Results The epithelial-rich CMS2 subtype of CRC benefitted significantly from treatment with adjuvant chemotherapy in both stage II and III disease (P = .02 and P < .001, respectively), whereas the CMS3 subtype significantly benefitted in stage III only (P = .001). After CRIS substratification of CMS2, we observed that only the CRIS-C subtype significantly benefitted from treatment with adjuvant chemotherapy in stage II and III disease (P = .0081 and P < .001, respectively), whereas the CRIS-D subtype significantly benefitted in stage III only (P = .0034). We also observed that CRIS-C patients with low levels of CD8+ tumor-infiltrating lymphocytes were most at risk for relapse in both stage II and III disease (log-rank P = .0031; hazard ratio, 12.18 [95% CI, 1.51 to 98.58]). Conclusion Patient stratification using a combination of transcriptional subtyping and CD8 immunohistochemistry analyses is capable of identifying patients with poor prognostic stage II and III disease who benefit from adjuvant standard-of-care chemotherapy. These findings are particularly relevant for patients with stage II disease, where the overall benefit of adjuvant chemotherapy is marginal.
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Affiliation(s)
- W L Allen
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - P D Dunne
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - S McDade
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - E Scanlon
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - M Loughrey
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - H Coleman
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - C McCann
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - K McLaughlin
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - Z Nemeth
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - N Syed
- Sidra Medical and Research Center, Qatar
| | - P Jithesh
- Sidra Medical and Research Center, Qatar
| | - K Arthur
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - R Wilson
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - V Coyle
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - D McArt
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | | | | | - P Nuciforo
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - J Jimenez
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - G Argiles
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - R Dienstmann
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - J Tabernero
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | | | - E Mini
- University of Florence, Italy
| | - K Sheahan
- School of Medicine and Medical Science, University College Dublin
| | - E Ryan
- School of Medicine and Medical Science, University College Dublin
| | - P G Johnston
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - S Van Schaeybroeck
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - M Lawler
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - D B Longley
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
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Verrilli L, Vaughn S, Ryan E, Lathi R. Subclinical chronic endometritis and test of cure rates in a recurrent pregnancy loss cohort. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Walsh G, Curley S, Costello A, Elliott L, Ryan E, Blanco A, Kolch W, Eissner G. PO-311 Characterisation of colorectal tumour endothelial cells. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Jones TP, Brennan PC, Ryan E. THE IMPACT OF DIGITAL TECHNOLOGY ON DOSE REDUCTION IN PAEDIATRIC CARDIAC CATHETERISATION WITHIN A LARGE METROPOLITAN CHILDREN'S HOSPITAL. Radiat Prot Dosimetry 2018; 179:358-363. [PMID: 29309695 DOI: 10.1093/rpd/ncx294] [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: 08/03/2017] [Accepted: 12/06/2017] [Indexed: 06/07/2023]
Abstract
This study examines the kerma-area product (PKA) levels from paediatric cardiac catheterisations at a major Children's Hospital over three different time periods in order to gain an understanding of the causation of dose variations over time and to present a model for dose reduction. A retrospective review of 1245 paediatric procedural records was undertaken. This cohort consisted of patients that were catheterised over a period from November 2007 to July 2009, October 2009 to November 2011 and January 2016 to December 2016. The age distribution was from newborn to 18 years. Archived (PKA) readings were retrieved and analysed. The 75th percentile PKA values for the specific age categories over time periods (1, 2, 3) were 0-30 days-(5.47, 1.37, 1.37) Gy cm2; 1-12 months-(6.42, 2.03, 1.06) Gy cm2; 1-3 years-(11.25, 3.20, 1.25) Gy cm2; 3-5 years-(12.65, 3.72, 2.88) Gy cm2; 5-10 years-(12.80, 8.53, 3.52) Gy cm2; 10-15 years-(27.92, 10.85, 2.97) Gy cm2; >15 years-(29.09, 27.81, 11.65) Gy cm2. Using newer imaging technologies, optimising dose reduction strategies and regular dose auditing can transform radiation dose delivery for paediatric x-ray examinations. Our centre provides a template for dose reduction success worldwide.
