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Read GJM, McLean S, Thompson J, Stanton NA, Baber C, Carden T, Salmon PM. Managing the risks associated with technological disruption in the road transport system: a control structure modelling approach. Ergonomics 2024; 67:498-514. [PMID: 37381733 DOI: 10.1080/00140139.2023.2226850] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 06/11/2023] [Indexed: 06/30/2023]
Abstract
Road transport is experiencing disruptive change from new first-of-a-kind technologies. While such technologies offer safety and operational benefits, they also pose new risks. It is critical to proactively identify risks during the design, development and testing of new technologies. The Systems Theoretic Accident Model and Processes (STAMP) method analyses the dynamic structure in place to manage safety risks. This study applied STAMP to develop a control structure model for emerging technologies in the Australian road transport system and identified control gaps. The control structure shows the actors responsible for managing risks associated with first-of-a-kind technologies and the existing control and feedback mechanisms. Gaps identified related to controls (e.g. legislation) and feedback mechanisms (e.g. monitoring for behavioural adaptation). The study provides an example of how STAMP can be used to identify control structure gaps requiring attention to support the safe introduction of new technologies.
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Affiliation(s)
- G J M Read
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Maroochydore, Australia
- School of Health, University of the Sunshine Coast, Maroochydore, Australia
| | - S McLean
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Maroochydore, Australia
| | - J Thompson
- Transport, Health and Urban Design Research Hub, University of Melbourne, Melbourne, Australia
- University Department of Rural Health, School of Medicine, University of Melbourne, Melbourne, Australia
| | - N A Stanton
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Maroochydore, Australia
- Transportation Research Group, University of Southampton, Southampton, UK
| | - C Baber
- School of Computer Science, University of Birmingham, Birmingham, UK
| | - T Carden
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Maroochydore, Australia
| | - P M Salmon
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Maroochydore, Australia
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Worthington J, Frost J, Sanderson E, Cochrane M, Wheeler J, Cotterill N, MacNeill SJ, Noble S, Avery M, Clarke S, Fader M, Hashim H, McGeagh L, Macaulay M, Rees J, Robles L, Taylor G, Taylor J, Thompson J, Lane JA, Ridd MJ, Drake MJ. Lower urinary tract symptoms in men: the TRIUMPH cluster RCT. Health Technol Assess 2024; 28:1-162. [PMID: 38512051 PMCID: PMC11017146 DOI: 10.3310/gvbc3182] [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] [Indexed: 03/22/2024] Open
Abstract
Background Conservative therapies are recommended as initial treatment for male lower urinary tract symptoms. However, there is a lack of evidence on effectiveness and uncertainty regarding approaches to delivery. Objective The objective was to determine whether or not a standardised and manualised care intervention delivered in primary care achieves superior symptomatic outcome for lower urinary tract symptoms to usual care. Design This was a two-arm cluster randomised controlled trial. Setting The trial was set in 30 NHS general practice sites in England. Participants Participants were adult men (aged ≥ 18 years) with bothersome lower urinary tract symptoms. Interventions Sites were randomised 1 : 1 to deliver the TReatIng Urinary symptoms in Men in Primary Health care using non-pharmacological and non-surgical interventions trial intervention or usual care to all participants. The TReatIng Urinary symptoms in Men in Primary Health care using non-pharmacological and non-surgical interventions intervention comprised a standardised advice booklet developed for the trial from the British Association of Urological Surgeons' patient information sheets, with patient and expert input. Patients were directed to relevant sections by general practice or research nurses/healthcare assistants following urinary symptom assessment, providing the manualised element. The healthcare professional provided follow-up contacts over 12 weeks to support adherence to the intervention. Main outcome measures The primary outcome was the validated patient-reported International Prostate Symptom Score 12 months post consent. Rather than the minimal clinically important difference of 3.0 points for overall International Prostate Symptom Score, the sample size aimed to detect a difference of 2.0 points, owing to the recognised clinical impact of individual symptoms. Results A total of 1077 men consented to the study: 524 in sites randomised to the intervention arm (n = 17) and 553 in sites randomised to the control arm (n = 13). A difference in mean International Prostate Symptom Score at 12 months was found (adjusted mean difference of -1.81 points, 95% confidence interval -2.66 to -0.95 points), with a lower score in the intervention arm, indicating less severe symptoms. Secondary outcomes of patient-reported urinary symptoms, quality of life specific to lower urinary tract symptoms and perception of lower urinary tract symptoms all showed evidence of a difference between the arms favouring the intervention. No difference was seen between the arms in the proportion of urology referrals or adverse events. In qualitative interviews, participants welcomed the intervention, describing positive effects on their symptoms, as well as on their understanding of conservative care and their attitude towards the experience of lower urinary tract symptoms. The interviews highlighted that structured, in-depth self-management is insufficiently embedded within general practitioner consultations. From an NHS perspective, mean costs and quality-adjusted life-years were similar between trial arms. The intervention arm had slightly lower mean costs (adjusted mean difference of -£29.99, 95% confidence interval -£109.84 to £22.63) than the usual-care arm, and a small gain in quality-adjusted life-years (adjusted mean difference of 0.001, 95% confidence interval -0.011 to 0.014). Conclusions The intervention showed a small, sustained benefit for men's lower urinary tract symptoms and quality of life across a range of outcome measures in a UK primary care setting. Qualitative data showed that men highly valued the intervention. Intervention costs were marginally lower than usual-care costs. Limitations of the study included that trial participants were unmasked, with limited diversity in ethnicity and deprivation level. Additional research is needed to assess the applicability of the intervention for a more ethnically diverse population.. Trial registration This trial is registered as ISRCTN11669964. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 16/90/03) and is published in full in Health Technology Assessment; Vol. 28, No. 13. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Jo Worthington
- Bristol Trials Centre, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jessica Frost
- Bristol Trials Centre, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Emily Sanderson
- Bristol Trials Centre, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Madeleine Cochrane
- Bristol Trials Centre, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jessica Wheeler
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nikki Cotterill
- School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, UK
| | - Stephanie J MacNeill
- Bristol Trials Centre, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sian Noble
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Miriam Avery
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Samantha Clarke
- Clinical Research Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Mandy Fader
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Hashim Hashim
- Bristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Lucy McGeagh
- National Institute for Health and Care Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Margaret Macaulay
- School of Health Sciences, University of Southampton, Southampton, UK
| | | | - Luke Robles
- National Institute for Health and Care Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK
| | | | - Jodi Taylor
- Bristol Trials Centre, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Joanne Thompson
- Clinical Research Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - J Athene Lane
- Bristol Trials Centre, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Matthew J Ridd
- Centre of Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Marcus J Drake
- Bristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Sykes DL, See YY, Chow ECY, Crooks MG, Cummings H, Robinson M, Watkins K, Thompson J, Overton K, Riches C, Faruqi S. Digitally monitored inhaled therapy: a 'smart' way to manage severe asthma? J Asthma 2024:1-6. [PMID: 38323583 DOI: 10.1080/02770903.2024.2316726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/05/2024] [Indexed: 02/08/2024]
Abstract
INTRODUCTION One of the fundamental challenges of managing patients with severe asthma is treatment adherence, particularly with inhaled corticosteroids. Adherence is difficult to measure objectively and poor adherence is associated with worse outcomes. In this study, assess the ability of a 'smart' inhaler to record adherence in severe asthma patients and measure the impact of this on asthma control. METHODS Consecutive consenting patients meeting criteria for biologics had their existing high-dose ICS/LABA//LAMA combination inhaler/s switched to mometasone/indacaterol/glycopyrronium (114/46/136). Routine clinical data, including blood eosinophils, FeNO, and ACQ-6 scores were collected at baseline and at 4 wk. Adherence was then checked on the Propeller Health app, and good adherence was defined as >80% of prescribed usage. Participants were then followed-up at 12 months to record the proportion of patients who were initiated on biologics. RESULTS 77 patients (mean [SD] age = 50.4 [15.7] years, 67.5% female [n = 52]) participated. 71 participants were able to use the device and 65% (n = 46) of these attained good asthma control and were not initiated on biologics at 12-month follow-up. Both groups demonstrated a significant reduction in ACQ6 score at follow-up (2.81 vs. 1.92, p < 0.001 and 3.05 vs. 2.60, p < 0.001, respectively), but there was no statistically significant difference in improvement between groups. Patients with optimal adherence also demonstrated a significant reduction in median FeNO at follow-up (47 ppb vs. 40 ppb, p = 0.003). CONCLUSIONS In severe asthma patients, 'smart' inhalers may represent an effective management tool to improve adherence and asthma control, therefore avoiding the need for patients to commence biological therapies.
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Affiliation(s)
- Dominic L Sykes
- Respiratory Research Group, Hull York Medical School, Heslington, UK
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | - Yee Yong See
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | - Evon C Y Chow
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | - Michael G Crooks
- Respiratory Research Group, Hull York Medical School, Heslington, UK
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | | | - Mandy Robinson
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | - Karen Watkins
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | - Joanne Thompson
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | - Kylie Overton
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | - Charlotte Riches
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | - Shoaib Faruqi
- Respiratory Research Group, Hull York Medical School, Heslington, UK
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
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England A, Thompson J, Dorey S, Al Islam S, Long M, Maiorino C, McEntee MF. Corrigendum to "A comparison of perceived image quality between computer display monitors and augmented reality smart glasses" [Radiography 29 (3) (May 2023) 641-646]. Radiography (Lond) 2024; 30:1. [PMID: 37586969 DOI: 10.1016/j.radi.2023.08.003] [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: 08/18/2023]
Affiliation(s)
- A England
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland.
| | - J Thompson
- University Hospitals of Morecambe Bay NHS Foundation Trust, Barrow-in-Furness, UK
| | - S Dorey
- Tameside and Glossop Integrated Care NHS Foundation Trust, Tameside, UK
| | - S Al Islam
- East Lancashire Hospitals NHS Trust, Blackburn, UK
| | - M Long
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - C Maiorino
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - M F McEntee
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
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McLean S, King BJ, Thompson J, Carden T, Stanton NA, Baber C, Read GJM, Salmon PM. Forecasting emergent risks in advanced AI systems: an analysis of a future road transport management system. Ergonomics 2023; 66:1750-1767. [PMID: 38009364 DOI: 10.1080/00140139.2023.2286907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/19/2023] [Indexed: 11/28/2023]
Abstract
Artificial Intelligence (AI) is being increasingly implemented within road transport systems worldwide. Next generation of AI, Artificial General Intelligence (AGI) is imminent, and is anticipated to be more powerful than current AI. AGI systems will have a broad range of abilities and be able to perform multiple cognitive tasks akin to humans that will likely produce many expected benefits, but also potential risks. This study applied the EAST Broken Links approach to forecast the functioning of an AGI system tasked with managing a road transport system and identify potential risks. In total, 363 risks were identified that could have adverse impacts on the stated goals of safety, efficiency, environmental sustainability, and economic performance of the road system. Further, risks beyond the stated goals were identified; removal from human control, mismanaging public relations, and self-preservation. A diverse set of systemic controls will be required when designing, implementing, and operating future advanced technologies.Practitioner summary: This study demonstrated the utility of HFE methods for formally considering risks associated with the design, implementation, and operation of future technologies. This study has implications for AGI research, design, and development to ensure safe and ethical AGI implementation.
