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Biswas N, Bahr A, Howard J, Bonin JL, Grazda R, MacNamara KC. Survivors of polymicrobial sepsis are refractory to G-CSF-induced emergency myelopoiesis and hematopoietic stem and progenitor cell mobilization. Stem Cell Reports 2024:S2213-6711(24)00082-1. [PMID: 38608679 DOI: 10.1016/j.stemcr.2024.03.007] [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: 05/03/2023] [Revised: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 04/14/2024] Open
Abstract
Sepsis survivors exhibit immune dysfunction, hematological changes, and increased risk of infection. The long-term impacts of sepsis on hematopoiesis were analyzed using a surgical model of murine sepsis, resulting in 50% survival. During acute disease, phenotypic hematopoietic stem and progenitor cells (HSPCs) were reduced in the bone marrow (BM), concomitant with increased myeloid colony-forming units and extramedullary hematopoiesis. Upon recovery, BM HSPCs were increased and exhibited normal function in the context of transplantation. To evaluate hematopoietic responses in sepsis survivors, we treated recovered sham and cecal ligation and puncture mice with a mobilizing regimen of granulocyte colony-stimulating factor (G-CSF) at day 20 post-surgery. Sepsis survivors failed to undergo emergency myelopoiesis and HSPC mobilization in response to G-CSF administration. G-CSF is produced in response to acute infection and injury to expedite the production of innate immune cells; therefore, our findings contribute to a new understanding of how sepsis predisposes to subsequent infection.
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Affiliation(s)
- Nirupam Biswas
- Department of Immunology and Microbial Disease, Albany Medical College, Albany, NY 12208, USA
| | - Amber Bahr
- Department of Immunology and Microbial Disease, Albany Medical College, Albany, NY 12208, USA
| | - Jennifer Howard
- Department of Immunology and Microbial Disease, Albany Medical College, Albany, NY 12208, USA
| | - Jesse L Bonin
- Department of Immunology and Microbial Disease, Albany Medical College, Albany, NY 12208, USA
| | - Rachel Grazda
- Department of Immunology and Microbial Disease, Albany Medical College, Albany, NY 12208, USA
| | - Katherine C MacNamara
- Department of Immunology and Microbial Disease, Albany Medical College, Albany, NY 12208, USA.
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Pessarrodona A, Howard J, Pidgeon E, Wernberg T, Filbee-Dexter K. Carbon removal and climate change mitigation by seaweed farming: A state of knowledge review. Sci Total Environ 2024; 918:170525. [PMID: 38309363 DOI: 10.1016/j.scitotenv.2024.170525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/31/2023] [Accepted: 01/26/2024] [Indexed: 02/05/2024]
Abstract
The pressing need to mitigate the effects of climate change is driving the development of novel approaches for carbon dioxide removal (CDR) from the atmosphere, with the ocean playing a central role in the portfolio of solutions. The expansion of seaweed farming is increasingly considered as one of the potential CDR avenues among government and private sectors. Yet, comprehensive assessments examining whether farming can lead to tangible climate change mitigation remain limited. Here we examine the results of over 100 publications to synthesize evidence regarding the CDR capacity of seaweed farms and review the different interventions through which an expansion of seaweed farming may contribute to climate change mitigation. We find that presently, the majority of the carbon fixed by seaweeds is stored in short-term carbon reservoirs (e.g., seaweed products) and that only a minority of the carbon ends up in long-term reservoirs that are likely to fit within existing international accounting frameworks (e.g., marine sediments). Additionally, the tiny global area cultivated to date (0.06 % of the estimated wild seaweed extent) limits the global role of seaweed farming in climate change mitigation in the present and mid-term future. A first-order estimate using the best available data suggests that, at present, even in a low emissions scenario, any carbon removal capacity provided by seaweed farms globally is likely to be offset by their emissions (median global balance net emitter: -0.11 Tg C yr-1; range -2.07-1.95 Tg C yr-1), as most of a seaweed farms' energy and materials currently depend on fossil fuels. Enhancing any potential CDR though seaweed farming will thus require decarbonizing of supply chains, directing harvested biomass to long-term carbon storage products, expanding farming outside traditional cultivation areas, and developing robust models tracing the fate of seaweed carbon. This will present novel scientific (e.g., verifying permanence of seaweed carbon), engineering (e.g., developing farms in wave exposed areas), and economic challenges (e.g., increase market demand, lower costs, decarbonize at scale), many of which are only beginning to be addressed.
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Affiliation(s)
- Albert Pessarrodona
- UWA Oceans Institute and School of Biological Sciences, University of Western Australia, Crawley, Western Australia 6009, Australia; Conservation International, Arlington, VA, USA; International Blue Carbon Institute, Singapore.
| | - Jennifer Howard
- Conservation International, Arlington, VA, USA; International Blue Carbon Institute, Singapore
| | - Emily Pidgeon
- Conservation International, Arlington, VA, USA; International Blue Carbon Institute, Singapore
| | - Thomas Wernberg
- UWA Oceans Institute and School of Biological Sciences, University of Western Australia, Crawley, Western Australia 6009, Australia; Institute of Marine Research, His, Norway
| | - Karen Filbee-Dexter
- UWA Oceans Institute and School of Biological Sciences, University of Western Australia, Crawley, Western Australia 6009, Australia; Institute of Marine Research, His, Norway
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Maurel M, Howard J, Kissling E, Pozo F, Pérez-Gimeno G, Buda S, Sève N, McKenna A, Meijer A, Rodrigues AP, Martínez-Baz I, Mlinarić I, Latorre-Margalef N, Túri G, Lazăr M, Mazagatos C, Echeverria A, Abela S, Bourgeois M, Machado A, Dürrwald R, Petrović G, Oroszi B, Jancoriene L, Marin A, Husa P, Duffy R, Dijkstra F, Gallardo García V, Goerlitz L, Enouf V, Bennett C, Hooiveld M, Guiomar R, Trobajo-Sanmartín C, Višekruna Vučina V, Samuelsson Hagey T, Lameiras Azevedo AS, Castilla J, Xuereb G, Delaere B, Gómez V, Tolksdorf K, Bacci S, Nicolay N, Kaczmarek M, Rose AM. Interim 2023/24 influenza A vaccine effectiveness: VEBIS European primary care and hospital multicentre studies, September 2023 to January 2024. Euro Surveill 2024; 29:2400089. [PMID: 38390651 PMCID: PMC10899813 DOI: 10.2807/1560-7917.es.2024.29.8.2400089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 02/21/2024] [Indexed: 02/24/2024] Open
Abstract
Influenza A viruses circulated in Europe from September 2023 to January 2024, with influenza A(H1N1)pdm09 predominance. We provide interim 2023/24 influenza vaccine effectiveness (IVE) estimates from two European studies, covering 10 countries across primary care (EU-PC) and hospital (EU-H) settings. Interim IVE was higher against A(H1N1)pdm09 than A(H3N2): EU-PC influenza A(H1N1)pdm09 IVE was 53% (95% CI: 41 to 63) and 30% (95% CI: -3 to 54) against influenza A(H3N2). For EU-H, these were 44% (95% CI: 30 to 55) and 14% (95% CI: -32 to 43), respectively.
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Affiliation(s)
| | | | | | - Francisco Pozo
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- National Centre for Microbiology, National Influenza Reference Laboratory, WHO-National Influenza Centre, Institute of Health Carlos III, Madrid, Spain
| | - Gloria Pérez-Gimeno
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Silke Buda
- Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Robert Koch Institute, Berlin, Germany
| | - Noémie Sève
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Adele McKenna
- HSE Health Protection Surveillance Centre, Dublin, Ireland
| | - Adam Meijer
- National Institute for Public Health and the Environment, Centre for Infectious Diseases Control, Bilthoven, the Netherlands
| | - Ana Paula Rodrigues
- Epidemiology Department, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra - IdiSNA - CIBERESP, Pamplona, Spain
| | - Ivan Mlinarić
- Croatian Institute of Public Health, Zagreb, Croatia
| | | | - Gergő Túri
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Mihaela Lazăr
- Cantacuzino National Military Medical Institute for Research and Development, Bucharest, Romania
| | - Clara Mazagatos
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | - Stephen Abela
- Infectious Disease Prevention and Control Unit (IDCU), Health Promotion and Disease Prevention, Msida, Malta
| | - Marc Bourgeois
- Department of Infectious Diseases, CHU UCL Namur (site Godinne), Université catholique de Louvain, Yvoir, Belgium
| | - Ausenda Machado
- Epidemiology Department, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Ralf Dürrwald
- National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
| | | | - Beatrix Oroszi
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Ligita Jancoriene
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Alexandru Marin
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
| | - Petr Husa
- University Hospital Brno and Masaryk University, Brno, Czechia
| | - Roisin Duffy
- HSE Health Protection Surveillance Centre, Dublin, Ireland
| | - Frederika Dijkstra
- National Institute for Public Health and the Environment, Centre for Infectious Diseases Control, Bilthoven, the Netherlands
| | - Virtudes Gallardo García
- Servicio de Vigilancia y Salud Laboral, Dirección General de Salud Pública y Ordenación Farmacéutica, Consejería de Salud y Consumo, Andalucía, Spain
| | - Luise Goerlitz
- Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Robert Koch Institute, Berlin, Germany
| | - Vincent Enouf
- Centre National de Référence Virus des Infections Respiratoire (CNR VIR), Institut Pasteur Université Paris Cité, Paris, France
| | - Charlene Bennett
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | | | - Raquel Guiomar
- Laboratório Nacional Referência Gripe e outros Vírus Respiratórios, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | | | | | | | - Ana Sofía Lameiras Azevedo
- Servicio de vigilancia y control epidemiológico, Subdirección general de Epidemiología y Vigilancia de la Salud, Dirección General de Salud pública, Valencia, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra - IdiSNA - CIBERESP, Pamplona, Spain
| | - Gerd Xuereb
- Department of Child and Adolescent Health, Mater Dei Hospital, Msida, Malta
- Infectious Disease Prevention and Control Unit (IDCU), Health Promotion and Disease Prevention, Msida, Malta
| | - Bénédicte Delaere
- Department of Infectious Diseases, CHU UCL Namur (site Godinne), Université catholique de Louvain, Yvoir, Belgium
| | - Verónica Gómez
- Epidemiology Department, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Kristin Tolksdorf
- Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Robert Koch Institute, Berlin, Germany
| | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Nathalie Nicolay
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Marlena Kaczmarek
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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Rose AMC, Pozo F, Martínez-Baz I, Mazagatos C, Bossuyt N, Cauchi JP, Petrović G, Loghin II, Vaikutyte R, Buda S, Machado A, Duffy R, Oroszi B, Howard J, Echeverria A, Andreu C, Barbezange C, Džiugytė A, Nonković D, Popescu CP, Majauskaite F, Tolksdorf K, Gomez V, Domegan L, Horváth JK, Castilla J, García M, Demuyser T, Borg ML, Tabain I, Lazar M, Kubiliute I, Dürrwald R, Guiomar R, O'Donnell J, Kristóf K, Nicolay N, Bacci S, Kissling E. Vaccine effectiveness against influenza hospitalisation in adults during the 2022/2023 mixed season of influenza A(H1N1)pdm09, A(H3N2) and B circulation, Europe: VEBIS SARI VE hospital network. Influenza Other Respir Viruses 2024; 18:e13255. [PMID: 38403302 PMCID: PMC10894713 DOI: 10.1111/irv.13255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 02/27/2024] Open
Abstract
We conducted a multicentre hospital-based test-negative case-control study to measure vaccine effectiveness (VE) against PCR-confirmed influenza in adult patients with severe acute respiratory infection (SARI) during the 2022/2023 influenza season in Europe. Among 5547 SARI patients ≥18 years, 2963 (53%) were vaccinated against influenza. Overall VE against influenza A(H1N1)pdm09 was 11% (95% CI: -23-36); 20% (95% CI: -4-39) against A(H3N2) and 56% (95% CI: 22-75) against B. During the 2022/2023 season, while VE against hospitalisation with influenza B was >55%, it was ≤20% for influenza A subtypes. While influenza vaccination should be a priority for future seasons, improved vaccines against influenza are needed.
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Affiliation(s)
| | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Iván Martínez-Baz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
| | - Clara Mazagatos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | | | - John Paul Cauchi
- Department for Health Regulation, Health Promotion and Disease Prevention, Msida, Malta
| | | | - Isabela I Loghin
- St Parascheva Clinical Hospital of Infectious Diseases, Iasi, Romania
| | | | | | - Ausenda Machado
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Róisín Duffy
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | - Aitziber Echeverria
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
| | - Cristina Andreu
- Subdirección de Epidemiología, Dirección General de Salud Pública, Servicio Extremeño de Salud, Mérida, Spain
| | | | - Aušra Džiugytė
- Department for Health Regulation, Health Promotion and Disease Prevention, Msida, Malta
| | - Diana Nonković
- Teaching Public Health Institute of Split-Dalmatia County, Split, Croatia
| | - Corneliu-Petru Popescu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
| | - Fausta Majauskaite
- Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | | | - Verónica Gomez
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Jesús Castilla
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
| | - Miriam García
- Dirección General de Salud Pública, Departamento de Sanidad, Gobierno de Aragón, Zaragoza, Spain
| | - Thomas Demuyser
- Department of Microbiology and Infection control, UZ Brussel, Brussels, Belgium
| | - Maria-Louise Borg
- Department for Health Regulation, Health Promotion and Disease Prevention, Msida, Malta
| | - Irena Tabain
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Mihaela Lazar
- "Cantacuzino" National Military-Medical Institute for Research and Development, Bucharest, Romania
| | - Ieva Kubiliute
- Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | | | - Raquel Guiomar
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Nathalie Nicolay
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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5
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Chakravorty S, Drasar E, Kaya B, Kesse-Adu R, Velangi M, Wright J, Howard J. UK Haemoglobin Disorders Peer Review: A Quality Standards-based review programme for sickle cell disease and thalassaemia. Br J Haematol 2024; 204:668-676. [PMID: 37786398 DOI: 10.1111/bjh.19114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 08/17/2023] [Accepted: 09/08/2023] [Indexed: 10/04/2023]
Abstract
We evaluated the impact of peer reviews in driving improvement in healthcare quality for people with haemoglobinopathy in the United Kingdom. We analysed compliance to four Quality Standards (QS)-based peer reviews from 2010 to 2020 to evaluate its impact in driving healthcare quality. Seventeen paediatric and 29 adult haemoglobinopathy centres were reviewed in 2010/11 and 2012/13 respectively; 33 paediatric and 33 adult centres were reviewed in 2014/16, and 32 paediatric and 32 adult centres were reviewed in 2018/2020. Compliance with QS and participant feedback were analysed to assess the impact of peer review programmes to drive improvement in quality of care. We noted that haemoglobinopathy centres significantly improved their compliance to QS between the first two review programmes, but not in the final review programme. In comparison to other disease-group reviews, the haemoglobinopathy departments were less able to address critical peer review recommendations in their own institutions. The peer review programme was unable to drive sustained improvement in healthcare quality, underscoring the need for sustained development and support for haemoglobinopathy services in the National Health Service. Further work is needed to understand why disparities exist among peer review-driven improvement initiatives within different disease groups.
