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Lees-Murdock DJ, Khan D, Irwin R, Graham J, Hinch V, O’Hagan B, McClean S. Assessing the Efficacy of Active Learning to Support Student Performance Across Undergraduate Programmes in Biomedical Science. Br J Biomed Sci 2024; 81:12148. [PMID: 38501148 PMCID: PMC10945544 DOI: 10.3389/bjbs.2024.12148] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/16/2024] [Indexed: 03/20/2024]
Abstract
Introduction: Active learning is a useful tool to enhance student engagement and support learning in diverse educational situations. We aimed to assess the efficacy of an active learning approach within a large interprofessional first year Medical Cell Biology module taken by six healthcare programmes across the School of Biomedical Sciences at Ulster University, United Kingdom. Materials and methods: An active learning approach was developed for weekly formative assessment using Smartwork to design a weekly interactive multiple-choice quiz to reinforce key concepts specifically for each lecture. We tracked and assessed student performance in the module overall and in each element of course work and exam for 2 years prior to and following the introduction of an active learning strategy to engage and support learning for students from all academic backgrounds and abilities. Results: Full engagement with active learning was significantly associated with an increased overall module performance as well as a significantly increased performance in each element of class test (No engagement vs. Full engagement, p < 0.001), exam (No Engagement vs. Full engagement, p < 0.05) and coursework (No engagement vs. Full engagement, p < 0.001) within this overall total (No Engagement vs. Full engagement, p < 0.01). Partial engagement with active learning was associated significantly improved class test (No engagement vs. partially engaged, p < 0.001) and coursework (No engagement vs. partially engaged, p < 0.05) performance. While a trend toward increased performance in exam and overall module mark was observed, these were not significant. Discussion: Active learning is a useful tool to support student learning across a range of healthcare programmes taken by students with differing backgrounds and academic abilities in an interprofessional and widening participation setting. Student engagement in active learning was highlighted as a key contributory factor to enhanced student performance in all aspects of assessment.
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Affiliation(s)
- D. J. Lees-Murdock
- School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
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Graham J, Nguyen N, Hussain D, Nadimpalli ML. Traveller studies in low- and middle-income countries: a critical gap in global antibiotic resistance surveillance. J Travel Med 2024:taae019. [PMID: 38307512 DOI: 10.1093/jtm/taae019] [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: 11/14/2023] [Revised: 01/25/2024] [Indexed: 02/04/2024]
Abstract
A substantial proportion of global travel occurs between low- and middle-income countries (LMICs) for the purposes of migration, medical tourism, trade, and employment, and this is likely to accelerate due to climate change-related migration. Traveller studies based in LMICs are needed to better monitor the global spread of antibiotic resistance.
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Affiliation(s)
- Jay Graham
- Environmental Health Sciences Division, School of Public Health, University of California, Berkeley, California, United States
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- Environmental Health Sciences Division, School of Public Health, University of California, Berkeley, California, United States
| | - Dania Hussain
- Gangarosa Department of Environmental Health, Emory Rollins School of Public Health, Atlanta, Georgia, United States
| | - Maya L Nadimpalli
- Gangarosa Department of Environmental Health, Emory Rollins School of Public Health, Atlanta, Georgia, United States
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H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura 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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Rae S, Plummer E, Fitzgerald L, Hogarth L, Bridgewood A, Brown-Schofield L, Graham J, Haigh S, McAnulty C, Drew Y, Haris N, Bashir S, Plummer R, Greystoke A. Prevalence of mutations in common tumour types in Northern England and comparable utility of national and international Trial Finders. J Cancer Res Clin Oncol 2023; 149:16355-16363. [PMID: 37702806 PMCID: PMC10645649 DOI: 10.1007/s00432-023-05365-y] [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] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/28/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE Tumour genomic profiling is of increasing importance in early phase trials to match patients to targeted therapeutics. Mutations vary by demographic group; however, regional differences are not characterised. This was investigated by comparing mutation prevalence for common cancers presenting to Newcastle Experimental Cancer Medicine Centre (ECMC) to The Cancer Genome Atlas (TCGA) and utility of trial matching modalities. METHODS Detailed clinicogenomic data were obtained for patients presenting September 2017-December 2020. Prevalence of mutations in lung, colorectal, breast and prostate cancer was compared to TCGA GDC Data Portal. Experimental Cancer (EC) Trial Finder utility in matching trials was compared to a Molecular Tumour Board (MTB) and commercial sequencing reports. RESULTS Of 311 patients with advanced cancer, this consisted of lung (n = 131, 42.1%), colorectal (n = 44, 14.1%), breast (n = 36, 11.6%) and prostate (n = 18, 5.6%). More than one mutation was identified in the majority (n = 260, 84%). Significant prevalence differences compared to TCGA were identified, including a high prevalence of EGFR in lung (P = 0.001); RB1 in breast (P = 0.0002); and multiple mutations in prostate cancer. EC Trial Finder demonstrated significantly different utility than sequencing reports in identifying trials (P = 0.007). CONCLUSIONS Regional differences in mutations may exist with advanced stage accounting for prevalence of specific mutations. A national Trial Finder shows utility in finding targeted trials whilst commercial sequencing reports may over-report 'actionable' mutations. Understanding local prevalence and trial availability could increase enrolment onto matched early phase trials.
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Affiliation(s)
- S Rae
- Sir Bobby Robson Cancer Trials Research Centre, Northern Centre for Cancer Care, Freeman Hospital, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK.
- Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
| | - E Plummer
- Sir Bobby Robson Cancer Trials Research Centre, Northern Centre for Cancer Care, Freeman Hospital, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK
| | - L Fitzgerald
- Sir Bobby Robson Cancer Trials Research Centre, Northern Centre for Cancer Care, Freeman Hospital, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK
- Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - L Hogarth
- Sir Bobby Robson Cancer Trials Research Centre, Northern Centre for Cancer Care, Freeman Hospital, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK
- Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - A Bridgewood
- Sir Bobby Robson Cancer Trials Research Centre, Northern Centre for Cancer Care, Freeman Hospital, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK
| | - L Brown-Schofield
- Sir Bobby Robson Cancer Trials Research Centre, Northern Centre for Cancer Care, Freeman Hospital, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK
| | - J Graham
- Sir Bobby Robson Cancer Trials Research Centre, Northern Centre for Cancer Care, Freeman Hospital, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK
| | - S Haigh
- Sir Bobby Robson Cancer Trials Research Centre, Northern Centre for Cancer Care, Freeman Hospital, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK
| | - C McAnulty
- Newcastle Genetics Laboratory, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, UK
| | - Y Drew
- BC Cancer Centre, Vancouver, 600W 10th Avenue, Vancouver, BC, V5Z 4E6, Canada
- University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
| | - N Haris
- Sir Bobby Robson Cancer Trials Research Centre, Northern Centre for Cancer Care, Freeman Hospital, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK
- Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - S Bashir
- Sir Bobby Robson Cancer Trials Research Centre, Northern Centre for Cancer Care, Freeman Hospital, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK
| | - R Plummer
- Sir Bobby Robson Cancer Trials Research Centre, Northern Centre for Cancer Care, Freeman Hospital, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK
- Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - A Greystoke
- Sir Bobby Robson Cancer Trials Research Centre, Northern Centre for Cancer Care, Freeman Hospital, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK
- Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
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Lightley J, Kumar S, Lim MQ, Garcia E, Görlitz F, Alexandrov Y, Parrado T, Hollick C, Steele E, Roßmann K, Graham J, Broichhagen J, McNeish IA, Roufosse CA, Neil MAA, Dunsby C, French PMW. openFrame: A modular, sustainable, open microscopy platform with single-shot, dual-axis optical autofocus module providing high precision and long range of operation. J Microsc 2023; 292:64-77. [PMID: 37616077 PMCID: PMC10953376 DOI: 10.1111/jmi.13219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/04/2023] [Accepted: 08/21/2023] [Indexed: 08/25/2023]
Abstract
'openFrame' is a modular, low-cost, open-hardware microscopy platform that can be configured or adapted to most light microscopy techniques and is easily upgradeable or expandable to multiple modalities. The ability to freely mix and interchange both open-source and proprietary hardware components or software enables low-cost, yet research-grade instruments to be assembled and maintained. It also enables rapid prototyping of advanced or novel microscope systems. For long-term time-lapse image data acquisition, slide-scanning or high content analysis, we have developed a novel optical autofocus incorporating orthogonal cylindrical optics to provide robust single-shot closed-loop focus lock, which we have demonstrated to accommodate defocus up to ±37 μm with <200 nm accuracy, and a two-step autofocus mode which we have shown can operate with defocus up to ±68 μm. We have used this to implement automated single molecule localisation microscopy (SMLM) in a relatively low-cost openFrame-based instrument using multimode diode lasers for excitation and cooled CMOS cameras.