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Affiliation(s)
- T P Jones
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Lidcombe NSW 2141, Australia
| | - P C Brennan
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Lidcombe NSW 2141, Australia
| | - E Ryan
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Lidcombe NSW 2141, Australia
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Chaudhari N, Toshniwal P, Clemons T, Stevenson A, Ryan E, Jarolimek W, Wood F, Fear M. 527 Targeting Lysyl Oxidase (LOX) Activity to Improve Scar Appearance. J Burn Care Res 2018. [DOI: 10.1093/jbcr/iry006.450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- N Chaudhari
- University of Western Australia, Crawley, Australia; Pharmaxis Ltd, Sydney, Australia; burns service Western Australia, Murdoch, Australia
| | - P Toshniwal
- University of Western Australia, Crawley, Australia; Pharmaxis Ltd, Sydney, Australia; burns service Western Australia, Murdoch, Australia
| | - T Clemons
- University of Western Australia, Crawley, Australia; Pharmaxis Ltd, Sydney, Australia; burns service Western Australia, Murdoch, Australia
| | - A Stevenson
- University of Western Australia, Crawley, Australia; Pharmaxis Ltd, Sydney, Australia; burns service Western Australia, Murdoch, Australia
| | - E Ryan
- University of Western Australia, Crawley, Australia; Pharmaxis Ltd, Sydney, Australia; burns service Western Australia, Murdoch, Australia
| | - W Jarolimek
- University of Western Australia, Crawley, Australia; Pharmaxis Ltd, Sydney, Australia; burns service Western Australia, Murdoch, Australia
| | - F Wood
- University of Western Australia, Crawley, Australia; Pharmaxis Ltd, Sydney, Australia; burns service Western Australia, Murdoch, Australia
| | - M Fear
- University of Western Australia, Crawley, Australia; Pharmaxis Ltd, Sydney, Australia; burns service Western Australia, Murdoch, Australia
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Ramsay C, McRae C, Ryan E, McCallum A, Wellington L, Lauder L, Millar R, Haunch S, Othieno R. Carbon dioxide ingress into residential houses at Gorebridge in Midlothian, Scotland, United Kingdom. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Ramsay
- Health Protection Scotland, National Health Service, National Services Scotland, Glasgow, UK
| | - C McRae
- Health Protection Scotland, National Health Service, National Services Scotland, Glasgow, UK
| | - E Ryan
- Environmental Health Services, Midlothian Council, Dalkeith, UK
| | - A McCallum
- Directorate of Public Health and Health Policy, NHS Lothian, Edinburgh, UK
| | - L Wellington
- Directorate of Public Health and Health Policy, NHS Lothian, Edinburgh, UK
| | - L Lauder
- Environmental Health Services, Midlothian Council, Dalkeith, UK
| | - R Millar
- Public Health Department, NHS Tayside, Dundee, UK
| | - S Haunch
- Scottish Environment Protection Agency (SEPA), Edinburgh, UK
| | - R Othieno
- Directorate of Public Health and Health Policy, NHS Lothian, Edinburgh, UK
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Jones TP, Brennan PC, Ryan E. Cumulative Effective and Individual Organ Dose Levels in Paediatric Patients Undergoing Multiple Catheterisations for Congenital Heart Disease. Radiat Prot Dosimetry 2017; 176:252-257. [PMID: 28115657 DOI: 10.1093/rpd/ncx003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 01/06/2017] [Indexed: 06/06/2023]
Abstract
This study examines the cumulative radiation dose levels received by a group of children who underwent multiple cardiac catheterisation procedures during the investigation and management of congenital heart disease (CHD). The purpose is to calculate cumulative doses, identify higher dose individuals, outline the inconsistencies with risk assessment and encourage the establishment of dose databases in order to facilitate the longitudinal research necessary to better understand health risks. A retrospective review of patient records for 117 paediatric patients who have undergone two or more cardiac catheterisations for the investigation of CHD was undertaken. This cohort consisted of patients who were catheterised over a period from September 2002 to August 2014. The age distribution was from newborn to 17 y. Archived kerma-area product (PKA) and fluoroscopy time (T) readings were retrieved and analysed. Cumulative effective and individual organ doses were determined. The cumulative PKA levels ranged from 1.8 to 651.2 Gycm2, whilst cumulative effective dose levels varied from 2 to 259 mSv. The cumulative fluoroscopy time was shown to vary from 8.1 to 193.5 min. Median cumulative organ doses ranged from 3 to 94 mGy. Cumulative effective dose levels are highly variable but may exceed 250 mSv. Individual organ and effective dose measurements remain useful for comparison purposes between institutions although current methodologies used for determining lifetime risks are inadequate.
