1
|
Wisch JK, McKay NS, Boerwinkle AH, Kennedy J, Flores S, Handen BL, Christian BT, Head E, Mapstone M, Rafii MS, O'Bryant SE, Price JC, Laymon CM, Krinsky-McHale SJ, Lai F, Rosas HD, Hartley SL, Zaman S, Lott IT, Tudorascu D, Zammit M, Brickman AM, Lee JH, Bird TD, Cohen A, Chrem P, Daniels A, Chhatwal JP, Cruchaga C, Ibanez L, Jucker M, Karch CM, Day GS, Lee JH, Levin J, Llibre-Guerra J, Li Y, Lopera F, Roh JH, Ringman JM, Supnet-Bell C, van Dyck CH, Xiong C, Wang G, Morris JC, McDade E, Bateman RJ, Benzinger TLS, Gordon BA, Ances BM. Comparison of tau spread in people with Down syndrome versus autosomal-dominant Alzheimer's disease: a cross-sectional study. Lancet Neurol 2024; 23:500-510. [PMID: 38631766 DOI: 10.1016/s1474-4422(24)00084-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/01/2024] [Accepted: 02/21/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND In people with genetic forms of Alzheimer's disease, such as in Down syndrome and autosomal-dominant Alzheimer's disease, pathological changes specific to Alzheimer's disease (ie, accumulation of amyloid and tau) occur in the brain at a young age, when comorbidities related to ageing are not present. Studies including these cohorts could, therefore, improve our understanding of the early pathogenesis of Alzheimer's disease and be useful when designing preventive interventions targeted at disease pathology or when planning clinical trials. We compared the magnitude, spatial extent, and temporal ordering of tau spread in people with Down syndrome and autosomal-dominant Alzheimer's disease. METHODS In this cross-sectional observational study, we included participants (aged ≥25 years) from two cohort studies. First, we collected data from the Dominantly Inherited Alzheimer's Network studies (DIAN-OBS and DIAN-TU), which include carriers of autosomal-dominant Alzheimer's disease genetic mutations and non-carrier familial controls recruited in Australia, Europe, and the USA between 2008 and 2022. Second, we collected data from the Alzheimer Biomarkers Consortium-Down Syndrome study, which includes people with Down syndrome and sibling controls recruited from the UK and USA between 2015 and 2021. Controls from the two studies were combined into a single group of familial controls. All participants had completed structural MRI and tau PET (18F-flortaucipir) imaging. We applied Gaussian mixture modelling to identify regions of high tau PET burden and regions with the earliest changes in tau binding for each cohort separately. We estimated regional tau PET burden as a function of cortical amyloid burden for both cohorts. Finally, we compared the temporal pattern of tau PET burden relative to that of amyloid. FINDINGS We included 137 people with Down syndrome (mean age 38·5 years [SD 8·2], 74 [54%] male, and 63 [46%] female), 49 individuals with autosomal-dominant Alzheimer's disease (mean age 43·9 years [11·2], 22 [45%] male, and 27 [55%] female), and 85 familial controls, pooled from across both studies (mean age 41·5 years [12·1], 28 [33%] male, and 57 [67%] female), who satisfied the PET quality-control procedure for tau-PET imaging processing. 134 (98%) people with Down syndrome, 44 (90%) with autosomal-dominant Alzheimer's disease, and 77 (91%) controls also completed an amyloid PET scan within 3 years of tau PET imaging. Spatially, tau PET burden was observed most frequently in subcortical and medial temporal regions in people with Down syndrome, and within the medial temporal lobe in people with autosomal-dominant Alzheimer's disease. Across the brain, people with Down syndrome had greater concentrations of tau for a given level of amyloid compared with people with autosomal-dominant Alzheimer's disease. Temporally, increases in tau were more strongly associated with increases in amyloid for people with Down syndrome compared with autosomal-dominant Alzheimer's disease. INTERPRETATION Although the general progression of amyloid followed by tau is similar for people Down syndrome and people with autosomal-dominant Alzheimer's disease, we found subtle differences in the spatial distribution, timing, and magnitude of the tau burden between these two cohorts. These differences might have important implications; differences in the temporal pattern of tau accumulation might influence the timing of drug administration in clinical trials, whereas differences in the spatial pattern and magnitude of tau burden might affect disease progression. FUNDING None.
Collapse
Affiliation(s)
- Julie K Wisch
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA.
| | - Nicole S McKay
- Department of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - Anna H Boerwinkle
- McGovern Medical School, University of Texas in Houston, Houston, TX, USA
| | - James Kennedy
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Shaney Flores
- Department of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - Benjamin L Handen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bradley T Christian
- Department of Medical Physics and Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Elizabeth Head
- Department of Pathology, Gillespie Neuroscience Research Facility, University of California, Irvine, CA, USA
| | - Mark Mapstone
- Department of Neurology, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Michael S Rafii
- Alzheimer's Therapeutic Research Institute, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Sid E O'Bryant
- Institute for Translational Research Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Julie C Price
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA
| | - Charles M Laymon
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sharon J Krinsky-McHale
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, New York, NY, USA
| | - Florence Lai
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA
| | - H Diana Rosas
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA; Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA
| | - Sigan L Hartley
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Shahid Zaman
- Cambridge Intellectual and Developmental Disabilities Research Group, University of Cambridge, Cambridge, UK
| | - Ira T Lott
- Department of Pediatrics, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Dana Tudorascu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Matthew Zammit
- Department of Medical Physics and Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Adam M Brickman
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Joseph H Lee
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA; Department of Epidemiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Thomas D Bird
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Annie Cohen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Patricio Chrem
- Centro de Memoria y Envejecimiento, Buenos Aires, Argentina
| | - Alisha Daniels
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Jasmeer P Chhatwal
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University in St Louis, St Louis, MO, USA; Hope Center for Neurological Disorders, Washington University in St Louis, St Louis, MO, USA
| | - Laura Ibanez
- Department of Psychiatry, Washington University in St Louis, St Louis, MO, USA
| | - Mathias Jucker
- Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Celeste M Karch
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA; Department of Psychiatry, Washington University in St Louis, St Louis, MO, USA; German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Gregory S Day
- Department of Neurology, Mayo Clinic Florida, Jacksonville, FL, USA
| | - Jae-Hong Lee
- Department of Neurology, University of Ulsan College of Medicine, Asian Medical Center, Seoul, South Korea
| | - Johannes Levin
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases, site Munich, Munich, Germany; Munich Cluster for Systems Neurology, Munich, Germany
| | - Jorge Llibre-Guerra
- Hope Center for Neurological Disorders, Washington University in St Louis, St Louis, MO, USA
| | - Yan Li
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA; Department of Biostatistics, Washington University in St Louis, St Louis, MO, USA
| | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Jee Hoon Roh
- Departments of Physiology and Neurology, Korea University College of Medicine, Seoul, South Korea
| | - John M Ringman
- Alzheimer's Therapeutic Research Institute, Keck School of Medicine of USC, Los Angeles, CA, USA
| | | | | | - Chengjie Xiong
- Department of Biostatistics, Washington University in St Louis, St Louis, MO, USA
| | - Guoqiao Wang
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA; Department of Biostatistics, Washington University in St Louis, St Louis, MO, USA
| | - John C Morris
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Eric McDade
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Randall J Bateman
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | | | - Brian A Gordon
- Department of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - Beau M Ances
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| |
Collapse
|
2
|
Tchalova K, Lydon JE, Atkinson L, Fleming AS, Kennedy J, Lecompte V, Meaney MJ, Moss E, O'Donnell KA, O'Donnell KJ, Silveira PP, Sokolowski MB, Steiner M, Bartz JA. Variation in the mu-opioid receptor gene (OPRM1) moderates the influence of maternal sensitivity on child attachment. Transl Psychiatry 2024; 14:181. [PMID: 38580654 PMCID: PMC10997775 DOI: 10.1038/s41398-024-02888-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/15/2024] [Accepted: 03/20/2024] [Indexed: 04/07/2024] Open
Abstract
The endogenous opioid system is thought to play an important role in mother-infant attachment. In infant rhesus macaques, variation in the μ-opioid receptor gene (OPRM1) is related to differences in attachment behavior that emerges following repeated separation from the mother; specifically, infants carrying at least one copy of the minor G allele of the OPRM1 C77G polymorphism show heightened and more persistent separation distress, as well as a pattern of increased contact-seeking behavior directed towards the mother during reunions (at the expense of affiliation with other group members). Research in adult humans has also linked the minor G allele of the analogous OPRM1 A118G polymorphism with greater interpersonal sensitivity. Adopting an interactionist approach, we examined whether OPRM1 A118G genotype and maternal (in)sensitivity are associated with child attachment style, predicting that children carrying the G allele may be more likely to develop an ambivalent attachment pattern in response to less sensitive maternal care. The sample consisted of 191 mothers participating with their children (n = 223) in the Maternal Adversity, Vulnerability and Neurodevelopment (MAVAN) project, a community-based, birth cohort study of Canadian mothers and their children assessed longitudinally across the child's development. Maternal sensitivity was coded from at-home mother-child interactions videotaped when the child was 18 months of age. Child attachment was assessed at 36 months using the Strange Situation paradigm. As predicted, G allele carriers, but not AA homozygotes, showed increasing odds of being classified as ambivalently attached with decreasing levels of maternal sensitivity. Paralleling earlier non-human animal research, this work provides support for the theory that endogenous opioids contribute to the expression of attachment behaviors in humans.
Collapse
Affiliation(s)
- K Tchalova
- Department of Psychology, McGill University, Montréal, QC, Canada
| | - J E Lydon
- Department of Psychology, McGill University, Montréal, QC, Canada
| | - L Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - A S Fleming
- Department of Psychology, University of Toronto Mississauga, Toronto, ON, Canada
| | - J Kennedy
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - V Lecompte
- L'Université du Québec à Montréal, Montréal, QC, Canada
| | - M J Meaney
- Department of Psychology, McGill University, Montréal, QC, Canada
- Douglas Research Centre, Montréal, QC, Canada
- Singapore Institute for Clinical Sciences, A*STAR, Singapore, Singapore
| | - E Moss
- L'Université du Québec à Montréal, Montréal, QC, Canada
| | - K A O'Donnell
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - K J O'Donnell
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
| | - P P Silveira
- Department of Psychiatry, McGill University, Montréal, QC, Canada
| | - M B Sokolowski
- Department of Ecology and Evolutionary Biology, University of Toronto, Toronto, ON, Canada
| | - M Steiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - J A Bartz
- Department of Psychology, McGill University, Montréal, QC, Canada.
| |
Collapse
|
3
|
Kennedy J, Gunnarsson Á, Pampoulie C, Wienerroither R. Nesting behavior of greater eelpout (Lycodes esmarkii), identified through a predation event by spotted wolffish (Anarhichas minor). J Fish Biol 2024; 104:1247-1250. [PMID: 38193598 DOI: 10.1111/jfb.15648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/27/2023] [Accepted: 12/13/2023] [Indexed: 01/10/2024]
Abstract
The stomach of a spotted wolffish (Anarhichas minor) caught in Icelandic waters was found to contain ~727 greater eelpout larvae (Lycodes esmarkii). All the larvae were of similar size and at a similar state of digestion, indicating they were all consumed together. The likely explanation for this observation is that greater eelpout lay their eggs in a nest, with the larvae remaining in the nest for a short period after hatching. The larvae were then predated upon by the spotted wolffish while still in the nest. This study sheds new light on greater eelpout in Icelandic waters, with recently hatched larvae being present in March, breeding at a depth of ~200-250 m, and likely exhibiting nesting behavior, which has not previously been documented.
Collapse
Affiliation(s)
- James Kennedy
- Marine and Freshwater Research Institute, Ísafjörður, Iceland
| | | | | | | |
Collapse
|
4
|
Kennedy J, Ólafsdóttir AH, Aradóttir SE, Egilsdóttir S, Pampoulie C. Biological information on a rare pelagic fish, black ruff Centrolophus niger, caught in Icelandic waters: Distribution, feeding, and otoliths. J Fish Biol 2024; 104:598-610. [PMID: 37940609 DOI: 10.1111/jfb.15611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 09/14/2023] [Accepted: 11/06/2023] [Indexed: 11/10/2023]
Abstract
Black ruff (Centrolophus niger) is a rare and poorly studied species found in both the Atlantic and Pacific Oceans and also in the Mediterranean Sea. It is sporadically caught south of Iceland during the annual International Ecosystem Summer Survey of the Nordic Seas. In total, 43 specimens were caught from 2009 to 2021, of which 41 specimens were caught during 2017-2021. All specimens, except one, were caught using a pelagic trawl (cod-end mesh-size: 50 mm) close to the surface (trawl depth: 0-35 m) with in situ temperature ranging from 9 to 13°C. The area south of Iceland is characterized by having warmer temperatures than other areas around the island, which might be indicative of a northern limit for the distribution of black ruff. The fish were primarily in the range of 29-46 cm with a few larger individuals up to 71 cm. Fourteen fish, caught in 2017 and 2021, were dissected to gather biological information on this species. These fish were all juveniles with no obvious sign of gonad development. Correlations between total length, fork length, and standard length are presented. Otoliths were thin and delicate with a length of ~13-16 mm, and otolith size (length, width, and area) was correlated with fish size. Much of the stomach content was at an advanced stage of digestion, but some contents could be identified and consisted of invertebrates, primarily of the orders Amphipoda and Calanoida with some unidentified fish also present.
Collapse
Affiliation(s)
- James Kennedy
- Marine and Freshwater Research Institute, Ísafjörður, Iceland
| | | | | | | | | |
Collapse
|
5
|
Spartera M, Stracquadanio A, Pessoa-Amorim G, Harston G, Mazzucco S, Young V, Von Ende A, Hess AT, Ferreira VM, Kennedy J, Neubauer S, Casadei B, Wijesurendra RS. Reduced Left Atrial Rotational Flow Is Independently Associated With Embolic Brain Infarcts. JACC Cardiovasc Imaging 2023; 16:1149-1159. [PMID: 37204381 DOI: 10.1016/j.jcmg.2023.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/22/2023] [Accepted: 03/10/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Up to 25% of embolic strokes occur in individuals without atrial fibrillation (AF) or other identifiable mechanisms. OBJECTIVES This study aims to assess whether left atrial (LA) blood flow characteristics are associated with embolic brain infarcts, independently of AF. METHODS The authors recruited 134 patients: 44 with a history of ischemic stroke and 90 with no history of stroke but CHA2DS2VASc score ≥1. Cardiac magnetic resonance (CMR) evaluated cardiac function and LA 4-dimensional flow parameters, including velocity and vorticity (a measure of rotational flow), and brain magnetic resonance imaging (MRI) was performed to detect large noncortical or cortical infarcts (LNCCIs) (likely embolic), or nonembolic lacunar infarcts. RESULTS Patients (41% female; age 70 ± 9 years) had moderate stroke risk (median CHA2DS2VASc = 3, Q1-Q3: 2-4). Sixty-eight (51%) had diagnosed AF, of whom 58 (43%) were in AF during CMR. Thirty-nine (29%) had ≥1 LNCCI, 20 (15%) had ≥1 lacunar infarct without LNCCI, and 75 (56%) had no infarct. Lower LA vorticity was significantly associated with prevalent LNCCIs after adjustment for AF during CMR, history of AF, CHA2DS2VASc score, LA emptying fraction, LA indexed maximum volume, left ventricular ejection fraction, and indexed left ventricular mass (OR: 2.06 [95% CI: 1.08-3.92 per SD]; P = 0.027). By contrast, LA flow peak velocity was not significantly associated with LNCCIs (P = 0.21). No LA parameter was associated with lacunar infarcts (all P > 0.05). CONCLUSIONS Reduced LA flow vorticity is significantly and independently associated with embolic brain infarcts. Imaging LA flow characteristics may aid identification of individuals who would benefit from anticoagulation for embolic stroke prevention, regardless of heart rhythm.
Collapse
Affiliation(s)
- Marco Spartera
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom.
| | - Antonio Stracquadanio
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom
| | - Guilherme Pessoa-Amorim
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom; CTSU Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - George Harston
- Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom
| | - Sara Mazzucco
- Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom; Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neuroscience, Oxford, United Kingdom
| | - Victoria Young
- Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom
| | - Adam Von Ende
- CTSU Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Aaron T Hess
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom
| | - Vanessa M Ferreira
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom
| | - James Kennedy
- Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom
| | - Barbara Casadei
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom
| | - Rohan S Wijesurendra
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom; CTSU Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
6
|
Kennedy J, Parker M, Seaborne M, Mhereeg M, Walker A, Walker V, Denaxas S, Kennedy N, Katikireddi SV, Brophy S. Healthcare use attributable to COVID-19: a propensity-matched national electronic health records cohort study of 249,390 people in Wales, UK. BMC Med 2023; 21:259. [PMID: 37468884 PMCID: PMC10354936 DOI: 10.1186/s12916-023-02897-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 05/10/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND To determine the extent and nature of changes associated with COVID-19 infection in terms of healthcare utilisation, this study observed healthcare contact 1 to 4 and 5 to 24 weeks following a COVID-19 diagnosis compared to propensity-matched controls. METHODS Two hundred forty nine thousand three hundred ninety Welsh individuals with a positive reverse transcription-polymerase chain reaction (RT-PCR) test were identified from data from national PCR test results. After elimination criteria, 98,600 positive individuals were matched to test negative and never tested controls using propensity matching. Cohorts were split on test location. Tests could be taken in either the hospital or community. Controls were those who had tested negative in their respective environments. Survival analysis was utilised for first clinical outcomes which are grouped into primary and secondary. Primary outcomes include post-viral-illness and fatigue as an indication of long-COVID. Secondary outcomes include clinical terminology concepts for embolism, respiratory conditions, mental health conditions, fit notes, or hospital attendance. Increased instantaneous risk for positive individuals was quantified using hazard ratios (HR) from Cox regression, while absolute risk (AR) and relative risk were quantified using life table analysis. RESULTS Analysis was conducted using all individuals and stratified by test location. Cases are compared to controls from the same test location. Fatigue (HR: 1.77, 95% CI: 1.34-2.25, p = < 0.001) and embolism (HR: 1.50, 95% CI: 1.15-1.97, p = 0.003) were more likely to occur in all positive individuals in the first 4 weeks; however, anxiety and depression (HR: 0.83, 95% CI: 0.73-0.95, p = 0.007) were less likely. Positive individuals continued to be more at risk of fatigue (HR: 1.47, 95% CI: 1.24-1.75, p = < 0.001) and embolism (HR: 1.51, 95% CI: 1.13-2.02, p = 0.005) after 4 weeks. All positive individuals are also at greater risk of post-viral illness (HR: 4.57, 95% CI: 1.77-11.80, p = 0.002). Despite statistical association between testing positive and several conditions, life table analysis shows that only a small minority of the study population were affected. CONCLUSIONS Community COVID-19 disease is associated with increased risks of post-viral-illness, fatigue, embolism, and respiratory conditions. Despite elevated risks, the absolute healthcare burden is low. Subsequently, either very small proportions of people experience adverse outcomes following COVID-19 or they are not presenting to healthcare.