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Affiliation(s)
- J. Lightley
- Photonics Group, Physics DepartmentImperial College LondonLondonUK
- Francis Crick InstituteLondonUK
| | - S. Kumar
- Photonics Group, Physics DepartmentImperial College LondonLondonUK
- Francis Crick InstituteLondonUK
| | - M. Q. Lim
- Photonics Group, Physics DepartmentImperial College LondonLondonUK
- Department of Surgery and CancerImperial College LondonLondonUK
| | - E. Garcia
- Photonics Group, Physics DepartmentImperial College LondonLondonUK
- Department of Surgery and CancerImperial College LondonLondonUK
| | - F. Görlitz
- Photonics Group, Physics DepartmentImperial College LondonLondonUK
| | - Y. Alexandrov
- Photonics Group, Physics DepartmentImperial College LondonLondonUK
- Francis Crick InstituteLondonUK
| | | | | | - E. Steele
- Cairn Research LtdFavershamKentEngland
| | - K. Roßmann
- Leibniz‐Forschungsinstitut für Molekulare PharmakologieBerlinGermany
| | - J. Graham
- Cairn Research LtdFavershamKentEngland
| | - J. Broichhagen
- Leibniz‐Forschungsinstitut für Molekulare PharmakologieBerlinGermany
| | - I. A. McNeish
- Department of Surgery and CancerImperial College LondonLondonUK
| | - C. A. Roufosse
- Department of Inflammation and ImmunologyImperial College LondonLondonUK
| | - M. A. A. Neil
- Photonics Group, Physics DepartmentImperial College LondonLondonUK
- Francis Crick InstituteLondonUK
| | - C. Dunsby
- Photonics Group, Physics DepartmentImperial College LondonLondonUK
- Francis Crick InstituteLondonUK
| | - P. M. W. French
- Photonics Group, Physics DepartmentImperial College LondonLondonUK
- Francis Crick InstituteLondonUK
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Graham J, Mayne A, Craig J, Spence D. Patients undergoing hip hemiarthroplasty who require early return to theatre have early increased mortality and worse functional outcomes at short term follow-up. Injury 2023; 54:110946. [PMID: 37517375 DOI: 10.1016/j.injury.2023.110946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 07/08/2023] [Accepted: 07/15/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Re-operation following hip hemiarthroplasty is potentially devastating due to a frail, co-morbid surgical cohort. We aimed to assess the outcomes of patients who required early return to theatre (RTT) within 30 days of index operation in a high-volume hip fracture unit. METHODS A retrospective review of a prospectively maintained database was undertaken. All hip hemiarthroplasties performed between 1st January 2010 and 31st December 2019 was included. Demographic details, complications including reason for return to theatre, length of stay, discharge destination, functional outcome and mortality were collected and reviewed. RESULTS 4340 hip hemiarthroplasty procedures were performed, of which 64 patients (1.47%) required early RTT within 30 days of index procedure and 4276 patients did not require early-RTT. The most common reasons for RTT were infection (n = 47) and dislocation (n = 15). There were no cases of peri‑prosthetic fracture requiring RTT within 30 days. Patients requiring early RTT had a significantly increased rate of mortality within 120 days; 32.8% (21 of the 64 patients) versus 13.6% (580 out of the 4276) not requiring early RTT (p < 0.001). The median length of acute inpatient admission for patients who required early RTT was significantly longer at 31 days (range 6-185 days) compared to 10 days (range 3-171 days, p < 0.001) for those without early RTT. Early RTT was associated with a poorer functional mobility outcome at 120 days post-operatively, with a significantly greater reduction in Barthel score compared to the non-RTT cohort (p < 0.05). CONCLUSION Patients requiring early RTT following hip hemiarthroplasty had a significantly increased length of stay, mortality and worse functional outcome compared to patients who did not require early RTT within 30 days.
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Affiliation(s)
- J Graham
- Royal Victoria Hospital, Belfast Health & Social Care Trust, Northern Ireland.
| | - A Mayne
- Royal Victoria Hospital, Belfast Health & Social Care Trust, Northern Ireland
| | - J Craig
- Royal Victoria Hospital, Belfast Health & Social Care Trust, Northern Ireland
| | - D Spence
- Royal Victoria Hospital, Belfast Health & Social Care Trust, Northern Ireland
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McDougall GJ, Allwood JW, Dobson G, Austin C, Verrall S, Alexander CJ, Hancock RD, Graham J, Hackett CA. Quantitative trait loci mapping of polyphenol metabolites from a 'Latham' x 'Glen Moy' red raspberry (Rubus idaeus L) cross. Metabolomics 2023; 19:71. [PMID: 37552331 PMCID: PMC10409862 DOI: 10.1007/s11306-023-02033-7] [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: 01/12/2023] [Accepted: 07/13/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE The objective of this study was to investigate the genetic control of polyphenol accumulation in red raspberry (Rubus idaeus L). METHODS The levels of total anthocyanins and 37 individual polyphenol metabolites were measured over three years in a raspberry biparental mapping population. Quantitative trait loci (QTLs) for these traits were mapped onto a high-density SNP linkage map. RESULTS At least one QTL was detected for each trait, with good consistency among the years. On four linkage groups (LG), there were major QTLs affecting several metabolites. On LG1, a QTL had large effects on anthocyanins and flavonols containing a rutinoside or rhamnose group. On LG4, a QTL had large effects on several flavonols and on LG5 and LG6 QTLs had large effects on ellagic acid derivatives. Smaller QTLs were found on LG2 and LG3. CONCLUSION The identification of robust QTLs for key polyphenols in raspberry provides great potential for marker-assisted breeding for improved levels of potentially health beneficial components.
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Affiliation(s)
- G J McDougall
- Plant Biochemistry and Food Quality Group, Environmental and Biochemical Sciences Department, The James Hutton Institute, Dundee, DD2 5DA, Scotland, UK.
| | - J W Allwood
- Plant Biochemistry and Food Quality Group, Environmental and Biochemical Sciences Department, The James Hutton Institute, Dundee, DD2 5DA, Scotland, UK
| | - G Dobson
- Plant Biochemistry and Food Quality Group, Environmental and Biochemical Sciences Department, The James Hutton Institute, Dundee, DD2 5DA, Scotland, UK
| | - C Austin
- Plant Biochemistry and Food Quality Group, Environmental and Biochemical Sciences Department, The James Hutton Institute, Dundee, DD2 5DA, Scotland, UK
| | - S Verrall
- Ecological Sciences Department, The James Hutton Institute, Dundee, DD2 5DA, Scotland, UK
| | - C J Alexander
- Biomathematics and Statistics Scotland (BioSS), The James Hutton Institute, Dundee, DD2 5DA, Scotland, UK
| | - R D Hancock
- Cell and Molecular Sciences Department, The James Hutton Institute, Dundee, DD2 5DA, Scotland, UK
| | - J Graham
- Cell and Molecular Sciences Department, The James Hutton Institute, Dundee, DD2 5DA, Scotland, UK
| | - C A Hackett
- Biomathematics and Statistics Scotland (BioSS), The James Hutton Institute, Dundee, DD2 5DA, Scotland, UK
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Jarvis MS, Blackburn J, Hailstone C, Small CL, Dixon C, Rook W, Maniar R, Graham J, Sengar T, Dunn SJ, Tooley L, Blurton E, Mak K, Dunham R, Baker R, Lacey V, Basheer N, Freeman A, Delahunt S, Gurung S, Akhtar N, Parmar R, Whitney D, Shatananda L, Wallengren C, Pilsbury J, Cochran D, Sandur N, Girotra V, Greenwood J, Baines D, Olojede B, Bhat A, Baxendale L, Porter M, Whapples A, Kumar A, Ramamoorthy M, Perry R, Magill L. A survey in the West Midlands of the United Kingdom of current practice in managing hypotension in lower segment caesarean section under spinal anaesthesia. Int J Obstet Anesth 2023; 55:103899. [PMID: 37329691 DOI: 10.1016/j.ijoa.2023.103899] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 05/07/2023] [Accepted: 05/22/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Spinal anaesthesia, the most common form of anaesthesia for caesarean section, leads to sympathetic blockade and profound maternal hypotension resulting in adverse maternal and neonatal outcomes. Hypotension, nausea and vomiting remain common but until the publication of the National Institute of Health and Care Excellence (NICE) 2021 guidance, no national guideline existed on how best to manage maternal hypotension following spinal anaesthesia for caesarean section. A 2017 international consensus statement recommended prophylactic vasopressor administration to maintain a systolic blood pressure of >90% of an accurate pre-spinal value, and to avoid a drop to <80% of this value. This survey aimed to assess regional adherence to these recommendations, the presence of local guidelines for management of hypotension during caesarean section under spinal anaesthesia, and the individual clinician's treatment thresholds for maternal hypotension and tachycardia. METHODS The West Midlands Trainee-led Research in Anaesthesia and Intensive Care Network co-ordinated surveys of obstetric anaesthetic departments and consultant obstetric anaesthetists across 11 National Health Service Trusts in the Midlands, England. RESULTS One-hundred-and-two consultant obstetric anaesthetists returned the survey and 73% of sites had a policy for vasopressor use; 91% used phenylephrine as the first-line drug but a wide range of recommended delivery methods was noted and target blood pressure was only listed in 50% of policies. Significant variation existed in both vasopressor delivery methods and target blood pressures. CONCLUSIONS Although NICE has since recommended prophylactic phenylephrine infusion and a target blood pressure, the previous international consensus statement was not adhered to routinely.
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Affiliation(s)
- M S Jarvis
- University Hospitals of North Midlands NHS Trust, UK.