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Affiliation(s)
- S McLean
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sippy Downs, Australia
| | - B J King
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sippy Downs, Australia
| | - J Thompson
- Transport, Health and Urban Design (THUD) Research Lab, Melbourne School of Design, The University of Melbourne, Melbourne, Australia
| | - T Carden
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sippy Downs, Australia
| | - N A Stanton
- Transportation Research Group, University of Southampton, Southampton, UK
| | - C Baber
- School of Computer Science, University of Birmingham, Birmingham, UK
| | - G J M Read
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sippy Downs, Australia
- School of Health, University of the Sunshine Coast, Sippy Downs, Australia
| | - P M Salmon
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sippy Downs, Australia
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Lim N, Leventhal TM, Thomson MJ, Hassan M, Thompson J, Adams A, Chinnakotla S, Humphreville V, Kandaswamy R, Kirchner V, Pruett TL, Schuller L, McCarty M, Lake J. Protocolized screening and detection of occult alcohol use before and after liver transplant: Lessons learned from a quality improvement initiative. Clin Transplant 2023; 37:e15036. [PMID: 37218656 DOI: 10.1111/ctr.15036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 05/09/2023] [Accepted: 05/13/2023] [Indexed: 05/24/2023]
Abstract
INTRODUCTION Detection of alcohol (ETOH) use with biomarkers provides an opportunity to intervene and treat patients with alcohol use disorder before and after liver transplant (LT). We describe our center's experience using urine ethyl glucuronide (EtG) and serum phosphatidylethanol (PEth) in alcohol screening protocols. METHODS Single-center, retrospective review of patients presenting for LT evaluation, patients waitlisted for LT for alcohol-associated liver disease (ALD), and patients who received a LT for ALD over a 12-month period, from October 1, 2019 through September 30, 2020. Patients were followed from waitlisting to LT, or for up to 12 months post-LT. We monitored protocol adherence to screening for ETOH use- defined as completion of all possible tests over the follow-up period- at the initial LT visit, while on the LT waitlist and after LT. RESULTS During the study period, 227 patients were evaluated for LT (median age 57 years, 58% male, 78% white, 54.2% ALD). Thirty-one patients with ALD were placed on the waitlist, and 38 patients underwent LT for ALD during this time period. Protocolized adherence to screening for alcohol use was higher for PEth for all LT evaluation patients (191 [84.1%] vs. 146 [67%] eligible patients, p < .001), in patients with ALD waitlisted for LT (22 [71%] vs. 14 (48%] eligible patients, p = .04) and after LT for ALD, 20 (33 [86.8%] vs. 20 [52.6%] eligible patients, p < .01). Few patients with a positive test in any group completed chemical dependency treatment. CONCLUSIONS When screening for ETOH use in pre- and post-LT patients, protocol adherence is higher using PEth compared to EtG. While protocolized biomarker screening can detect recurrent ETOH use in this population, engagement of patients into chemical dependency treatment remains challenging.
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Affiliation(s)
- N Lim
- Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA
| | - T M Leventhal
- Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA
| | - M J Thomson
- Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA
| | - M Hassan
- Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA
| | - J Thompson
- Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA
| | - A Adams
- Division of Transplant Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - S Chinnakotla
- Division of Transplant Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - V Humphreville
- Division of Transplant Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - R Kandaswamy
- Division of Transplant Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - V Kirchner
- Division of Abdominal Transplantation, Stanford University, Palo Alto, California, USA
| | - T L Pruett
- Division of Transplant Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - L Schuller
- University of Minnesota Physicians, Minneapolis, Minnesota, USA
| | - M McCarty
- Complex Care Analytics, Fairview Health Services, Minneapolis, Minnesota, USA
| | - J Lake
- Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA
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Alvarado Sandino CO, Barnes AP, Sepúlveda I, Garratt MPD, Thompson J, Escobar-Tello MP. Examining factors for the adoption of silvopastoral agroforestry in the Colombian Amazon. Sci Rep 2023; 13:12252. [PMID: 37507434 PMCID: PMC10382530 DOI: 10.1038/s41598-023-39038-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
Current land use systems in the Amazon largely consist of extensive conventional productivist livestock operations that drive deforestation. Silvopastoral systems (SPS) support a transition to low carbon production if they intensify in sympathy with the needs of biophysical and socio-economic contexts. SPS have been promoted for decades as an alternative livestock production system but widespread uptake has yet to be seen. We provide a schema of associating factors for adoption of SPS based on past literature in tropical agriculture and apply this to a bespoke survey of 172 farms in the Caquetá region of the Colombian Amazon. We find a number of factors which do not apply to this region and argue for a context specific approach. The impact of managing increased market access and opportunities for SPS producers are crucial to avoiding additional deforestation. Further understanding of the underlying antecedents of common factors, such as perceptions of silvopastoral systems, would reduce the risk of perverse policy outcomes.
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Affiliation(s)
- C O Alvarado Sandino
- Rural Economy, Environment and Society, SRUC, The Kings Buildings, West Mains Road, Edinburgh, UK
- Faculty of Geosciences, University of Edinburgh, West Mains Road, Edinburgh, UK
| | - A P Barnes
- Rural Economy, Environment and Society, SRUC, The Kings Buildings, West Mains Road, Edinburgh, UK.
| | - I Sepúlveda
- Rural Economy, Environment and Society, SRUC, The Kings Buildings, West Mains Road, Edinburgh, UK
| | - M P D Garratt
- Sustainable Land Management, School of Agriculture, Policy and Development, University of Reading, Reading, UK
| | - J Thompson
- UK Centre for Ecology and Hydrology, Bush Estate, Penicuik, UK
| | - M P Escobar-Tello
- Bristol Veterinary School, University of Bristol, Langford House, Bristol, UK
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Davies RL, Thompson J, McGuire R, Smith JE, Webster S, Woolley T. Haemostatic resuscitation in practice: a descriptive analysis of blood products administered during Operation HERRICK, Afghanistan. BMJ Mil Health 2023:e002408. [PMID: 37400127 DOI: 10.1136/military-2023-002408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 06/10/2023] [Indexed: 07/05/2023]
Abstract
INTRODUCTION Life-threatening haemorrhage is the leading cause of potentially survivable injury in battlefield casualties. During Operation HERRICK (Afghanistan), mortality rates improved year on year due to a number of advances in trauma care, including haemostatic resuscitation. Blood transfusion practice has not previously been reported in detail during this period. METHODS A retrospective analysis of blood transfusion at the UK role 3 medical treatment facility (MTF) at Camp Bastion between March 2006 and September 2014 was performed. Data were extracted from two sources: the UK Joint Theatre Trauma Registry (JTTR) and the newly established Deployed Blood Transfusion Database (DBTD). RESULTS 3840 casualties were transfused 72 138 units of blood and blood products. 2709 adult casualties (71%) were fully linked with JTTR data and were transfused a total of 59 842 units. Casualties received between 1 unit and 264 units of blood product with a median of 13 units per patient. Casualties wounded by explosion required almost twice the volume of blood product transfusion as those wounded by small arms fire or in a motor vehicle collision (18 units, 9 units, and 10 units, respectively). More than half of blood products were transfused within the first 2 hours following arrival at the MTF. There was a trend towards balanced resuscitation with more equal ratios of blood and blood products being used over time. CONCLUSION This study has defined the epidemiology of blood transfusion practice during Operation HERRICK. The DBTD is the largest combined trauma database of its kind. It will ensure that lessons learnt during this period are defined and not forgotten; it should also allow further research questions to be answered in this important area of resuscitation practice.
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Affiliation(s)
- Rhys L Davies
- Anaesthetic Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Academic Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, Birmingham, UK
| | - J Thompson
- Academic Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, Birmingham, UK
| | | | - J E Smith
- Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine, Birmingham, UK
- Emergency Department, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - S Webster
- Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine, Birmingham, UK
| | - T Woolley
- Academic Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, Birmingham, UK
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England A, Thompson J, Dorey S, Al-Islam S, Long M, Maiorino C, McEntee MF. A comparison of perceived image quality between computer display monitors and augmented reality smart glasses. Radiography (Lond) 2023; 29:641-646. [PMID: 37130492 DOI: 10.1016/j.radi.2023.04.010] [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: 11/28/2022] [Revised: 03/28/2023] [Accepted: 04/14/2023] [Indexed: 05/04/2023]
Abstract
INTRODUCTION Augmented-reality (AR) smart glasses provide an alternative to standard computer display monitors (CDM). AR smart glasses may provide an opportunity to improve visualisation during fluoroscopy and interventional radiology (IR) procedures when there can be difficulty in viewing intra-procedural images on a CDM. The aim of this study was to evaluate radiographer perception of image quality (IQ) when comparing CDM and AR smart glasses. METHODS 38 radiographers attending an international congress evaluated ten fluoroscopic-guided surgery and IR images on both a CDM (1920 × 1200 pixels) and a set of Epson Moverio BT-40 AR smart glasses (1920 × 1080 pixels). Participants provided oral responses to pre-defined IQ questions generated by study researchers. Summative IQ scores for each participant/image were compared between CDM and AR smart glasses. RESULTS Of the 38 participants, the mean age was 39 ± 1 years. 23 (60.5%) participants required corrective glasses. In terms of generalisability, participants were from 12 different countries, the majority (n = 9, 23.7%) from the United Kingdom. For eight out of ten images, the AR smart glasses demonstrated a statistically significant increase in perceived IQ (median [IQR] 2.0 [-1.0 to 7.0] points) when compared to the CDM. CONCLUSION AR smart glasses appear to show improvements in perceived IQ when compared to a CDM. AR smart glasses could provide an option for improving the experiences of radiographers involved in image-guided procedures and should be subject to further clinical evaluations. IMPLICATIONS FOR PRACTICE Opportunities exist to improve perceived IQ for radiographers when reviewing fluoroscopy and IR images. AR smart glasses should be further evaluated as a potential opportunity to improve practice when visual attention is split between positioning equipment and image review.
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Affiliation(s)
- A England
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland.
| | - J Thompson
- University Hospitals of Morecambe Bay NHS Foundation Trust, Barrow-in-Furness, UK
| | - S Dorey
- Tameside and Glossop Integrated Care NHS Foundation Trust, Tameside, UK
| | - S Al-Islam
- East Lancashire Hospitals NHS Trust, Blackburn, UK
| | - M Long
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - C Maiorino
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - M F McEntee
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
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Guerisoli MM, Fergnani DM, Fracassi NG, Thompson J, Pereira JA. Activity patterns of the marsh deer: Effects of proxies of human movement, cattle presence, and moon phases on its behavior. J Zool (1987) 2023. [DOI: 10.1111/jzo.13053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Affiliation(s)
- M. M. Guerisoli
- División Mastozoología, Museo Argentino de Ciencias Naturales "Bernardino Rivadavia" (MACN‐CONICET) Buenos Aires Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) Buenos Aires Argentina
| | - D. M. Fergnani
- División Mastozoología, Museo Argentino de Ciencias Naturales "Bernardino Rivadavia" (MACN‐CONICET) Buenos Aires Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) Buenos Aires Argentina
| | - N. G. Fracassi
- Instituto Nacional de Tecnología Agropecuaria (INTA) Paraná de las Palmas and Canal Laurentino Comas (2804) Buenos Aires Argentina
| | - J. Thompson
- Guyra Paraguay, Asunción, Paraguay Instituto Saite, Consejo Nacional de Ciencia y Tecnología (CONACYT) Asunción Paraguay
| | - J. A. Pereira
- División Mastozoología, Museo Argentino de Ciencias Naturales "Bernardino Rivadavia" (MACN‐CONICET) Buenos Aires Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) Buenos Aires Argentina
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Pessin M, Campos-Chillon F, Hanna J, Thompson J. 50 Effects of lipoic acid, L-carnitine, and vitamin C on oocyte maturation and cryopreservation of. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab50] [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: 12/07/2022] Open
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12
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Thompson J, Hanna J, Pessin M, Campos-Chillon F. 217 Effects of mature - recombinant GDF9 and BMP15 on. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab217] [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: 12/12/2022] Open
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13
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Hanna J, Thompson J, Pessin M, Jeffs E, Campos-Chillon F. 221 Supplementation of bovine oocyte maturation media with umbilical cord-derived exosomes. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
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Joe R, Matsumura Y, Siddiqui A, Foulks J, Beg M, Thompson J, Yamamoto N, Spira A, Sarantopoulos J, Melear J, Lou Y, Lebedinsky C, Li J, Watanabe A, Warner S. The AXL inhibitor, TP-0903, reverses EMT and shows activity in non-small cell lung cancer preclinical models. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00954-6] [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: 11/03/2022]
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15
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Rej A, Avery A, Aziz I, Black CJ, Bowyer RK, Buckle RL, Seamark L, Shaw CC, Thompson J, Trott N, Williams M, Sanders DS. Diet and irritable bowel syndrome: an update from a UK consensus meeting. BMC Med 2022; 20:287. [PMID: 36096789 PMCID: PMC9469508 DOI: 10.1186/s12916-022-02496-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022] Open
Abstract
There has been a renewed interest in the role of dietary therapies to manage irritable bowel syndrome (IBS), with diet high on the agenda for patients. Currently, interest has focussed on the use of traditional dietary advice (TDA), a gluten-free diet (GFD) and the low FODMAP diet (LFD). A consensus meeting was held to assess the role of these dietary therapies in IBS, in Sheffield, United Kingdom.Evidence for TDA is from case control studies and clinical experience. Randomised controlled trials (RCT) have demonstrated the benefit of soluble fibre in IBS. No studies have assessed TDA in comparison to a habitual or sham diet. There have been a number of RCTs demonstrating the efficacy of a GFD at short-term follow-up, with a lack of long-term outcomes. Whilst gluten may lead to symptom generation in IBS, other components of wheat may also play an important role, with recent interest in the role of fructans, wheat germ agglutinins, as well as alpha amylase trypsin inhibitors. There is good evidence for the use of a LFD at short-term follow-up, with emerging evidence demonstrating its efficacy at long-term follow-up. There is overlap between the LFD and GFD with IBS patients self-initiating gluten or wheat reduction as part of their LFD. Currently, there is a lack of evidence to suggest superiority of one diet over another, although TDA is more acceptable to patients.In view of this evidence, our consensus group recommends that dietary therapies for IBS should be offered by dietitians who first assess dietary triggers and then tailor the intervention according to patient choice. Given the lack of dietetic services, novel approaches such as employing group clinics and online webinars may maximise capacity and accessibility for patients. Further research is also required to assess the comparative efficacy of dietary therapies to other management strategies available to manage IBS.