Collapse
Affiliation(s)
- J Kennedy
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, Wales, UK
| | - M Parker
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, Wales, UK.
| | - M Seaborne
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, Wales, UK
| | - M Mhereeg
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, Wales, UK
| | - A Walker
- Datalab, Nuffield Dept of Primary Care Health Science, Radcliffe Primary Care Building, Oxford, OX2 6GG, UK
| | - V Walker
- Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - S Denaxas
- Institute for Health Informatics, UCL, London, UK
| | - N Kennedy
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, Wales, UK
| | - S V Katikireddi
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - S Brophy
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, Wales, UK
| |
Collapse
|
7
|
de Souza N, Esopenko C, Jia Y, Parrott JS, Merkley T, Dennis E, Hillary F, Velez C, Cooper D, Kennedy J, Lewis J, York G, Menefee D, McCauley S, Bowles AO, Wilde E, Tate DF. Discriminating Mild Traumatic Brain Injury and Posttraumatic Stress Disorder Using Latent Neuroimaging and Neuropsychological Profiles in Active-Duty Military Service Members. J Head Trauma Rehabil 2023; 38:E254-E266. [PMID: 36602276 PMCID: PMC10264548 DOI: 10.1097/htr.0000000000000848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) commonly occur among military Service Members and Veterans and have heterogenous, but also overlapping symptom presentations, which often complicate the diagnoses of underlying impairments and development of effective treatment plans. Thus, we sought to examine whether the combination of whole brain gray matter (GM) and white matter (WM) structural measures with neuropsychological performance can aid in the classification of military personnel with mTBI and PTSD. METHODS Active-Duty US Service Members ( n = 156; 87.8% male) with a history of mTBI, PTSD, combined mTBI+PTSD, or orthopedic injury completed a neuropsychological battery and T1- and diffusion-weighted structural neuroimaging. Cortical, subcortical, ventricular, and WM volumes and whole brain fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) were calculated. Latent profile analyses were performed to determine how the GM and WM indicators, together with neuropsychological indicators, classified individuals. RESULTS For both GM and WM, respectively, a 4-profile model was the best fit. The GM model identified greater ventricular volumes in Service Members with cognitive symptoms, including those with a diagnosis of mTBI, either alone or with PTSD. The WM model identified reduced FA and elevated RD in those with psychological symptoms, including those with PTSD or mTBI and comorbid PTSD. However, contrary to expectation, a global neural signature unique to those with comorbid mTBI and PTSD was not identified. CONCLUSIONS The findings demonstrate that neuropsychological performance alone is more robust in differentiating Active-Duty Service Members with mTBI and PTSD, whereas global neuroimaging measures do not reliably differentiate between these groups.
Collapse
Affiliation(s)
- N.L. de Souza
- School of Graduate Studies, Biomedical Sciences, Rutgers Biomedical and Health Sciences, Newark, NJ, USA
| | - C. Esopenko
- Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, USA
| | - Y. Jia
- Department of Interdisciplinary Studies, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, USA
| | - J. S. Parrott
- Department of Interdisciplinary Studies, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, USA
| | - T.L. Merkley
- Department of Psychology & Neuroscience Center, Brigham Young University, Provo, UT, USA
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - E.L. Dennis
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT
| | - F.G. Hillary
- Department of Psychology, Pennsylvania State University, University Park, PA 16802, United States
- Social Life and Engineering Sciences Imaging Center, University Park, PA 16802, United States
| | - C. Velez
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - D.B. Cooper
- San Antonio VA Polytrauma Rehabilitation Center, San Antonio, TX
- Departments of Rehabilitation Medicine and Psychiatry, UT Health San Antonio, TX
| | - J. Kennedy
- General Dynamics Information Technology (GDIT) contractor for the Traumatic Brain Injury Center of Excellence (TBICoE), Neurology Service, Department of Medicine, Brooke Army Medical Center, Joint Base San Antonio, Fort Sam Houston, TX, USA
| | - J. Lewis
- Neurology Clinic, Wright Patterson Air Force Base, Wright Patterson AFB, Ohio
| | - G. York
- Alaska Radiology Associates, Anchorage, AK
| | - D.S. Menefee
- Michael E. DeBakey VA Medical Center, Houston, TX, USA
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX USA
| | - S.R. McCauley
- Department of Neurology, Baylor College of Medicine, Houston, TX USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX USA
| | - A. O. Bowles
- Brain Injury Rehabilitation Service, Department of Rehabilitation Medicine, Brooke Army Medical Center, Joint Base San Antonio, Fort Sam Houston, TX, US
| | - E.A. Wilde
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX USA
| | - D. F. Tate
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT
| |
Collapse
|
8
|
Kharbanda RK, Perkins AD, Kennedy J, Banning AP, Baumbach A, Blackman DJ, Dodd M, Evans R, Hildick-Smith D, Jamal Z, Ludman P, Palmer S, Stables R, Clayton T. Routine cerebral embolic protection in transcatheter aortic valve implantation: rationale and design of the randomised British Heart Foundation PROTECT-TAVI trial. EUROINTERVENTION 2023; 18:1428-1435. [PMID: 36706009 PMCID: PMC10111121 DOI: 10.4244/eij-d-22-00713] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/14/2022] [Indexed: 01/28/2023]
Abstract
Transcatheter aortic valve implantation (TAVI) is an established treatment for aortic stenosis. Cerebral embolic protection (CEP) devices may impact periprocedural stroke by capturing debris destined for the brain. However, there is a lack of high-quality randomised trial evidence supporting the use of CEP during TAVI. The British Heart Foundation (BHF) PROTECT-TAVI trial will address whether the routine use of CEP reduces the incidence of stroke in patients undergoing TAVI. BHF PROTECT-TAVI is a prospective, open-label, outcome-adjudicated, multicentre randomised controlled trial. The trial is open to all adult patients scheduled for TAVI at participating specialist cardiac centres across the United Kingdom who are able to receive the CEP device. The trial will recruit 7,730 participants. Participants will be randomised in a 1:1 ratio to undergo TAVI with CEP or TAVI without CEP (standard of care). The primary outcome is the incidence of stroke at 72 hours post-TAVI. Key secondary outcomes include the incidence of stroke and all-cause mortality up to 12 months post-TAVI, disability and cognitive outcomes, stroke severity, access site complications and a health economics analysis. The sample size of 7,730 participants has 80% power to detect a 33% relative risk reduction from a 3% incidence of the primary outcome in the controls. Trial recruitment commenced in October 2020. As of October 2022, 3,068 patients have been enrolled. BHF PROTECT-TAVI is designed to provide definitive evidence on the clinical efficacy and cost-effectiveness of using routine CEP with the SENTINEL device to reduce stroke in TAVI.
Collapse
Affiliation(s)
- Rajesh K Kharbanda
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Department of Cardiovascular Medicine, University of Oxford, Oxford, UK
| | - Alexander David Perkins
- Clinical Trials Unit and Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - James Kennedy
- Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Adrian P Banning
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Andreas Baumbach
- Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, UK and Barts Heart Centre, London, UK
| | - Daniel J Blackman
- Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Matthew Dodd
- Department of Cardiovascular Medicine, University of Oxford, Oxford, UK
| | - Richard Evans
- Department of Cardiovascular Medicine, University of Oxford, Oxford, UK
| | - David Hildick-Smith
- Cardiac Surgery, Cardiac Center, Royal Sussex County Hospital, Brighton, UK and Sussex University Hospitals Trust, Brighton, UK
| | - Zahra Jamal
- Department of Cardiovascular Medicine, University of Oxford, Oxford, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Stephen Palmer
- Centre for Health Economics, University of York, York, UK
| | - Rodney Stables
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Tim Clayton
- Department of Cardiovascular Medicine, University of Oxford, Oxford, UK
| |
Collapse
|
9
|
Cochrane A, Nable M, Barber A, Shah P, Kennedy J, Isseh I, Rollins A, Thatcher A, Bussa K, Mauro K, Maydosz M, Sinha S, Desai S, Psotka M. An Overlooked Contributor to CAV. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
|
10
|
Wahl M, Cochrane A, Fregoso M, Kennedy J, Aryal S. Use of Donor-Derived Cell Free Dna in Heart/Lung Transplant Recipients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
|
11
|
Kulshrestha K, Greenberg J, Kennedy J, Hogue S, Guzman-Gomez A, Cooper D, Zafar F, Morales D. In-Hospital Opioid Requirements Predict Poor Survival in Pediatric Heart Transplant. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
|
12
|
Nable M, Kumar S, Goldberg J, Cochrane A, Psotka M, Tang D, Isseh I, Desai S, Rollins A, Klein K, Bussa K, Mauro K, Maydosz M, Thatcher A, Kennedy J, Shah P. Does Echocardiography-Guided Endomyocardial Biopsy Reduce the Incidence of Tricuspid Regurgitation after Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
|
13
|
Thomas C, Klein K, Kennedy J, Psotka M, Isseh I, Tang D, Aryal S, Khangoora V, Nyquist A, Singhal A, Cantres-Fonseca O, Shlobin O, Nathan S, King C. Heart-lung Transplantation for Restrictive Cardiomyopathy and Pulmonary Hypertension Due to Emery-Dreifuss Muscular Dystrophy. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
|
14
|
Contador Mejias T, Gañan M, Rendoll-Cárcamo J, Maturana CS, Benítez HA, Kennedy J, Rozzi R, Convey P. A polar insect's tale: Observations on the life cycle of Parochlus steinenii, the only winged midge native to Antarctica. Ecology 2023; 104:e3964. [PMID: 36565174 DOI: 10.1002/ecy.3964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 11/28/2022] [Indexed: 12/25/2022]
Affiliation(s)
- Tamara Contador Mejias
- Millennium Institute Biodiversity of Antarctic and Subantarctic Ecosystems (BASE), Santiago, Chile.,Cape Horn International Center (CHIC), Puerto Williams, Chile.,Millennium Nucleus of Austral Invasive Salmonids (INVASAL), Concepción, Chile.,Sub-Antarctic Biocultural Conservation Program, Wankara Laboratory, Universidad de Magallanes, Punta Arenas, Chile
| | - Melisa Gañan
- Millennium Institute Biodiversity of Antarctic and Subantarctic Ecosystems (BASE), Santiago, Chile.,Cape Horn International Center (CHIC), Puerto Williams, Chile.,Millennium Nucleus of Austral Invasive Salmonids (INVASAL), Concepción, Chile.,Sub-Antarctic Biocultural Conservation Program, Wankara Laboratory, Universidad de Magallanes, Punta Arenas, Chile
| | - Javier Rendoll-Cárcamo
- Millennium Institute Biodiversity of Antarctic and Subantarctic Ecosystems (BASE), Santiago, Chile.,Cape Horn International Center (CHIC), Puerto Williams, Chile.,Millennium Nucleus of Austral Invasive Salmonids (INVASAL), Concepción, Chile.,Sub-Antarctic Biocultural Conservation Program, Wankara Laboratory, Universidad de Magallanes, Punta Arenas, Chile
| | - Claudia S Maturana
- Millennium Institute Biodiversity of Antarctic and Subantarctic Ecosystems (BASE), Santiago, Chile.,Cape Horn International Center (CHIC), Puerto Williams, Chile.,Sub-Antarctic Biocultural Conservation Program, Wankara Laboratory, Universidad de Magallanes, Punta Arenas, Chile
| | - Hugo A Benítez
- Millennium Institute Biodiversity of Antarctic and Subantarctic Ecosystems (BASE), Santiago, Chile.,Cape Horn International Center (CHIC), Puerto Williams, Chile.,Laboratorio de Ecología y Morfometría Evolutiva, Centro de Investigación de Estudios Avanzados del Maule, Universidad Católica del Maule, Talca, Chile
| | - James Kennedy
- Cape Horn International Center (CHIC), Puerto Williams, Chile.,Sub-Antarctic Biocultural Conservation Program, Wankara Laboratory, Universidad de Magallanes, Punta Arenas, Chile.,Department of Biological Sciences, University of North Texas, Denton, Texas, USA
| | - Ricardo Rozzi
- Cape Horn International Center (CHIC), Puerto Williams, Chile.,Sub-Antarctic Biocultural Conservation Program, Wankara Laboratory, Universidad de Magallanes, Punta Arenas, Chile.,Department of Philosophy and Religion Studies, University of North Texas, Denton, Texas, USA
| | - Peter Convey
- Millennium Institute Biodiversity of Antarctic and Subantarctic Ecosystems (BASE), Santiago, Chile.,Cape Horn International Center (CHIC), Puerto Williams, Chile.,British Antarctic Survey, NERC, Cambridge, UK.,Department of Zoology, University of Johannesburg, Johannesburg, South Africa
| |
Collapse
|
15
|
Aslam AM, Kennedy J, Seghol H, Khisty N, Nicols TA, Adie S. A randomized controlled trial of patient recall after detailed written consent versus standard verbal consent in adults with routine orthopaedic trauma. Bone Jt Open 2023; 4:104-109. [PMID: 37051851 PMCID: PMC9999121 DOI: 10.1302/2633-1462.42.bjo-2022-0148.r1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
Patient decision aids have previously demonstrated an improvement in the quality of the informed consent process. This study assessed the effectiveness of detailed written patient information, compared to standard verbal consent, in improving postoperative recall in adult orthopaedic trauma patients. This randomized controlled feasibility trial was conducted at two teaching hospitals within the South Eastern Sydney Local Health District. Adult patients (age ≥ 18 years) pending orthopaedic trauma surgery between March 2021 and September 2021 were recruited and randomized to detailed or standard methods of informed consent using a random sequence concealed in sealed, opaque envelopes. The detailed group received procedure-specific written information in addition to the standard verbal consent. The primary outcome was total recall, using a seven-point interview-administered recall questionnaire at 72 hours postoperatively. Points were awarded if the participant correctly recalled details of potential complications (maximum three points), implants used (maximum three points), and postoperative instructions (maximum one point). Secondary outcomes included the anxiety subscale of the Hospital and Anxiety Depression Scale (HADS-A) and visual analogue scale (VAS) for pain collected at 24 hours preoperatively and 72 hours postoperatively. Additionally, the Patient Satisfaction Questionnaire Short Form (PSQ-18) measured satisfaction at 72 hours postoperatively. A total of 60 patients were randomized, 32 to the standard group and 28 to the detailed group. Patients in the detailed group had significantly higher total recall score compared to the standard group (mean difference 1.29 points (95% confidence interval (CI) 0.51 to 2.08); p = 0.002). There were no differences in HADS-A (mean difference 0.39 (95% CI -2.11 to 2.88); p = 0.757), VAS pain (mean difference 5.71 (95% CI -22.25 to 11.11); p = 0.499), or PSQ-18 (mean difference 0.499; 95% CI -1.6 to 3.42; p = 0.392). Detailed written tools are useful in improving postoperative recall in adult orthopaedic trauma patients.
Collapse
Affiliation(s)
- Amjad M Aslam
- St. George and Sutherland Centre for Clinical Orthopaedic Research (SCORe), Sydney, Australia
| | | | | | | | | | - Sam Adie
- St. George and Sutherland Centre for Clinical Orthopaedic Research (SCORe), Sydney, Australia
- School of Clinical Medicine, UNSW Medicine and Health, St. George and Sutherland Campuses, Sydney, Australia
| |
Collapse
|
16
|
Lim S, Kennedy J, Chavira A, Hirsch M, Wei T, Ryu D. The profile of extreme tension wave front in aluminum. J Mater Sci 2023; 58:3360-3374. [PMID: 36817314 PMCID: PMC9925567 DOI: 10.1007/s10853-023-08244-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/21/2023] [Indexed: 06/18/2023]
Abstract
In this study, the extreme tension wave front profile (pull speed up to 1.6 km/s) in pure aluminum (density 2.7 g / cm 3 ) is analyzed using the LAMMPS molecular dynamics (MD) code and based on the tension conservation equations of mass, momentum, and energy. The simulation results agree favorably with the theoretical calculation. The profile of the extreme tension wave front is observed from the MD code simulation, and a typical shockless ramp wave front formation is identified during forced extreme tension loading. Further analysis was accomplished based on the formation of the ramp wave front, illustrating the behavior of the isentrope of aluminum under extreme tension loading.
Collapse
Affiliation(s)
| | | | | | | | - Tie Wei
- New Mexico Tech, Socorro, NM 87801 USA
| | | |
Collapse
|
17
|
Jansson E, Faust E, Bekkevold D, Quintela M, Durif C, Halvorsen KT, Dahle G, Pampoulie C, Kennedy J, Whittaker B, Unneland L, Post S, André C, Glover KA. Global, regional, and cryptic population structure in a high gene-flow transatlantic fish. PLoS One 2023; 18:e0283351. [PMID: 36940210 PMCID: PMC10027230 DOI: 10.1371/journal.pone.0283351] [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] [Received: 10/27/2022] [Accepted: 03/07/2023] [Indexed: 03/21/2023] Open
Abstract
Lumpfish (Cyclopterus lumpus) is a transatlantic marine fish displaying large population sizes and a high potential for dispersal and gene-flow. These features are expected to result in weak population structure. Here, we investigated population genetic structure of lumpfish throughout its natural distribution in the North Atlantic using two approaches: I) 4,393 genome wide SNPs and 95 individuals from 10 locations, and II) 139 discriminatory SNPs and 1,669 individuals from 40 locations. Both approaches identified extensive population genetic structuring with a major split between the East and West Atlantic and a distinct Baltic Sea population, as well as further differentiation of lumpfish from the English Channel, Iceland, and Greenland. The discriminatory loci displayed ~2-5 times higher divergence than the genome wide approach, revealing further evidence of local population substructures. Lumpfish from Isfjorden in Svalbard were highly distinct but resembled most fish from Greenland. The Kattegat area in the Baltic transition zone, formed a previously undescribed distinct genetic group. Also, further subdivision was detected within North America, Iceland, West Greenland, Barents Sea, and Norway. Although lumpfish have considerable potential for dispersal and gene-flow, the observed high levels of population structuring throughout the Atlantic suggests that this species may have a natal homing behavior and local populations with adaptive differences. This fine-scale population structure calls for consideration when defining management units for exploitation of lumpfish stocks and in decisions related to sourcing and moving lumpfish for cleaner fish use in salmonid aquaculture.