| | - J Blackburn
- Birmingham Women's and Children's NHS Foundation Trust, UK
| | - C Hailstone
- University Hospitals Birmingham NHS Foundation Trust, UK
| | | | | | - W Rook
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - R Maniar
- Kettering General Hospital NHS Foundation Trust, UK
| | - J Graham
- Worcestershire Acute Hospitals NHS Trust, UK
| | - T Sengar
- Kettering General Hospital NHS Foundation Trust, UK
| | - S J Dunn
- Royal Wolverhampton NHS Trust, UK
| | - L Tooley
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - E Blurton
- University Hospitals of Derby and Burton NHS Foundation Trust, UK
| | - K Mak
- University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - R Dunham
- Birmingham Women's and Children's NHS Foundation Trust, UK
| | - R Baker
- The Dudley Group NHS Foundation Trust, UK
| | | | | | - A Freeman
- Worcestershire Acute Hospitals NHS Trust, UK
| | - S Delahunt
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - S Gurung
- University Hospitals of Derby and Burton NHS Foundation Trust, UK
| | - N Akhtar
- University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - R Parmar
- Worcestershire Acute Hospitals NHS Trust, UK
| | - D Whitney
- Worcestershire Acute Hospitals NHS Trust, UK
| | | | | | - J Pilsbury
- Birmingham Women's and Children's NHS Foundation Trust, UK
| | | | - N Sandur
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - V Girotra
- Kettering General Hospital NHS Foundation Trust, UK
| | - J Greenwood
- Worcestershire Acute Hospitals NHS Trust, UK
| | - D Baines
- Kettering General Hospital NHS Foundation Trust, UK
| | | | - A Bhat
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - L Baxendale
- University Hospitals of Derby and Burton NHS Foundation Trust, UK
| | - M Porter
- University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - A Whapples
- Birmingham Women's and Children's NHS Foundation Trust, UK
| | - A Kumar
- University Hospitals of North Midlands NHS Trust, UK
| | | | - R Perry
- University of Birmingham, UK
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Bradley LE, Brunson OH, Graham J. A quick fix: B12 deficiency causing hemolytic anemia. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00218-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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11
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Hitt M, Robertson A, Graham J, Milner C. Apparently localized rectal cancer presents with thrombotic microangiopathy and leukoerythroblastosis secondary to myelophthisis. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00231-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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12
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Chowdhury Z, Graham J, Elkins S. Acquired factor VIII inhibitor following medicinal termination of pregnancy. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00228-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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13
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Xiao-Kim E, Shountz T, Graham J, Barfield J. 33 Cryopreservation of Jamaican fruit bat (. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab33] [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: 12/09/2022] Open
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Saunders MP, Graham J, Cunningham D, Plummer R, Church D, Kerr R, Cook S, Zheng S, La Thangue N, Kerr D. CXD101 and nivolumab in patients with metastatic microsatellite-stable colorectal cancer (CAROSELL): a multicentre, open-label, single-arm, phase II trial. ESMO Open 2022; 7:100594. [PMID: 36327756 PMCID: PMC9808483 DOI: 10.1016/j.esmoop.2022.100594] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Patients with microsatellite stable (MSS) colorectal carcinoma (CRC) do not respond to immune checkpoint inhibitors. Preclinical models suggested synergistic anti-tumour activity combining CXD101 and anti-programmed cell death protein 1 treatment; therefore, we assessed the clinical combination of CXD101 and nivolumab in heavily pre-treated patients with MSS metastatic CRC (mCRC). PATIENTS AND METHODS This single-arm, open-label study enrolled patients aged 18 years or older with biopsy-confirmed MSS CRC; at least two lines of systemic anticancer therapies (including oxaliplatin and irinotecan); at least one measurable lesion; Eastern Cooperative Oncology Group performance status of 0, 1 or 2; predicted life expectancy above 3 months; and adequate organ and bone marrow function. Nine patients were enrolled in a safety run-in study to define a tolerable combination schedule of CXD101 and nivolumab, followed by 46 patients in the efficacy assessment phase. Patients in the efficacy assessment cohort were treated orally with 20 mg CXD101 twice daily for 5 consecutive days every 3 weeks, and intravenously with 240 mg nivolumab every 2 weeks. The primary endpoint was immune disease control rate (iDCR). RESULTS Between 2018 and 2020, 55 patients were treated with CXD101 and nivolumab. The combination therapy was well tolerated with the most frequent grade 3 or 4 adverse events being neutropenia (18%) and anaemia (7%). Immune-related adverse reactions commonly ascribed to checkpoint inhibitors were surprisingly rare although we did see single cases of pneumonitis, hypothyroidism and hypopituitarism. There were no treatment-related deaths. Of 46 patients assessable for efficacy, 4 (9%) achieved partial response and 18 (39%) achieved stable disease, translating to an immune disease control rate of 48%. The median overall survival (OS) was 7.0 months (95% confidence interval 5.13-10.22 months). CONCLUSIONS The primary endpoint was met in this phase II study, which showed that the combination of CXD101 and nivolumab, at full individual doses in the treatment of advanced or metastatic MSS CRC, was both well tolerated and efficacious.
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Affiliation(s)
- M P Saunders
- The Christie NHS Foundation Trust, Manchester, UK.
| | - J Graham
- The Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - D Cunningham
- The Royal Marsden NHS Foundation Trust, London, UK
| | - R Plummer
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - D Church
- The Churchill Hospital Oxford University Hospitals NHS Trust, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - R Kerr
- The Churchill Hospital Oxford University Hospitals NHS Trust, Oxford, UK
| | - S Cook
- Celleron Therapeutics Limited, Oxford, UK
| | - S Zheng
- Celleron Therapeutics Limited, Oxford, UK
| | | | - D Kerr
- The Churchill Hospital Oxford University Hospitals NHS Trust, Oxford, UK; Celleron Therapeutics Limited, Oxford, UK
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Di Giacomo A, Santangelo F, Amato G, E. Simonetti, Graham J, Lahn M, van der Veen L, Hammett T, Pickering C, Durini M, Ziyang T, Lakshmikanth T, Brodin P, Occhipinti M, Simonelli M, Carlo-Stella C, Santoro A, Spiliopoulou P, Evans T, Maio M. 192P Safety and clinical activity of IOA-244: A highly selective phosphoinositide 3-kinase inhibitor delta (PI3Kδ), in a phase I first-in-human (FIH) study. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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16
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Cifuentes SG, Graham J, Loayza F, Saraiva C, Salinas L, Trueba G, Cárdenas PA. Evaluation of changes in the faecal resistome associated with children's exposure to domestic animals and food animal production. J Glob Antimicrob Resist 2022; 31:212-215. [PMID: 36202201 PMCID: PMC9850782 DOI: 10.1016/j.jgar.2022.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/02/2022] [Accepted: 09/19/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The paediatric gut microbiota is a reservoir of antimicrobial resistance genes. Environmental factors such as a child's exposure to faecal contamination and antimicrobial resistance genes of animal origin likely shape the resistome of infants and children. This study measured how different levels of exposure to domestic or food animals affect the structure of the intestinal resistome in children between 1 and 7 years of age. METHODS One hundred nineteen faecal samples from 39 children were analysed according to the level of exposure to domestic or food animals and categorized into three risk groups. Using high-throughput sequencing with an Illumina NovaSeq 6000 SP platform, we performed faecal resistome analyses using the ResFinder database. Additionally, ResistoXplorer was used to characterize the resistomes of children differentially exposed to domestic animals. RESULTS Our data indicated that specific antimicrobial resistance genes such as those that confer resistance to MATFPR (macrolide, aminoglycoside, tetracycline, fluoroquinolone, phenicol, and rifamycin) and tetracyclines were statistically less abundant in the group of children without exposure to animals (group 2), compared with the groups exposed to domestic and food animals (groups 1 and 3). However, the overall resistome structure among the children was not affected by the different levels of exposure to animals. CONCLUSIONS This study suggests that animal exposure is a risk factor for young children acquiring specific antimicrobial resistance genes from domestic animals or animal production areas. However, the overall resistome structure was not affected.
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Affiliation(s)
- Sara G. Cifuentes
- Universidad San Francisco de Quito USFQ, Colegio de Ciancias Biológicas y Ambientales, Instituto de Microbiología, Quito, Pichincha, Ecuador
| | - Jay Graham
- Environmental Health Sciences Division, University of California, Berkeley, California
| | - Fernanda Loayza
- Universidad San Francisco de Quito USFQ, Colegio de Ciancias Biológicas y Ambientales, Instituto de Microbiología, Quito, Pichincha, Ecuador
| | - Carlos Saraiva
- Universidad San Francisco de Quito USFQ, Colegio de Ciancias Biológicas y Ambientales, Instituto de Microbiología, Quito, Pichincha, Ecuador
| | - Liseth Salinas
- Universidad San Francisco de Quito USFQ, Colegio de Ciancias Biológicas y Ambientales, Instituto de Microbiología, Quito, Pichincha, Ecuador
| | - Gabriel Trueba
- Universidad San Francisco de Quito USFQ, Colegio de Ciancias Biológicas y Ambientales, Instituto de Microbiología, Quito, Pichincha, Ecuador
| | - Paúl A. Cárdenas
- Universidad San Francisco de Quito USFQ, Colegio de Ciancias Biológicas y Ambientales, Instituto de Microbiología, Quito, Pichincha, Ecuador,Corresponding author. Universidad San Francisco de Quito USFQ, Instituto de Microbiología, Vía Interoceánica y Diego de Robles, Cumbayá, Ecuador., (P.A. Cárdenas)
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Dohm A, Kalagotla H, Jiang S, Bhandari M, Mills M, Graham J, Khushalani N, Forsyth P, Etame A, Liu J, Tran N, Vogelbaum M, Yu H, Oliver D, Ahmed K. Stereotactic Radiosurgery and Anti-PD-1 + CTLA-4 Therapy, Anti-PD-1 Therapy, Anti-CTLA-4 Therapy, BRAF/MEK Inhibitors, BRAF Inhibitor, or Conventional Chemotherapy for the Management of Melanoma Brain Metastases. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.854] [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: 11/26/2022]
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Killackey T, Kohut SA, Morgan C, Gill N, Aiello S, Alonso-Gonzalez R, Graham J, Veloso L, Desbiens C, Desbiens C, Stinson J. VIRTUAL PEER-TO-PEER MENTORING FOR ADOLESCENTS WITH CONGENITAL HEART DISEASE: AN IMPLEMENTATION STUDY. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.220] [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: 11/17/2022] Open
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Lamarca A, Roberts K, Graham J, Kocher H, Chang D, Ghaneh P, Jamieson N, Propper D, Bridgewater J, Ajithkumar T, Palmer D, Wedgwood K, Grose D, Corrie P, Valle J. P-85 Pre-surgical staging and surveillance after curative treatment for pancreatic ductal adenocarcinoma (PDAC): Survey of practice in the United Kingdom (UK). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.175] [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: 11/27/2022] Open
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20
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Gan H, White M, McGaffin G, Lannagan T, Campbell A, Graham J, Sansom O, Wilson R. P-36 Real-world outcomes in BRAFV600E metastatic colorectal cancer – the Glasgow experience. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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21
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Rae S, Plummer E, Fitzgerald L, Hogarth L, Bridgewood A, Brown-Schofield L, Graham J, Drew Y, Haris N, Bashir S, Plummer R, Greystoke A. 47P Prevalence of mutations in common tumour types in Northern England and utility of Experimental Cancer Medicine Centre (ECMC) CRUK Trial Finder. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.01.056] [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] Open
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22
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Di Giacomo A, Santangelo F, Amato G, Simonetti E, Graham J, Lahn M, Zorilla R, van der Veen L, Johnson Z, Pickering C, Maréchal E, Blanco J, Durini M, Gufford B, Lakshmikanth T, Brodin P, Spiliopoulou P, Evans T, Maio M. 139P First-in-human (FIH), pharmacokinetic (PK) and pharmacodynamic (PD) study of IOA-244, a phosphoinositide 3-kinase delta (PI3Kδ) inhibitor, in patients with advanced metastatic mesothelioma, uveal and cutaneous melanoma. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.158] [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: 11/27/2022] Open
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23
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Hassoun-Kheir N, Stabholz Y, Kreft JU, de la Cruz R, Dechesne A, Smets BF, Romalde JL, Lema A, Balboa S, García-Riestra C, Torres-Sangiao E, Neuberger A, Graham D, Quintela-Baluja M, Stekel DJ, Graham J, Pruden A, Nesme J, Sørensen SJ, Hough R, Paul M. EMBRACE-WATERS statement: Recommendations for reporting of studies on antimicrobial resistance in wastewater and related aquatic environments. One Health 2021; 13:100339. [PMID: 34746357 PMCID: PMC8554267 DOI: 10.1016/j.onehlt.2021.100339] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 11/26/2020] [Revised: 10/17/2021] [Accepted: 10/17/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A One Health approach requires integrative research to elucidate antimicrobial resistance (AMR) in the environment and the risks it poses to human health. Research on this topic involves experts from diverse backgrounds and professions. Shortcomings exist in terms of consistent, complete, and transparent reporting in many environmental studies. Standardized reporting will improve the quality of scientific papers, enable meta-analyses and enhance the communication among different experts. In this study, we aimed to generate a consensus of reporting standards for AMR research in wastewater and related aquatic environments. METHODS Based on a risk of bias assessment of the literature in a systematic review, we proposed a set of study quality indicators. We then used a multistep modified Delphi consensus to develop the EMBRACE-WATERS statement (rEporting antiMicroBial ResistAnCE in WATERS), a checklist of recommendations for reporting in studies of AMR in wastewater and related aquatic environments. FINDINGS Consensus was achieved among a multidisciplinary panel of twenty-one experts in three steps. The developed EMBRACE-WATERS statement incorporates 21 items. Each item contains essential elements of high-quality reporting and is followed by an explanation of their rationale and a reporting-example. The EMBRACE-WATERS statement is primarily intended to be used by investigators to ensure transparent and comprehensive reporting of their studies. It can also guide peer-reviewers and editors in evaluation of manuscripts on AMR in the aquatic environment. This statement is not intended to be used to guide investigators on the methodology of their research. INTERPRETATION We are hopeful that this statement will improve the reporting quality of future studies of AMR in wastewater and related aquatic environments. Its uptake would generate a common language to be used among researchers from different disciplines, thus advancing the One Health approach towards understanding AMR spread across aquatic environments. Similar initiatives are needed in other areas of One Health research.