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Affiliation(s)
- A Rej
- Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK.
| | - A Avery
- Division of Nutritional Sciences, School of Biosciences, University of Nottingham, Nottingham, UK
| | - I Aziz
- Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | - C J Black
- Leeds Gastroenterology Institute, St James's University Hospital, Leeds, UK; Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - R K Bowyer
- Department of Nutrition and Dietetics, Royal United Hospitals NHS Foundation Trust, Bath, UK
| | - R L Buckle
- Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | - L Seamark
- Specialist Gastroenterology Community Dietetic Service, Somerset Partnership NHS Foundation Trust, Bridgwater, UK
| | - C C Shaw
- Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | - J Thompson
- Information Manager/Specialist Gastroenterology Dietitian, Guts UK Charity, 3 St Andrews Place, London, NW1 4LB, UK
| | - N Trott
- Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | - M Williams
- Specialist Gastroenterology Community Dietetic Service, Somerset Partnership NHS Foundation Trust, Bridgwater, UK
| | - D S Sanders
- Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
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Rankin A, Gorman A, Cole J, Cadogan CA, Barry HE, Agus A, Logan D, McDowell C, Molloy GJ, Ryan C, Leathem C, Maxwell M, Brennan C, Gormley GJ, Ferrett A, McCarthy P, Fahey T, Hughes CM, Murphy L, Kennedy G, Adams C, Martin L, Thompson J, Toase S, Boyd C, McQuillan R, O’Dwyer M. An external pilot cluster randomised controlled trial of a theory-based intervention to improve appropriate polypharmacy in older people in primary care (PolyPrime). Pilot Feasibility Stud 2022; 8:203. [PMID: 36088445 PMCID: PMC9463515 DOI: 10.1186/s40814-022-01161-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background For older populations with multimorbidity, polypharmacy (use of multiple medications) is a standard practice. PolyPrime is a theory-based intervention developed to improve appropriate polypharmacy in older people in primary care. This pilot study aims to assess the feasibility of the PolyPrime intervention in primary care in Northern Ireland (NI) and the Republic of Ireland (ROI). Methods This external pilot cluster randomised controlled trial (cRCT) aimed to recruit 12 general practitioner (GP) practices (six in NI; six in the ROI counties that border NI) and ten older patients receiving polypharmacy (≥ 4 medications) per GP practice (n = 120). Practices allocated to the intervention arm watched an online video and scheduled medication reviews with patients on two occasions. We assessed the feasibility of collecting GP record (medication appropriateness, health service use) and patient self-reported data [health-related quality of life (HRQoL), health service use)] at baseline, 6 and 9 months. HRQoL was measured using the EuroQol-5 dimension-5 level questionnaire (EQ-5D-5L) and medication-related burden quality-of-life (MRB-QoL) tool. An embedded process evaluation and health economics analysis were also undertaken. Pre-specified progression criteria were used to determine whether to proceed to a definitive cRCT. Results Twelve GP practices were recruited and randomised. Three GP practices withdrew from the study due to COVID-related factors. Sixty-eight patients were recruited, with 47 (69.1%) being retained until the end of the study. GP record data were available for 47 patients for medication appropriateness analysis at 9 months. EQ-5D-5L and MRB-QoL data were available for 46 and 41 patients, respectively, at 9 months. GP record and patient self-reported health service use data were available for 47 patients at 9 months. Health service use was comparable in terms of overall cost estimated from GP record versus patient self-reported data. The intervention was successfully delivered as intended; it was acceptable to GPs, practice staff, and patients; and potential mechanisms of action have been identified. All five progression criteria were met (two ‘Go’, three ‘Amend’). Conclusion Despite challenges faced during the COVID-19 pandemic, this study has demonstrated that it may be feasible to conduct an intervention to improve appropriate polypharmacy in older people in primary care across two healthcare jurisdictions. Trial registration ISRCTN, ISRCTN41009897. Registered 19 November 2019. Clinicaltrials.gov, NCT04181879. Registered 02 December 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01161-6.
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Lim E, Reeves J, Gandhi S, Spigel D, Arrowsmith E, George D, Karlix J, Pouliot G, Hattersley M, Gangl E, James G, Thompson J, Russell D, Patel B, Kumar R, Falchook G. 1396P Phase II study of AZD4635 in combination with durvalumab or oleclumab in patients (pts) with metastatic castrate-resistant prostate cancer (mCRPC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1882] [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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18
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Mehta B, Goodman S, Dicarlo E, Jannat-Khah D, Gibbons JA, Otero M, Donlin L, Pannellini T, Robinson W, Sculco P, Figgie M, Rodriguez J, Kirschmann J, Thompson J, Slater D, Frezza D, Xu Z, Wang F, Orange D. OP0223 DISTINGUISHING OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS SYNOVIUM WITH MACHINE LEARNING USING AUTOMATED CELL DENSITY AND PATHOLOGIST SCORES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundJoint damage in the knee can be severe in both rheumatoid arthritis (RA) and osteoarthritis (OA) such that total knee replacement (TKR) is often the only management option. Pathological assessment of the extent or type of synovial tissue inflammation from joint explants or biopsies can be useful. However, an ongoing challenge in using semi-quantitative assessments of synovitis is the disagreement between human pathologist scores of the same sample. We previously developed and validated a computer vision algorithm to automatically count each cell nucleus in an H&E-stained synovial whole slide image and yield a value of cell density, defined as mean nuclei count per mm2 of tissue1.ObjectivesWe sought to develop methods to distinguish OA from RA based on machine learning analysis of histologic features on H&E-stained synovial tissue samples.MethodsWe measured 14 pathologist-scored histology features (137 RA and 152 OA patients) and computer vision quantified cell density (60 RA and 147 OA patients) in H&E stained synovial tissue samples from total knee replacement arthroplasty explants. A random forest model was trained using disease state (OA vs RA) as classifier and histology features and/or cell density as inputs, and feature importance scores for the model were calculated.ResultsSynovium from patients with RA exhibited increased lymphocytic inflammation, lining hyperplasia, neutrophils, detritus, plasma cells, Russell bodies, binucleate plasma cells, sub-lining giant cells, synovial lining giant cells, and fibrin (all p<0.001), while synovium from patients with OA had increased mast cells and fibrosis (both p<0.001). Fourteen pathologist-scored features allowed for discrimination between RA and OA samples, producing a macro-averaged area under the receiver operating curve (AUC) of 0.85. This discriminatory ability was comparable to that of the computer vision score of cell density alone (AUC = 0.88). Combining the pathologist scores with the cell density metric improved the discriminatory power of the model (AUC = 0.91). The three most important features in this combined model were mast cells followed by cell density and fibrosis (Figure 1). AUC values for each individual feature are provided in Table 1. The optimal cell density threshold to distinguish RA from OA synovium was 3,400 cells per mm2, which yielded a sensitivity of 0.82 and specificity of 0.82.Table 1.Area under receiver operating characteristic curves (AUC) of the synovial features in distinguishing RA and OA patientsFeatureAUCAutomated Cell Density0.88Fibrosis0.84Mast cells0.80Lining hyperplasia0.78Lymphocytic inflammation0.69Fibrin0.68Plasma cells0.66Detritus0.64Binucleate plasma cells0.60Neutrophils0.60Synovial giant cells0.58Sub-lining giant cells0.57Russell bodies0.56Germinal centers0.51Mucoid change0.50Figure 1.Importance of synovial features in distinguishing RA and OA synoviumFeature importance scores for supervised machine learning model including all 14 pathology scores and the computer vision-generated cell density.ConclusionH&E-stained images of RA and OA TKR explant synovium are distinct. We identified cell density, mast cells and fibrosis as the three most important features for making this distinction, with RA being characterized by increased cell density, low mast cells, and low fibrosis. Cell density greater than 3400 per mm2 of tissue yields a sensitivity of 0.82 and a specificity of 0.82 for distinguishing RA from OA. In the future, this can have clinical and research applications as this technique removes the requirement for subjective selection of a certain field of interest, is reproducible, and is scalable as it does not require technical expertise of a pathologist.References[1]Guan S, Mehta B…Orange DE. Rheumatoid Arthritis Synovial Inflammation Quantification Using Computer Vision. ACR Open Rheumatology. 2022 Jan 10;acr2.11381.AcknowledgementsThis work was supported by the C. Ronald MacKenzie Young Scientist Endowment Award, the Leon Lowenstein Foundation, and the Kellen Scholar Award supported by the Anna Marie and Stephen Kellen Foundation Total Knee Improvement Program.Disclosure of InterestsBella Mehta Paid instructor for: Novartis, Susan Goodman Consultant of: UCB, Grant/research support from: Novartis, Edward DiCarlo: None declared, Deanna Jannat-Khah Shareholder of: AstraZeneca, Cytodyn, and Walgreens, J. Alex Gibbons: None declared, Miguel Otero Consultant of: Regeneron Pharmaceuticals, Grant/research support from: Tissue Genesis, Laura Donlin Speakers bureau: Stryker, Consultant of: Stryker, Grant/research support from: Karius, Inc, Tania Pannellini: None declared, William Robinson: None declared, Peter Sculco Consultant of: Intellijoint Surgical, DePuy Synthes, Lima Corporate, Zimmer Biomet, and EOS Imaging, Grant/research support from: Intellijoint Surgical and Zimmer Biomet, Mark Figgie Shareholder of: HS2, Mekanika, and Wishbone, Consultant of: Lima and Wishbone, Jose Rodriguez Consultant of: ConforMIS, Medacta, Exactech, Inc, and Smith & Nephew, Grant/research support from: DePuy, Exactech, Inc, and Smith & Nephew, Jessica Kirschmann: None declared, James Thompson: None declared, David Slater: None declared, Damon Frezza: None declared, Zhenxing Xu: None declared, Fei Wang: None declared, Dana Orange: None declared
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Katelaris A, Browne L, Bucci J, Malouf D, Thompson J. Long term impact of LDR brachytherapy for prostate cancer on erectile function: Single centre tertiary referral outcomes with 8-year follow up. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Thompson J, Widdows G, Parbat M. An audit of acute respiratory antibiotic prescribing in COPD patients during the COVID-19 pandemic. International Journal of Pharmacy Practice 2022. [PMCID: PMC9383641 DOI: 10.1093/ijpp/riac019.033] [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: 11/13/2022]
Abstract
Abstract
Introduction
Coronavirus-2 is the virus responsible for the COVID-19 pandemic. People with certain risk factors, such as having chronic obstructive pulmonary disease (COPD) may be more likely to develop complications. Research has identified that ~7% of patients with COVID-19 have a bacterial infection, however antibiotic prescribing rates have been found to vary from 38% to 72% (1,2). Primary care is estimated to make up 75% of antibiotic prescribing and was therefore a key target to evaluate whether antimicrobial stewardship principles were being followed during the COVID-19 pandemic.