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Affiliation(s)
| | - E Drasar
- Whittington Hospital NHS Trust, London, UK
| | - B Kaya
- Barts Health NHS Trust, London, UK
| | - R Kesse-Adu
- Guy's and St Thomas's Hospital NHS Trust, London, UK
| | - M Velangi
- Birmingham Children's Hospital NHS Trust, Birmingham, UK
| | - J Wright
- Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - J Howard
- Guy's and St Thomas's Hospital NHS Trust, London, UK
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6
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Antunes L, Mazagatos C, Martínez-Baz I, Gomez V, Borg ML, Petrović G, Duffy R, Dufrasne FE, Dürrwald R, Lazar M, Jancoriene L, Oroszi B, Husa P, Howard J, Melo A, Pozo F, Pérez-Gimeno G, Castilla J, Machado A, Džiugytė A, Karabuva S, Fitzgerald M, Fierens S, Tolksdorf K, Popovici SO, Mickienė A, Túri G, Součková L, Nicolay N, Rose AM. Effectiveness of the adapted bivalent mRNA COVID-19 vaccines against hospitalisation in individuals aged ≥ 60 years during the Omicron XBB lineage-predominant period: VEBIS SARI VE network, Europe, February to August, 2023. Euro Surveill 2024; 29:2300708. [PMID: 38240061 PMCID: PMC10797659 DOI: 10.2807/1560-7917.es.2024.29.3.2300708] [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: 12/15/2023] [Accepted: 01/18/2024] [Indexed: 01/22/2024] Open
Abstract
We conducted a multicentre hospital-based test-negative case-control study to measure the effectiveness of adapted bivalent COVID-19 mRNA vaccines against PCR-confirmed SARS-CoV-2 infection during the Omicron XBB lineage-predominant period in patients aged ≥ 60 years with severe acute respiratory infection from five countries in Europe. Bivalent vaccines provided short-term additional protection compared with those vaccinated > 6 months before the campaign: from 80% (95% CI: 50 to 94) for 14-89 days post-vaccination, 15% (95% CI: -12 to 35) at 90-179 days, and lower to no effect thereafter.
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Affiliation(s)
| | - Clara Mazagatos
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain
- CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Verónica Gomez
- Epidemiology Department, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Maria-Louise Borg
- Infectious Disease Prevention and Control Unit (IDCU), Health Promotion and Disease Prevention, Msida, Malta
| | | | - Róisín Duffy
- Health Service Executive-Health Protection Surveillance Centre (HPSC), Dublin, Ireland
| | - François E Dufrasne
- National Influenza Centre Laboratory of Viral Diseases, Sciensano, Brussels, Belgium
| | - Ralf Dürrwald
- National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
| | - Mihaela Lazar
- Cantacuzino National Military-Medical Institute for Research and Development, Bucharest, Romania
| | - Ligita Jancoriene
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Lithuania
| | - Beatrix Oroszi
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Petr Husa
- University Hospital Brno, Masaryk University, Brno, Czechia
| | | | - Aryse Melo
- Infectious Diseases Department, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Gloria Pérez-Gimeno
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain
- CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Ausenda Machado
- Epidemiology Department, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Aušra Džiugytė
- Infectious Disease Prevention and Control Unit (IDCU), Health Promotion and Disease Prevention, Msida, Malta
| | | | - Margaret Fitzgerald
- Health Service Executive-Health Protection Surveillance Centre (HPSC), Dublin, Ireland
| | - Sébastien Fierens
- Service Epidemiology of Infectious Diseases, Sciensano, Brussels, Belgium
| | - Kristin Tolksdorf
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Silvia-Odette Popovici
- National Institute of Public Health, National Centre for Communicable Diseases Surveillance and Control, Bucharest, Romania
| | - Auksė Mickienė
- Department of Infectious Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gergő Túri
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Lenka Součková
- University Hospital Brno, Masaryk University, Brno, Czechia
| | - Nathalie Nicolay
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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7
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Lakritz J, Aarnes TK, Alva B, Howard J, Magnin G, Lerche P, Kukanich B. Pharmacokinetics of oral tapentadol in cats. J Vet Pharmacol Ther 2024; 47:14-20. [PMID: 37350452 DOI: 10.1111/jvp.13399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/28/2023] [Accepted: 06/06/2023] [Indexed: 06/24/2023]
Abstract
To evaluate pharmacokinetics of one dose of tapentadol hydrochloride orally administered to cats. Prospective experimental study. Five healthy adult mixed-breed cats. Each cat received 18.8 ± 1.0 mg/kg tapentadol orally. Venous blood samples were collected at time 0 (immediately prior to administration of tapentadol) 1, 2, 5, 10, 15, 30, 45, 60, 90 min, and 2, 4, 8, 12 to 24 h after drug administration. Plasma tapentadol concentrations and its metabolites were determined using ultra-performance liquid chromatography-tandem mass spectrometry. Geometric mean Tmax of tapentadol, desmethyltapentadol, tapentadol-O-glucuronide, and tapentadol-O-sulfate was 2.3, 7.0, 6.0, and 4.6 h, respectively. Mean Cmax of tapentadol, desmethyltapentadol, tapentadol-O-glucuronide, and tapentadol-O-sulfate was 637, 66, 1134, and 15,757 ng/mL, respectively, after administration. Mean half-life of tapentadol, desmethyltapentadol, tapentadol-O-glucuronide, and tapentadol-O-sulfate was 2.4, 4.7, 2.9, and 10.8 h. The relative exposure of tapentadol and its metabolites were tapentadol 2.65%, desmethyltapentadol 0.54%, tapentadol-O-glucuronide 6.22%, and tapentadol-O-sulfate 90.6%. Tapentadol-O-sulfate was the predominant metabolite following the administration of oral tapentadol in cats. Further studies are warranted to evaluate the association of analgesia with plasma concentrations of tapentadol.
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Affiliation(s)
- J Lakritz
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - T K Aarnes
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - B Alva
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - J Howard
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - G Magnin
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - P Lerche
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - B Kukanich
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
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Pessarrodona A, Franco-Santos RM, Wright LS, Vanderklift MA, Howard J, Pidgeon E, Wernberg T, Filbee-Dexter K. Carbon sequestration and climate change mitigation using macroalgae: a state of knowledge review. Biol Rev Camb Philos Soc 2023; 98:1945-1971. [PMID: 37437379 DOI: 10.1111/brv.12990] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 07/14/2023]
Abstract
The conservation, restoration, and improved management of terrestrial forests significantly contributes to mitigate climate change and its impacts, as well as providing numerous co-benefits. The pressing need to reduce emissions and increase carbon removal from the atmosphere is now also leading to the development of natural climate solutions in the ocean. Interest in the carbon sequestration potential of underwater macroalgal forests is growing rapidly among policy, conservation, and corporate sectors. Yet, our understanding of whether carbon sequestration from macroalgal forests can lead to tangible climate change mitigation remains severely limited, hampering their inclusion in international policy or carbon finance frameworks. Here, we examine the results of over 180 publications to synthesise evidence regarding macroalgal forest carbon sequestration potential. We show that research efforts on macroalgae carbon sequestration are heavily skewed towards particulate organic carbon (POC) pathways (77% of data publications), and that carbon fixation is the most studied flux (55%). Fluxes leading directly to carbon sequestration (e.g. carbon export or burial in marine sediments) remain poorly resolved, likely hindering regional or country-level assessments of carbon sequestration potential, which are only available from 17 of the 150 countries where macroalgal forests occur. To solve this issue, we present a framework to categorize coastlines according to their carbon sequestration potential. Finally, we review the multiple avenues through which this sequestration can translate into climate change mitigation capacity, which largely depends on whether management interventions can increase carbon removal above a natural baseline or avoid further carbon emissions. We find that conservation, restoration and afforestation interventions on macroalgal forests can potentially lead to carbon removal in the order of 10's of Tg C globally. Although this is lower than current estimates of natural sequestration value of all macroalgal habitats (61-268 Tg C year-1 ), it suggests that macroalgal forests could add to the total mitigation potential of coastal blue carbon ecosystems, and offer valuable mitigation opportunities in polar and temperate areas where blue carbon mitigation is currently low. Operationalizing that potential will necessitate the development of models that reliably estimate the proportion of production sequestered, improvements in macroalgae carbon fingerprinting techniques, and a rethinking of carbon accounting methodologies. The ocean provides major opportunities to mitigate and adapt to climate change, and the largest coastal vegetated habitat on Earth should not be ignored simply because it does not fit into existing frameworks.
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Affiliation(s)
- Albert Pessarrodona
- UWA Oceans Institute and School of Biological Sciences, University of Western Australia, Crawley, 6009, Western Australia, Australia
- Conservation International, 2011 Crystal Dr., Suite 600, Arlington, VA, USA
- International Blue Carbon Institute, 42B Boat Quay, Singapore, 049831, Singapore
| | - Rita M Franco-Santos
- CSIRO Environment, Indian Ocean Marine Research Centre, Crawley, 6009, Western Australia, Australia
| | - Luka Seamus Wright
- UWA Oceans Institute and School of Biological Sciences, University of Western Australia, Crawley, 6009, Western Australia, Australia
- CSIRO Environment, Indian Ocean Marine Research Centre, Crawley, 6009, Western Australia, Australia
| | - Mathew A Vanderklift
- CSIRO Environment, Indian Ocean Marine Research Centre, Crawley, 6009, Western Australia, Australia
| | - Jennifer Howard
- Conservation International, 2011 Crystal Dr., Suite 600, Arlington, VA, USA
- International Blue Carbon Institute, 42B Boat Quay, Singapore, 049831, Singapore
| | - Emily Pidgeon
- Conservation International, 2011 Crystal Dr., Suite 600, Arlington, VA, USA
- International Blue Carbon Institute, 42B Boat Quay, Singapore, 049831, Singapore
| | - Thomas Wernberg
- UWA Oceans Institute and School of Biological Sciences, University of Western Australia, Crawley, 6009, Western Australia, Australia
- Institute of Marine Research, Nye Flødevigveien 20, His, 4817, Norway
| | - Karen Filbee-Dexter
- UWA Oceans Institute and School of Biological Sciences, University of Western Australia, Crawley, 6009, Western Australia, Australia
- Institute of Marine Research, Nye Flødevigveien 20, His, 4817, Norway
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9
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Rose AM, Nicolay N, Sandonis Martín V, Mazagatos C, Petrović G, Baruch J, Denayer S, Seyler L, Domegan L, Launay O, Machado A, Burgui C, Vaikutyte R, Niessen FA, Loghin II, Husa P, Aouali N, Panagiotakopoulos G, Tolksdorf K, Horváth JK, Howard J, Pozo F, Gallardo V, Nonković D, Džiugytė A, Bossuyt N, Demuyser T, Duffy R, Luong Nguyen LB, Kislaya I, Martínez-Baz I, Gefenaite G, Knol MJ, Popescu C, Součková L, Simon M, Michelaki S, Reiche J, Ferenczi A, Delgado-Sanz C, Lovrić Makarić Z, Cauchi JP, Barbezange C, Van Nedervelde E, O'Donnell J, Durier C, Guiomar R, Castilla J, Jonikaite I, Bruijning-Verhagen PC, Lazar M, Demlová R, Wirtz G, Amerali M, Dürrwald R, Kunstár MP, Kissling E, Bacci S, Valenciano M. Vaccine effectiveness against COVID-19 hospitalisation in adults (≥ 20 years) during Omicron-dominant circulation: I-MOVE-COVID-19 and VEBIS SARI VE networks, Europe, 2021 to 2022. Euro Surveill 2023; 28:2300187. [PMID: 37997665 PMCID: PMC10668256 DOI: 10.2807/1560-7917.es.2023.28.47.2300187] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/24/2023] [Indexed: 11/25/2023] Open
Abstract
IntroductionThe I-MOVE-COVID-19 and VEBIS hospital networks have been measuring COVID-19 vaccine effectiveness (VE) in participating European countries since early 2021.AimWe aimed to measure VE against PCR-confirmed SARS-CoV-2 in patients ≥ 20 years hospitalised with severe acute respiratory infection (SARI) from December 2021 to July 2022 (Omicron-dominant period).MethodsIn both networks, 46 hospitals (13 countries) follow a similar test-negative case-control protocol. We defined complete primary series vaccination (PSV) and first booster dose vaccination as last dose of either vaccine received ≥ 14 days before symptom onset (stratifying first booster into received < 150 and ≥ 150 days after last PSV dose). We measured VE overall, by vaccine category/product, age group and time since first mRNA booster dose, adjusting by site as a fixed effect, and by swab date, age, sex, and presence/absence of at least one commonly collected chronic condition.ResultsWe included 2,779 cases and 2,362 controls. The VE of all vaccine products combined against hospitalisation for laboratory-confirmed SARS-CoV-2 was 43% (95% CI: 29-54) for complete PSV (with last dose received ≥ 150 days before onset), while it was 59% (95% CI: 51-66) after addition of one booster dose. The VE was 85% (95% CI: 78-89), 70% (95% CI: 61-77) and 36% (95% CI: 17-51) for those with onset 14-59 days, 60-119 days and 120-179 days after booster vaccination, respectively.ConclusionsOur results suggest that, during the Omicron period, observed VE against SARI hospitalisation improved with first mRNA booster dose, particularly for those having symptom onset < 120 days after first booster dose.