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Affiliation(s)
- Nasreen Hassoun-Kheir
- Infectious Diseases Institute, Rambam Health Care Campus, HaAliya HaShniya St 8, Haifa 3109601, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Efron St 1, Haifa 3109601, Israel
| | - Yoav Stabholz
- Infectious Diseases Institute, Rambam Health Care Campus, HaAliya HaShniya St 8, Haifa 3109601, Israel
| | - Jan-Ulrich Kreft
- School of Biosciences, Institute of Microbiology and Infection (IMI), Centre for Computational Biology (CCB), University of Birmingham, Birmingham, UK
| | - Roberto de la Cruz
- School of Biosciences, Institute of Microbiology and Infection (IMI), Centre for Computational Biology (CCB), University of Birmingham, Birmingham, UK
| | - Arnaud Dechesne
- Technical University of Denmark, Department of Environmental Engineering, bygning 115, Bygningstorvet, 2800 Kongens Lyngby, Denmark
| | - Barth F. Smets
- Technical University of Denmark, Department of Environmental Engineering, bygning 115, Bygningstorvet, 2800 Kongens Lyngby, Denmark
| | - Jesús L. Romalde
- Department of Microbiology and Parasitology, CIBUS-Faculty of Biology, Universidade de Santiago de Compostela, Santiago de Compostela 15782, Spain
- CRETUS, Universidade de Santiago de Compostela, Santiago de Compostela 15782, Spain
| | - Alberto Lema
- Department of Microbiology and Parasitology, CIBUS-Faculty of Biology, Universidade de Santiago de Compostela, Santiago de Compostela 15782, Spain
| | - Sabela Balboa
- CRETUS, Universidade de Santiago de Compostela, Santiago de Compostela 15782, Spain
| | - Carlos García-Riestra
- Department of Microbiology and Parasitology, University Hospital Complex of Santiago (CHUS), Spain
| | - Eva Torres-Sangiao
- Escherichia coli Group, Research Foundation Institute (FIDIS), University Hospital Complex (CHUS), Santiago de Compostela, ES, Spain
| | - Ami Neuberger
- Infectious Diseases Institute, Rambam Health Care Campus, HaAliya HaShniya St 8, Haifa 3109601, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Efron St 1, Haifa 3109601, Israel
| | - David Graham
- School of Engineering, Newcastle University, Newcastle upon Tyne, UK
| | | | - Dov J. Stekel
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, College Road, Loughborough LE12 5RD, UK
| | - Jay Graham
- University of California, Berkeley School of Public Health, Berkeley, CA, USA
| | - Amy Pruden
- The Charles Edward Via, Jr. Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Joseph Nesme
- Section of Microbiology, Department of Biology, Faculty of Science, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Søren Johannes Sørensen
- Section of Microbiology, Department of Biology, Faculty of Science, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Rupert Hough
- Information and Computational Sciences, The James Hutton Institute, Aberdeen AB15 8QH, Scotland, UK
| | - Mical Paul
- Infectious Diseases Institute, Rambam Health Care Campus, HaAliya HaShniya St 8, Haifa 3109601, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Efron St 1, Haifa 3109601, Israel
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Graham J, Redler G, DeLozier K, Yu H, Oliver D, Rosenberg S. Dosimetric Feasibility of HA-WBRT With an MRI-Guided Linear Accelerator. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1403] [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: 12/01/2022]
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Padmanabhan R, Zhang G, Oliver D, Graham J, Grass D, Sahebjam S, Yu H. Patterns of Failure in Patients With Recurrent High-Grade Glioma Treated With Hypofractionated Stereotactic Re-Irradiation, Pembrolizumab, and Bevacizumab. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Spiliopoulou P, Kazmi F, Aroldi F, Holmes J, Graham J, Holmes T, Lord S, Veal G, Qi C, Coyle V, Evans T, Blagden S. 549P Results of a first-in-human study of the ProTide thymidylate synthase inhibitor NUC-3373, in patients with advanced solid tumours (NuTide:301). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Graham J, Brown L, Adams R, Seligmann J, Wilson R, Maughan T. 430P Learning from FOCUS4: A molecularly stratified adaptive trial platform in metastatic colorectal cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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28
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Seligmann J, Fisher D, Brown L, Adams R, Graham J, Quirke P, Richman S, Butler R, Domingo E, Blake A, Braun M, Collinson F, Jones R, Brown E, De Winton E, Humphies T, Kaplan R, Wilson R, Seymour M, Maughan T. 382O Inhibition of WEE1 is effective in TP53 and RAS mutant metastatic colorectal cancer (mCRC): A randomised phase II trial (FOCUS4-C) comparing adavosertib (AZD1775) with active monitoring. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Graham J, Novosat T, Sun H, Piper B, Boscarino J, Duboski V, Kern M, Wright E, Robinson R, Casey E, Beck C, Hall J, Schepman P. POS1089 ASSOCIATION BETWEEN PAIN SEVERITY AND HEALTHCARE UTILIZATION IN AN OSTEOARTHRITIS POPULATION: AN 18-YEAR RETROSPECTIVE COHORT STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Osteoarthritis (OA) is a common disease that varies in severity among patients. A standardized definition to classify patients into different severity levels is lacking, however, due to the disease’s complex pathogenesis and presentation. Prior studies have shown associations between pain severity and higher healthcare resource utilization (HRU) and costs. We investigated an association between pain severity and higher healthcare resource utilization by examining the use of specific OA-related treatments across pain intensity levels in a large, integrated health system’s OA population over an 18-year period.Objectives:Our aim was to compare use of medications and other treatments among OA patients experiencing mild, moderate, or severe pain.Methods:This was a retrospective study of electronic health records from 2001 to 2018 at Geisinger, an integrated health system in Pennsylvania. Patients were included with a diagnosis code for OA (ICD-9: 715.*, ICD-10 M15-19) on a problem list or encounter or an OA-specific procedure (hip or knee replacement, arthroscopy or injection). We examined pain scores (0-10 scale, with 10 being worst pain) taken after the first OA diagnosis date and defined pain episodes starting on the pain score’s date and lasting for 90 days. If a new pain score was measured before 90 days elapsed, the episode was extended for an additional 90 days, with this process repeated as necessary. Each episode was categorized as mild (pain score 0-3), moderate (4-6), or severe (7-10) based on initial score, and patients could contribute multiple episodes to the analysis. Descriptive statistics were used to quantify treatment utilization during each patients’ mild, moderate and severe episodes. Percentages of patients who had any use of 10 medication types (tramadol, non-tramadol opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), injectable corticosteroids, acetaminophen, salicylates, duloxetine, homeopathic medications, other topical medications, and other over-the-counter (OTC) medications were compared across pain episode types. Percentages of patients with knee or hip surgeries, spine or joint imaging procedures (x-ray, computed tomography or magnetic resonance) and consults to OA-related care (pain management, orthopedics or physical medicine and rehabilitation) were also compared. All analyses used logistic regression with p-values <0.05 considered significant.Results:We identified 290,897 patients with OA, representing 34% of the health system population in 2018; 58% were female with mean age of 49 years and mean BMI of 30.5 kg/m2. A total of 801,144 pain episodes were defined, with 75% of patients having at least one pain score. The two most frequently occurring pain scores were 0 (17%) and 5 (13%), and pain episodes were classified as 43% mild, 32% moderate and 25% severe. Significantly higher percentages of patients used certain medication types (NSAIDs, injectable corticosteroids, non-tramadol opioid, duloxetine) in both moderate and severe pain episodes as compared to mild episodes, but other medication types were less likely to be used as pain severity increased (acetaminophen, salicylates, homeopathic medications, other OTC medications). Knee or hip surgeries, imaging, and consults to OA-related specialists were all consistently significantly more likely to occur in patients during moderate or severe pain episodes versus mild episodes (relative risk ratios of 1.76, 1.25 and 1.35 for moderate vs mild, respectively, and 2.00, 1.44 and 1.46 for severe vs mild, all p-values <0.05).Conclusion:While pain is generally recognized to be a subjective measure that could be influenced by other unmeasured factors and can be confounded with treatment effectiveness, it is nevertheless the primary symptom of OA. It is important to understand the relationship between pain intensity and treatment utilization, and our results support an overall association between pain and utilization but provide new details on the extent to which it depends on specific utilization type.Acknowledgements:Pfizer and Eli Lilly and Company for sponsoring this study.Disclosure of Interests:Jove Graham Grant/research support from: I am an employee of Geisinger which received financial support from Pfizer and Eli Lilly and Company in connection with the development of this abstract, Tonia Novosat Grant/research support from: I am an employee of Geisinger which received financial support from Pfizer and Eli Lilly and Company in connection with the development of this abstract, Haiyan Sun Grant/research support from: I am an employee of Geisinger which received financial support from Pfizer and Eli Lilly and Company in connection with the development of this abstract, Brian Piper Grant/research support from: I am an employee of Geisinger which received financial support from Pfizer and Eli Lilly and Company in connection with the development of this abstract, Joseph Boscarino Grant/research support from: I am an employee of Geisinger which received financial support from Pfizer and Eli Lilly and Company in connection with the development of this abstract, Vanessa Duboski Grant/research support from: I am an employee of Geisinger which received financial support from Pfizer and Eli Lilly and Company in connection with the development of this abstract, Melissa Kern Grant/research support from: I am an employee of Geisinger which received financial support from Pfizer and Eli Lilly and Company in connection with the development of this abstract, Eric Wright Grant/research support from: I am an employee of Geisinger which received financial support from Pfizer and Eli Lilly and Company in connection with the development of this abstract, Rebecca Robinson Shareholder of: Eli Lilly & Co., Employee of: Eli Lilly & Co., Edward Casey Shareholder of: Pfizer, Inc., Paid instructor for: As an employee of Pfizer, Inc. this is part of my role., Employee of: Pfizer, Inc., Craig Beck Shareholder of: Pfizer, Inc., Employee of: Pfizer, Inc., Jerry Hall Shareholder of: Eli Lilly & Co., Employee of: Eli Lilly & Co., Patricia Schepman Shareholder of: Pfizer, Inc., Employee of: Pfizer, Inc.