Aim
To audit the adherence of antibiotic prescribing in people with COPD during the COVID-19 pandemic across a primary care network (PCN) in England against national and local guidelines.
Methods
The management of patients with COPD should follow NICE Guideline (NG) 114, NG168 and the local formulary. Three audit standards were created: 1) 100% of COPD patients should not be started on prophylactic antibiotics to reduce risk from COVID-19; 2) 100% of COPD patients should not be prescribed antibiotics for COVID-19 symptoms; 3) 90% of antibiotic prescription regimens should adhere to local and national guidelines. Prescribing data was collected from 12 practices linked to the PCN. Data of patients who had COPD, were prescribed an antibiotic, and had an indication for the antibiotic between 01/03/20 and the 30/06/20 were extracted and transferred into an anonymised spreadsheet. A total of 1088 data points were extracted. Random stratified sampling provided 300 data points for analysis, ensuring each GP surgery was represented proportionally; the required sample size to determine significance was 291. For each practice, the total number of antibiotics prescribed to COPD patients between March-June 2019 and March-June 2020 was extracted. Descriptive statistics were used to determine antibiotic prescribing adherence and overall rates of prescribing. Inferential statistics were used to compare rates of prescribing pre-vs-during the pandemic.
Results
Antibiotics were not prescribed for any patient for prophylaxis against COVID-19 (100% adherence to criteria 1). Two patients were prescribed antibiotics for ‘suspected disease caused by COVID-19’ (99.4% adherence to criteria 2). In only 28.7% of cases, the antibiotic was prescribed in line with the national and local guidelines (criteria 3). In most cases, treatment duration was the main reason for poor adherence, with longer courses of antibiotics being prescribed (7 rather than 5 days). Prescribing rates did not change significantly in 2020 compared to 2019 (1134 antibiotic prescriptions vs 1029 antibiotic prescriptions; p>0.05).
Conclusion
The audit was successful in determining that the COVID-19 pandemic did not significantly affect antibiotic prescribing rates across the PCN for people with COPD. Adherence to NICE and local guidelines was low, specifically concerning the duration of antibiotic treatment. This highlights an area for improvement; to ensure healthcare professionals across the PCN prescribe in-line with antimicrobial stewardship principles. Extracted data was limited to antibiotic prescribing and could have been expanded to include steroids to provide a fuller audit of prescribing in COPD exacerbations. A re-audit may be beneficial since the publication of NG191.
References
(1) Lansbury L, Lim B, Baskaran V, Lim WS. Co-infections in people with COVID-19: a systematic review and meta-analysis. J Infect. 2020 Aug;81(2):266-275.
(2) Seaton RA, Gibbons CL, Cooper L, Malcolm W, McKinney R, Dundas S, Griffith D, Jeffreys D, Hamilton K, Choo-Kang B, Brittain S, Guthrie D, Sneddon J. Survey of antibiotic and antifungal prescribing in patients with suspected and confirmed COVID-19 in Scottish hospitals. J Infect. 2020 Dec;81(6):952-960.
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Affiliation(s)
- J Thompson
- School of Pharmacy and Bioengineering, Keele University, Staffordshire, UK
| | - G Widdows
- School of Pharmacy and Bioengineering, Keele University, Staffordshire, UK
| | - M Parbat
- School of Pharmacy and Bioengineering, Keele University, Staffordshire, UK
- North Solihull Primary Care Network, UK
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Essel D, Thompson J, Chapman S. The effect of an augmented reality educational tool on the motivation towards learning in pharmacy students: an evaluative survey. International Journal of Pharmacy Practice 2022. [DOI: 10.1093/ijpp/riac019.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Within the context of education, motivation relates to the desire students possess to engage in their learning environment. This quality is vital in determining the effort an individual expresses towards their learning and the desire they have to achieve higher academic performances (1). Educational technologies, particularly digital technologies, have long been used in post-secondary education to increase collaboration, critical thinking and motivation among students (2). The advancements in technology have led to the creation of novel augmented reality (AR) educational tools, however they have not been widely implemented or researched with the education of pharmacy students in the United Kingdom.
Aim
To identify changes of pharmacy students’ self-reported intrinsic motivation towards learning after using the ‘Pharma Compounds AR’ (PCAR) educational tool.
Methods
The PCAR tool was an image-based educational AR mobile application – it displayed 3-D models and animations of complex molecules when unique target images were scanned with the mobile’s camera. 118 stage two undergraduate Pharmacy students from a University in England were approached through cohort emails that contained a link to an online consent form and pre-intervention questionnaire. Participants were required to complete the pre-questionnaire before they received the PCAR tool for at least two months. Students were informed that they could use the tool to accommodate their learning in any way they felt appropriate. Once the intervention period ended, participants completed an online post-questionnaire. Changes in self-reported intrinsic motivation were determined with the use of adapted Intrinsic Motivation Inventory (IMI) Likert scale questions. The pre-questionnaire focused on motivation towards learning using conventional methods and their perceived usefulness, whereas the post-questionnaire focused on motivation towards learning with the PCAR tool and its perceived usefulness. Descriptive and inferential statistical analyses were conducted on the IMI adapted Likert scales.
Results
A total of 68 (57.6% rr) undergraduate Pharmacy students completed the pre-questionnaire. The majority were aged 18-21(82.4%), female (70.6%) and domestic (94.1%). The post-questionnaire was completed by 30 students (44.1% rr), mainly aged 18-21 (83.3%), female (70%), and domestic (86.7%). Participants ranked their agreement to each Likert statement from 1 (not true at all) to 7 (very true). Mean agreement motivation scores were increased after the use of the PCAR tool (pre-3.88 vs post-5.15), as were the mean agreement scores of the learning tools’ perceived usefulness (pre-4.69 vs post-5.29). Dependant T-tests performed on responses of students who completed both questionnaires revealed a significant increase in students’ mean pre- and post-intervention motivation towards learning scores (p=0.000). No significance was calculated between the mean pre-and post-agreement usefulness scores (p>0.05).
Conclusion
Incorporating the PCAR tool into the education of stage two Pharmacy students significantly increased their reported motivation towards learning when compared to conventional methods, it was also reported as being a more useful learning tool. The drop in post-questionnaire responses has to be acknowledge as a limitation as well as not explicitly knowing how students used the PCAR tool in their studies. Nevertheless, the incorporation of AR into schools of Pharmacy could provide students and tutors more engaging teaching and learning experiences.
References
(1) Budiman R. Developing Learning Media Based on Augmented Reality (AR) to Improve Learning Motivation. J Educ Teach Learn. 2016 Sep;1(2):89–94. Available from: https://www.learntechlib.org/p/209026
(2) Martin F, Polly D, Coles S, Wang C. Examining higher education faculty use of current digital technologies: Importance, competence, and motivation. Int J Teach Learn High Educ. 2020;32(1):73–86.
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Affiliation(s)
- D Essel
- School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, UK
| | - J Thompson
- School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, UK
| | - S Chapman
- School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, UK
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22
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Thompson J, Al-Attbi S, Patel B. Patient perceptions of clinical pharmacists in general practice. International Journal of Pharmacy Practice 2022. [DOI: 10.1093/ijpp/riac019.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
As a result of changes in the demands and pressures on the NHS, the role of the pharmacist has advanced from purely dispensing and compounding medicines to a more clinical and patient-centred approach to care (1). Since 2015, NHS England set a target of recruiting practice-based pharmacists into 20% of practices by 2020-2021 as a way of reducing these pressures (2). Conducting evaluations of clinical pharmacists in individual practices is essential for role integration and evolution.
Aim
To explore patient perceptions of clinical pharmacists across three general practices.
Methods
A paper-based questionnaire consisting of open and closed questions was used to gather patient perceptions on the role of a clinical pharmacist and their consultation experiences. Participants included patients over the age of 18 who had attended a face-to-face appointment with a clinical pharmacist from one of three general practice surgeries in England between November and December 2019. The clinical pharmacists were used as a gateway to recruit participants; post-consultation, the pharmacist asked patients if they would complete a questionnaire. Patients were provided with an information sheet and consent form prior to completion of the questionnaire. The questionnaire was anonymous. Data were analysed using descriptive statistics and content analysis.
Results
A total of 39 participants completed the questionnaire. Most participants were elderly (28%) and female (64%). The primary reason for the consultations was due to an acute illness (79%), and the most common outcome was the supply of a prescription (83%). Patients were predominantly unfamiliar with the role of a clinical pharmacist (56%) and 31% of patients reportedly thought their appointment had been with a doctor. All patients were positive about their experience and reported they would “be more than happy to see a pharmacist in the future” and that the role was “a very necessary addition to the practice”. All patients reported that their consultation was the same (51%) or better than they have had with a doctor (49%). Patients commented on the pharmacists’ consultation skills, making statements such as [they] “listened to me”, “asked me questions”, “were really good at explaining” and “spoke in a way I understood”. Clinical pharmacists were reported as being “very professional” and knowledgeable as “[they] knew more about my medication [than the doctor] and prescribed me something to help”. Patients reported that they would recommend the clinical pharmacist to their family and friends when seeking an appointment.
Conclusion
This research highlights patient acceptance towards consultations with a clinical pharmacist and reinforces the competence of pharmacists to undertake this role. A key finding related to the effective consultation skills of the pharmacists and involving the patients in their care. The number of patients who participated limits the generalisability of the findings, and the patient responses may have been a reaction to the individual clinical pharmacists rather than their thoughts on the role overall. Increased publicity and patient education of the role of a clinical pharmacist may promote a greater integration into the multidisciplinary team.
References
(1) Robertson R, Wenzel L, Thompson J, Charles A. Understanding NHS financial pressures. How are they affecting patient care. 2017. The Kings Fund. https://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/Understanding%20NHS%20financial%20pressures%20-%20full%20report.pdf
(2) NHS England 2016. General Practice Forward View. https://www.england.nhs.uk/wp-content/uploads/2016/04/gpfv.pdf
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Affiliation(s)
- J Thompson
- School of Pharmacy and Bioengineering, Keele University, Staffordshire, UK
| | - S Al-Attbi
- School of Pharmacy and Bioengineering, Keele University, Staffordshire, UK
| | - B Patel
- Midlands Practice Pharmacy Network, UK
- Rushall Medical Centre, Walsall, West Midlands, UK
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Walsh TS, Pauley E, Donaghy E, Thompson J, Barclay L, Parker RA, Weir C, Marple J. Does a screening checklist for complex health and social care needs have potential clinical usefulness for predicting unplanned hospital readmissions in intensive care survivors: development and prospective cohort study. BMJ Open 2022; 12:e056524. [PMID: 35321894 PMCID: PMC8943772 DOI: 10.1136/bmjopen-2021-056524] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Intensive care (ICU) survivors are at high risk of long-term physical and psychosocial problems. Unplanned hospital readmission rates are high, but the best way to triage patients for interventions is uncertain. We aimed to develop and evaluate a screening checklist to help predict subsequent readmissions or deaths. DESIGN A checklist for complex health and social care needs (CHSCNs) was developed based on previous research, comprising six items: multimorbidity; polypharmacy; frequent previous hospitalisations; mental health issues; fragile social circumstances and impaired activities of daily living. Patients were considered to have CHSCNs if two or more were present. We prospectively screened all ICU discharges for CHSCNs for 12 months. SETTING ICU, Royal Infirmary, Edinburgh, UK. PARTICIPANTS ICU survivors over a 12-month period (1 June 2018 and 31 May 2019). INTERVENTIONS None. OUTCOME MEASURE Readmission or death in the community within 3 months postindex hospital discharge. RESULTS Of 1174 ICU survivors, 937 were discharged alive from the hospital. Of these 253 (27%) were classified as having CHSCNs. In total 28% (266/937) patients were readmitted (N=238) or died (N=28) within 3 months. Among CHSCNs patients 45% (n=115) patients were readmitted (N=105) or died (N=10). Patients without CHSCNs had a 22% readmission (N=133) or death (N=18) rate. The checklist had: sensitivity 43% (95% CI 37% to 49%), specificity 79% (95% CI 76% to 82%), positive predictive value 45% (95% CI 41% to 51%), and negative predictive value 78% (95% CI 76% to 80%). Relative risk of readmission/death for patients with CHSCNs was 2.06 (95% CI 1.69 to 2.50), indicating a pretest to post-test probability change of 28%-45%. The checklist demonstrated high inter-rater reliability (percentage agreement ≥87% for all domains; overall kappa, 0.84). CONCLUSIONS Early evaluation of a screening checklist for CHSCNs at ICU discharge suggests potential clinical usefulness, but this requires further evaluation as part of a care pathway.