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Affiliation(s)
| | - Nathalie Nicolay
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | - Clara Mazagatos
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Joaquin Baruch
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | | | - Lucie Seyler
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Odile Launay
- Inserm, CIC Cochin-Pasteur, Paris, France
- AP-HP, Hôpital Cochin, Paris, France
- Faculty of Medicine, University of Paris City, Paris, France
| | - Ausenda Machado
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - F Annabel Niessen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Isabela I Loghin
- St. Parascheva Clinical Hospital of Infectious Diseases, Iasi, Romania
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Petr Husa
- Faculty of Medicine, Masaryk University, Brno, Czechia
- University Hospital Brno, Brno, Czechia
| | | | | | | | - Judit Krisztina Horváth
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | | | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Virtudes Gallardo
- Dirección General de Salud Pública y Ordenación Farmacéutica, Junta de Andalucía, Spain
| | - Diana Nonković
- Teaching Public Health Institute of Split-Dalmatia County, Split, Croatia
| | - Aušra Džiugytė
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | | | | | - Róisín Duffy
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Irina Kislaya
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Giedre Gefenaite
- Faculty of Medicine, Lund University, Lund, Sweden
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Mirjam J Knol
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Corneliu Popescu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Marc Simon
- Centre Hospitalier de Luxembourg, Luxembourg
| | | | | | - Annamária Ferenczi
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Concepción Delgado-Sanz
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - John Paul Cauchi
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | | | | | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Raquel Guiomar
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Patricia Cjl Bruijning-Verhagen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Mihaela Lazar
- "Cantacuzino" National Military Medical Institute for Research-Development, Bucharest, Romania
| | | | - Gil Wirtz
- Centre Hospitalier de Luxembourg, Luxembourg
| | - Marina Amerali
- National Public Health Organisation (EODY), Athens, Greece
| | | | - Mihály Pál Kunstár
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | | | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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Rose AM, Nicolay N, Sandonis Martín V, Mazagatos C, Petrović G, Niessen FA, Machado A, Launay O, Denayer S, Seyler L, Baruch J, Burgui C, Loghin II, Domegan L, Vaikutytė R, Husa P, Panagiotakopoulos G, Aouali N, Dürrwald R, Howard J, Pozo F, Sastre-Palou B, Nonković D, Knol MJ, Kislaya I, Luong Nguyen LB, Bossuyt N, Demuyser T, Džiugytė A, Martínez-Baz I, Popescu C, Duffy R, Kuliešė M, Součková L, Michelaki S, Simon M, Reiche J, Otero-Barrós MT, Lovrić Makarić Z, Bruijning-Verhagen PC, Gomez V, Lesieur Z, Barbezange C, Van Nedervelde E, Borg ML, Castilla J, Lazar M, O'Donnell J, Jonikaitė I, Demlová R, Amerali M, Wirtz G, Tolksdorf K, Valenciano M, Bacci S, Kissling E. Vaccine effectiveness against COVID-19 hospitalisation in adults (≥ 20 years) during Alpha- and Delta-dominant circulation: I-MOVE-COVID-19 and VEBIS SARI VE networks, Europe, 2021. Euro Surveill 2023; 28:2300186. [PMID: 37997666 PMCID: PMC10668259 DOI: 10.2807/1560-7917.es.2023.28.47.2300186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/24/2023] [Indexed: 11/25/2023] Open
Abstract
IntroductionTwo large multicentre European hospital networks have estimated vaccine effectiveness (VE) against COVID-19 since 2021.AimWe aimed to measure VE against PCR-confirmed SARS-CoV-2 in hospitalised severe acute respiratory illness (SARI) patients ≥ 20 years, combining data from these networks during Alpha (March-June)- and Delta (June-December)-dominant periods, 2021.MethodsForty-six participating hospitals across 14 countries follow a similar generic protocol using the test-negative case-control design. We defined complete primary series vaccination (PSV) as two doses of a two-dose or one of a single-dose vaccine ≥ 14 days before onset.ResultsWe included 1,087 cases (538 controls) and 1,669 cases (1,442 controls) in the Alpha- and Delta-dominant periods, respectively. During the Alpha period, VE against hospitalisation with SARS-CoV2 for complete Comirnaty PSV was 85% (95% CI: 69-92) overall and 75% (95% CI: 42-90) in those aged ≥ 80 years. During the Delta period, among SARI patients ≥ 20 years with symptom onset ≥ 150 days from last PSV dose, VE for complete Comirnaty PSV was 54% (95% CI: 18-74). Among those receiving Comirnaty PSV and mRNA booster (any product) ≥ 150 days after last PSV dose, VE was 91% (95% CI: 57-98). In time-since-vaccination analysis, complete all-product PSV VE was > 90% in those with their last dose < 90 days before onset; ≥ 70% in those 90-179 days before onset.ConclusionsOur results from this EU multi-country hospital setting showed that VE for complete PSV alone was higher in the Alpha- than the Delta-dominant period, and addition of a first booster dose during the latter period increased VE to over 90%.
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Affiliation(s)
| | - Nathalie Nicolay
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | - Clara Mazagatos
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - F Annabel Niessen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Ausenda Machado
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Odile Launay
- Inserm, CIC Cochin-Pasteur, Paris, France
- AP-HP, Hôpital Cochin, Paris, France
- Faculty of Medicine, University of Paris City, Paris, France
| | | | - Lucie Seyler
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Joaquin Baruch
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Isabela I Loghin
- St. Parascheva Clinical Hospital of Infectious Diseases, Iasi, Romania
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Petr Husa
- Faculty of Medicine, Masaryk University, Brno, Czechia
- University Hospital Brno, Brno, Czechia
| | | | | | | | | | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Bartolomé Sastre-Palou
- Servicio de Medicina Preventiva Hospital Universitario Son Espases, Servicio de Epidemiología, Consellería de Salut, Palma, Spain
| | - Diana Nonković
- Teaching Public Health Institute of Split-Dalmatia County, Split, Croatia
| | - Mirjam J Knol
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Irina Kislaya
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | | | | | | | - Aušra Džiugytė
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Corneliu Popescu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Róisín Duffy
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Monika Kuliešė
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | | | - Marc Simon
- Centre Hospitalier de Luxembourg, Luxembourg
| | | | - María Teresa Otero-Barrós
- Servicio de Epidemiología, Dirección General de Salud Pública, Consejería de Sanidad de Galicia, Santiago de Compostela, A Coruna, Spain
| | | | - Patricia Cjl Bruijning-Verhagen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Verónica Gomez
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | | | | | | | - Maria-Louise Borg
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mihaela Lazar
- "Cantacuzino" National Military Medical Institute for Research-Development, Bucharest, Romania
| | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | - Marina Amerali
- National Public Health Organisation (EODY), Athens, Greece
| | - Gil Wirtz
- Luxembourg Institute of Health, Luxembourg
| | | | | | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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11
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Kissling E, Maurel M, Emborg HD, Whitaker H, McMenamin J, Howard J, Trebbien R, Watson C, Findlay B, Pozo F, Bolt Botnen A, Harvey C, Rose A. Interim 2022/23 influenza vaccine effectiveness: six European studies, October 2022 to January 2023. Euro Surveill 2023; 28:2300116. [PMID: 37227299 PMCID: PMC10283457 DOI: 10.2807/1560-7917.es.2023.28.21.2300116] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [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: 02/15/2023] [Accepted: 03/21/2023] [Indexed: 05/26/2023] Open
Abstract
BackgroundBetween October 2022 and January 2023, influenza A(H1N1)pdm09, A(H3N2) and B/Victoria viruses circulated in Europe with different influenza (sub)types dominating in different areas.AimTo provide interim 2022/23 influenza vaccine effectiveness (VE) estimates from six European studies, covering 16 countries in primary care, emergency care and hospital inpatient settings.MethodsAll studies used the test-negative design, but with differences in other study characteristics, such as data sources, patient selection, case definitions and included age groups. Overall and influenza (sub)type-specific VE was estimated for each study using logistic regression adjusted for potential confounders.ResultsThere were 20,477 influenza cases recruited across the six studies, of which 16,589 (81%) were influenza A. Among all ages and settings, VE against influenza A ranged from 27 to 44%. Against A(H1N1)pdm09 (all ages and settings), VE point estimates ranged from 28% to 46%, higher among children (< 18 years) at 49-77%. Against A(H3N2), overall VE ranged from 2% to 44%, also higher among children (62-70%). Against influenza B/Victoria, overall and age-specific VE were ≥ 50% (87-95% among children < 18 years).ConclusionsInterim results from six European studies during the 2022/23 influenza season indicate a ≥ 27% and ≥ 50% reduction in disease occurrence among all-age influenza vaccine recipients for influenza A and B, respectively, with higher reductions among children. Genetic virus characterisation results and end-of-season VE estimates will contribute to greater understanding of differences in influenza (sub)type-specific results across studies.
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Affiliation(s)
| | | | - Hanne-Dorthe Emborg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | | | | | | | - Ramona Trebbien
- Department of Virus and Microbiological Special diagnostics, National Influenza Center, Statens Serum Institut, Copenhagen, Denmark
| | | | | | - Francisco Pozo
- National Centre for Microbiology, National Influenza Reference Laboratory, WHO-National Influenza Centre, Institute of Health Carlos III, Madrid, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Amanda Bolt Botnen
- Department of Virus and Microbiological Special diagnostics, National Influenza Center, Statens Serum Institut, Copenhagen, Denmark
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12
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Wolfer LA, Basso WU, Frey CF, Schuller S, Amphimaque B, Jankovic J, Howard J, Peters LM. Biliary Enterocytozoon bieneusi infection in a dog under immunomodulatory therapy. J Small Anim Pract 2023. [PMID: 37017013 DOI: 10.1111/jsap.13612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/08/2023] [Accepted: 03/05/2023] [Indexed: 04/06/2023]
Abstract
An 8-year-old female spayed Labrador retriever was presented for the evaluation of severe weight loss 10 weeks after starting an immunomodulatory treatment, including prednisolone and cyclosporine, for meningoencephalitis of unknown origin. Plasma biochemistry analysis showed mild to moderate increases in liver enzyme activities and a moderate decrease in urea concentration. Abdominal ultrasound revealed mild hepatomegaly and a large gall bladder with unremarkable wall and content. Cholecystocentesis was performed and bile was examined both cytologically and by molecular methods, which revealed the presence of Enterocytozoon bieneusi. Treatment was initiated with albendazole but was discontinued due to the development of severe neutropenia. The medical management was subsequently changed to fenbendazole and the dog made a complete recovery. This report describes the first case of clinical manifestation and successful treatment of biliary E. bieneusi infection in a dog.
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Affiliation(s)
- L A Wolfer
- Clinical Diagnostic Laboratory, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012, Bern, Switzerland
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012, Bern, Switzerland
| | - W U Basso
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, 3012, Bern, Switzerland
| | - C F Frey
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, 3012, Bern, Switzerland
| | - S Schuller
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012, Bern, Switzerland
| | - B Amphimaque
- Division of Clinical Radiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012, Bern, Switzerland
| | - J Jankovic
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012, Bern, Switzerland
| | - J Howard
- Clinical Diagnostic Laboratory, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012, Bern, Switzerland
| | - L M Peters
- Clinical Diagnostic Laboratory, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012, Bern, Switzerland
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Howard J, Grobman M, Lever T, Reinero CR. Videofluoroscopic swallow study abnormalities identify aerodigestive disorders in dogs with respiratory disease versus healthy controls. J Vet Intern Med 2023; 37:1166-1178. [PMID: 36951400 DOI: 10.1111/jvim.16685] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/02/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Aerodigestive diseases (AeroD) pathologically link respiratory and alimentary tracts. Dogs with respiratory signs lacking dysphagia, vomiting, or regurgitation typically do not undergo diagnostic testing that identifies comorbid alimentary disease. A videofluoroscopic swallow study (VFSS) identifies defects in swallowing, reflux, and aspiration. OBJECTIVES/HYPOTHESIS We hypothesized that dogs with respiratory and no alimentary disease (RESP) would have significantly more abnormal VFSS metrics versus controls (CON). We hypothesized RESP dogs with pulmonary parenchymal disease would have more reflux and higher penetration-aspiration score (PAS) than those with airway disease. ANIMALS Client-owned dogs: RESP (n = 45) and CON (n = 15) groups. METHODS Prospectively, all dogs underwent VFSS. The RESP dogs had advanced respiratory diagnostic testing. Eight subjective and 3 objective VFSS metrics (pharyngeal constriction ratio [PCR], PAS, and esophageal transit time [ETT]) were assessed. Fisher's exact test compared differences between groups (presence or absence of VFSS abnormalities). The Mann-Whitney rank sum test was used to compare PCR and PAS. RESULTS Subjective VFSS abnormalities were present in 34/45 (75%) RESP and 2/15 (13%) CON dogs, with RESP dogs significantly more likely to have VFSS abnormalities (P = .01). No difference in PCR was found between groups. Pathologic PAS was more common in RESP than CON dogs (P = .03). The RESP dogs with airway disease had higher PAS than CON dogs (P = .01) but not RESP dogs with parenchymal disease (P = .25). CONCLUSIONS Most (75%) RESP dogs had VFSS abnormalities, emphasizing that AeroD are common. The VFSS has value in diagnostic evaluation of respiratory disease.
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Affiliation(s)
- Jennifer Howard
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, Columbia, Missouri, USA
| | - Megan Grobman
- Department of Clinical Sciences, Veterinary Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
| | - Teresa Lever
- Department of Otolaryngology-Head and Neck Surgery, University of Missouri, School of Medicine, Columbia, Missouri, USA
| | - Carol R Reinero
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, Columbia, Missouri, USA
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Leite CBG, Merkely G, Zgoda M, Farina EM, Görtz S, Howard J, Lattermann C. Systematic Review of Clinical Results After Medial Meniscus Allograft Transplantation Reveals Improved Patient Reported Outcomes at Greater Than 5 Years Follow-Up. Arthroscopy 2023; 39:802-811. [PMID: 36543661 DOI: 10.1016/j.arthro.2022.11.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/25/2022] [Accepted: 11/25/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE To systematically summarize the medial meniscus allograft transplantation (MAT) reported outcomes and evaluate whether the surgical technique is associated with allograft extrusion and knee function. METHODS Systematic review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Inclusion criteria were English-language clinical studies involving arthroscopically assisted medial MAT that reported the surgical technique and the presence of graft extrusion or functional outcomes after surgery. Studies in which outcomes for medial MAT could not be separated from lateral MAT were excluded. Surgical technique, allograft-related characteristics, and clinical outcomes were extracted. RESULTS Twenty-four studies with 328 medial MAT were included, 58.3% studies qualified as level 4 of evidence, 29.2% as level 3, and 12.5% as level 2. Allograft fixation techniques were bone plug (235/328 [71.6%]), bone bridge/trough (55/328 [16.8%]), and soft-tissue suture fixation only (38/328 [11.6%]). Relative percentage of extrusion after surgery ranged from 24.8% to 53.7%. Major extrusion (>3 mm) ranged from zero to 78%. Overall, functional scores improved after medial MAT. None of surgical techniques were associated with poor functional outcomes or extruded meniscus; however, nonanatomical placement of the anterior and posterior horns appeared to increase meniscus extrusion. CONCLUSION Medial MAT provides favorable outcomes, with acceptable rates of complication and failure regardless of surgical technique. Although allograft extrusion appears equivalent for both bone plug and soft-tissue fixation techniques, positioning allograft horns at the native meniscal footprint may be critical for preventing extrusion. However, the heterogeneity and low level of evidence of the studies included in this review prevent decisive conclusions regarding optimal MAT fixation techniques, clinical significance of allograft extrusion, or comparative clinical outcomes after medial MAT. LEVEL OF EVIDENCE Level IV - systematic review of Level II to IV studies.