Collapse
Affiliation(s)
- Eeva Jansson
- Institute of Marine Research, Nordnes, Bergen, Norway
| | - Ellika Faust
- Department of Marine Sciences - Tjärnö Marine Laboratory, University of Gothenburg, Strömstad, Sweden
| | - Dorte Bekkevold
- DTU-Aqua National Institute of Aquatic Resources, Technical University of Denmark, Silkeborg, Denmark
| | | | - Caroline Durif
- Institute of Marine Research, Austevoll Research Station, Storebø, Norway
| | | | - Geir Dahle
- Institute of Marine Research, Nordnes, Bergen, Norway
| | | | - James Kennedy
- Marine and Freshwater Research Institute, Hafnarfjörður, Iceland
| | - Benjamin Whittaker
- Department of Biosciences, Centre for Sustainable Aquatic Research, Swansea University, Swansea, United Kingdom
| | | | - Søren Post
- Greenland Institute of Natural Resources, Nuuk, Greenland
| | - Carl André
- Department of Marine Sciences - Tjärnö Marine Laboratory, University of Gothenburg, Strömstad, Sweden
| | | |
Collapse
|
18
|
Mays D, Friedman A, Kennedy J, Yiannias J, Morgan J. Non-adherence to Labeling Standards Can Misrepresent Safety of Ingredients in Cosmetic Cleansers. J Drugs Dermatol 2023; 22:98-100. [PMID: 36607752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
US Labeling requirements for cosmetic products are established by the US Food and Drug Administration (USFDA) and detailed in the Code of Federal Regulations (21 CFR 701.3).1 Over 16,000 cosmetic ingredients names have been documented and ingredient nomenclature resources are recommended by the USFDA for use by manufacturers and suppliers.
Collapse
|
19
|
Bienz M, Gupta A, Goldstein J, Kennedy J, Lin Y. Severe acute haemolytic transfusion reaction secondary to a plasma incompatible group B platelet transfusion. Transfus Med 2022; 33:188-193. [PMID: 36380475 DOI: 10.1111/tme.12938] [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] [Received: 07/22/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To report a rare case of acute hemolytic transfusion reaction (AHTR) following an ABO plasma incompatible group B platelet transfusion. BACKGROUND AHTR is an uncommon, but potentially fatal event. Most reported cases of platelet transfusions associated with AHTR involve group O donors. CASE REPORT A 34-year-old man, recipient of a group AB haploidentical haematopoietic stem cell transplantation (HSCT), had received re-induction chemotherapy for leukaemia relapse. A group B whole blood-derived buffy coat platelet pool was transfused. He developed rigours/fever, profound hemolytic anaemia, and hemodynamic instability. Serological investigations revealed AHTR from passive transfer of high titre anti-A (256 for IgM and 8192 for IgG). DISCUSSION This case highlights the potential risks associated with ABO-mismatched transfusions, and the complexity associated with transfusing HSCT recipients and red cell transfusion recipients with dual populations of circulating red cells. The literature on minor ABO plasma incompatible transfusions, challenges in establishing local policies to limit the risks of AHTR and risk mitigation strategies are discussed. CONCLUSION Clinicians must maintain a high level of suspicion for AHTR after ABO plasma incompatible platelet transfusions. Patients must be aware of the risks of AHTR, and early recognition and diagnosis of this complication may be lifesaving.
Collapse
Affiliation(s)
- Marc Bienz
- Department of Laboratory Medicine and Pathobiology University of Toronto Toronto Ontario Canada
| | - Akash Gupta
- Department of Laboratory Medicine and Pathobiology University of Toronto Toronto Ontario Canada
- Precision Diagnostics and Therapeutics Program Sunnybrook Health Sciences Centre Toronto Ontario Canada
- University of Toronto Quality in Utilization Education and Safety in Transfusion (QUEST) Research Program Toronto Ontario Canada
| | - Jenette Goldstein
- Precision Diagnostics and Therapeutics Program Sunnybrook Health Sciences Centre Toronto Ontario Canada
| | - James Kennedy
- Division of Medical Oncology and Haematology, Department of Medicine Sunnybrook Health Sciences Centre Toronto Ontario Canada
| | - Yulia Lin
- Department of Laboratory Medicine and Pathobiology University of Toronto Toronto Ontario Canada
- Precision Diagnostics and Therapeutics Program Sunnybrook Health Sciences Centre Toronto Ontario Canada
- University of Toronto Quality in Utilization Education and Safety in Transfusion (QUEST) Research Program Toronto Ontario Canada
| |
Collapse
|
20
|
Oputa TJ, Plastow R, Kennedy J, Jain N. There is no difference in the complication or re-operation rates between tension band wiring and locking plate fixation for olecranon fractures. The findings of a multicentre study. Arch Orthop Trauma Surg 2022; 142:3341-3345. [PMID: 34581860 DOI: 10.1007/s00402-021-04159-6] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Tension band wire (TBW) and locking plate fixation (LPF) are widely used fixation methods for displaced fractures of the olecranon. The aim of our study was to review the current operative management of olecranon fractures and compare the complication and re-operation rates for patients undergoing TBW and LPF. MATERIALS AND METHODS Retrospective data were collected for all patients who underwent acute fixation of olecranon fractures in 2016 across nine hospitals in the United Kingdom. We reviewed these cases to determine the incidence of complications and re-operations. RESULTS One hundred and forty patients were included in the study. Seventy-three (52%) had TBW, 67 (48%) had LPF. Males were more likely to have LPF (p = 0.01) as were patients with comminuted fractures (p < 0.01). The overall complication rate was 25%, including an infection rate of 3%, a prominent metalwork irritation rate of 12% and the overall re-operation rate was 17%. There was no significant difference in the complication rate (p = 0.38), infection rate (p = 0.92) or rate of prominent metalwork irritation (p = 0.10) between patients undergoing TBW and LPF. Sub group analysis of patients with comminuted fractures also demonstrated no significant difference in complication rates (p = 0.75) or re-operation rates (p = 0.26). CONCLUSION LPF has previously been advocated to be advantageous to TBW due to lower reported complication and re-operation rates despite there being no significant difference in functional outcomes. In this multicentre case series, which is the largest in the literature to date, we did not observe any significant differences in complication rates or re-operation rates between the two, even amongst comminuted fractures (which are traditionally treated with LPF), when decision making was left to surgeon preference. We, therefore, recommend that choice of fixation method should be left to individual surgeon's preference.
Collapse
Affiliation(s)
- Tobenna J Oputa
- Trauma and Orthopaedics, Health Education North West, Manchester, M1 3BN, UK.
| | - Ricci Plastow
- Trauma and Orthopaedics, Health Education North West, Manchester, M1 3BN, UK
| | - James Kennedy
- Trauma and Orthopaedics, Health Education North West, Manchester, M1 3BN, UK
| | - Neil Jain
- Department of Trauma and Orthopaedics, Pennine Acute Hospitals, North Manchester General Hospital, Delaunay's Road, Manchester, M8 5RB, UK
| | | |
Collapse
|
21
|
Spartera M, Stracquadanio A, Von Ende A, Pessoa-Amorim G, Hess A, Young V, Mazzucco S, Kennedy J, Ferreira V, Neubauer S, Casadei B, Wijesurendra R. Left atrial vorticity is independently associated with embolic brain infarcts and represents a promising imaging biomarker of cardioembolism in sinus rhythm and atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.274] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is associated with embolic stroke, but risk scores such as CHA2DS2-VASc perform only modestly (C statistics 0.6–0.7). Meanwhile, up to 25% of embolic strokes in patients without AF have no identifiable cause, and occult left atrial (LA) thromboembolism may be a relevant mechanism in such cases.
Purpose
We hypothesised that imaging of left atrial blood flow could improve embolic risk prediction in patients with and without AF. We used 4D flow magnetic resonance imaging (MRI) to identify a biomarker that is: (a) independently associated with embolic brain infarction by brain MRI, (b) able to stratify blood flow characteristics both during AF and in sinus rhythm (SR), and (c) reproducible.
Methods
We recruited 3 patient cohorts to respectively address each aim. Firstly, to assess the association between LA flow parameters and embolic brain infarcts, we recruited cohort A, consisting of 134 patients (41% female; age 70±9 years) with a history of ischaemic stroke (N=44) or no history of stroke but with CHA2DS2VASc score ≥1 (N=90). Next, the sensitivity of 4D flow parameters to rhythm change was assessed in cohort B: 37 patients with persistent AF studied before and after cardioversion, whose results were compared with those of 23 healthy controls in SR [CHA2DS2-VASc = 0.0 (0.0–0.0)]. Finally, scan-rescan coefficients of variation (CV) and interval-scan CV at 30 days were determined in Cohort C (86 subjects; 64 in SR, 22 in AF). Brain MRI was used to identify large non-cortical or cortical brain infarcts (LNCCI) – i.e. infarcts likely to be embolic in origin.
Results
At least one LNCCI was present in 39 of 134 patients in cohort A. Lower LA vorticity was significantly associated with higher risk of prevalent LNCCIs (Figure 1), after adjustment for AF, age, and CHA2DS2VASc score [OR=2.10 (95% CI 1.12–3.92) per SD, P=0.02]. This association remained significant after further adjustment for other cardiac parameters (all P<0.05, Figure 1). By contrast, there was no significant association between peak velocity and LNCCIs (P=0.21).
LA vorticity was sensitive to rhythm change, improving significantly in patients in cohort B in SR at ≥4 weeks after cardioversion (CV) of persistent AF (Figure 2A, paired P<0.001 vs pre-CV), but remained impaired compared to healthy controls (Figure 2B, P<0.01).
Finally, reproducibility studies in cohort C showed that LA vorticity had a same-day scan-rescan CV of 7% without significant differences between SR and AF subjects (P>0.05), and also showed no significant temporal variability on interval scanning (P>0.05).
Conclusions
LA vorticity is reproducible, sensitive to changes in heart rhythm, and independently associated with embolic brain infarcts, suggesting a promising imaging biomarker of cardioembolism in SR and AF. LA blood flow imaging could improve stroke prediction and the personalisation of decisions about anticoagulation, regardless of heart rhythm.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Oxford BRC, BHF
Collapse
Affiliation(s)
- M Spartera
- University of Oxford , Oxford , United Kingdom
| | | | - A Von Ende
- University of Oxford , Oxford , United Kingdom
| | | | - A Hess
- University of Oxford , Oxford , United Kingdom
| | - V Young
- University of Oxford , Oxford , United Kingdom
| | - S Mazzucco
- University of Oxford , Oxford , United Kingdom
| | - J Kennedy
- University of Oxford , Oxford , United Kingdom
| | - V Ferreira
- University of Oxford , Oxford , United Kingdom
| | - S Neubauer
- University of Oxford , Oxford , United Kingdom
| | - B Casadei
- University of Oxford , Oxford , United Kingdom
| | | |
Collapse
|
22
|
Pandya S, Le T, Demissie S, Zaky A, Arjmand S, Patel N, Moko L, Garces J, Rivera P, Singer K, Fedoriv I, Garcia Z, Kennedy J, Makkapati B, Mukherjee I, Szerszen A, Gross J, Glinik G, Younan D. The Association of Gender and Mortality in Geriatric Trauma Patients. Healthcare (Basel) 2022; 10:healthcare10081472. [PMID: 36011129 PMCID: PMC9407800 DOI: 10.3390/healthcare10081472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022] Open
Abstract
The association of gender with mortality in trauma remains a subject of debate. Geriatric trauma patients have a higher risk of mortality compared to younger patients. We sought to evaluate the association of gender with mortality in a group of geriatric trauma patients presenting to an academic level 1 trauma center (trauma center designated by New York State capable of handling the most severe injuries and most complex cases). Methods: We performed a retrospective review of geriatric trauma patients who were admitted to our trauma center between January 2018 and December 2020. Data collected included vital signs, demographics, injury, and clinical characteristics, laboratory data and outcome measures. The study controlled for co-morbidities, injury severity score (ISS), and systolic blood pressure (SBP) in the ED. Multivariable logistic regression analysis was performed to evaluate the association of gender and mortality. Results: 4432 geriatric patients were admitted during the study period, there were 1635 (36.9%) men and 3859 (87.2%) were White with an average age of 81 ± 8.5 years. The mean ISS was 6.7 ± 5.4 and average length of stay was 6 ± 6.3 days. There were 165 deaths. Male gender (OR 1.94, 95% CI 1.38 to 2.73), ISS (OR 1.12, 95% CI 1.09 to 1.14), Emergency Department SBP less than 90 mmHg (OR 6.17, 95% CI 3.17 to 12.01), and having more than one co-morbidity (OR 2.28, 95% CI 1.55 to 3.35) were independently predictive of death on multivariable logistic regression analysis. Conclusion: Male gender, Emergency Department systolic blood pressure less than 90 mmHg, having more than one co-morbidity, and injury severity are independent predictors of mortality among geriatric trauma patients.
Collapse
Affiliation(s)
- Shreya Pandya
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Timothy Le
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Seleshi Demissie
- Biostatistics Unit, Feinstein Institutes for Medical Research, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Ahmed Zaky
- Department of Anesthesia, The University of Alabama in Birmingham, Birmingham, AL 35294, USA
| | - Shadi Arjmand
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Nikhil Patel
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Lilamarie Moko
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Juan Garces
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Paula Rivera
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Kiara Singer
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Ivan Fedoriv
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Zachery Garcia
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - James Kennedy
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Bhavana Makkapati
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Indraneil Mukherjee
- Department of Surgery, Division of Minimally Invasive Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Anita Szerszen
- Department of Medicine, Division of Geriatric Medicine, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Jonathan Gross
- Department of Orthopedics, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Galina Glinik
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Duraid Younan
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
- Correspondence:
| |
Collapse
|
23
|
Msayib Y, Harston GWJ, Ray KJ, Larkin JR, Sutherland BA, Sheerin F, Blockley NP, Okell TW, Jezzard P, Baldwin A, Sibson NR, Kennedy J, Chappell MA. Quantitative chemical exchange saturation transfer imaging of nuclear overhauser effects in acute ischemic stroke. Magn Reson Med 2022; 88:341-356. [PMID: 35253936 PMCID: PMC9314583 DOI: 10.1002/mrm.29187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE In chemical exchange saturation transfer imaging, saturation effects between - 2 to - 5 ppm (nuclear Overhauser effects, NOEs) have been shown to exhibit contrast in preclinical stroke models. Our previous work on NOEs in human stroke used an analysis model that combined NOEs and semisolid MT; however their combination might feasibly have reduced sensitivity to changes in NOEs. The aim of this study was to explore the information a 4-pool Bloch-McConnell model provides about the NOE contribution in ischemic stroke, contrasting that with an intentionally approximate 3-pool model. METHODS MRI data from 12 patients presenting with ischemic stroke were retrospectively analyzed, as well as from six animals induced with an ischemic lesion. Two Bloch-McConnell models (4 pools, and a 3-pool approximation) were compared for their ability to distinguish pathological tissue in acute stroke. The association of NOEs with pH was also explored, using pH phantoms that mimic the intracellular environment of naïve mouse brain. RESULTS The 4-pool measure of NOEs exhibited a different association with tissue outcome compared to 3-pool approximation in the ischemic core and in tissue that underwent delayed infarction. In the ischemic core, the 4-pool measure was elevated in patient white matter ( 1 . 20 ± 0 . 20 ) and in animals ( 1 . 27 ± 0 . 20 ). In the naïve brain pH phantoms, significant positive correlation between the NOE and pH was observed. CONCLUSION Associations of NOEs with tissue pathology were found using the 4-pool metric that were not observed using the 3-pool approximation. The 4-pool model more adequately captured in vivo changes in NOEs and revealed trends depending on tissue pathology in stroke.
Collapse
Affiliation(s)
- Yunus Msayib
- Institute of Biomedical Engineering, Department of Engineering ScienceUniversity of OxfordOxfordUK
| | - George W. J. Harston
- Acute Vascular Imaging Centre, Radcliffe Department of MedicineUniversity of OxfordOxfordUK
| | - Kevin J. Ray
- Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - James R. Larkin
- Department of Oncology, CRUK and MRC Oxford Institute for Radiation OncologyUniversity of OxfordOxfordUK
| | - Brad A. Sutherland
- Acute Vascular Imaging Centre, Radcliffe Department of MedicineUniversity of OxfordOxfordUK
- School of MedicineUniversity of TasmaniaHobartTasmaniaAustralia
| | - Fintan Sheerin
- Acute Vascular Imaging Centre, Radcliffe Department of MedicineUniversity of OxfordOxfordUK
| | - Nicholas P. Blockley
- Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - Thomas W. Okell
- Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - Peter Jezzard
- Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | | | - Nicola R. Sibson
- Department of Oncology, CRUK and MRC Oxford Institute for Radiation OncologyUniversity of OxfordOxfordUK
| | - James Kennedy
- Acute Vascular Imaging Centre, Radcliffe Department of MedicineUniversity of OxfordOxfordUK
| | - Michael A. Chappell
- Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Sir Peter Mansfield Imaging Center, School of MedicineUniversity of NottinghamNottinghamUK
- Mental Health & Clinical Neuroscience, School of Medicine, University of NottinghamNottinghamUK
| |
Collapse
|
24
|
Panimalar S, Subash M, Chandrasekar M, Uthrakumar R, Inmozhi C, Al-Onazi WA, Al-Mohaimeed AM, Chen TW, Kennedy J, Maaza M, Kaviyarasu K. Reproducibility and long-term stability of Sn doped MnO 2 nanostructures: Practical photocatalytic systems and wastewater treatment applications. Chemosphere 2022; 293:133646. [PMID: 35063549 DOI: 10.1016/j.chemosphere.2022.133646] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/03/2022] [Accepted: 01/13/2022] [Indexed: 06/14/2023]
Abstract
Sn-doped MnO2 were synthesized as an oxidant, a mediator of maleic acid (C4H4O4) and SnCl2 as doping ingredient via a basic sol-gel reaction with KMnO4. XRD study signposts that tetragonal crystal structure of MnO2 (ICDD#44-0141) with a plane group of 12/m (87) for both pure and Sn doped MnO2 nanostructures. The photocatalyst synthesized has mesoporosity, allowing to the N2 adsorption/desorption experiments. The geometry of the materials varies from spherical shape in pristine MnO2 to a rod-like shape in Sn-MnO2, as observed in the SEM and TEM pictures. To examine optic properties and energy bandgaps topologies, UV-visible diffuse reflectance spectroscopy was applied. In visible spectrum, overall catalytic performance of Sn-doped MnO2 was tested using methyl orange and phenol as dyes. The results suggest that the optimized Sn doped MnO2 (10 wt.%) catalyst showed higher degradation efficiency (98.5%), apparent constant (0.7841 min-1) and long term permanence. For this improved charge extraction efficiency, a potential photocatalytic mechanism was proposed.