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Affiliation(s)
- Timothy Simon Walsh
- Critical Care Medicine; Usher Institute of Population Health Sciences, University of Edinburgh Division of Clinical and Surgical Sciences, Edinburgh, UK
| | - Ellen Pauley
- Department of Anaesthesia, Critical Care & Pain Medicine, University of Edinburgh Division of Clinical and Surgical Sciences, Edinburgh, UK
| | - Eddie Donaghy
- Department of Anaesthesia, Critical Care & Pain Medicine, NHS Lothian, Edinburgh, UK
| | - Joanne Thompson
- Department of Anaesthesia, Critical Care & Pain Medicine, NHS Lothian, Edinburgh, UK
| | - Lucy Barclay
- Department of Anaesthesia, Critical Care & Pain Medicine, NHS Lothian, Edinburgh, UK
| | | | - Christopher Weir
- Usher Institute of Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - James Marple
- Department of Anaesthesia, Critical Care & Pain Medicine, NHS Lothian, Edinburgh, UK
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Thompson J, Gusev V, Dervin P, Tevendale E. 712 EVALUATING AN ‘ACUTE FRAILTY TEAM’ MODEL OF CARE IN IMPROVING OUTCOMES FOR PATIENTS WITH FRAILTY ACUTELY ADMITTED TO HOSPITAL. Age Ageing 2022. [DOI: 10.1093/ageing/afac034.712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
In frailty, Comprehensive geriatric assessment (CGA) has benefit in improving patient outcomes, including hospital readmissions and institutionalisation. We looked to evaluate the effectiveness of our newly initiated multi-disciplinary, acute frailty team (AFT) in improving acute care. This team works on the Acute Medical Unit (AMU), delivering early CGA alongside the existing acute medical care.
Methods
The AFT initially targeted identification of frailty using the Rockwood clinical frailty score (CFS) through local quality improvement work. A standard operating procedure, encompassing CGA for all patients with frailty (define as a CFS 5 to 8 or, 4 with a frailty syndrome) was introduced. This assessment was additional to usual acute medical care. The impact was measured by retrospective case note review of 100 AMU admissions with frailty prior to the team being in post (Jan-March 2020) with a subsequent 100 patients seen by the AFT (March–April 2021). The 2 groups were matched for age, gender, frailty scores and pre-admission residence. These 2 cohorts were compared against key performance indices.
Results
The mean age of patients in the Pre and post AFT cohorts were 85 years and 84 years respectively with an average CFS of 6. The identification and documentation of frailty improved in the AFT intervention cohort from 31% to 100% and screening for delirium with 4AT improved from 27% to 91%. The number of patients in the AFT cohort discharged directly from AMU increased from 5% to 14% with the average length of in-patient stay reducing from 10.2 days to 7.8 days. Thirty day remission fell from 23% to 16% in the AFT cohort, and the number of patients discharge to new 24 hour care declined from 21% to 9%.
Conclusion
Our AFT alongside existing acute medical care improved outcomes including, frailty identification, delirium screening, length of stay, re-admissions and institutionalisation.
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Affiliation(s)
- J Thompson
- County Durham and Dralington Foundation Trust
| | - V Gusev
- County Durham and Dralington Foundation Trust
| | - P Dervin
- County Durham and Dralington Foundation Trust
| | - E Tevendale
- County Durham and Dralington Foundation Trust
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25
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Doan P, Counter W, Sheehan-Dare G, Papa N, Ho B, Lee J, Liu V, Thompson J, Agrawal S, Roberts M, Algharzo O, Buteau J, Hofman M, Moon D, Murphy D, Stricker P, Emmett L. Diagnostic accuracy, concordance and certainty with 68Ga-PSMA-11 PET/MRI fusion compared to mpMRI and 68Ga-PSMA-11 PET/CT alone for prostate cancer diagnosis: A PRIMARY trial sub-study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00822-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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26
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Doan P, Scheltema M, Amin A, Shnier R, Geboers B, Gondoputro W, Moses D, Van Leeuwen P, Haynes AM, Matthews J, Brenner P, O'Neill G, Yuen C, Delprado W, Stricker P, Thompson J. 3-year outcomes from the prospective ‘MRIAS’ trial: A novel active surveillance protocol which incorporates multiparametric MRI to reduce frequency of biopsy in men with prostate cancer. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00359-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Geboers B, Gondoputro W, Thompson J, Reesink D, Van Riel L, Zhang D, Blazevski A, Doan P, Agrawal S, Mathews J, Haynes AM, Liu Z, Delprado W, Shnier R, De Reijke T, Lawrentschuk N, Stijns P, Yaxley J, Scheltema M, Stricker P. Multicenter validation of the diagnostic accuracy of multiparametric magnetic resonance imaging to detect residual prostate cancer in the follow-up of focal therapy with irreversible electroporation. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00410-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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28
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Gallen C, Bignert A, Taucare G, O'Brien J, Braeunig J, Reeks T, Thompson J, Mueller JF. Temporal trends of perfluoroalkyl substances in an Australian wastewater treatment plant: A ten-year retrospective investigation. Sci Total Environ 2022; 804:150211. [PMID: 34798742 DOI: 10.1016/j.scitotenv.2021.150211] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 04/09/2021] [Revised: 09/01/2021] [Accepted: 09/03/2021] [Indexed: 06/13/2023]
Abstract
Per- and poly-fluoroalkyl substances (PFAS) are a problematic group of chemicals used in various industrial and household products. They have been extensively detected in wastewater as a result of day-to-day product usage. Due to concerns about their safety, voluntary and regulatory action to limit the manufacture and use of some individual PFAS has occurred since the year 2000. The impact that this intervention has had on the use and potential exposure of Australians has not been measured. Wastewater serves as a powerful tool to assess the chemical use or consumption patterns of a population over time. We accessed a ten-year wastewater archiving program to conduct a temporal analysis of PFAS trends in an urban Australian population between the years 2010 and 2020. Results showed a decline in the concentrations for most PFAS, and a change in the PFAS profile from perfluorosulfonic acids and long-chain perfluorocarboxylic acids, to the short-chain perfluorocarboxylic acids and PFOS-replacement degradation products such as 5:3 FTCA. Intermittent pulses of PFAS that were significantly higher than 'background' levels (i.e., representing the PFAS input from primarily households) were observed, suggesting continuing industrial PFAS input within the wastewater catchment. This study highlights the long-term consequences of the diffuse use of persistent chemicals in products, and their ability to continue to enter the wastewater stream for decades.
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Affiliation(s)
- C Gallen
- Queensland Alliance for Environmental Health Sciences, 20 Cornwall St, Woolloongabba 4102, Australia.
| | - A Bignert
- Department of Environmental Research and Monitoring, Swedish Museum of Natural History, Frescativägen 40, 114 18 Stockholm, Sweden.
| | - G Taucare
- Queensland Alliance for Environmental Health Sciences, 20 Cornwall St, Woolloongabba 4102, Australia.
| | - J O'Brien
- Queensland Alliance for Environmental Health Sciences, 20 Cornwall St, Woolloongabba 4102, Australia.
| | - J Braeunig
- Queensland Alliance for Environmental Health Sciences, 20 Cornwall St, Woolloongabba 4102, Australia.
| | - T Reeks
- Queensland Alliance for Environmental Health Sciences, 20 Cornwall St, Woolloongabba 4102, Australia.
| | - J Thompson
- Queensland Alliance for Environmental Health Sciences, 20 Cornwall St, Woolloongabba 4102, Australia.
| | - J F Mueller
- Queensland Alliance for Environmental Health Sciences, 20 Cornwall St, Woolloongabba 4102, Australia.
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29
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Mooney JP, DonVito SM, Lim R, Keith M, Pickles L, Maguire EA, Wagner-Gamble T, Oldfield T, Bermejo Pariente A, Ehimiyien AM, Philbey AA, Bottomley C, Riley EM, Thompson J. Intestinal inflammation and increased intestinal permeability in Plasmodium chabaudi AS infected mice. Wellcome Open Res 2022; 7:134. [PMID: 36408291 PMCID: PMC9647155 DOI: 10.12688/wellcomeopenres.17781.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Gastrointestinal symptoms are commonly associated with acute Plasmodium spp infection. Malaria-associated enteritis may provide an opportunity for enteric pathogens to breach the intestinal mucosa, resulting in life-threatening systemic infections. Methods: To investigate whether intestinal pathology also occurs during infection with a murine model of mild and resolving malaria, C57BL/6J mice were inoculated with recently mosquito-transmitted Plasmodium chabaudi AS. At schizogony, intestinal tissues were collected for quantification and localisation of immune mediators and malaria parasites, by PCR and immunohistochemistry. Inflammatory proteins were measured in plasma and faeces and intestinal permeability was assessed by FITC-dextran translocation after oral administration. Results: Parasitaemia peaked at approx. 1.5% at day 9 and resolved by day 14, with mice experiencing significant and transient anaemia but no weight loss. Plasma IFN-γ, TNF-α and IL10 were significantly elevated during peak infection and quantitative RT-PCR of the intestine revealed a significant increase in transcripts for ifng and cxcl10. Histological analysis revealed parasites within blood vessels of both the submucosa and intestinal villi and evidence of mild crypt hyperplasia. In faeces, concentrations of the inflammatory marker lactoferrin were significantly raised on days 9 and 11 and FITC-dextran was detected in plasma on days 7 to 14. At day 11, plasma FITC-dextran concentration was significantly positively correlated with peripheral parasitemia and faecal lactoferrin concentration. Conclusions: In summary, using a relevant, attenuated model of malaria, we have found that acute infection is associated with intestinal inflammation and increased intestinal permeability. This model can now be used to explore the mechanisms of parasite-induced intestinal inflammation and to assess the impact of increased intestinal permeability on translocation of enteropathogens.