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Graham J, Kroetz AM, Poulakis GR, Scharer RM, Carlson JK, Lowerre-Barbieri S, Morley D, Reyier EA, Grubbs RD. Large-scale space use of large juvenile and adult smalltooth sawfish Pristis pectinata: implications for management. ENDANGER SPECIES RES 2021. [DOI: 10.3354/esr01088] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The smalltooth sawfish Pristis pectinata is an endangered species endemic to the Atlantic Ocean. The only known viable populations occur in the USA along both coasts of Florida and in the western Bahamas. Little is known about habitat use and movement ecology of large juvenile and adult smalltooth sawfish. Although Critical Habitat—a management designation in the USA—has been identified for small juveniles, it has yet to be identified for these life stages. Between May 2016 and April 2019, we used passive acoustic telemetry and 3 large data sharing networks of receivers to track movements of 43 large juvenile and adult smalltooth sawfish. During this study, 24 females and 19 males were implanted with transmitters with estimated 4 or 10 yr battery lives. These tagged individuals were detected off the southeastern USA on 461 receivers ranging from off the coast of Brunswick, Georgia, to the lower Florida Keys, and along the Gulf coast to Apalachee Bay, Florida. Seasonal migrations were undertaken by 58% (43% mature; 57% immature) of the tagged individuals, with the remainder being apparent residents of their tagging locations. Tagged sawfish from both size classes and of both sexes migrated, which indicates that neither sex nor length is a predictor of whether a sawfish will migrate or not. Although both coasts of Florida were used for migration, most individuals consistently used the same coast when they migrated. The areas surrounding Boca Grande, Cape Canaveral, and the lower Florida Keys were heavily visited sites that could be further evaluated as potential Critical Habitat for these life stages. Understanding the movement patterns of this Critically Endangered species is essential for creating policies to protect areas important for promoting growth of the population.
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Affiliation(s)
- J Graham
- Florida State University Coastal and Marine Laboratory, St. Teresa, Florida 32358, USA
| | - AM Kroetz
- Riverside Technology, Inc. for NOAA, National Marine Fisheries Service, Southeast Fisheries Science Center, Panama City, Florida 32408, USA
| | - GR Poulakis
- Charlotte Harbor Field Laboratory, Fish and Wildlife Research Institute, Florida Fish and Wildlife Conservation Commission, Port Charlotte, Florida 33954, USA
| | - RM Scharer
- Charlotte Harbor Field Laboratory, Fish and Wildlife Research Institute, Florida Fish and Wildlife Conservation Commission, Port Charlotte, Florida 33954, USA
| | - JK Carlson
- NOAA, National Marine Fisheries Service, Southeast Fisheries Science Center, Panama City, Florida 32408, USA
| | - S Lowerre-Barbieri
- Fisheries and Aquatic Sciences Program, University of Florida, 7922 NW 71st Street, Gainesville, Florida 32653, USA
- Fish and Wildlife Research Institute, Florida Fish and Wildlife Conservation Commission, St. Petersburg, Florida 33701, USA
| | - D Morley
- South Florida Regional Laboratory, Fish and Wildlife Research Institute, Florida Fish and Wildlife Conservation Commission, Marathon, Florida 33050, USA
| | - EA Reyier
- Herndon Solutions Group, LLC, NASA Environmental and Medical Contract, Kennedy Space Center, Florida 32899, USA
| | - RD Grubbs
- Florida State University Coastal and Marine Laboratory, St. Teresa, Florida 32358, USA
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Butzin-Dozier Z, Waters WF, Baca M, Vinueza RL, Saraiva-Garcia C, Graham J. Assessing Upstream Determinants of Antibiotic Use in Small-Scale Food Animal Production through a Simulated Client Method. Antibiotics (Basel) 2020; 10:antibiotics10010002. [PMID: 33374513 PMCID: PMC7822171 DOI: 10.3390/antibiotics10010002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 01/25/2023] Open
Abstract
Small-scale food animal production has been celebrated as a means of economic mobility and improved food security but the use of veterinary antibiotics among these producers may be contributing to the spread of antibiotic resistance in animals and humans. In order to improve antibiotic stewardship in this sector, it is critical to identify the drivers of producers’ antibiotic use. This study assessed the determinants of antibiotic use in small-scale food animal production through simulated client visits to veterinary supply stores and surveys with households that owned food animals (n = 117) in Ecuador. Eighty percent of households with food animals owned chickens and 78% of those with chickens owned fewer than 10 birds. Among the households with small-scale food animals, 21% reported giving antibiotics to their food animals within the last six months. Simulated client visits indicated that veterinary sales agents frequently recommended inappropriate antibiotic use, as 66% of sales agents recommended growth promoting antibiotics, and 48% of sales agents recommended an antibiotic that was an inappropriate class for disease treatment. In contrast, few sales agents (3%) were willing to sell colistin, an antibiotic banned for veterinary use in Ecuador as of January 2020, which supports the effectiveness of government regulation in antibiotic stewardship. The cumulative evidence provided by this study indicates that veterinary sales agents play an active role in promoting indiscriminate and inappropriate use of antibiotics in small-scale food animal production.
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Affiliation(s)
| | - William F. Waters
- San Francisco de Quito University, Quito 170157, Ecuador; (W.F.W.); (M.B.); (R.L.V.); (C.S.-G.)
| | - Martin Baca
- San Francisco de Quito University, Quito 170157, Ecuador; (W.F.W.); (M.B.); (R.L.V.); (C.S.-G.)
| | - Rommel Lenin Vinueza
- San Francisco de Quito University, Quito 170157, Ecuador; (W.F.W.); (M.B.); (R.L.V.); (C.S.-G.)
| | - Carlos Saraiva-Garcia
- San Francisco de Quito University, Quito 170157, Ecuador; (W.F.W.); (M.B.); (R.L.V.); (C.S.-G.)
| | - Jay Graham
- School of Public Health, University of California, Berkeley, CA 94704, USA;
- Correspondence: ; Tel.: +1-(443)-286-8335
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Azzi Y, Parides M, Alani O, Loarte-Campos P, Bartash R, Forest S, Colovai A, Ajaimy M, Liriano-Ward L, Pynadath C, Graham J, Le M, Greenstein S, Rocca J, Kinkhabwala M, Akalin E. COVID-19 infection in kidney transplant recipients at the epicenter of pandemics. Kidney Int 2020; 98:1559-1567. [PMID: 33069762 PMCID: PMC7561527 DOI: 10.1016/j.kint.2020.10.004] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/24/2020] [Accepted: 10/01/2020] [Indexed: 12/24/2022]
Abstract
We investigated the prevalence and clinical outcomes of COVID-19 in recipients of kidney transplants in the Bronx, New York, one of the epicenters of the pandemic. Between March 16 and June 2, 2020, 132 kidney transplant recipients tested positive by SARS-CoV-2 RT-PCR. From May 3 to July 29, 2020, 912 kidney transplant recipients were screened for SARS-CoV-2 IgG antibodies during routine clinic visits, of which 16.6% tested positive. Fifty-five of the 152 patients had previously tested positive by RT-PCR, while the remaining 97 did not have significant symptoms and had not been previously tested by RT-PCR. The prevalence of SARS-CoV-2 infection was 23.4% in the 975 patients tested by either RT-PCR or SARS-CoV-2 IgG. Older patients and patients with higher serum creatinine levels were more likely diagnosed by RT-PCR compared to SARS-CoV-2 IgG. Sixty-nine RT-PCR positive patients were screened for SARS-CoV-2 IgG antibodies at a median of 44 days post-diagnosis (Inter Quartile Range 31-58) and 80% were positive. Overall mortality was 20.5% but significantly higher (37.8%) in the patients who required hospitalization. Twenty-three percent of the hospitalized patients required kidney replacement therapy and 6.3% lost their allografts. In multivariable analysis, older age, receipt of deceased-donor transplantation, lack of influenza vaccination in the previous year and higher serum interleukine-6 levels were associated with mortality. Thus, 42% of patients with a kidney transplant and with COVID-19 were diagnosed on antibody testing without significant clinical symptoms; 80% of patients with positive RT-PCR developed SARS-CoV-2 IgG and mortality was high among patients requiring hospitalization.