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Affiliation(s)
- Chilan Bou Ghosson Leite
- Department of Orthopedic Surgery, Center for Cartilage Repair and Sports Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Gergo Merkely
- Department of Orthopedic Surgery, Center for Cartilage Repair and Sports Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Molly Zgoda
- Department of Orthopedic Surgery, Center for Cartilage Repair and Sports Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Evan M Farina
- Department of Orthopedic Surgery, Center for Cartilage Repair and Sports Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Simon Görtz
- Department of Orthopedic Surgery, Center for Cartilage Repair and Sports Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jennifer Howard
- Department of Rehabilitation Sciences, Beaver College of Health Sciences, Appalachian State University, Boone, North Carolina, U.S.A
| | - Christian Lattermann
- Department of Orthopedic Surgery, Center for Cartilage Repair and Sports Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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15
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Stieber F, Allen N, Carpenter K, Hu P, Alagna R, Rao S, Manissero D, Howard J, Nikolayevskyy V. Durability of COVID-19 vaccine induced T-cell mediated immune responses measured using the QuantiFERON SARS-CoV-2 assay. Pulmonology 2023; 29:151-153. [PMID: 36402704 PMCID: PMC9671490 DOI: 10.1016/j.pulmoe.2022.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- F Stieber
- QIAGEN Sciences Inc, 19300 Germantown Road, Germantown, MD 20874, USA.
| | - N Allen
- QIAGEN Sciences Inc, 19300 Germantown Road, Germantown, MD 20874, USA
| | - K Carpenter
- QIAGEN Sciences Inc, 19300 Germantown Road, Germantown, MD 20874, USA
| | - P Hu
- QIAGEN Sciences Inc, 19300 Germantown Road, Germantown, MD 20874, USA
| | - R Alagna
- QIAGEN SRL, Via Filippo Sassetti 16, 20124 Milan, Italy
| | - S Rao
- QIAGEN Sciences Inc, 19300 Germantown Road, Germantown, MD 20874, USA
| | - D Manissero
- QIAGEN Manchester Ltd, Citylabs 2.0 Hathersage Road, Manchester M13 0BH, United Kingdom
| | - J Howard
- QIAGEN Sciences Inc, 19300 Germantown Road, Germantown, MD 20874, USA
| | - V Nikolayevskyy
- QIAGEN Manchester Ltd, Citylabs 2.0 Hathersage Road, Manchester M13 0BH, United Kingdom
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16
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Weatherald J, Iqbal H, Mielniczuk L, Syed AR, Legkaia L, Howard J, Dempsey N, Rader T, Swiston J, Provencher S. Priorities for pulmonary hypertension research: A James Lind Alliance priority setting partnership. J Heart Lung Transplant 2023; 42:1-6. [PMID: 36283952 DOI: 10.1016/j.healun.2022.09.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/26/2022] [Accepted: 09/21/2022] [Indexed: 11/05/2022] Open
Abstract
Pulmonary hypertension (PH) is a rare condition associated with significant morbidity and mortality. The priorities for future research in PH according to patients, caregivers, and clinicians have not been established. We performed a James Lind Alliance priority setting partnership in Canada. An initial survey of 249 respondents (76% patients and/or caregivers, 12.5% clinicians) generated 1588 questions, which were combined into 187 summary questions. An evidence check identified 352 systematic reviews and guidelines which were mapped to the summary questions, which determined that 157 summary questions were unanswered by existing research. An interim prioritisation survey (240 respondents, 66% patients and/or caregivers, 18% clinicians) asked respondents to choose which of the 157 summary questions were among the 30-40 most important. In a final workshop patients, caregivers, and clinicians discussed and ranked the top 25 questions from the interim survey to identify the Top 10 PH research priorities. These results will inform researchers and funding bodies about patient, caregiver, and clinician priorities for future research on PH.
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Affiliation(s)
- Jason Weatherald
- Department of Medicine, Division of Pulmonary Medicine, University of Alberta, Edmonton, Canada; Department of Medicine, Division of Respirology, University of Calgary, Calgary, Canada; Libin Cardiovascular Institute, University of Calgary, Calgary, Canada; Alberta Health Services, Edmonton Zone, Edmonton, Canada.
| | - Hina Iqbal
- Department of Medicine, Division of Respirology, University of Calgary, Calgary, Canada; Libin Cardiovascular Institute, University of Calgary, Calgary, Canada; Alberta Health Services, Edmonton Zone, Edmonton, Canada
| | - Lisa Mielniczuk
- Department of Medicine, Division of Cardiology, University of Ottawa Heart Institute and University of Ottawa
| | - Abdul Rehman Syed
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Lena Legkaia
- Pulmonary Hypertension Clinic, Division of Respirology, University of British Columbia, Vancouver, Canada
| | | | | | - Tamara Rader
- James Lind Alliance, Canadian Agency for Drugs and Technologies in Health (CADTH), Ottawa, Ontario
| | - John Swiston
- Department of Medicine, Division of Respirology, University of British Columbia
| | - Steeve Provencher
- Pulmonary Hypertension Research Group (http://phrg.ca), Insititut universitaire de cardiologie et de pneumologie de Québec Research Centre (IUCPQ), Department of Medicine, Université Laval, Québec City, Canada
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17
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Howard J, Awad M, Ma Y, Abdelwahab M, Poomkonsarn S, Riley R, Yung-Chuan Liu S. Quality of Life after Large Maxillomandibular Advancement Surgery for Obstructive Sleep Apnea using a Single-Item Global Instrument. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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18
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Howard J, Levinger C, Wang W, Takata H, Nathanson S, Fromentin R, Chomont N, Trautmann L, Bosque A. PP 1.10 – 00069 Isotretinoin enhances IL-15 mediated HIV latency reversal and reduces the inducible latent reservoir. J Virus Erad 2022. [DOI: 10.1016/j.jve.2022.100115] [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: 12/24/2022] Open
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19
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Ashkir Z, Teoh Z, Ganesananthan S, Ahmed-Jushuf F, Beattie CJ, Asher A, Kelshiker M, Howard J, Al-Lamee R. Medication adherence assessment and reporting in cardiovascular randomised controlled trials. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2865] [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
Background
Despite the knowledge that suboptimal adherence to medications may have an impact on the impact of treatment interventions, the assessment and reporting of medication adherence in cardiovascular randomised controlled trials has not been well studied. In this review we sought to study the differences in medication adherence assessment and reporting in cardiovascular randomised controlled trials (RCTs) comparing interventional procedures to medical therapy alone in four major cardiovascular conditions: coronary disease (CAD), atrial fibrillation (AF), heart failure (HF) and hypertension (HTN).
Methods
Comprehensive searches of PUBMED/MEDLINE, Clinicaltrials.gov and Cochrane Central Register of Controlled Trials (CENTRAL) were performed. Two independent authors screened and extracted general study data, adherence assessment methodology and adherence reporting characteristics from eligible RCTs.
Results
A total of 568 studies (257 HTN, 120 HF, 116 CAD and 75 AF RCTs) published between 2014–2019 were included in the review. Overall, only 44.7% of RCTs assessed adherence, 14.1% defined “good” adherence and 21.1% reported adherence results. HTN and CAD trials performed significantly better than HF and AF studies in all three parameters. Compared to drug trials, procedural trials were significantly less likely to assess adherence (21.1% vs 45.7%, p<0.001), define good adherence (7% vs 15.5%, p<0.001) or report adherence results (10.5% vs 21.3%, p=0.046). Adherence assessment practices were further significantly influenced by funding, placebo status and study outcome. Pill count/return of packaging was the most utilised method (49.5%) and direct observation the least utilised (1.1%). Adherence was calculated in 55.9% of RCTs with studies using different formulas and setting different thresholds for “good” adherence but most setting this at 80% adherence. Adherence reporting practices also varied significantly between RCTs. Most studies (53%) that assessed adherence, did not in fact report their results.
Conclusion
Our findings expose significant inconsistencies in adherence assessment and reporting practices amongst cardiovascular RCTs. This is a systemic problem with important implications on research quality and reliability. We therefore recommend the incorporation of mandatory adherence assessment and reporting into international reporting guidelines for RCTs such as the CONSORT statement. We also propose a grading system which once validated may be used to appraise standards of adherence assessment and reporting in RCTs.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- Z Ashkir
- National Heart and Lung Institute Imperial College , London , United Kingdom
| | - Z Teoh
- Barts and The London School of Medicine and Dentistry , London , United Kingdom
| | - S Ganesananthan
- West Middlesex University Hospital , London , United Kingdom
| | - F Ahmed-Jushuf
- Guy's & St Thomas' NHS Foundation Trust , London , United Kingdom
| | - C J Beattie
- North West London Hospitals NHS Trust , London , United Kingdom
| | - A Asher
- Barts and The London School of Medicine and Dentistry , London , United Kingdom
| | - M Kelshiker
- National Heart and Lung Institute Imperial College , London , United Kingdom
| | - J Howard
- National Heart and Lung Institute Imperial College , London , United Kingdom
| | - R Al-Lamee
- National Heart and Lung Institute Imperial College , London , United Kingdom
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20
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Vimalesvaran K, Uslu F, Zaman S, Howard J, Bharath A, Cole G. Machine learning can accurately detect abnormal aortic valves in CMR. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Improving the efficiency of CMR by acquiring fewer, and more targeted sequences, would improve the diagnostic yield and reduce patient recalls. An AI-assisted clinical decision support system (CDSS) could deliver this efficiency using adaptive scanning protocols which replicate the expertise of highly trained clinicians. Normal aortic valve anatomy on the three-chamber (3CH) cine CMR is a guide to rationalising subsequent sequences, and therefore is a suitable base case for developing an AI-CDSS for CMR.
Purpose
We propose a machine learning approach to differentiate between normal and abnormal aortic valves from the 3CH cine.
Methods
We curated a unique expert-annotated dataset of 1221 frames from eighty CMR studies. For each frame, AV landmarks (two hinge points and two leaflets), and stenotic and regurgitant jets were labelled by three cardiologists.
We then tested two AI models (Figure 1) to detect these AV abnormalities: A) a convolutional neural network (CNN), and B) a random forest approach.
A) Using heat map regression, the AV was localised, and the jets (if present) were identified as pathological curves. We then tracked and quantified the curves in the estimated heatmaps based on their proximity, the length, orientation and angle with respect to the hinge points.
B) We used a random forest approach to classify cases as normal or abnormal by using the characteristics of estimated pathological curves obtained from the heat map regression output.
We trained and evaluated our models on an unseen dataset of 1017 CMR studies obtained from different scanner types across three NHS hospitals. Each CMR study report was manually assigned a binary ground truth label for a normal or abnormal AV. In total 496/1017 patients had an abnormal AV. Of those abnormal cases, 184 patients had aortic stenosis, 222 aortic regurgitation and 90 cases had mixed valve disease.
We assessed the classification performance of our method with accuracy and an F1 score – a composite of precision and recall, where 1 is perfect; and heatmap regression performance for curves with mean absolute error.
Results
This machine learning approach classified abnormal aortic valves with good agreement to the ground truth labels with mean accuracy of 0.93 (representing approximately 451/496 patients) and mean F1 score of 0.91. The AV hinge points were localised with a mean distance error of 3.5 pixels. This was despite the small size of expert labelled data.
Conclusion
This machine learning solution successfully differentiated between normal and abnormal aortic valves from routine 3CH cine CMR views. More labelled datasets will enable further classification of pathology and severity, and greater accuracy. Our results represent an important stepping stone towards an AI-assisted CDSS for CMR.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): This work was supported by the UKRI CDT in AI for Healthcare http://ai4health.io
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Affiliation(s)
| | - F Uslu
- Bursa Technical University, Electrical and Electronics Engineering , Bursa , Turkey
| | - S Zaman
- Imperial College Healthcare NHS Trust , London , United Kingdom
| | - J Howard
- Imperial College Healthcare NHS Trust , London , United Kingdom
| | - A Bharath
- Imperial College London , London , United Kingdom
| | - G Cole
- Imperial College Healthcare NHS Trust , London , United Kingdom
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21
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Dencer-Brown AM, Shilland R, Friess D, Herr D, Benson L, Berry NJ, Cifuentes-Jara M, Colas P, Damayanti E, García EL, Gavaldão M, Grimsditch G, Hejnowicz AP, Howard J, Islam ST, Kennedy H, Kivugo RR, Lang'at JKS, Lovelock C, Malleson R, Macreadie PI, Andrade-Medina R, Mohamed A, Pidgeon E, Ramos J, Rosette M, Salim MM, Schoof E, Talukder B, Thomas T, Vanderklift MA, Huxham M. Integrating blue: How do we make nationally determined contributions work for both blue carbon and local coastal communities? Ambio 2022; 51:1978-1993. [PMID: 35503201 PMCID: PMC9063623 DOI: 10.1007/s13280-022-01723-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/14/2021] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
Blue Carbon Ecosystems (BCEs) help mitigate and adapt to climate change but their integration into policy, such as Nationally Determined Contributions (NDCs), remains underdeveloped. Most BCE conservation requires community engagement, hence community-scale projects must be nested within the implementation of NDCs without compromising livelihoods or social justice. Thirty-three experts, drawn from academia, project development and policy, each developed ten key questions for consideration on how to achieve this. These questions were distilled into ten themes, ranked in order of importance, giving three broad categories of people, policy & finance, and science & technology. Critical considerations for success include the need for genuine participation by communities, inclusive project governance, integration of local work into national policies and practices, sustaining livelihoods and income (for example through the voluntary carbon market and/or national Payment for Ecosystem Services and other types of financial compensation schemes) and simplification of carbon accounting and verification methodologies to lower barriers to entry.
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Affiliation(s)
| | - Robyn Shilland
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, EH11 4BN, Scotland
| | - Daniel Friess
- Department of Geography, National University of Singapore, Singapore, Singapore
- NUS Centre for Nature-Based Climate Solutions, National University of Singapore, Singapore, Singapore
| | - Dorothée Herr
- Global Marine and Polar Program, IUCN, Gland, Switzerland
| | - Lisa Benson
- The Centre for Environment, Fisheries and Aquaculture Science (Cefas), Pakefield Road, Lowestoft, NR33 0HT, Suffolk, UK
| | | | - Miguel Cifuentes-Jara
- CATIE - Centro Agronómico Tropical de Investigación y Enseñanza, Turrialba, 30501, Costa Rica
| | - Patrick Colas
- Conservation Finance Africa Field Division - Conservation International, Ndege Road, Nairobi, Kenya
| | - Ellyn Damayanti
- Faculty of Forestry and Environment, IPB University, Bogor, 16680, Indonesia
| | - Elisa López García
- CINVESTAV - Laboratorio de Producción Primaria, Recursos del Mar, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional - Unidad Mérida, Carretera Antigua a Progreso Km 6, CP 97310, Mérida, Yucatán, México
- Resiliencia Azul (NPO), Mogi das Cruzes, Mexico
| | - Marina Gavaldão
- Ubá Sustainability Institute - Blue Carbon Hub, Marseille, France
| | - Gabriel Grimsditch
- United Nations Environment Programme, UN Avenue, PO Box 67578, Nairobi, Kenya
| | - Adam P Hejnowicz
- School of Engineering, Newcastle University, Newcastle upon Tyne, UK
- Department of Biology, University of York, York, UK
| | - Jennifer Howard
- Blue Carbon Program, Conservation International, 2011 Crystal Drive, Suite 600, Arlington, VA, 22202, USA
| | - Sheikh Tawhidul Islam
- Institute of Remote Sensing and GIS, Jahangirnagar University, Dhaka, 1342, Bangladesh
| | - Hilary Kennedy
- School of Ocean Sciences, Bangor University, Wales, LL59 5AB, UK
| | - Rahma Rashid Kivugo
- Mikoko Pamoja Community Base Organization, P.O. BOX 178-80404, Msambweni, Kenya
| | - Joseph K S Lang'at
- Kenya Marine and Fisheries Research Institute, P. O. Box 81651-80100, Mombasa, Kenya
| | - Catherine Lovelock
- School of Biological Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - Ruth Malleson
- University College London, 14 Taviton Street, London, WC1H 0BW, UK
| | - Peter I Macreadie
- Centre for Integrative Ecology, School of Life and Environmental Sciences, Deakin University, Burwood Campus, Burwood, VIC, 3125, Australia
| | - Rosalía Andrade-Medina
- CINVESTAV - Laboratorio de Producción Primaria, Recursos del Mar, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional - Unidad Mérida, Carretera Antigua a Progreso Km 6, CP 97310, Mérida, Yucatán, México
- Resiliencia Azul (NPO), Mogi das Cruzes, Mexico
| | - Ahmed Mohamed
- United Nations Environment Programme, UN Avenue, PO Box 67578, Nairobi, Kenya
| | - Emily Pidgeon
- Center for Oceans, Conservation International, 2011 Crystal Drive, Suite 500, Arlington, VA, 22202, USA
| | - Jorge Ramos
- Institute for Land, Water and Society, Charles Sturt University, PO Box 6087, South Bunbury, WA, 6230, Australia
| | - Minerva Rosette
- CINVESTAV - Laboratorio de Producción Primaria, Recursos del Mar, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional - Unidad Mérida, Carretera Antigua a Progreso Km 6, CP 97310, Mérida, Yucatán, México
- Resiliencia Azul (NPO), Mogi das Cruzes, Mexico
| | - Mwanarusi Mwafrica Salim
- Vanga Blue Forest Community Based Organization, P.O Box 115-80402, Lungalunga, Kwale County, Kenya
| | - Eva Schoof
- Plan Vivo Foundation, Thorn House, 5 Rose Street, Edinburgh, EH2 2PR, UK
| | - Byomkesh Talukder
- Dahdaleh Institute for Global Health Research, York University, Toronto, ON, Canada
| | - Tamara Thomas
- International Ocean Policy, Global Policy and Government Relations, Conservation International, 2011 Crystal Drive, Suite 600, Arlington, VA, 22202, USA
| | - Mathew A Vanderklift
- CSIRO Oceans & Atmosphere, Indian Ocean Marine Research Centre, Crawley, WA, 6009, Australia
| | - Mark Huxham
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, EH11 4BN, Scotland
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22
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Achebe M, Hassab H, Alkindi S, Brown C, Telfer P, Biemond B, Gordeuk V, Lipato T, Alfa Cissé O, Darson F, Tonda M, Gray S, Howard J. Sécurité et efficacité à long terme du voxelotor chez des patients atteints de drépanocytose : résultats d’une étude d’extension en ouvert de l’essai de phase 3 HOPE. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.136] [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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23
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Palmer L, Howard J, Voltmer H, Ferrell A, Mulmule N, Levinson A, Karon S. Federal Interventions Targeting Social Isolation and Loneliness: An Exploratory Review. Innov Aging 2021. [PMCID: PMC8680390 DOI: 10.1093/geroni/igab046.1929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Even prior to the COVID-19 Public Health and Medical Emergency, the experiences of chronic social isolation and loneliness (SIL) were growing among older adults. Countries began increasing national visibility for these issues and implementing programs and services focused on addressing them. In the United States (US), however, little is known about successful national interventions or their effectiveness in tackling SIL among older Americans. We conducted a rapid review of the peer-reviewed and grey literature from 2009-2019, focusing on existing federal programs, health systems, and health care models in the US that address SIL among older adults. Of the 110 articles identified, 36 met the inclusion criteria and were synthesized. Our review found few federal interventions that directly address SIL; several may be addressing SIL as an auxiliary outcome to addressing social determinants of health, such as group exercise, transportation support, or food insecurity. While these interventions may provide a promising opportunity, implementation and evaluation challenges were identified. Thus, federal and state agencies face significant obstacles to understanding the impact of existing interventions and their effectiveness in addressing SIL, hampering progress toward large scale implementation. As SIL receives increasing attention, we add another voice to existing literature that indicates significant heterogeneity among existing programs; we found that few evidence-based, scalable federal initiatives exist in the US that target SIL. Without resources from federal and state agencies, the ability of health entities, community-based organizations, and direct care providers to implement effective interventions is significantly diminished.