Collapse
Affiliation(s)
- S Panimalar
- Department of Physics, Periyar University, Salem, 636011, Tamil Nadu, India
| | - M Subash
- Department of Physics, Govt. Arts College (Autonomous), Salem, 636007, Tamil Nadu, India
| | - M Chandrasekar
- Department of Physics, Periyar University, Salem, 636011, Tamil Nadu, India
| | - R Uthrakumar
- Department of Physics, Govt. Arts College (Autonomous), Salem, 636007, Tamil Nadu, India
| | - C Inmozhi
- Department of Physics, Govt. Arts College for Women, Salem, 636008, Tamil Nadu, India.
| | - Wedad A Al-Onazi
- Department of Chemistry, College of Science, King Saud University, P.O. Box 22452, Riyadh, 11495, Saudi Arabia
| | - Amal M Al-Mohaimeed
- Department of Chemistry, College of Science, King Saud University, P.O. Box 22452, Riyadh, 11495, Saudi Arabia
| | - Tse-Wei Chen
- Department of Materials, Imperial College London, London, SW7 2AZ, United Kingdom
| | - J Kennedy
- National Isotope Centre, GNS Science, PO Box 31312, Lower Hutt, 5010, New Zealand
| | - M Maaza
- UNESCO-UNISA Africa Chair in Nanosciences/Nanotechnology Laboratories, College of Graduate Studies, University of South Africa (UNISA), Muckleneuk Ridge, PO Box 392, Pretoria, South Africa; Nanosciences African Network (NANOAFNET), Materials Research Group (MRG), iThemba LABS-National Research Foundation (NRF), 1 Old Faure Road, 7129, PO Box 722, Somerset West, Western Cape Province, South Africa
| | - K Kaviyarasu
- UNESCO-UNISA Africa Chair in Nanosciences/Nanotechnology Laboratories, College of Graduate Studies, University of South Africa (UNISA), Muckleneuk Ridge, PO Box 392, Pretoria, South Africa; Nanosciences African Network (NANOAFNET), Materials Research Group (MRG), iThemba LABS-National Research Foundation (NRF), 1 Old Faure Road, 7129, PO Box 722, Somerset West, Western Cape Province, South Africa.
| |
Collapse
|
25
|
Panimalar S, Logambal S, Thambidurai R, Inmozhi C, Uthrakumar R, Muthukumaran A, Rasheed RA, Gatasheh MK, Raja A, Kennedy J, Kaviyarasu K. Effect of Ag doped MnO 2 nanostructures suitable for wastewater treatment and other environmental pollutant applications. Environ Res 2022; 205:112560. [PMID: 34915030 DOI: 10.1016/j.envres.2021.112560] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/15/2021] [Accepted: 12/07/2021] [Indexed: 06/14/2023]
Abstract
A modest sol-gel method has been employed to prepare the pure and Ag doped MnO2 nanoparticles and methodologically studied their physical, morphological, and photosensitive properties through XRD, TEM, EDAX, Raman, UV, PL and N2 adsorption - desorption study. Tetragonal crystalline arrangement with spherical nanoparticles was found out through XRD and TEM studies. The EDAX studies further supported that formation Ag in the MnO2 crystal matrix. The bandgap energy of Ag doped MnO2 was absorbed through UV spectra. Photo -generated recombination process and surface related defects were further recognized by PL spectra. Through visible light irradiation, the photo - degradation of methyl orange (MO) and phenol dye solutions were observed. The optimum condition of (10 wt% of Ag) Ag doped MnO2 catalyst showed tremendous photocatalytic efficiency towards MO than phenol under same experimental study.
Collapse
Affiliation(s)
- S Panimalar
- Department of Physics, Periyar University, Salem, 636011, Tamil Nadu, India
| | - S Logambal
- Department of Physics, Government Arts College (Autonomous), Salem, 636007, Tamil Nadu, India
| | - R Thambidurai
- Department of Physics, Government Arts College (Autonomous), Salem, 636007, Tamil Nadu, India
| | - C Inmozhi
- Department of Physics, Government Arts College for Women, Salem, 636008, Tamil Nadu, India.
| | - R Uthrakumar
- Department of Physics, Government Arts College (Autonomous), Salem, 636007, Tamil Nadu, India
| | - Azhaguchamy Muthukumaran
- Department of Biotechnology, Kalasalingam Academy of Research and Education, Krishnankoil, Tamilnadu, India
| | - Rabab Ahmed Rasheed
- Histology & Cell Biology Department, Faculty of Medicine, King Salman International University, South Sinai, Egypt
| | - Mansour K Gatasheh
- Department of Biochemistry, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - A Raja
- Department of Chemistry, College of Natural Sciences, Yeungnam University, Gyeongsan, Gyeongbuk, 38541, Republic of Korea
| | - J Kennedy
- National Isotope Centre, GNS Science, PO Box 31312, Lower Hutt, 5010, New Zealand
| | - K Kaviyarasu
- UNESCO-UNISA Africa Chair in Nanosciences/Nanotechnology Laboratories, College of Graduate Studies, University of South Africa (UNISA), Muckleneuk Ridge, PO Box 392, Pretoria, South Africa; Nanosciences African Network (NANOAFNET), Materials Research Group (MRG), iThemba LABS-National Research Foundation (NRF), 1 Old Faure Road, 7129, PO Box 722, Somerset West, Western Cape Province, South Africa.
| |
Collapse
|
26
|
Yip TCF, Lee HW, Chan WK, Wong GLH, Wong VWS, Armstrong MJ, Pose E, Brenner EJ, Cargill T, Catana MA, Dhanasekaran R, Eshraghian A, García-Juárez I, Gill US, Jones PD, Kennedy J, Marshall A, Matthews C, Mells G, Mercer C, Perumalswami PV, Avitabile E, Qi X, Su F, Ufere NN, Wong YJ, Zheng MH, Barnes E, Barritt AS, Webb GJ. Asian perspective on NAFLD-associated HCC. J Hepatol 2022; 76:726-734. [PMID: 34619251 DOI: 10.1016/j.jhep.2021.09.024] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/10/2021] [Accepted: 09/18/2021] [Indexed: 12/18/2022]
Abstract
Recent data suggest that non-alcoholic fatty liver disease (NAFLD) has become a major public health problem in Asia, with an updated population prevalence of 34%. In parallel, NAFLD-associated hepatocellular carcinoma (HCC) is also on the rise. In this review, we describe the changing epidemiology of HCC in Asia over the past 30 years. While traditional risk factors for HCC (older age, male sex and metabolic factors) are also important in Asia, the PNPLA3 gene polymorphism is particularly prevalent in East Asia and may increase the risk of HCC. NAFLD among non-obese individuals is also commonly described in Asia. Because NAFLD is often undiagnosed, few patients receive HCC surveillance, and the target surveillance population beyond patients with cirrhosis remains poorly defined. As a result, NAFLD-associated HCC is often diagnosed at an advanced stage, rendering curative treatment impossible. Finally, despite around 20-30 years of universal vaccination, chronic HBV infection remains prevalent in Asia, and emerging evidence highlights the importance of metabolic factors and concomitant hepatic steatosis on HCC development in infected patients. Future studies should explore the role of metabolic treatments in HCC prevention among patients with hepatic steatosis and concomitant liver diseases.
Collapse
Affiliation(s)
- Terry Cheuk-Fung Yip
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; Medical Data Analytics Centre, The Chinese University of Hong Kong, Hong Kong; State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - Hye Won Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Wah Kheong Chan
- Gastroenterology and Hepatology Unit, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Grace Lai-Hung Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; Medical Data Analytics Centre, The Chinese University of Hong Kong, Hong Kong; State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - Vincent Wai-Sun Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; Medical Data Analytics Centre, The Chinese University of Hong Kong, Hong Kong; State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong.
| | | | - Elisa Pose
- Liver Unit, Hospital Clínic, Barcelona, Spain Institut d'Investigacions Biomèdiques, August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain
| | - Erica J Brenner
- Division of Pediatric Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Tamsin Cargill
- Oxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Maria-Andreea Catana
- Division of Gastroenterology/Hepatology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Renumathy Dhanasekaran
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Ahad Eshraghian
- Shiraz Transplant Center, Abu-Ali Sina Hospital, Shiraz, Iran
| | - Ignacio García-Juárez
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Upkar S Gill
- Barts Liver Centre, Barts Health NHS Trust & Barts & The London School of Medicine & Dentistry, QMUL, London, UK
| | - Patricia D Jones
- Division of Digestive Health and Liver Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - James Kennedy
- Oxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | | | - Charmaine Matthews
- Department of Gastroenterology and Hepatology, Royal Liverpool Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - George Mells
- Cambridge Liver Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK
| | - Carolyn Mercer
- Oxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Ponni V Perumalswami
- Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Emma Avitabile
- Liver Unit, Hospital Clínic, Barcelona, Spain Institut d'Investigacions Biomèdiques, August Pi i Sunyer, Barcelona, Spain
| | - Xialong Qi
- CHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou, China
| | - Feng Su
- Division of Gastroenterology, University of Washington, Seattle, WA, USA
| | - Nneka N Ufere
- Liver Center, Gastrointestinal Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Yu Jun Wong
- Department of Gastroenterology & Hepatology, Changi General Hospital Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ming-Hua Zheng
- MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China; Key Laboratory of Diagnosis and Treatment for The Development of Chronic Liver Disease, Zhejiang Province, Wenzhou, Zhejiang, China
| | - Eleanor Barnes
- Oxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Alfred S Barritt
- Division of Gastroenterology and Hepatology, University of North Carolina, North Carolina, USA
| | - Gwilym J Webb
- Oxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK; Cambridge Liver Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK
| |
Collapse
|
27
|
Bourgault Z, Matheson J, Mann RE, Brands B, Wickens CM, Tiwari AK, Zai CC, Kennedy J, Le Foll B. Mu opioid receptor gene variant modulates subjective response to smoked cannabis. Am J Transl Res 2022; 14:623-632. [PMID: 35173880 PMCID: PMC8829626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
The mu-opioid receptor (MOR) mediates the rewarding properties of many psychoactive drugs and is an important target in the treatment of addictions. Functional interactions between the opioid and endocannabinoid systems are established and have been hypothesized to contribute to the effects of cannabis. We investigated associations between three single nucleotide polymorphisms in the MOR gene OPRM1 (rs1799971, rs2281617, and rs510769) and subjective responses to smoked cannabis. Fifty-two regular cannabis users (1-4 days/week) were given a cannabis cigarette (12.5% THC) and rated their subjective responses on visual analog scales at baseline and at multiple time points after smoking. Blood samples were collected for THC quantification. There was a significant impact of the intronic variant rs510769 on subjective cannabis effects and THC blood levels. The influence of this gene variant may thus be mediated by pharmacodynamics and/or pharmacokinetic factors. We provide novel evidence that variability in OPRM1 contributes to individual responses to cannabis and may affect risk of cannabis use disorder. Our findings add to the growing body of literature on the genetic basis of individual responses to cannabis and may have implications for targeting the endogenous opioid system in the treatment of cannabis use disorder.
Collapse
Affiliation(s)
- Zoe Bourgault
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, University of Toronto33 Ursula Franklin Street, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of TorontoToronto, ON, Canada
| | - Justin Matheson
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, University of Toronto33 Ursula Franklin Street, Toronto, ON, Canada
| | - Robert E Mann
- Institute for Mental Health Policy Research, Centre for Addiction and Mental HealthToronto, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental HealthToronto, Ontario, Canada
- Dalla Lana School of Public Health, University of TorontoToronto, Ontario, Canada
| | - Bruna Brands
- Department of Pharmacology and Toxicology, University of TorontoToronto, ON, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental HealthToronto, Canada
- Controlled Substances and Cannabis Directorate, Health CanadaOttawa, Canada
| | - Christine M Wickens
- Department of Pharmacology and Toxicology, University of TorontoToronto, ON, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental HealthToronto, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental HealthToronto, Ontario, Canada
- Dalla Lana School of Public Health, University of TorontoToronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of TorontoToronto, Ontario, Canada
| | - Arun K Tiwari
- Neurogenetics Section, Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science, Campbell Family Mental Health Research InstituteCAMH, Toronto, ON, Canada
- Department of Psychiatry, University of TorontoToronto, ON, Canada
| | - Clement C Zai
- Neurogenetics Section, Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science, Campbell Family Mental Health Research InstituteCAMH, Toronto, ON, Canada
- Department of Psychiatry, University of TorontoToronto, ON, Canada
- Institute of Medical Science, University of TorontoToronto, ON, Canada
- Laboratory Medicine and Pathobiology, University of TorontoON, Canada
- T.H. Chan School of Public Health, Harvard UniversityBoston, MA, USA
- Broad InstituteCambridge, MA, USA
| | - James Kennedy
- Neurogenetics Section, Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science, Campbell Family Mental Health Research InstituteCAMH, Toronto, ON, Canada
- Department of Psychiatry, University of TorontoToronto, ON, Canada
- Institute of Medical Science, University of TorontoToronto, ON, Canada
| | - Bernard Le Foll
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, University of Toronto33 Ursula Franklin Street, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of TorontoToronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental HealthToronto, Ontario, Canada
- Department of Psychiatry, University of TorontoToronto, ON, Canada
- Institute of Medical Science, University of TorontoToronto, ON, Canada
- Acute Care Program, Centre for Addiction and Mental HealthToronto, ON, Canada
- Department of Family and Community Medicine, University of TorontoToronto, ON, Canada
| |
Collapse
|
28
|
Turner J, Clarke M, George G, Jones RW, Pullinger R, Kharbanda R, Kennedy J, Hands L. Video-consultation in the Emergency Department: An Assessment of the Potential Benefit for a UK District General Hospital (Preprint). Interact J Med Res 2021; 11:e36081. [PMID: 36107488 PMCID: PMC9523531 DOI: 10.2196/36081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/15/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jane Turner
- Nuffield Department of Surgical Science, University of Oxford, Oxford, United Kingdom
| | - Malcolm Clarke
- Department of Electronic Engineering, Maynooth International Engineering College, Fuzhou, China
| | - Grizelda George
- Oxford University Hospitals National Health Service Foundation Trust, Oxford, United Kingdom
| | | | - Rick Pullinger
- Oxford University Hospitals National Health Service Foundation Trust, Oxford, United Kingdom
| | - Rajesh Kharbanda
- Oxford University Hospitals National Health Service Foundation Trust, Oxford, United Kingdom
| | - James Kennedy
- Oxford University Hospitals National Health Service Foundation Trust, Oxford, United Kingdom
| | - Linda Hands
- Nuffield Department of Surgical Science, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
29
|
Scully K, Marchetti P, Sawicki G, Uluer A, Cernadas M, Cagnina R, Kennedy J, Putman M. 4: The effect of elexacaftor/tezacaftor/ivacaftor on glycemia in adults with cystic fibrosis: A prospective continuous glucose monitoring study. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01429-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
30
|
Ansari SA, Kennedy J, Irwin B, Rogers S. 1082 Are Trauma and Orthopaedics Consultant Posts Decreasing in Frequency and Increasing in Subspecialisation? Br J Surg 2021. [DOI: 10.1093/bjs/znab259.893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
Changes to the configuration of the NHS Trauma Services in T&O and the level of subspecialisation are changing and could impact training and the number of consultant posts available at CCT. The aim of this study was to review the number of T&O Consultant posts and determine the frequency of the subspecialist requirements of these posts from 2011 to 2020, to assess the perceived reduction in advertised numbers and the increasing sub specialisation as a whole.
Method
451 volumes of the BMJ were reviewed over Jan 2011 - April 2020. The total number of jobs advertised were recorded. Additionally, for each post, sub-specialism, regional analysis and substansive or locum tenure were recorded.
Results
1141 jobs were advertised during this period. There has been a decreasing trend in the total number of advertised posts of 13% per annum. Proportion of specialty jobs remain constant yearly. However, jobs listing Trauma clearly decreased after 2012, when trauma centres were initiated. Clear decreases were present in North-west and Scotland in number of jobs. There has also been an increasing trend of advertisement of substantive posts, with locum posts forming less than 13% of total advertisements.
Conclusions
We found no significant increase in job specialism contradicting previous research. Overall, the total number of Consultant jobs in Trauma and Orthopaedics is decreasing, especially in the north-west and Scotland, two of the biggest employers. Questions must be asked for the future of training in T&O to meet service needs.