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Affiliation(s)
- Jason P Mooney
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK
| | - Sophia M DonVito
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK
| | - Rivka Lim
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK
| | - Marianne Keith
- Division of Infection and Immunity, The Roslin Institute, University of Edinburgh, Edinburgh, EH25 9RG, UK
| | - Lia Pickles
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK
| | - Eleanor A Maguire
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK
| | - Tara Wagner-Gamble
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK
| | - Thomas Oldfield
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK
| | - Ana Bermejo Pariente
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK.,Editorial Team, F1000 Ltd., London, UK
| | - Ajoke M Ehimiyien
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK.,Department of Veterinary Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Adrian A Philbey
- Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, United Kingdom., Edinburgh, EH25 9RG, UK
| | - Christian Bottomley
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Eleanor M Riley
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK
| | - Joanne Thompson
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK
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30
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Mooney JP, DonVito SM, Lim R, Keith M, Pickles L, Maguire EA, Wagner-Gamble T, Oldfield T, Bermejo Pariente A, Ehimiyein AM, Philbey AA, Bottomley C, Riley EM, Thompson J. Intestinal inflammation and increased intestinal permeability in Plasmodium chabaudi AS infected mice. Wellcome Open Res 2022; 7:134. [PMID: 36408291 PMCID: PMC9647155 DOI: 10.12688/wellcomeopenres.17781.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Gastrointestinal symptoms are commonly associated with acute Plasmodium spp infection. Malaria-associated enteritis may provide an opportunity for enteric pathogens to breach the intestinal mucosa, resulting in life-threatening systemic infections. Methods: To investigate whether intestinal pathology also occurs during infection with a murine model of mild and resolving malaria, C57BL/6J mice were inoculated with recently mosquito-transmitted Plasmodium chabaudi AS. At schizogony, intestinal tissues were collected for quantification and localisation of immune mediators and malaria parasites, by PCR and immunohistochemistry. Inflammatory proteins were measured in plasma and faeces and intestinal permeability was assessed by FITC-dextran translocation after oral administration. Results: Parasitaemia peaked at approx. 1.5% at day 9 and resolved by day 14, with mice experiencing significant and transient anaemia but no weight loss. Plasma IFNγ, TNFα and IL10 were significantly elevated during peak infection and quantitative RT-PCR of the intestine revealed a significant increase in transcripts for ifng and cxcl10. Histological analysis revealed parasites within blood vessels of both the submucosa and intestinal villi and evidence of mild crypt hyperplasia. In faeces, concentrations of the inflammatory marker lactoferrin were significantly raised on days 9 and 11 and FITC-dextran was detected in plasma on days 7 to 14. At day 11, plasma FITC-dextran concentration was significantly positively correlated with peripheral parasitemia and faecal lactoferrin concentration. Conclusions: In summary, using a relevant, attenuated model of malaria, we have found that acute infection is associated with intestinal inflammation and increased intestinal permeability. This model can now be used to explore the mechanisms of parasite-induced intestinal inflammation and to assess the impact of increased intestinal permeability on translocation of enteropathogens.
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Affiliation(s)
- Jason P Mooney
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK
| | - Sophia M DonVito
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK
| | - Rivka Lim
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK
| | - Marianne Keith
- Division of Infection and Immunity, The Roslin Institute, University of Edinburgh, Edinburgh, EH25 9RG, UK
| | - Lia Pickles
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK
| | - Eleanor A Maguire
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK
| | - Tara Wagner-Gamble
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK
| | - Thomas Oldfield
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK
| | - Ana Bermejo Pariente
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK.,Editorial Team, F1000 Ltd., London, UK
| | - Ajoke M Ehimiyein
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK.,Department of Veterinary Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Adrian A Philbey
- Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, United Kingdom., Edinburgh, EH25 9RG, UK
| | - Christian Bottomley
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Eleanor M Riley
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK
| | - Joanne Thompson
- Institute of Immunology and Infection Research, University of Ediburgh, Edinburgh, Midlothian, EH93JT, UK
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31
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Anderson M, Sathe N, Polacek C, Vawter J, Fritz T, Mann M, Hernandez P, Nguyen MC, Thompson J, Penderville J, Arling M, Safo S, Christopher R. Site Readiness Framework to Improve Health System Preparedness for a Potential New Alzheimer’s Disease Treatment Paradigm. J Prev Alzheimers Dis 2022; 9:542-549. [PMID: 35841255 PMCID: PMC8978498 DOI: 10.14283/jpad.2022.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
New therapies that address the underlying pathophysiology of Alzheimer’s Disease (AD), coupled with the growth of the AD population, will transform the AD care pathway and present significant challenges to health systems. We explored real-world challenges health systems may face in delivering potential new AD therapies with diverse stakeholders. Key challenges in care included integrating primary care providers into assessment and management, availability of memory care specialists, understanding payment and coverage issues and training mid-level providers to help coordinate care and serve as a shared resource across the system. This input informed a novel Site Readiness Framework for AD, comprising self-assessment exercises to identify health system capabilities and gaps and a framework of core strategies and responsive tools to help prepare to integrate new AD therapies. These resources may help health systems improve readiness to modify care pathways to integrate new therapies for AD.
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Affiliation(s)
- M Anderson
- Cate Polacek, Premier Inc, Charlotte, NC, USA, E-Mail:
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32
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De Silva S, Lockhart K, Aslan P, Nash P, Hutton A, Malouf D, Lee D, Cozzi P, Maclean F, Thompson J. The differentiation of benign from malignant solid renal masses with multi-parametric MRI: A retrospective study and proposed classification scheme. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)03155-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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33
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Rosenfeld M, Ong T, Carlin K, McNamara S, Gorry S, Kanter A, Gibson R, Cassidy J, Greene L, Choi M, Reonal R, Culley L, Thompson J. 68: Improving timeliness of CF diagnosis following a positive CF newborn screen in Washington State. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01493-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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34
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Giorga A, Thompson J, Lo T, Baker R. 902 Safe Elective & Emergency Surgery During the COVID-19 Crisis: Experience of a Large Tertiary Centre During the First Wave of the Pandemic. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
In addition to a reduction in elective surgery, the COVID-19 pandemic has been associated with concerning rates of post-operative mortality in COVID-19 patients highlighting the threat of nosocomial transmission. Relocation of elective patients into a protected cold wing of a tertiary centre, vigilant testing and staff test, and trace were implemented to address these issues.
Method
Retrospective analysis of 5069 consecutive patients who underwent procedures in theatre from 11/03/20 – 08/09/20 was performed. Comparison of numbers of procedures was compared with the same study dates in 2019. Detailed analysis of nosocomial transmission of COVID-19 and mortality was performed using patient notes and death certificates.
Results
5854 procedures were performed in 2020 compared with 13219 in 2019, representing a reduction of 55.7%. The overall mortality in 2020 was 2.7% (135/5069). COVID-19 negative mortality was 2.36% (119/5033). 74 patients tested positive for COVID-19 at any time (1.3%); mortality amongst patients who tested positive seven days pre- to 30 days post-procedure was 5.4% (4/74). Nosocomial transmission rate was 0.27% in elective admissions (10/3773) and 0.97% in acute admissions (20/2052).
Conclusions
The first wave of the pandemic has predictably caused a significant reduction in elective activity. Our hospital infection prevention measures have kept nosocomial transmission rates low, particularly for elective admissions. We have observed lower rates of post-operative mortality in COVID-19 patients than published in other centres. Continuation of surgical services is important for patient outcomes, and essential for training the surgeons of tomorrow.
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Affiliation(s)
- A Giorga
- Leeds Teaching Hospitals Trust, Leeds, United Kingdom
| | - J Thompson
- Leeds Teaching Hospitals Trust, Leeds, United Kingdom
| | - T Lo
- Hull University Teaching Hospitals Trust, Hull, United Kingdom
| | - R Baker
- Leeds Teaching Hospitals Trust, Leeds, United Kingdom
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35
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Ellison C, Griffiths C, Thompson J, Arapi I, Martens M, Gore E. P40.07 Immunotherapy Toxicity in Lung Cancer & the Impact of Thoracic Radiation Therapy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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36
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Djeddi S, Reiss D, Menuet A, Freismuth S, Neves JDC, Djerroud S, Massana-Muñoz X, Sosson A, Kretz C, Raffelsberger W, Keime C, Dorchies O, Thompson J, Laporte J. CONGENITAL MYOPATHIES – CENTRONUCLEAR MYOPATHIES. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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37
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Gadalla AAH, Siciliano G, Farid R, Alano P, Ranford-Cartwright L, McCarthy JS, Thompson J, Babiker HA. Real-time PCR assays for detection and quantification of early P. falciparum gametocyte stages. Sci Rep 2021; 11:19118. [PMID: 34580326 PMCID: PMC8476600 DOI: 10.1038/s41598-021-97456-4] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 08/25/2021] [Indexed: 11/11/2022] Open
Abstract
The use of quantitative qRT-PCR assays for detection and quantification of late gametocyte stages has revealed the high transmission capacity of the human malaria parasite, Plasmodium falciparum. To understand how the parasite adjusts its transmission in response to in-host environmental conditions including antimalarials requires simultaneous quantification of early and late gametocytes. Here, we describe qRT-PCR assays that specifically detect and quantify early-stage P. falciparum gametocytes. The assays are based on expression of known early and late gametocyte genes and were developed using purified stage II and stage V gametocytes and tested in natural and controlled human infections. Genes pfpeg4 and pfg27 are specifically expressed at significant levels in early gametocytes with a limit of quantification of 190 and 390 gametocytes/mL, respectively. In infected volunteers, transcripts of pfpeg4 and pfg27 were detected shortly after the onset of blood stage infection. In natural infections, both early (pfpeg4/pfg27) and late gametocyte transcripts (pfs25) were detected in 71.2% of individuals, only early gametocyte transcripts in 12.6%, and only late gametocyte transcripts in 15.2%. The pfpeg4/pfg27 qRT-PCR assays are sensitive and specific for quantification of circulating sexually committed ring stages/early gametocytes and can be used to increase our understanding of epidemiological processes that modulate P. falciparum transmission.
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Affiliation(s)
- Amal A H Gadalla
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.,Division of Population Medicine, School of Medicine, College of Biomedical Sciences, Cardiff University, Cardiff, UK
| | - Giulia Siciliano
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Ryan Farid
- QIMR Berghofer Medical Research Institute and University of Queensland, Brisbane, Australia
| | - Pietro Alano
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Lisa Ranford-Cartwright
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - James S McCarthy
- QIMR Berghofer Medical Research Institute and University of Queensland, Brisbane, Australia
| | - Joanne Thompson
- Institute of Immunology and Infection Research, School of Biological Sciences, Ashworth Laboratories, University of Edinburgh, Edinburgh, UK
| | - Hamza A Babiker
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.