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Affiliation(s)
- Lauren Palmer
- RTI International, RTI International, Massachusetts, United States
| | | | - Helena Voltmer
- RTI International, Waltham, Massachusetts, United States
| | - Abigail Ferrell
- Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania, United States
| | - Natalie Mulmule
- RTI International, RTI International, North Carolina, United States
| | - Abbie Levinson
- RTI International, Waltham, Massachusetts, United States
| | - Sarita Karon
- RTI International, Waltham, Massachusetts, United States
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24
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Howard J, Reinero CR, Almond G, Vientos-Plotts A, Cohn LA, Grobman M. Bacterial infection in dogs with aspiration pneumonia at 2 tertiary referral practices. J Vet Intern Med 2021; 35:2763-2771. [PMID: 34751462 PMCID: PMC8692172 DOI: 10.1111/jvim.16310] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 01/31/2023] Open
Abstract
Background In dogs, antimicrobial drugs are widely prescribed for aspiration pneumonia (AP) despite poor documentation of bacterial infection in AP (b‐AP) using bronchoalveolar lavage fluid (BALF) analysis. Interpretating discordant cytology and culture results is challenging, contributing to lack of a criterion standard, and highlighting differences between veterinary and human medical criteria for b‐AP. Objectives Determine how many dogs with AP had BALF collection and differences in diagnosis of b‐AP using veterinary vs human medical criteria. Report findings of noninvasive markers (e.g. fever, band neutrophilia, radiographic severity score) in dogs with and without b‐AP. Animals Retrospective cohort study of client‐owned dogs (n = 429) with AP at 2 university veterinary hospitals. Twenty‐four dogs met enrollment criteria. Methods Inclusion criteria were radiographic diagnosis of AP, ≥1 risk factor, CBC findings, and BALF cytology and culture results. Veterinary medical b‐AP criteria were cytology findings compatible with sepsis with or without positive culture, or cytology findings not consistent with sepsis and positive culture (≥1.7 × 103 cfu/mL). Human medical b‐AP criteria required culture with ≥104 cfu/mL or > 7% cells with intracellular bacteria on cytology. Results Only 24/429 dogs met all enrollment criteria; 379/429 dogs lacked BALF collection. Diagnosis of b‐AP differed using veterinary (79%) vs human (29%) medical criteria. Fever, band neutrophils and high radiographic scores were noted in dogs with and without b‐AP. Conclusions and Clinical Importance Lack of routine BALF collection hampers definitive recognition of bacterial infection in AP. Differences in dogs meeting veterinary vs human medical definitions for b‐AP and usefulness of noninvasive markers warrant further study to improve understanding of the role of bacteria in AP.
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Affiliation(s)
- Jennifer Howard
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, Columbia, Missouri, USA.,Department of Clinical Sciences, Veterinary Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
| | - Carol R Reinero
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, Columbia, Missouri, USA
| | - Greg Almond
- Department of Clinical Sciences, Veterinary Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
| | - Aida Vientos-Plotts
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, Columbia, Missouri, USA
| | - Leah A Cohn
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, Columbia, Missouri, USA
| | - Megan Grobman
- Department of Clinical Sciences, Veterinary Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
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25
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Stieber F, Howard J, Manissero D, Boyle J, Ndunda N, Love J, Yang M, Schumacher A, Uchiyama R, Parsons S, Miller C, Douwes H, Mielens Z, Laing T, Nikolayevskyy V. Evaluation of a lateral-flow nanoparticle fluorescence assay for TB infection diagnosis. Int J Tuberc Lung Dis 2021; 25:917-922. [PMID: 34686234 PMCID: PMC8544925 DOI: 10.5588/ijtld.21.0391] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Programmatic management of TB infection is a critical component of the WHO End TB Strategy. Interferon-gamma release assays (IGRAs) overcome some limitations of the tuberculin skin test, but implementation of IGRA testing in low-resource settings is challenging. METHODS: In this feasibility study, we evaluated performance of a novel digital lateral-flow assay, the QIAreach® QuantiFERON® TB (QIAreach-QFT) test, against the QuantiFERON®-TB Gold Plus (QFT-Plus) assay. A population with a mix of risk factors for TB infection (111 donors) were sampled over multiple days. A total of 207 individual blood samples were tested according to the manufacturer’s instructions. RESULTS: The overall percentage agreement was 95.6% (two-sided 95% CI 91.8–98), with a positive percentage agreement (i.e., sensitivity) of 100% (95% CI 94.7–100) and a negative percentage agreement (i.e., specificity) of 95.6% (95% CI 90.6–98.4). All QFT-Plus positive specimens with TB1-Nil and TB2-Nil values less than 1 IU/ml tested positive on QIAreach-QFT. CONCLUSIONS: QIAreach QFT is a deployable, accurate testing solution for decentralised testing. It has the potential to overcome key hurdles for TB infection screening in high-burden settings thus helping to achieve the WHO End TB programme goals.
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Affiliation(s)
| | | | | | | | | | | | - M Yang
- Qiagen Inc, Germantown, MD, USA
| | | | | | - S Parsons
- Ellume Limited, East Brisbane, QLD, Australia
| | - C Miller
- Ellume Limited, East Brisbane, QLD, Australia
| | - H Douwes
- Ellume Limited, East Brisbane, QLD, Australia
| | - Z Mielens
- Ellume Limited, East Brisbane, QLD, Australia
| | - T Laing
- Ellume Limited, East Brisbane, QLD, Australia
| | - V Nikolayevskyy
- Qiagen Manchester Ltd, Manchester, UK, Imperial College, London, UK
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26
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Stowell C, Howard J, Cole G, Ananthan K, Demetrescu C, Pearce K, Rajani R, Sehmi J, Vimalesvaran K, Kanaganayagam S, Ghosh A, Chambers J, Rana B, Francis D, Shun-Shin M. Automated left ventricular dimension assessment using artificial intelligence. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and purpose
Artificial intelligence (AI) has the potential to greatly improve efficiency and reproducibility of quantification in echocardiography, but to gain widespread use it must both meet expert standards of excellence and have a transparent methodology. We developed an online platform to enable multiple collaborators to annotate medical images for training and validating neural networks.
Methods
Using our online collaborative platform 9 expert echocardiographers labelled 2056 images that comprised the training dataset. They labelled the four points from where the standard parasternal long axis (PLAX) measurements (interventricular septum, posterior wall, left ventricular dimension) would be made. Using these labelled images we trained a 2d convolutional neural network to replicate these labels. Separately, we curated an external validation dataset of the systolic and diastolic frames of 100 PLAX acquisitions. Each of these images were labelled twice by 13 different experts, and the average of the 26 measurements was taken as the consensus standard.
We then compared the individual experts and the AI measurements on the external validation dataset to the consensus standard, and calculated the precision standard deviation (SD) of the signed differences from the consensus standard.
Results
For diastolic septum thickness, the AI had a precision SD of 1.8 mm (ICC 0.81; 95% CI 0.73 to 0.97), compared with 2.0 mm for the individual experts (ICC 0.64; 95% CI 0.57 to 0.72). For diastolic posterior wall thickness, the AI had a precision SD 1.4 mm (ICC 0.54; 95% CI 0.38 to 0.66), and the individual experts 2.2 mm (ICC 0.37; 95% CI 0.29 to 0.46).
The AI's precision SD for left ventricular internal dimension was 3.5 mm (ICC 0.93, 95% CI 0.90 to 0.94), and for individual experts was 4.4mm (ICC 0.82, 95% CI 0.78 to 0.95). Both the experts and AI performed better in diastole than systole (precision SD AI 2.5mm vs 4.3mm, p<0.0001; experts 3.3mm vs 5.3mm, p<0.0001).
Conclusions
AI trained by a group of echocardiography experts was able to perform PLAX measurements which matched the reference standard more closely than any individual expert's own measurements.
This open, collaborative approach may be a model for the development of AI that is explainable to, and trusted by clinicians.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): NIHR Imperil BRC ITMATDr Howard was additionally funded by Wellcome. Online collaborative platformResults of AI and experts
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Affiliation(s)
- C Stowell
- Imperial College London, NHLI, London, United Kingdom
| | - J Howard
- Imperial College London, NHLI, London, United Kingdom
| | - G Cole
- Imperial College London, NHLI, London, United Kingdom
| | - K Ananthan
- Imperial College London, London, United Kingdom
| | - C Demetrescu
- Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom
| | - K Pearce
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - R Rajani
- Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom
| | - J Sehmi
- West Hertfordshire Hospitals NHS Trust, Watford, United Kingdom
| | | | - S Kanaganayagam
- Chelsea and Westminster Hospital NHS Trust, London, United Kingdom
| | - A Ghosh
- Barts Heart Centre, London, United Kingdom
| | - J Chambers
- Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom
| | - B Rana
- Hammersmith Hospital, London, United Kingdom
| | - D Francis
- Imperial College London, NHLI, London, United Kingdom
| | - M Shun-Shin
- Imperial College London, NHLI, London, United Kingdom
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Stowell C, Howard J, Demetrescu C, Bhattacharyya S, Mangion K, Vimalesvaran K, Cole G, Rajani R, Sehmi J, Alzetani M, Zolgharni M, Rana B, Francis D, Shun-Shin M. Fully automated global longitudinal strain assessment using artificial intelligence developed and validated by a UK-wide echocardiography expert collaborative. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.002] [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
Background
Left ventricular longitudinal strain has been reported to deliver reproducibility, sensitivity and prognostic value over and above ejection fraction. However, it currently relies on uninspectable proprietary algorithms and suffers from a lack of widespread clinical use. Uptake may be improved by increasing user trust through greater transparency.
Purpose
We therefore developed a machine-learning based method, trained, and validated with accredited experts from our AI Echocardiography Collaborative. We make the dataset, code, and trained network freely available under an open-source license.
Methods
AI enables strain to be calculated without relying on speckle tracking by directly locating key points and borders across frames. Strain can then be calculated as the fractional shortening of the left ventricular perimeter. We first curated a dataset of 7523 images, including 2587 apical four chamber, each labelled by a single expert from our collaboration of 17 hospitals, using our online platform (Figure 1). Using both this dataset and a semi-supervised approach, we trained a 3d convolutional neural network to identify the annulus, apex, and the endocardial border throughout the cardiac cycle.
Separately, we constructed an external validation dataset of 100 apical 4 chamber video-loops. The systolic and diastolic frame were identified, and each image was separately labelled by 11 experts. From these labels we then derived the expert consensus strain for each of the 100 video loops. These experts also ordered all 100 echocardiograms by their visual grading of left ventricular longitudinal function. Finally, a single expert calculated strain using two different proprietary commercial packages (A and B).
Results
Consensus strain measurements (obtained by averaging individual assessments by the 11 experts) across the 100 cases ranged from −4% to −27%, with strong correlations with the individual experts and machine methods (Figure 2). Using each cases' consensus across experts as the gold standard, median error from consensus was 3.1% for individual experts, 3.4% for Propriety A, 2.6% for Proprietary B, 2.6% for our AI.
Using the visual grading of longitudinal strain as the reference, the 11 individual experts and 4 machine methods each showed significant correlation: coefficients ranged from 0.55 to 0.69 for experts, and for Proprietary A was 0.68, Proprietary B 0.69, and our AI 0.69.