Collapse
Affiliation(s)
- S A Ansari
- St Helens and Knowsley NHS Trust, Prescot, United Kingdom
| | - J Kennedy
- Trauma and Orthopaedics Health Education England Northwest, Manchester, United Kingdom
| | - B Irwin
- University of Lancaster, Lancaster, United Kingdom
| | - S Rogers
- Trauma and Orthopaedics Health Education England Northwest, Manchester, United Kingdom
| |
Collapse
|
31
|
Al-Shahi Salman R, Keerie C, Stephen J, Lewis S, Norrie J, Dennis MS, Newby DE, Wardlaw JM, Lip GY, Parry-Jones A, White PM, Baigent C, Lasserson D, Oliver C, O'Mahony F, Amoils S, Bamford J, Armitage J, Emberson J, Rinkel GJ, Lowe G, Innes K, Adamczuk K, Dinsmore L, Drever J, Milne G, Walker A, Hutchison A, Williams C, Fraser R, Anderson R, Covil K, Stewart K, Rees J, Hall P, Bullen A, Stoddart A, Moullaali TJ, Palmer J, Sakka E, Perthen J, Lyttle N, Samarasekera N, MacRaild A, Burgess S, Teasdale J, Coakley M, Taylor P, Blair G, Whiteley W, Shenkin S, Clancy U, Macleod M, Sutherland R, Moullaali T, Barugh A, Lerpiniere C, Moreton F, Fethers N, Anjum T, Krishnan M, Slade P, Storton S, Williams M, Davies C, Connor L, Gainard G, Murphy C, Barber M, Esson D, Choulerton J, Shaw L, Lucas S, Hierons S, Avis J, Stone A, Gbadamoshi L, Costa T, Pearce L, Harkness K, Richards E, Howe J, Kamara C, Lindert R, Ali A, Rehan J, Chapman S, Edwards M, Bathula R, Cohen D, Devine J, Mpelembue M, Yesupatham P, Chhabra S, Adewetan G, Ballantine R, Brooks D, Smith G, Rogers G, Marsden S, Clark S, Wilkinson A, Brown E, Stephenson L, Nyo K, Abraham A, Pai Y, Shim G, Baliga V, Nair A, Robinson M, Hawksworth C, Greig J, Alam I, Nortcliffe T, Ramiz R, Shaw R, Parry-Jones A, Lee S, Marsden T, Perez J, Birleson E, Yadava R, Sangombe M, Stafford S, Hughes T, Knibbs L, Morse B, Schwarz S, Jelley B, White S, Richard B, Lawson H, Moseley S, Tayler M, Edwards M, Triscott C, Wallace R, Hall A, Dell A, Rashed K, Board S, Buckley C, Tanate A, Pitt-Kerby T, Beesley K, Perry J, Hellyer C, Guyler P, Menon N, Tysoe S, Prabakaran R, Cooper M, Rajapakse A, Wynter I, Smith S, Weir N, Boxall C, Yates H, Smith S, Crawford P, Marigold J, Smith F, Harvey J, Evans S, Baldwin L, Hammond S, Mudd P, Bowring A, Keenan S, Thorpe K, Haque M, Taaffe J, Temple N, Peachey T, Wells K, Haines F, Butterworth-Cowin N, Horne Z, Licenik R, Boughton H, England T, Hedstrom A, Menezes B, Davies R, Johnson V, Whittingham-Jones S, Werring D, Obarey S, Watchurst C, Ashton A, Feerick S, Francia N, Banaras A, Epstein D, Marinescu M, Williams A, Robinson A, Humphries F, Anwar I, Annamalai A, Crawford S, Collins V, Shepherd L, Siddle E, Penge J, Epstein D, Qureshi S, Krishnamurthy V, Papavasileiou V, Waugh D, Veraque E, Douglas N, Khan N, Ramachandran S, Sommerville P, Rudd A, Kullane S, Bhalla A, Birns J, Ahmed R, Gibbons M, Klamerus E, Cendreda B, Muir K, Day N, Welch A, Smith W, Elliot J, Eltawil S, Mahmood A, Hatherley K, Mitchell S, Bains H, Quinn L, Teal R, Gbinigie I, Harston G, Mathieson P, Ford G, Schulz U, Kennedy J, Nagaratnam K, Bangalore K, Bhupathiraju N, Wharton C, Fotherby K, Nasar A, Stevens A, Willberry A, Evans R, Rai B, Blake C, Thavanesan K, Hann G, Changuion T, Nix S, Whiting A, Dharmasiri M, Mallon L, Keltos M, Smyth N, Eglinton C, Duffy J, Tone E, Sykes L, Porter E, Fitton C, Kirkineziadis N, Cluckie G, Kennedy K, Trippier S, Williams R, Hayter E, Rackie J, Patel B, Rita G, Blight A, Jones V, Zhang L, Choy L, Pereira A, Clarke B, Al-Hussayni S, Dixon L, Young A, Bergin A, Broughton D, Raghunathan S, Jackson B, Appleton J, Wilkes G, Buck A, Richardson C, Clarke J, Fleming L, Squires G, Law Z, Hutchinson C, Cvoro V, Couser M, McGregor A, McAuley S, Pound S, Cochrane P, Holmes C, Murphy P, Devitt N, Osborn M, Steele A, Guthrie LB, Smith E, Hewitt J, Chaston N, Myint M, Smith A, Fairlie L, Davis M, Atkinson B, Woodward S, Hogg V, Fawcett M, Finlay L, Dixit A, Cameron E, Keegan B, Kelly J, Concannon D, Dutta D, Ward D, Glass J, O'Connell S, Ngeh J, O'Kelly A, Williams E, Ragab S, Jenkinson D, Dube J, Gleave L, Leggett J, Kissoon N, Southern L, Naghotra U, Bokhari M, McClelland B, Adie K, Mate A, Harrington F, James A, Swanson E, Chant T, Naccache M, Coutts A, Courtauld G, Whurr S, Webber S, Shead E, Luder R, Bhargava M, Murali E, Cuenoud L, Pasco K, Speirs O, Chapman L, Inskip L, Kavanagh L, Srinivasan M, Motherwell N, Mukherjee I, Tonks L, Donaldson D, Button H, Wilcox R, Hurford F, Logan R, Taylor A, Arden T, Carpenter M, Datta P, Zahoor T, Jackson L, Needle A, Stanners A, Ghouri I, Exley D, Akhtar S, Brooke H, Beadle S, O'Brien E, Francis J, McGee J, Amis E, Mitchell J, Finlay S, Sinha D, Manoczki C, King S, Tarka J, Choudhary S, Premaruban J, Sutton D, Kumar P, Culmsee C, Winckley C, Davies H, Thatcher H, Vasileiadis E, Aweid B, Holden M, Mason C, Hlaing T, Madzamba G, Ingram T, Linforth M, Cullen C, Thomas N, France J, Saulat A, Bhaskaran B, Fitzell P, Horan K, Manyoni C, Garfield-Smith J, Griffin H, Atkins S, Redome J, Muddegowda G, Maguire H, Barry A, Abano N, Varquez R, Hiden J, Lyjko S, Remegoso A, Finney K, Butler A, Strecker M, MaCleod MJ, Irvine J, Nelson S, Guzmangutierrez G, Furnace J, Taylor V, Ramadan H, Storton K, Hassan S, Abdus Sami E, Bellfield R, Stewart K, Quinn O, Patterson C, Emsley H, Gregary B, Ahmed S, Patel S, Raj S, Sultan S, Wright F, Langhorne P, Graham R, Quinn T, McArthur K. Effects of oral anticoagulation for atrial fibrillation after spontaneous intracranial haemorrhage in the UK: a randomised, open-label, assessor-masked, pilot-phase, non-inferiority trial. Lancet Neurol 2021; 20:842-853. [PMID: 34487722 DOI: 10.1016/s1474-4422(21)00264-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Oral anticoagulation reduces the rate of systemic embolism for patients with atrial fibrillation by two-thirds, but its benefits for patients with previous intracranial haemorrhage are uncertain. In the Start or STop Anticoagulants Randomised Trial (SoSTART), we aimed to establish whether starting is non-inferior to avoiding oral anticoagulation for survivors of intracranial haemorrhage who have atrial fibrillation. METHODS SoSTART was a prospective, randomised, open-label, assessor-masked, parallel-group, pilot phase trial done at 67 hospitals in the UK. We recruited adults (aged ≥18 years) who had survived at least 24 h after symptomatic spontaneous intracranial haemorrhage, had atrial fibrillation, and had a CHA2DS2-VASc score of at least 2. Web-based computerised randomisation incorporating a minimisation algorithm allocated participants (1:1) to start or avoid long-term (≥1 year) full treatment dose open-label oral anticoagulation. The participants assigned to start oral anticoagulation received either a direct oral anticoagulant or vitamin K antagonist, and the group assigned to avoid oral anticoagulation received standard clinical practice (antiplatelet agent or no antithrombotic agent). The primary outcome was recurrent symptomatic spontaneous intracranial haemorrhage, and was adjudicated by an individual masked to treatment allocation. All outcomes were ascertained for at least 1 year after randomisation and assessed in the intention-to-treat population of all randomly assigned participants, using Cox proportional hazards regression adjusted for minimisation covariates. We planned a sample size of 190 participants (one-sided p=0·025, power 90%, allowing for non-adherence) based on a non-inferiority margin of 12% (or adjusted hazard ratio [HR] of 3·2). This trial is registered with ClinicalTrials.gov (NCT03153150) and is complete. FINDINGS Between March 29, 2018, and Feb 27, 2020, consent was obtained at 61 sites for 218 participants, of whom 203 were randomly assigned at a median of 115 days (IQR 49-265) after intracranial haemorrhage onset. 101 were assigned to start and 102 to avoid oral anticoagulation. Participants were followed up for median of 1·2 years (IQR 0·97-1·95; completeness 97·2%). Starting oral anticoagulation was not non-inferior to avoiding oral anticoagulation: eight (8%) of 101 in the start group versus four (4%) of 102 in the avoid group had intracranial haemorrhage recurrences (adjusted HR 2·42 [95% CI 0·72-8·09]; p=0·152). Serious adverse events occurred in 17 (17%) participants in the start group and 15 (15%) in the avoid group. 22 (22%) patients in the start group and 11 (11%) patients in the avoid group died during the study. INTERPRETATION Whether starting oral anticoagulation was non-inferior to avoiding it for people with atrial fibrillation after intracranial haemorrhage was inconclusive, although rates of recurrent intracranial haemorrhage were lower than expected. In view of weak evidence from analyses of three composite secondary outcomes, the possibility that oral anticoagulation might be superior for preventing symptomatic major vascular events should be investigated in adequately powered randomised trials. FUNDING British Heart Foundation, Medical Research Council, Chest Heart & Stroke Scotland.
Collapse
|
32
|
Hunjan S, Sampson R, Evans J, Chenoweth H, Garrobo-Calleja I, Lekomtsev S, Zhang J, Zona S, Breuning J, Oren R, Davies M, Di-Tullio A, Euesden J, Kennedy J, Kay C, Colebrook J, Kloke B, Southgate T, Lee J. 36P In-vitro tonic signalling profiling of CAR-T cells generated to support pre-clinical studies for solid tumour targets. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
33
|
Marjot T, Buescher G, Sebode M, Barnes E, Barritt AS, Armstrong MJ, Baldelli L, Kennedy J, Mercer C, Ozga AK, Casar C, Schramm C, Moon AM, Webb GJ, Lohse AW. SARS-CoV-2 infection in patients with autoimmune hepatitis. J Hepatol 2021; 74:1335-1343. [PMID: 33508378 PMCID: PMC7835076 DOI: 10.1016/j.jhep.2021.01.021] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/24/2020] [Accepted: 01/12/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19) continues to have a devastating impact across the globe. However, little is known about the disease course in patients with autoimmune hepatitis (AIH). METHODS Data for patients with AIH and SARS-CoV-2 infection were combined from 3 international reporting registries and outcomes were compared to those in patients with chronic liver disease of other aetiology (non-AIH CLD) and to patients without liver disease (non-CLD). RESULTS Between 25th March and 24th October 2020, data were collected for 932 patients with CLD and SARS-CoV-2 infection including 70 with autoimmune hepatitis (AIH). Fifty-eight (83%) patients with AIH were taking ≥1 immunosuppressive drug. There were no differences in rates of major outcomes between patients with AIH and non-AIH CLD, including hospitalization (76% vs. 85%; p = 0.06), intensive care unit admission (29% vs. 23%; p = 0.240), and death (23% vs. 20%; p = 0.643). Factors associated with death within the AIH cohort included age (odds ratio [OR] 2.16/10 years; 1.07-3.81), and Child-Pugh class B (OR 42.48; 4.40-409.53), and C (OR 69.30; 2.83-1694.50) cirrhosis, but not use of immunosuppression. Propensity score matched (PSM) analysis comparing patients with AIH with non-AIH CLD demonstrated no increased risk of adverse outcomes including death (+3.2%; -9.2%-15.7%). PSM analysis of patients with AIH vs. non-CLD (n = 769) demonstrated increased risk of hospitalization with AIH (+18.4%; 5.6-31.2%), but equivalent risk of all other outcomes including death (+3.2%; -9.1%-15.6%). CONCLUSION Patients with AIH were not at increased risk of adverse outcomes despite immunosuppressive treatment compared to other causes of CLD and to matched cases without liver disease. LAY SUMMARY Little is known about the outcomes of COVID-19 in patients with autoimmune hepatitis (AIH), a rare chronic inflammatory liver disease. This study combines data from 3 large registries to describe the course of COVID-19 in this patient group. We show that AIH patients do not appear to have an increased risk of death from COVID-19 compared to patients with other forms of liver disease and compared to patients without liver disease, despite the use of medications which suppress the immune system.
Collapse
Affiliation(s)
- Thomas Marjot
- Oxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK.
| | - Gustav Buescher
- Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Germany
| | - Marcial Sebode
- Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Germany
| | - Eleanor Barnes
- Oxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | - A Sidney Barritt
- Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | - Luke Baldelli
- Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - James Kennedy
- Oxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Carolyn Mercer
- Oxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Ann-Kathrin Ozga
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Casar
- Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Germany
| | - Christoph Schramm
- Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Germany; Martin Zeitz Centre for Rare Diseases, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Andrew M Moon
- Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Gwilym J Webb
- Cambridge Liver Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK
| | - Ansgar W Lohse
- Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Germany.
| |
Collapse
|
34
|
Melchior P, Erlenkötter A, Zawada A, Delinski D, Schall C, Stauss-Grabo M, Kennedy J. MO676COMPLEMENT ACTIVATION BY DIALYSIS MEMBRANES AND ITS ASSOCIATION WITH SECONDARY MEMBRANE FORMATION AND SURFACE CHARGE. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab099.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and Aims
Activation of the complement system may occur during blood-membrane interactions in hemodialysis and contribute to chronic inflammation of patients with end-stage renal disease (ESRD). Hydrophilic modification with polyvinylpyrrolidone (PVP) has been suggested to increase the biocompatibility profile of dialysis membranes. In the present study we compared complement activation of synthetic and cellulose-based membranes, including the polysulfone membrane with α-tocopherol-stabilized, PVP-enriched inner surface of the novel FX CorAL dialyzer, and linked the results to their physical characteristics.
Method
Eight synthetic and cellulose-based dialyzers (FX CorAL, FX CorDiax [Fresenius Medical Care]; Polyflux, THERANOVA [Baxter]; ELISIO, SUREFLUX [Nipro]; xevonta [B. Braun]; FDX [Nikkisio Medical]) were investigated in the present study. Complement activation (C3a, C5a, sC5b-9) was evaluated in a 3h ex vivo recirculation model with human blood. Albumin sieving coefficients were determined over a 4h ex vivo recirculation model with human plasma as a surrogate of secondary membrane formation. Zeta potential was measured as an indicator for the surface charge of the membranes.
Results
The FX CorAL dialyzer induced the lowest activation of the three complement factors (C3a: -39.4%; C5a: -57.5%; sC5b-9: -58.9% compared to the reference). Highest complement activation was found for the cellulose-based SUREFLUX (C3a: +154.0%) and the FDX (C5a: +335.0%; sC5b-9: +287.9%) dialyzers. Moreover, the FX CorAL dialyzer had the nearest-to-neutral zeta potential (-2.38 mV) and the lowest albumin sieving coefficient decrease over time. Albumin sieving coefficient decrease was associated with complement activation by the investigated dialyzers.
Conclusion
Our present results indicate that the surface modification implemented in the FX CorAL dialyzer reduces secondary membrane formation and improves the biocompatibility profile. Further clinical studies are needed to investigate whether these observations will result in a lower inflammatory burden of hemodialysis patients.
Collapse
Affiliation(s)
- Pascal Melchior
- Fresenius Medical Care Deutschland GmbH, Global Research and Development, Product Engineering Center Dialyzers & Membranes, Product Development, St. Wendel, Germany
| | - Ansgar Erlenkötter
- Fresenius Medical Care Deutschland GmbH, Global Research and Development, Product Engineering Center Dialyzers & Membranes, Biosciences – Biotechnology, St. Wendel, Germany
| | - Adam Zawada
- Fresenius Medical Care Deutschland GmbH, Global Research and Development, Product Engineering Center Dialyzers & Membranes, Product Development, St. Wendel, Germany
| | - Dirk Delinski
- Fresenius Medical Care Deutschland GmbH, Global Research and Development, Product Engineering Center Dialyzers & Membranes, Product Development, St. Wendel, Germany
| | - Christian Schall
- Fresenius Medical Care Deutschland GmbH, Process Technology, Filter Production, St. Wendel, Germany
| | - Manuela Stauss-Grabo
- Fresenius Medical Care Deutschland GmbH, Global Medical Office, Clinical and Epidemiological Research, Bad Homburg, Germany
| | - James Kennedy
- Fresenius Medical Care Deutschland GmbH, Global Research and Development, Product Engineering Center Dialyzers & Membranes, Product Development, St. Wendel, Germany
| |
Collapse
|
35
|
Kempkes-Koch M, Stauss-Grabo M, Erlenkötter A, Rauber L, Kennedy J, Gauly A, Schmidt-Gürtler H. MO387CLINICAL PERFORMANCE, HEMOCOMPATIBILITY AND SAFETY OF A NEW DIALYZER WITH A MODIFIED POLYSULFONE MEMBRANE. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab082.0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Hemodialyzers containing membranes made from a blend of polysulfone and polyvinylpyrrolidone (PVP) are widely used. PVP makes the membrane material more hydrophilic to reduce interactions with plasma proteins and platelets. A modified spinning technique has been established to stabilize the PVP on the blood-side surface in the polysulfone dialysis membrane in the new dialyzer FX CorAL 600.
The objective of the present study was to prove for this new dialyzer non-inferiority of performance in comparison to established dialyzers. Further, hemocompatibility and safety of the dialyzers were explored.