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Affiliation(s)
- Yorg Azzi
- Division of Nephrology, Montefiore Medical Center Transplant Center, Albert Einstein College of Medicine, Bronx, New York, USA; Einstein-Montefiore Abdominal Transplant Center, Bronx, New York, USA
| | - Michael Parides
- Department of Surgery, Montefiore Medical Center Transplant Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Omar Alani
- Einstein-Montefiore Abdominal Transplant Center, Bronx, New York, USA
| | - Pablo Loarte-Campos
- Division of Nephrology, Montefiore Medical Center Transplant Center, Albert Einstein College of Medicine, Bronx, New York, USA; Einstein-Montefiore Abdominal Transplant Center, Bronx, New York, USA
| | - Rachel Bartash
- Division of infectious Disease, Montefiore Medical Center Transplant Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Stefanie Forest
- Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Adriana Colovai
- Einstein-Montefiore Abdominal Transplant Center, Bronx, New York, USA
| | - Maria Ajaimy
- Division of Nephrology, Montefiore Medical Center Transplant Center, Albert Einstein College of Medicine, Bronx, New York, USA; Einstein-Montefiore Abdominal Transplant Center, Bronx, New York, USA
| | - Luz Liriano-Ward
- Division of Nephrology, Montefiore Medical Center Transplant Center, Albert Einstein College of Medicine, Bronx, New York, USA; Einstein-Montefiore Abdominal Transplant Center, Bronx, New York, USA
| | - Cindy Pynadath
- Division of Nephrology, Montefiore Medical Center Transplant Center, Albert Einstein College of Medicine, Bronx, New York, USA; Einstein-Montefiore Abdominal Transplant Center, Bronx, New York, USA
| | - Jay Graham
- Einstein-Montefiore Abdominal Transplant Center, Bronx, New York, USA; Department of Surgery, Montefiore Medical Center Transplant Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Marie Le
- Einstein-Montefiore Abdominal Transplant Center, Bronx, New York, USA; Department of Surgery, Montefiore Medical Center Transplant Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Stuart Greenstein
- Einstein-Montefiore Abdominal Transplant Center, Bronx, New York, USA; Department of Surgery, Montefiore Medical Center Transplant Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Juan Rocca
- Einstein-Montefiore Abdominal Transplant Center, Bronx, New York, USA; Department of Surgery, Montefiore Medical Center Transplant Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Milan Kinkhabwala
- Einstein-Montefiore Abdominal Transplant Center, Bronx, New York, USA; Department of Surgery, Montefiore Medical Center Transplant Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Enver Akalin
- Division of Nephrology, Montefiore Medical Center Transplant Center, Albert Einstein College of Medicine, Bronx, New York, USA; Einstein-Montefiore Abdominal Transplant Center, Bronx, New York, USA.
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O’Neal L, Alvarez D, Mendizábal-Cabrera R, Ramay BM, Graham J. Community-Acquired Antimicrobial Resistant Enterobacteriaceae in Central America: A One Health Systematic Review. Int J Environ Res Public Health 2020; 17:ijerph17207622. [PMID: 33086731 PMCID: PMC7589814 DOI: 10.3390/ijerph17207622] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/10/2020] [Accepted: 10/14/2020] [Indexed: 12/21/2022]
Abstract
Community-acquired antimicrobial resistant Enterobacteriaceae (CA-ARE) are an increasingly important issue around the world. Characterizing the distribution of regionally specific patterns of resistance is important to contextualize and develop locally relevant interventions. This systematic review adopts a One Health framework considering the health of humans, animals, and the environment to describe CA-ARE in Central America. Twenty studies were identified that focused on antimicrobial resistance (AMR) in Enterobacteriaceae. Studies on CA-ARE in Central America characterized resistance from diverse sources, including humans (n = 12), animals (n = 4), the environment (n = 2), and combinations of these categories (n = 2). A limited number of studies assessed prevalence of clinically important AMR, including carbapenem resistance (n = 3), third generation cephalosporin resistance (n = 7), colistin resistance (n = 2), extended spectrum beta-lactamase (ESBL) production (n = 4), or multidrug resistance (n = 4). This review highlights significant gaps in our current understanding of CA-ARE in Central America, most notably a general dearth of research, which requires increased investment and research on CA-ARE as well as AMR more broadly.
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Affiliation(s)
- Lauren O’Neal
- School of Public Health, University of California, Berkeley, CA 94720, USA;
| | - Danilo Alvarez
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City 01015, Guatemala; (D.A.); (R.M.-C.); (B.M.R.)
| | - Renata Mendizábal-Cabrera
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City 01015, Guatemala; (D.A.); (R.M.-C.); (B.M.R.)
| | - Brooke M. Ramay
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City 01015, Guatemala; (D.A.); (R.M.-C.); (B.M.R.)
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA 99164, USA
| | - Jay Graham
- School of Public Health, University of California, Berkeley, CA 94720, USA;
- Correspondence:
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Graham J, Fleet A. Effectiveness of the Pediatric Nutrition Screening Tool at Tallahassee Memorial Healthcare. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Liu S, Choi D, Romaniuk A, Graham J, Buller C, Cheema A. NATURAL HISTORY OF SPONTANEOUS CORONARY ARTERY DISSECTIONS (SCAD): FINDINGS OF A ROUTINE SURVEILLANCE ANGIOGRAPHIC STUDY. Can J Cardiol 2020. [DOI: 10.1016/j.cjca.2020.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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MacDonald N, Harmon SHE, Faour D, Graham J, Steffen C, Henaff L, Shendale S. Mandatory immunization: Empirical examination of governance instruments in 28 Global NITAG Network (GNN) countries. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In the Global Vaccine Action Plan 2017 Assessment Report, WHO's SAGE noted need to understand ways in which legislation and regulation are used to advance or undermine immunization. The NITAG Environmental Scan Project sought to address this in a pilot study.
Methods
Data was collected via a secure online survey of GNN members (40 countries Sept 2018). Respondents reporting a mandatory element were asked: (1) what vaccinations were required by law; and (2) what population groups were subject to mandates; (3) what grounds, if any, were available for requesting exemptions.
Results
28 (70%) countries responded, representing every WHO region and World Bank income level. While mandatory immunization programs / elements within broader NIPs were relatively common, jurisdictions varied with respect to immunizations required, population groups affected, grounds for exemptions, and penalties for non-compliance. We observed some loose associations with geography and income level. Children were the most common population group subject to mandates at some stage of childhood development (28/28); healthcare workers were second (8/15 (53%)). Sanctions for failure to immunize varied broadly, ranging from no penalty, to loss of access to social services e.g. admission to school, monetary fines, and incarceration. A variance between countries as to how strictly immunization mandates are enforced was noted.
Conclusions
A variety of approaches existed ranging from Narrow/Permissive to Broad/ Inclusive in scope with enforcement mapping loosely to this continuum from Loose/Permissive to Tight/Coercive. Jurisdictions with few/no vaccines mandated, and few/no target groups identified, Loose approach is expected; for those closer to Broad approach, Tighter controls expected. Coercive measures may be 'positive' (vaccination as a gateway to public services, with possible work-arounds), or 'negative' (failure to vaccinate = penalties).
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Affiliation(s)
- N MacDonald
- Department of Paediatrics, Dalhousie University, Halifax, Canada
| | - S H E Harmon
- Faculty of Law and Department of Paediatrics, Dalhousie University, Halifax, Canada
| | - D Faour
- Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - J Graham
- Department of Paediatrics, Dalhousie University, Halifax, Canada
| | - C Steffen
- Department of Immunization, Vaccines and Biologicals, WHO, Geneva, Switzerland
| | - L Henaff
- Department of Immunization, Vaccines and Biologicals, WHO, Geneva, Switzerland
| | - S Shendale
- Department of Immunization, Vaccines and Biologicals, WHO, Geneva, Switzerland
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Graham J, Li A, Pareek A, Kim MH, Leveridge M, Doiron C. 726P Collecting duct and renal medullary carcinoma: A population based analysis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Gault A, Dobeson C, Haney S, Graham J, Humphreys A. Review of Outcomes in North East England for Patients Receiving Neoadjuvant Chemotherapy for Breast Carcinoma. Clin Oncol (R Coll Radiol) 2020. [DOI: 10.1016/j.clon.2020.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Welsh K, Marashi H, Grose D, McIntosh D, Evans J, Martin A, Graham J, Smith G, Forshaw M, Fullarton G, Craig C, Macdonald A, MacKay C, Wilson C. P-17 Peri-operative FLOT: West of Scotland regional experience. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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40
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Grothey A, Tabernero J, Taieb J, Yaeger R, Yoshino T, Maiello E, Fernandez EE, Casado AR, Ross P, André T, Kato T, Ruffinelli J, Graham J, den Eynde MV, Vera R, Jean B, Roussel EC, Cahuzac C, Issiakhem Z, Vedovato J, Cutsem EV. LBA-5 ANCHOR CRC: a single-arm, phase 2 study of encorafenib, binimetinib plus cetuximab in previously untreated BRAF V600E-mutant metastatic colorectal cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.080] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Akalin E, Azzi Y, Bartash R, Seethamraju H, Parides M, Hemmige V, Ross M, Forest S, Goldstein YD, Ajaimy M, Liriano-Ward L, Pynadath C, Loarte-Campos P, Nandigam PB, Graham J, Le M, Rocca J, Kinkhabwala M. Covid-19 and Kidney Transplantation. N Engl J Med 2020; 382:2475-2477. [PMID: 32329975 PMCID: PMC7200055 DOI: 10.1056/nejmc2011117] [Citation(s) in RCA: 609] [Impact Index Per Article: 152.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
| | - Yorg Azzi
- Montefiore Medical Center, Bronx, NY
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marie Le
- Montefiore Medical Center, Bronx, NY
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Sourial MY, Sourial MH, Dalsan R, Graham J, Ross M, Chen W, Golestaneh L. Urgent Peritoneal Dialysis in Patients With COVID-19 and Acute Kidney Injury: A Single-Center Experience in a Time of Crisis in the United States. Am J Kidney Dis 2020; 76:401-406. [PMID: 32534129 PMCID: PMC7287441 DOI: 10.1053/j.ajkd.2020.06.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 06/02/2020] [Indexed: 12/21/2022]
Abstract
At Montefiore Medical Center in The Bronx, NY, the first case of coronavirus disease 2019 (COVID-19) was admitted on March 11, 2020. At the height of the pandemic, there were 855 patients with COVID-19 admitted on April 13, 2020. Due to high demand for dialysis and shortages of staff and supplies, we started an urgent peritoneal dialysis (PD) program. From April 1 to April 22, a total of 30 patients were started on PD. Of those 30 patients, 14 died during their hospitalization, 8 were discharged, and 8 were still hospitalized as of May 14, 2020. Although the PD program was successful in its ability to provide much-needed kidney replacement therapy when hemodialysis was not available, challenges to delivering adequate PD dosage included difficulties providing nurse training and availability of supplies. Providing adequate clearance and ultrafiltration for patients in intensive care units was especially difficult due to the high prevalence of a hypercatabolic state, volume overload, and prone positioning. PD was more easily performed in non–critically ill patients outside the intensive care unit. Despite these challenges, we demonstrate that urgent PD is a feasible alternative to hemodialysis in situations with critical resource shortages.