Conclusions
Our open-source, vendor-independent AI-based strain measure automatically produces values that agree with expert consensus, as strongly as the individual experts do. It also agrees with the subjective visual ranking by longitudinal function. Our open-source AI strain performs at least as well as closed-source speckle-based approaches, and may enable increased clinical and research use of longitudinal strain.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): NIHR Imperial BRC ITMAT.Dr Howard was additionally funded by Wellcome. Figure 1. Collaborative online platformFigure 2. Correlations between strain methods
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Affiliation(s)
- C Stowell
- Imperial College London, London, United Kingdom
| | - J Howard
- Imperial College London, London, United Kingdom
| | - C Demetrescu
- Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom
| | | | - K Mangion
- University of Glasgow, Glasgow, United Kingdom
| | | | - G Cole
- Imperial College London, London, United Kingdom
| | - R Rajani
- King's College London, London, United Kingdom
| | - J Sehmi
- West Hertfordshire Hospitals NHS Trust, Watford, United Kingdom
| | - M Alzetani
- Luton and Dunstable University Hospital, Luton, United Kingdom
| | - M Zolgharni
- University of West London, London, United Kingdom
| | - B Rana
- Hammersmith Hospital, London, United Kingdom
| | - D Francis
- Imperial College London, London, United Kingdom
| | - M Shun-Shin
- Imperial College London, London, United Kingdom
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Sadhu S, Decker C, Sansbury BE, Marinello M, Seyfried A, Howard J, Mori M, Hosseini Z, Arunachalam T, Finn AV, Lamar JM, Jourd'heuil D, Guo L, MacNamara KC, Spite M, Fredman G. Radiation-Induced Macrophage Senescence Impairs Resolution Programs and Drives Cardiovascular Inflammation. J Immunol 2021; 207:1812-1823. [PMID: 34462312 DOI: 10.4049/jimmunol.2100284] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/31/2021] [Indexed: 01/21/2023]
Abstract
Radiation is associated with tissue damage and increased risk of atherosclerosis, but there are currently no treatments and a very limited mechanistic understanding of how radiation impacts tissue repair mechanisms. We uncovered that radiation significantly delayed temporal resolution programs that were associated with decreased efferocytosis in vivo. Resolvin D1 (RvD1), a known proresolving ligand, promoted swift resolution and restored efferocytosis in sublethally irradiated mice. Irradiated macrophages exhibited several features of senescence, including increased expression of p16INK4A and p21, heightened levels of SA-β-gal, COX-2, several proinflammatory cytokines/chemokines, and oxidative stress (OS) in vitro, and when transferred to mice, they exacerbated inflammation in vivo. Mechanistically, heightened OS in senescent macrophages led to impairment in their ability to carry out efficient efferocytosis, and treatment with RvD1 reduced OS and improved efferocytosis. Sublethally irradiated Ldlr -/- mice exhibited increased plaque necrosis, p16INK4A cells, and decreased lesional collagen compared with nonirradiated controls, and treatment with RvD1 significantly reduced necrosis and increased lesional collagen. Removal of p16INK4A hematopoietic cells during advanced atherosclerosis with p16-3MR mice reduced plaque necrosis and increased production of key intraplaque-resolving mediators. Our results demonstrate that sublethal radiation drives macrophage senescence and efferocytosis defects and suggest that RvD1 may be a new therapeutic strategy to limit radiation-induced tissue damage.
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Affiliation(s)
- Sudeshna Sadhu
- The Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY
| | - Christa Decker
- The Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY
| | - Brian E Sansbury
- Department of Anesthesiology, Perioperative and Pain Medicine, Center for Experimental Therapeutics and Reperfusion Injury, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Michael Marinello
- The Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY
| | - Allison Seyfried
- The Department of Immunology and Infectious Disease, Albany Medical College, Albany, NY; and
| | - Jennifer Howard
- The Department of Immunology and Infectious Disease, Albany Medical College, Albany, NY; and
| | | | - Zeinab Hosseini
- The Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY
| | - Thilaka Arunachalam
- The Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY
| | | | - John M Lamar
- The Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY
| | - David Jourd'heuil
- The Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY
| | | | - Katherine C MacNamara
- The Department of Immunology and Infectious Disease, Albany Medical College, Albany, NY; and
| | - Matthew Spite
- Department of Anesthesiology, Perioperative and Pain Medicine, Center for Experimental Therapeutics and Reperfusion Injury, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Gabrielle Fredman
- The Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY;
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29
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Huang LL, Mah JY, Howard J, Roberts MA, McMahon LP. Incremental peritoneal dialysis is a safe and feasible prescription in incident patients with preserved residual kidney function. Nephrology (Carlton) 2021; 27:74-81. [PMID: 34392587 DOI: 10.1111/nep.13962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 08/08/2021] [Accepted: 08/09/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Incremental peritoneal dialysis (PD) is recommended as a component of high-quality care by the international society for PD; however, its feasibility and clinical outcomes have not been widely reported. The aim of this study is to describe our experience with incremental PD. METHODS This was a retrospective cohort study of incident PD patients at Eastern Health between 2015 and 2019. Patients who stopped PD within 30 days were excluded. Incremental PD was defined in CAPD as using <8 L/day of exchange volume and in automated PD as dialysing without a last fill. Dialysis modality accorded with patient and physician preferences. RESULTS The 96 patients were included in this study; 54 with incremental PD. Compared to full-dose PD, incremental PD patients were more likely to be female, had less comorbid diabetes (28% vs. 52%) and higher residual kidney function (RKF) (Kt/V 2.0 ± 0.7 vs. 1.4 ± 0.7). Age, BMI and starting eGFR did not differ between groups. Incremental PD exposed patients to lower exchange volumes (4.4 ± 2.1 vs. 8.5 ± 1.1 L/day), glucose load (46 ± 41 g/day vs. 119 ± 46) and was associated with a longer peritonitis-free survival. PD technique survival, rates of peritonitis or hospitalization were comparable between groups. Predictors for longer incremental PD use included older age and higher starting eGFR. CONCLUSIONS Incremental PD is a feasible, goal-directed initial prescription in patients with RKF with comparable peritonitis rates and technique survival. Validation of this prescription in prospective studies is warranted.
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Affiliation(s)
- Louis L Huang
- Eastern Health Integrated Renal Service, Box Hill Hospital, Box Hill, Victoria, Australia.,Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
| | - Jia Y Mah
- Eastern Health Integrated Renal Service, Box Hill Hospital, Box Hill, Victoria, Australia
| | - Jennifer Howard
- Eastern Health Integrated Renal Service, Box Hill Hospital, Box Hill, Victoria, Australia
| | - Matthew A Roberts
- Eastern Health Integrated Renal Service, Box Hill Hospital, Box Hill, Victoria, Australia.,Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
| | - Lawrence P McMahon
- Eastern Health Integrated Renal Service, Box Hill Hospital, Box Hill, Victoria, Australia.,Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
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30
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Howard J, Cruz J, MacNamara K. 3072 – TYPE I AND II INTERFERONS CONVERGE TO INDUCE HEMATOPOIETIC SUPPRESSION VIA IL-18-INDUCED CELL DEATH DURING SEVERE INFECTION. Exp Hematol 2021. [DOI: 10.1016/j.exphem.2021.12.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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31
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Christopherson AR, Betti R, Forrest CJ, Howard J, Theobald W, Delettrez JA, Rosenberg MJ, Solodov AA, Stoeckl C, Patel D, Gopalaswamy V, Cao D, Peebles JL, Edgell DH, Seka W, Epstein R, Wei MS, Gatu Johnson M, Simpson R, Regan SP, Campbell EM. Direct Measurements of DT Fuel Preheat from Hot Electrons in Direct-Drive Inertial Confinement Fusion. Phys Rev Lett 2021; 127:055001. [PMID: 34397224 DOI: 10.1103/physrevlett.127.055001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/02/2021] [Accepted: 06/11/2021] [Indexed: 06/13/2023]
Abstract
Hot electrons generated by laser-plasma instabilities degrade the performance of laser-fusion implosions by preheating the DT fuel and reducing core compression. The hot-electron energy deposition in the DT fuel has been directly measured for the first time by comparing the hard x-ray signals between DT-layered and mass-equivalent ablator-only implosions. The electron energy deposition profile in the fuel is inferred through dedicated experiments using Cu-doped payloads of varying thickness. The measured preheat energy accurately explains the areal-density degradation observed in many OMEGA implosions. This technique can be used to assess the viability of the direct-drive approach to laser fusion with respect to the scaling of hot-electron preheat with laser energy.
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Affiliation(s)
- A R Christopherson
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
- Department of Mechanical Engineering, University of Rochester, Rochester, New York 14623, USA
| | - R Betti
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
- Department of Mechanical Engineering, University of Rochester, Rochester, New York 14623, USA
- Department of Physics and Astronomy, University of Rochester, Rochester, New York 14623, USA
| | - C J Forrest
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
| | - J Howard
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
- Department of Mechanical Engineering, University of Rochester, Rochester, New York 14623, USA
| | - W Theobald
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
| | - J A Delettrez
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
| | - M J Rosenberg
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
| | - A A Solodov
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
| | - C Stoeckl
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
| | - D Patel
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
- Department of Mechanical Engineering, University of Rochester, Rochester, New York 14623, USA
| | - V Gopalaswamy
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
- Department of Mechanical Engineering, University of Rochester, Rochester, New York 14623, USA
| | - D Cao
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
| | - J L Peebles
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
| | - D H Edgell
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
| | - W Seka
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
| | - R Epstein
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
| | - M S Wei
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
| | - M Gatu Johnson
- Plasma Science and Fusion Center, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - R Simpson
- Plasma Science and Fusion Center, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - S P Regan
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
| | - E M Campbell
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299, USA
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32
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Galazis C, Vimalesvaran K, Zaman S, Petri C, Howard J, Linton N, Peters N, Cole G, Bharath AA, Varela M. Framework for large-scale automatic curation of heterogeneous cardiac MRI (ACUR MRI). Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): UKRI CDT in AI for Healthcare http://ai4health.io and British Heart Foundation
Background
Data curation is an important process that structures and organises data, supporting research and the development of artificial intelligence models. However, manually curating a large volume of medical data is a time-consuming, repetitive and costly process that puts additional strain on clinical experts. The curation becomes more complex and demanding as more data sources are used. This leads to an introduction of disparity in the data structure and protocols.
Purpose
Here, we propose an automatic framework to curate large volumes of heterogenous cardiac MRI scans acquired across different sites and scanner vendors. Our framework requires minimal expert involvement throughout and works directly on DICOM images from the scanner or PACS. The resulting structured standardised data allow for straightforward image analysis, hypothesis testing and the training and application of artificial intelligence models.
Methods
It is broken down into three main components
anonymisation, cataloguing and outlier detection (see Figure 1). Anonymisation automatically removes any identifiable patient information from the DICOM image attributes. These data are replaced with anonymised labels, whilst maintaining relevant longitudinal information from each patient. DICOM attributes are also used to automatically group the different images according to imaging sequence (e.g. CINE, Delayed-Enhancement, T1 maps), acquisition geometry (e.g. short-axis, 2-chamber, 4-chamber) and imaging attributes (e.g. slice thickness, TE, TR), for easier querying. The sorting characteristics are flexible and can easily be defined by the user. Finally, we detect and flag, for subsequent manual inspection, any outliers within those groups, based on the similarity levels of chosen DICOM attributes. This framework additionally offers interactive image visualisation to allow users to assess its performance in real time.
Results
We tested the performance of ACUR CMRI on 26,668 CMR image series (723,531 images) from 858 patient examinations, which took place across two sites in four different scanners. With an average execution time per patient of 100 seconds, ACUR was able to sort imaging data with 1191 different sequence names into 43 categories. The framework can be freely downloaded from https://bitbucket.org/cmr-ai-working-group/acur/.
Conclusions
We present ACUR, an automatic framework to curate large volumes of heterogeneous cardiac MRI data. We show how it can quickly and automatically curate data, grouping it according to desired imaging characteristics defined in DICOM attributes. The proposed framework is flexible and ideally suited as a pre-processing tool for large biomedical imaging data studies.
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Affiliation(s)
- C Galazis
- Imperial College London, Department of Computing, Faculty of Engineering, London, United Kingdom of Great Britain & Northern Ireland
| | - K Vimalesvaran
- Imperial College London, Myocardial Function, National Heart and Lung Institute, Faculty of Medicine, London, United Kingdom of Great Britain & Northern Ireland
| | - S Zaman
- Imperial College London, Myocardial Function, National Heart and Lung Institute, Faculty of Medicine, London, United Kingdom of Great Britain & Northern Ireland
| | - C Petri
- Imperial College London, Myocardial Function, National Heart and Lung Institute, Faculty of Medicine, London, United Kingdom of Great Britain & Northern Ireland
| | - J Howard
- Imperial College London, Myocardial Function, National Heart and Lung Institute, Faculty of Medicine, London, United Kingdom of Great Britain & Northern Ireland
| | - N Linton
- Imperial College London, Myocardial Function, National Heart and Lung Institute, Faculty of Medicine, London, United Kingdom of Great Britain & Northern Ireland
| | - N Peters
- Imperial College London, Myocardial Function, National Heart and Lung Institute, Faculty of Medicine, London, United Kingdom of Great Britain & Northern Ireland
| | - G Cole
- Imperial College London, Myocardial Function, National Heart and Lung Institute, Faculty of Medicine, London, United Kingdom of Great Britain & Northern Ireland
| | - AA Bharath
- Imperial College London, Department of Bioengineering, Faculty of Engineering, London, United Kingdom of Great Britain & Northern Ireland
| | - M Varela
- Imperial College London, Myocardial Function, National Heart and Lung Institute, Faculty of Medicine, London, United Kingdom of Great Britain & Northern Ireland
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33
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Fouché N, Oesch S, Gerber V, Richter H, Howard J, Peters LM. Pre-analytical stability of sorbitol dehydrogenase in equine heparinized plasma. Vet J 2021; 274:105706. [PMID: 34148016 DOI: 10.1016/j.tvjl.2021.105706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/04/2021] [Accepted: 06/04/2021] [Indexed: 10/21/2022]
Abstract
Sorbitol dehydrogenase (SDH) activity is one of the most sensitive and specific markers for hepatocellular injury in horses, but its reported lability makes it impractical for use in many clinical settings. To date, stability of SDH in equine samples has only been evaluated in a limited number of studies in serum samples of horses with activities within reference intervals. The objective of the study was to determine pre-analytical stability of equine SDH activity in heparinized plasma stored at different temperatures for up to 72 h. Twenty client-owned horses admitted to a veterinary teaching hospital for any reason were included in the study. Blood samples collected in lithium-heparin tubes were immediately centrifuged and SDH activity was analyzed within 1 h of collection (T0). Aliquots of plasma were stored at room temperature, 4 °C and -20 °C and SDH activity was re-analyzed after 4 h (T4), 24 h (T24) and 72 h (T72). A significant difference from values measured at T0 was found for samples stored at room temperature (P = 0.022) and -20 °C (P < 0.001), but not at 4 °C. The activity of SDH was within ±20% of that measured at T0 for all samples under all temperature conditions stored for 4 h, and for all samples stored at 4 °C for 24 h. Bland-Altman plots revealed narrow limits of agreement at T4 for all storage temperatures and at T24 for samples stored at 4 °C. The mean absolute percentage error and 95th percentile of the absolute percentage error were lower for samples stored at 4 °C than those stored at room temperature or -20 °C. The activity of SDH has adequate stability for 4 h regardless of storage temperature and 24 h if stored at 4 °C across a wide range of values. Knowledge of the pre-analytical stability of SDH may permit its broader use in assessing hepatic disorders in horses.