Method
In a multicenter, prospective, randomized, crossover study adult patients on online hemodiafiltration (HDF) were enrolled. They were treated for one week each with on-line HDF in post-dilution mode, and in randomized order with the dialyzers FX CorAL 600, FX 600, and FX CorDiax 600 (all Fresenius Medical Care, Bad Homburg, Germany). Blood samples were taken on the midweek session before start, at the end to analyze removal rate and at 60 min to determine clearance of ß2-microglobulin, myoglobin, urea, creatinine and phosphate. Further a pattern of hemocompatibility parameters and safety was evaluated. Assuming no carry over effect, linear mixed models were used for statistical analysis.
Results
The mean age of the 49 enrolled patients was 66.3±13.6 years, 76% were male. Treatments were performed in post-dilution mode with a mean blood flow > 300 mL/min and a substitution volume >19 L.
The removal rate of ß2-microglobulin was 74.4, 70.4, and 73.1% for the FX CorAL 600, FX 600, and FX CorDiax 600 dialyzer, respectively. FX CorAL 600 proved to be statistically significantly non-inferior to FX 600 (p=0.0006) and to FX CorDiax 600 (p=0.036). The removal rate of FX CorAL 600 was by 4.0% (confidence interval 0.4 – 7.5%) significantly higher than with FX 600. The difference to FX CorDiax 600 was not significant. The clearance of ß2-microglobulin and myoglobin and the removal rate of myoglobin were significantly higher with the new dialyzer FX CorAL 600 than with the FX 600, and comparable to the FX CorDiax 600. Performance for small molecules was similar for all dialyzers.
The complement factors C3a and C5a increased early in the treatment with a peak at 15 min, without differences between the three dialyzers for C3a, and for C5a with significantly lower increase at 15 min with FX CorAL 600 than for FX 600 (p=0.007); the difference of increase between FX CorAL 600 and FX CorDiax 600 was not significant (p=0.515). The course of sC5b9 was similar for all three dialyzers, with significantly lower increase at 15 min for both FX CorAL 600 (p=0.009) and FX CorDiax 600 (p=0.026) as compared to FX 600 and similar increase at 60 min for both FX CorAL 600 (p=0.573) and FX CorDiax 600 (p=0.386) as compared to FX 600. The area-under-the-curve for the course of sC5b-9 with FX CorAL 600 was significantly lower than with FX 600 (p=0.044) and comparable to FX CorDiax 600 (p=0.092). The leukocyte count showed a decrease in the first 15 min of the treatment, which recovered afterwards, similarly for all treatment phases with the different dialyzers. Further, the dialyzers did not differ with respect to adverse events.
Conclusion
All three dialyzers showed good performance, with higher removal rates for middle molecules with the new dialyzer FX CorAL 600 compared to the FX 600. Hemocompatibility profiles were mostly similar, with lower activation of C5a and of sC5b9 with FX CorAL 600 compared to FX 600. The new dialyzer provides comparable performance levels capable of delivering adequate treatment and good tolerability for the patient.
Collapse
Affiliation(s)
| | | | - Ansgar Erlenkötter
- Fresenius Medical Care, Global Research & Development, St. Wendel, Germany
| | - Lena Rauber
- Fresenius Medical Care, Global Research & Development, St. Wendel, Germany
| | - James Kennedy
- Fresenius Medical Care, Global Research & Development, St. Wendel, Germany
| | - Adelheid Gauly
- Fresenius Medical Care, Global Medical Office, Bad Homburg, Germany
| | | |
Collapse
|
36
|
Zawada A, Melchior P, Erlenkötter A, Delinski D, Stauss-Grabo M, Kennedy J. MO658POLYVINYLPYRROLIDONE IN HEMODIALYSIS MEMBRANES: IMPACT ON PLATELET LOSS DURING HEMODIALYSIS. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab099.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and Aims
Hydrophilic modification with polyvinylpyrrolidone (PVP) increases the biocompatibility profile of synthetic dialysis membranes. However, PVP may be eluted into patient’s blood, which has been discussed as a possible cause for adverse reactions rarely occurring with synthetic membranes. We now investigated the content of PVP and its elution from the blood-side surface from commercially available dialyzers, including the novel FX CorAL with α-tocopherol-stabilized, PVP-enriched membrane, and link the results to the level of platelet loss during dialysis as a maker of biocompatibility.
Method
Six synthetic, PVP containing, dialyzers (FX CorAL, FX CorDiax [Fresenius Medical Care]; Polyflux, THERANOVA [Baxter]; ELISIO [Nipro]; xevonta [B. Braun]) were investigated in the present study. The content of PVP on blood-side surface was determined with X-ray photoelectron spectroscopy (XPS). The amount of elutable PVP was measured photometrically after 5h recirculation. The level of platelet loss was evaluated in an ex vivo recirculation model with human blood.
Results
Highest PVP content on the blood-side surface was found for the polysulfone-based FX CorAL (26.3%), while the polyethersulfone-based THERANOVA (15.6%) had the lowest PVP content. Elution of PVP was highest for the autoclave steam sterilized THERANOVA (9.1 mg/1.6m² dialyzer) and Polyflux (9.0 mg/1.6m² dialyzer), while the lowest PVP elution was found for the INLINE steam sterilized FX CorAL and FX CorDiax (< 0.5 mg/1.6m² dialyzer, for both). Highest platelet loss was found for xevonta (+164.4% compared to the reference) and the lowest for the FX CorAL (-225.2%) among the polysulfone-based dialyzers; among the polyethersulfone-based dialyzers, THERANOVA (+95.5%) had the highest and ELISIO (-52.1%) the lowest platelet loss.
Conclusion
PVP content and elution differs between commercially available dialyzers and was found to be linked to the membrane material and sterilization method. The amount of non-eluted PVP on the blood-side surface may be an important determinant for the hemocompatibility of dialyzers.
Collapse
Affiliation(s)
- Adam Zawada
- Fresenius Medical Care Deutschland GmbH, Global Research and Development, Product Engineering Center Dialyzers & Membranes, Product Development, St. Wendel, Germany
| | - Pascal Melchior
- Fresenius Medical Care Deutschland GmbH, Global Research and Development, Product Engineering Center Dialyzers & Membranes, Product Development, St. Wendel, Germany
| | - Ansgar Erlenkötter
- Fresenius Medical Care Deutschland GmbH, Global Research and Development, Product Engineering Center Dialyzers & Membranes, Biosciences – Biotechnology, St. Wendel, Germany
| | - Dirk Delinski
- Fresenius Medical Care Deutschland GmbH, Global Research and Development, Product Engineering Center Dialyzers & Membranes, Product Development, St. Wendel, Germany
| | - Manuela Stauss-Grabo
- Fresenius Medical Care Deutschland GmbH, Global Medical Office, Clinical and Epidemiological Research, Bad Homburg, Germany
| | - James Kennedy
- Fresenius Medical Care Deutschland GmbH, Global Research and Development, Product Engineering Center Dialyzers & Membranes, Product Development, St. Wendel, Germany
| |
Collapse
|
37
|
Ehlerding G, Erlenkötter A, Gauly A, Griesshaber B, Kennedy J, Rauber L, Ries W, Schmidt-Gürtler H, Stauss-Grabo M, Wagner S, Zawada AM, Zschätzsch S, Kempkes-Koch M. Performance and Hemocompatibility of a Novel Polysulfone Dialyzer: A Randomized Controlled Trial. ACTA ACUST UNITED AC 2021; 2:937-947. [PMID: 35373083 PMCID: PMC8791382 DOI: 10.34067/kid.0000302021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/06/2021] [Indexed: 11/27/2022]
Abstract
AbstractBackgroundHigh-flux dialyzers effectively remove uremic toxins, are hemocompatible to minimize intradialytic humoral and cellular stimulation, and have long-term effects on patient outcomes. A new dialyzer with a modified membrane surface has been tested for performance and hemocompatibility.MethodsThis multicenter, prospective, randomized, crossover study involved the application of the new polysulfone-based FX CorAL 600 (Fresenius Medical Care, Bad Homburg, Germany), the polyarylethersulfone-based Polyflux 170H (Baxter Healthcare Corporation, Deerfield, IL), and the cellulose triacetate–based SureFlux 17UX (Nipro Medical Europe, Mechelen, Belgium), for 1 week each, to assess the noninferiority of the FX CorAL 600’s removal rate of β2-microglobulin. Performance was assessed by removal rate and clearance of small- and medium-sized molecules. Hemocompatibility was assessed through markers of complement, cell activation, contact activation, and coagulation.ResultsOf 70 patients, 58 composed the intention-to-treat population. The FX CorAL 600’s removal rate of β2-microglobulin was noninferior to both comparators (P<0.001 versus SureFlux 17UX; P=0.0006 versus Polyflux 170H), and superior to the SureFlux 17UX. The activation of C3a and C5a with FX CorAL 600 was significantly lower 15 minutes after treatment start than with SureFlux 17UX. The activation of sC5b-9 with FX CorAL 600 was significantly lower over the whole treatment than with SureFlux 17UX, and lower after 60 minutes than with the Polyflux 170H. The treatments with FX CorAL 600 were well tolerated.ConclusionsFX CorAL 600 efficiently removed small- and medium-sized molecules, showed a favorable hemocompatibility profile, and was associated with a low frequency of adverse events in this study, with a limited patient number and follow-up time. Further studies, with longer observation times, are warranted to provide further evidence supporting the use of the new dialyzer in a wide range of therapeutic options, and for long-term treatment of patients on hemodialysis, to minimize the potential effects on inflammatory processes.
Collapse
|
38
|
Diniz BS, Vieira EM, Mendes‐Silva AP, Bowie CR, Butters MA, Fischer CE, Flint A, Herrmann N, Kennedy J, Lanctôt KL, Mah L, Pollock BG, Mulsant BH, Rajji TK. Mild cognitive impairment and major depressive disorder are associated with molecular senescence abnormalities in older adults. Alzheimers Dement (N Y) 2021; 7:e12129. [PMID: 33816758 PMCID: PMC8012242 DOI: 10.1002/trc2.12129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/10/2020] [Accepted: 11/25/2020] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The biological mechanisms linking mild cognitive impairment (MCI) and major depressive disorder are not well understood. We investigated whether molecular senescence changes in older adults are associated with a history of major depressive disorder (MDD) or MCI. METHODS We included 371 participants: 167 with MCI; 62 cognitively normal with a history of MDD; 97 with MDD+MCI; and 45 cognitively unimpaired (CU) without a history of MDD. The candidate Senescence-Associated Secretory Phenotype (SASP) biomarkers were measured in the plasma using a customized LUMINEX assay. RESULTS The MDD+MCI group had a higher SASP index than the other groups (P < .001). A higher SASP index was significantly associated with worse global cognitive performance, executive dysfunction, slower processing speed, and episodic memory deficits. DISCUSSION Our study suggests that increased molecular changes are associated with cognitive impairment in older adults with MDD and indicate that accelerated biological aging is an underlying feature of MDD.
Collapse
Affiliation(s)
- Breno S. Diniz
- Platform for Peripheral Biomarkers DiscoveryCentre for Addiction and Mental Health (CAMH)Campbell Family Mental Health Research InstituteTorontoOntarioCanada
- Adult Neurodevelopment and Geriatric Psychiatry DivisionCentre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | - Erica M. Vieira
- Platform for Peripheral Biomarkers DiscoveryCentre for Addiction and Mental Health (CAMH)Campbell Family Mental Health Research InstituteTorontoOntarioCanada
| | - Ana Paula Mendes‐Silva
- Platform for Peripheral Biomarkers DiscoveryCentre for Addiction and Mental Health (CAMH)Campbell Family Mental Health Research InstituteTorontoOntarioCanada
| | - Christopher R. Bowie
- Adult Neurodevelopment and Geriatric Psychiatry DivisionCentre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
- Department of PsychologyQueen's UniversityKingstonOntarioCanada
| | - Meryl A. Butters
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Corinne E. Fischer
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Keenan Research Centre for Biomedical ResearchSt. Michael's HospitalLi Ka Shing Knowledge InstituteTorontoOntarioCanada
| | - Alastair Flint
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Centre for Mental HealthUniversity Health NetworkTorontoOntarioCanada
| | - Nathan Herrmann
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Sunnybrook Health Sciences CentreTorontoOntarioCanada
| | - James Kennedy
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Centre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
| | - Krista L. Lanctôt
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Sunnybrook Health Sciences CentreTorontoOntarioCanada
| | - Linda Mah
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Baycrest Health Sciences CentreRotman Research InstituteTorontoOntarioCanada
| | - Bruce G. Pollock
- Adult Neurodevelopment and Geriatric Psychiatry DivisionCentre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | - Benoit H. Mulsant
- Adult Neurodevelopment and Geriatric Psychiatry DivisionCentre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | - Tarek K. Rajji
- Adult Neurodevelopment and Geriatric Psychiatry DivisionCentre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | | |
Collapse
|
39
|
Smith E, Huang J, Viswabandya A, Maze D, Malik S, Cheung V, Siddiq N, Claudio J, Arruda A, Kennedy J, Bankar A, Law AD, Lam W, Michelis FV, Kim D, Lipton J, Kumar R, Mattsson J, McNamara C, Sibai H, Xu W, Gupta V. Association of Factors Influencing Selection of Upfront Hematopoietic Cell Transplantation versus Nontransplantation Therapies in Myelofibrosis. Transplant Cell Ther 2021; 27:600.e1-600.e8. [PMID: 33798769 DOI: 10.1016/j.jtct.2021.03.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/11/2021] [Accepted: 03/22/2021] [Indexed: 11/29/2022]
Abstract
Despite the curative potential of allogeneic hematopoietic cell transplantation (HCT) for myelofibrosis (MF), a significant number of patients with MF do not undergo HCT. Factors influencing treatment preferences in these patients have not been well studied. This study was conducted to identify patient-, disease-, and donor-related factors influencing the decision regarding HCT in patients with MF. A secondary objective was to compare survival between patients who elected upfront HCT and those who opted for nontransplantation therapy. We conducted a retrospective chart review amongst patients meeting criteria for transplant indication, evaluating clinical characteristics, treatment preferences, and outcomes. Of the 183 study eligible patients age <70 years, 129 (70%) developed an HCT indication. Age >60 years was significantly associated with higher rates of HLA-typing refusal (13 of 72 versus 1 of 44; P = .02). Caucasian ethnicity was significantly associated with an increased rate of identifying well-matched donors compared with non-Caucasian ethnicity (75% versus 48%; P = .02). Of the 69 patients with well-matched donors, 34 (49%) preferred to not pursue upfront HCT despite an indication for transplantation. Patient preference for nontransplantation therapies was the most common reason for declining HCT. We did not find any difference in survival between patients pursuing upfront HCT and those opting for nontransplantation therapies, although more patients in the HCT arm were in remission at the last follow-up. Patients of Caucasian ethnicity were significantly more likely than non-Caucasian patients to identify a well-matched donor. Despite availability of a well-matched donor, a significant proportion of MF patients with an indication for transplantation do not pursue HCT. Patient age, donor type, and patient preference play major roles in the selection of upfront HCT. Although a survival difference was not observed between upfront HCT versus non-transplant therapy, more patients in the HCT arm were in remission at the last follow-up.
Collapse
Affiliation(s)
- Elliot Smith
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Jingyue Huang
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Auro Viswabandya
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Dawn Maze
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Malik
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Verna Cheung
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Nancy Siddiq
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Jaime Claudio
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Andrea Arruda
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - James Kennedy
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Aniket Bankar
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Arjun Datt Law
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Wilson Lam
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Fotios V Michelis
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Dennis Kim
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Jeffrey Lipton
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Rajat Kumar
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Jonas Mattsson
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Caroline McNamara
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Hassan Sibai
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Wei Xu
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Vikas Gupta
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
40
|
Marjot T, Moon AM, Cook JA, Abd-Elsalam S, Aloman C, Armstrong MJ, Pose E, Brenner EJ, Cargill T, Catana MA, Dhanasekaran R, Eshraghian A, García-Juárez I, Gill US, Jones PD, Kennedy J, Marshall A, Matthews C, Mells G, Mercer C, Perumalswami PV, Avitabile E, Qi X, Su F, Ufere NN, Wong YJ, Zheng MH, Barnes E, Barritt AS, Webb GJ. Outcomes following SARS-CoV-2 infection in patients with chronic liver disease: An international registry study. J Hepatol 2021; 74:567-577. [PMID: 33035628 PMCID: PMC7536538 DOI: 10.1016/j.jhep.2020.09.024] [Citation(s) in RCA: 330] [Impact Index Per Article: 110.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/22/2020] [Accepted: 09/25/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Chronic liver disease (CLD) and cirrhosis are associated with immune dysregulation, leading to concerns that affected patients may be at risk of adverse outcomes following SARS-CoV-2 infection. We aimed to determine the impact of COVID-19 on patients with pre-existing liver disease, which currently remains ill-defined. METHODS Between 25th March and 8th July 2020, data on 745 patients with CLD and SARS-CoV-2 (including 386 with and 359 without cirrhosis) were collected by 2 international registries and compared to data on non-CLD patients with SARS-CoV-2 from a UK hospital network. RESULTS Mortality was 32% in patients with cirrhosis compared to 8% in those without (p <0.001). Mortality in patients with cirrhosis increased according to Child-Pugh class (A [19%], B [35%], C [51%]) and the main cause of death was from respiratory failure (71%). After adjusting for baseline characteristics, factors associated with death in the total CLD cohort were age (odds ratio [OR] 1.02; 1.01-1.04), Child-Pugh A (OR 1.90; 1.03-3.52), B (OR 4.14; 2.4-7.65), or C (OR 9.32; 4.80-18.08) cirrhosis and alcohol-related liver disease (OR 1.79; 1.03-3.13). Compared to patients without CLD (n = 620), propensity-score-matched analysis revealed significant increases in mortality in those with Child-Pugh B (+20.0% [8.8%-31.3%]) and C (+38.1% [27.1%-49.2%]) cirrhosis. Acute hepatic decompensation occurred in 46% of patients with cirrhosis, of whom 21% had no respiratory symptoms. Half of those with hepatic decompensation had acute-on-chronic liver failure. CONCLUSIONS In the largest such cohort to date, we demonstrate that baseline liver disease stage and alcohol-related liver disease are independent risk factors for death from COVID-19. These data have important implications for the risk stratification of patients with CLD across the globe during the COVID-19 pandemic. LAY SUMMARY This international registry study demonstrates that patients with cirrhosis are at increased risk of death from COVID-19. Mortality from COVID-19 was particularly high among patients with more advanced cirrhosis and those with alcohol-related liver disease.