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Affiliation(s)
- T P Jones
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Lidcombe, NSW2141, Australia
| | - P C Brennan
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Lidcombe, NSW2141, Australia
| | - E Ryan
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Lidcombe, NSW2141, Australia
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Creavin B, Kelly ME, Ryan E, Winter DC. Meta-analysis of the impact of surgical approach on the grade of mesorectal excision in rectal cancer. Br J Surg 2017; 104:1609-1619. [PMID: 29044484 DOI: 10.1002/bjs.10664] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 05/17/2017] [Accepted: 07/07/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND The subspecialization of colorectal surgeons, and improvements in the quality of mesorectal excision have revolutionized rectal cancer surgery. With the increasing use of minimally invasive techniques, the completeness of the mesorectal excision has been questioned. This study aimed to assess the pathological outcomes of open versus laparoscopic rectal resection. METHODS A meta-analysis of RCTs was undertaken. The primary endpoint was the adequacy of the mesorectal excision. Secondary endpoints included circumferential resection margin and distance to resection margins. RESULTS Four studies were included, reporting on 2319 patients; 972 (41·9 per cent) had open and 1347 (58·1 per cent) had laparoscopic resections. Meta-analysis of adequacy of the mesorectal excision showed a small difference in achieving an intact mesorectum in favour of open surgery (risk ratio (RR) 1·06, 95 per cent c.i. 1·02 to 1·10; P = 0·001). Superficial defects were more common in laparoscopic surgery (RR 0·70, 0·54 to 0·89; P = 0·004). Deep mesorectal defects (RR 0·78, 0·51 to 1·20; P = 0·256), circumferential margin (CRM) positivity (RR 0·85, 0·62 to 1·16; P = 0·310), and distance to radial (mean difference (MD) -0·06, 95 per cent c.i. -0·10 to 0·23; P = 0·443) and distal (MD 0·03, -0·06 to 0·12; P = 0·497) margins were all similar. A complete resection (intact mesorectum, negative CRM and distal margin) was achieved in 350 of 478 patients (73·2 per cent) in the laparoscopic group and 372 of 457 (81·4 per cent) in the open group (risk difference (RD) 8 (95 per cent c.i. 3 to 13) per cent; P = 0·003). However, an acceptable mesorectum (intact or superficial defects only) was present in 1254 of 1308 (95·9 per cent) and 916 of 949 (96·5 per cent) in the laparoscopic and open groups respectively (RD 1 (-1 to 3) per cent; P = 0·263). CONCLUSION Small differences in mesorectal quality were evident between open and laparoscopic rectal resections. This may be attributable to use of laparoscopic instruments; however, to date minor defects have not affected oncological outcomes.
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Affiliation(s)
- B Creavin
- Centre for Colorectal Disease, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - M E Kelly
- Centre for Colorectal Disease, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - E Ryan
- Centre for Colorectal Disease, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - D C Winter
- Centre for Colorectal Disease, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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Patel P, Rebollo-Mesa I, Ryan E, Sinha MD, Marks SD, Banga N, Macdougall IC, Webb MC, Koffman G, Olsburgh J. Prophylactic Ureteric Stents in Renal Transplant Recipients: A Multicenter Randomized Controlled Trial of Early Versus Late Removal. Am J Transplant 2017; 17:2129-2138. [PMID: 28188678 DOI: 10.1111/ajt.14223] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 01/19/2017] [Accepted: 01/31/2017] [Indexed: 01/25/2023]
Abstract
Prophylactic ureteric stenting in renal transplantation reduces major urological complications; however, morbidity is related to the indwelling duration of a stent. We aimed to determine the optimal duration for stents in this clinical setting. Patients (aged 2-75 years) from six UK hospitals who were undergoing renal transplantation were recruited and randomly assigned to either early stent removal at 5 days (without cystoscopy) or late removal at 6 weeks after transplantation (with cystoscopy). The primary outcome was a composite of stent-related complications defined as pain, visible hematuria, migration, fragmentation, and urinary tract infections (UTIs) within 3 mo of transplantation. Between May 2010 and Nov 2013, we randomly assigned 227 participants, with 205 included in the final analysis of the primary outcome. Stent-related complications were significantly higher in the late versus early stent removal groups (36 of 126 [28.6%] vs. 6 of 79 [7.6%]; p < 0.001). The majority of stent complications consisted of UTIs, with an incidence of 31 of 126 (24.6%) in the late group compared with 6 of 79 (7.6%) in the early group (p = 0.004). We found early stent removal on day 5 significantly reduced stent-related complications and improved quality of life in the first 3 mo after transplantation (ISRCTN09184595).