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Sidloff D, Saratzis A, Thompson J, Katsogridakis E, Bown M. Infra-Renal Aortic Diameter and Cardiovascular Risk: Making Better Use of Abdominal Aortic Aneurysm Screening Outcomes. J Vasc Surg 2021. [DOI: 10.1016/j.jvs.2021.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gondoputro W, Thompson J, Frydenberg M, Murphy D, Bolton D, Stricker P, Papa N. Does age affect continence outcomes following robot-assisted radical prostatectomy? Results from an Australian multi-institutional study. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01524-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Thompson J, Parikh N, Gavigan K, Venkatachalam S, Nowell WB. OP0280-PARE A MINDFULNESS PROGRAM DOSING STUDY TO EVALUATE IMPROVEMENT IN EMOTIONAL DISTRESS AMONG PEOPLE WITH RHEUMATIC DISEASE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Mindfulness-based interventions for chronic pain and emotional distress have increased in popularity as complementary therapies among people living with rheumatic and musculoskeletal disease (RMD).1,2 Despite growing evidence that mindfulness meditation reduces pain and anxiety associated with RMD, more research is needed to specify the optimal duration of mindfulness training necessary to be effective for short- and long-term benefit.Objectives:To evaluate and compare the effectiveness of full-length versus brief mindfulness training programs for improving anxiety among people living with RMD.Methods:Adult US participants (pts) within the ArthritisPower registry were invited to participate in the Healthy Mind Healthy You study comparing the effectiveness of two online mindfulness training programs of different lengths accessed via the MoodNetwork platform. The full-length mindfulness based cognitive therapy program lasted 8 weeks, while the brief evidence-based mindfulness program lasted 3 weeks. Pts were randomized to one of the two programs and completed assessments every two weeks during the program and then every four weeks during the 12-week follow-up period. Assessments included World Health Organization-Five Well-Being Index (WHO-5), Five Facet Mindfulness Questionnaire (FFMQ), Perceived Stress Scale (PSS), and two measures of emotional distress, PROMIS Short Forms for Anxiety and Depression. Analyses compared demographic characteristics and assessment scores by program length.Results:324 pts completed assessments at baseline and 70 pts completed them at week 8, an attrition rate of 78% in each of the program arms. The majority of pts were female, White, with 67% between the ages of 45-64 years. No statistically significant differences were observed at baseline between participants randomized to each of the two programs, and in their assessment scores at week 8 (Table 1); PROMIS Anxiety and Depression scores improved from baseline to week 8 for pts in both programs (Figure 1). Overall, mean (SD) PROMIS Depression scores improved from 58.4 (7.7) at baseline to 55.4 (7.2) at week 8 (p=0.018), a meaningfully important difference, among the 70 pts reporting scores at both time points.Table 1.Assessment Scores at Baseline and Week 8, Mean (SD)BaselineWeek 8All (n=324)8-week course (n=163)3-week course (n=161)p-valueAll (n=70)8-week course (n=35)3-week course (n=35)p-valueWHO-5 b10.6 (4.9)10.4 (4.8)10.9 (5.0)0.37812.0 (5.1)12.5 (5.5)11.6 (4.7)0.488FFMQ c42.7 (6.1)42.7 (6.1)42.7 (6.1)0.93239.2 (5.7)38.9 (6.1)39.4 (5.3)0.741PSS d18.7 (7.5)19.2 (6.8)18.3 (8.2)0.30416.6 (7.3)15.7 (7.8)17.6 (6.8)0.291PROMIS Depression e56.5 (8.3)57.3 (8.0)55.7 (8.6)0.09755.1 (8.5)54.8 (9.3)55.5 (7.8)0.735PROMIS Anxiety f58.7 (8.2)59.0 (8.2)58.4 (8.1)0.47055.4 (7.2)54.6 (7.4)56.1 (7.1)0.404a denotes use of Fisher’s Exact Test b Range 0 (worse) to 25 (better), c Range 3 (worse) to 15 (better), d Range 0 (better) to 40 (worse), e Range 24.7 (better) to 63.5 (worse), f Range 25.7 (better) to 62.0 (worse)Conclusion:People living with RMD who are part of a real-world US registry are willing to participate in an online mindfulness training program study, but may require additional support to remain engaged and adherent throughout the program and to participate to study conclusion. Participation in a mindfulness training program, whether full-length or brief, appears to improve symptoms of emotional distress among people with RMD.References:[1]Zhou, B. et al. Comp. Ther. in Clin. Prac. 2020; 39:1-7[2]Reiner, K. et al. Pain Medicine. 2013; 14(2): 230-242Acknowledgements:The authors would like to thank ArthritisPower members for participating in the study, and the Healthy Mind Healthy You study team at Massachusetts General Hospital (see MoodNetwork.org) for leading it. The study was funded by the Patient-Centered Outcomes Research Institute (XPPRN-1512-33786).Disclosure of Interests:Julia Thompson: None declared, Nupur Parikh: None declared, Kelly Gavigan: None declared, Shilpa Venkatachalam: None declared, W. Benjamin Nowell Grant/research support from: Full-time employee of Global Healthy Living Foundation, an independent nonprofit organization, which has received funding to conduct research; Principal Investigator for studies with grant support from AbbVie, Amgen and Eli Lilly.
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Izbicki P, Stegemöller EL, Compton J, Thompson J. Dancing for Parkinson's: A Gateway for Connectedness to Peers and Social Assurance. CBE Life Sci Educ 2021; 20:ar27. [PMID: 33944618 PMCID: PMC8734394 DOI: 10.1187/cbe.20-05-0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 02/22/2021] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
The first-year student experience in college is a crucial time for personal and professional development, especially for students entering science, technology, education, and mathematics (STEM) disciplines. Unfortunately, it is also the time when students most commonly leave STEM, largely due to disconnection from faculty and peers. The Freshman Research Initiative (FRI) is a program that introduces first-year undergraduates to research in a variety of fields. The program has shown positive outcomes for student success and retention in STEM fields. However, it has not been demonstrated whether this program can increase social connectedness and assurance, potentially contributing to students' longer-term retention in STEM. In this pilot study, we measured social connectedness/assurance among students before and after a 16-week course in neurophysiology. We found that combined scores of social connectedness and assurance significantly increased by the end of the course. We also found that individual constructs of social connectedness and assurance significantly increased. Furthermore, the majority of students from FRI were retained in STEM fields. We plan future studies to include collection of longitudinal data and measures to identify additional reasons that the FRI increased these positive outcomes among our student participants.
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Affiliation(s)
- P. Izbicki
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL 33136
| | | | - J. Compton
- Department of Natural Resource Ecology and Management, Iowa State University, Ames, IA 50011
| | - J. Thompson
- Office of the Registrar, Iowa State University, Ames, IA 50011
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Thompson J, Pelc CE, Jordan TE. Water quality sampling methods may bias evaluations of watershed management practices. Sci Total Environ 2021; 765:142739. [PMID: 33097255 DOI: 10.1016/j.scitotenv.2020.142739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/17/2020] [Accepted: 09/20/2020] [Indexed: 06/11/2023]
Abstract
Accurate measurement of the discharge of total suspended solids (TSS) from watersheds is complicated by the extreme temporal variability of suspended solid concentrations during periods of high stream flow. Consequently, TSS loads estimated from data collected at different temporal frequencies may differ in accuracy and precision. Moreover, there remains a need for optimal sampling methods which yield the highest possible accuracy for the least effort. We investigated the effect of sampling frequency on estimations of TSS loads and retention within a restored stream in Maryland, USA. We found that coarser temporal sampling methods can lead to erroneous conclusions of restoration efficacy with poor accuracy and precision in estimates of sediment retention. Additionally, we synthesized 28 years of continuous turbidity-based TSS data from Europe and North America to assess the effect of sampling frequency. Our synthesis suggests that flow-paced composite sampling may be the most accurate and precise sampling method. This method is also economical, requiring analysis of only one sample per week. Thus, the flow-paced method may be a potential solution to economize and standardize water quality monitoring.
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Affiliation(s)
- J Thompson
- Smithsonian Environmental Research Center, Edgewater, MD, USA.
| | - C E Pelc
- Smithsonian Environmental Research Center, Edgewater, MD, USA
| | - T E Jordan
- Smithsonian Environmental Research Center, Edgewater, MD, USA
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Krebs M, Helland Å, Carcereny Costa E, Arriola Aperribay E, Dómine Gómez M, Trigo Pérez J, Thompson J, Strauss J, Ortega Granados A, Felip E, Schmidt E, Chisamore M, Madeleine N, Rayford A, Lorens K, Siddiqui A, Gabra H, Nautiyal J, Micklem D, Lorens J, Spicer J. OA01.07 A Phase II Study of the Oral Selective AXL Inhibitor Bemcentinib with Pembrolizumab in Patients with Advanced NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zhang H, Gu M, Jiang XD, Thompson J, Cai H, Paesani S, Santagati R, Laing A, Zhang Y, Yung MH, Shi YZ, Muhammad FK, Lo GQ, Luo XS, Dong B, Kwong DL, Kwek LC, Liu AQ. An optical neural chip for implementing complex-valued neural network. Nat Commun 2021; 12:457. [PMID: 33469031 PMCID: PMC7815828 DOI: 10.1038/s41467-020-20719-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [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: 04/13/2020] [Accepted: 12/14/2020] [Indexed: 01/29/2023] Open
Abstract
Complex-valued neural networks have many advantages over their real-valued counterparts. Conventional digital electronic computing platforms are incapable of executing truly complex-valued representations and operations. In contrast, optical computing platforms that encode information in both phase and magnitude can execute complex arithmetic by optical interference, offering significantly enhanced computational speed and energy efficiency. However, to date, most demonstrations of optical neural networks still only utilize conventional real-valued frameworks that are designed for digital computers, forfeiting many of the advantages of optical computing such as efficient complex-valued operations. In this article, we highlight an optical neural chip (ONC) that implements truly complex-valued neural networks. We benchmark the performance of our complex-valued ONC in four settings: simple Boolean tasks, species classification of an Iris dataset, classifying nonlinear datasets (Circle and Spiral), and handwriting recognition. Strong learning capabilities (i.e., high accuracy, fast convergence and the capability to construct nonlinear decision boundaries) are achieved by our complex-valued ONC compared to its real-valued counterpart.
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Affiliation(s)
- H Zhang
- Quantum Science and Engineering Centre (QSec), Nanyang Technological University, 50 Nanyang Ave, 639798, Singapore, Singapore
| | - M Gu
- Complexity Institute and School of Physical and Mathematical Sciences, Nanyang Technological University, 50 Nanyang Ave, 639798, Singapore, Singapore.
- Centre for Quantum Technologies, National University of Singapore, Block S15, 3 Science Drive 2, Singapore, 117543, Singapore.
| | - X D Jiang
- Quantum Science and Engineering Centre (QSec), Nanyang Technological University, 50 Nanyang Ave, 639798, Singapore, Singapore.
| | - J Thompson
- Centre for Quantum Technologies, National University of Singapore, Block S15, 3 Science Drive 2, Singapore, 117543, Singapore
| | - H Cai
- Institute of Microelectronics, A*STAR (Agency for Science, Technology and Research), 138634, Singapore, Singapore
| | - S Paesani
- Centre for Quantum Photonics, H. H. Wills Physics Laboratory and Department of Electrical and Electronic Engineering, University of Bristol, Merchant Venturers Building, Woodland Road, Bristol, BS8 1UB, UK
| | - R Santagati
- Centre for Quantum Photonics, H. H. Wills Physics Laboratory and Department of Electrical and Electronic Engineering, University of Bristol, Merchant Venturers Building, Woodland Road, Bristol, BS8 1UB, UK
| | - A Laing
- Centre for Quantum Photonics, H. H. Wills Physics Laboratory and Department of Electrical and Electronic Engineering, University of Bristol, Merchant Venturers Building, Woodland Road, Bristol, BS8 1UB, UK
| | - Y Zhang
- Quantum Science and Engineering Centre (QSec), Nanyang Technological University, 50 Nanyang Ave, 639798, Singapore, Singapore
- School of Mechanical & Aerospace Engineering, Nanyang Technological University, 50 Nanyang Ave, 639798, Singapore, Singapore
| | - M H Yung
- Institute for Quantum Science and Engineering, Department of Physics, Southern University of Science and Technology, Shenzhen, 518055, China
- Shenzhen Key Laboratory of Quantum Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Y Z Shi
- Quantum Science and Engineering Centre (QSec), Nanyang Technological University, 50 Nanyang Ave, 639798, Singapore, Singapore
| | - F K Muhammad
- Quantum Science and Engineering Centre (QSec), Nanyang Technological University, 50 Nanyang Ave, 639798, Singapore, Singapore
| | - G Q Lo
- Advanced Micro Foundry, 11 Science Park Road, 117685, Singapore, Singapore
| | - X S Luo
- Advanced Micro Foundry, 11 Science Park Road, 117685, Singapore, Singapore
| | - B Dong
- Advanced Micro Foundry, 11 Science Park Road, 117685, Singapore, Singapore
| | - D L Kwong
- Institute of Microelectronics, A*STAR (Agency for Science, Technology and Research), 138634, Singapore, Singapore
| | - L C Kwek
- Quantum Science and Engineering Centre (QSec), Nanyang Technological University, 50 Nanyang Ave, 639798, Singapore, Singapore.
- Centre for Quantum Technologies, National University of Singapore, Block S15, 3 Science Drive 2, Singapore, 117543, Singapore.
- National Institute of Education, 1 Nanyang Walk, 637616, Singapore, Singapore.
| | - A Q Liu
- Quantum Science and Engineering Centre (QSec), Nanyang Technological University, 50 Nanyang Ave, 639798, Singapore, Singapore.