Collapse
Affiliation(s)
- Thomas Marjot
- Oxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK.
| | - Andrew M Moon
- Division of Gastroenterology and Hepatology, University of North Carolina, North Carolina, USA
| | - Jonathan A Cook
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Sherief Abd-Elsalam
- Tropical Medicine and Infectious diseases Department, Tanta University, Tanta, Egypt
| | - Costica Aloman
- Department of Medicine, Section of Hepatology, Rush University Medical Center, Chicago, Illinois, USA
| | | | - Elisa Pose
- Liver Unit, Hospital Clínic, Barcelona, Spain Institut d'Investigacions Biomèdiques, August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain
| | - Erica J Brenner
- Division of Pediatric Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Tamsin Cargill
- Oxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Maria-Andreea Catana
- Division of Gastroenterology/Hepatology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Renumathy Dhanasekaran
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Ahad Eshraghian
- Shiraz Transplant Center, Abu-Ali Sina Hospital, Shiraz, Iran
| | - Ignacio García-Juárez
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Upkar S Gill
- Barts Liver Centre, Barts Health NHS Trust & Barts & The London School of Medicine & Dentistry, QMUL, London, UK
| | - Patricia D Jones
- Division of Digestive Health and Liver Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - James Kennedy
- Oxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | | | - Charmaine Matthews
- Department of Gastroenterology and Hepatology, Royal Liverpool Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - George Mells
- Cambridge Liver Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK
| | - Carolyn Mercer
- Oxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Ponni V Perumalswami
- Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Emma Avitabile
- Liver Unit, Hospital Clínic, Barcelona, Spain Institut d'Investigacions Biomèdiques, August Pi i Sunyer, Barcelona, Spain
| | - Xialong Qi
- CHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou, China
| | - Feng Su
- Division of Gastroenterology, University of Washington, Seattle, WA, USA
| | - Nneka N Ufere
- Liver Center, Gastrointestinal Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Yu Jun Wong
- Department of Gastroenterology & Hepatology, Changi General Hospital Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ming-Hua Zheng
- MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China; Key Laboratory of Diagnosis and Treatment for The Development of Chronic Liver Disease, Zhejiang Province, Wenzhou, Zhejiang, China
| | - Eleanor Barnes
- Oxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Alfred S Barritt
- Division of Gastroenterology and Hepatology, University of North Carolina, North Carolina, USA
| | - Gwilym J Webb
- Oxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK; Cambridge Liver Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK
| |
Collapse
|
41
|
Petrosan A, Zassman S, Cohn S, Guerra M, Soares K, Kennedy J, Abdelghany O, Gutman E. Impact of Intravenous Methadone Administered Intraoperatively on Postoperative Opioid Utilization. Ann Pharmacother 2021; 55:1341-1346. [PMID: 33615830 DOI: 10.1177/1060028021997390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Studies have shown that intravenous methadone intraoperatively can reduce opioid usage postoperatively. OBJECTIVE This study's purpose was to evaluate the effect of intravenous methadone on postoperative opioid use. METHODS A prospective, single-center observational study was conducted to evaluate patients who received intravenous methadone intraoperatively. A control group was identified by matching procedure, gender, and age in a 1:3 ratio of methadone to control. Exclusion criteria included patients less than 18 years old or on methadone maintenance therapy. The primary outcome was morphine milligram equivalents (MME) administered 24h postoperatively. Secondary outcomes included MME administered 48h and 72h postoperatively, discharge prescription MME, daily mean postoperative pain scores, and length of hospital stay. A subgroup analysis was performed comparing opioid-naïve patients. RESULTS A total of 240 patients were included in the analysis. At 24h, postoperative MME was increased in the methadone group (142.6 vs 84.5; P = 0.0026). Postoperative MME was also increased in the methadone group at 48h and 72h. Daily pain scores were similar between both groups at all time intervals. Discharge prescription MME was reduced in the methadone group compared with controls, but not statistically significant. A subgroup analysis of opioid-naïve patients showed a significant reduction in MME at 48h (P = 0.0240) and daily pain scores at 24h (P = 0.0366) in the methadone group. CONCLUSION AND RELEVANCE Intravenous methadone intraoperatively did not show a significant reduction in postoperative opioid use and discharge prescription MMEs when comparing all patients; however, benefit was seen when examining opioid-naïve patients.
Collapse
Affiliation(s)
| | | | - Sara Cohn
- Yale New Haven Hospital, New Haven, CT, USA
| | | | | | | | | | | |
Collapse
|
42
|
Gañan M, Contador T, Rendoll J, Simoes F, Carolina Pérez, Graham G, Castillo S, Kennedy J, Convey P. Records of Parochlus steinenii in the Maritime Antarctic and sub-Antarctic regions. Zookeys 2021; 1011:63-71. [PMID: 33551650 PMCID: PMC7835200 DOI: 10.3897/zookeys.1011.56833] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/27/2020] [Indexed: 11/12/2022] Open
Abstract
This study provides the summary of the reports of the geographical distribution in the Maritime Antarctic and sub-Antarctic regions of Parochlus steinenii (Gercke, 1889) (Diptera, Chironomidae), the only flying insect occurring naturally in the Antarctic continent. The distribution encompasses the South Shetland Islands (Maritime Antarctic), South Georgia (sub-Antarctic), and parts of the Cape Horn Biosphere Reserve (CHBR, southern Chile). In total 78 occurrence records were identified, 53 from our own records, 19 from the literature, and six from other data present in GBIF. Of the 78 records, 66 are from the South Shetland Islands, eight are from South Georgia, and four from the CHBR. This database was developed as one of the main objectives of two Chilean-funded research projects addressing understanding the effects of climate change on sub-Antarctic and Antarctic insects. It provides dataset documenting the distribution of Parochlus steinenii in the Maritime Antarctic, the sub-Antarctic, and the CHBR in southern South America (Chile). The complete dataset is available in Darwin Core Archive format via the Global Biodiversity Information Facility (GBIF).
Collapse
Affiliation(s)
- Melisa Gañan
- Wankara Sub-Antarctic and Antarctic Freshwater Ecosystems Laboratory, Sub-Antarctic Biocultural, Conservation Program, Universidad de Magallanes, Puerto Williams, Teniente Muñoz 166, Chile Universidad de Magallanes Puerto Williams Chile.,Núcleo Milenio de Salmónidos Invasores (INVASAL) Iniciativa Científica Milenio, ICM, Núcleo Científico Milenio, Concepción, Chile Universidad de Chile Las Palmeras Chile
| | - Tamara Contador
- Wankara Sub-Antarctic and Antarctic Freshwater Ecosystems Laboratory, Sub-Antarctic Biocultural, Conservation Program, Universidad de Magallanes, Puerto Williams, Teniente Muñoz 166, Chile Universidad de Magallanes Puerto Williams Chile.,Institute of Ecology and Biodiversity, Universidad de Chile, Santiago, Las Palmeras 3425, Chile Núcleo Científico Milenio Concepción Chile.,Núcleo Milenio de Salmónidos Invasores (INVASAL) Iniciativa Científica Milenio, ICM, Núcleo Científico Milenio, Concepción, Chile Universidad de Chile Las Palmeras Chile
| | - Javier Rendoll
- Wankara Sub-Antarctic and Antarctic Freshwater Ecosystems Laboratory, Sub-Antarctic Biocultural, Conservation Program, Universidad de Magallanes, Puerto Williams, Teniente Muñoz 166, Chile Universidad de Magallanes Puerto Williams Chile.,Institute of Ecology and Biodiversity, Universidad de Chile, Santiago, Las Palmeras 3425, Chile Núcleo Científico Milenio Concepción Chile
| | - Felipe Simoes
- British Antarctic Survey, NERC, High Cross, Madingley Road, Cambridge CB3 0ET, UK British Antarctic Survey, NERC Cambridge United Kingdom.,Department of Zoology, Museum of Zoology, University of Cambridge , Downing Street, Cambridge CB2 3EJ, UK University of Cambridge Cambridge United Kingdom
| | - Carolina Pérez
- Wankara Sub-Antarctic and Antarctic Freshwater Ecosystems Laboratory, Sub-Antarctic Biocultural, Conservation Program, Universidad de Magallanes, Puerto Williams, Teniente Muñoz 166, Chile Universidad de Magallanes Puerto Williams Chile.,Institute of Ecology and Biodiversity, Universidad de Chile, Santiago, Las Palmeras 3425, Chile Núcleo Científico Milenio Concepción Chile
| | - Gillian Graham
- Department of Biological Sciences, University of North Texas, 1511W Sycamore, Denton, TX 76201, USA University of North Texas Denton United States of America
| | - Simón Castillo
- Department of Ecology, Pontificia Universidad Católica, Facultad de Ciencias Biológicas. Avda. Libertador Bernardo O'Higgins 340, Santiago, Chile Pontificia Universidad Católica Santiago Chile
| | - James Kennedy
- Wankara Sub-Antarctic and Antarctic Freshwater Ecosystems Laboratory, Sub-Antarctic Biocultural, Conservation Program, Universidad de Magallanes, Puerto Williams, Teniente Muñoz 166, Chile Universidad de Magallanes Puerto Williams Chile.,Institute of Ecology and Biodiversity, Universidad de Chile, Santiago, Las Palmeras 3425, Chile Núcleo Científico Milenio Concepción Chile.,Department of Biological Sciences, University of North Texas, 1511W Sycamore, Denton, TX 76201, USA University of North Texas Denton United States of America
| | - Peter Convey
- British Antarctic Survey, NERC, High Cross, Madingley Road, Cambridge CB3 0ET, UK British Antarctic Survey, NERC Cambridge United Kingdom
| |
Collapse
|
43
|
Mays DA, Friedman AJ, Kennedy J, Yiannias JA, Morgan JA. Undisclosed Fragrance Allergens in Clean Cosmetic Cleansers Place Patients at Risk. Dermatitis 2021; 32:e36-e37. [PMID: 33443374 DOI: 10.1097/der.0000000000000604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
44
|
Li P, Kennedy J, Mohammad HR, Pang Z, Mellon S, Jackson W, Price A, Dodd C, Murray D. Acceptable outcomes with unicompartmental knee replacement and PCL deficiency are achievable: a case series of nine patients. Knee Surg Sports Traumatol Arthrosc 2021; 29:3272-3278. [PMID: 32642912 PMCID: PMC8458205 DOI: 10.1007/s00167-020-06112-3] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/11/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE Posterior cruciate ligament (PCL) deficiency is considered to be a contraindication for unicompartmental knee replacement (UKR); however, there is no evidence to support or contradict this. There are occasional circumstances where UKR in PCL deficient patients have been performed where the patient otherwise satisfies the indications for UKR. The aim of this paper is to describe the outcome of UKR in PCL deficient patients. METHODS A retrospective study of patients with painful medial compartment osteoarthritis and PCL deficiency treated with Oxford UKR between 2006 and 2015 was undertaken. Clinical records from a prospectively recorded database were reviewed and outcomes were assessed based on revision rate, Oxford Knee Score (OKS), American Knee Society score and Tegner Activity Score. RESULTS Nine patients were identified. The median age at surgery was 51 years (range 42-80) and median follow-up was 6 years (range 1-10). There was one bearing dislocation requiring open exchange. The outcome of seven patients was excellent (OKS > 41). Two patients, who were both elderly, had good outcomes (OKS 41 and 39). One patient had a poor outcome, but it is not clear if this was related to the knee as she had a learning disability and examination and radiographs of the knee were satisfactory. CONCLUSION The results of this small series suggest that excellent results can be achieved with UKR for selected patients with medial osteoarthritis in a PCL deficient knee that was functioning well before the osteoarthritis developed. On the basis of this a larger study should be undertaken. Until more results are available PCL deficiency should be considered a relative contra-indication to UKR. LEVEL OF EVIDENCE IV.
Collapse
Affiliation(s)
- Pengfei Li
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD UK ,Jiangmen Central Hospital/Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, 529030 China ,Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405 China
| | - James Kennedy
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK.
| | - Hasan Raza Mohammad
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD UK
| | - Zhihui Pang
- Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405 China
| | - Stephen Mellon
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD UK
| | | | - Andrew Price
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD UK ,Nuffield Orthopaedic Centre, Oxford, OX3 7LD UK
| | | | - David Murray
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD UK ,Nuffield Orthopaedic Centre, Oxford, OX3 7LD UK
| |
Collapse
|
45
|
Catford SR, Lewis S, Halliday J, Kennedy J, O'Bryan MK, McBain J, Amor DJ, Rombauts L, Saffery R, Hart RJ, McLachlan RI. Health and fertility of ICSI-conceived young men: study protocol. Hum Reprod Open 2020; 2020:hoaa042. [PMID: 33033755 PMCID: PMC7532549 DOI: 10.1093/hropen/hoaa042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/23/2020] [Indexed: 12/27/2022] Open
Abstract
STUDY QUESTIONS What are the long-term health and reproductive outcomes for young men conceived using ICSI whose fathers had spermatogenic failure (STF)? Are there epigenetic consequences of ICSI conception? WHAT IS KNOWN ALREADY Currently, little is known about the health of ICSI-conceived adults, and in particular the health and reproductive potential of ICSI-conceived men whose fathers had STF. Only one group to date has assessed semen parameters and reproductive hormones in ICSI-conceived men and suggested higher rates of impaired semen quality compared to spontaneously conceived (SC) peers. Metabolic parameters in this same cohort of men were mostly comparable. No study has yet evaluated other aspects of adult health. STUDY DESIGN SIZE DURATION This cohort study aims to evaluate the general health and development (aim 1), fertility and metabolic parameters (aim 2) and epigenetic signatures (aim 3) of ICSI-conceived sons whose fathers had STF (ICSI study group). There are three age-matched control groups: ICSI-conceived sons whose fathers had obstructive azoospermia (OAZ) and who will be recruited in this study, as well as IVF sons and SC sons, recruited from other studies. Of 1112 ICSI parents including fathers with STF and OAZ, 78% (n = 867) of mothers and 74% (n = 823) of fathers were traced and contacted. Recruitment of ICSI sons started in March 2017 and will finish in July 2020. Based on preliminary participation rates, we estimate the following sample size will be achieved for the ICSI study group: mothers n = 275, fathers n = 225, sons n = 115. Per aim, the sample sizes of OAZ-ICSI (estimated), IVF and SC controls are: Aim 1-OAZ-ICSI: 28 (maternal surveys)/12 (son surveys), IVF: 352 (maternal surveys)/244 (son surveys), SC: 428 (maternal surveys)/255 (son surveys); Aim 2-OAZ-ICSI: 12, IVF: 72 (metabolic data), SC: 391 (metabolic data)/365 (reproductive data); Aim 3-OAZ-ICSI: 12, IVF: 71, SC: 292. PARTICIPANTS/MATERIALS SETTING METHODS Eligible parents are those who underwent ICSI at one of two major infertility treatment centres in Victoria, Australia and gave birth to one or more males between January 1994 and January 2000. Eligible sons are those aged 18 years or older, whose fathers had STF or OAZ, and whose parents allow researchers to approach sons. IVF and SC controls are age-matched men derived from previous studies, some from the same source population. Participating ICSI parents and sons complete a questionnaire, the latter also undergoing a clinical assessment. Outcome measures include validated survey questions, physical examination (testicular volumes, BMI and resting blood pressure), reproductive hormones (testosterone, sex hormone-binding globulin, FSH, LH), serum metabolic parameters (fasting glucose, insulin, lipid profile, highly sensitive C-reactive protein) and semen analysis. For epigenetic and future genetic analyses, ICSI sons provide specimens of blood, saliva, sperm and seminal fluid while their parents provide a saliva sample. The primary outcomes of interest are the number of mother-reported hospitalisations of the son; son-reported quality of life; prevalence of moderate-severe oligozoospermia (sperm concentration <5 million/ml) and DNA methylation profile. For each outcome, differences between the ICSI study group and each control group will be investigated using multivariable linear and logistic regression for continuous and binary outcomes, respectively. Results will be presented as adjusted odds ratios and 95% CIs. STUDY FUNDING/COMPETING INTERESTS This study is funded by an Australian National Health and Medical Research Council Partnership Grant (NHMRC APP1140706) and was partially funded by the Monash IVF Research and Education Foundation. L.R. is a minority shareholder and the Group Medical Director for Monash IVF Group, and reports personal fees from Monash IVF group and Ferring Australia, honoraria from Ferring Australia, and travel fees from Merck Serono, MSD and Guerbet; R.J.H. is the Medical Director of Fertility Specialists of Western Australia and has equity in Western IVF; R.I.M. is a consultant for and a shareholder of Monash IVF Group and S.R.C. reports personal fees from Besins Healthcare and non-financial support from Merck outside of the submitted work. The remaining authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER Not applicable. TRIAL REGISTRATION DATE Not applicable. DATE OF FIRST PATIENT’S ENROLMENT Not applicable.