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Affiliation(s)
- P Patel
- Department of Nephrology, Transplantation and Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - I Rebollo-Mesa
- MRC Centre for Transplantation, King's College Hospital; Global Exploratory Development, UCB Biopharma, London, UK
| | - E Ryan
- Biostatistics Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M D Sinha
- Department of Paediatric Nephrology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - S D Marks
- Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - N Banga
- Department of Renal Transplantation, Royal Free London NHS Foundation Trust, London, UK
| | - I C Macdougall
- Department of Renal Medicine, King's College Hospital, London, UK
| | - M C Webb
- Department of Renal Medicine, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
| | - G Koffman
- Department of Nephrology, Transplantation and Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - J Olsburgh
- Department of Nephrology, Transplantation and Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
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Maher B, Ryan E, Little M, Boardman P, Stedman B. The management of colorectal liver metastases. Clin Radiol 2017; 72:617-625. [DOI: 10.1016/j.crad.2017.05.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 05/30/2017] [Indexed: 02/07/2023]
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Abstract
OBJECTIVE A clinical audit was performed to evaluate whether Acapsil micropore particle technology (MPPT) powder could improve the management of acute wounds to heal by secondary intention. METHOD Wounds, which could be characterised as sloughy, wet and probably infected, normally managed by debridement followed by negative pressure wound therapy (NPWT), were included in the evaluation. The MPPT powder was applied topically to the wound surface either once daily or on alternate days, with each wound receiving a total of two to five applications. Most patients had NPWT after the MPPT powder treatment had finished to assist healing. RESULTS The study included nine patients with dehisced surgical wounds and one with a category IV pressure ulcer (PU). The wounds were generally covered in slough, exudate and showing signs of local infection. The topical MPPT powder rapidly desloughed the wounds, controlled exudate levels, promoted granulation and was well tolerated. All wounds proceeded towards closure. CONCLUSION Comparison of the present data with MPPT powder to standard treatment suggests that the speed of healing using MPPT was improved. Further examination is required to determine if this reduces dressing changes, nursing time, and financial cost.
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Affiliation(s)
- E Ryan
- Acting Tissue Viability Lead, Bristol University Hospital, Bristol Royal Infirmary, Upper Maudlin St., Bristol, UK
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Micci L, Harper J, Paganini S, King C, Ryan E, Lifson J, Paiardini M. OA4-1 Combined IL-21 and IFNα treatment limits residual inflammation, viral persistence and delays viral rebound in SIV-infected rhesus macaques. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30841-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Ryan E, Tartarini W, Palastro M, Lukas S. 0472 OBSTRUCTIVE SLEEP APNEA IN A PSYCHIATRIC POPULATION: HIGH PREVALENCE AND LACK OF RISK FACTORS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Jones T, Brennan PC, Mello-Thoms C, Ryan E. CONTEMPORARY AUSTRALIAN DOSE AREA PRODUCT LEVELS IN THE FLUOROSCOPIC INVESTIGATION OF PAEDIATRIC CONGENITAL HEART DISEASE. Radiat Prot Dosimetry 2017; 173:374-379. [PMID: 26908924 DOI: 10.1093/rpd/ncw012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 01/06/2016] [Indexed: 06/05/2023]
Abstract
This study examines radiation dose levels delivered to children from birth to 15 y of age in the investigation of congenital heart disease (CHD) at a major Sydney children's hospital. The aims are to compare values with those derived from similar studies, to provide a template for more consistent dose reporting, to establish local and national diagnostic reference levels and to contribute to the worldwide paediatric dosimetry database. A retrospective review of 1007 paediatric procedural records was undertaken. The cohort consisted of 795 patients over a period from January 2007 to December 2012 who have undergone cardiac catheterisation for the investigation of CHD. The age range included was from the day of birth to 15 y. Archived dose area product (DAP) and fluoroscopy time (FT) readings were retrieved and analysed. The mean, median, 25th and 75th percentile DAP levels were calculated for six specific age groupings. The 75th percentile DAP values for the specific age categories were as follows: 0-30 d-1.9 Gy cm2, 1-12 months-2.9 Gy cm2, 1-3 y-5.3 Gy cm2, 3-5 y-6.2 Gy cm2, 5-10 y-7.5 Gy cm2 and 10-15 y-17.3 Gy cm2. These levels were found to be lower than the values reported in comparable overseas studies. Individual year-specific levels were determined, and it is proposed that these are more useful than the common grouping method. The age-specific 75th percentile DAP levels outlined in this study can be used as baseline local diagnostic reference levels. The needs for the standardisation of DAP reporting and for a greater range of age-specific diagnostic reference levels have been highlighted. For the first time, Australian dose values for paediatric cardiac catheterisation are presented.
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Affiliation(s)
- T Jones
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Room M208, Lidcombe, NSW 2141, Australia
| | - P C Brennan
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Room M208, Lidcombe, NSW 2141, Australia
| | - C Mello-Thoms
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Room M208, Lidcombe, NSW 2141, Australia
| | - E Ryan
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, 75 East Street, Room M208, Lidcombe, NSW 2141, Australia
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