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Domingo-Domenech E, Duarte RF, Boumedil A, Onida F, Gabriel I, Finel H, Arcese W, Browne P, Beelen D, Kobbe G, Veelken H, Arranz R, Greinix H, Lenhoff S, Poiré X, Ribera JM, Thompson J, Zuckerman T, Mufti GJ, Cortelezzi A, Olavarria E, Dreger P, Sureda A, Montoto S. Allogeneic hematopoietic stem cell transplantation for advanced mycosis fungoides and Sézary syndrome. An updated experience of the Lymphoma Working Party of the European Society for Blood and Marrow Transplantation. Bone Marrow Transplant 2021; 56:1391-1401. [PMID: 33420392 DOI: 10.1038/s41409-020-01197-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 10/05/2020] [Accepted: 12/09/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative treatment option in advanced-stage mycosis fungoides (MF) and Sézary syndrome (SS). This study presents an updated analysis of the initial experience of the Lymphoma Working Party of the European Society for Blood and Marrow Transplantation (EBMT) describing the outcomes after allo-HSCT for MF and SS, with special emphasis on the impact of the use of unrelated donors (URD). METHODS AND PATIENTS Eligible for this study were patients with advanced-stage MF or SS who underwent a first allo-HSCT from matched HLA-identical related or URD between January/1997 and December/2011. Sixty patients have been previously reported. RESULTS 113 patients were included [77 MF (68%)]; 61 (54%) were in complete or partial remission, 86 (76%) received reduced-intensity protocols and 44 (39%) an URD allo-HSCT. With a median follow up for surviving patients of 73 months, allo-HSCT resulted in an estimated overall survival (OS) of 38% at 5 years, and a progression-free survival (PFS) of 26% at 5 years. Multivariate analysis demonstrated that advanced-phase disease (complete remission/partial remission >3, primary refractory or relapse/progression in patients that had received 3 or more lines of systemic treatment prior to transplant or the number of treatment lines was not known), a short interval between diagnosis and transplant (<18 months) were independent adverse prognostic factors for PFS; advanced-phase disease and the use of URDs were independent adverse prognostic factors for OS. CONCLUSIONS This extended series supports that allo-HSCT is able to effectively rescue over one third of the population of patients with advanced-stage MF/SS. High relapse rate is still the major cause of failure and needs to be improved with better strategies before and after transplant. The negative impact of URD is a matter of concern and needs to be further elucidated in future studies.
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Affiliation(s)
- E Domingo-Domenech
- Hematology Department, Institut Català d'Oncologia. Hospital Duran i Reynals, IDIBELL, Universitat de Barcelona, Barcelona, Spain.
| | - R F Duarte
- Hematology Department, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - A Boumedil
- EBMT Central Registry Office, Paris, France
| | - F Onida
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico IRCCS, Milano, Italy
| | - I Gabriel
- Department of Hematology, Imperial College, Hammersmith Hospital, London, United Kingdom
| | - H Finel
- EBMT Central Registry Office, Paris, France
| | - W Arcese
- Tor Vergata University of Rome, Stem Cell Transplant Unit, Policlinico Universitario Tor Vergata, Rome, Italy
| | - P Browne
- St's James Hospital, Dublin, Ireland
| | - D Beelen
- University Hospital, Department of Bone Marrow Transplantation, Essen, Germany
| | - G Kobbe
- Heinrich Heine University, Medical F, Department of Hematology, Düsseldorf, Germany
| | - H Veelken
- Leiden University Medical Center, Leiden, The Netherlands
| | - R Arranz
- Hematology Department, Hospital La Princesa, Madrid, Spain
| | - H Greinix
- Division of Hematology, Medical University Graz, Graz, Austria
| | - S Lenhoff
- Skanes University Hospital, Department of Hematology, Lund, Sweden
| | - X Poiré
- Cliniques Universitaires St. Luc, Department of Hematology, Brussels, Belgium
| | - J M Ribera
- Hematology Department, Institut Català d'Oncologia, Josep Carreras Leukemia Research Institute, Badalona, Spain
| | - J Thompson
- Albert's Stem Cell Transplantation Center, Pretoria, South Africa
| | - T Zuckerman
- Ramban Medical Center, Department of Hematology and Bone Marrow Transplantation, Haifa, Israel
| | - G J Mufti
- GKT School of Medicine, Dept. of Haematological Medicine, King's Denmark Hill Campus, London, United Kingdom
| | - A Cortelezzi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico IRCCS, Milano, Italy
| | - E Olavarria
- Department of Hematology, Imperial College, Hammersmith Hospital, London, United Kingdom
| | - P Dreger
- Universitaetsklinkum Heidelberg, Heidelberg, Germany
| | - A Sureda
- Hematology Department, Institut Català d'Oncologia. Hospital Duran i Reynals, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - S Montoto
- Department of Haemato-Oncology, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
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Smith NL, Nahrendorf W, Sutherland C, Mooney JP, Thompson J, Spence PJ, Cowan GJM. A Conserved TCRβ Signature Dominates a Highly Polyclonal T-Cell Expansion During the Acute Phase of a Murine Malaria Infection. Front Immunol 2020; 11:587756. [PMID: 33329568 PMCID: PMC7719809 DOI: 10.3389/fimmu.2020.587756] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/27/2020] [Indexed: 01/31/2023] Open
Abstract
CD4+ αβ T-cells are key mediators of the immune response to a first Plasmodium infection, undergoing extensive activation and splenic expansion during the acute phase of an infection. However, the clonality and clonal composition of this expansion has not previously been described. Using a comparative infection model, we sequenced the splenic CD4+ T-cell receptor repertoires generated over the time-course of a Plasmodium chabaudi infection. We show through repeat replicate experiments, single-cell RNA-seq, and analyses of independent RNA-seq data, that following a first infection - within a highly polyclonal expansion - T-effector repertoires are consistently dominated by TRBV3 gene usage. Clustering by sequence similarity, we find the same dominant clonal signature is expanded across replicates in the acute phase of an infection, revealing a conserved pathogen-specific T-cell response that is consistently a hallmark of a first infection, but not expanded upon re-challenge. Determining the host or parasite factors driving this conserved response may uncover novel immune targets for malaria therapeutic purposes.
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Affiliation(s)
- Natasha L. Smith
- Institute of Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
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Awad H, Gadalla AAH, Postigo M, Al-Hamidhi S, Tageldin MH, Skariah S, Sultan AA, Johnson EH, Shiels B, Pain A, Thompson J, Babiker HA. Dynamics and within-host interaction of Theileria lestoquardi and T. ovis among naive sheep in Oman. Sci Rep 2020; 10:19802. [PMID: 33188233 PMCID: PMC7666211 DOI: 10.1038/s41598-020-76844-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 10/22/2020] [Indexed: 02/07/2023] Open
Abstract
Mixed species infections of Theileria spp. are common in nature. Experimental and epidemiological data suggest that mixed species infections elicit cross-immunity that can modulate pathogenicity and disease burden at the population level. The present study examined within-host interactions, over a period of 13 months during natural infections with two Theileria spp., pathogenic (T. lestoquardi) and non-pathogenic (T. ovis), amongst a cohort of naive sheep in Oman. In the first two months after exposure to infection, a high rate of mortality was seen among sheep infected with T. lestoquardi alone. However, subsequently mixed-infections of T. lestoquardi and T. ovis prevailed, and no further death occurred. The overall densities of both parasite species were significantly higher as single infection vs mixed infection and the higher relative density of pathogenic T. lestoquardi indicated a competitive advantage over T. ovis in mixed infection. The density of both species fluctuated significantly over time, with no difference in density between the very hot (May to August) and warm season (September to April). A high degree of genotype multiplicity was seen among T. lestoquardi infections, which increased with rising parasite density. Our results illustrate a potential competitive interaction between the two ovine Theileria spp., and a substantial reduction in the risk of mortality in mixed parasite infections, indicating that T. ovis confers heterologous protection against lethal T. lestoquardi infection.
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Affiliation(s)
- Hoyam Awad
- Department of Biochemistry, College of Medicine and Health Sciences, Sultan Qaboos University, AlKhoud 123, Muscat, Oman
| | - Amal A H Gadalla
- Division of Population Medicine, School of Medicine, College of Biomedical Sciences, Cardiff University, Cardiff, UK
| | - Milagros Postigo
- Department of Biochemistry, College of Medicine and Health Sciences, Sultan Qaboos University, AlKhoud 123, Muscat, Oman
| | - Salama Al-Hamidhi
- Department of Biology, College of Science, Sultan Qaboos University, Muscat, Oman
| | - Mohammed H Tageldin
- College of Agriculture and Marine Sciences, Sultan Qaboos University, Muscat, Oman
| | - Sini Skariah
- Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation, Doha, Qatar
| | - Ali A Sultan
- Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation, Doha, Qatar
| | - Eugene H Johnson
- College of Agriculture and Marine Sciences, Sultan Qaboos University, Muscat, Oman
| | - Brian Shiels
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Arnab Pain
- Biological and Environmental Science and Engineering Diversion, King Abdullah, University for Science and Technology, Thuwal, Saudi Arabia.,GI-CoRE, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Joanne Thompson
- Institute of Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, UK
| | - Hamza A Babiker
- Department of Biochemistry, College of Medicine and Health Sciences, Sultan Qaboos University, AlKhoud 123, Muscat, Oman.
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Simone C, Movsas B, Gore E, Mohindra P, Vujaskovic Z, Wang D, Ajlouni M, Menon S, Thompson J, Brown S, Kurman M, Dykstra J, Rillo L, Ingram M, Serebrenik A, Kaytor M. A Phase 1b/2a Study Evaluating the Pharmacokinetics, Safety, and Efficacy of Nanogenistein in Combination with Chemoradiotherapy for Non-small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Faruqi S, Sykes DL, Crooks MG, Brindle K, Thompson J, Morice AH. Objective Assessment of Cough: An Early Marker of Response to Biological Therapies in Asthma? Lung 2020; 198:767-770. [PMID: 32910307 DOI: 10.1007/s00408-020-00391-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/27/2020] [Indexed: 11/28/2022]
Abstract
Cough is an important symptom of asthma. The objective assessment of chronic cough has been enhanced by the development of ambulatory cough monitoring systems. Mepolizumab has been demonstrated to reduce exacerbations in eosinophilic asthmatics long-term. We evaluate the utility of objective cough count as an outcome measure in severe eosinophilic asthma treated with mepolizumab. Consecutive, consenting patients initiated on treatment with mepolizumab had a 24-h cough count recorded at baseline; this was repeated at 1, 3 and 6 months. Asthma control questionnaire (ACQ) scores and exacerbation frequency were also recorded. The mean 24-h cough count in 11 subjects (8 females, mean age 53.6 years) was 172.4 at baseline; at 1, 3 and 6 months following initiation of treatment this decreased to 101.4, 92 and 70.8, respectively (p < 0.02). Significant improvements were also observed in mean ACQ score (3-1.6, p < 0.01) and exacerbation frequency (5.5 per year - 1.3, p < 0.01). Objective cough measurement could be used as an early, precise and clinically relevant endpoint in assessing response to asthma therapy.
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Affiliation(s)
- Shoaib Faruqi
- Respiratory Research Group, Hull University Teaching Hospitals, Hull, UK
| | - Dominic L Sykes
- Respiratory Research Group, Hull University Teaching Hospitals, Hull, UK.
| | - Michael G Crooks
- Respiratory Research Group, Hull University Teaching Hospitals, Hull, UK
| | - Kayleigh Brindle
- Respiratory Research Group, Hull University Teaching Hospitals, Hull, UK
| | - Joanne Thompson
- Respiratory Research Group, Hull University Teaching Hospitals, Hull, UK
| | - Alyn H Morice
- Respiratory Research Group, Hull University Teaching Hospitals, Hull, UK
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Thompson J, Albalawi F, Wickremasinghe N, Salvan G, Zahn DRT, Schmitzer H, Wagner HP. Index matching in multilayered organic waveguides. J Phys Condens Matter 2020; 32:485702. [PMID: 32897873 DOI: 10.1088/1361-648x/abb31b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Index matching of guided modes in birefringent multilayered organic waveguides opens new prospects for the design of mode coupling and mode switching devices. We demonstrate index matching of guided modes in two multilayered structures, in (a) a PTCDA-Alq3-PTCDA three-layer and (b) a PTCDA-Alq3 effective medium multilayer waveguide. The optical waveguides were grown on a Pyrex substrate by organic molecular beam deposition. The occurrence of index matching was investigated both experimentally by measuring the effective refractive index dispersion of transverse electric and magnetic modes using the m-line technique and theoretically by modelling the index dispersion with a transfer matrix algorithm.
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Affiliation(s)
- J Thompson
- Department of Physics, University of Cincinnati, Cincinnati, OH 45221, United States of America
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