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Affiliation(s)
- N Fouché
- Swiss Institute of Equine Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, and Agroscope, Bern, Switzerland.
| | - S Oesch
- Swiss Institute of Equine Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, and Agroscope, Bern, Switzerland
| | - V Gerber
- Swiss Institute of Equine Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, and Agroscope, Bern, Switzerland
| | - H Richter
- Diagnostic Imaging Research Unit, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - J Howard
- Clinical Diagnostic Laboratory, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - L M Peters
- Clinical Diagnostic Laboratory, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Al-Hity S, Bhamra N, Kumar R, Gupta K, Howard J, Jolly K, Darr A. 908 Personal Protective Equipment (PPE) Guidance During A Global Pandemic: A Statistical Analysis of National Perceived Confidence, Knowledge, And Educational Deficits Amongst U.K. Based Doctors. Br J Surg 2021. [PMCID: PMC8135915 DOI: 10.1093/bjs/znab134.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction March 11th, 2020 saw the World Health Organisation declare a global pandemic following the eruption of the novel coronavirus disease 2019. Unprecedented global demand for personal protective equipment (PPE) was complicated by limited availability and conflicting guidance from healthcare bodies. This study aimed to assess perceived confidence and knowledge of Public Health England’s PPE guidance amongst doctors of varying specialties and grades. Method A nationwide 11-point survey comprising of multiple-choice questions (MCQs) and a Likert scale assessing perceived confidence (1=not confident, 5=very confident) was disseminated to U.K. based doctors using multiple platforms. Results Data collated from 697 respondents revealed average perceived confidence was low. Notably, 59% felt they had received insufficient education regarding up-to-date guidance, with 81% advocating further training. Anaesthetics and ophthalmology were the highest and lowest scoring specialties in knowledge based MCQs, achieving 59% and 31% respectively. Subsequent statistical analysis revealed significant differences between specialties." Conclusions Ensuring consistency in published PPE guidance and education can develop doctor’s confidence and knowledge of appropriate PPE use. The absence of a unified consensus and global education regarding the use of PPE poses significant ramifications for patient and healthcare professional (HCP) safety whilst risking further depletion of already sparse resources.
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Affiliation(s)
- S Al-Hity
- The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
| | - N Bhamra
- The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
| | - R Kumar
- The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
| | - K Gupta
- The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
| | - J Howard
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - K Jolly
- The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
| | - A Darr
- The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
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Walker I, Trompeter S, Howard J, Williams A, Bell R, Bingham R, Bankes M, Vercueil A, Dalay S, Whitaker D, Elton C. Guideline on the peri-operative management of patients with sickle cell disease: Guideline from the Association of Anaesthetists. Anaesthesia 2021; 76:805-817. [PMID: 33533039 DOI: 10.1111/anae.15349] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2020] [Indexed: 11/30/2022]
Abstract
Sickle cell disease is a multisystem disease characterised by chronic haemolytic anaemia, painful vaso-occlusive crises and acute and chronic end-organ damage. It is one of the most common serious inherited single gene conditions worldwide and has a major impact on the health of affected individuals. Peri-operative complications are higher in patients with sickle cell disease compared with the general population and may be sickle or non-sickle-related. Complications may be reduced by meticulous peri-operative care and transfusion, but unnecessary transfusion should be avoided, particularly to reduce the risk of allo-immunisation. Planned surgery and anaesthesia for patients with sickle cell disease should ideally be undertaken in centres with experience in caring for these patients. In an emergency, advice should be sought from specialists with experience in sickle cell disease through the haemoglobinopathy network arrangements. Emerging data suggest that patients with sickle cell disease are at increased risk of COVID-19 infection but may have a relatively mild clinical course. Outcomes are determined by pre-existing comorbidities, as for the general population.
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Affiliation(s)
- I Walker
- Working Party, on behalf of the Association of Anaesthetists
| | - S Trompeter
- Department of Haematology, University College London NHS Foundation Trust and NHS Blood and Transplant, London, UK
| | - J Howard
- Department of Haematology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Williams
- Department of Anaesthesia, Bart's Health NHS Trust, London, UK
| | - R Bell
- Department of Anaesthesia, University College London NHS Foundation Trust, London, UK
| | - R Bingham
- 6Department of Paediatric Anaesthesia, Great Ormond Street Hospital NHS Trust and Association of Paediatric Anaesthetists of Great Britain and Ireland, London, UK
| | - M Bankes
- Department of Orthopaedic Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Vercueil
- Department of Anaesthesia, Department of Critical Care Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - S Dalay
- Department of Anaesthesia, Worcestershire Acute Hospitals NHS Trust UK and Association of Anaesthetists Trainee Committee
| | - D Whitaker
- Manchester and Royal College of Anaesthetists
| | - C Elton
- Department of Anaesthesia, University Hospitals of Leicester NHS Trust and Obstetric Anaesthetists' Association, Leicester, UK
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Bawor M, Kesse-Adu R, Gardner K, Marino P, Howard J, Webb J. Prevalence of cardiac abnormalities in sickle cell disease identified using cardiac magnetic resonance imaging. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1026] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Sickle cell disease (SCD) affects thousands of individuals in the United Kingdom causing significant morbidity and mortality. Modern therapies have been successful in increasing life expectancy, however these patients have an increased risk of cardiovascular complications and the extent to which sickle cell disease affects cardiac function is not well understood. Cardiac magnetic resonance imaging (MRI) is the gold standard imaging modality for evaluating myocardial function. It is known that sickle cell patients can present with pulmonary hypertension, left ventricular diastolic dysfunction, and atrial enlargement however the prevalence of other cardiac abnormalities has not been sufficiently investigated with cardiac MRI. In addition, the European Society of Cardiology (ESC) updated their definition of Heart Failure in 2016 and therefore will need to be re-assessed in this population.
Purpose
To evaluate the prevalence of cardiac abnormalities in the sickle cell population using cardiac MRI and based on the recently updated diagnostic criteria.
Methods
We conducted a retrospective review including all patients with sickle cell disease at a large tertiary hospital in London, United Kingdom who had been referred for cardiac MRI between 2011 and 2019. Data was collected data on various measures of cardiac function including: left ventricular ejection fraction (LVEF), left ventricular hypertrophy, left and right atrial enlargement, regional wall motion abnormalities, valvular disease, myocardial scarring, and cardiac iron load.
Results
82 patients and 123 cardiac MRI scans were reviewed in this study. 68% of patients were female and the average age at time of scan was 37 years. The average left ventricular ejection fraction was 57% (n=82). Cardiac abnormalities were identified in 60% of patients. The most common cardiac abnormalities reported were: valvular regurgitation (46%; n=28), left atrial enlargement (28%; n=19), right atrial enlargement (16%; n=11), left ventricular hypertrophy (11%; n=8), regional wall motion abnormalities (10%; n=7), and myocardial scar with late gadolinium enhancement (9%; n=7). 28% of the patients were diagnosed with Heart Failure; 11% of the patients satisfied the diagnostic criteria for HFpEF (Heart failure with preserved ejection fraction, n=9), 10% with HFrEF (Heart Failure with reduced ejection fraction, n=8), and 7% with HFmrEF (Heart Failure with mid-range ejection fraction, n=6).
Conclusion
Sickle cell disease affects cardiac function in the majority of patients resulting in numerous cardiac abnormalities. We have described the overall extent of these effects using data from cardiac MRI scans, which has not been commonly used thus far. This has implications for both the diagnosis and subsequent management of cardiac abnormalities in this population, and it can be used to further investigate and guide the development of targeted treatments for these patients.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Bawor
- Guys and St Thomas Hospital, London, United Kingdom
| | - R Kesse-Adu
- Guys and St Thomas Hospital, London, United Kingdom
| | - K Gardner
- Guys and St Thomas Hospital, London, United Kingdom
| | - P Marino
- Guys and St Thomas Hospital, London, United Kingdom
| | - J Howard
- Guys and St Thomas Hospital, London, United Kingdom
| | - J Webb
- Guys and St Thomas Hospital, London, United Kingdom
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Dion C, Yamomo G, Howard J, Teeter M, Willing R, Lanting B. Revision total knee arthroplasty using a novel 3D printed titanium augment: A biomechanical cadaveric study. J Mech Behav Biomed Mater 2020; 110:103944. [DOI: 10.1016/j.jmbbm.2020.103944] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 05/27/2020] [Accepted: 06/21/2020] [Indexed: 10/23/2022]
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Trapp G, Hurworth M, Christian H, Bromberg M, Howard J, McStay C, Ambrosini G, Martin K, Harray A, Cross D, Oddy W, Hammond D. Prevalence and pattern of energy drink intake among Australian adolescents. J Hum Nutr Diet 2020; 34:300-304. [PMID: 32827226 DOI: 10.1111/jhn.12789] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Energy drinks (ED) are popular among young people despite evidence of associated health risks. Research into the prevalence and pattern of ED intake among young people is sparse. The present study investigates the prevalence and pattern of ED intake among a large sample of adolescents, including how many consume them, how often, for what reasons and in what contexts. METHODS In 2018, all students in grades 7-12 attending 25 randomly selected Western Australian schools were invited to complete an online self-report survey about EDs. RESULTS Of the 3688 respondents, 51.2% reported consuming an ED. Of these 'ever consumers', 23.4% drank them monthly, 19.2% weekly and 2% every day. The average age of first intake was 10.7 years. One-fifth (19.7%) of 'ever consumers' reported consuming more than two EDs in 1 day. Reasons for ED use included taste, to boost energy levels, sport performance and studying. CONCLUSIONS The findings add to limited international evidence about adolescent ED use and provide valuable information to help ensure interventions to reduce intake address the underlying reasons and contexts of ED consumption.
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Affiliation(s)
- G Trapp
- Telethon Kids Institute, Perth Children's Hospital, Nedlands, WA, Australia.,School of Population and Global Health, The University of Western Australia, Nedlands, WA, Australia
| | - M Hurworth
- Telethon Kids Institute, Perth Children's Hospital, Nedlands, WA, Australia
| | - H Christian
- Telethon Kids Institute, Perth Children's Hospital, Nedlands, WA, Australia.,School of Population and Global Health, The University of Western Australia, Nedlands, WA, Australia
| | - M Bromberg
- The Law School, The University of Western Australia, Crawley, WA, Australia
| | - J Howard
- School of Law, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - C McStay
- The Western Australian Department of Health, East Perth, WA, Australia
| | - G Ambrosini
- School of Population and Global Health, The University of Western Australia, Nedlands, WA, Australia.,The Western Australian Department of Health, East Perth, WA, Australia
| | - K Martin
- School of Population and Global Health, The University of Western Australia, Nedlands, WA, Australia
| | - A Harray
- School of Public Health, Curtin University, Bentley, WA, Australia
| | - D Cross
- Telethon Kids Institute, Perth Children's Hospital, Nedlands, WA, Australia.,School of Population and Global Health, The University of Western Australia, Nedlands, WA, Australia
| | - W Oddy
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - D Hammond
- School of Public Health & Health Systems, University of Waterloo, Waterloo, ON, Canada
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Long T, Allcock JS, Nie L, Sharples RM, Xu M, Ke R, Zhang S, Silburn SA, Howard J, Yu Y, Yuan B, Wang ZH, Song XM, Liu L, Duan XR. Doppler coherence imaging of scrape-off-layer impurity flows in the HL-2A tokamak. Rev Sci Instrum 2020; 91:083504. [PMID: 32872906 DOI: 10.1063/5.0005609] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 07/24/2020] [Indexed: 06/11/2023]
Abstract
A new Doppler coherence imaging spectroscopy interferometer has been developed on the HL-2A tokamak for the scrape-off-layer impurity flow measurement. Its spatial resolution is estimated to be up to ∼0.8 mm in the horizontal direction and ∼9 mm in the vertical direction, with a field of view of ∼34°. Its typical temporal resolution is about 1 ms. This salient feature allows for time-resolved 2D measurements in short-time phenomena on HL-2A, such as edge localized modes. Group delay and interference fringe pattern were calibrated with a dedicated calibration system. The robustness of group delay calibration and the feasibility of the extrapolation model for fringe pattern calibration are demonstrated. In this paper, we report the details of the optical instruments, calibration, and the initial experimental results of this Doppler coherence imaging spectroscopy interferometer.