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Affiliation(s)
- Maryanne Y Sourial
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
| | - Mina H Sourial
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Rochelle Dalsan
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Jay Graham
- Montefiore-Einstein Center for Transplantation, Department of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Michael Ross
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Wei Chen
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Ladan Golestaneh
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
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Cheema F, Leuvennink J, Ee C, Macklin J, Graham J. How medical student placements at a psychiatry hospital can be utilised to make psychiatry a popular career choice. Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(11)73411-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
It is perceived that negative attitudes towards mental illness in undergraduate medical students can impact student's decision in choosing psychiatry as a medical career. Improvement in psychiatry placements for undergraduate medical students can result in changing student's attitude towards psychiatry as a career choice. We demonstrate how students’ placements from various medical schools at a major psychiatric hospital contributed towards enhancing student's interest towards psychiatry. Medical students who had their placement over the last one year were contacted for an anonymised student perspective survey.While majority of students did not have psychiatry as their potential career choice before they started their placements more than two third rated psychiatry as a potential career choice based on their experience from the placements. This encouraged us to improve the placement standards based on student's perspective. Students suggested that more use of medical training in psychiatry, improvement in teaching and placement standards and more psychiatry placements before specialised training can contribute towards making psychiatry as one of the popular career choices. Student's preferred interactive teaching sessions including case based discussions and informal teaching sessions during ward rounds and clinics. Overall students found their placements helpful but more so to perform well in their examinations as compared to coverage of full psychiatry curriculum.It is planned to conduct the survey again after necessary changes based on student's perspective to evaluate whether further improvement in placements can continue in contributing towards increasing medical recruitment in psychiatry.
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Lancette GA, Harmon SM, Brooks D, Bryant R, Chiu J, Graham J, Guilfoyle D, Hill W, Latt T, Noah C, Placencia A, Pratt M, Radle D, Smith A, Solomon H, Staben D, Stern N, Thaker N. Enumeration and Confirmation of Bacillus cereus in Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/63.3.581] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A collaborative study was conducted in 15 laboratories to evaluate 2 different techniques for enumerating Bacillus cereus in foods. A direct plating technique using mannitol-egg yolk-polymyxin agar and a most probable number (MPN) technique using trypticase-soy-polymyxin broth were compared for the enumeration of high and low populations of B. cereus in mashed potatoes. The collaborative results showed that the overall mean recovery obtained with the low population level was essentially the same by both techniques. However, the overall mean recovery was significantly higher by the direct plating technique at the high population level. A statistical evaluation of the data also showed that the direct plating technique had better repeatability and reproducibility than did the MFN technique at both the high and low population levels. These results suggest that the MPN technique is suitable for examining foods containing low populations of B. cereus, but that the direct plating technique is preferable for foods that contain a high population of this organism. The confirmatory technique used in the proposed method is reliable for presumptive identification of isolates as B. cereus. The method has been adopted as official first action.
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Affiliation(s)
- Gayle A Lancette
- Food and Drug Administration, Minneapolis Center for Microbiological Investigations, Minneapolis, MN 55401
| | - Stanley M Harmon
- Food and Drug Administration, Minneapolis Center for Microbiological Investigations, Minneapolis, MN 55401
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Fuller D, Herrick J, Graham J, Barfield J. 42 Vitrification of invitro-produced feline embryos. Reprod Fertil Dev 2020. [DOI: 10.1071/rdv32n2ab42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Preservation of feline embryos is useful in propagating endangered species, preserving valuable genetics, and supporting biomedical research. Although a wide variety of cryoprotectants (CP) and protocols are successfully used for vitrification of invitro-produced (IVP) embryos, there are often species-specific differences in viability of embryos post-warming. The purpose of this study was to evaluate the viability of IVP feline embryos after vitrification using two common CPs, propanediol (PrOH) or ethylene glycol (EG). Embryos were produced with oocytes and frozen-thawed epididymal sperm collected from local spay-neuter clinics using a published IVP protocol developed for producing domestic feline embryos. Day 7 early blastocysts (stage 5), blastocysts (stage 6), and expanded blastocysts (stage 7) were evaluated for quality (grade 1 or 2) and randomly assigned to one of three treatments: vitrification with PrOH (n=32), vitrification with EG (n=31), or control (n=47), which was allowed to continue in culture until Day 8. The vitrification protocol was as follows. The base medium for all vitrification media was a HEPES-buffered feline optimized culture medium (FOCMH). Embryos were placed in 0.5mL of equilibration medium (7.5% dimethyl sulfoxide, 7.5% PrOH or EG, 0.5M sucrose, 10% Ficoll, and 20% fetal calf serum (FCS)) for 5min at room temperature. Individual embryos were then moved to 20-μL drops of vitrification medium (15% dimethyl sulfoxide, 15% PrOH or EG, 0.5M sucrose, 10% Ficoll, and 20% FCS) at room temperature for 30s before being loaded onto Cryolock devices and plunged into liquid nitrogen. Warming was done using a 3-step process for all vitrified embryos. First, embryos were moved from liquid nitrogen directly to 0.5mL of 1M sucrose, 10% Ficoll, and 20% FCS at 37°C for 1min. Next, embryos were moved to 0.5mL of 0.5M sucrose, 10% Ficoll, and 20% FCS at 20°C for 3min. Finally, embryos were transferred to 0.5mL of FOCMH for 5min at 37°C. All warmed embryos were cultured in medium, optimized for feline embryos, with 5% FCS and evaluated for re-expansion of the blastocoele and progression in development at 24 and 48h. Results are from five replicates. Embryos vitrified in EG exhibited higher percentages of viable embryos 24h after warming (84%) than embryos vitrified in PrOH (59%; P<0.05). The continued embryonic growth of viable embryos after culture for 48h showed equivalent developmental rates, at 87, 96, and 100% for control, EG-treated, and PrOH-treated embryos, respectively (P>0.05). Results indicate EG is a more successful CP treatment for vitrification of feline embryos when evaluating viability 24h post-warming. We report a higher viability of embryos post-thaw than previous studies using the same CPs (Pope et al. 2012 Reprod. Domest. Anim. 47, 125). This may be due to the shorter exposure time to the CPs we used during the vitrification process. We conclude that EG and PrOH are effective CPs for Day 7 feline IVP embryos using this protocol. Further research is needed to increase treatment numbers and evaluate pregnancy rates from embryos transferred post-warming.
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Skuce R, Breadon E, Allen A, Milne G, McCormick C, Hughes C, Rutherford D, Smith G, Thompson S, Graham J, Harwood R, Byrne A. Longitudinal dynamics of herd-level Mycobacterium bovis MLVA type surveillance in cattle in Northern Ireland 2003-2016. Infect Genet Evol 2019; 79:104131. [PMID: 31786341 DOI: 10.1016/j.meegid.2019.104131] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/28/2019] [Accepted: 11/27/2019] [Indexed: 02/02/2023]
Abstract
Investigating genetically-structured diversity in pathogen populations over time is important to better understand disease maintenance and spread. Herd-level surveillance of Mycobacterium bovis genotypes (multi-locus VNTR analysis types, MLVA types) from all culture-confirmed bovine tuberculosis (TB) herd cases was undertaken in Northern Ireland (NI), generating an unparalleled, longitudinal, population-level 14-year survey for this pathogen. Across this population, 295 genetically-distinct M. bovis MLVA types were identified in the 19,717 M. bovis isolates surveyed. Of these, the most frequent was MLVA type 002 (23.0%); 151 MLVA types were represented more than once, in groups ranging from 2 to 4438 isolates. Only 23 MLVA types were isolated in all 14 years. Investigating inter-annual frequency of M. bovis MLVA types, examples of statistically-significant expansions (MLVA types 002, 004, 006, 009 and 027), contractions (MLVA types 001, 007 and 011) and maintenance (MLVA types 003 and 005) were disclosed, during a period of fluctuating bovine TB herd-level incidence at the NI scale. The fixed period frequency distribution of MLVA types remained highly right-skewed. Novel VNTR copy number variant MLVA types (N = 242; an average of 17 per annum) were identified throughout the survey. The MLVA type distribution in the landscape was not random; MLVA types showed statistically-significant geographical localization and strong spatial associations with Divisional Veterinary Office (DVO) regions. There was also evidence of differential risk of particular MLVA types across breeds (Holstein/Friesian vs. other), age-class, and sex and some evidence of an association between the number of animals testing positive for bovine TB during the disclosing test and particular MLVA types, although there was substantial variation.