Collapse
Affiliation(s)
- S R Catford
- Hudson Institute of Medical Research, Melbourne 3168, Australia.,Department of Obstetrics and Gynaecology, Monash University, Melbourne 3168, Australia.,Murdoch Children's Research Institute, Melbourne 3052, Australia
| | - S Lewis
- Murdoch Children's Research Institute, Melbourne 3052, Australia.,Department of Paediatrics, University of Melbourne, Melbourne 3052, Australia
| | - J Halliday
- Murdoch Children's Research Institute, Melbourne 3052, Australia.,Department of Paediatrics, University of Melbourne, Melbourne 3052, Australia
| | - J Kennedy
- Murdoch Children's Research Institute, Melbourne 3052, Australia.,Department of Paediatrics, University of Melbourne, Melbourne 3052, Australia
| | - M K O'Bryan
- The School of Biological Sciences, Monash University, Melbourne 3168, Australia
| | - J McBain
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne 3052, Australia.,Melbourne IVF, East Melbourne 3002, Australia.,Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Melbourne 3052, Australia
| | - D J Amor
- Murdoch Children's Research Institute, Melbourne 3052, Australia.,Department of Paediatrics, University of Melbourne, Melbourne 3052, Australia
| | - L Rombauts
- Department of Obstetrics and Gynaecology, Monash University, Melbourne 3168, Australia.,Monash IVF Group Pty Ltd, Melbourne 3121, Australia
| | - R Saffery
- Murdoch Children's Research Institute, Melbourne 3052, Australia.,Department of Paediatrics, University of Melbourne, Melbourne 3052, Australia
| | - R J Hart
- Division of Obstetrics and Gynaecology, University of Western Australia, Crawley 6009, Australia.,Fertility Specialists of Western Australia, Claremont 6010, Australia
| | - R I McLachlan
- Hudson Institute of Medical Research, Melbourne 3168, Australia.,Department of Obstetrics and Gynaecology, Monash University, Melbourne 3168, Australia.,Monash IVF Group Pty Ltd, Melbourne 3121, Australia
| |
Collapse
|
46
|
Honap S, Chee D, Chapman TP, Patel M, Kent AJ, Ray S, Sharma E, Kennedy J, Cripps S, Walsh A, Goodhand JR, Ahmad T, Satsangi J, Irving PM, Kennedy NA, O’Neill R, Mawdsley J, Samaan M, Anderson S, Sanderson J, Gordon C, Prasad S, Lin S, Chanchlani N, Elworthy C, Cairnes V, Travis S, Brain O, Palmer R, Ambrose T, Dubois P, Hayee BH, Chung-Faye G, Medcalf L, Begum Y, O’Neill R, Mawdsley J, Samaan M, Anderson S, Sanderson J, Gordon C, Prasad S, Lin S, Chanchlani N, Elworthy C, Cairnes V, Travis S, Brain O, Palmer R, Ambrose T, Dubois P, Hayee BH, Chung-Faye G, Medcalf L. Real-world Effectiveness of Tofacitinib for Moderate to Severe Ulcerative Colitis: A Multicentre UK Experience. J Crohns Colitis 2020; 14:1385-1393. [PMID: 32280965 DOI: 10.1093/ecco-jcc/jjaa075] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Tofacitinib is a partially selective Janus kinase inhibitor approved for the treatment of refractory moderate to severe ulcerative colitis [UC]. We sought to define the effectiveness and adverse effects of tofacitinib in a real-world cohort. METHODS We conducted a retrospective observational cohort study of 134 patients with UC [64% male; median age 37 years [range 16-81]; 83% of patients had previously received at least one biologic] treated with tofacitinib from October 2018 to October 2019 in four UK centres. Disease activity was assessed using the Simple Clinical Colitis Activity Index [SCCAI] or partial Mayo score [PMS], depending on study site. Response and remission were defined as a reduction in SCCAI or PMS of ≥3and SCCAI ≤2 or a PMS ≤1, respectively. RESULTS Overall, 74% (88/119; 95 confidence interval [CI] 65-81%] patients responded to tofacitinib at Week 8 and steroid-free remission was observed in 44% [47/108; 95% CI 3453%] patients at Week 26. Primary non-response was independently associated with younger age [p = 0.014] and higher C-reactive protein [CRP] levels at baseline [p = 0.004]. Only 23% [3/13] of patients who continued tofacitinib in the setting of primary non-response were in steroid-free remission at Week 26. Prior biologic exposure did not influence response or remission rates. Dose escalation, however, recaptured response in approximately half of patients who had lost response. Dyslipidaemia was observed in 20% [27/134; 95% CI 1428%] of patients, but adverse events necessitating drug withdrawal were uncommon and no venous thromboembolic events occurred. CONCLUSIONS In this multicentre real-world cohort, tofacitinib was well tolerated and clinically effective in a treatment-refractory UC population.
Collapse
Affiliation(s)
- Sailish Honap
- IBD Centre, Guy's and St Thomas' Hospitals NHS Foundation Trust, London, UK
| | - Desmond Chee
- Department of Gastroenterology, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK
| | - Thomas P Chapman
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - Mehul Patel
- Department of Gastroenterology, King's College Hospital NHS Foundation Trust, London, UK
| | - Alexandra J Kent
- Department of Gastroenterology, King's College Hospital NHS Foundation Trust, London, UK
| | - Shuvra Ray
- IBD Centre, Guy's and St Thomas' Hospitals NHS Foundation Trust, London, UK
| | - Esha Sharma
- IBD Centre, Guy's and St Thomas' Hospitals NHS Foundation Trust, London, UK
| | - James Kennedy
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - Sarah Cripps
- Department of Pharmacy, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - Alissa Walsh
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - James R Goodhand
- Department of Gastroenterology, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK
| | - Tariq Ahmad
- Department of Gastroenterology, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK
| | - Jack Satsangi
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - Peter M Irving
- IBD Centre, Guy's and St Thomas' Hospitals NHS Foundation Trust, London, UK.,School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Nicholas A Kennedy
- Department of Gastroenterology, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Kennedy J, Westacott D, Camp M, Howard A. Tibial tuberosity ossification predicts reoperation for growth disturbance in distal femoral physeal fractures. J Child Orthop 2020; 14:299-303. [PMID: 32874363 PMCID: PMC7453177 DOI: 10.1302/1863-2548.14.190073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Distal femoral physeal fractures (DFPF) can cause growth disturbance that requires further surgical intervention. The aim of this study is to determine if Tibial Tuberosity Ossification Stage (TTOS) at the time of injury predicts secondary surgery for growth disturbance in patients who have sustained a DFPF. METHODS We retrospectively investigated all patients who had operative treatment for a DFPF at a single centre over a 17-year period. Regression analysis was performed investigating associations between secondary surgery to treat growth disturbance and TTOS, age, Salter-Harris fracture classification type, mode of fixation or mechanism of injury. RESULTS In all, 85 consecutive patients were identified. A total of 74 met the inclusion criteria. The mean age at time of injury was 13.1 years (2.0 to 17.1). Following fixation, 30 patients (41%) underwent further surgery to treat growth disturbance. Absence of tibial tuberosity fusion to the metaphysis was significantly associated with the need for further surgery (p < 0.001). Odds of requiring secondary surgery after tibial tuberosity fusion to metaphysis (compared with not fused) were 0.12 (95% confidence interval (CI) 0.04 to 0.34). The estimate of the effect of TTOS on reoperation rates did not vary when adjusted for gender, mechanism, fixation and Salter-Harris type. When accounting for age, the odds of any further operation if the tibial tuberosity is fused to the metaphysis (compared with not fused) were 0.28 (95% CI 0.08 to 0.94). CONCLUSION TTOS at the time of injury is a predictor of further surgery to treat growth disturbance in paediatric distal femoral fractures. LEVEL OF EVIDENCE Diagnostic Level II.
Collapse
Affiliation(s)
- James Kennedy
- The Hospital for Sick Children, Toronto, Ontario, Canada,Correspondence should be sent to Jim Kennedy, Our Lady’s Children’s Hospital Crumlin, Dublin, D12V004, Ireland. E-mail:
| | - Dan Westacott
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mark Camp
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Andrew Howard
- The Hospital for Sick Children, Toronto, Ontario, Canada
| |
Collapse
|
48
|
Roberto-Charron A, Kennedy J, Reitsma L, Tremblay JA, Krikun R, Hobson KA, Ibarzabal J, Fraser KC. Widely distributed breeding populations of Canada warbler (Cardellina canadensis) converge on migration through Central America. BMC ZOOL 2020. [DOI: 10.1186/s40850-020-00056-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To effectively conserve migratory species, the entire range encompassed by their annual life cycle needs to be considered. Most research on Nearctic-Neotropical migratory birds has focused on the breeding grounds resulting in a general lack of knowledge regarding the wintering and migratory periods. The Canada Warbler (Cardellina canadensis) has declined by 71% from 1970 to 2012, at a rate of 2.9% per year, and is listed as Threatened in Canada. As with most Nearctic-Neotropical migrants, conservation efforts outside the breeding range are limited by a poor understanding of migration routes and the connectivity between specific breeding and wintering populations.
Results
To determine migratory routes of multiple breeding populations of Canada Warblers, we directly-tracked individuals using light-level geolocators deployed at four sites across the breeding range, spanning approximately 43 degrees in longitude (Alberta, Manitoba and Québec, Canada, and New Hampshire, USA). Twenty-five geolocators with usable data were recovered from three sites and were analyzed using FlightR to determine fall migration routes (n = 18) and individual wintering sites (n = 25). Individuals from all breeding populations took a western fall migration route at the Gulf of Mexico; with 77.8% of birds funnelling into a narrow geographic space along the western side of the Gulf of Mexico (97°W-99°W). We found no evidence for population-specific, parallel migration routes. Most individuals (72%) overwintered in Colombia. The remaining individuals overwintered in Venezuela.
Conclusions
Our results demonstrate convergence of migratory routes around a migration barrier for individuals originating from widely distributed breeding areas. Further, we suggest the potential importance of habitat around the Gulf of Mexico during migration and Andean forest in Colombia as overwintering habitat for this threatened species. Future research should be directed at understanding how these areas are used by Canada Warblers.
Collapse
|
49
|
Mbambo MC, Khamlich S, Khamliche T, Moodley MK, Kaviyarasu K, Madiba IG, Madito MJ, Khenfouch M, Kennedy J, Henini M, Manikandan E, Maaza M. Remarkable thermal conductivity enhancement in Ag-decorated graphene nanocomposites based nanofluid by laser liquid solid interaction in ethylene glycol. Sci Rep 2020; 10:10982. [PMID: 32620923 PMCID: PMC7335043 DOI: 10.1038/s41598-020-67418-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 01/09/2020] [Accepted: 06/01/2020] [Indexed: 11/09/2022] Open
Abstract
We report on the synthesis and enhanced thermal conductivity of stable Ag-decorated 2-D graphene nanocomposite in ethylene glycol based nanofluid by laser liquid solid interaction. A surfactant free nanofluid of Ag nanoparticles anchored onto the 2-D graphene sheets were synthesized using a two-step laser liquid solid interaction approach. In order to understand a pulsed Nd:YAG laser at the fundamental frequency (λ = 1,064 nm) to ablate Ag and graphite composite target submerged in ethylene glycol (EG) to form AgNPs decorated 2-D GNs-EG based nanofluid. From a heat transfer point of view, it was observed that the thermal conductivity of this stable Ag-graphene/EG is significantly enhanced by a factor of about 32.3%; this is highest reported value for a graphene based nanofluid.
Collapse
Affiliation(s)
- M C Mbambo
- UNESCO-UNISA Africa Chair in Nanosciences-Nanotechnology, College of Graduate Studies, University of South Africa, Muckleneuk Ridge, PO Box 392, Pretoria, South Africa. .,Nanosciences African Network (NANOAFNET), iThemba LABS-National Research Foundation, 1 Old Faure Road, Somerset West 7129, PO Box 722, Somerset West, Western Cape Province, South Africa.
| | - S Khamlich
- UNESCO-UNISA Africa Chair in Nanosciences-Nanotechnology, College of Graduate Studies, University of South Africa, Muckleneuk Ridge, PO Box 392, Pretoria, South Africa.,Nanosciences African Network (NANOAFNET), iThemba LABS-National Research Foundation, 1 Old Faure Road, Somerset West 7129, PO Box 722, Somerset West, Western Cape Province, South Africa
| | - T Khamliche
- UNESCO-UNISA Africa Chair in Nanosciences-Nanotechnology, College of Graduate Studies, University of South Africa, Muckleneuk Ridge, PO Box 392, Pretoria, South Africa.,Nanosciences African Network (NANOAFNET), iThemba LABS-National Research Foundation, 1 Old Faure Road, Somerset West 7129, PO Box 722, Somerset West, Western Cape Province, South Africa
| | - M K Moodley
- Discipline of Physics, School of Chemistry and Physics, University of KwaZulu-Natal, Durban, South Africa
| | - K Kaviyarasu
- UNESCO-UNISA Africa Chair in Nanosciences-Nanotechnology, College of Graduate Studies, University of South Africa, Muckleneuk Ridge, PO Box 392, Pretoria, South Africa. .,Nanosciences African Network (NANOAFNET), iThemba LABS-National Research Foundation, 1 Old Faure Road, Somerset West 7129, PO Box 722, Somerset West, Western Cape Province, South Africa.
| | - I G Madiba
- UNESCO-UNISA Africa Chair in Nanosciences-Nanotechnology, College of Graduate Studies, University of South Africa, Muckleneuk Ridge, PO Box 392, Pretoria, South Africa.,Nanosciences African Network (NANOAFNET), iThemba LABS-National Research Foundation, 1 Old Faure Road, Somerset West 7129, PO Box 722, Somerset West, Western Cape Province, South Africa
| | - M J Madito
- Nanosciences African Network (NANOAFNET), iThemba LABS-National Research Foundation, 1 Old Faure Road, Somerset West 7129, PO Box 722, Somerset West, Western Cape Province, South Africa
| | - M Khenfouch
- UNESCO-UNISA Africa Chair in Nanosciences-Nanotechnology, College of Graduate Studies, University of South Africa, Muckleneuk Ridge, PO Box 392, Pretoria, South Africa.,Nanosciences African Network (NANOAFNET), iThemba LABS-National Research Foundation, 1 Old Faure Road, Somerset West 7129, PO Box 722, Somerset West, Western Cape Province, South Africa
| | - J Kennedy
- UNESCO-UNISA Africa Chair in Nanosciences-Nanotechnology, College of Graduate Studies, University of South Africa, Muckleneuk Ridge, PO Box 392, Pretoria, South Africa.,Nanosciences African Network (NANOAFNET), iThemba LABS-National Research Foundation, 1 Old Faure Road, Somerset West 7129, PO Box 722, Somerset West, Western Cape Province, South Africa.,National Isotope Centre, GNS Science, PO Box 31312, Lower Hutt, 5010, New Zealand
| | - M Henini
- UNESCO-UNISA Africa Chair in Nanosciences-Nanotechnology, College of Graduate Studies, University of South Africa, Muckleneuk Ridge, PO Box 392, Pretoria, South Africa.,Nanosciences African Network (NANOAFNET), iThemba LABS-National Research Foundation, 1 Old Faure Road, Somerset West 7129, PO Box 722, Somerset West, Western Cape Province, South Africa.,School of Physics and Astronomy, The University of Nottingham, University Park, Nottingham, Nottingham, NG7 2RD, UK
| | - E Manikandan
- UNESCO-UNISA Africa Chair in Nanosciences-Nanotechnology, College of Graduate Studies, University of South Africa, Muckleneuk Ridge, PO Box 392, Pretoria, South Africa.,Nanosciences African Network (NANOAFNET), iThemba LABS-National Research Foundation, 1 Old Faure Road, Somerset West 7129, PO Box 722, Somerset West, Western Cape Province, South Africa.,Department of Physics, Thiruvalluvar University College of Arts and Science, Thennangur Village, Vandavasi Taluk, Tiruvannamalai, Tamil Nadu, 604408, India
| | - M Maaza
- UNESCO-UNISA Africa Chair in Nanosciences-Nanotechnology, College of Graduate Studies, University of South Africa, Muckleneuk Ridge, PO Box 392, Pretoria, South Africa. .,Nanosciences African Network (NANOAFNET), iThemba LABS-National Research Foundation, 1 Old Faure Road, Somerset West 7129, PO Box 722, Somerset West, Western Cape Province, South Africa.
| |
Collapse
|
50
|
Contador T, Gañan M, Bizama G, Fuentes-Jaque G, Morales L, Rendoll J, Simoes F, Kennedy J, Rozzi R, Convey P. Assessing distribution shifts and ecophysiological characteristics of the only Antarctic winged midge under climate change scenarios. Sci Rep 2020; 10:9087. [PMID: 32493944 PMCID: PMC7270094 DOI: 10.1038/s41598-020-65571-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 04/11/2019] [Accepted: 01/06/2020] [Indexed: 11/30/2022] Open
Abstract
Parts of Antarctica were amongst the most rapidly changing regions of the planet during the second half of the Twentieth Century. Even so, today, most of Antarctica remains in the grip of continental ice sheets, with only about 0.2% of its overall area being ice-free. The continent's terrestrial fauna consists only of invertebrates, with just two native species of insects, the chironomid midges Parochlus steinenii and Belgica antarctica. We integrate ecophysiological information with the development of new high-resolution climatic layers for Antarctica, to better understand how the distribution of P. steinenii may respond to change over the next century under different IPCC climate change scenarios. We conclude that the species has the potential to expand its distribution to include parts of the west and east coasts of the Antarctic Peninsula and even coastal ice-free areas in parts of continental Antarctica. We propose P. steinenii as an effective native sentinel and indicator species of climate change in the Antarctic.
Collapse
Affiliation(s)
- Tamara Contador
- Sub-Antarctic Biocultural Conservation Program, Universidad de Magallanes, Punta Arenas, Chile.
- Millennium Nucleus of Invasive Salmonids (INVASAL), Concepción, Chile.
- Institute of Ecology and Biodiversity (IEB-Chile), Santiago de Chile, Chile.
| | - Melisa Gañan
- Sub-Antarctic Biocultural Conservation Program, Universidad de Magallanes, Punta Arenas, Chile.
| | - Gustavo Bizama
- Laboratory for Research in Environmental Sciences (LARES), Faculty of Agricultural Sciences, Department of Environmental Sciences and Natural Renewable Resources, University of Chile, Santiago, Chile
| | - Guillermo Fuentes-Jaque
- Laboratory for Research in Environmental Sciences (LARES), Faculty of Agricultural Sciences, Department of Environmental Sciences and Natural Renewable Resources, University of Chile, Santiago, Chile
| | - Luis Morales
- Laboratory for Research in Environmental Sciences (LARES), Faculty of Agricultural Sciences, Department of Environmental Sciences and Natural Renewable Resources, University of Chile, Santiago, Chile
| | - Javier Rendoll
- Sub-Antarctic Biocultural Conservation Program, Universidad de Magallanes, Punta Arenas, Chile
- Institute of Ecology and Biodiversity (IEB-Chile), Santiago de Chile, Chile
| | | | - James Kennedy
- Sub-Antarctic Biocultural Conservation Program, Universidad de Magallanes, Punta Arenas, Chile
- Department of Biological Sciences, University of North Texas, Texas, USA
| | - Ricardo Rozzi
- Sub-Antarctic Biocultural Conservation Program, Universidad de Magallanes, Punta Arenas, Chile
- Institute of Ecology and Biodiversity (IEB-Chile), Santiago de Chile, Chile
- Department of Philosophy and Religion Studies, University of North Texas, Texas, USA
| | | |
Collapse
|