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Affiliation(s)
- T Long
- Southwestern Institute of Physics, Chengdu 610041, China
| | - J S Allcock
- Centre for Advanced Instrumentation, Department of Physics, Durham University, Durham DH1 3LE, United Kingdom
| | - L Nie
- Southwestern Institute of Physics, Chengdu 610041, China
| | - R M Sharples
- Centre for Advanced Instrumentation, Department of Physics, Durham University, Durham DH1 3LE, United Kingdom
| | - M Xu
- Southwestern Institute of Physics, Chengdu 610041, China
| | - R Ke
- Southwestern Institute of Physics, Chengdu 610041, China
| | - S Zhang
- Southwestern Institute of Physics, Chengdu 610041, China
| | - S A Silburn
- Kingdom Atomic Energy Authority, Culham Centre for Fusion Energy, Culham Science Centre, Abingdon, Oxon OX14 3DB, United Kingdom
| | - J Howard
- Australian National University, Canberra, ACT 0200, Australia
| | - Y Yu
- University of Science and Technology of China, Hefei 230026, China
| | - B Yuan
- Southwestern Institute of Physics, Chengdu 610041, China
| | - Z H Wang
- Southwestern Institute of Physics, Chengdu 610041, China
| | - X M Song
- Southwestern Institute of Physics, Chengdu 610041, China
| | - L Liu
- Southwestern Institute of Physics, Chengdu 610041, China
| | - X R Duan
- Southwestern Institute of Physics, Chengdu 610041, China
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Kalamaras A, NR K, Moore S, Aarnes T, Ricco PC, Howard J, Peng J, SC J. Comparison of Perioperative Analgesic Protocols and Evaluation of the Development of a Chronic Neuropathic Pain State in Dogs Undergoing TPLO for Naturally Occurring Cranial Cruciate Ligament Rupture. Vet Comp Orthop Traumatol 2020. [DOI: 10.1055/s-0040-1714956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A Kalamaras
- The Ohio State University, Columbus, Ohio, United States
| | - Kieves NR
- The Ohio State University, Columbus, Ohio, United States
| | - S Moore
- The Ohio State University, Columbus, Ohio, United States
| | - T Aarnes
- The Ohio State University, Columbus, Ohio, United States
| | | | - J Howard
- The Ohio State University, Columbus, Ohio, United States
| | - J Peng
- Center for Biostatistics, The Ohio State University, Columbus, Ohio, United States
| | - Jones SC
- The Ohio State University, Columbus, Ohio, United States
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Abbas Y, Abdelkader M, Adams M, Addison A, Advani R, Ahmed T, Alexander V, Alexander V, Alli B, Alvi S, Amiraraghi N, Ashman A, Balakumar R, Bewick J, Bhasker D, Bola S, Bowles P, Campbell N, Can Guru Naidu N, Caton N, Chapman J, Chawdhary G, Cherko M, Coates M, Conroy K, Coyle P, Cozar O, Cresswell M, Dalton L, Danino J, Daultrey C, Davies K, Carrie S, Dick D, Dimitriadis PA, Doddi N, Dowling M, Easto R, Edmiston R, Ellul D, Erskine S, Evans A, Farboud A, Forde C, Fussey J, Gaunt A, Gilchrist J, Gohil R, Gosnell E, Grech Marguerat D, Green R, Grounds R, Hall A, Hardman J, Harris A, Harrison L, Hone R, Hoskison E, Howard J, Ioannidis D, Iqbal I, Janjua N, Jolly K, Kamal S, Kanzara T, Keates N, Kelly A, Khan H, Korampalli T, Kuet M, Kul‐loo P, Lakhani R, Lambert A, Lancer H, Leonard C, Lloyd G, Lowe E, Mair J, Maughan E, Gao C, Mayberry T, McCadden L, McClenaghan F, McKenzie G, Mcleod R, Meghji S, Mian M, Millington A, Mirza O, Mistry S, Molena E, Morris J, Myuran T, Navaratnam A, Noon E, Okonkwo O, Oremule B, Pabla L, Papesch E, Puranik V, Roplekar R, Ross E, Rudd J, Schechter E, Senior A, Sethi N, Sharma S, Sharma R, Shelton F, Sherazi Z, Tahir A, Tikka T, Tkachuk Hlinicanova O, To K, Tse A, Toll E, Ubayasiri K, Unadkat S, Upile N, Vijendren A, Walijee H, Wilkie M, Williams R, Williams M, Wilson G, Wong W, Wong G, Xie C, Yao A, Zhang H, Ellis M, Mehta N, Milinis K, Tikka T, Slovick A, Swords C, Hutson K, Smith ME, Hopkins C, Ng Kee Kwong F. Nasal Packs for Epistaxis: Predictors of Success. Clin Otolaryngol 2020; 45:659-666. [DOI: 10.1111/coa.13555] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 03/08/2020] [Accepted: 04/13/2020] [Indexed: 11/30/2022]
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Nour D, Shun-shin M, Fung M, Howard J, Ahmed Y, Allahwala U, Alzuhairi K, Bhindi R, Chamie D, Cook C, Doi S, Funayama N, Hansen P, Horinaka R, Ishibashi Y, Hijikata N, Kaihara T, Kawase Y, Koga M, Kotecha T, Kuwata S, Manica A, Matsuo H, Nakayama M, Nijjer S, Petraco R, Rajkumar C, Ramrakha P, Ruparelia N, Seligman H, Sen S, Takahashi T, Tanabe Y, Warisawa T, Watanabe A, Weaver J, Yong T, Francis D, Al-Lamee R. 834 How Accurately can Physicians Predict Invasive Physiology Using Coronary Angiography? Results of an International Multi-Centre Survey. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.841] [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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43
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Peyronnet B, Jericevic D, Rude T, Ekenchukwu E, Sussman R, Palmerola R, Pape D, Escobar C, Zhovtis L, Howard J, Charlson R, Krupp L, Rosenblum N, Nitti V, Brucker B. Comparaison prospective non randomisée de la solifenacine et du mirabegron chez les patients atteints de sclérose en plaques ayant des symptômes d’hyperactivité vésicale. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.204] [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: 10/25/2022]
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44
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Smith-Carrier TA, Béres L, Johnson K, Blake C, Howard J. Digging into the experiences of therapeutic gardening for people with dementia: An interpretative phenomenological analysis. Dementia (London) 2019; 20:130-147. [PMID: 31426675 DOI: 10.1177/1471301219869121] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Gardening programmes aim to promote improved engagement and quality of life in persons with dementia. Although a substantial literature has amassed documenting the overall positive outcomes associated with therapeutic gardening and horticulture for persons with dementia, little is known about the specific aspects of the gardening process that engender these benefits, and how and why they are important. The purpose of this research was to explore, using interpretative phenomenological analysis, the experiences of therapeutic gardening for persons with dementia, and their perspectives on the senses and emotions elicited in the gardening process that promote well-being. The themes that emerged in our analysis are to varying degrees substantiated in the literature: the usefulness of activating the senses, particularly those of touch and smell; the significance of being occupied in meaningful, productive work; the importance of cultivating a sense of curiosity, wonder, and learning; the positive gains derived from socialization in a group context; the peace and hope derived from being 'in the moment'; and the positive mental and physical well-being derived from participating in the outdoor garden. Our findings support the integration of therapeutic gardening as a valuable practice for people with dementia.
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Affiliation(s)
| | - Laura Béres
- School of Social Work, King's University College at Western University, London, Ontario, Canada
| | | | | | - Jennifer Howard
- Arthur Labatt Family School of Nursing, London, Ontario, Canada
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Willis J, Awogbade M, Howard J, Breen C, Abbas A, Harber M, Shendi M A, Andrews P, Galliford J, Shah S, Sharpe C. SUN-053 OUTCOMES FOLLOWING KIDNEY TRANSPLANTATION IN PATIENTS WITH SICKLE CELL DISEASE WITH AND WITHOUT EXCHANGE BLOOD TRANSFUSION. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.449] [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] Open
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Shen X, Liang M, Chen X, Pasha MA, D'Souza SS, Hidde K, Howard J, Sultana DA, Fung ITH, Ye L, Pan J, Liu G, Drake JR, Drake LA, Zhu J, Bhandoola A, Yang Q. Cutting Edge: Core Binding Factor β Is Required for Group 2 Innate Lymphoid Cell Activation. J Immunol 2019; 202:1669-1673. [PMID: 30728212 DOI: 10.4049/jimmunol.1800852] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 01/20/2019] [Indexed: 01/08/2023]
Abstract
Group 2 innate lymphoid cells (ILC2) are tissue-resident, long-lived innate effector cells implicated in allergy and asthma. Upon activation, mature ILC2 rapidly secrete large amounts of type-2 cytokines and other effector molecules. The molecular pathways that drive ILC2 activation are not well understood. In this study, we report that the transcriptional controller core binding factor β (CBFβ) is required for ILC2 activation. Deletion or inhibition of CBFβ did not impair the maintenance of ILC2 at homeostasis but abolished ILC2 activation during allergic airway inflammation. Treatment with CBFβ inhibitors prevented ILC2-mediated airway hyperresponsiveness in a mouse model of acute Alternaria allergen inhalation. CBFβ promoted expression of key ILC2 genes at both transcriptional and translational levels. CBF transcriptional complex directly bound to Il13 and Vegfa promoters and enhancers, and controlled gene transcription. CBFβ further promoted ribosome biogenesis and enhanced gene translation in activated ILC2. Together, these data establish an essential role for CBFβ in ILC2 activation.
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Affiliation(s)
- Xiaofei Shen
- Department of Immunology and Microbial Diseases, Albany Medical College, Albany, NY 12208
| | - Mingwei Liang
- Department of Immunology and Microbial Diseases, Albany Medical College, Albany, NY 12208
| | - Xiangyu Chen
- Department of Immunology and Microbial Diseases, Albany Medical College, Albany, NY 12208
| | - Muhammad Asghar Pasha
- Division of Allergy, Asthma and Immunology, Department of Medicine, Albany Medical Center, Albany, NY 12203
| | - Shanti S D'Souza
- Department of Immunology and Microbial Diseases, Albany Medical College, Albany, NY 12208
| | - Kelsi Hidde
- Department of Immunology and Microbial Diseases, Albany Medical College, Albany, NY 12208
| | - Jennifer Howard
- Department of Immunology and Microbial Diseases, Albany Medical College, Albany, NY 12208
| | - Dil Afroz Sultana
- Department of Immunology and Microbial Diseases, Albany Medical College, Albany, NY 12208
| | - Ivan Ting Hin Fung
- Department of Immunology and Microbial Diseases, Albany Medical College, Albany, NY 12208
| | - Longyun Ye
- Department of Immunology and Microbial Diseases, Albany Medical College, Albany, NY 12208
| | - Jiexue Pan
- Department of Immunology and Microbial Diseases, Albany Medical College, Albany, NY 12208
| | - Gang Liu
- Department of Immunology and Microbial Diseases, Albany Medical College, Albany, NY 12208
| | - James R Drake
- Department of Immunology and Microbial Diseases, Albany Medical College, Albany, NY 12208
| | - Lisa A Drake
- Department of Immunology and Microbial Diseases, Albany Medical College, Albany, NY 12208
| | - Jinfang Zhu
- Molecular and Cellular Immunoregulation Unit, Laboratory of Immunology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and
| | - Avinash Bhandoola
- Laboratory of Genome Integrity, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892
| | - Qi Yang
- Department of Immunology and Microbial Diseases, Albany Medical College, Albany, NY 12208;
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47
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Coelho CH, Gazzinelli-Guimaraes PH, Howard J, Barnafo E, Alani NAH, Muratova O, McCormack A, Kelnhofer E, Urban JF, Narum DL, Anderson C, Langhorne J, Nutman TB, Duffy PE. Chronic helminth infection does not impair immune response to malaria transmission blocking vaccine Pfs230D1-EPA/Alhydrogel® in mice. Vaccine 2019; 37:1038-1045. [PMID: 30685251 PMCID: PMC6382667 DOI: 10.1016/j.vaccine.2019.01.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 12/20/2022]
Abstract
Pfs230 is a candidate malaria transmission blocking vaccine against P. falciparum. Pfs230 vaccine is being tested in areas where malaria and helminth infections are co-endemic. Chronic helminth infection induces a marked increase in systemic Th2 and regulatory cytokine levels in mice. Chronic H. polygyrus bakeri infection does not alter Pfs230 vaccine specific-antibody levels. Functional activity of Pfs230 vaccine was not impaired by chronic helminth infection in mice.
Introduction Malaria transmission blocking vaccines (TBV) are innovative approaches that aim to induce immunity in humans against Plasmodium during mosquito stage, neutralizing the capacity of the infected vectors to transmit malaria. Pfs230D1-EPA/Alhydrogel®, a promising protein-protein conjugate malaria TBV, is currently being tested in human clinical trials in areas where P. falciparum malaria is coendemic with helminth parasites. Helminths are complex metazoans that share the master capacity to downregulate the host immune response towards themselves and also to bystander antigens, including vaccines. However, it is not known whether the activity of a protein-based malaria TBV may be affected by a chronic helminth infection. Methods Using an experimental murine model for a chronic helminth infection (Heligmosomoides polygyrus bakeri - Hpb), we evaluated whether prior infection alters the activity of Pfs230D1-EPA/Alhydrogel® TBV in mice. Results After establishment of a chronic infection, characterized by a marked increase of parasite antigen-specific IgG1, IgA and IgE antibody responses, concomitant with an increase of systemic IL-10, IL-5 and IL-6 levels, the Hpb-infected mice were immunized with Pfs230D1-EPA/Alhydrogel® and the vaccine-specific immune response was compared with that in non-infected immunized mice. TBV immunizations induced an elevated vaccine specific-antibody response, however Pfs230D1 specific-IgG levels were similar between infected and uninfected mice at days 15, 25 and 35 post-vaccination. Absolute numbers of Pfs230D1-activated B cells generated in response to the vaccine were also similar among the vaccinated groups. Finally, vaccine activity assessed by reduction of oocyst number in P. falciparum infected mosquitoes was similar between Hpb-infected and immunized mice with non-infected immunized mice. Conclusion Pfs230D1-EPA/Alhydrogel® efficacy is not impaired by a chronic helminth infection in mice.
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Affiliation(s)
- Camila H Coelho
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | | | - Jennifer Howard
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | - Emma Barnafo
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | - Nada A H Alani
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | - Olga Muratova
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | - Ashley McCormack
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | - Emily Kelnhofer
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | - Joseph F Urban
- US Department of Agriculture, Agricultural Research Service, Beltsville Human Nutrition Research Center, Diet, Genomic and Immunology Laboratory, Beltsville, MD, USA
| | - David L Narum
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | - Charles Anderson
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | | | - Thomas B Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Patrick E Duffy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA.
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48
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Maltecca C, Howard J, Baes C, Pryce J. 309 Beyond predictions: managing inbreeding and variability in the genomic era. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C Maltecca
- NC State University,Cary, NC, United States
| | - J Howard
- University of Nebraska Lincoln,Lincoln, NE, United States
| | - C Baes
- University of Guelph,Guelph, ON, Canada
| | - J Pryce
- Department of Economic Development, Jobs, Transport and Resources,Bundorra, Vic, Australia
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49
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Howard J, Zaidi I, Loizon S, Mercereau-Puijalon O, Déchanet-Merville J, Mamani-Matsuda M. Human Vγ9Vδ2 T Lymphocytes in the Immune Response to P. falciparum Infection. Front Immunol 2018; 9:2760. [PMID: 30538708 PMCID: PMC6277687 DOI: 10.3389/fimmu.2018.02760] [Citation(s) in RCA: 17] [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: 03/31/2018] [Accepted: 11/09/2018] [Indexed: 01/02/2023] Open
Abstract
Malaria is an infectious disease caused by the protozoan parasite Plasmodium sp, the most lethal being Plasmodium falciparum. Clinical malaria is associated with the asexual replication cycle of Plasmodium parasites inside the red blood cells (RBCs) and a dysregulated immune response. Although the mechanisms of immune responses to blood—or liver-stage parasites have been extensively studied, this has not led to satisfactory leads for vaccine design. Among innate immune cells responding to infection are the non-conventional gamma-delta T-cells. The Vγ9Vδ2 T-cell subset, found only in primates, is activated in response to non-peptidic phosphoantigens produced by stressed mammalian cells or by microorganisms such as Mycobacteria, E.coli, and Plasmodium. The potential protective role of Vγ9Vδ2 T-cells against infections and cancer progression is of current research interest. Vγ9Vδ2 T-cells have been shown to play a role in the early control of P. falciparum parasitemia and to influence malaria adaptive immunity via cytokine release and antigen presentation. They are activated and expanded during a primary P. falciparum infection in response to malaria phosphoantigens and their activity is modulated upon subsequent infections. Here, we review the wide range of functions by which Vγ9Vδ2 T-cells could both contribute to and protect from malaria pathology, with a particular focus on their ability to induce both innate and adaptive responses. We discuss how the multifunctional roles of these T-cells could open new perspectives on gamma-delta T-cell-based interventions to prevent or cure malaria.
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Affiliation(s)
- Jennifer Howard
- Division of Intramural Research (DIR), National Institutes of Allergy and Infectious Diseases, Bethesda, MD, United States
| | - Irfan Zaidi
- Division of Intramural Research (DIR), National Institutes of Allergy and Infectious Diseases, Bethesda, MD, United States
| | - Séverine Loizon
- Univ. Bordeaux, CNRS ImmunoConcEpT UMR 5164, Bordeaux, France
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50
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Allen SL, Samuell CM, Meyer WH, Howard J. Laser calibration of the DIII-D coherence imaging system. Rev Sci Instrum 2018; 89:10E110. [PMID: 30399797 DOI: 10.1063/1.5038739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 06/15/2018] [Indexed: 06/08/2023]
Abstract
In this paper, we describe an in situ calibration technique for Coherence Imaging Spectroscopy (CIS) that measures 2-D images of ion flows on DIII-D. A low power CW diode laser that is tuneable in the range 464-468 nm along with a precision wavemeter (10-5 nm resolution) is used to characterize the interferometer phase as a function of wavelength in the region of C iii (465 nm) and He ii (468 nm). The interferometer is stabilized both mechanically and thermally to minimize drift during the calibration. Optical stirring and an integration sphere are used to obtain spatially uniform calibration images. The quality of the calibration data enables a measurement of phase versus wavelength over approximately 10 fringes of the interferometer. These coefficients can also be related to the geometry of the optics and the birefringent crystal of the interferometer. On DIII-D, the integration sphere with the laser light is inserted into the CIS optical system between shots and the laser image and wavelength are automatically recorded, providing a zero velocity reference.
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Affiliation(s)
- S L Allen
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - C M Samuell
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - W H Meyer
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Howard
- Australian National Laboratory, Canberra, ACT 0200, Australia
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