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Affiliation(s)
- R Skuce
- Veterinary Sciences Division, Agri-food and Biosciences Institute (AFBI), Stoney Road, Stormont, Belfast BT4 3SD, UK; School of Biological Sciences, Queen's University Belfast, Belfast BT7 1NN, UK.
| | - E Breadon
- Veterinary Sciences Division, Agri-food and Biosciences Institute (AFBI), Stoney Road, Stormont, Belfast BT4 3SD, UK
| | - A Allen
- Veterinary Sciences Division, Agri-food and Biosciences Institute (AFBI), Stoney Road, Stormont, Belfast BT4 3SD, UK
| | - G Milne
- Veterinary Sciences Division, Agri-food and Biosciences Institute (AFBI), Stoney Road, Stormont, Belfast BT4 3SD, UK
| | - C McCormick
- Veterinary Sciences Division, Agri-food and Biosciences Institute (AFBI), Stoney Road, Stormont, Belfast BT4 3SD, UK; Veterinary Service and Animal Health Group, Department of Agriculture, Environment and Rural Affairs, Dundonald House, Stormont, Belfast BT4 3SB, UK
| | - C Hughes
- Veterinary Sciences Division, Agri-food and Biosciences Institute (AFBI), Stoney Road, Stormont, Belfast BT4 3SD, UK
| | - D Rutherford
- Veterinary Sciences Division, Agri-food and Biosciences Institute (AFBI), Stoney Road, Stormont, Belfast BT4 3SD, UK; Faculty of Electrical Engineering, Czech Technical University, Prague, Czech Republic (⁎)current address
| | - G Smith
- Veterinary Sciences Division, Agri-food and Biosciences Institute (AFBI), Stoney Road, Stormont, Belfast BT4 3SD, UK
| | - S Thompson
- Veterinary Sciences Division, Agri-food and Biosciences Institute (AFBI), Stoney Road, Stormont, Belfast BT4 3SD, UK
| | - J Graham
- Veterinary Sciences Division, Agri-food and Biosciences Institute (AFBI), Stoney Road, Stormont, Belfast BT4 3SD, UK
| | - R Harwood
- Veterinary Service and Animal Health Group, Department of Agriculture, Environment and Rural Affairs, Dundonald House, Stormont, Belfast BT4 3SB, UK
| | - A Byrne
- Veterinary Sciences Division, Agri-food and Biosciences Institute (AFBI), Stoney Road, Stormont, Belfast BT4 3SD, UK; School of Biological Sciences, Queen's University Belfast, Belfast BT7 1NN, UK; One-Health Unit, Surveillance, Animal By-Products and TSEs (SAT), Division Department of Agriculture, Food and Marine (DAFM), Agriculture House, Dublin 2, Ireland
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Akther F, Rahatullah Razan MD, Graham J, Stanhope K, Havel P, Rahimian R. P716Role of EDRFs in aortic and mesenteric arterial function of the UC Davis Type 2 Diabetic Mellitus (UCD-T2DM) male rats. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0321] [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: 11/14/2022] Open
Abstract
Abstract
Several studies have shown vascular dysfunction in diabetic rats, however, there is no data on the vascular function of UC Davis type 2 diabetes Mellitus (UCD-T2DM) rats. UCD-T2DM is a novel but validated model of type 2 diabetes (T2D) which more closely resembles the pathophysiology of diabetes in humans. The aim of this study was to determine whether aortic or mesenteric arterial function were altered in UCD-T2DM male rats. Specifically, we determined the responses to endothelium-dependent vasodilator and vasoconstrictor in this model. We also studied the relative contribution of endothelium-derived relaxing factors (EDRFs) in modulating vascular reactivity of aorta or mesenteric artery (MA) in UCD-T2DM male rats.
Endothelium-dependent vasodilation (EDV) to acetylcholine (ACh) was measured in rat aorta or MA pre-contracted with phenylephrine (PE). Particularly, EDV to ACh were measured before and after pretreatment with indomethacin (indo, cyclooxygenase inhibitor), ODQ (soluble guanylate cyclase inhibitor), L-NNA (nitric oxide synthase (NOS) inhibitor), TRAM-34 (IKca blocker), or Apamin (SKca blocker). Constrictor response curves to PE were also generated in both aorta and MA. Furthermore, the protein expression of IK channels were determined using Western blotting.
We demonstrated that EDV to ACh was impaired in MA, while potentiated in the aortic rings of UCD-T2DM rats. In diabetic MA, the importance of endothelium-derived hyperpolarizing factor (EDHF) in ACh-induced relaxation was decreased, while the contribution of nitric oxide (NO) was enhanced. On the other hand, in diabetic aorta, the relative contribution of EDHF in relaxation responses to ACh was significantly enhanced (as measured by ACh response which was insensitive to indo, ODQ and L-NNA).
The incubation of aorta or MA with TRAM-34 blunted the relaxation responses to ACh in both control and diabetic groups. However, the inhibitory effects of TRAM 34 on ACh responses were more prominent in arteries taken from UCD-T2DM groups compared to those in controls. By contrast, ACh responses were not affected following incubation of aorta or MA with Apamin in either control or diabetic groups suggesting that SKca channels plays no role in EDHF-mediated relaxation in either vascular beds. Accordingly, the IKca expression level was significantly higher in aortic rings of diabetic group than in the controls.
The responsiveness to PE was significantly enhanced in the aortic rings of diabetic group, whereas in MA, diabetes did not alter the contractile responses to PE.
These data suggest that in MA of UCD-T2DM rats, the predisposition to vascular injury may be due to a shift away from EDHF, initially the major vasodilatory factor, toward a greater reliance on NO. However, in aorta, despite elevated contractile responses, ACh responses were enhanced. Increased contribution of NO-independent factors specifically IKca channel plays a role in potentiated responses to ACh in this model.
Acknowledgement/Funding
NIHLBI
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Affiliation(s)
- F Akther
- University of the Pacific, Stockton, United States of America
| | | | - J Graham
- University of California, Davis, United States of America
| | - K Stanhope
- University of California, Davis, United States of America
| | - P Havel
- University of California, Davis, United States of America
| | - R Rahimian
- University of the Pacific, Stockton, United States of America
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Vergneau-Grosset C, Peña L, Cluzel C, Hawkins M, Maccolini E, Sinclair K, Graham J, Sadar M, Guzman DSM, Lair S, Langlois I, Paul-Murphy J. Evaluation of deslorelin implant on subsequent mammary tumors of rats (Rattus norvegicus). J Exot Pet Med 2019. [DOI: 10.1053/j.jepm.2019.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Milne MG, Graham J, Allen A, McCormick C, Presho E, Skuce R, Byrne AW. Variation in Mycobacterium bovis genetic richness suggests that inwards cattle movements are a more important source of infection in beef herds than in dairy herds. BMC Microbiol 2019; 19:154. [PMID: 31277578 PMCID: PMC6612228 DOI: 10.1186/s12866-019-1530-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 06/25/2019] [Indexed: 02/08/2023] Open
Abstract
Background We used genetic Multi-Locus VNTR Analysis (MLVA) data gathered from surveillance efforts to better understand the ongoing bovine tuberculosis (bTB) epidemic in Northern Irish cattle herds. We modelled the factors associated with Mycobacterium bovis MLVA genotype richness at three analytical scales; breakdown level, herd level, and patch level, and compared the results between dairy and non-dairy production types. Results In 83% of breakdowns and in 63% of herds, a single MLVA genotype was isolated. Five or more MLVA genotypes were found in less than 3 % of herds. Herd size and the total number of reactors were important explanatory variables, suggesting that increasing MLVA genotype richness was positively related to increases in the number of host animals. Despite their smaller relative size, however, the highest MLVA genotype richness values were observed in non-dairy herds. Increasing inwards cattle movements were important positive predictors of MLVA genotype richness, but mainly in non-dairy settings. Conclusions The principal finding is that low MLVA genotype richness indicates that small-scale epidemics, e.g. wildlife, contiguous farms, and within-herd recrudescence, are important routes of M. bovis infection in cattle herds. We hypothesise that these mechanisms will maintain, but may not explicitly increase, MLVA genotype richness. The presence of elevated MLVA richness is relatively rare and likely indicates beef fattening enterprises, which purchase cattle from over long distances. Cattle movements were furthermore an important predictor of MLVA genotype richness in non-dairy herds, but not in dairy herds; this may represent reduced cattle purchasing levels in dairy enterprises, compared to beef. These observations allude to the relative contribution of different routes of bTB infection between production types; we posit that infection associated with local factors may be more evident in dairy herds than beef herds, however in beef herds, inwards movements offer additional opportunities for introducing M. bovis into the herd. Electronic supplementary material The online version of this article (10.1186/s12866-019-1530-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M G Milne
- Veterinary Sciences Division, Agri-food and Biosciences Institute (AFBI), 12 Stoney Road, Stormont, Belfast, BT4 3SD, UK.
| | - J Graham
- Veterinary Sciences Division, Agri-food and Biosciences Institute (AFBI), 12 Stoney Road, Stormont, Belfast, BT4 3SD, UK
| | - A Allen
- Veterinary Sciences Division, Agri-food and Biosciences Institute (AFBI), 12 Stoney Road, Stormont, Belfast, BT4 3SD, UK
| | - C McCormick
- Veterinary Sciences Division, Agri-food and Biosciences Institute (AFBI), 12 Stoney Road, Stormont, Belfast, BT4 3SD, UK.,Department of Agriculture, Environment and Rural Affairs (DAERA), Veterinary Service Animal Health, Coleraine, UK
| | - E Presho
- Veterinary Sciences Division, Agri-food and Biosciences Institute (AFBI), 12 Stoney Road, Stormont, Belfast, BT4 3SD, UK
| | - R Skuce
- Veterinary Sciences Division, Agri-food and Biosciences Institute (AFBI), 12 Stoney Road, Stormont, Belfast, BT4 3SD, UK
| | - A W Byrne
- Veterinary Sciences Division, Agri-food and Biosciences Institute (AFBI), 12 Stoney Road, Stormont, Belfast, BT4 3SD, UK.,School of Biological Sciences, Queen's University, Belfast, UK.,Present Address: Surveillance, Animal By-Products, and TSEs (SAT) Division, Department of Agriculture, Food and Marine (DAFM), Agriculture House, Dublin 2, Ireland
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Graham J, Dickerson S, Longhitano Y, Zanza C, Widjaja W, Aron M, Kim M. Immediate impact of a multidisciplinary enhanced recovery after surgery program for robotic radical prostatectomies. Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2019.03.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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